Psychosocial pathways linking type D personality traits to quality of life in patients with permanent intestinal...

Patients with permanent intestinal stomas often experience long-term physical and psychosocial challenges, including lifelong appliance management, altered body image, social embarrassment, and self-care burden, which can adversely affect their quality of life. Because Type D personality traits are characterized by negative affectivity and social inhibition, they may be particularly relevant to psychosocial adaptation in this population. However, the potential psychosocial and behavioral pathways linking Type D personality traits to quality of life in patients with permanent intestinal stomas remain unclear.

This cross-sectional study included 200 patients with permanent intestinal stomas recruited from a tertiary hospital. All major variables were assessed using self-report questionnaires, including the 14-item Type D Scale (DS14), the Social Support Rating Scale (SSRS), the General Self-Efficacy Scale (GSES), the Ostomy Self-Care Index (OSCI), and the Stoma Quality of Life Scale (Stoma-QOL). Pearson correlation analysis, structural equation modeling, and bootstrap analysis with 5,000 resamples were performed to examine associations and indirect effects.

Higher Type D personality trait scores were negatively associated with social support, self-efficacy, stoma self-care ability, and quality of life. The structural equation model showed an acceptable fit to the data (χ²/df = 2.63, CFI = 0.92, TLI = 0.90, RMSEA = 0.071, SRMR = 0.061). Self-efficacy significantly mediated the association between Type D personality traits and quality of life. The sequential pathway involving social support and self-efficacy was also statistically significant. In contrast, the indirect pathway through social support alone and the longer sequential pathway through social support, self-efficacy, and stoma self-care ability did not reach statistical significance.

Stronger Type D personality traits were associated with lower quality of life in patients with permanent intestinal stomas. These findings suggest partial statistical mediation within a cross-sectional SEM framework, particularly through self-efficacy, rather than confirmed causal mechanisms. Self-efficacy and supportive resources may be useful targets for future longitudinal and intervention studies aimed at improving quality of life in this population.