The Effect of Ho'Oponopono Technique on Ostomy Adjustment, Body Image, and Quality of Life

Primary outcomes

1. Quality of Life as Assessed by the Stoma Quality of Life Scale (Stoma-QOL) Total Score

   Time frame: The Ho'oponopono technique will be applied on postoperative days 1, 2, and 3 at 10:00 a.m. and will continue until the end of the first month. Data will be collected using the study scales on days 1, 3, and 10, and at the end of the first month.

   Quality of life in individuals with an ostomy will be evaluated using the Baxter et al. Stoma Quality of Life Scale (Stoma-QOL), a standardized self-report questionnaire specifically developed for individuals with a stoma. The scale consists of 21 items that measure stoma-related quality of life. The first two items assess overall life satisfaction and are scored from 0 to 100, with higher scores indicating greater satisfaction. The remaining items evaluate three subdimensions: work and social life (6 items), sexuality and body image (5 items), and stoma function (6 items), and one item assesses perceived economic status. Item scores are summed and transformed according to the scoring manual to obtain a total score. The total Stoma-QOL score will be used as the single reported outcome, with higher scores indicating better quality of life.

   Score range: 0-100 Minimum: 0 Maximum: 100 Higher scores indicate better quality of life.

2. Ostomy Adjustment Level as Assessed by the Ostomy Adjustment Scale (OAS) Total Score

   Time frame: The Ho'oponopono technique will be applied on postoperative days 1, 2, and 3 at 10:00 a.m. and will continue until the end of the first month. Data will be collected using the study scales on days 1, 3, and 10, and at the end of the first month.

   Adaptation to living with an ostomy will be evaluated using the Ostomy Adjustment Scale, a Likert-type, self-report measurement tool that provides a quantitative assessment of overall ostomy adjustment. The scale includes items addressing physical adjustment (stoma care, pouch management, and ability to perform daily activities), psychological adjustment (acceptance of the ostomy, anxiety, body image, and self-esteem), social adjustment (participation in social relationships, comfort in social environments, and perceived stigma), and coping and adaptation skills (problem-solving, use of support resources, and managing daily life with an ostomy). Each item is scored on a Likert scale, and item scores are summed to obtain a total score. The total score will be used as the single reported outcome, with higher scores indicating better adjustment to the ostomy.

   Score range: 34-204 Minimum: 34 Maximum: 204 Higher scores indicate better adjustment to the ostomy.

3. Body Image Perception as Assessed by the Body Image Scale (BIS) Total Score

   Time frame: The Ho'oponopono technique will be applied on postoperative days 1, 2, and 3 at 10:00 a.m. and will continue until the end of the first month. Data will be collected using the study scales on days 1, 3, and 10, and at the end of the first month.

   Body image perception in individuals with an ostomy will be evaluated using the Body Image Scale, a self-report psychometric instrument that quantitatively measures satisfaction with body appearance and attitudes toward the body. The scale consists of Likert-type items assessing affective, cognitive, and behavioral responses related to body image. Each item is scored on a 4-point scale, and the item scores are summed to obtain a total score. The total score will be used as the single reported outcome. Higher scores indicate greater body image disturbance, whereas lower scores reflect a more positive body image perception.

   Score range: 0-30 Minimum: 0 Maximum: 30 Higher scores indicate poorer body image.