Lulu Ma, Ying Piao, Yu Zhou, Xiaohuan Wang
Patients with colostomies commonly experience perceived stigma. Stigma influences post-traumatic growth through both direct and sequential indirect pathways. Specifically, higher levels of perceived stigma are associated with reduced use of confrontational coping strategies, which subsequently diminish self-care ability and ultimately hinder post-traumatic growth.
OBJECTIVE: This study aimed to investigate whether coping styles and self-care competence sequentially mediate the association between perceived stigma and post-traumatic growth among patients undergoing enterostomy.
METHODS: This was a retrospective cross-sectional study. A total of 240 patients with enterostomies who were admitted to our hospital between January 2024 and June 2025 were selected. The clinical data of these patients were extracted from the hospital's electronic medical record system, including the General Information Questionnaire, Social Impact Scale (SIS), Medical Coping Modes Questionnaire (MCMQ), Exercise of Self-Care Agency Scale (ESCA), and Post-Traumatic Growth Inventory (PTGI). Data analysis was performed using SPSS 26.0 software and the PROCESS macro(Model 6); regression-based path analysis was used to test the hypothesized chain mediating pathway.
RESULTS: The total stigma score of the 240 patients with enterostomy was (59.54 ± 12.66) points; the scores of confrontation, avoidance, and resignation were (17.91 ± 4.24), (15.19 ± 3.58), and (11.25 ± 3.21) points, respectively; the total self-care score was (63.52 ± 5.50) points; and the total post-traumatic growth score was (53.36 ± 6.10) points. Stigma in patients with enterostomy was negatively correlated with confrontation, self-care, and post-traumatic growth (r = -0.502, -0.430, -0.472, P < 0.05), and positively correlated with avoidance and resignation (r = 0.563, 0.482, P < 0.05). Stigma had a significant negative total effect on post-traumatic growth (unstandardized β = -0.930, t = -8.268, P < 0.001). After controlling for mediating variables, stigma still had a significant direct negative effect on post-traumatic growth. The serial chain mediating effect of "stigma→confrontation→self-care→post-traumatic growth" was significant. The total indirect effect was β=-0.529, which accounted for 63.75% of the total effect. The overall model had an R² of 0.265 (F = 38.642, P < 0.001), indicating that the model explained 26.5% of the variance in post-traumatic growth.
CONCLUSION: Patients with colostomies commonly experience perceived stigma. Stigma influences post-traumatic growth through both direct and sequential indirect pathways. Specifically, higher levels of perceived stigma are associated with reduced use of confrontational coping strategies, which subsequently diminish self-care ability and ultimately hinder post-traumatic growth.