Rovira i Virgili University, Tarragona, Spain.
Tianjin People's Hospital, Tianjin, China.
J Adv Nurs. 2020 Oct;76(10):2547-2558. doi: 10.1111/jan.14457. Epub 2020 Jul 23.
This paper is a report of a study exploring the relationship between stoma acceptance and stoma care self-efficacy in patients with colostomy and whether self-disgust and stigma play mediating roles in this relationship.
A cross-sectional survey design.
In all, 476 participants were recruited from a tertiary hospital and completed structured, anonymous, self-report measures of stoma acceptance, self-disgust, stigma, and stoma care self-efficacy between January 2016-March 2017.
Stoma acceptance was significantly negatively associated with personal disgust (r = -.640, p<.001), behavioural disgust (r = -.384, p<.001), and stigma (r = -.309, p<.001) and significantly positively associated with stoma care self-efficacy (r = .689, p<.001). Furthermore, regression-based mediation modelling showed that personal disgust and stigma had significant mediating effects on stoma acceptance and stoma care self-efficacy.
We demonstrated, for the first time, that emotional responses (self-disgust and stigma) play important roles in the association between stoma acceptance and stoma care self-efficacy. Addressing concerns about emotional disorder should become part of the routine care for patients with stoma.
Patients with colostomy must cope with many challenges and undergo profound changes in daily life. Acceptance of the existence of the stoma and effective management of the stoma can aid patients in the return to a full and active life. Illness acceptance and psychological states have been widely reported to be correlates of the ability to successfully reconstitute a meaning of life, but these have not been specifically explored in patients with colostomy. This study examined the effect of stoma acceptance on stoma care self-efficacy with the mediation role of self-disgust and stigma. Evidence of the relationship between illness acceptance and self-efficacy could offer practitioners to consider emotional factors like self-disgust and stigma when aiming to improve stoma care and management.
本研究旨在探讨造口患者的造口接受度与造口护理自我效能之间的关系，以及自我厌恶和污名感是否在其中起中介作用。
横断面调查设计。
2016 年 1 月至 2017 年 3 月，共招募了 476 名来自三级医院的参与者，他们完成了关于造口接受度、自我厌恶、污名感和造口护理自我效能的结构化、匿名、自我报告式测量。
造口接受度与个人厌恶感（r=-0.640，p<.001）、行为厌恶感（r=-0.384，p<.001）和污名感（r=-0.309，p<.001）显著负相关，与造口护理自我效能显著正相关（r=0.689，p<.001）。此外，基于回归的中介模型显示，个人厌恶感和污名感对造口接受度和造口护理自我效能有显著的中介作用。
我们首次证明，情感反应（自我厌恶和污名感）在造口接受度和造口护理自我效能之间的关系中起着重要作用。关注情绪障碍问题应成为造口患者常规护理的一部分。
肠造口患者必须应对许多挑战，并经历日常生活的深刻变化。接受造口的存在并有效地管理造口可以帮助患者重新过上充实和积极的生活。疾病接受度和心理状态已被广泛报道为成功重建生活意义的能力的相关因素，但这些因素尚未在肠造口患者中得到具体探讨。本研究考察了造口接受度对造口护理自我效能的影响，以及自我厌恶和污名感的中介作用。关于疾病接受度和自我效能之间关系的证据可以为从业者提供参考，使他们在努力改善造口护理和管理时考虑自我厌恶和污名感等情感因素。
