Guodong Han

Date of Completion

2022

Document Type

Thesis

Degree Name

Master of Arts in Nursing

Keywords

Social Support, Ostomy, Adaptation, Psychological

Abstract

Introduction:The purpose of this study is to understand the current situation of social support and adaptation of ostomy patients, analyze the factors affecting the adaptation of ostomy patients and their relationships, and provide theoretical references and nursing countermeasures to promote the adaptation of ostomy patients.

Methods: In this study, a convenience sampling method based on Roy's theory and a cross-sectional study design were used to collect quantitative data by facilitating

a questionnaire survey through the Questionnaire Star software. Thirty-five post- ostomy patients who were followed up in an outpatient clinic in a tertiary care

hospital in Liao Cheng City, Shandong Province, from February 2022 to March 2022, were selected for the ostomy patient General Information Questionnaire, the Multidimensional Scale of Perceived Social Support (MSPSS) and the Ostomy Adaptation Scale (OAS), after all patients agreed and signed the researcher-issued informed consent form. Data analysis included descriptive analysis, percentages, standard deviations and multiple linear regression analysis.

Conclusion: From the data presented, we constructed and described the following conclusions from the questions posed at the beginning of the study.

1. The participants are mainly male, aged 46-61 years old, mostly with a bachelor's degree in education, married, with an average monthly household income of 3000-5000 RMB, and the type of ostomy was mostly permanent, with the duration of ostomy mostly between 1-3 months.

2. The overall social support level of ostomy patients was high (M=5.73, SD=1.16). Patients with ostomy received the most support from their significant others or spouses, followed by support from friends, leaders and colleagues, and the least support from relatives.

3. The overall level of adaptation of patients with ostomy was moderate (M=4.29, SD=0.69). Patients with ostomy had the highest level of physical adaptation, followed by the level of psychological adaptation and the least level of social adaptation.

4. The results of correlation and multiple regression analyses show that the social support of ostomy patients was significantly correlated with the level of patient's ostomy adaptation. This suggests that improving ostomy adaptation in patients with enterostomies can be accomplished by improving patients' social support. The multiple linear regression model predicted 68.44% of the variance in the level of adaptation of ostomy patients, using the f-test, which was statistically significant. The independent variables that were significant predictors of level of adaptation in ostomy patients were overall level of support and a high school education. In the multiple regression equation for this study, the junior high school degree was used as a reference for the high school degree with a correlation coefficient of -1.530. That is, after controlling for all other covariates, participants who completed a high school degree had a significantly lower level of adaptation compared to those who completed only a junior high school degree.

This study provides strong evidence that the support of significant others, family support and friends support play an important role in facilitating adaptation. This suggests that social support is an important factor influencing the adaptation of patients with ostomy and that the level of adaptation of patients with ostomy can be improved by increasing the social support of patients.

Recommendations: The following recommendations are made based on the findings of the aforesaid study:

1. To ostomy patients

This study concludes that social support is significantly correlated with the level of adaptation of patients with ostomy. For patients with ostomy, social support can be improved by increasing all aspects of the patient's social support, including the support of significant others, family support, and friend support. It can successfully regulate the patient's own state and perception of the ostomy, increase mental toughness, minimize emotional suffering due to social image pressure, and instill confidence in ostomy treatment, thus minimizing negative feelings like anxiety and fear. Support in all parts of the patient's life can assist in lessening the patient's feelings of helplessness and failure, as well as increase the patient's feelings of respect and affection, reducing the patient's sense of meaninglessness and dissatisfaction.

2. To unit nurses/family members

This study enhanced the intrinsic support of ostomy patients by guiding caregivers and patients' families to help improve the mental health of ostomy

patients, through listening and psychological step-down strategies. The current policy-driven development of community care should provide more rational medical care resources to provide more care and support for patients with ostomy. This will improve the patient's ability to perceive social support and promote patient's perception of the disease, with the goal of improving the level of adaptation of ostomy patients.

3. To nursing administration

It is necessary for nursing staff to strengthen health education and psychological care for patients with ostomy, and to educate patients in the form of videos or pictures on how to take care of or change the ostomy bag, so that patients can have a better understanding of ostomy, strengthen their understanding of ostomy, and reduce anxiety, in order to improve patients' social support and eventually achieve the purpose of improving patients' adaptation level.

4. To nursing education

The findings presented in this study regarding the level of social support to improve the adaptation of ostomy patients hold true, and the success of the results can provide a learning environment that is conducive to learning. They are guided through individualized instruction to have a developmental perspective and to explore different topics, strategies, and methods to make their health education more effective and meaningful.

5. To nursing profession

This study investigated the current status of social support and adaptation level of ostomy patients and clarified the correlation between social support and adaptation level of ostomy patients, which provides a reference for further research on nursing interventions in this area in the future.

6. To future researchers

As this study does not focus on an interventional experiment on ostomy adaptation in patients with enterostomies, future studies may introduce interventional variables, such as positive thinking and other measures, for factors affecting patients with enterostomies in order to improve the reference for guiding clinical care in the future and thus improve the level of ostomy adaptation in patients with enterostomies. The time span of this study was not long as well as the data collected from a single hospital, and the small sampling area of the survey resulted in a small sample size. There are limitations to the study findings and their generalizability to other regions needs to be verified through further studies. It is hoped that future studies would expand the scope to a larger random sample. Adaptation is a dynamic process of change, and this study only represents the disease status of ostomy patients at a certain moment in time, and is a cross- sectional study, and the conclusions are one-sided. Future researchers can furtheranalyze the level of patient needs in longitudinal studies.

First Advisor

Adrain M. Lawsin

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