造口接受度在预防性肠造口患者积极心理健康与病耻感间的关联路径分析

doi:10.3761/j.issn.0254-1769.2026.18.009

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (18): 2519-2525.DOI: 10.3761/j.issn.0254-1769.2026.18.009

造口接受度在预防性肠造口患者积极心理健康与病耻感间的关联路径分析

王凤娟¹(), 阮征¹^,^*(), 陈付红²

¹ 厦门大学附属第一医院结直肠肿瘤外科厦门市 361003
² 厦门大学附属第一医院护理部厦门市 361003

收稿日期:2026-02-24 出版日期:2026-09-20 发布日期:2026-09-23
*通讯作者: *阮征，E-mail：123801419@qq.com
作者简介:王凤娟：女，硕士，主管护师，E-mail：fengjuan710@163.com
第一联系人：作者贡献声明
王凤娟：研究设计、资料收集与数据分析、论文撰写与修改；阮征：研究指导、论文修改与审阅、经费支持；陈付红：研究设计指导、资料收集协调、论文审阅
基金资助:
福建中医药大学校管课题(XB2023157)

Statistical mediation of stoma acceptance between positive mental health and stigma in patients with prophylactic enterostomy

WANG Fengjuan¹(), RUAN Zheng¹^,^*(), CHEN Fuhong²

¹ Department of Colorectal Surgery， the First Affiliated Hospital of Xiamen University， Xiamen 361003， China
² Department of Nursing， the First Affiliated Hospital of Xiamen University， Xiamen 361003， China

Received:2026-02-24 Online:2026-09-20 Published:2026-09-23
* Corresponding author: *RUAN Zheng，E-mail：123801419@qq.com
Funding program:
School-level Project of Fujian University of Traditional Chinese Medicine(XB2023157)

摘要/Abstract

摘要：

目的探讨预防性肠造口患者积极心理健康、造口接受度与病耻感的关系，分析造口接受度的中介效应，为临床制订精准心理干预策略提供理论依据。方法采用便利抽样法，于2024年1月—2025年6月，选取196例预防性肠造口患者作为调查对象。采用一般资料调查表、中文版积极心理健康量表、简体中文版社会影响量表和造口接受度量表进行调查。利用Amos 29.0软件构建结构方程模型、Bootstrap法检验中介效应。结果预防性肠造口患者的积极心理健康得分为（30.11±4.91）分，病耻感得分为（61.15±11.81）分，造口接受度得分为（27.34±5.02）分。相关分析显示，造口接受度与病耻感呈负相关（r=-0.427，P<0.01），与积极心理健康正相关（r=0.316，P<0.01）；病耻感与积极心理健康呈负相关（r=-0.477，P<0.01）。结构方程模型显示，造口接受度在积极心理健康与病耻感间起部分中介作用，中介效应值为-0.097，占总效应的20.42%。结论预防性肠造口患者的病耻感水平较高，造口接受度在积极心理健康与病耻感之间存在间接关联路径。医护人员应关注患者的积极心理资源，探索以强化心理资源、促进造口接纳、缓解病耻感为路径的整合性心理干预。

关键词: 肠造口, 造口接受度, 病耻感, 积极心理健康, 中介效应, 护理

Abstract:

Objective To explore the relationship between positive mental health，stoma acceptance，and stigma in patients with prophylactic enterostomy，and to analyze the mediating effect of stoma acceptance，so as to provide a theoretical basis for developing targeted psychological interventions. Methods From January 2024 to June 2025，a total of 196 patients with temporary enterostomy were recruited via convenience sampling. The survey was conducted using a general information questionnaire，the Chinese version of the Positive Mental Health Scale，the simplified Chinese version of the Social Impact Scale，and the Stoma Acceptance Scale. A structural equation model was constructed using Amos 29.0，and the mediating effect was tested using the Bootstrap method. Results The scores for positive mental health，stigma，and stoma acceptance were（30.11±4.91）points，（61.15±11.81）points，and（27.34±5.02）points，respectively. Correlation analysis showed that stoma acceptance was negatively correlated with stigma（r=-0.427，P<0.01） and positively correlated with positive mental health（r=0.316，P<0.01）；stigma was negatively correlated with positive mental health（r=-0.477，P<0.01）. The structural equation model indicated that stoma acceptance partially mediated the relationship between positive mental health and stigma，with a mediating effect of -0.097，which accounted for 20.42% of the total effect. Conclusion Patients with prophylactic enterostomy experience high levels of stigma. The statistical mediation model indicated an indirect association between positive mental health and stigma through stoma acceptance. Healthcare professionals should focus on patients’ positive psychological resources and explore integrated psychological interventions that follow the pathway of strengthening resources，promoting acceptance，and alleviating stigma.

Key words: Enterostomy, Stoma Acceptance, Stigma, Positive Mental Health, Mediating Effect, Nursing Care

王凤娟, 阮征, 陈付红. 造口接受度在预防性肠造口患者积极心理健康与病耻感间的关联路径分析[J]. 中华护理杂志, 2026, 61(18): 2519-2525.

WANG Fengjuan, RUAN Zheng, CHEN Fuhong. Statistical mediation of stoma acceptance between positive mental health and stigma in patients with prophylactic enterostomy[J]. Chinese Journal of Nursing, 2026, 61(18): 2519-2525.

图/表 4

表1 预防性肠造口患者的一般资料及病耻感得分的单因素分析（n=196）

Table 1 Demographic characteristics and univariate analysis of stigma in patients with prophylactic enterostomy（n=196）

表2 预防性肠造口患者病耻感影响因素的分层回归分析（n=196）

Table 2 Hierarchical regression analysis of factors influencing stigma in patients with prophylactic enterostomy（n=196）

表3 预防性肠造口患者的造口接受度在积极心理健康与病耻感间的中介效应分析（n=196）

Table 3 Mediating effect of stoma acceptance on the relationship between positive mental health and stigma（n=196）

图1 造口接受度在积极心理健康与病耻感间的中介效应模型 1）P<0.001，e1~e4观测变量的测量误差，e5造口接受度残差。

Figure 1 Mediation model of stoma acceptance on the relationship between positive mental health and stigma

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造口接受度在预防性肠造口患者积极心理健康与病耻感间的关联路径分析

Statistical mediation of stoma acceptance between positive mental health and stigma in patients with prophylactic enterostomy

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