Self-disgust and stigma both mediate the relationship between stoma acceptance and stoma care self-efficacy.

ABSTRACT

AIM: This paper is a report of a study exploring the relationship between stoma acceptance and stoma care self-efficacy in patients with colostomy and whether self-disgust and stigma play mediating roles in this relationship. DESIGN: A cross-sectional survey design. METHOD: In all, 476 participants were recruited from a tertiary hospital and completed structured, anonymous, self-report measures of stoma acceptance, self-disgust, stigma, and stoma care self-efficacy between January 2016-March 2017. RESULTS: Stoma acceptance was significantly negatively associated with personal disgust (r = -.640, p<.001), behavioural disgust (r = -.384, p<.001), and stigma (r = -.309, p<.001) and significantly positively associated with stoma care self-efficacy (r = .689, p<.001). Furthermore, regression-based mediation modelling showed that personal disgust and stigma had significant mediating effects on stoma acceptance and stoma care self-efficacy. CONCLUSION: We demonstrated, for the first time, that emotional responses (self-disgust and stigma) play important roles in the association between stoma acceptance and stoma care self-efficacy. Addressing concerns about emotional disorder should become part of the routine care for patients with stoma. IMPACT Patients with colostomy must cope with many challenges and undergo profound changes in daily life. Acceptance of the existence of the stoma and effective management of the stoma can aid patients in the return to a full and active life. Illness acceptance and psychological states have been widely reported to be correlates of the ability to successfully reconstitute a meaning of life, but these have not been specifically explored in patients with colostomy. This study examined the effect of stoma acceptance on stoma care self-efficacy with the mediation role of self-disgust and stigma. Evidence of the relationship between illness acceptance and self-efficacy could offer practitioners to consider emotional factors like self-disgust and stigma when aiming to improve stoma care and management.