Study On Self-Perceived Burden And Its Influential Factors In Colorectal Cancer Patients With Intestinal Stoma

Objective:This study used qualitative and quantitative research to investigate the status of self-perception burden and its related influencing factorsin colorectal cancer patients with enterostomy,to explore the relationship among self-feeling burden,medical coping methods,stigma of diseases,and stoma self-efficacy,to provide a theoretical basisfor reducing the patient's self-feeling burden and developing effective interventions.Methods:This study is divided into two parts.1.The first part of this study is also said the qualitative study which applied the phenomenological approach.After outlining an interview,semi-structured interviewswould be used when interviewing 15 colorectal cancerpatients with enterostomy.Noivo11 software would be used to code the interview results,and Colaizzi's seven-step methodwould be usedto analyze the data,refine the theme,and suimmarize the real feelingsof colorectal cancer patients with enterostomy.2.The second part of this study iscalled the quantitative study which used the method of questionnaire survey.165 colorectal cancer patients with enterostomy in four tertiary hospitals in Jinan,Shandong Province were enrolledfrom May to December 2018.The questionnaire included general demographic data and clinical results such as self-feeling burden,medical coping methods,diseases stigma,and enterostomy self-efficacy.SPSS22.0 software and R software were used to analysis related data including descriptive data analysis,one-way ANOVA,independent sample t test,Pearson correlation analysis,multiple linear regression analysis and mediation effect analysis.ResultS:1.The qualitative interviews extracted six major themes:daily inconvenience and embarrassment,high economic pressure,complex psychological feelings,lack of knowledge,reduced self-worth and positive factors experienced.2.The total self-receptive burden of colorectal cancer patients with enterostomywas(31.15±9.01),including body burden score(5.93±2.15),emotional burden score(18.68±5.69),and economic burden score(6.48±2.27)points.3.In the medical coping style of colorectal cancerpatients withenterostomy,the scores were(18.58±3.04),the avoidance score(15.56±2.63),and the yield score(10.80±2.87).4.The total score of disease stigma in colorectal cancer patients with enterostomy was(48.05±7.69)points,which was at a moderate level.The social exclusion score was(16.63±3.09)points,the economic discrimination score was(7.11±2.02)points,and internal shamescore was(7.80±1.88)points and the social isolation score was(16.43±3.34)points.5.The self-efficacy score of patients with colorectal post-enteral stoma was(74.11±20.02),at the level of secondary care,the self-efficacy of ostomy care was(38.12±10.25),and the social self-efficacy was(21.73±7.68)points.The choice was(2.81±1.08),the sexual life performance was(2.07±1.09),the sexual satisfaction was(2.02±1.07),which was the lowest score,and the heavy physical strength was(2.47±1.17)points.The vitality is(2.56±1.11)points,which is the highest score,and the ostomy is(2.55±1.07)points.6.The results of univariate analysis showed that the monthly income of the patient,the surgical method,the payment method,the time of retraction of the enterostomy and Doctor-patient communicationcould significantly influence the self-perception burden(P<0.05).In addition,the age was trend to influence the self-perception burden(0.05<P<0.1).7.Correlation analysis showed that the patient's self-feeling burden was negatively correlated with the faceand enterostomy self-efficacy(all P<0.05),and positively correlated with yield and diseases stigma(all P<0.05).8.Multiple regression results showed that age,gender,doctor-patient communication,surgical methods,surrender,social exclusion,and economic discrimination can explain 52.44%of the self-perception burden of enterostomy patients.9.The mediating effect test results showed that the mediating effect of the response mode of yielding on the stoma self-efficacy and self-feeling burden is-0.118,and the Risk ratio is 50.43%.The mediating effect of enterostomy in the self-efficacy and self-feeling burden were-0.176,and the effect ratio was 75.21%.In conclusion:1.Clinical health care workers should attach great importance to the real experience related to the self-feeling burden of colorectal cancer patients with enterostomy,and do some work in health education and continuing care.2.The self-feeling burden of colorectal cancerpatients with enterostomywere largely at moderate and above levels.3.The level of self-experience burden of colorectal cancer patients with enterostomy would be affected by gender,family monthly income,doctor-patient communication,surgical methods,payment methods,and the time of retraction of the enterostomy.4.Medical coping methods,enterostomy self-efficacy,and diseases stigma could also affect the self-experience burden of colorectal cancer patients with enterostomy.Patients with higher level of face of coping and self-efficacy would have lower self-feeling burden,while patients with higher yield of coping and diseases stigmawould have higherself-feeling burden.5.There is a mediating effect between diseasesstigma or yielding of coping andenterostomy self-efficacy or self-feeling burden.