Analysis of stigma in patients with rectal cancer and permanent enterostomy and its influencing factors

Abstract

Objective To investigate the stigma of patients with rectal cancer and permanent enterostomy and its influencing factors. Methods Totally 101 patients with rectal cancer and permanent enterostomy were selected from six tertiary hospitals of a province in central China from September 2013 to October 2014 by convenience sampling method. The questionnaire survey and social impact scale (SIS) were used to investigate participants′ general information and stigma issues. T-test, analysis of variance (ANOVA) , and linear multivariate stepwise regression analysis were used to analyze the influencing factors of stigma. Results The total SIS score of 101 participants was (60.7±10.4) . The scores for social exclusion, economic discrimination, intrinsic stigma, and social isolation were (21.8±4.3) , (8.0±1.9) , (12.7±2.5) and (18.2±3.6) . The scores of all dimensions in SIS for patients with rectal cancer and enterostomy were higher than general cancer patients. The top five items were: need more concern, adverse impact on career, embarrassing conditions, economic burden, and worse health status. Single factor analysis and multiple-factor analysis indicated that the communication with doctors and nurses had an impact on patients′ stigma level(P<0.05). Conclusions The stigma of patients with rectal cancer and enterostomy was at a moderate level, and it can be influenced by the communication with medical staff. Thus, patients should be taught about the nursing skills and mental adjustment methods before their discharge. After their discharge, continuous nursing care and other supports (e.g. providing professional information, organizing communicating and educational activities, and cooperating with community nurses) should be achieved. Key words: Cross-sectional studies; Rectal neoplasms; Enterostomy; Stigma; Influencing factors