The main purpose of this study was to explore factors related to stress in outpatients with permanent colostomies, using a convenience sample. Subjects were selected from one medical center in southern Taiwan. The Stress of Colostomy Patients Scale and demographic data were collected using questionnaires either at the colorectal outpatient department or in the home of colostomy patients. Seventy-three subjects with colostomies participated in the study. Other diseases and caregivers of colostomy patients influenced overall stress in outpatients with permanent colostomies. The five major stressors were: "I have urination problems"; "I feel tired easily owing to physical decline"; "I can't travel freely because of my colostomy"; "I worry about recurrence of the disease"; and, "I suffer from insomnia". This study provides important information for assessing the stress level of outpatients with permanent colostomies and for developing nursing assessment tools for colostomy patients. To alleviate the overall stress of colostomy patients and to help them return to the activities of daily living before the operation, health care professionals could design individual nursing care plans based on data from assessment tools.