title: Effect of gender on psychosocial adjustment of colorectal cancer survivors with ostomy.
abstract: BACKGROUND
  Stoma can pose extensive challenges for colorectal cancer survivors. Identifying the psychological and social adjustment among them and how it differs by gender will aid in identifying those particularly at risk of having poor adjustment and in planning programs to improve their adjustment. The purpose of this study was to determine the effect of gender on psychosocial adjustment of colorectal cancer survivors with ostomy.
  
  
  METHODS
  A descriptive cross sectional study was carried out in the stoma clinic of B.P. Koirala Memorial Cancer Hospital, Bharatpur, Nepal. A purposive sample of 122 patients with ostomy was taken from the above mentioned setting. Selection criteria included colorectal cancer survivors having ostomy for at least 6 months. Data on socio-demographic and clinical variables were collected. Psychosocial adjustment was measured using Ostomy Adjustment Inventory-23 (OAI-23).
  
  
  RESULTS
  A total of 122 patients were included in the study. Mean time since ostomy surgery was 2.53 and 1.98 years for men and women respectively. Both men and women had significant impairment in the psychosocial adjustment, however, men had significantly lower psychosocial adjustment score (37.68±12.96vs. 43.45±12.81, t=-2.47, P=0.015) at 95% CI as compared to women and they reported more negative emotions. Furthermore, men significantly predicted low acceptance {β=-3.078, P=0.023, ΔR2=0.036, F [4,117] =7.90, P<0.001} and social engagement score {β=-2.501, P<0.001, ΔR2=0.098, F [4,117] =6.03, P<0.001}.
  
  
  CONCLUSIONS
  Colorectal cancer survivors with ostomy should be monitored for psychosocial concerns in regular basis and health care providers should tailor care based on their need. Approaches of survivorship care and psychosocial interventions in colorectal cancer survivors with ostomy should take into account gender specific concerns and requirements to aid adjustment.
authors.affiliation: Department of Nursing, Nepal Medical College, Kathmandu, Nepal.
authors.forename: Sital
authors.initials: S
authors.lastname: Gautam
authors.affiliation: Department of Nursing, Nepal Medical College, Kathmandu, Nepal.
authors.forename: Anju
authors.initials: A
authors.lastname: Poudel
keywords: Gender; ostomates; ostomy; psychosocial adjustment; stoma surgery