| Objectives(1)The status of psychological flexibility,psychological distress,social support and social isolation of colostomy patients in three Grade A general hospitals in Jinan City and the influencing factors of social isolation were investigated by questionnaire.(2)To explore the correlation between variables and the effects of psychological distress and social support on psychological flexibility and social isolation in patients with colostomy.The purpose is to provide reference for clinical nurses to improve the psychological flexibility of patients,reduce the degree of social isolation of patients and improve the quality of life of patients.MethodsThis study was designed as a cross-sectional study.Convenient sampling method was adopted to select patients with colorectal cancer ostomy who visited outpatient clinics of three Grade A hospitals in Jinan,Shandong Province from January 2022 to December 2022.The survey tools including general information questionnaire,General isolation Scale、Commitment Action Questionnaire,Distress Management Screening Measure,perceptive social support scalewere used to investigate.Descriptive statistics,single factor analysis,Pearson correlation analysis and PROCESS plug-in mediating effect and moderating effect test were used in SPSS 26.0 software.ResultsA total of 274 questionnaires were sent out in this study and all of them were recovered.7 unqualified questionnaires were excluded and 267 valid questionnaires were retained,with an effective recovery rate of 97.4%.I.The total score of social alienation of colorectal cancer stoma patients was(35.22±8.73),and the mean score of entries was(2.35 ± 0.58),with an average overall score at a medium level;the mean scores of dimensional entries were,from highest to lowest,powerlessness dimension(2.67±0.70),social isolation dimension(2.52±0.76),self-alienation dimension(2.50±0.82),and the sense of meaninglessness dimension(1.48±0.48)scores.2.The total score of psychological flexibility of patients with colostomy was(29.16 ±7.32),and the scores of positive and negative items were(16.03±4.57)and(13.13±4.89),respectively,among which the average score of positive items was higher than that of negative items.3.According to the DT survey,the lowest score was 1 point,the highest score was 10 points,and the mean ± standard deviation was 4.52±2.26.Among 267 patients with colorectal cancer ostomy,184 patients had DT scores≥4 points,and the detection rate was 68.9%.Top 10 problems related to psychological distress in patients with colorectal cancer ostomy The factors were emotional worry(59.6%),relationship with children and the elderly(54.3%),financial problems(53.6%),getting along with partners 50.2%,and getting along with relatives and friends 48.7%,bathing/dressing(47.2%),memory loss(43.4%),concentration problems(43.4%),physical activity restriction(42.3%)and lack of time to care for children and the elderly(41.6%).4.The total score of perceived social support was(62.90±12.34).Among the three dimensions,the perceived family support dimension scored the highest(22.48±4.41),while the perceived friend support dimension scored the lowest(19.91±4.87).5.Univariate analysis showed that social isolation scores of patients with colostomy were statistically significant in education,occupation,residence,average family monthly income,and whether there were ostomy complications(P<0.05).The pairings of multiple categorical variables showed that the scores of social isolation in the group with primary school education or below were higher than those in the other groups(F=2.650,P=0.034);Farmers currently score higher on social isolation than patients in other occupations(F=1.984,P=0.041);The scores of social isolation in rural areas were higher than those in other groups(F=3.633,P=0.013).Patients with average monthly family income of 2001-4000 yuan scored higher than those in the other two groups(F=4.122,P=0.001).6.Pearson correlation analysis showed that social isolation was negatively correlated with psychological flexibility(r=-0.576,P<0.01),and was positively correlated with psychological distress(r=0.3 58,P<0.01).Psychological flexibility was negatively correlated with psychological distress(r=-0.353,P<0.01).7.The findings of the mediating effect analysis revealed that psychological distress had a partial mediating effect on psychological flexibility and social lienation in colostomy patients,accounting for 10.93%of the total effect.8.The results of regression analysis showed that,after controlling for the control variables,the coefficient of interaction between psychological distress and perceived social support was significant(β=0.144,P<0.05),indicating that perceived social support had a moderating effect on psychological distress and social isolation.When the level of social support is high,the effect of psychological distress on social isolation can be weakened.Conclusions1.In this cross-sectional survey,the psychological flexibility,psychological distress and social isolation of colostomy patients were all at a moderate level.2.Education level,occupation,place of residence,monthly family income and the presence or absence of ostomy complications are the influencing factors of social isolationg in colostomy patients.3.There is a correlation between the psychological flexibility,psychological distress and social isolation in patients with colostomy.The higher the psychological flexibility,the lower the psychological distress and the lower the degree of social isolation.4.Psychological distress in colostomy patients plays a partial mediating role between psychological flexibility and social isolation.5.Social support plays a moderating role in the relationship between psychological distress and social isolation in colostomy patients.The higher the social support,the weaker the effect of psychological distress on social isolation. |
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