Published online Nov 27, 2026. doi: 10.4240/wjgs.123938
Revised: July 3, 2026
Accepted: July 31, 2026
Published online: November 27, 2026
Processing time: 162 Days and 19.1 Hours
Permanent colostomy poses substantial physical and psychological challenges that impede postoperative recovery.
To evaluate whether adding narrative therapy (NT) to standard ostomy care (SOC) improves postoperative outcomes in patients undergoing permanent colo
This retrospective cohort study included patients who underwent elective permanent colostomy from June 2022 to June 2025. Patients were divided into an NT combined with SOC (NTSOC) group and an SOC group on the basis of receipt of postoperative NT. Outcomes assessed included gastrointestinal recovery, early mobilization, hospital stay, self-care ability at 3 months, stoma complications within 3 months, psychosocial adaptation at 3 months, and stigma perception immediately postoperatively and at 3 months.
The baseline information of each group was comparable. The NTSOC group showed significantly faster gastrointestinal recovery (first oral rehydration: 48.24 hours vs 56.43 hours, P < 0.001) and earlier resumption of normal activities (3.31 days vs 3.75 days). The length of hospital stay was significantly shorter in the NTSOC group than in the SOC group (11.46 days vs 12.37 days, P = 0.016). By 3 months, the NTSOC group exhibited lower persisting concern than the SOC group (12.27 vs 13.75, P = 0.002). A significant difference was found in terms of accepting life (11.59 vs 10.36, P = 0.002); more optimistic attitude (17.44 vs 16.02, P = 0.001); and reduction in the stigmatized perception of social isolation, internalized shame, and perceived social exclusion. However, economic insecurity did not vary significantly (P = 0.091).
NTSOC is associated with accelerated recovery, fewer complications, enhanced self-care, better psychosocial adaptation, and reduced stigma in patients undergoing permanent colostomy.
Core Tip: Permanent colostomy poses substantial physical and psychological challenges that impede postoperative recovery. This retrospective study of 148 patients indicates that narrative therapy combined with standard ostomy care is associated with accelerated gastrointestinal recovery, a lower incidence of stoma complications, and improved self-care and psychosocial adaptation at 3 months. These findings suggest that integrating structured psychological support into routine ostomy management may offer benefits for both physical and psychosocial rehabilitation.