Body image disturbance and post-traumatic growth among patients with an intestinal stoma: a sequential mixed-methods study

Background Intestinal stoma surgery is widely performed to restore bowel function in patients with severe intestinal diseases. However, the creation of a stoma often results in substantial changes in body image and may challenge patients’ self-identity, psychological wellbeing, and adaptation to daily life. Although previous studies have mainly focused on psychological distress associated with body image concerns, how body image disturbance relates to positive psychological adaptation, particularly post-traumatic growth (PTG), among individuals living with an intestinal stoma remains insufficiently understood. Methods An explanatory sequential mixed-methods design was adopted, with quantitative analysis conducted first and qualitative interviews used to further explain the findings. A total of 253 patients with an intestinal stoma were recruited, and 10 participants were purposively selected for semi-structured interviews. Quantitative data were collected using the Body Image Scale (BIS) and Post-Traumatic Growth Inventory (PTGI) and analyzed using correlation and hierarchical regression analyses. Qualitative data were analyzed using reflexive thematic analysis. Results Body image disturbance was significantly and negatively associated with PTG ( r = −0.598, p < 0.001) and remained significantly associated with PTG after adjustment for demographic and clinical characteristics ( β = −0.585, p < 0.001). Qualitative findings indicated that patients commonly described body-related distress during the early postoperative period and retrospectively described a gradual process of accepting bodily changes, self-acceptance, and psychological adaptation. Integrated findings indicated that adaptation to bodily changes represents an important aspect of psychological adjustment after stoma surgery. Conclusion Body image disturbance is significantly associated with post-traumatic growth among patients with an intestinal stoma. The findings highlight the importance of assessing and addressing body image disturbance and supporting psychological adaptation as part of comprehensive stoma care. Future longitudinal studies are needed to clarify the temporal relationship between body image adaptation and psychological growth.