Stigma, stoma acceptance, quality of life among patients with colorectal cancer intestinal ostomy: a cross-sectional study.

BACKGROUND: Stigma is a common psychological distress among patients with colorectal cancer and an intestinal ostomy. It severely impacts their quality of life. However, the heterogeneity of stigma and its underlying mechanisms remain underexplored. OBJECTIVE: This study aimed to identify latent subtypes of stigma in this population using latent profile analysis. It also examined factors associated with different stigma profiles and tested the mediating role of stoma acceptance between stigma profiles and quality of life. METHODS: A cross-sectional survey was conducted among 449 patients with colorectal cancer and an intestinal ostomy recruited from tertiary hospitals in the Sichuan-Chongqing region, China. Stigma, stoma acceptance, and quality of life were assessed using the Social Impact Scale, Chinese version of the Stoma Acceptance Questionnaire, and Stoma-Quality of Life Questionnaire, respectively. Latent profile analysis was performed to identify stigma subtypes. Multinomial logistic regression examined predictors of profile membership. Mediation analysis tested whether stoma acceptance mediated the relationship between stigma profiles and quality of life. RESULTS: Three distinct stigma profiles were identified: low (46.55%), moderate (39.20%), and high stigma groups (14.25%). Multivariate analysis revealed that being unmarried/divorced/widowed (OR = 2.28, 95% CI: 1.14-4.57); lower monthly household income (<3000 CNY) (OR = 8.65, 95% CI: 1.84-40.67); and complete dependence on others for stoma care (OR = 2.09, 95% CI: 0.97-4.51) were independent predictors of high stigma group membership. Significant stepwise decreases in stoma acceptance and quality of life scores were observed across the three profiles (all P < 0.05). Stoma acceptance partially mediated the relationship between stigma profiles and quality of life, with indirect effects accounting for 23.8% and 25.9% of the total effects in the moderate and high stigma groups, respectively. CONCLUSIONS: The characteristics of stigma among patients with colorectal cancer and intestinal ostomy. Stoma acceptance plays a significant mediating role in the relationship between stigma and quality of life. CLINICAL TRIAL REGISTRATION: http://www.chictr.org.cn/, identifier ChiCTR2500095532.