INTRODUCTION

Ostomy can be defined as a surgical opening that establishes a channel between the internal middle of an organ with the surface of the skin. Elimination stomas, as the name implies, have as their purpose the elimination of feces (colostomy or ileostomy) or urine (urostomy or cystostomy). Its nomenclature depends on where it is made⁽¹⁾.

After the construction of the stoma, the individual goes through a series of changes in their activities of daily life, requiring adaptation. This process can trigger moments of depression, sadness, fear, withdrawal from the activities you used to do and social isolation⁽²⁾.

From this, the nurse plays an essential role in the adaptation process, as it is responsible for providing guidance on ostomy care, emotional support and stimulating the return to their daily life activities⁽²⁾. In addition, this professional provides the person with ostomy health education actions, promoting autonomy and family involvement in this care process.

And, for the effectiveness of health education, among the technological resources used, videos are gaining an interesting space. We highlight the category of animation video, which is considered a great pedagogical resource because it presents information in a playful, indirect way, with lightness and subtlety, which naturally attracts the focus of the viewer⁽³⁾.

Therefore, it is necessary to create and validate audiovisual technologies for health education on digital platforms that help promote self-care of people with ostomies by promoting safe and quality content⁽⁴⁾.

Therefore, the study has as a research question: "what are the characteristics of animation videos existing in the literature and available on YouTube® about elimination stomas?" and the objective was to identify and characterize animation videos on health education related to elimination stomas.

MATERIAL AND METHOD

This is a quantitative study of descriptive type with a stage of technological prospection. To guide the research, a research protocol was implemented to organize and standardize the search. This protocol consists of: title, record, objective, guiding question, eligibility criteria, data collection and data extraction and presentation.

The literature search was conducted in June 2022 in the journals available on the CAPES platform, through access via the Federated Academic Community (CAF - Comunidade Acadêmica Federada). The following databases were consulted: ColecionaSUS, Institutional Repository for Information Sharing (PAHO-Iris), Índice Bibliográfico Español en Ciencias de la Salud (IBECS), Brazilian Nursing Database (BDENF), Latin American and Caribbean Health Sciences Literature (LILACS) and Medical Literature Analysis and Retrieval System Online (MEDLINE) via Virtual Health Library (VHL). Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and SCOPUS databases were also used.

In gray literature, it was researched in the following locations: Brazilian Digital Library of theses and dissertations (BDTD - Biblioteca Digital Brasileira de teses e dissertações), Scientific Open Access Repository of Portugal (RCAAP - Repositório Científico de Acesso Aberto de Portugal), Theses Canada, DART-Europe E-Theses Portal, National ETD Portal and YouTube^br. Youtube was chosen because it is currently the most common, popular and easily accessible site for free videos with various content.

The search for the videos was carried out on June 15, 2022 on the video platform YouTube (youtube.com), chosen because it is currently the largest free video sharing platform on the internet. The descriptors used for the search were: "animação estomias", "animation ostomy" and "animacíon estomías". Only the relevance filter was used in the search of the videos.

For the search of the files, the DeSC/MeSH and the Boolean operators were used with some crossings described in Table 01 for better understanding.

Table 01. Files found from the crossings of DeSC/Mesh. Natal, RN. 2022. 

Source: created by the authors.

The eligibility criteria defined were complete available documents, in all languages, addressing the theme of animation, responding to the objective of the study and that contemplate at least one elimination ostomy. The files that did not meet the objectives of the research were excluded, as well as those that addressed another type of ostomy than the elimination, videos that present only a moment of animation, addressing other types of ostomy and videos of commercial representatives in order to publicize the products.

The selection of the sample was made by the title and cover of the video, later the full reproduction of the video. It was not possible to identify the amount of videos in the search, because the platform does not provide the exact number of findings from the search for the descriptors. Therefore, the search took place until no video related to the theme could be found.

After the search, some information such as title, link, length of the video, year of posting, views, language, type of stoma and theme were extracted from the videos. This information was organized in a Microsoft® Excel spreadsheet and organized for the presentation of the results.

RESULTS

Regarding the research, 346 articles were identified, of which only one was selected by the title and abstract and was fully read, and it did not respond to the inclusion criteria or the research question and was not added to the sample, total of zero publications related to the theme. 171 files from grey literature were also identified. Of these, only 30 YouTube videos were analyzed, and only 19 entered the final sample. This search can be further explained in Table 02 below.

Table 02. Flow of searches in literature and grey literature. Natal, RN. 2022. 

Source: created by the authors.

Given the results of the videos on YouTube, the sample was composed of 19 videos, which corresponds to 1h28min of video, the shortest lasting 31 seconds and the longest, 9min44sec. In addition, the number of views of the videos stands out. The total resulted in 3,025,706 views. Regarding the year of posting, it is observed that the one that presented more videos was 2021 with six (31.6%) videos, followed by 2014 with 5 (26.4%), 2019 and 2020 with two (10.6%) videos each year, and 2018, 2014, 2013 and 2012 presented only one video (5.5%) each.

Regarding the language, only two languages were identified in the videos with the predominance of English (94.7%) and Spanish with one (5.3%) video. Moreover, it is observed that the types of elimination ostomies addressed in the videos are colostomies, appearing in 15 videos (78.84%), and ileostomy and urostomy, being addressed in videos 10 (52.63%) and 9 times (47.36%), respectively. Chart 01 shows the search result with video title, link and identification number.

Chart 01. Result with video number, link, video title, duration, number of views and year of posting. Natal, RN. 2022. 

Source: created by the authors.

Chart 02 shows the topics covered in the videos, followed by the video number for identification.

Chart 02. Themes of the videos. Natal, RN. 2022. 

Source: created by the authors.

DISCUSSION

Although there are not yet publications about animation video productions for people with ostomy, it is already possible to find some publications in the literature using animation for health education addressing themes, such as risk of falling in hospitalized elderly, drug use, cardiopulmonary resuscitation for the deaf and sexually transmitted infections^(5,6,7).

In a study on digital health, it was possible to identify the use of technologies used in health education and as support for nursing consultation, among these technologies YouTube videos were placed as easy and easy to cover, improving the care process and promoting a higher quality of life for people⁽⁸⁾.

It is interesting to note that most of the animations found on Youtube feature the language in English, and none in Portuguese. This fact may reveal the scarcity of this type of material for people with elimination stomas in Brazil.

It was observed that the two themes most discussed in the videos were the definition and the making of the colostomy. This fact is due to the fact that, according to studies that raise the profile of people with ostomy, colostomy presents the highest number of elimination ostomies in the surveys^(9,10,11,12).

Following the same line, the causes for the making of the stoma may be related to neoplasms, inflammatory diseases such as Crohn's disease, and traumas such as gunshot or firearm injuries, car accidents, among others. However, of these factors, the most prevalent for the construction of stoma are neoplasms⁽¹⁰⁾.

One theme addressed in two videos were complications and another theme that is related to complications is the consultation with the stoma nurse, which appears in only one video. It is known that the consultation with the stoma nurse addresses from prevention to rehabilitation of the individual, and has a direct impact on the reduction of the rates of complications related to elimination stomas⁽¹³⁾.

Related to the support group, it is observed that two videos demonstrate this. The support network is paramount for the adaptation process of the person with ostomy, as it plays a helping role in the materials and services, emotional support and social company, and among these, the one that stands out is the help in the materials and services, since while the person is with the ostomy, he will need specific care with the collecting devices⁽¹⁴⁾.

Another important issue that was addressed in a single video was the care of the ostomy in pandemic time. Several services that assist this public had to make adaptations in their routines not to fail to assist patients or put their lives at risk, being these changes since the use of personal protective equipment, adequacy of the physical area, changes in service flows, among others⁽¹⁵⁾.

Related to the care of the devices and the exchange of bags, it is seen that the main self-care activities are the hygiene and exchange of the collection bag. In addition to these practices, peristomal skin care, eating habits and changes in the way of dressing are also present⁽¹⁶⁾.

Another theme that is directly related to adaptation and improvement in the quality of life of people with stomas is colostomy irrigation, which was present in a video. This practice associated with the occlusion system directly impacts the self-esteem and safety of the person with ostomy, since its use makes fecal control possible⁽¹⁷⁾.

Concerning physical activity, it was seen that a video addressed this issue. In a study on quality of life related to sociodemographic indicators, housing, sanitation and lifestyle, it was seen that in a number of participants of 106 people with ostomies, only 67.92% did not perform physical activities, and there are no reports on daily routine of physical activity, only weekly or sporadic. This fact may be related to the feelings of fear that accompany the person during their journey⁽¹⁸⁾.

When the subject is colostomy or ileostomy reversal, it is interesting that only one video presented this theme, but did not address the repercussions of this in the life of the person with ostomy. After stoma reversal, patients report difficulty with body changes, dietary restrictions and changes in fecal continence with evacuation emergencies. However, they also end up referring to the improvement of appearance, the use of tighter clothes, the improvement in social interaction, the loss of fear of moving, and even returning to the beach⁽¹⁹⁾.

For the reversal of the ostomy it is also necessary that the individual adapts again after the closing of the ostium. This adaptation involves the physiological mechanism with the new transit of elimination and feeding, but also reaches psychosocial aspects, such as changes in self-image, adaptation of clothes and places. From this, it is necessary that the nurse deepens his knowledge and presents a humanized look at the person who has undergone reversal, and may even use instruments such as singular therapeutic projects to assist the individual in this new process of adaptation⁽¹⁹⁾.

The limitations found for the development of this research are related to the search for videos on YouTube, because the platform itself does not provide the total number of videos found regarding the descriptors. In addition, there are few filter features available for search.

CONCLUSION

The present article had objective reached in a partial way, because it was not identified any study on the construction of animation video for people with stoma, however, 19 animation videos that address several themes related to stoma, definition and preparation of colostomy and ileostomy were identified in YouTube.

Thus, it can be inferred that there is a need for construction and validation of animation videos on elimination ostomies to be used as tools for health education and support for professionals in the pre and postoperative period. In addition, it is important to highlight the importance of having more studies that discuss this topic in order to contribute to knowledge and future research.