Psychosocial effects and quality of life after stoma surgery: systematic review and qualitative meta-synthesis

TL;DR

This study explores how living with a stoma affects people's mental health, social life, and quality of life after colorectal cancer surgery.

Contribution

A novel qualitative meta-synthesis providing a comprehensive understanding of psychosocial impacts and adaptation processes in stoma patients.

Findings

Patients experience body image issues, emotional distress, and social isolation due to stoma surgery.

Support from family, partners, and healthcare professionals is crucial for adaptation and coping.

Living with a stoma requires reorganizing daily routines and adjusting to physical limitations, affecting quality of life.

Abstract

Although stoma surgery is a life-saving intervention, it can lead to significant physical, emotional, and social changes that affect individuals’ psychosocial well-being and overall quality of life. This qualitative meta-synthesis aims to systematically investigate and synthesize the psychological and social impacts, as well as the quality-of-life experiences, of adult individuals living with a permanent stoma due to colorectal cancer.

This qualitative meta-synthesis was conducted via systematic review and thematic synthesis methods, following the ENTREQ, PRISMA, and JBI guidelines. Five databases, EBSCO (MEDLINE), PubMed, CINAHL, Web of Science (WoS), and Scopus, were searched up to December 28, 2024. Studies focusing on the psychological, social, and quality-of-life experiences of adults living with a permanent stoma were included. The data were analysed via three-step thematic synthesis. Study quality was assessed via JBI tools. Two independent researchers conducted the selection, extraction, and synthesis processes to ensure reliability.

A total of 36 qualitative studies involving 1736 patients with stoma were included. Three main themes and six subthemes were identified: (1) Reshaping Daily Life in the Shadow of the Stoma, (2) From Inner Turmoil to Silent Resilience: Psychosocial and Emotional Effects After Stoma, and (3) Care and Support Dynamics in Stoma Adaptation. Patients experienced body image disturbance, emotional distress, social isolation, changes in daily routines, physical limitations, hygiene challenges, and stigma. Family, partner, peer, and professional support are key factors in coping and adaptation.

Adults living with a permanent stoma reported experiencing physical limitations related to mobility, sleep, self-care, and sexual life, which were perceived to negatively influence their quality of life. Participants also described the need to reorganize daily routines, social roles, and work-related activities, and to develop new patterns of living within existing constraints. Overall, the findings suggest that living with a stoma is associated with adjustments in living arrangements, social roles, and bodily experiences, underscoring the importance of addressing the adaptation process through a holistic and person-centered approach.

The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (ID: CRD42025631485).

The online version contains supplementary material available at 10.1186/s40359-026-03993-w.

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