Background: Colorectal Cancer (CRC) survivors commonly experience bowel dysfunction symptoms as a consequence of treatment, leading to physical and psychological distress. While previous studies have focused on managing physical symptoms and the impact of stoma on psychological outcomes, CRC patients without a stoma may also suffer from psychological distress due to their bowel dysfunction symptoms. Body image distress has been identified as a significant factor in CRC patients, and it may mediate the relationship between bowel dysfunction symptoms and psychological outcomes.
Objectives: This study aims to (1) identify bowel dysfunction symptoms, body image distress, and psychological outcomes in CRC survivors and (2) explore the mediating role of body image in the relationship between bowel dysfunction symptoms and psychological outcomes.
Methods: A cross-sectional and correlational design was employed, and CRC survivors completed the Low Anterior Resection Syndrome Score (LARS), Body Image Scale (BIS), and Hospital Anxiety and Depression Scale (HADS) questionnaires. The mediated role of body image was examined using Hayes' PROCESS macro with model 4 and 5000 bootstrap samples.
Results: A total of 193 CRC patients provided data for the study. Among the participants, 65.8% reported experiencing bowel dysfunction symptoms, 44.6% reported body image distress, and 40.4% reported anxiety and depression. Body image was found to partially mediate the effect of bowel dysfunction symptoms on both anxiety (β=.0446, 95% CI: 0.0061, 0.0968) and depression (β=.0411, 95% CI: 0.0034, 0.0941).
Conclusion and Implications: The high prevalence of bowel dysfunction symptoms and body image distress among CRC patients highlights the significance of early recognition and intervention. It emphasizes the need for nurses to be aware of bowel dysfunction symptoms and body image concerns. The significant mediating role of body image underscores the importance of addressing both bowel dysfunction symptoms and body image distress. These findings have important implications for comprehensive care planning, where healthcare professionals should integrate both physical and psychological aspects, addressing body image concerns and promoting psychological well-being.

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