Relationship among self-concept clarity, social support, and psychological resilience in Chinese patients with an enterostomy: A cross-sectional study and structural equation model analysis

作者：Liang, Jiayi; Zhen, Li; Ye, Xinmei; Zhu, Mulan; Gan, Huaxiu; Liu, Jingping; Shi, Lei^*; Gao, Yulin^*; Qin, Fang^*

来源：European Journal of Oncology Nursing, 2022, 59: 102151.

DOI：10.1016/j.ejon.2022.102151

• Psychological resilience
• Self-concept clarity
• Social support
• Enterostomy
• Colorectal cancer

Purpose: This study was to explore the relationship between self-concept clarity, social support, and psychological resilience in Chinese enterostomy patients.Methods: A cross-sectional, descriptive study was conducted from October 2019 to April 2020 among enterostomy patients visiting the stoma clinic and inpatients with an enterostomy in general surgery of three tertiary grade A hospitals in Guangzhou, China. Patients (n=201) were required to complete paper questionnaires, including sociodemographic information, the 10-Item Resilience Scale Specific to Cancer, Self-concept Clarity Scale, and Social Support Rating Scale. Multiple linear regression analyses and structural equation modeling were conducted to explore the effect of self-concept clarity and social support on psychological resilience.Results: Psychological resilience was at a median level among enterostomy patients, with a mean score of 38.21 (SD, 7.24). Education level (beta = 1.032, P = .004), own acceptance of stoma (beta = 2.445, P < .001), social support (beta = 206, P = .001) and self-concept clarity (beta = 0.285, P < .001) were factors related to psychological resilience, explaining 33.1% of the variance of psychological resilience. It was also shown that self-concept clarity exerted its direct positive effect on social support (beta = 0.098, SE = 0.025, BC 95%CI = 0.047/0.143), and it also had an indirect positive effect on psychological resilience through mediating social support (beta = 0.193, SE = 0.033, BC 95%CI = 0.121/0.245).Conclusions: This study suggests that self-concept clarity has an indirect positive effect on psychological resilience by influencing social support in enterostomy patients. Medical staff should strive to improve the self-concept clarity as a new means to enhance patients' psychological resilience, especially focusing on patients' social support, education level and own acceptance of enterostomy.

• 单位
  中山大学; 6; 南方医科大学