Culture and psychosocial function in British and Japanese people with an ostomy

PURPOSE: We compared social and psychological adjustment to surgery ending with an ostomy in British and Japanese patients. METHODS: In response to a postal survey, 948 ostomy patients (464 British and 484 Japanese), selected at random from respective national databases, provided assessable data on the Ostomy Adjustment Inventory-23 (OAl-23), a validated scale for measurement of psychosocial adjustment to an ostomy. RESULTS: Analysis of variance revealed that country of residence (F-1,F-876 (-)50.9, P <.001) and time since surgery (F-3,F-876 (-)9.9, P <.001) significantly influenced psychosocial adjustment to an ostomy. British persons with an ostomy experienced higher psychosocial adjustment to an ostomy than did Japanese respondents. Multivariate analysis based on acceptance, social engagement, anxious-preoccupation, and anger also found that country of residence and time since surgery influenced psychosocial adjustment (Pillai's Trace: V = 0.22, F = 67.15, P < 0.001, and V = 0.05, F = 3.6, P <.001, respectively). Acceptance and social engagement (discriminant coefficient = 0.92 and 0.56, respectively) made the largest contribution. CONCLUSION: Psychosocial functioning differed in British and Japanese persons with an ostomy, suggesting that culture influences psychosocial adjustment to life with an ostomy. These findings support the need for culturally informed ostomy care.