Relationship Between Health-related Behavior And Quality Of Life In Patients With Permanent Enterostomy

Objective To research the situation of self-disclosure,rumination,loneliness,health promoting behavior and quality of life on patients who were subjected to permanent ostomy,and to analyze the correlation among self-disclosure,rumination,health promoting behavior and quality of life,and to explore the path of self-disclosure,rumination,loneliness and health promoting behavior on quality of life,thereby providing reference to take effective psychologyl and behavior guidance,improve the prognosis and enhance quality of life on patients with permanent ostomy.Methods The study is a cross-sectional survey.Through the use of convenient sampling method,a total of 225 permanent enterostomypatients whoreview and participated in the stoma Association were enrolled in this study from November 2014 to September 2016 in Qingdao,in there tertiary A hospital.And the Distress Disclosure Index,Ruminative responses scale,Uiversity of California Los Angeles Loneliness Scale-8,the Health-Promoting Lifestyle Profile ?,Chinese Version of City of Hope Quality of Life-Ostomy Questionnaire and General social demographic data of the patients were respectively used to investigate the patient's health-related behavior and quality of life.The Statistical package of SPSS17.0 and AMOS21.0 were used to analyze all of the data.The main statistical analysis methods included: destriptive analysis,independent sample t test,one-way analysis of variance(ANOVA),Pearson correlation analysis,Multivariate linear regression analysis and structural equation model.Results1.The average score for self-disclosure of patients with permanent enterostomy was30.35 ± 8.09.And the influencing factors of self-disclosure included gender,age,education level,resident situation,daily nursing stoma time and stoma complications.2.The mean score for rumination was 2.44 ± 0.46,it was symptom rumination, brooding and reflective pondering arranging from high to low.And the influencing factors of rumination included gender,daily nursing stoma time,stoma postoperative time,current working condition,stoma complications and situation of postoperative radiotherapy and chemotherapy.3.The average score for loneliness was 19.81 ± 3.77.And the influencing factors of loneliness included stoma postoperative time,marital status,education level,gender,current working condition,stoma complications and situation of postoperative radiotherapy and chemotherapy.4.The average score of health promoting behavior was 122.76 ± 25.00,it was interpersonal relations,nutrition,physical activity,health responsibility,spiritual growth and stress management arranging from high to low.And the influencing factors of health promoting hehavior included daily nursing stoma time,education level and occupation.5.The average score of quality of life was 4.84 ± 0.92,it was mental health,spirital health,physical health and social health arranging from high to low.And the influencing factors of quality of life included daily nursing stoma time and education level.6.The results of the pearson correlation analysis showed that:self-disclosure scores were negatively correlated with ruminationandloneliness(r=-0.762;r=-0.372,P<0.01);self-disclosure were postively correlated with health promoting behaviors and quality of life(r=0.527;r=0.411,P<0.01);there were a significant positive correlation between rumination scores and loneliness(r=0.593,P<0.05);rumination scores were negatively correlated with health promoting behaviors and quality of life(r=-0.523;r=-0.405,P<0.01);loneliness scores were negatively correlated with health promoting behaviors and quality of life(r=-0.525,r=-0.430,P<0.01);health promoting behaviors scores were postively correlated with quality of life(r=0.840,p<0.01).7.Structural equation model showed that self-disclosure may predict quality of life directly forward positive way(?=0.124,P<0.05),loneliness had a negative predictive role on quality of life(?=-0.124,P < 0.05),health promoting behavior had a positive predictive role on quality of life(?=0.831,P<0.001),rumination had a negative predictive role on quality of life(?=-0.452,P<0.01).In the path of self-disclosure for the quality of life,rumination,loneliness,health promoting behavior played a part of intermediary role,and the mediating effect values were respectively accounted for 53.69%?7.06%?19.78%of the total effect;in the path of loneliness for the quality of life,health promoting behavior played a part of intermediary role,and median effect accounted for 48.55% of the total effect;in the path of rumination for quality of life,loneliness and health promoting behavior played a part of intermediary role,and the mediating effect values respectively accounted for 7.89% and 43.30% of the total effect.Conclusion1.Education level,daily nursing stoma time,stoma postoperative time and so on,there were a certain degree of impact on self-disclosure,rumination,loneliness,health promoting behavior and quality of life.2.There were positive correlations between self-disclosure,health promoting behavior and quality.And and rumination and loneliness were negatively correlated with quality of life.3.Self-disclosure may directly affect patients?quality of life,and rumination,loneliness and health promoting behavior can also be used as mediating variables to regulate the impact of self-disclosure on quality of life;loneliness may directly affect quality of life,and health promoting behavior can also be used as mediating variable to regulate the relationship between them;rumination may directly affect quality,and loneliness and health promoting behavior can also be used as mediating variables to adjust the impact of rumination on the quality of life.