Influence of Disability Acceptance on the Psychological Distress of Patients with Permanent Stoma:A Chain Mediating Effect Model

ZHANG Zhenzhen; SONG Lifang; LIU Xiaoyan; SHI Xiaoyan

doi:10.3969/j.issn.1004-437X.2025.13.013

Abstract：Objective To analyze the impact of disability acceptance on the psychological distress of patients with permanent stoma through the chain mediating effect model.Methods A total of 326 patients with permanent stoma admitted to the Second Affiliated Hospital of Zhengzhou University from July 2021 to July 2024 were selected as the research subjects.A general information questionnaire,acceptance of disability scale(AODS),self-management ability questionnaire,Chinese-posttraumatic growth inventory(C-PTGI),and distress thermormeter(DT)were used for investigation.The DT scores of patients with different demographic characteristics were compared.The Pearson method was used to analyze the correlation between disability acceptance,self-management ability,post-traumatic growth,and psychological pain.The chain mediation effect model was used to analyze the chain mediation effect of self-management ability and post-traumatic growth on the relationship between disability acceptance and psychological pain in permanent stoma patients,which was validated by Bootstrap method.Results A total of 326 questionnaires were distributed,and 217 valid questionnaires were collected.The DT scores of the 217 patients with permanent stoma were(4.59±1.36)scores.There were statistically significant differences in DT scores among patients with permanent stoma with different educational backgrounds,monthly household incomes,and complications(P＜0.05).The AODS scores of the 217 patients with permanent stoma were(74.12±6.18)scores,the self-management ability scores were(96.86±11.59)scores,and the C-PTGI scores were(59.32±5.14)scores.Correlation analysis showed that AODS scores were positively correlated with self-management ability(r=0.796,P＜0.001)and C-PTGI scores(r=0.835,P＜0.001),and negatively correlated with DT scores(r=-0.768,P＜0.001).Self-management ability was positively correlated with C-PTGI scores(r=0.770,P＜0.001)and negatively correlated with DT scores(r=-0.813,P＜0.001).C-PTGI scores were negatively correlated with DT scores(r=-0.787,P＜0.001).The chained mediation effect model showed that post-traumatic growth and self-management ability played a chained mediation effect between disability acceptance and psychological distress(95％ CI:0.132-0.876).Conclusion The acceptance of disability not only directly affects the psychological distress of patients with permanent stoma,but also reduces the degree of psychological distress through the chain mediating effect of post-traumatic growth and self-management ability.