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

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