The psychological experience of body image change in adult stoma patients: A systematic review and qualitative meta-synthesis.

In 30 seconds

This systematic review and qualitative meta-ethnography synthesised English-language qualitative research on body image change in adults with a stoma. Eighteen studies involving 602 participants were included. The synthesis identified three themes across two phases—immediately after surgery and living with the stoma: all-consuming shock, visible “otherness” and fluctuating acceptance. The findings describe how stoma formation may disrupt bodily integrity and identity, while self-scrutiny, shame and perceived social exposure can contribute to ongoing distress. The review also maps processes associated with adaptation over time.

Key findings

• The synthesis included 18 qualitative studies with 602 participants.
• Three themes emerged: all-consuming shock, visible “otherness” and fluctuating acceptance.
• Themes spanned two phases: immediately after surgery and living with the stoma.
• Self-scrutiny, shame and perceived social exposure were identified as processes that may maintain body image distress.

Why it matters

The review offers a framework for understanding body image concerns as changing psychological and social experiences, rather than a single response to stoma formation. Recognising the roles of identity, shame and perceived exposure may help clinicians identify distress and understand why adjustment can fluctuate, informing supportive conversations across the surgical and recovery pathway.

What to keep in mind

The synthesis was restricted to primary qualitative research published in English, so its findings may not represent experiences reported in other languages or captured by other study designs.