| Objective:(1)To investigate the status of post-traumatic stress disorder(PTSD)in rectal cancer enterostomy patients;(2)To analyze the influencing factors of PTSD in rectal cancer enterostomy patients;(3)To explore the correlation of self-transcendence,resilience,Fear of Cancer Recurrence(FCR),social support and PTSD;(4)To clarify the main influencing factors causing PTSD in patients,and analyze the mediating effects of factors affecting PTSD in patients with enterostomy for rectal cancer,so as to provide theoretical basis for the implementation of comprehensive and individualized intervention measures to alleviate PTSD.Methods: In this study,540 patients with colorectal cancer enterostomy who met the inclusion criteria in the departments of enterology and oncology of 6 general hospitals in Hunan Province were selected by multi-stage cluster sampling method from January 2022 to December 2022.The patients were quantitatively assessed by the General demographic data Questionnaire,the PostTraumatic Stress Disorder Scale(PCL-C),the self-transcendence questionnaire,the Resilience Scale(CD-RISC),the Simplified Fear of Disease Progression Scale(FOP-Q-SF),and the Social Support Scale(SSRS).Excel software was used to input the collected original data and establish a database.SPSS26.0 software was used to conduct statistical analysis of the data,mainly using descriptive analysis,independent sample t test,single factor ANOVA analysis,Pearson correlation analysis and multiple linear regression analysis.The mediation effect was analyzed using the Bootstrap sampling test method in AMOS.Results:(1)The average score of post-traumatic stress disorder was(44.28±14.36).The level of self-transcendence,resilience,social support and fear of cancer recurrence all had an impact on PTSD.Gender,education,average monthly income,form of medical security,family relationship,primary carer,time after ostomy operation,time to replace the ostomy bag,self-care ability of the ostomy,daily time to care for the ostomy,and acceptance of the ostomy were statistically significant differences in the total score of PTSD(P<0.05);(2)The average score of selftranscendence in rectal cancer enterostomy patients was(35.17±10.8).Marriage,occupation,place of residence,income,form of medical security,family relationship,primary carer,postoperative time,self-care ability of stoma,daily nursing time of stoma,stoma acceptance,postoperative complications,duration of rectal cancer disease,and total hospital stay of rectal cancer patients had statistically significant differences in self-surpassing score(P<0.05);(3)The mean score of stress tolerance was(51.65±10.62),and there were statistically significant differences in the total score of stress tolerance among different occupations,family residence,religious belief,average monthly family income,forms of medical security,family relationship,health status of main caregivers,nursing ostomy time,ostomy acceptance,duration of rectal cancer,and length of hospital stay(P<0.05);(4)Average FCR score(40.38±9.46)points,age,marriage,occupation,income,main caregiver,time after enterostomy operation,time to replace the ostomy bag,ostomy self-care ability,daily time to care for the ostomy,and acceptance of the ostomy had statistically significant differences in the total score of fear of recurrence(P<0.05);(5)The average score of social support was(38.93±9.13),Gender,marriage,occupation,family residence,average monthly family income,form of medical security,family relationship,time after enterostomy operation,time to change the ostomy bag,health status of main caregivers,self-care ability of ostomy,daily nursing time of ostomy,acceptance of ostomy,whether there are complications,duration of rectal cancer,total length of hospital stay in total social support differences specific statistics Academic significance(P<0.05);(6)Pearson correlation analysis showed that self-transcendence was significantly negatively correlated with PTSD and FCR in colorectal cancer enterostomy patients(r=-0.525,P<0.01,r=-0.268,P<0.01),positive correlation with stress resistance and social support(r=0.256,P<0.01,r=0.549,P<0.01);There was a significant negative correlation between stress resistance and post-traumatic stress disorder and cancer disease fear(r=-0.307,P <0.01,r=-0.275,P <0.01),was positively correlated with social support(r=0.293,P<0.01);There was a significant positive correlation between the total score of recurrent fear and PTSD(r=-0.364,P<0.01)was negatively correlated with social support(r=-0.244,P<0.01);There was a significant negative correlation between social support and PTSD(r=-0.639,P<0.01);(7)Multiple linear regression analysis shows that: Gender,education background,average monthly family income,form of medical security,family relationship,primary caregiver,time after permanent enterostomy operation,time to replace the ostomy bag,self-care ability of stoma,time required to care for stoma,acceptance of(permanent)stoma)and self-transcending,resilience,fear of cancer recurrence,and total score of social support were independent variables for regression model analysis.R2 was 0.525,which could explain 52.5% variation of the dependent variable;8)The results of mediating effect analysis showed that self-transcendence,resilience and fear of cancer recurrence could be the mediating factors affecting PTSD in rectal cancer enterostomy patients.Social support can not only directly affect PTSD,but also indirectly through self-transcendence,resilience,and fear of relapse.Relapse fear had the strongest mediating effect between social support and PTSD(29.2%),followed by self-transcendence(27.1%),and the weakest mediating effect between social support and PTSD(9.5%).Conclusions:(1)In this study,the positive rate of post-traumatic stress disorder in rectal cancer enterostomy patients was 61.85%,and the status of self-surpassing was at a medium level,the level of resilience was at a low level,the score of fear of recurrence was high,and the social support was at a medium level;(2)Gender,education background,average monthly family income,form of medical security,main caregivers,time after permanent enterostomy,nursing time and acceptance of(permanent)stomy are the main factors affecting post-traumatic stress disorder in rectal cancer enterostomy patients.Social support can not only directly affect PTSD,but also indirectly through self-transcendence,resilience,and fear of relapse;(3)Self-transcendence,resilience,FCR,social support and post-traumatic stress disorder were correlated in patients with enterostomy for rectal cancer.The higher the level of self-transcendence,the higher the resilience and the more social support patients received,the less fear of cancer and the lower the level of post-traumatic stress disorder. |
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