Does an Online Self-Compassion Expressive Writing Exercise Offer Benefit to Stoma Patients? A randomised controlled trial

Abstract

Individuals living with a stoma can experience a range of unique physical complications and psychological challenges such as psychological distress, negative body image, and overall reduced quality of life (QOL). However, existing interventions are both limited and insufficient at improving psychological well-being. The current study explores the potential benefit of a self-compassion expressive writing intervention to people with a stoma and the moderating influence of dispositional disgust propensity (i.e., frequency of disgust) and disgust sensitivity (i.e., level of disgust when it occurs) on well-being. In this experimental study, 175 individuals with a stoma living in New Zealand or Australia completed an online questionnaire assessing demographics, medical characteristics, and psychological measures (disgust propensity and sensitivity, psychological distress, body image, self-compassion, and stoma QOL). Participants were randomly allocated to either the intervention (n = 89) or control (n = 86) condition. One-week and one-month follow-up questionnaires were sent to participants who completed their writing exercise (n = 140). Older age, longer stoma duration, and stoma permanency correlated with reduced body image distress and stoma-QOL (all p < .05). Higher disgust propensity was associated with greater body image distress (β = .18, p < .05) but not lower stoma-QOL (β = -.08, p = .37), whereas, disgust sensitivity had no significant influence on the measures. Depression was the greatest predictor of well-being (all p < .001). Repeated-measures ANOVA results revealed no main effect of time or condition on measured outcomes. However, dispositional disgust (propensity and sensitivity)e moderated participants’ psychological well-being whereby participants with lower disgust were more responsive to expressive writing compared to participants with higher disgust This is with the exception of disgust propensity which had no moderating influence on body image distress (p = .41). Potential explanations for why the intervention benefits were limited to those with low disgust are examined. This is the first study to examine the use of self-compassion expressive writing in stoma patients and identify the moderating influence of dispositional disgust on psychological well-being. Importantly, this study highlights the gaps in research on how best to support those living with a stoma and provides justification for further examination of the role of disgust in this context.