Integrated factors associated with ostomy patients’ self management behaviors and peristomal skin complications using structural equation model: a cross-sectional study in Shanghai, China

Abstract

Purpose Peristomal skin complications are major problems for ostomy patients. Social support, self efficacy and self management behaviors are vital for ostomy patients. The objective of this study is to explore the interrelationships of social support, self efficacy and self management behaviors among ostomy patients with peristomal skin complications. Methods A cross-sectional study was conducted with 265 ostomy patients from Shanghai, China, using a questionnaire survey including the Chronic Disease Self-Management Study Program (CDSSP), Self-efficacy for Managing Chronic Disease (SEMCD-6), and Medical Outcomes Study-Social Support Survey (MOS-SSS). Results Out of 265 ostomy patients, 184 (69.43%) did not have PSCs while 81 (30.57%) did. Significant differences (P<0.01) were observed in social support (MOS-SSS) and self-management behaviors (CDSSP) between ostomy patients with and without PSCs, with no significant difference in self-efficacy (SEMCD-6). The model fit statistics showed χ2/DF = 1.38; GFI = 0.973, CFI = 0.985, and RMSEA = 0.038. Social support positively predicted self-efficacy (β = 0.31, P<0.01), self-efficacy predicted self-management behaviors (β = 0.35, P<0.01), and social support predicted self-management behaviors (β = 0.32, P<0.01). Mediation analysis revealed that social support influences self-management behaviors through self-efficacy (mediation effect = 0.110, 95% CI = 0.019–0.250). Conclusion Social support and self-efficacy play significant roles in the self-management behaviors of ostomy patients, highlighting the importance of healthcare professionals recognizing predictors for PSCs management and providing support to vulnerable ostomy patients.