Linking stigma to social isolation among colorectal cancer survivors with permanent stomas: the chain mediating roles of stoma acceptance and valuable actions

Colorectal cancer (CRC) survivors with permanent stomas might be at higher risk of social isolation, and stigma can play an important role in the development of social isolation. However, the underlying psychological mechanisms are understudied. The current study examined how stoma acceptance and valuable actions mediated the relationships between stigma and social isolation among CRC survivors with permanent stomas.

A cross-sectional survey was conducted with a sample of 303 CRC survivors with permanent stomas. The chain mediation models were conducted using the PROCESS macro for SPSS to explore the pathways through which stigma can be associated with CRC survivors’ social isolation, mediated by stoma acceptance and valuable actions.

The results indicated that higher stigma was related to lower stoma acceptance, less personal values enactment, and higher social isolation, as well as lower objective social connectedness and subjective social belongingness among CRC survivors with permanent stomas. Additionally, the mediational analyses revealed that stoma acceptance and valuable actions jointly mediated the relationships between stigma and social isolation.

Social isolation among CRC survivors during the adjustment to both stoma and stigma may be alleviated through tailored interventions that improve stoma acceptance and valuable actions.

The chain mediating roles of stoma acceptance and valuable actions highlight that tailored interventions, such as acceptance and commitment therapy, can be targeted for this population, considering this population’s unique needs.