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将耻辱感与永久性造口的结直肠癌幸存者的社会隔离联系起来:造口接纳和有价值行为的链式中介作用。

Linking stigma to social isolation among colorectal cancer survivors with permanent stomas: the chain mediating roles of stoma acceptance and valuable actions.

作者信息

Li Guopeng, He Xudong, Qin Rui, Yao Qi, Dong Xiaoling, Li Ping

机构信息

School of Nursing and Rehabilitation, Shandong University, 44 Wenhua West Road, Jinan, 250012, Shandong, P.R. China.

Colorectal Surgery Ward I, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, 250117, Shandong, P.R. China.

出版信息

J Cancer Surviv. 2024 Jun 15. doi: 10.1007/s11764-024-01614-2.

Abstract

PURPOSE

Colorectal cancer (CRC) survivors with permanent stomas might be at higher risk of social isolation, and stigma can play an important role in the development of social isolation. However, the underlying psychological mechanisms are understudied. The current study examined how stoma acceptance and valuable actions mediated the relationships between stigma and social isolation among CRC survivors with permanent stomas.

METHODS

A cross-sectional survey was conducted with a sample of 303 CRC survivors with permanent stomas. The chain mediation models were conducted using the PROCESS macro for SPSS to explore the pathways through which stigma can be associated with CRC survivors' social isolation, mediated by stoma acceptance and valuable actions.

RESULTS

The results indicated that higher stigma was related to lower stoma acceptance, less personal values enactment, and higher social isolation, as well as lower objective social connectedness and subjective social belongingness among CRC survivors with permanent stomas. Additionally, the mediational analyses revealed that stoma acceptance and valuable actions jointly mediated the relationships between stigma and social isolation.

CONCLUSION

Social isolation among CRC survivors during the adjustment to both stoma and stigma may be alleviated through tailored interventions that improve stoma acceptance and valuable actions.

IMPLICATIONS FOR CANCER SURVIVORS

The chain mediating roles of stoma acceptance and valuable actions highlight that tailored interventions, such as acceptance and commitment therapy, can be targeted for this population, considering this population's unique needs.

摘要

目的

患有永久性造口的结直肠癌(CRC)幸存者可能面临更高的社会隔离风险,而耻辱感在社会隔离的形成中可能起重要作用。然而,其潜在的心理机制尚未得到充分研究。本研究探讨了造口接纳和有价值行为如何在患有永久性造口的CRC幸存者中,介导耻辱感与社会隔离之间的关系。

方法

对303名患有永久性造口的CRC幸存者进行了横断面调查。使用SPSS的PROCESS宏进行链式中介模型分析,以探索耻辱感通过造口接纳和有价值行为与CRC幸存者社会隔离相关联的途径。

结果

结果表明,较高的耻辱感与较低的造口接纳度、较少的个人价值观践行、较高的社会隔离度相关,同时与患有永久性造口的CRC幸存者较低的客观社会联系和主观社会归属感相关。此外,中介分析表明,造口接纳和有价值行为共同介导了耻辱感与社会隔离之间的关系。

结论

通过改善造口接纳和有价值行为的针对性干预措施,可能会减轻CRC幸存者在适应造口和耻辱感过程中的社会隔离。

对癌症幸存者的启示

造口接纳和有价值行为的链式中介作用凸显,考虑到这一人群的独特需求,可针对这一人群开展针对性干预措施,如接纳与承诺疗法。

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