Ostomy Leakage, Odor, and Peristomal Skin Complications as Predictors of Anxiety Symptoms in Colorectal Cancer Survivors

PURPOSE: The aim is to examine the relationships between ostomy leakage, odor, peristomal skin complications (PSC), and anxiety symptoms in colorectal cancer (CRC) survivors with ostomies. DESIGN: Cross-sectional design. METHODS: One hundred thirty CRC survivors with ostomies (Stages I-III) were recruited from online support groups. Participants completed assessments of ostomy-related issues using single-item Likert scales measuring leakage, odor, and PSC. Anxiety symptoms were measured using the Generalized Anxiety Disorder-7. Baron and Kenny’s mediation model, with a series of regression analyses, examined relationships between variables while controlling for demographic and clinical factors. RESULTS: Ostomy leakage significantly predicted odor intensity (β = 0.61, P < .001), PSC (β = 0.51, P < .001), and anxiety (β = 0.23, P = .003). In mediation analysis, odor demonstrated a significant association with anxiety (β = 0.19, P = 0.039), while leakage’s direct effect became nonsignificant (β = 0.11, P = 0.249). Peristomal skin complications showed no significant association with anxiety (β = −0.05, P = 0.575). Race and treatment status maintained significant associations with anxiety across all models. CONCLUSIONS: Ostomy odor mediates the relationship between leakage and anxiety among CRC survivors with ostomies, suggesting that odor management may be crucial for reducing anxiety in this population.