Analysis of influencing factors of adaptation level in patients with permanent enterostomy

doi:10.3969/j.issn.1674-8115.2023.11.010

Abstract

Abstract:

Objective ·To investigate the level of stoma adaptation in patients with permanent enterostomy and its influencing factors. Methods ·In this cross-sectional study, 260 patients with permanent enterostomy from North Campus in Hongkou and South Campus in Songjiang of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine were recruited by convenience sampling approach from January to December, 2022. The level and the influencing factors of stoma adaptation were investigated by general information questionnaire, Chinese version of Ostomy Adjustment Inventory-20 (OAI-20), Hospital Anxiety and Depression Scale, Stoma Self-Efficacy Scale, Body Image Scale, and The Revised Dyadic Adjustment Scale. Statistical description used mean and standard deviation, frequency and percentage. T test, ANOVA, Spearman correlation and multiple linear regression analyses were preformed to explore the influencing factors of the level of stoma adaptation. Results ·The mean score of OAI-20 was (42.28±11.47). One-way ANOVA results showed the effects of registered residence (P=0.001), monthly income (P=0.000) and the ostomy-related complications (P=0.000) on the OAI-20 score were statistically significant. Spearman correlation analysis results showed that the OAI-20 score was positively correlated with stoma self-efficacy and marital adjustment score (r=0.713, P=0.000; r=0.645, P=0.000), but negatively correlated with anxiety and depression and body image score (r=-0.391, P=0.000; r=-0.523, P=0.000). Four of the eleven variables, ostomy-related complications, anxiety, self-efficacy of ostomy caring and marital satisfaction, were selected by the multiple linear stepwise regression analysis, and could explain 59.8% of total variance (P=0.000). Conclusion ·Most patients with permanent enterostomy have a low level of adaptation. Ostomy-related complications, anxiety, self-efficacy of ostomy caring and marital satisfaction are the main influencing factors of the level of stoma adaptation.

Key words: colorectal cancer, enterostomy, ostomy adaptation, marital relationship, regression analysis

CLC Number:

R473.6

TAI Rui, FANG Fang, MAO Jingjue, ZHOU Xia. Analysis of influencing factors of adaptation level in patients with permanent enterostomy[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(11): 1423-1429.

Figures/Tables 4

TrendMD

References 31

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Characteristic variable	Sample size/n (%)	OAI-20/point	Statistical value	P value
Age/year			0.038	0.845
<60	68 (26.2)	42.51±11.78
≥60	192 (73.8)	42.20±11.39
Gender			0.113	0.737
Male	164 (63.1)	42.10±11.27
Female	96 (36.9)	42.59±11.85
Registered residence			14.803	0.001
City	141 (54.2)	45.38±10.94
Town	59 (22.7)	40.78±11.11
Country	60 (23.1)	36.47±10.61
Education			1.318	0.270
Junior high school and below	142 (54.6)	41.33±11.26
Technical secondary school/senior high school	95 (36.5)	41.05±10.83
Junior college and above	23 (8.9)	42.87±11.88
Marital status			1.585	0.209
Married	245 (94.2)	42.50±11.51
Single and others	15 (5.8)	38.67±10.41
Children			0.210	0.647
Yes	251 (96.5)	42.34±11.56
No	9 (3.5)	40.56±8.75
Work			0.281	0.839
In service	5 (1.9)	42.40±7.27
Sick leave	92 (35.4)	42.26±11.90
Jobless	73 (28.1)	41.37±10.94
Retired	90 (34.6)	43.03±11.72
Family monthly income/yuan			19.090	0.000
<10 000	110 (42.3)	38.77±11.23
≥10 000	150 (57.7)	44.85±10.98
Payment			1.436	0.232
URBMI	174 (66.9)	42.88±12.44
NCMS	86 (33.1)	41.07±9.13
Ostomy-related complications			47.045	0.000
No	239 (91.9)	43.93±10.40
Yes	31 (8.1)	30.06±11.74

Characteristic variable	Sample size/n (%)	OAI-20/point	Statistical value	P value
Age/year			0.038	0.845
<60	68 (26.2)	42.51±11.78
≥60	192 (73.8)	42.20±11.39
Gender			0.113	0.737
Male	164 (63.1)	42.10±11.27
Female	96 (36.9)	42.59±11.85
Registered residence			14.803	0.001
City	141 (54.2)	45.38±10.94
Town	59 (22.7)	40.78±11.11
Country	60 (23.1)	36.47±10.61
Education			1.318	0.270
Junior high school and below	142 (54.6)	41.33±11.26
Technical secondary school/senior high school	95 (36.5)	41.05±10.83
Junior college and above	23 (8.9)	42.87±11.88
Marital status			1.585	0.209
Married	245 (94.2)	42.50±11.51
Single and others	15 (5.8)	38.67±10.41
Children			0.210	0.647
Yes	251 (96.5)	42.34±11.56
No	9 (3.5)	40.56±8.75
Work			0.281	0.839
In service	5 (1.9)	42.40±7.27
Sick leave	92 (35.4)	42.26±11.90
Jobless	73 (28.1)	41.37±10.94
Retired	90 (34.6)	43.03±11.72
Family monthly income/yuan			19.090	0.000
<10 000	110 (42.3)	38.77±11.23
≥10 000	150 (57.7)	44.85±10.98
Payment			1.436	0.232
URBMI	174 (66.9)	42.88±12.44
NCMS	86 (33.1)	41.07±9.13
Ostomy-related complications			47.045	0.000
No	239 (91.9)	43.93±10.40
Yes	31 (8.1)	30.06±11.74

Variable OAI-20	Acceptance		Anxious preoccupation		Social life attitude		Total
Variable OAI-20	r	P	r	P	r	P	r	P
HADS	-0.421	0.000	-0.363	0.000	-0.333	0.000	-0.391	0.000
Factor1: Anxiety	-0.431	0.000	-0.379	0.000	-0.355	0.000	-0.409	0.000
Factor2: Depression	-0.351	0.000	-0.302	0.000	-0.269	0.000	-0.324	0.000
SSS	0.690	0.000	0.661	0.000	0.645	0.000	0.713	0.000
Factor1: Stoma care self-efficacy	0.691	0.000	0.661	0.000	0.631	0.000	0.705	0.000
Factor2: Social functional self-efficacy	0.662	0.000	0.363	0.000	0.637	0.000	0.696	0.000
BIS	-0.548	0.000	-0.541	0.000	-0.523	0.000	-0.523	0.000
RDAS	0.658	0.000	0.565	0.000	0.576	0.000	0.645	0.000
Factor1: Marital consistency	0.620	0.000	0.528	0.000	0.539	0.000	0.605	0.000
Factor2: Marital satisfaction	0.631	0.000	0.569	0.000	0.573	0.000	0.635	0.000
Factor3: Marital cohesion	0.548	0.000	0.438	0.000	0.466	0.000	0.524	0.000

Variable OAI-20	Acceptance		Anxious preoccupation		Social life attitude		Total
Variable OAI-20	r	P	r	P	r	P	r	P
HADS	-0.421	0.000	-0.363	0.000	-0.333	0.000	-0.391	0.000
Factor1: Anxiety	-0.431	0.000	-0.379	0.000	-0.355	0.000	-0.409	0.000
Factor2: Depression	-0.351	0.000	-0.302	0.000	-0.269	0.000	-0.324	0.000
SSS	0.690	0.000	0.661	0.000	0.645	0.000	0.713	0.000
Factor1: Stoma care self-efficacy	0.691	0.000	0.661	0.000	0.631	0.000	0.705	0.000
Factor2: Social functional self-efficacy	0.662	0.000	0.363	0.000	0.637	0.000	0.696	0.000
BIS	-0.548	0.000	-0.541	0.000	-0.523	0.000	-0.523	0.000
RDAS	0.658	0.000	0.565	0.000	0.576	0.000	0.645	0.000
Factor1: Marital consistency	0.620	0.000	0.528	0.000	0.539	0.000	0.605	0.000
Factor2: Marital satisfaction	0.631	0.000	0.569	0.000	0.573	0.000	0.635	0.000
Factor3: Marital cohesion	0.548	0.000	0.438	0.000	0.466	0.000	0.524	0.000

Independent variable	Assignment
Registered residence	City=1, Town=2, Country=3
Family monthly income	<10 000 yuan=0, ≥10 000 yuan=1
Ostomy-related complications	No=0, Yes=1