A Situation-Specific Theory of Self-Care Behaviors in People Living With an Intestinal or Urinary Ostomy

ANS Adv Nurs Sci. 2025 Sep 25. doi: 10.1097/ANS.0000000000000601. Online ahead of print.

Abstract

The literature on self-care in people living with an ostomy pouch is expanding rapidly, yet a guiding theoretical framework remains lacking. This article aims to present the development of a situation-specific theory of self-care in people living with an ostomy pouch, encompassing both intestinal (colostomy and ileostomy) and urinary (urostomy) diversions. We describe the process of ostomy self-care, the key predictors of self-care behaviors, and their outcomes. Underlying assumptions and theoretical propositions are also outlined. Self-care includes actions directed toward maintaining the physiological stability of the stoma (maintenance), detecting complications (monitoring), and responding to them (management). Factors influencing ostomy self-care include self-efficacy and cultural context. Predictors of self-care may be sociodemographic, psychological, or clinical. Outcomes are categorized as clinical or psychosocial. A total of 9 theoretical propositions are proposed. This situation-specific theory offers a framework for understanding the multifaceted nature of self-care engagement in people living with an ostomy pouch. Future research should refine the theory by testing its propositions and assessing its applicability across diverse populations and health care settings.

Keywords: nursing theory; ostomy; self-care; self-efficacy; situation-specific theory; theory development.