| Objective1 To investigate the status of self-disgust,self-esteem,stoma acceptance,social avoidance and distress in patients with permanent colostomy;2.To analyze the influencing factors of social avoidance and distress in patients with permanent colostomy;3 To explore the path of self-disgust on social avoidance and distress in patients with permanent colostomy through structural equation modeling,and to explore the mediating role of self-esteem and stoma acceptance in the path.MethodsThrough the convenience sampling method,patients with permanent colostomy in an ostomy clinic of a tertiary first-class hospital in Tianjin were selected as the research objects,and 487 patients with permanent colostomy who met the inclusion criteria were selected from May to October 2021.Questionnaire survey,survey tools include general information questionnaire,self-disgust scale,Rosenberg self-esteem scale,disease acceptance scale,social avoidance and distress scale.SPSS26.0 and AMOS26.0 were used for statistical analysis of data.General information,self-disgust,self-esteem,stoma acceptance,social avoidance and distress status of patients with permanent colostomy were used as mean±standard deviation,frequency,composition than description;the social avoidance and distress scores of the general information of patients with permanent colostomy were analyzed by independent samples t-test and one-way ANOVA;the self-disgust,self-esteem,stoma acceptance and The correlation between social avoidance and distress was analyzed by Pearson correlation;the influencing factors of social avoidance and distress in patients with permanent colostomy were analyzed by multiple linear regression;the path of the influence of self-disgust on social avoidance and distress in patients with permanent colostomy The relationship was tested using a structural equation model.1 The self-disgust score of patients with permanent colostomy was(38.29±5.41),which was at a high level,including the personal disgust dimension score(25.34±3.16)and the behavioral disgust dimension score(12.95±3.22).2 The self-esteem score of patients with permanent colostomy was(25.81±5.67),which was at a moderate level.3 The stoma acceptance score of patients with permanent colostomy was(22.94±5.74),which was at a medium level.4 The score of social avoidance and distress in patients with permanent colostomy was(14.08±6.81),which was at a moderately high level.The scores of social avoidance and social distress were(8.47±3.91)and(5.61±3.36)respectively.5 Permanent colostomy patients with different genders,marital status,place of residence,living conditions,occupational status,educational level,time after ostomy,oral care methods,stoma complications,and the number of stoma-related activities.The differences in social avoidance and distress were statistically significant(P<0.05).6 The overall and various dimensions of self-disgust in patients with permanent colostomy were negatively correlated with self-esteem(P<0.05);the overall and each dimension of self-disgust was negatively correlated with stoma acceptance(P<0.05);the overall and each dimension of self-disgust was negatively correlated with stoma acceptance There was a positive correlation with social avoidance and distress in general and each dimension(P<0.05);self-esteem was positively correlated with stoma acceptance(P<0.05);self-esteem was negatively correlated with social avoidance and distress in general and each dimension(P<0.05);Stoma acceptance was negatively correlated with social avoidance and distress in general and each dimension(P<0.05).7 The multiple linear regression of social avoidance and distress in patients with permanent colostomy showed that the influencing factors of social avoidance and distress included education level,living conditions,stoma care methods,self-disgust,self-esteem and stoma acceptance(P<0.05).The six variables explained 78.8% of the variance.Results8 The effect of self-disgust on social avoidance and distress in patients with permanent colostomy: self-disgust has a direct effect of 0.493 on social avoidance and distress;self-disgust has a direct effect on self-esteem-0.708;self-esteem has a direct effect on stoma acceptance The effect is 0.687;the stoma acceptance has a direct effect of-0.386 on social avoidance and distress.Self-disgust can indirectly affect social avoidance distress through self-esteem,with an indirect effect of 0.142;self-disgust can indirectly affect social avoidance distress through stoma acceptance,with an indirect effect of 0.087;The indirect effect was0.188,and the indirect effect was 0.188.Self-esteem could indirectly affect social avoidance and distress through stoma acceptance,and the indirect effect was 0.265.The mediating effect of self-esteem and stoma acceptance accounted for 45.82% of the total effect of self-disgust on social avoidance and distress.Conclusions1 In this study,patients with permanent colostomy had high levels of self-disgust;self-esteem and stoma acceptance were at moderate levels;social avoidance and distress were at moderately high levels.2 Self-disgust in patients with permanent colostomy was negatively correlated with self-esteem and stoma acceptance,and positively correlated with social avoidance and distress.Self-esteem and stoma acceptance were negatively correlated with social avoidance and distress.3 The influencing factors of social avoidance and distress in patients with permanent colostomy include educational level,living conditions,stoma nursing methods,self-disgust,self-esteem,and stoma acceptance.4 Self-disgust in patients with permanent colostomy can directly affect social avoidance and distress,and self-disgust can also affect social avoidance and distress through the chain mediating effect of self-esteem and stoma acceptance. |
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