Perceived stress profiles, resourcefulness, and quality of life among patients with colorectal cancer and intestinal ostomy: a cross-sectional latent profile and mediation study.

BACKGROUND: Colorectal cancer patients with intestinal ostomy often experience high levels of perceived stress, which may be associated with impaired quality of life. However, the heterogeneity of perceived stress and the underlying mechanisms linking it to quality of life remain unclear. This study aimed to identify latent profiles of perceived stress and to examine the mediating role of resourcefulness in the relationship between perceived stress profiles and quality of life among these patients. METHODS: A cross-sectional study was conducted in two tertiary hospitals in the Sichuan-Chongqing region of China from February to December 2025. A total of 464 patients with colorectal cancer and intestinal ostomy completed the Perceived Stress Scale, the Resourcefulness Scale, and the Stoma-Quality of Life questionnaire. Analyses of latent profiles and mediations were performed. RESULTS: Three perceived stress profiles were identified: Tension-Activated (31.68%), Control-Loss Dominant (52.59%), and Chronic High-Stress (15.73%). Compared with the Tension-Activated Profile, primary school education or below was a risk factor for the Chronic High-Stress Profile (OR = 6.09, 95% CI: 1.67-22.20, P= 0.006). Being married (OR = 0.34, 95% CI: 0.16-0.73, P = 0.005) and complete self-care in stoma management (OR = 0.24, 95% CI: 0.07-0.80, P= 0.021) were protective factors. Resourcefulness is consistent with a partial mediating role in the relationship between perceived stress profiles and quality of life (P < 0.001), with the indirect effects accounting for 33.2% and 36.7% of the total associations for the Control-Loss Dominant and Chronic High-Stress profile, respectively. CONCLUSIONS: Perceived stress is heterogeneous. Low education is a risk factor, whereas being married and having complete stoma self-care ability are protective factors against chronic high stress. Enhancing resourcefulness may improve quality of life. CLINICAL TRIAL REGISTRATION: http://www.chictr.org.cn/, ChiCTR2500095532.