The Effects of Religion-Based Cognitive-Behavioral Therapy on the Quality of Life and Self-Efficacy of Colostomy Patients

Every day, a large number of patients are exposed to critical decisions to lose their normal stool excretion and abdominal, and undergo bowel surgery. A colostomy is a part of the intestine, i.e., excreted from the abdominal wall to dispose of waste; in other words, it is the mouth of the colon on the abdomen, i.e., caused by surgery. Depression, suicidal ideation, low self–esteem, and withdrawal from social activities are prevalent in the affected patients. Furthermore, the above–mentioned issues are significantly higher in this population, compared to those without abdominal surgery experiences. It is necessary to help individuals undergoing colostomy to solve problems related to colostomy and identify factors affecting their Quality of Life (QoL) and self–efficacy that can be improved using different approaches. The present study aimed to determine the effects of Religion–based Cognitive–Behavioral Therapy (RCBT) on the QoL and self–efficacy in patients undergoing colostomy.

This was a quasi–experimental study with a pretest–posttest–follow–up and a control group design. The statistical population of this study included colostomy patients referring to the psychosomatic ward of Imam Khomeini Hospital in Sari City, Iran, in 2019. Accordingly, 50 subjects were selected as the study samples by convenience sampling method and based on the inclusion and exclusion criteria of the study; accordingly, they were randomly divided into two groups of experimental and control (n=25/group). The inclusion criteria of the study were as follows: colostomy patients (based on medical records) aged 30 to 60 years; having the ability to participate in the treatment sessions; not presenting acute psychosis (based on medical records); not having neurological conditions, such as brain injury, stroke, Alzheimerchr('39')s disease, and Parkinsonchr('39')s disease (based on medical records); having belief in Islam (based on the obtained demographic data); having reading and writing literacy, and providing informed consent forms to participate in the study. The exclusion criteria of the study included reluctance to complete the research course or providing incomplete questionnaires, developing a debilitating physical illness during the study course, and refusing to continue attending and continuing the research project. The experimental group received RCBT, while the controls received no training. Additionally, a follow–up assessment was performed 6 weeks after the completion of the study program. RCBT was performed in ten 120–minute sessions twice a week for two months based on the Pierce et al.̓s educational package (2015). The required data were collected using a demographic data questionnaire, the Quality of Life Questionnaire for Ostomy Patients (Grant et al., 2004), and the Stoma Self–Efficacy Scale (Bekkers et al., 1996). The obtained data were analyzed using descriptive statistics, such as central and dispersion indices, e.g., mean and standard deviation, as well as inferential statistics, including repeated–measures Analysis of Variance (ANOVA) and Bonferroni posthoc test. Statistical analysis was performed using SPSS at the significance level of 0.05.

The present research results suggested that RCBT was effective in improving the QoL (p<0.001) and self–efficacy (p<0.001) of the explored patients undergoing colostomy. Bonferroni test data indicated that the posttest scores of QoL were higher than those of the pretest phase in the experimental group (p<0.001). Moreover, the values of QoL were significantly different in the follow–up stage, compared to the pretest step (p<0.001); however, there was no significant difference between the scores of posttest and follow–up phases (p=0.105). Furthermore, the posttest scores of self–efficacy were higher than those of the pretest stage in the test group (p<0.001). Additionally, the follow–up scores of self–efficacy significantly differed from those of the pretest stage (p<0.001); however, there was no significant difference between the scores of posttest and follow–up steps (p=0.925).

Considering the positive effects of RCBT on the QoL and self–efficacy of the explored patients undergoing colostomy, it is recommended to use this approach in planning mental health measures, especially in colostomy patients.