Study On Correlation Between Stress And Coping, Social Support Among Pre-discharged Rectal Cancer Patients With Permanent Colostomy

Objectives 1. To explore the major stressors among pre-discharged Rectal Cancer Patients with Permanent Colostomy;2. To identify the level of stress and Social Support and major coping strategies among pre-discharged Rectal Cancer Patients with Permanent Colostomy;3. To examine the relationship between stress and major coping strategies and the relationship between stress and Social Support;4. To explore the predicted factors of stress;Methods English version'the Stress of Colostomy Patients Scale'was translated, and back-translated, andrevised.Five experts were evaluated for the content validity.A pilot study was taken for making sure the feasibility of the questionnaire,estimating the sample size,and testing validity and reliability。It was a cross-sectional survey。The target population was Rectal Cancer Patients with Permanent Colostomy。Five state-own tertiary hospitals in Changsha, Hunan, were chosen by cluster sampling。They were three affiliated hospital of central south university, hunan Cancer hospital and hunan people's hospital。The Stress of Colostomy Patients Scale, Jalowiec coping scale, and Social Support Scale were used to measure the stressors, Stress, Coping and Social Support among pre-discharged Rectal Cancer Patients with Permanent Colostomy.The data were analyzed with software SPSS13.0.Results 1. The Chinese version of The Stress of Colostomy Patients Scale was consistent with the original version and the result from the invited experts'assessment was satisfactory.The content validity index (CVI) was 0.88.2. Internal consistency analysis showed that the overall Conbach's a of The Stress of Colostomy Patients Scale was 0.92,and the Conbach's a of the subscales were from 0.76-0.88,and this scale has a better internal coherency.3. The five major stressors were'I worry about the recurrence of the disease';'I worry that my drainage appliance will drop out unexpectedly';'I don't know how to care for my colostomy complications';'My family members have increasing burdens from my colostomy care'; and'I worry that exercise and physical activities are harmful to the colostomy'.The stressors comes'Stressors from change in physical status'and'Stressors from colostomy care'4. Colostomy patients before discharge had a moderate level of stress (2.30±0.70), while 18.86% patients had a high level of stress; 47.54% patients had a moderate level of stress; 26.28% patients had a low level of stress; and only 7.38% had no stress.5. Demographic data of patients patients such as sex different, age, residence, working position,family relationship,family income, uninformed to stoma surgery and whether there were stoma therapy nurse had significant influence on the stress of colostomy patients(p<0.05).6. The colostomy patients used both of problem-focused coping and emotion-focused coping,but they mainly used problem-focused coping; The score of problem-focused coping was 2.46±0.67, the score of emotion-focused coping was 2.01±0.61.But the colostomy patients mainly used problem-focused coping(P<0.01).The score of social support was 63.91±7.86,patients receiving the most support from their family, followed by other people(1eaders, relatives and colleagues) and friends(P<0.01). Problem-focused coping was negatively correlated with theirstress(P<0.05),and emotion-focused coping was positively correlated with their stress(P<0.01).The social support of colostomy patients was negatively correlated with stress(P<0.01).7. Stepwise regression analysis revealed that stress related family income, problem-focused coping, age,whether they konw stoma surgery, social support,and emotion-focused coping were included to the regression equations in which the stress was as dependent variables.Conclusion 1. The main stressor was'Stressors from change in physical status',followed'Stressors from colostomy care'.2.64.09% of the colostomy patients before discharge had a moderate level of stress.3. The colostomy patients mainly used problem-focused coping, Problem-focused coping was negatively correlated with theirstress,and emotion-focused coping was positively correlated with their stress. Patients receiving the most support from their family, followed by other people(1eaders, relatives and colleagues) and friends. The social support of colostomy patients was negatively correlated with stress.4. Demographic data of patients patients such as age,family income,whether they know stoma surgery,coping and social support and so on.