The association between health anxiety and psychological adjustment in patients undergoing stoma surgery

Simone Raenker

Research output: ThesisDoctoral Thesis

761 Downloads (Pure)


Stoma surgery is challenging and has been found to impact body image, social relationships including sexuality, health-related and general quality of life. Some patients exhibit negative affect and struggle to adjust to living with a stoma. Stoma care nursing and the self-efficacy beliefs appear to be protective factors for adaptation in this patient group. Health anxiety seems highly prevalent in medical health conditions but has not yet been investigated in a stoma patient population.
The aim of the current study was to investigate the role of health anxiety in the adjustment to stoma in patients undergoing emergency or planned surgery. Health anxiety was also examined as mediator for the relationship between stoma self-efficacy and stoma adjustment. A further aim was to explore psychological differences (i.e. health anxiety, self-efficacy, adjustment, overall distress, preparedness for surgery) in the two patient groups that were included in this study (i.e. emergency versus planned stoma operation).
The study used a cross-sectional design and patients were assessed using valid and reliable self-report measures. Patients were recruited from one NHS hospital setting and internet-based sources such as websites and support groups.
The results show that health anxiety is associated with poorer adjustment. Patients who are highly health anxious appear to adjust less well to living with a stoma. The protective impact stoma self-efficacy has on adjustment, as demonstrated in previous studies, was replicated. In addition, the current study shows that the positive relationship between self-efficacy and adjustment is negatively impacted by health anxiety. A further finding of this study is that emergency and planned surgery patients do not differ on psychological variables including health anxiety, distress, self-efficacy and adjustment.
The study has offered valuable insight in the processes that are involved in the adjustment process after stoma surgery. It is proposed that patients with clinical levels of health anxiety may benefit from psychological therapy focusing on health anxiety before they can adaptively engage in the journey of helpful coping and adjustment to living with their stoma. Adjustment is a complex and fluid process and future research should endeavour to investigate how pre-operative psychological factors influence how patients cope after their surgery.
Original languageEnglish
Awarding Institution
  • Royal Holloway, University of London
Award date1 Nov 2015
Publication statusUnpublished - 2015

Cite this