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. 2025 Jul 22;33(8):711.
doi: 10.1007/s00520-025-09773-3.

Trajectories and interactions of body image and subjective well-being in colorectal cancer patients with colostomy: a longitudinal study

Song Guo #  1 , Wen Shi #  1 , Caiyun Zhao  2 , Yue Wang  1 , Huiping Tian  1
Affiliations

Trajectories and interactions of body image and subjective well-being in colorectal cancer patients with colostomy: a longitudinal study

Song Guo et al. Support Care Cancer. .

Abstract

Objective: To explore the developmental trajectory of body image and subjective well-being in colorectal cancer patients with colostomy, and to examine the predictive relationship between the two, in order to provide a theoretical basis for improving the well-being of ostomy patients.

Methods: A total of 285 ostomy patients were selected as the study population. Body image and subjective well-being were assessed at three time points: T1 (initial diagnosis), T2 (3 months post-diagnosis), and T3 (6 months post-diagnosis). A follow-up investigation was conducted, and data were analyzed using a cross-lagged model and latent growth modeling.

Results: A total of 260 valid questionnaires were collected. Pearson correlation analysis revealed significant correlations between body image and subjective well-being at all three time points (P < 0.05). The cross-lagged model showed that body image significantly predicted subsequent subjective well-being (T1 → T2: β = -0.467, P < 0.01; T2 → T3: β = -0.457, P < 0.001), while subjective well-being did not significantly predict later body image (T1 → T2: β = -0.102, P = 0.151; T2 → T3: β = -0.133, P = 0.124). The latent growth model indicated that body image significantly increased over time (S = 0.288, P < 0.001), whereas subjective well-being decreased (S = -0.355, P < 0.001). At baseline, body image was negatively correlated with subjective well-being (r = -0.377, P = 0.002). Furthermore, the initial level of body image positively predicted both its own trajectory (β = 0.345, P = 0.006) and the rate of change in subjective well-being (β = 0.530, P = 0.002). The growth rate of body image also positively predicted the growth rate of subjective well-being (β = 0.552, P < 0.001).

Conclusions: While body image among ostomy patients improves over time, their subjective well-being declines. Body image exerts a significant predictive effect on subjective well-being, suggesting that it is a critical risk factor affecting the psychological adjustment of ostomy patients.

Keywords: Body image; Colorectal cancer; Colostomy; Cross-lagged model; Latent growth model; Nursing; Subjective well-being.

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Conflict of interest statement

Declarations. Consent to participate: Informed consent was obtained from all patients in this study. Conflict of interest: The authors declare no competing interests.

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