Associations among fatigue, self-efficacy for managing chronic disease, social support, and demoralization in elderly postoperative stoma patients with colorectal cancer

OBJECTIVES: Demoralization seriously threatens the physical and mental health of elderly patients with colorectal cancer who have undergone ostomy surgery. This study aimed to examine the interrelationships between fatigue, self-efficacy in chronic disease management, social support, and demoralization in a clinical population, with a specific focus on potential mediating pathways among these variables. METHODS: Participants were administered a series of validated psychometric instruments, including the Fatigue Scale-14 (FS-14), the Social Support Rating Scale (SSRS), the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SEMCD-S), and the Demoralization Scale (DS), alongside a demographic questionnaire. Structural equation modelling was subsequently employed to analyse the hypothesised mediational pathways. RESULTS: In the pathway "fatigue - self-efficacy for managing chronic disease - demoralization," the indirect effect was 24.74%. For the pathway "fatigue - social support - demoralization," the indirect effect was 20.55%. Additionally, for the pathway "fatigue - self-efficacy for managing chronic disease - social support - demoralization," the indirect effect was 5.52%. DISCUSSIONS: The self-efficacy for managing chronic disease and social support serve as mediators in the relationship between fatigue and demoralization. Clinical staff should prioritize the development of a robust social support system for elderly postoperative stoma patients with colorectal cancer. Encouraging patients to express their thoughts can enhance their self-confidence and facilitate resilience in the face of adversity.