| ObjectiveThis study was to investigate the level of acceptance of disability,coping modes,quality of life and analyse their factors in patients with a permanent colostomy;and test the mediator of coping modes between acceptance of disability and quality of life to provide reference basis for guiding patients to choose effective coping modes and improving the quality of life in patients with a permanent colostomy.Methods234 patients with a permanent colostomy were included with convenient sampling during November 2014 to September 2016.To investigate demographic data and disease related data,acceptance of disability,coping modes and quality of life of patients,all participants were tested with demographic characteristics,Acceptance of Disability Scale(AODS),Medical Coping Modes Questionaire(MCMQ)and City of Hope-Quality of life-Ostomy Questionaire(COH-QOL-OQ).All data were analyzed by SPSS version 17.0 and AMOS version 21.0.The measurement data was statistically descripted using mean,standard deviation,and enumeration data using frequency,percentage.T-test,one way analysis of variance and multiple linear regression were used to analyze the influencing factors of acceptance of disability,coping modes and quality of life,respectively.Pearson correlation analysis was used to analyze the correlation between acceptance of disability,coping modes and quality of life.Path analysis was employed to test the mediator of coping modes between acceptance of disability and quality of life.Results1.For these patients,the total score of acceptance of disability was 77.68±5.55,at a moderate level.The standardized score of the attributes of body form was 55.75,at the lowest level,and the standardized score of the expansion of value,the change from comparative value to intrinsic value and the tolerance of disability were 23.64±2.33,11.15±2.17,21.98±2.52 and 20.91±2.46,respectively.The influcing factors of acceptance of disability were age,family average monthly income and stoma self-care ability.2.The scores of confrontation,avoidance and resignation were 18.98±3.68,16.00±3.15,and 9.86±3.03,respectively.The total score of confrontation was lower than norms in China(P=0.040),and the total score of avoidance and resignation were higher than norms in China(P<0.001).The influcing factors of coping modes were age,family average monthly income and stoma self-care ability.3.The total score of quality of life was 4.48±0.66.The average scores of all dimensions were as follows:physical health 0.44±0.11,mental health 0.42±0.09,social health 0.54±0.12 and emotional health 1.23±0.22,respectively.The influcing factors of quality of life were degree of education,family average monthly income,postoperative time,stoma self-care ability,complications.4.The correlation between different coping modes and the dimensions of acceptance of disability were as follows:confrontation and expansion of value,tolerance of disability,attributes of body form positively correlated(r=0.168?0.163?0.162,P<0.05 or P<0.01);avoidance and attributes of body form negatively correlated(r=?0.265,P<0.01);resignation and all the dimensions of acceptance of disability negatively correlated(r=?0.143~?0.244,P<0.05 or P<0.01).The correlation between different coping modes and the dimensions of quality of life were as follows:confrontation and social health positively correlated(r=0.188,P <0.01);avoidance and all the dimensions of quality of life negatively correlated(r=?0.175~?0.250,P<0.01);resignation and all the dimensions of quality of life negatively correlated(r=?0.142~?0.255,P<0.05 or P<0.01).The correlation between the dimensions of acceptance of disability and the dimensions of quality of life were as follows:change from comparative value to intrinsic value and physical health,social health positively correlated(r=0.178 ? 0.226,P <0.01);expansion of value and social health positively correlated(r=0.170,P <0.01);tolerance of disability and all the dimensions of quality of life positively correlated(r=0.194~0.295,P<0.01);attributes of body form and physical health,mental health,emotional health positively correlated(r=0.189?0.187?0.315,P<0.01).5.Different coping modes had partial or complete mediating effect between acceptance of disability and quality of life.The three structural models obtained from this research,the path model of confrontation as the intermediary variable could explain the dimension variasion of social health 9.7%,and the mediating effect of confrontation accounted for the total effect 15.13% and 100%;the path model of avoidance as the intermediary variable could explain the dimension variasion of mental health,physical health,social health,mental health dimension 5.7% ? 4.9%? 4.2% and 12.5%,and the mediating effect of avoidance accounted for the total effect 15.64%?20.90%?25.28%?100%;the path model of resignation as the intermediary variable could explain the dimension variasion of mental health 8.1%,and the mediating effect of resignation accounted for the total effect 14.64% and 100%.Conclusion1.Acceptance of disability,coping modes and quality of life were all affected by family average monthly income,stoma self-care ability and other demographic data and disease related data.2.Patients with permanent colostomy could not fully accept the fact that their own disability,and they were more concerned about the impact of disability on physical function and external image.3.Patients with permanent colostomy adopted a variety of coping modes in the face of disease and disability,and they were less likely to adopt the coping modes of confrontation,but more coping modes of avoidance and resignation.4.There was a correlation between acceptance of disability,coping modes and quality of life in patients with permanent colostomy,and coping modes could be used as mediator variable to adjust the influence of acceptance of disability on quality of life. |
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