Stigma and social withdrawal among colorectal cancer survivors with permanent stomas: the mediating role of social motivation in psychosocial adaptation

Abstract

Purpose: Social withdrawal is common among colorectal cancer (CRC) survivors with permanent stomas, and stigma can play an important role in the development of social withdrawal. However, the underlying psychological mechanisms are understudied. The current study examined the associations of stigma with social motivation, and social withdrawal among CRC survivors with permanent stomas. Methods: A cross-sectional survey was conducted with a sample of 305 CRC survivors with permanent stomas. The mediation model was conducted using the PROCESS macro for SPSS to explore the pathways through which stigma can be associated with CRC survivors’ social withdrawal, mediated by social motivation. Results: Stigma was negatively associated with social motivation (β = -0.192, P < 0.01) and positively associated with social withdrawal (β = 0.345, P < 0.001). Additionally, social motivation was negatively associated with social withdrawal (β = -0.229, P < 0.001). The mediating effect of social motivation was 0.044, accounting for 11.3% of the total effect. Conclusion: This study is the first to validate the mediating role of social motivation in this population, highlighting its significance in understanding the psychosocial adaptation of CRC survivors with permanent stomas. Future interventions aimed at preventing social withdrawal in this group should focus on tailored motivation activation strategies, particularly by actively fostering social interaction and encouraging new social connections.