Patient adherence to an oral rehydration solution intervention to prevent dehydration following ileostomy creation: A qualitative study

Am J Surg. 2024 Mar 1:S0002-9610(24)00156-9. doi: 10.1016/j.amjsurg.2024.02.045. Online ahead of print.

Abstract

Background: Patients undergoing surgery for ileostomy creation frequently experience postoperative dehydration and subsequent renal injury. The use of oral rehydration solutions (ORS) has been shown to prevent dehydration, but compliance may be variable.

Methods: Semi-structured qualitative interviews were conducted with 17 patients who received a postoperative hydration kit and dehydration education to assess barriers and facilitators to compliance with ORS kit instructions.

Results: Qualitative analysis revealed five themes affecting patient adherence to the ORS intervention: (1) patient's perception of the effectiveness of the ORS solution, (2) existing co-morbidities, (3) kit quality and taste of the ORS product, (4) quality of the dehydration education, and (5) social support.

Conclusions: Given that patient adherence can greatly affect the success of an ORS intervention, the design of future ORS interventions should emphasize the educational component, the "patient friendliness" of the ORS kit, and ways that social supports can be leveraged to increase adherence.

Keywords: Dehydration; Ileostomy; Oral rehydration solution; Patient compliance.