Clinical research on stoma patients: validation of TOR Form for evaluation and monitoring

  • Elena Toma Registered Nurse, Clinical Specialist in Wound Care, Clinical Specialist in Ostomy Care, Independent tissue viability consultant, Rome, Italy
  • Ercolani Maria Sole . Registered Nurse, Clinical Specialist in Wound Care and Clinical Specialist in Stoma Care Specialist, Policlinico Umberto I , Rome, Italy
  • Del Missier Alexandra Registered Nurse, Clinical Specialist in Ostomy Care, Latina, Italiy
  • Barone Filippo . Registered Nurse, Clinical Specialist in Ostomy Care , Regional General Hospital ”Francesco Miulli”, Acquaviva Delle Fonti , Bari, Italy
  • La Torre Giuseppe Department of Public Health and Infectious Diseases , Sapienza University of Rome, Italy
Keywords: ostomy research, stoma complications, stoma evaluation, stoma care, ostomy assessment, peristomal wound


Background: The absence of exact data for stoma patients, and the low attention given to
results obtained through current protocols, lead to the study of a dedicated research form.
The Toma Ostomy Research Form (TOR Form) was created following the need to have a
standardised and validated form to gather data, to be used in the clinical and
observational research on stoma (urinary and/or intestinal) patients.
Method: The TOR Form for monitoring osthomates for a time of 28days, is devised in a
section for initial assessment, and separate sections for each following evaluation and for
follow up. To enable the form validation, the same patient was assessed by two different
nurses evaluators, during the same treatment/dressing change session. After having
agreed on the wound/issue to be assessed, the two assessments were carried out at 10
minutes’ distance one from the other. 45adult patients, stoma carriers (intestinal and
urinary), following the same treatment protocol were enrolled as sample.
Results: In the general patient’s assessment, normally the suitability for using validated
scales (Barthel IndexBraden Scale, MNA, NRS, PAINAD) is quite high (p<0.001). If used
correctly, they do not allow margins for error. As regards the stoma assessment, the
Cohen’s kappa coefficients has values around 0.784-1(p<0.001), except for two items
(peristomal skin and new peristomal wound) in which the value, overall acceptable, is
0.656(p<0.001). This demonstrates that the description factors used are adequate for the
various situations observed.
Conclusions: The results obtained confirm that the TOR Form is a valid tool for clinical
and personal data collection. The form can be used as a data collection for clinical research
purposes, as well as nursing documentation in monitoring the stoma-carrying patient.