Effects of self-management interventions on self-care ability and quality of life in patients with urinary ostomy after bladder cancer: a systematic review and meta-analysis.

OBJECTIVE: To systematically assess the effects of structured self-management interventions on self-care ability, quality of life (QoL), anxiety, and stoma-related complications in bladder cancer patients with urinary ostomy, providing evidence to guide clinical practice and intervention design. METHODS: A systematic search of CNKI, WanFang, VIP Database, CINAHL, Cochrane Library, PubMed, Embase, and Web of Science was conducted from January 1, 2016, to January 1, 2026. Randomized controlled trials evaluating self-management interventions in bladder cancer patients with urinary ostomy were included. Two reviewers independently performed study selection, data extraction, and quality assessment. Meta-analysis was conducted using Review Manager 5.4, and effect sizes were expressed as standardized mean difference (SMD) or risk ratio (RR) with 95% confidence intervals (95% CI). Heterogeneity was assessed using the I2 statistic. RESULTS: A total of 27 RCTs involving 1,674 patients were included. Self-management interventions significantly improved self-care ability (SMD = 2.42, 95% CI: 1.63-3.22, P < 0.001), with substantial heterogeneity (I2 = 93.7%). QoL was also significantly improved (SMD = 1.44, 95% CI: 0.46-2.42, P < 0.01; I2 = 96%), with wide prediction intervals indicating variability across settings. Anxiety levels were significantly reduced (SMD = -1.12, 95% CI: -1.44 to -0.80, P < 0.001; I2 = 21.9%), and stoma-related complications were markedly decreased (RR = 0.24, 95% CI: 0.19-0.32, P < 0.001; I2 = 0%). Sensitivity analyses confirmed the robustness of the findings, and subgroup analyses suggested that intervention characteristics and follow-up duration contributed to heterogeneity. CONCLUSION: Structured self-management interventions improve self-care ability, QoL, psychological well-being, and stoma-related outcomes in bladder cancer patients with urinary ostomy. Integration into routine postoperative care is recommended, while future multicenter trials with standardized protocols and longer follow-up are needed to strengthen evidence. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261424084, identifier CRD420261424084.