{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T04:01:44Z","timestamp":1788494504294,"version":"build-2803163510"},"reference-count":47,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T00:00:00Z","timestamp":1750118400000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004697","name":"Hamadan University of Medical Sciences","doi-asserted-by":"publisher","award":["9809056603"],"award-info":[{"award-number":["9809056603"]}],"id":[{"id":"10.13039\/501100004697","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing Open"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To compare the effects of two different education techniques, Teach\u2010back communication and Pictorial\u2010based learning, on new colostomates' knowledge and adherence to self\u2010care, self\u2010efficacy and peristomal skin lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A three\u2010arm randomised controlled clinical trial was conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Self\u2010care education can bring about numerous benefits for colostomy patients; thus, it is important to choose an appropriate educational approach for postoperative ostomates. A total of 111 new ostomates admitted to the surgical wards were randomly assigned into three groups using a permuted\u2010block design. All participants received routine education. The two intervention groups received education that included the same educational topics during 30\u201340\u2009min sessions over 3\u2009days using Teach\u2010back or pictorial\u2010based methods. The demographic and clinical information form, self\u2010care knowledge questionnaire, self\u2010care adherence checklist, stoma self\u2010efficacy scale and peristomal skin checklist were completed before the intervention (the day after surgery) and at follow\u2010ups (on day four and 1\u2009month after surgery). Analysis of covariance in SPSS\u201021 software was used for data analysis with a significance level of 0.05 or less.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After taking confounding variables into account (supplementary insurance status, place of residence, smoking history and diet), both Teach\u2010back and pictorial\u2010based groups demonstrated a significant improvement in colostomy self\u2010care knowledge and adherence as well as in self\u2010efficacy compared to the control group (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Additionally, at the follow\u2010up stage, patients in the Teach\u2010back group had higher levels of self\u2010efficacy than those in the pictorial\u2010based group (<jats:italic>p<\/jats:italic>\u2009=\u20090.036). At this point, all three groups had similar erythematous lesions all around peristomal skin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patient or Public Contribution<\/jats:title><jats:p>Implementing either teach\u2010back or pictorial\u2010based resulted in improved knowledge of colostomy care and adherence as well as enhanced self\u2010efficacy. However, it was reported that teach\u2010back communication was more effective in sustaining overall self\u2010efficacy than pictorial\u2010based education. In light of this, nurses should use these strategies to provide more effective and enduring training for new colostomy patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>Iranian Clinical Trial Registration Center: IRCT20160110025929N27<\/jats:p><\/jats:sec>","DOI":"10.1002\/nop2.70258","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T18:23:49Z","timestamp":1750184629000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Teach\u2010Back Communication Versus Pictorial\u2010Based Learning on Self\u2010Care Knowledge and Adherence, Self\u2010Efficacy and Peristomal Skin Healing in Patients After Emergency Surgery Colostomy: A 3\u2010Arm, Randomised, Controlled Trial"],"prefix":"10.1002","volume":"12","author":[{"given":"Zoleykha","family":"Rajabi","sequence":"first","affiliation":[{"name":"Besat Specialized and Sub\u2010Specialized Hospital, Hamadan University of Medical Sciences  Hamadan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7060-2205","authenticated-orcid":false,"given":"Mahnaz","family":"Khatiban","sequence":"additional","affiliation":[{"name":"Mother and Child Care Research Center, Department of Medical\u2010Surgical Nursing, School of Nursing and Midwifery Hamadan University of Medical Sciences  Hamadan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4016-4934","authenticated-orcid":false,"given":"Seyedeh Nayereh","family":"Falahan","sequence":"additional","affiliation":[{"name":"Student Research Committee, School of Nursing and Midwifery Hamadan University of Medical Sciences  Hamadan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Reza","family":"Soltanian","sequence":"additional","affiliation":[{"name":"Modelling of Noncommunicable Diseases Research Center, Department of Biostatistics School of Health Hamadan University of Medical Sciences  Hamadan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/apjon.apjon_24_20"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.30699\/ajnmc.28.3.193"},{"key":"e_1_2_12_4_1","first-page":"26","article-title":"Assessing the Validity and Reliability of the Peristomal Skin Lesion Assessment Instrument Adapted for Use in Turkey","volume":"61","author":"Ay A.","year":"2015","journal-title":"Ostomy\/Wound Management"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.13018"},{"key":"e_1_2_12_6_1","volume-title":"Stoma Care","author":"Balachandar T.","year":"2018"},{"key":"e_1_2_12_7_1","first-page":"22","article-title":"Content Validation of a Standardized Algorithm for Ostomy Care","volume":"56","author":"Beitz J.","year":"2010","journal-title":"Ostomy\/Wound Management"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006842-199603000-00013"},{"key":"e_1_2_12_9_1","first-page":"38","article-title":"A Proposal for Classifying Peristomal Skin Disorders: Results of a Multicenter Observational Study","volume":"53","author":"Bosio G.","year":"2007","journal-title":"Ostomy\/Wound Management"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/WON.0000000000000876"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18052443"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.12968\/bjon.2020.29.22.S20"},{"key":"e_1_2_12_13_1","first-page":"677","article-title":"Effect of Educational Intervention in Postoperative People With Intestinal Elimination Stomies: Systematic Review","volume":"19","author":"Costa Monteiro A. 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