Postoperative sleep experiences of colorectal cancer patients with temporary stomas are complex, influenced by multiple factors including physical, psychological, and care-related aspects, and have relatively inadequate supportive measures.
Key Findings
Results
Treatment-related physical symptoms were a primary theme disrupting postoperative sleep in colorectal cancer patients with temporary stomas.
Three subthemes were identified under this theme: postoperative pain and discomfort, nighttime stoma care burden, and drug-related adverse reactions.
Seventeen patients with temporary stomas were purposively sampled and participated in face-to-face, semi-structured interviews.
Data were analyzed using thematic analysis, yielding 4 main themes and 12 subthemes total.
Physical disruptions included both direct surgical consequences and medication side effects affecting sleep.
Results
Bidirectional reinforcement between psychosocial distress and sleep disturbances was identified as a major theme affecting patients with temporary stomas.
Three subthemes emerged: nocturnal rumination in the context of self-perceived burden, nighttime exacerbation of negative emotions, and mutual aggravation of distress and sleep dysfunction.
The relationship between psychological distress and sleep was characterized as bidirectional, meaning each factor worsened the other.
Nocturnal rumination was specifically linked to patients perceiving themselves as a burden, suggesting psychosocial concerns were prominent at night.
Negative emotions were reported to worsen specifically during nighttime hours.
Results
Patients experienced adaptive challenges to both hospital and home sleep environments and routines following stoma surgery.
Three subthemes were identified: hospital-environmental barriers to sleep, home sleep-environment reorganization, and changes in sleep habits.
Patients faced distinct environmental challenges in both inpatient and post-discharge home settings.
The need to reorganize the home sleep environment after discharge suggests stoma care requirements altered patients' physical sleeping arrangements.
Changes in sleep habits indicated that stoma management altered previously established sleep routines.
Results
Patients initiated their own sleep optimization strategies in the absence of adequate professional support.
Three subthemes were identified: self-management techniques for relaxation, dietary modifications, and seeking professional support.
The overall finding noted that supportive measures for sleep were 'relatively inadequate,' suggesting patients were largely self-managing.
Patients sought dietary modifications as a self-initiated strategy, likely related to managing stoma output affecting nighttime sleep.
That 'seeking professional support' appeared as a patient-initiated strategy rather than a routinely provided service suggests a gap in clinical care.
Methods
A descriptive qualitative design using purposive sampling and thematic analysis was employed to capture the sleep experience of this patient population.
Sample size was 17 patients with temporary stomas following colorectal cancer surgery.
Participants were purposively sampled to ensure relevant experience with the phenomenon under study.
Data collection involved face-to-face, semi-structured interviews.
Thematic analysis was the analytic method, producing 4 main themes and 12 subthemes.
The study was classified as a descriptive qualitative study.
What This Means
This research suggests that colorectal cancer patients who have a temporary stoma (a surgically created opening in the abdomen to divert waste) after surgery face a wide range of complex challenges that disrupt their sleep. These challenges fall into four broad categories: physical symptoms like pain and the need to manage the stoma bag during the night; psychological difficulties such as anxiety, negative emotions, and lying awake worrying about being a burden to others; problems adapting to both the hospital environment and reorganizing their home sleeping arrangements; and attempts to cope on their own through relaxation techniques, changing their diet, or seeking help from healthcare providers.
A key finding is that poor sleep and psychological distress appear to reinforce each other — disturbed sleep worsens emotional wellbeing, and emotional distress in turn further disrupts sleep, creating a difficult cycle. Additionally, the burden of managing a stoma at night (such as checking or changing the pouch) is a unique and under-recognized factor that interrupts sleep in ways not typically seen in other surgical patients.
This research matters because it highlights that current supportive care for this group of patients is 'relatively inadequate,' meaning that hospitals and healthcare teams may not be providing enough structured help for sleep problems after stoma surgery. The findings suggest that care teams should consider addressing sleep as a specific concern for stoma patients, potentially by offering guidance on pain management, psychological support, nighttime stoma care routines, and environmental adjustments both in the hospital and at home.
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Wei X, Tang L, Li J, Cheng Z, Chen Y, Zhang B. (2026). Exploring the postoperative sleep experience of colorectal cancer patients with temporary stomas: a descriptive qualitative study.. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. https://doi.org/10.1007/s00520-026-10758-z