The experiences of Chinese colorectal cancer survivors in marital intimacy after ostomy creation: A qualitative study


colorectal cancer
marital intimacy
qualitative research

How to Cite

Du, X., Chaiviboontham, S., & Sumdaengrit, B. (2024). The experiences of Chinese colorectal cancer survivors in marital intimacy after ostomy creation: A qualitative study. Belitung Nursing Journal, 10(2), 222–230.
Google Scholar

Link to Google Scholar

Accepted for publication: 2024-03-13
Peer reviewed: Yes

Related articles in

Search Relations - Article by Author(s)

Share this article on:


Background: Colorectal cancer (CRC) ranks as the third most prevalent cancer globally. The disease and its treatment significantly impact marital intimacy, particularly among individuals who have undergone ostomy creation. Therefore, it is necessary to explore their experiences.

Objective: This study aimed to explore the experiences of colorectal cancer survivors in marital intimacy after ostomy creation and clarify the domain and sub-domain of marital intimacy in CRC survivors with ostomy.

Method: This study used a qualitative descriptive design, and participants were selected by purposive sampling from two hospitals in Henan province, China. Sixteen patients participated in this research, and the data were collected through an in-depth interview from June 27 to September 27, 2023. Colaizzi’s method was used to analyze the data.

Results: Five themes emerged from data analysis, including physical intimacy, psychological intimacy, social intimacy, spiritual intimacy, and operational intimacy.

Conclusion: By profiling the experiences of CRC survivors in marital intimacy after ostomy creation, the domain and sub-domain of marital intimacy were clarified in this cohort and revealed that ostomy had a severe effect on marital intimacy among colorectal cancer survivors.  The results from this study could be used by nurses, midwives, and other healthcare professionals to design specific interventions covering all aspects of marital intimacy.  Also, the findings will guide the development of a particular instrument for marital intimacy in CRC survivors with ostomy.

Supporting Agencies

This work was supported by the Health Commission in Henan Provincial, China (LHGJ20210931)


Copyright (c) 2024 Xixi Du, Suchira Chaiviboontham, Bualuang Sumdaengrit

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Article Metrics

Total views 116 [Abstract: 63 | PDF: 53 | XML: 0 ]


Download data is not yet available.

PlumX Metrics

Declaration of Conflicting Interest

The authors declare no conflict of interest.


We extend our special thanks to the participants for their invaluable cooperation in this study. We express our sincere appreciation to the Ramathibodi School of Nursing for supporting this research. Additionally, we acknowledge the Health Commission in Henan Provincial for providing funding support.

Authors’ Contributions

Xixi Du contributes to conceptualization, methodology, resources, investigation, data curation, software, formal analysis, and writing -original draft. SuchiraChaiviboontham contributes to conceptualization, methodology, formal analysis, validation, project administration, supervision, and writing - review & editing. BualuangSumdaengrit contributes to conceptualization, methodology, formal analysis, validation, project administration, supervision, and writing - review & editing. All authors contributed to writing and finalizing the manuscript, and all authors have read and agreed to the published version of the manuscript.

Data Availability

The datasets generated during and analyzed during the current study are available from the corresponding author upon reasonable request.

Declaration of Use of AI in Scientific Writing

The authors have declared that no generative AI was used in writing.


Aktas, D. (2015). Body image perceptions of persons with a stoma and their partners: A descriptive, cross-sectional study. Ostomy/Wound Management, 61(5), 26-40.

Albaugh, J. A., Tenfelde, S., & Hayden, D. M. (2017). Sexual dysfunction and intimacy for ostomates. Clinics in Colon and Rectal Surgery, 30(3), 201-206.

Altschuler, A., Ramirez, M., Grant, M., Wendel, C., Hornbrook, M. C., Herrinton, L., & Krouse, R. S. (2009). The influence of husbands' or male partners' support on women's psychosocial adjustment to having an ostomy resulting from colorectal cancer. Journal of Wound Ostomy & Continence Nursing, 36(3), 299-305.

Ayaz Alkaya, S. (2019). Overview of psychosocial problems in individuals with stoma: A review of literature. International Wound Journal, 16(1), 243-249.

Ayik, C., Özden, D., & Kahraman, A. (2021). Spiritual care needs and associated factors among patients with ostomy: A cross‐sectional study. Journal of Clinical Nursing, 30(11-12), 1665-1674.

Bagarozzi, D. A. (1997). Marital intimacy needs questionnaire: Preliminary report. American Journal of Family Therapy, 25(3), 285-290.

Banaszkiewicz, Z., Woda, Ł. P., Zwoliński, T., Tojek, K., Jarmocik, P., & Jawień, A. (2015). Intestinal stoma in patients with colorectal cancer from the perspective of 20-year period of clinical observation. Gastroenterology Review/Przegląd Gastroenterologiczny, 10(1), 23-27.

Bulkley, J., McMullen, C. K., Hornbrook, M. C., Grant, M., Altschuler, A., Wendel, C. S., & Krouse, R. S. (2013). Spiritual well‐being in long‐term colorectal cancer survivors with ostomies. Psycho‐Oncology, 22(11), 2513-2521.

Che Ya, S. N., Muhamad, R., Mohd Zain, N., Zakaria, R., Ishak, A., Hassan, I. I., Ab Hadi, I., Yahya, M. M., Low, W. Y., & Liamputtong, P. (2021). Coping strategies for sexual problems and sexual dysfunction amongst Malay women with breast cancer. A qualitative study. Sexual Medicine, 9(3), 100336.

Colaizzi, P. F. (1978). Psychological research as the phenomenologist views it. In R. S. Valle & M. King (Eds.), Existential Phenomenological Alternatives for Psychology. Open University Press.

Custers, J. A. E., Gielissen, M. F. M., Janssen, S. H. V., de Wilt, J. H. W., & Prins, J. B. (2016). Fear of cancer recurrence in colorectal cancer survivors. Supportive Care in Cancer, 24, 555-562.

Danielsen, A. K., Burcharth, J., & Rosenberg, J. (2013). Spouses of patients with a stoma lack information and support and are restricted in their social and sexual life: A systematic review. International Journal of Colorectal Disease, 28, 1603-1612.

Davidson, F. (2016). Quality of life, wellbeing and care needs of Irish ostomates. British Journal of Nursing, 25(17), S4-S12.

Den Oudsten, B. L., Traa, M. J., Thong, M. S. Y., Martijn, H., De Hingh, I., Bosscha, K., & Van De Poll-Franse, L. V. (2012). Higher prevalence of sexual dysfunction in colon and rectal cancer survivors compared with the normative population: A population-based study. European Journal of Cancer, 48(17), 3161-3170.

García-Rodríguez, M. T., Barreiro-Trillo, A., Seijo-Bestilleiro, R., & González-Martin, C. (2021). Sexual dysfunction in ostomized patients: A systematized review. Healthcare, 9(5), 520.

Gilbert, S. J. (1976). Self disclosure, intimacy and communication in families. Family Coordinator, 25(3), 221-231.

Hofmann, S. G., & Gómez, A. F. (2017). Mindfulness-based interventions for anxiety and depression. Psychiatric Clinics, 40(4), 739-749.

Hu, A., Pan, Y., Zhang, M., Zhang, J., Zheng, M., Huang, M., Ye, X., & Wu, X. (2014). Factors influencing adjustment to a colostomy in chinese patients: A cross-sectional study. Journal of Wound Ostomy & Continence Nursing, 41(5), 455-459.

Jakubiak, B. K., & Feeney, B. C. (2017). Affectionate touch to promote relational, psychological, and physical well-being in adulthood: A theoretical model and review of the research. Personality and Social Psychology Review, 21(3), 228-252.

Jayarajah, U., & Samarasekera, D. N. (2017). Psychological adaptation to alteration of body image among stoma patients: A descriptive study. Indian Journal of Psychological Medicine, 39(1), 63-68.

Ji, Z., & Yan, E. (2022). Psycho-social factors associated with intimacy needs in divorced and widowed older chinese women. International Journal of Environmental Research and Public Health, 19(19), 12360.

Kardan-Souraki, M., Hamzehgardeshi, Z., Asadpour, I., Mohammadpour, R. A., & Khani, S. (2016). A review of marital intimacy-enhancing interventions among married individuals. Global Journal of Health Science, 8(8), 74-93.

Kim, H., Sefcik, J. S., & Bradway, C. (2017). Characteristics of qualitative descriptive studies: A systematic review. Research in Nursing & Health, 40(1), 23-42.

Knowles, S. R., Wilson, J., Wilkinson, A., Connell, W., Salzberg, M., Castle, D., Desmond, P., & Kamm, M. A. (2013). Psychological well-being and quality of life in Crohn's disease patients with an ostomy: A preliminary investigation. Journal of Wound Ostomy & Continence Nursing, 40(6), 623-629.

Korstjens, I., & Moser, A. (2018). Series: Practical guidance to qualitative research. Part 4: Trustworthiness and publishing. European Journal of General Practice, 24(1), 120-124.

Liao, C., & Qin, Y. (2014). Factors associated with stoma quality of life among stoma patients. International Journal of Nursing Sciences, 1(2), 196-201.

Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. California: Sage Publications.

Lopes, A., & Decesaro, M. D. (2014). The adjustments experienced by persons with an ostomy: An integrative review of the literature. Ostomy Wound Management, 60(10), 34-42.

Lu, Z., H.,, & Wan, D., S. . (2009). Complications and treatment of enterostomy. Guangdong Medicine, 30(8), 1029-1030.

Mäkelä, J. T., & Niskasaari, M. (2006). Stoma care problems after stoma surgery in Northern Finland. Scandinavian Journal of Surgery, 95(1), 23-27.

Manne, S. L., Kissane, D. W., Nelson, C. J., Mulhall, J. P., Winkel, G., & Zaider, T. (2011). Intimacy‐enhancing psychological intervention for men diagnosed with prostate cancer and their partners: A pilot study. The Journal of Sexual Medicine, 8(4), 1197-1209.

Mills, B., & Turnbull, G. (2001). After trauma: Why assessment of intimacy should be an integral part of medico‐legal reports. Sexual and Relationship Therapy, 16(3), 299-308.

NasiriZiba, F., & Kanani, S. (2020). The effect of education with a family-centered and client-centered approach on the quality of life in patients with stoma. Journal of Caring Sciences, 9(4), 225-230.

Olson, D. H. (1975). Intimacy and the aging family. Realities of aging. College of Home Economics, University of Minnesota.

Petersén, C., & Carlsson, E. (2021). Life with a stoma—coping with daily life: Experiences from focus group interviews. Journal of Clinical Nursing, 30(15-16), 2309-2319.

Polit, D. F., & Beck, C. T. (2009). International differences in nursing research, 2005–2006. Journal of Nursing Scholarship, 41(1), 44-53.

Polit, D. F., & Beck, C. T. (2014). Essentials of nursing research: Appraising evidence for nursing practice (8th ed.). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.

Qin, F., Ye, X., Wei, H., Wen, Y., Shi, L., Zhen, L., Zhi, M., & Zhang, L. (2019). Sexual experience and stigma among Chinese patients with an enterostomy: A cross-sectional, descriptive study. Wound Management & Prevention, 65(12), 22-30.

Robinson, L., Miedema, B., & Easley, J. (2014). Young adult cancer survivors and the challenges of intimacy. Journal of Psychosocial Oncology, 32(4), 447-462.

Sandelowski, M. (2010). What's in a name? Qualitative description revisited. Research in Nursing & Health, 33(1), 77-84.

Schaefer, M. T., & Olson, D. H. (1981). Assessing intimacy: The PAIR inventory. Journal of Marital and Family Therapy, 7(1), 47-60.

Shin, J. H., & Choi, J. Y. (2021). Development and evaluation of resilience enhancement program applying mindfulness meditation in patients with ileostomy. Journal of Korean Academy of Nursing, 51(3), 334-346.

Silva, A. L., Monteiro, P. S., Sousa, J. B., Vianna, A. L., & Oliveira, P. G. (2014). Partners of patients having a permanent colostomy should also receive attention from the healthcare team. Colorectal Disease, 16(12), O431-O434.

Sivero, L., Bottone, M., Siciliano, S., Volpe, S., Maione, R., Chini, A., Pollastro, M., Iovino, S., & Sivero, S. (2022). Post-operative oncological and psychological evaluation of patients with colostomy for colorectal cancer. Annali Italiani di Chirurgia, 93(4), 435-438.

Smith, J. A., Spiers, J., Simpson, P., & Nicholls, A. R. (2017). The psychological challenges of living with an ileostomy: An interpretative phenomenological analysis. Health Psychology, 36(2), 143-151.

Speziale, H. S., Streubert, H. J., & Carpenter, D. R. (2011). Qualitative research in nursing: Advancing the humanistic imperative (5th ed.). Philadelphia: Lippincott Williams & Wilkins.

Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021). Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 71(3), 209-249.

Turnbull, N., Peltzer, K., Pengpid, S., Low, W. Y., Huu, T. N., Rochmawati, E., & Win, H. H. (2018). Pathological Internet use and psychosocial risk factors among ASEAN university students. Iranian Journal of Psychiatry and Behavioral Sciences, 12(1), e10063.

Vonk-Klaassen, S. M., de Vocht, H. M., den Ouden, M. E. M., Eddes, E. H., & Schuurmans, M. J. (2016). Ostomy-related problems and their impact on quality of life of colorectal cancer ostomates: A systematic review. Quality of Life Research, 25, 125-133.

Vural, F., Harputlu, D., Karayurt, O., Suler, G., Edeer, A. D., Ucer, C., & Onay, D. C. (2016). The impact of an ostomy on the sexual lives of persons with stomas: A phenomenological study. Journal of Wound Ostomy & Continence Nursing, 43(4), 381-384.

Walker, L. M., Hampton, A., & Robinson, J. W. (2014). Assessment of relational intimacy: Factor analysis of the personal assessment of intimacy in relationships questionnaire. Psycho‐Oncology, 23(3), 346-349.

Wiltink, L. M., Chen, T. Y. T., Nout, R. A., Kranenbarg, E. M.-K., Fiocco, M., Laurberg, S., van de Velde, C. J. H., & Marijnen, C. A. M. (2014). Health-related quality of life 14 years after preoperative short-term radiotherapy and total mesorectal excision for rectal cancer: Report of a multicenter randomised trial. European Journal of Cancer, 50(14), 2390-2398.

Yuan, J. M., Zhang, J. E., Zheng, M. C., & Bu, X. Q. (2018). Stigma and its influencing factors among Chinese patients with stoma. Psycho‐Oncology, 27(6), 1565-1571.

Zeng, H., Chen, W., Zheng, R., Zhang, S., Ji, J. S., Zou, X., Xia, C., Sun, K., Yang, Z., & Li, H. (2018). Changing cancer survival in China during 2003–15: A pooled analysis of 17 population-based cancer registries. The Lancet Global Health, 6(5), e555-e567.

Zewude, W. C., Derese, T., Suga, Y., & Teklewold, B. (2021). Quality of life in patients living with stoma. Ethiopian Journal of Health Sciences, 31(5), 993-1000.

Readers are able to give us their valuable feedbacks here. The comments will be reviewed by the editors and then published here. Important Note: The "Comments" related to the Galley Proof PDF must NOT be submitted via this form. Authors should submit their comments on their galley proofs only via system