Investigation And Intervention For The Stigma Of Colostomy Patients

Colostomy patients because defecation exit from the perineum to the abdomen,it’s integrity is destroyed,resulting in a negative discrimination by others,rejection of experience,and the manure cause aversion,nausea and other negative emotions,patients will internalize these negative experiences and emotional,so that patients felt shame or different from others,the formation of stigma associated with decreased self-esteem and social difficulties.Stigma as a kind of common psychological problems exist in a variety of disease,both at home and abroad has launched a comprehensive study for stigma,but lack of research on the colostomy stigma intervention,study of colostomy stigma intervention using WeChat education method,the researcher have not yet access to relevant reports.Objective To describe the stigma of colostomy patients,analyze the influencing factors,investigate the WeChat education intervention effect on stigma level in colostomy patients.To provide reference for the clinical nursing for the research of stigma.Method1.Investigation the stigma of colostomy patients and analyze the influencing factors: Convenience sampling method was used to select 200 cases meet the inclusion criteria colostomy patients from September 2015 to September 2016 in first affiliated hospital of Chongqing medical university.Survey information consists of general situation,stigma level and social psychological adaptability.Measurement tools involved includes general information questionnaire,Social Impact Scale(SIS),Ostomy Adjustment Inventory-20(OAI-20).2.Intervention for the stigma of colostomy patients: 100 cases of the disease at the level of the height stigma of colostomy patients,randomly divided into the intervention group and the control group,each of them was 50,intervention studies from October 2015 to January 2017.The intervention group was treated with WeChat,and the control group received routine nursing care.The patients before intervention and 12 weeks after intervention,respectively,using the modified version of the social impact scale,Chinese version of Ostomy Adjustment Inventory-20,investigate the stigma,social psychological adaptability,and two groups were compared,to explore the intervention effect of WeChat model.3.SPSS 22 software was used to analyze the data。Results1.178 questionnaires were recollected,the effective rate was 89%.Colostomy patients had a moderate level of stigma(55.60±9.12);Colostomy patients had a moderate level of social psychological adaptability(51.23±12.36).The social psychological adaptation of patients was negatively correlated with the level of ability of stigma(R=-0.522).2.In a multiple stepwise regression analysis,age,self-nursing ability,stoma acceptance and complication rate were included in the regression equation.They are affecting factors of the stigma.3.90 cases of colostomy patients finished intervention research each group 45 cases.Before intervention,the score of stigma was the control group vs.the intervention group as 53.62±9.47 points vs.54.70±9.45 points,P=0.088,there was no significant difference between two groups.After intervention 12 weeks,the score was the control group vs.the intervention group as 50.16±9.24 points vs.35.61±3.21 points,P=0.032.After intervention,intervention group with higher score than before intervention.There was significant difference between two groups,P=0.042.Conclusion1.Colostomy patients were in moderate and severe level of stigma.2.Age,degree of self-care,stoma acceptance and stoma complications are the main factors influencing the stigma of colostomy patients.Young patients,lower degree of self-care and stoma acceptance,with stoma complications,higher levels of stigma.3.WeChat education can improve the patient’s psychological adapt ability,reduce the stigma in patients with colostomy.