A longitudinal study on dynamic trajectories and influencing factors of psychosocial adaptation among colorectal cancer stoma patients.

PURPOSE: This study explored psychosocial adaptation trajectories and influencing factors in colorectal cancer stoma patients from one day before discharge to 6 months post-discharge, to guide relatively targeted nursing interventions.

METHODS

232 stoma patients were recruited from two tertiary hospitals in Shanxi, with follow-up at one day before discharge, 1, 3, and 6 months. Data were analyzed via latent class growth modeling and multivariate logistic regression.

RESULTS

207 patients completed follow-up (10.8% dropout). Three trajectories were identified: moderate adaptation with steady improvement group (19.3%), low adaptation with continuous improvement group (53.6%), and low adaptation with fluctuating adjustment group (27.1%). Significant predictors included per capita monthly income, stoma location, stoma complications, stoma care knowledge, stoma self-care, self-efficacy, perceived discrimination, and social support (P < 0.05).

CONCLUSIONS

Psychosocial adaptation trajectories in stoma patients show clear heterogeneity, with distinct factors linked to different trajectory classes. Nurses should screen for trajectory subgroups, prioritize the low adaptation with fluctuating adjustment group, and deliver personalized interventions to enhance psychosocial adaptation.