The interplay of anxiety and self-esteem in quality of life among patients with a stoma.

Abstract

Objective: This study aimed to investigate the relationships between anxiety, depression, self-esteem, and quality of life in patients with a stoma. Additionally, it sought to evaluate the independent contribution of stoma-related sociodemographic and clinical variables to psychosocial outcomes in order to support a more holistic approach in clinical practice.

Methods: The study sample consisted of 50 patients aged between 25 and 80 years who presented to the General Surgery outpatient clinic of Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Türkiye between 2024 and 2025 and had a temporary or permanent intestinal stoma due to malignancy or other causes. Participants were administered the Sociodemographic and Clinical Information Form, Rosenberg Self-Esteem Scale (RSES), Beck Anxiety Inventory (BAI), Quality of Life-BREF (WHOQOL-BREF), and Beck Depression Inventory (BDI).

Results: In multivariate linear regression analysis, female gender and lower Beck Anxiety Inventory (BAI) scores were independently associated with higher self-esteem; self-esteem was lower in males and in those with higher anxiety levels (male gender: B = -3.379, β = -0.720, p = 0.005; anxiety: B = -0.224, β =-0.594, p = 0.002). The only variable independently associated with quality of life was the BAI score (B = -0.517, β =-0.487, p < 0.001). Self-esteem was positively correlated with overall quality of life scores and all subdomains (r = 0.336-0.662; all p ≤ 0.017). When self-esteem was included in the quality of life model, only self-esteem remained independently significant (B = 1.135, β = 0.403, p = 0.022), and the association between anxiety and quality of life disappeared.

Conclusion: This study suggests that anxiety is closely associated with quality of life in patients with a stoma; however, this association is no longer independent after accounting for self-esteem. These findings suggest that self-esteem may be an important psychosocial factor associated with quality of life and may be relevant to the observed relationship between anxiety and quality of life.