Network Analysis of Psychosocial Adaptation in Intestinal Stoma Patients: A National Cross-Sectional Study in China

Aims: The aim of this study was to investigate factors affecting psychosocial adaptation in intestinal stoma patients and to identify central symptoms that might guide future interventions through network analysis. Design: A multicenter cross-sectional study. Methods: All intestinal stoma patients were evaluated for psychosocial adaptation using the Ostomy Adjustment Inventory-20 (OAI-20). Univariate and multivariate linear regression were used to analyse the potential relationship between the level of psychological adjustment of intestinal stoma patients and individual factors. By network analysis, we calculated the centrality indicators for each node in the ostomy psychosocial adaptation network at different levels of low, medium and high, respectively. Results: This study ultimately enrolled a total of 19,909 intestinal stoma patients from 202 Chinese hospitals, out of which 6408 reported low psychosocial adaptation. It was found that there is a negative association between being female, partially self-care, completely dependent on others for care and having no medical insurance with psychosocial adaptation scores. In the low-level psychosocial adaptation network, no. OAI-14:limited activity, no. OAI-9: worried about ostomy, and no. OAI-11:always like a patient were identified as central indicators. Conclusions: Being female, partially self-care, completely dependent on others for care, and having no health insurance can be considered characteristics of patients with lower psychosocial adaptation. Network analysis results provide intervention targets to improve adaptation. Impact: Individualised and precise interventions can be carried out in terms of both the influencing factors and the most influential nodes of psychosocial adaptation in order to improve the level of psychosocial adaptation in intestinal stoma patients. Patient or Public Contribution: No patient or public contribution.