大肠癌癌症和造口术患者的家庭护理和社会疏远：复原力和耻辱感的顺序中介效应
Family care and social alienation in patients with colorectal cancer and an ostomy: The sequential mediating effects of resilience and stigma.
摘要(中文译文)
本研究旨在探讨结直肠癌造口患者家庭关怀与社会疏离之间的关系，并基于ABC-X模型探索心理弹性与病耻感的链式中介作用。本研究于2024年10月至2025年8月在中国福建省对290例结直肠癌造口患者进行横断面研究。参与者完成了评估家庭关怀、心理弹性、病耻感和社会疏离的问卷。采用PROCESS宏程序进行串行多重中介分析以检验假设路径。使用5000次重抽样的Bootstrap法及偏差校正95%置信区间检验间接效应的显著性。家庭关怀与社会疏离（r=-0.526，P<0.001）和病耻感（r=-0.483，P<0.001）呈负相关，与心理弹性呈正相关（r=0.473，P<0.001）。串行中介分析显示，心理弹性和病耻感共同且部分中介了家庭关怀与社会疏离之间的关联。总间接效应占总效应的54.26%，包含三条显著路径：心理弹性（25.25%）、病耻感（22.91%）以及“心理弹性→病耻感”链式路径（6.10%）。家庭关怀与较高的心理弹性、较低的感知病耻感相关，进而缓解社会疏离。家庭关怀与结直肠癌造口患者较低的社会疏离相关，其潜在机制可能通过提高心理弹性和降低病耻感实现。这些发现凸显了家庭为基础的心理社会资源在促进身体改变手术后适应性调整中的重要作用。护理干预应优先加强家庭关怀、培养心理弹性并减少疾病相关病耻感，以促进结直肠癌造口患者的社会重新融入和整体福祉。
Abstract
This study aimed to examine the association between family care and social alienation among patients with colorectal cancer (CRC) and an ostomy, and to explore the sequential mediating roles of resilience and stigma based on the ABC-X model. A cross-sectional study was conducted among 290 CRC patients with an ostomy in Fujian Province, China from October 2024 to August 2025. The participants completed questionnaires assessing family care, resilience, stigma, and social alienation. Serial multiple mediation analysis using the PROCESS macro tested the hypothesized pathways. Bootstrapping with 5000 resamples and bias-corrected 95% confidence intervals was used for testing the significance of indirect effects. Family care negatively correlated with social alienation ( = -0.526, < 0.001) and stigma ( = -0.483, < 0.001) and positively correlated with resilience ( = 0.473, < 0.001). Using serial mediation analysis, resilience and stigma jointly and partially mediated the association between family care and social alienation. The total indirect effect accounted for 54.26% of the total effect, with three significant pathways via: resilience (25.25%), stigma (22.91%), and the chained path "resilience→stigma" (6.10%). Family care was associated with higher resilience, reduced perceived stigma, and consequently alleviated social alienation. Family care was associated with lower social alienation among CRC patients with an ostomy, potentially through higher resilience and lower stigma. These findings highlight the important role of family-based psychosocial resources in promoting adaptive adjustment following body-altering surgery. Nursing interventions should prioritize strengthening family care, cultivating resilience, and reducing illness-related stigma to promote social reintegration and overall well-being in CRC patients with an ostomy.
如何引用
AMA
Baochuan Chen, Huifen Zhao, Xiaoyan Yang, Juying Hong, Lihui Wang, Yaping Xie, et al. Family care and social alienation in patients with colorectal cancer and an ostomy: The sequential mediating effects of resilience and stigma.. Asia-Pacific journal of oncology nursing. 2026; doi:10.1016/j.apjon.2026.100980.
APA
Baochuan Chen, Huifen Zhao, Xiaoyan Yang, Juying Hong, Lihui Wang, Yaping Xie, et al (2026). Family care and social alienation in patients with colorectal cancer and an ostomy: The sequential mediating effects of resilience and stigma.. Asia-Pacific journal of oncology nursing. https://doi.org/10.1016/j.apjon.2026.100980
GB/T 7714
Baochuan Chen, Huifen Zhao, Xiaoyan Yang, Juying Hong, Lihui Wang, Yaping Xie, et al. Family care and social alienation in patients with colorectal cancer and an ostomy: The sequential mediating effects of resilience and stigma.[J]. Asia-Pacific journal of oncology nursing, 2026 doi:10.1016/j.apjon.2026.100980.
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