Happily hopeless: adaptation to a permanent, but not to a temporary, disability

Objective: The authors tracked patients with either irreversible or reversible colostomies over a 6-month period, beginning a week after the procedure, to examine how they adapted hedonically over time. Based on prior research and theorizing, the authors hypothesized that, paradoxically, those with irreversible colostomies would adapt more fully, and become happier, than would those with colostomies that were potentially reversible.

Design: The authors contacted 107 patients who had recently received either a colostomy or ileostomy. The initial interviews were conducted while patients were still in the hospital recovering from their surgery. Consenting participants were mailed surveys at three time points: 1 week after release from the hospital, 1 month after release, and 6 months after release.

Main outcome measures: The surveys included measures of life satisfaction and perceived quality of life.

Results: As predicted, overall life satisfaction and quality of life increased with time for patients with permanent, but not temporary, ostomies.

Conclusion: These findings suggest that knowing an adverse situation is temporary can interfere with adaptation, leading to a paradoxical situation in which people who are better off objectively are worse off subjectively.