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Acceptance and commitment therapy combined with usual care improves psychosocial outcomes and reduces complications in patients with permanent colostomies after colorectal cancer surgery: a retrospective cohort study

Year: 2025

Type: article

Abstract: Background Permanent colostomies after colorectal cancer surgery can seriously affect patients' quality of life (QoL) and psychosocial adjustment. Research on the benefits of Acceptance and Commitment Therapy (ACT) for this group is still limited. Objective To examine whether adding ACT to standard stoma care improves self-efficacy, resilience, QoL, and stoma-related complication rates compared with standard care alone. Methods This single-center retrospective cohort study (2022–2024) included 120 patients with permanent colostomies. After 1:1 propensity score matching (60 patients per group, caliper = 0.2 SD), one group received an 8-session ACT program over 6 weeks alongside usual care, while the control group received usual care only. Outcomes were measured at 3 months (T1) and 6 months (T2) post-surgery. Primary outcomes were self-efficacy (C-SSES), resilience (CD-RISC), and stoma-related QoL (Stoma-QOL). Secondary outcomes included stoma complications. Linear mixed-effects models and conditional logistic regression were applied for analysis. Results Significant improvements over time were observed in the ACT group compared with controls (all p < 0.001). At T2, the ACT group showed higher self-efficacy [mean difference (MD) = 14.7, 95% CI: 10.9–18.5; d = 0.92], resilience (MD = 11.1, 95% CI: 7.8–14.4; d = 0.89), and QoL (MD = 12.3, 95% CI: 8.7–15.9; d = 0.86). ACT also reduced overall complication rates (33.3% vs. 51.7%; OR = 0.48, 95% CI: 0.24–0.96), particularly dermatitis (16.7% vs. 31.7%; OR = 0.43, 95% CI: 0.19–0.99). At T2, self-efficacy, resilience, and QoL were strongly correlated (all r ≥ 0.65, p < 0.001). Conclusion Adding ACT to routine stoma care improves self-efficacy, resilience, and quality of life, while also lowering complication rates in patients with permanent colostomies. These findings suggest ACT is a valuable supportive therapy in stoma care.

Source: Frontiers in Surgery

DOI: 10.3389/fsurg.2025.1693290

Authors: Yali Shi, Hongwei Yu, Lihui Wang, Haiqiang Zhang

Institutions: Hebei Medical University, Second Hospital of Hebei Medical University

Language: English

Topic: Stoma care and complications

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801