结直肠癌造口患者病耻感与生活质量的相关性研究

A Correlational Study of Stigma and Quality of Life in Colorectal Cancer Patients with an Ostomy

摘要: 目的：调查结直肠癌造口患者的病耻感及生活质量现状，分析两者的相关性，并探讨生活质量的影响因素。方法：采用便利抽样法，选取2023年11月至2025年12月在广州市某三级甲等医院胃肠外科就诊的239例结直肠癌造口患者作为研究对象。纳入标准：经病理学确诊为结直肠癌，已行肠造口手术，年龄 ≥ 18周岁，意识清楚，知情同意。采用一般资料调查表、社会影响量表(SIS)和EORTC QLQ-CR38量表进行横断面调查。采用SPSS 26.0进行统计分析，组间比较采用t检验或单因素方差分析，相关性采用Pearson相关分析，影响因素采用多元线性回归分析。结果：239例患者SIS总分为(54.62 ± 10.51)分，条目均分为(2.28 ± 0.44)分。轻度病耻感58例(24.3%)，中度175例(73.2%)，重度6例(2.5%)。病耻感总分与造口相关问题呈正相关(r = 0.606)，与身体形象(r = −0.374)、未来期望(r = −0.398)呈负相关(均P < 0.001)。病耻感是造口相关问题(β = 0.532)、身体形象(β = −0.165)和未来期望(β = −0.171)的独立影响因素(均P < 0.001)。结论：结直肠癌造口患者病耻感处于中等水平，病耻感与生活质量呈显著负相关，且病耻感是生活质量的独立影响因素。临床护理人员应重视病耻感的筛查与干预。

Abstract: Objective: To investigate the current status of stigma and quality of life in colorectal cancer patients with an ostomy, analyze their correlation, and explore the influencing factors of quality of life. Methods: Using a convenience sampling method, 239 colorectal cancer patients with an ostomy who attended the Department of Gastrointestinal Surgery in a tertiary Class A hospital in Guangzhou from November 2023 to December 2025 were selected as subjects. Inclusion criteria: Pathologically confirmed colorectal cancer, having undergone ostomy surgery, aged ≥18 years, conscious, and provided informed consent. A cross-sectional survey was conducted using a general information questionnaire, the Social Impact Scale (SIS), and the EORTC QLQ-CR38 scale. Statistical analysis was performed using SPSS 26.0. Inter-group comparisons were made using t-test or one-way ANOVA, correlation analysis used Pearson correlation, and influencing factors were analyzed by multiple linear regression. Results: The total SIS score of the 239 patients was 54.62 ± 10.51, and the average item score was 2.28 ± 0.44. Mild stigma was found in 58 cases (24.3%), moderate in 175 cases (73.2%), and severe in 6 cases (2.5%). The total stigma score was positively correlated with ostomy-related problems (r = 0.606), and negatively correlated with body image (r = −0.374) and future expectations (r = −0.398), all P < 0.001. Stigma was an independent influencing factor for ostomy-related problems (β = 0.532), body image (β = −0.165), and future expectations (β = −0.171), all P < 0.001. Conclusion: The stigma level of colorectal cancer patients with an ostomy is moderate. Stigma is significantly negatively correlated with quality of life, and it is an independent influencing factor of quality of life. Clinical nurses should pay attention to the screening and intervention of stigma.