The research examined how people managed colostomy and ileostomy products and interpreted the remote support available to them. Interviews were conducted between 30 September and 30 October 2024 with adults who had received telenursing from one private healthcare provider. To be eligible, participants had to communicate in Turkish, be at least 15 days beyond surgery, have been discharged and reintegrated into daily life, and have an intestinal stoma.

They ranged from 18 to 77 years old, and five were men. Their appliances included flat and convex adapters and one-piece and two-piece systems. Telenursing was not tested as a stand-alone intervention in this study.

It was already included without an additional fee in the provider’s routine follow-up service for people using its stoma-care products. Researchers used criterion-based purposive sampling and arranged one audio-recorded, semistructured online interview with each participant. The interviews lasted approximately 20 to 30 minutes and used prompts intended to elicit detailed descriptions of situations, feelings and the meaning participants attached to their experiences.

All transcripts were transcribed verbatim. The interviews were analysed through conventional content analysis using MAXQDA 24. Meaning units were condensed and grouped into codes, which were then organised into categories and five overarching themes.

Saturation was reached at the sixth interview, when consecutive interviews produced no new codes or concepts; a seventh interview was conducted to confirm that assessment and likewise added no new concepts. The researchers also used member checking, independent review by two qualitative researchers, an audit trail of coding decisions and direct quotations to support the credibility and dependability of the analysis. Participants sought telenursing support for practical uncertainties that extended across the stoma-care process.

Questions concerned when to clean a stoma, how to respond to changes in output, how to apply paste and how to assess skin and wounds. A recurring technical issue was leakage associated with an adapter that did not fit properly. Some sent photographs during consultations, received suggestions for alternative equipment and adjusted their products accordingly.

One participant whose initially flat adapter produced constant leakage tried a dimpled adapter after remote advice and reported that the leakage stopped. Other participants associated product changes with less irritation or greater comfort. These were individual accounts, not controlled measurements of leakage or skin outcomes.

Skin protection and wound assessment were equally prominent. Patients asked how to use skin-protective pastes, powders and creams, and described sores, cracks, bleeding and open wounds around the stoma. Telenurses gave advice about product choice and application, reviewed photographs and recommended when a problem warranted assessment by a physician.

One participant said that a telenurse suggested a non-allergenic product after sores appeared, but the account did not establish whether the sores subsequently improved. Another reported that recommended creams helped with cracks and bleeding. A participant with an open wound described sending an image every two days and receiving feedback about whether the care was being performed correctly.

The recommendations received by telenursing extended beyond appliance selection. Participants sought guidance about bathing, nutrition, changing adapters, medication use and wound-care products. Some were unsure whether an appliance should be removed before showering, while others described uncertainty about what to eat after colostomy.

They valued detailed demonstrations of how to change an adapter, including which materials to use and how to apply them. Participants also reported receiving advice about creams, powders and medication, including instruction to consult a doctor when inflammation occurred. In their accounts, these tailored recommendations made routine care more manageable and increased their confidence in applying products correctly.

Participants attributed both emotional and practical effects to remote consultations. They described feeling safer, relieved and satisfied when a telenurse answered quickly or helped them decide how to respond to an unfamiliar problem. Several said that reliable information made it possible for them to manage an issue at home that they otherwise might have taken to a hospital.

One participant explained that receiving the right information made the situation easier, while another described phone support as comforting when they felt stuck or worried. Participants valued access to a known professional through messaging, including at weekends, and regarded the explanations as clear, detailed and technically competent. The counselling was perceived as effective because it was accessible, rapid and sufficiently comprehensive, but it operated within a wider support network.

Some participants continued to use one trusted telenurse and did not seek additional solutions. Others contacted product companies, asked physicians for information or searched online, then used the nurse to verify what they had found. Physicians were approached for issues perceived as urgent, while the telenurse remained their main source of technical stoma-care guidance.

The interviews therefore portray remote nursing as a trusted reference point within, rather than a replacement for, the broader healthcare system. Several limitations restrict the findings. All participants came from one private provider, limiting geographical and institutional diversity, although qualitative studies are not designed to produce statistical generalisations.

The interviews drew on retrospective accounts, which may be influenced by recall and by participants’ current adaptation to stoma care. Telenursing was embedded within a broader package of routine care, so the positive experiences cannot be separated from the effects of clinical treatment, earlier education, product design or other support. The interviewer had previously provided telenursing to the participants, creating a risk of socially desirable answers despite separate research appointments and assurances about confidentiality and uninterrupted care.

Interpretive bias also remained possible because coding and preliminary analysis involved a limited number of researchers. The study identifies areas for further evaluation rather than proving clinical efficacy. Participants’ experiences point to repeated product-use education after discharge, review of adapter fit and leakage, skin assessment, clear escalation criteria, secure procedures for sharing images and dependable response times.

The authors also note structural obstacles to wider telehealth use, including limited familiarity with digital tools among some older adults, internet connectivity problems, data-security concerns and incomplete legal standardisation of telehealth in Türkiye. Larger studies involving multiple regions and care organisations, as well as comparisons between service models, would be needed to determine whether telenursing can measurably affect complication rates, quality of life and sustained self-care. For now, the study provides a detailed account of how seven stoma patients used remote advice to navigate product uncertainty, skin problems and everyday complications.

Subject of Research: Patient experiences of stoma product management and telenursing support

Article Title: Product Management Experiences of Patients With a Stoma Receiving Telenursing Services

Article References: Korkmaz, E., Akkaya, G., Can, K., Taylan, S., & Eti Aslan, F. (2026). Product Management Experiences of Patients With a Stoma Receiving Telenursing Services. Nursing Open, 13(10), Article e70755. https://doi.org/10.1002/nop2.70755

Image Credits: AI Generated

DOI: 10.1002/nop2.70755

Keywords: telenursing, stoma care, colostomy, ileostomy, ostomy products, peristomal skin, wound care, digital health, qualitative research, Product, Management, Experiences

Eligible participants were at least 18 years old and had access to a mobile phone and internet. Individuals with a diagnosed psychiatric disorder, sensory impairments that could interfere with participation, or major psychological stress during the preceding six months were excluded. Caregivers were recruited by convenience sampling at the hospital and randomly allocated in a 1:1 ratio to the intervention or control group, with 35 participants in each arm.

All 70 randomized caregivers completed the pre-intervention and post-intervention assessments, with no withdrawals. The intervention was delivered through weekly Zoom sessions lasting 60 to 90 minutes, supported by telephone follow-up and WhatsApp messages between sessions. Its content combined psychoeducation, cognitive-behavioral strategies, stress management, coping-skills training, mindfulness, resilience-building activities, communication-skills training, problem solving, and recognition of positive caregiving experiences.

Arabic multimedia materials and examples of caregiving situations in Egyptian families were used to make the program culturally relevant. The intervention was manualized and structured around the Transactional Model of Stress and Coping, cognitive-behavioral theory, positive psychology, and family-centred care. Caregivers in the control group received the hospital’s usual psychiatric care for eight weeks, including standard outpatient follow-up, medication management by the treating psychiatrist, and nursing care under routine clinical procedures.

They did not receive the structured psychoeducational sessions, telenursing follow-up, stress-management training, coping-skills training, mindfulness activities, resilience-building strategies, or additional psychosocial support provided to the intervention group. Both groups completed the same outcome measures before and immediately after the study period. Caregiver burden was measured with the 10-item Modified Zarit Burden Interview, on which scores range from 0 to 40, with higher scores indicating greater perceived burden.

Psychological resilience was assessed with the 25-item Connor–Davidson Resilience Scale, ranging from 0 to 100, with higher scores indicating greater resilience. The 10-item Positive Aspects of Caregiving Questionnaire measured rewarding feelings on a 0-to-40 scale, including personal satisfaction, accomplishment, and emotional closeness. The instruments had internal consistency coefficients of 0.87, 0.90, and 0.85, respectively, and were reviewed for clarity and cultural appropriateness by five psychiatric nursing experts.

The primary analysis used separate repeated-measures analyses of variance for the three outcomes. These results indicated different patterns of change between the groups, with greater reductions in burden and increases in resilience and rewarding feelings among intervention participants. Independent-samples t-tests also found significantly lower post-test burden and higher post-test resilience and rewarding feelings in the intervention group than in the control group, again with all reported p-values below 0.001.

Separate analyses of covariance confirmed that the between-group differences in post-test burden, resilience, and rewarding feelings remained significant after adjustment for the corresponding baseline scores. The reported group-effect statistics were F = 58.43 for burden, F = 54.76 for resilience, and F = 65.28 for rewarding feelings, with p < 0.001 in each case. At post-test, burden was negatively correlated with resilience at r = −0.604 and with rewarding feelings at r = −0.519, while resilience and rewarding feelings were positively correlated at r = 0.703; all correlations were significant at p < 0.001.

Exploratory multiple regression analysis found that psychological resilience and caregiving rewarding feelings were independently associated with lower post-test caregiver burden. Together, the two variables explained 51% of the variance in burden, with an adjusted R² of 0.49. The overall model was significant at F(2,67) = 34.87 and p < 0.001.

These analyses establish statistical associations rather than causal or mediating mechanisms. The study also did not isolate which individual component of the multicomponent intervention was responsible for the observed differences. The findings require cautious interpretation because the trial was conducted at one Egyptian hospital and used convenience sampling, limiting generalizability to other caregiver populations and healthcare settings.

Outcomes were self-reported and assessed only immediately after the intervention, so response and social-desirability biases were possible and the durability of the effects could not be established. The small sample also limited statistical power for smaller effects, while the absence of blinded outcome assessment may have introduced detection bias. Because the control group received usual care without an attention-control condition, nonspecific effects of contact and attention cannot be excluded.

The trial was also registered retrospectively, and the effect-size assumption used in its original sample-size calculation was not retained. The authors therefore call for larger multicenter trials with more diverse samples, longer follow-up, and assessment of feasibility and cost-effectiveness before conclusions about routine implementation can be drawn.

Subject of Research: Effects of an eight-week nurse-led telenursing intervention on burden, resilience, and rewarding feelings among Egyptian family caregivers of people with bipolar disorder

Article Title: From caregiver burden to psychological resilience and positive emotional outcomes: the effectiveness of innovative psychiatric nursing intervention among family caregivers of patients with bipolar disorder

Article References: Alhalawany, R. M., Khatatbeh, Y. M., Mansour, O. Z., & Hashem, S. R. (2026). From caregiver burden to psychological resilience and positive emotional outcomes: the effectiveness of innovative psychiatric nursing intervention among family caregivers of patients with bipolar disorder. BMC Nursing, 25(1), Article 996. https://doi.org/10.1186/s12912-026-05326-z

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05326-z

Keywords: bipolar disorder, family caregivers, caregiver burden, psychological resilience, rewarding caregiving feelings, telenursing, psychiatric nursing, psychoeducation, randomized controlled trial, Egypt, caregiver, burden

The study, conducted by researchers at Mashhad University of Medical Sciences in Iran, enrolled 96 patients recovering from upper gastrointestinal bleeding and randomly assigned half to a telenursing intervention and half to routine care. The trial was prospectively registered in the Iranian Registry of Clinical Trials under number IRCT20201231049897N1, and it received ethics approval from the university’s ethics committee along with funding from the university’s Deputy of Research. The central question was whether a carefully choreographed month of remote nursing contact could measurably improve patients’ quality of life and their satisfaction with care, compared with the standard discharge experience.

The intervention itself combined three channels of communication. Patients received a self-care mobile application designed to guide them through the practical realities of recovery, including medication adherence, diet, warning signs of rebleeding, and activity pacing. They also took part in weekly telephone counseling sessions with nurses, providing an opportunity to ask questions, report symptoms, and receive individualized advice. Finally, a WhatsApp group connected participants with peers going through the same experience, adding a social dimension to the educational program. The control group received routine discharge care plus brief weekly telephone calls, but these calls were deliberately limited to controlling for the attention patients received from research staff, with no structured education, counseling, or digital content provided and no outcome data collected from them.

The primary outcome was health-related quality of life, measured with the Gastrointestinal Quality of Life Index, a validated instrument that captures symptoms, emotional status, physical function, and social aspects of digestive health. One month after discharge, the intervention group scored 116.02 on average, with a standard deviation of 15.05, while the control group averaged 95.10 with a standard deviation of 13.57. That gap of roughly 21 points was highly statistically significant, with a p-value below 0.001. Because patients inevitably start out with different baseline quality of life, the researchers also ran an analysis of covariance adjusting for initial scores, and the intervention effect remained robust, with F equal to 13.38 and a p-value of 0.001.

Satisfaction told a similar story. Using the Telenursing Interaction and Satisfaction Questionnaire, the team found that intervention patients rated their experience far more positively than controls, with mean scores of 77.39 versus 47.04, again a difference that was highly significant. Interestingly, the control group’s satisfaction scores reflect their contact with the study’s brief follow-up calls, which underscores how much the structured program, rather than mere telephone contact, drove the difference. Patients in the intervention arm also evaluated the mobile application itself using the Mobile Application Rating Scale, awarding it a mean score of 98.24 out of a possible maximum, with a standard deviation of 6.54, indicating that the digital tool was perceived as high quality across engagement, functionality, aesthetics, and information content.

Why would a month of phone calls and an app make such a large difference in how patients feel? The answer likely lies in the nature of recovery from upper gastrointestinal bleeding. Patients are typically discharged with strict instructions about avoiding nonsteroidal anti-inflammatory drugs, managing acid suppression therapy, and watching for signs of recurrent bleeding such as black stools or vomiting blood. Without reinforcement, these instructions are easy to forget or misunderstand, and anxiety about rebleeding can dominate daily life. Structured telenursing gives patients a reliable channel for clarifying doubts, and the peer group normalizes the worries and setbacks that accompany recovery, both of which plausibly translate into better perceived health and greater confidence in self-management.

The trial’s design deserves attention for how it handled the placebo problem inherent in behavioral interventions. Any extra contact with healthcare staff can make patients feel cared for, so a control group that receives nothing at all can exaggerate the apparent benefit of an intervention. By giving controls brief weekly calls purely to equalize the amount of attention between groups, the researchers isolated the effect of the structured educational content itself. The fact that a large difference in quality of life and satisfaction persisted despite this attention control strengthens the conclusion that the self-care education, not simply human contact, produced the gains.

The authors are careful about the limits of what their data show. Because the trial did not assess objective clinical outcomes such as recurrent bleeding, hospital readmission, or mortality, the results should be read as evidence of improved patient-reported recovery rather than proof of a better clinical prognosis. Quality of life and satisfaction are meaningful endpoints in their own right, and they are strongly associated with adherence and engagement with follow-up care, but a larger and longer trial would be needed to determine whether telenursing also reduces the risk of dangerous rebleeding episodes or keeps patients out of the emergency department.

Even with those caveats, the findings arrive at a moment when health systems worldwide are searching for scalable ways to support patients beyond hospital walls. Telenursing requires no exotic technology, only a phone line, a well-designed application, and nurses with time and training. The near-perfect app rating in this study suggests that when digital tools are built around genuine patient needs and paired with live human support, patients embrace them enthusiastically. For a condition like upper gastrointestinal bleeding, where the first month after discharge is a vulnerable window, that combination of automated guidance and personal counseling appears to fill a real gap in care.

The study also highlights the broader potential of nursing-led telehealth programs across chronic and acute gastrointestinal disease. If structured remote education can lift quality-of-life scores by more than 20 points in a month for bleeding patients, the same model could plausibly benefit people managing peptic ulcer disease, inflammatory bowel conditions, or recovery from other acute events. The trial’s open-access publication means that its intervention structure, outcome instruments, and statistical approach are available to any clinical team willing to replicate or adapt them. For now, the message for patients leaving the hospital after a gastrointestinal bleed is encouraging: a month of structured, nurse-guided self-care support, delivered largely through devices most people already own, can make the road back to normal life measurably smoother.

Subject of Research: Telenursing-based self-care education for patients recovering from upper gastrointestinal bleeding

Article Title: Telenursing-based self-care education improves quality of life and patient satisfaction in upper gastrointestinal bleeding: a randomized controlled trial

Article References: Lajevardi, R., Aghebati, N., Ghavami, V., & Rajabpour, M. (2026). Telenursing-based self-care education improves quality of life and patient satisfaction in upper gastrointestinal bleeding: a randomized controlled trial. BMC Nursing. https://doi.org/10.1186/s12912-026-05055-3

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05055-3

Keywords: telenursing, telehealth, upper gastrointestinal bleeding, self-care education, quality of life, patient satisfaction, randomized controlled trial, mobile application, nursing, digital health, patient recovery, GIQLI