Qualitative Study of Learned Helplessness in Colorectal Cancer Patients with Colostomy: A Social-Ecological Perspective

Xianqi Wei,1 Lujuan Wu,1 Xuan Chen,1 Jinxia Ding,1,2 Qingling Hua2 1School of Nursing, Anhui Medical University, Hefei, People’s Republic of China; 2Department of Medical Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of ChinaCorrespondence: Jinxia Ding, School of Nursing, Anhui Medical University, Hefei, People’s Republic of China, Email 786303584@qq.comPurpose: To explore the experience of learned helplessness among colorectal cancer ostomy patients within the theoretical framework of social ecosystems, and to provide a theoretical basis for developing targeted nursing interventions for this population.Methods: Employing purposive sampling, semi-structured in-depth interviews were conducted with 16 colorectal cancer patients with ostomies at the First Affiliated Hospital of Anhui Medical University between March and June 2024. Data analysis was performed using Colaizzi’s phenomenological methodology.Results: A total of three main themes and nine sub-themes were identified, as follows: (1) Micro-level systems: fear and negative cognition, self-care barriers and dependency, and self-regulation fatigue and loss of control; (2) Meso-level systems: heavy economic burden, the importance of family support, and social avoidance and stigma; (3) Macro-level systems: insufficient medical information and services, social cognitive bias, and the importance of social security policies.Conclusion: Learned helplessness in colorectal-cancer patients is driven by synergistic systemic factors. Healthcare providers should implement multifaceted, individualized interventions that target psychological distress and mitigate helplessness across the entire care trajectory.Keywords: colorectal cancer, stoma, learned helplessness, social-ecological theory, qualitative research