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

Jiayi Liang; Li Zhen; Xinmei Ye; Mulan Zhu; Huaxiu Gan; Jingping Liu; Lei Shi; Yulin Gao; Fang Qin

doi:10.1016/j.ejon.2022.102151

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

Eur J Oncol Nurs. 2022 Aug:59:102151. doi: 10.1016/j.ejon.2022.102151. Epub 2022 Jun 10.

Authors

Jiayi Liang¹, Li Zhen², Xinmei Ye³, Mulan Zhu², Huaxiu Gan⁴, Jingping Liu⁵, Lei Shi⁶, Yulin Gao⁷, Fang Qin⁸

Affiliations

¹ School of Nursing, Southern Medical University, Guangzhou, Guangdong, China.
² Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
³ Department of Colorectal Anal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
⁴ Department of Nursing, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
⁵ Department of Nursing, The Seventh Affiliated Hospital, Southern Medical University, Foshan, Guangdong, China.
⁶ School of Nursing, Southern Medical University, Guangzhou, Guangdong, China. Electronic address: lei1105@fimmu.com.
⁷ School of Nursing, Southern Medical University, Guangzhou, Guangdong, China. Electronic address: gyl@i.smu.edu.cn.
⁸ School of Nursing, Southern Medical University, Guangzhou, Guangdong, China. Electronic address: qf_smu@163.com.

PMID: 35816933
DOI: 10.1016/j.ejon.2022.102151

Abstract

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 (β = 1.032, P = .004), own acceptance of stoma (β = 2.445, P < .001), social support (β = 206, P = .001) and self-concept clarity (β = 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 (β = 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 (β = 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.

Keywords: Colorectal cancer; Enterostomy; Psychological resilience; Self-concept clarity; Social support.

MeSH terms

China
Cross-Sectional Studies
Enterostomy* / psychology
Humans
Resilience, Psychological*
Social Support
Surgical Stomas*
Surveys and Questionnaires