Opening Ceremony Of The 13th Biennial Congress Of The World Council Of Enterostomal Therapists

02 Jul 2000

By Mr Lim Hng Kiang

Theme: Enterostomal Therapy into the 21st century

Good evening,

Distinguished guests,

Ladies and gentlemen

INTRODUCTION

It is a pleasure for me to be present this evening at the opening ceremony of the 13th Biennial Congress of the World Council of Enterostomal Therapists. First, let me extend a warm welcome to all our foreign visitors.

Singapore is privileged to be the first country in South East Asia to host this international congress. The Congress provides Enterostomal Therapists (ETs) the opportunity to come together to share knowledge, experiences and innovations. Through this exchange, ETs can keep abreast of developments all over the world and adapt them to suit each country's needs and practices.

CHALLENGES OF ENTEROSTOMAL THERAPY

Rising Incidence

Although ET as a speciality is a relatively recent development, with some 40 years behind it, it's role is increasingly important. The incidence of colorectal cancer is increasing around the world and the need for ET is growing.

Colorectal cancer is one of the most common cancers in Singapore. The incidence of colorectal cancer has risen from 23 per 100,000 in 1987 to 29 per 100,000 in 1997. We aim to contain this growing incidence through a combination of prevention, early detection and effective treatment. For prevention, we must improve the dietary habits of Singaporeans, getting them to reduce fat consumption and increase fruit and vegetable consumption. For early detection, we are encouraging more widespread screening with faecal occult blood test. For effective treatment, we are building up the capabilities of our National Cancer Centre and NUH Cancer Centre. But despite our best efforts, we can expect more cases. The population is ageing and it will take time for the incidence rate to plateau and then decline.

Currently, about 500 patients undergo stoma formation each year. Today, there are 31 trained ETs in Singapore who assist in the care and rehabilitation of patients with stomas in our public and private hospitals. Since 1993, Singapore has also conducted 3 courses in Enterostomal Therapy. With the rising incidence of colorectal cancer, ETs will continue to play an important role in the care and rehabilitation of this group of patients.

Provision of holistic care

Patients with stomas face many problems, both physical and psychological. The patient has to come to terms with the diagnosis and prognosis, and where cancer is concerned, the adjunctive treatment required. There are also issues relating to employment, family and other social support networks, body image and sexuality. Anxiety and embarrassment over a stoma may lead to an alteration in lifestyle, and may affect the ability to find work.

Faced with these problems, the patient looks up to you as ETs for care and psychological support. The role of the surgeon in enterostomal care is to create a functioning stoma, but it is the ETs who make the difference in enabling the patient to return to normal or near normal life.

The concept of caring is thus the central tenet of your practice. You will always face the constant challenge of not only providing professional care but to comfort and maintain the patient's dignity. We must all remember that, at the end of it all, it is the patient's welfare that is of paramount importance.

Besides offering pre and post operative care and counselling, the ET needs to plan an effective rehabilitation programme for each patient. A well-planned programme is essential, as it will assist your patients to gain confidence in coping with their altered body image and to live a new life after the creation of the stoma. It will also help your patients to remain economically and socially active.

Although ETs are able to provide professional and personal care, the patient also requires empathy and the benefit of personal experience to manage and cope with the ostomy on a day-to-day basis. An ostomy support group can provide this much-needed information and emotional support. There are Ostomy Clubs world-wide to assist patients to understand their illness better and to enable them to adjust their life style. I am pleased to note that the Singapore Cancer Society had set up a Stoma Club in 1981 for patients to relate and support each other. Its members meet regularly to organise educational and social activities.

Provision of evidence-based care

Like all other healthcare professionals today, ETs have to rise to the challenge of rapid change in the working environment, fuelled by the dramatic advances in medical practice, information technology and escalating healthcare costs. However, amidst all these changes, some things remain unchanged - the professional responsibility to ensure that the care you provide is appropriate and of a high standard. In the pursuit of delivering better and more cost-effective nursing care, evidence-based medicine and nursing practice has emerged. This requires practice to be based on the best currently available scientific evidence. To provide high quality, yet cost-effective care to patients, ETs must be imbued with the culture of evidence-based practice.

My Ministry therefore fully supports research and evidence based practice. We have established the Nursing Research Centre. It is equipped with a wide range of resource material so that nurses can keep abreast of developments from all over the world. Three groups of nurses from both the public and private sector have been appointed to develop clinical practice guidelines on the prevention and treatment of pressure sores and the care of patients on intravenous therapy. I encourage ETs to get together and develop clinical practice guidelines for the management of patients with stomas.

Professional development

As ET, you are valued and respected for your specialised knowledge, skills and abilities. Nurses have traditionally formed the backbone of healthcare services and play a vital role in caring for the sick. Over the years, the nursing profession has developed to meet the more complex challenges confronting it. In addition to the traditional nursing care, we now expect our nurses to be better managers, and part-time educationists; we expect them to develop specialist skills and adopt research techniques to improve nursing care. ET exemplifies these changes in the nursing profession. You have responded very well to the unique requirements of your speciality. I commend you for coming together to address the challenges in the new millennium.

Conclusion

The 21st century brings many challenges. By embracing and preparing for the changes which the new millennium brings and by adding to the flow of new ideas and new practices, ETs can truly enrich their profession and improve the lives of patients under their care.

I hope you will have a stimulating and enlightening forum and I trust that the many collaborative networks established here will help you to set the agenda for ETs in the 21st century. I now have the pleasure to declare the 13th Biennial Congress of the World Council of Enterostomal Therapists open.