Current Financial Toxicity Status and Influencing Factors in Patients Undergoing Enterostomy: A Cross-sectional Study

Current Financial Toxicity Status and Influencing Factors in Patients Undergoing Enterostomy: A Cross-sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Current Financial Toxicity Status and Influencing Factors in Patients Undergoing Enterostomy: A Cross-sectional Study Wen Li, Meng Wang, Hui Zheng, Minghao Zou, Kim Lam Soh This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7821894/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Aim and Objective The aim of this study is to explore the financial toxicity status of enterostomy patients and analyse the influencing factors in Shandong Province, China. Background Post-enterostomy patients require long-term use of stoma products, which presents significant financial challenges for patients. Identifying the factors contributing to this burden is crucial for developing targeted interventions and health insurance policies to improve patients' quality of life. Methods This study used the general data questionnaire, the comprehensive financial toxicity score scale of patient-reported outcomes, the understanding social support scale and the psychological resilience scale, 190 patients with enterostomy from three tertiary A hospitals in Yantai were selected for investigation. Univariate and multivariate linear regression analyses were employed to identify factors associated with financial toxicity. Results Financial toxicity was present in 72.63% of enterostomy patients. Social support was negatively correlated with financial toxicity ( P <0.001). Multivariate regression analysis identified residential status, primary caregiver, stoma-related complications, and social support as significant factors contributing to financial toxicity. Conclusion The results of the study showed that more than half of the patients with enterostomies face financial difficulties. Those living alone, experiencing stoma-related complications, and with low social support require greater attention from healthcare providers. This provides a reference for the future development of appropriate health insurance systems. Relevance to clinical practice This study identifies the factors that contribute to the high financial burden of patients with enterostomies and can assist in planning and delivering needed care, which may help reduce predictable problems. It points to relevant future research directions for the Medicare system. Enterostomy Financial toxicity Influencing factor 1 INTRODUCTION According to the World Health Organization, colorectal cancer is the third most common cancer worldwide, accounting for approximately 10% of all cancer cases and is the second leading cause of cancer-related deaths worldwide. In 2020, more than 1.9 million new cases of colorectal cancer and more than 940,000 deaths due to colorectal cancer were estimated to have occurred worldwide (Yue Xi et al., 2021). The incidence rates were highest in Europe, Australia and New Zealand, and the mortality rates were highest in Eastern Europe. In China, colorectal cancer is the second most common type of cancer, accounting for 28.8% of all colorectal cancer cases worldwide (Zhou Xiong et al., 2022). By 2040 the burden of colorectal cancer will increase to 3.2 million new cases per year (an increase of 63%) and 1.6 million deaths per year (an increase of 73%) (Eileen Morgan et al.,2023). Enterostomy is a common surgical procedure for the clinical treatment of colorectal cancer, which involves connecting the intestinal lumen to the outside of the body through an incision in the abdominal wall after the removal of the tumour, anus and surrounding tissues, and replacing its secretory function with the anus (Nicholas L Syn et al.,2017). The number of enterostomy patients in China has exceeded 1 million, with about 100,000 new patients added each year, and the trend is still growing (Gao Wenjun et al.,2017). Ostomy surgery negatively impacts patient's physical activity, psychological performance and social relationships and can lead to reduced quality of life (Alenezi et al., 2021 ) While an enterostomy alleviates disease symptoms, it introduces new challenges, including financial difficulties associated with long-term stoma care. Patients with enterostomies need stoma care for a short period of several months or even for a lifetime, and the long-term use of stoma products such as ostomy bags and anti-leakage creams makes them consumable, which will undoubtedly increase the financial burden on patients and their families (Jiang Hua et al., 2022). Studies have shown that approximately one-third of patients with enterostomies develop stoma-related complications within 90 days of surgery and that the occurrence of complications increases the average cost of care for the patient, which on the other hand adds to the patient's financial burden (Taneja et al., 2017 ). Yousuf Zafar introduced the term "financial toxicity" in 2013, a new term that refers to the high cost of cancer treatment caused by high economic stress that bankrupts patients and their families (Zafar et al., 2013). Several studies show that people with cancer and survivors are more likely to have financial toxicity than people without cancer (Mudaranthakam et al., 2023 ; Mudaranthakam et al., 2023 ). This is because when a patient is diagnosed with cancer, the patient and his or her family face a reduction in income and assets, debts incurred as a result of the treatment, and even difficulty in paying rent and food, and eventually bankruptcy. Patients with financial toxicity have a lower quality of life, more symptoms, and more pain. One study suggests that some patients consider financial toxicity to be more serious than physical, emotional, social or family pain (McLoone et al., 2023 ). China is the world's largest developing country, and although a health insurance system covering nearly 96% of the population and benefiting more than 1.36 billion people has been established, the gap between supply and demand for health care is widening as the problem of an ageing population in society becomes more and more prominent, and it is challenging for the Government to set up a large and effective health care system (Xinxin Chen et al., 2022 ). For patients with chronic diseases such as enterostomies, if they do not have an organization to pay for their medical insurance, they cannot enjoy the corresponding national reimbursement system, which undoubtedly adds to their financial burden. Currently, studies on financial toxicity are mainly focused on patients with various types of cancer and chemotherapy (Wang Zhe et al., 2023 ), and in China, stoma patients are only involved in patients with ureteral dermal stoma (Cheng Wenyu et al., 2023), and the study of financial toxicity in patients with enterostomies has still not been addressed. This study examined the factors contributing to the presence of financial toxicity in Chinese enterostomy patients. 2 MATERIAL AND METHODS 2.1 Objectives The purpose of this study was to investigate the factors affecting the presence of financial toxicity in Chinese enterostomy patients and to provide direction for future reforms of the health insurance system. 2.2 Design The cross-sectional survey method was used in this study, which was a multicenter study conducted across three tertiary A hospitals in Shandong Province, in the period between November 2022 and February 2023. This study was employed The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies. 2.3 Participants A convenience sample of patients with enterostomies was used in this study. The eligibility criteria for participation in this study were as follows: (a) pathologically diagnosed as rectal or colorectal cancer; (b) surgically treated patients with intestinal stoma; (c) age ≥ 16 years; (d) informed consent and voluntary participation in the research project. Exclusion criteria: (a) severe psychiatric history; (b) cognitive dysfunction, no basic reading and writing ability. After obtaining informed consent from the patients, during the patient's follow-up visit to the outpatient clinic after discharge, the researcher distributed the questionnaires and instructed the patients to fill them out independently by using a uniform instruction. For those who had poor reading ability, the researcher read aloud the items one by one to assist them in filling them out, avoiding the use of suggestive language. The questionnaires were filled out and collected on the spot to ensure their reliability. A convenience sample of patients who underwent enterostomy surgery between November 2022 and February 2023 at the participating hospitals was screened for eligibility. Data collection occurred during the patients' scheduled follow-up visits to the outpatient clinic after discharge. 2.4 Data collection Quantitative data were collected using the Chinese versions of the Comprehensive Scores for Financial Toxicity based on the Patient-Reported Outcome Measures, the Social Support Scale, and the Psychological Resilience Scale for patients with enterostomies. 2.4.1 General Information Questionnaire According to the purpose of the study, the members of the study group designed their own questionnaire based on a review of the literature, including the patient's gender, age, education level, marital status, state of residence, main companion, monthly income, mode of payment for treatment, and the presence of complications of the stoma. Stoma-related complications were assessed based on patient self-report and clinical examination during the follow-up visit, and included conditions such as peristomal skin irritation, leakage, stenosis, retraction, or parastomal hernia. 2.4.2 Comprehensive Scores for Financial Toxicity Based on the Patient-Reported Outcome Measures (COST-PROM) The scale was used to assess the patient's understanding of the financial stress in the questionnaire, and consisted of 11 items in 3 dimensions, i.e., financial expenditure (1 item), financial resources (2 items), and psychosocial reactions (8 items), and was scored on a 5-point Likert scale from "not at all" to "very much" in order of 0–4. The Likert 5-point scale was used, with scores ranging from "not at all" to "very much" in the order of 0 to 4. The lower the total score, the greater the financial toxicity of the patient due to the disease, and a total score of < 26 was defined as the cut-off point for the presence of financial toxicity. In this study, the Chinese version of the scale, which was Chineseised by Yu Huihui et al, was used, and its Cronbach's alpha coefficient was tested to be 0.889 (Yu Huihui et al., 2017 ). 2.4.3 Social Support Scale This scale is used to assess the degree of understanding of social support, including family support (4 entries), friend support (4 entries) and other support (4 entries) in 3 dimensions, with a total of 12 entries. A 7-point Likert scale was used, with 1 indicating "strongly disagree" and 7 indicating "strongly agree", and the total score ranged from 12 to 84, with higher scores indicating higher social support. According to the study, it can be divided into low support (12–36 points), intermediate support (37–60 points) and high support (61–84 points), and the Cronbach's alpha coefficient of each dimension of the scale is greater than 0.8 (Chen Ke et al., 2023). 2.4.4 Psychological Resilience Scale This scale is used to assess whether subjects can adapt well to stress and adversity and can maintain and restore their psychological health, including change, personal problems, illness, stress, failure and pain, etc. 10 entries, using the Likert 5-point scale, with a score of 0 indicating "never", 4 indicating "Almost always", with a total score of 0–40, the higher the score, the better the psychological resilience (Dong Ao et al., 2022 ). The Cronbach's alpha coefficient of this scale has been shown to be 0.89 (Shen Yalin et al., 2022). 2.5 Ethical review The study complied with the Declaration of Helsinki and "Good Clinical Practice" guidelines and was approved by the Ethics Committee of Yantai Yuhuanding Hospital. Informed consent was obtained from all individual participants included in the study. Any information obtained in connection with this research that can identify participants remains confidential. 2.6 Data analysis This study used SPSS 27.0 statistical software package for statistical analysis. Measured data obeying normal distribution were described using mean ± standard deviation; intergroup comparisons were made using t-test or one-way ANOVA; data conforming to normal distribution were analysed using Pearson's correlation analysis; multiple linear regression was used to analyse the influencing factors of financial toxicity of patients with intestinal stoma, and differences were considered to be statistically significant at P < 0.05. 3 RESULTS Completed survey instruments were obtained from 190 participants across the three sites, representing a 95% (190/200) response rate. Most of the participants were male N = 110 (57.89%), Participants in the age > 60 years old were the highest group with N = 94 (49.47%), Most enterostomy patients spend 100 ~ 500 yuan per month on ostomy products N = 124 (65.26%) (Table 1 ). Table 1 Sociodemographic and clinical characteristics of the participants (n = 190) Characteristics No. Percentage Sex Male 110 57.89% Female 80 42.11% Age 16 ~ 20 0 0.00% 21 ~ 30 6 3.16% 31 ~ 40 12 6.32% 41 ~ 50 38 20.00% 51 ~ 60 40 21.05% >60 94 49.47% Educational level Elementary school 40 21.05% Junior high school 80 42.11% High school 34 17.89% Junior college 16 8.42% Bachelor's degree and above 20 10.53% Occupation Institutions 24 12.63% Professionals and technicians 16 8.42% Commerce and services 8 4.21% Agriculture, forestry, animal husbandry, fisheries, and water production 26 13.68% Operators of production and transportation equipment 18 9.47% Self-employed 98 51.58% Marital status Unmarried 4 2.11% Married 152 80% Divorced 6 3.16% Widowed 28 14.74% Home location Rural 98 51.58% Urban 92 48.42% Residence status Living with spouse 114 60.00% Living with children 20 10.53% Living with spouse and children 36 18.95% Living alone 20 10.53% Primary caregivers Parents 14 7.37% Spouse 114 60.00% Children 52 27.37% Brothers and sisters 2 1.05% Others 8 4.21% Monthly per capita family income < 1000 yuan 54 28.42% 1000 ~ 2999 yuan 46 24.21% 3000 ~ 4999 yuan 52 27.37% ≥ 5000 yuan 38 20.00% Time after surgery < 6 months 106 55.79% 6 months ~ 1 year 28 14.74% 1 year ~ 5 years 56 29.47% Type of medical insurance Urban workers 92 48.42% Urban residents 86 45.26% Out-of-pocket expenses 8 4.21% Others 4 2.11% Monthly cost of purchasing stoma products 1,000 yuan 32 16.84% Status of self-care Completely self-care 34 17.89% Partially self-care 90 47.37% Completely unable to care for themselves 66 34.74% Ostomy complications None 128 67.37% Presence 62 32.63% In this study, the total score on the financial toxicity scale for enterostomy patients was (21.52 ± 7.80), 72.63% of patients (score less than 26) presented positive for financial toxicity (Table 2 ); the total score on the social support scale was (63.16 ± 12.68), the highest scores came from friend support (Table 3 ); and the psychological resilience scale total score was (25.35 ± 8.09). Table 2 Scores on the Financial Toxicity Scale (COST-PROM) for Patients with Enterostomies Scale / Subscale Items, n Mean SD COST-PROM Total Score 11 21.52 7.80 Financial Expenditure 1 1.22 1.34 Financial Resources 2 4.71 2.60 Psychosocial Reactions 8 15.59 5.83 Table 3 Scores on the Social Support Scale for Patients with Enterostomies Scale / Subscale Items, n Mean SD Social Support Total Score 12 63.16 12.68 Family Support 4 20.82 3.42 Friend Support 4 21.78 4.45 Other Support 4 20.56 4.81 In exploring the factors influencing the dependent variable, financial toxicity, we first conducted a one-way analysis of factors. The results showed that the educational level, marital status, residence status, primary caregivers, monthly per capita family income, type of medical insurance, and ostomy complications showed statistically significant differences ( P < 0.05) (Table 4 ). Table 4 Comparison of total financial toxicity scores in patients with different characteristics of enterostomies (n = 190) Characteristics No. COST-PROM score F P Sex Male 110 21.05 ± 7.00 0.912 0.341 Female 80 22.15 ± 8.80 Age 16 ~ 20 0 0.00 ± 0.00 0.575 0.681 21 ~ 30 6 19.67 ± 8.31 31 ~ 40 12 22.17 ± 2.37 41 ~ 50 38 20.00 ± 6.87 51 ~ 60 40 21.85 ± 9.60 >60 94 22.02 ± 7.77 Educational level Elementary school 40 22.55 ± 9.12 2.497 0.032 Junior high school 80 22.73 ± 7.72 High school 34 17.94 ± 6.98 Junior college 16 19.13 ± 6.56 Bachelor's degree and above 20 23.13 ± 4.33 Occupation Institutions 24 18.42 ± 6.37 1.877 0.100 Professionals and technicians 16 21.63 ± 6.79 Commerce and services 8 22.00 ± 5.90 Agriculture, forestry, animal husbandry, fisheries, and water production 26 21.85 ± 6.94 Operators of production and transportation equipment 18 18.33 ± 5.31 Self-employed 98 22.71 ± 8.73 Marital status Unmarried 4 25.00 ± 5.77 6.439 < 0.001 Married 152 20.64 ± 7.33 Divorced 6 33.33 ± 8.73 Widowed 28 23.21 ± 7.80 Home location Rural 98 21.39 ± 7.30 0.054 0.816 Urban 92 21.65 ± 8.35 Residence status Living with spouse 114 20.54 ± 7.77 51.549 0.034 Living with children 20 22.40 ± 4.50 Living with spouse and children 36 20.72 ± 5.99 Living alone 20 27.60 ± 10.66 Primary caregivers Parents 14 20.57 ± 6.27 15.404 0.002 Spouse 114 19.79 ± 6.55 Children 52 23.92 ± 9.15 Brothers and sisters 2 32.00 ± 13.86 Others 8 27.50 ± 3.89 Monthly per capita family income < 1000 yuan 54 23.26 ± 8.09 94.245 0.008 1000 ~ 2999 yuan 46 23.43 ± 9.04 3000 ~ 4999 yuan 52 20.38 ± 4.88 ≥ 5000 yuan 38 18.26 ± 7.97 Time after surgery < 6 months 106 21.15 ± 7.82 2.953 0.055 6 months ~ 1 year 28 19.21 ± 6.61 1 year ~ 5 years 56 23.36 ± 8.05 Type of medical insurance Urban workers 92 21.04 ± 8.10 7.604 < 0.001 Urban residents 86 20.95 ± 6.55 Out-of-pocket expenses 8 22.67 ± 5.16 Others 4 35.67 ± 9.97 Monthly cost of purchasing stoma products 1,000 yuan 32 21.44 ± 8.78 Status of self-care Completely self-care 34 23.24 ± 9.56 80.423 0.135 Partially self-care 90 20.80 ± 6.07 Completely unable to care for themselves 66 20.06 ± 7.75 Ostomy complications None 128 19.91 ± 7.04 18.210 < 0.001 Presence 62 24.84 ± 8.30 Correlation analyses between the subscales of financial toxicity and social support were conducted to provide a more nuanced understanding of the relationships between specific dimensions of these constructs. The normality test for each variable in the survey of enterostomy patients revealed that the data conformed to a normal distribution, so the correlation analysis was performed using Pearson correlation analysis. The results showed that there was a negative correlation between social support and financial toxicity (r=-0.308, P < 0.001), and a positive correlation between social support and psychological resilience (r = 0.164, P 0.05) (Table 5 ). Table 5 Correlation analysis between variables and financial toxicity in patients with enterostomies Financial expenditure Financial resources Psychosocial reactions Financial toxicity Family support Friend support Other support Social support Psychological resilience Financial expenditure 1 Financial resources -0.244 ** 1 Psychosocial reactions 0.178 * 0.571 ** 1 Financial toxicity 0.223 ** 0.718 ** 0.968 ** 1 Family support -0.022 -0.191 ** -0.265 ** -0.265 ** 1 Friend support 0.098 -0.338 ** -0.346 ** -0.354 ** 0.787 ** 1 Other support 0.157 * -0.230 ** -0.231 ** -0.222 ** 0.652 ** 0.826 ** 1 Social support 0.086 -0.278 ** -0.308 ** -0.308 ** 0.885 ** 0.955 ** 0.904 ** 1 psychological resilience 0.341 ** -0.016 -0.006 0.049 0.138 0.153 * 0.160 * 0.164 * 1 **. At the 0.01 level (two-tailed), the correlation is significant *. Significant at 0.05 level (two-tailed) The financial toxicity score was used as the dependent variable, and the statistically significant variables ( P < 0.05) in the univariate analysis as well as the social support scale were used as the independent variables to enter the multiple linear regression model. The results showed that four variables, residence status, primary caregivers, ostomy complications, and social support, entered the regression equation, and explained a total of 24.7% of the total variance (Table 6 ). Table 6 Multiple linear regression analysis of financial toxicity in patients with enterostomies Unstandardized coefficient Standardized coefficient t P Covariance statistics B Standard error Beta Ttolerances VIF (Constant) 18.786 4.399 4.271 0.000 Residence status 1.022 0.513 0.142 1.991 0.048 0.782 1.278 Primary caregivers 2.394 0.748 0.252 3.199 0.002 0.641 1.560 Ostomy complications 3.689 1.135 0.222 3.250 0.001 0.852 1.174 Social support -0.119 0.041 -0.193 -2.860 0.005 0.876 1.142 4. DISCUSSION Although many studies have examined the financial toxicity of cancer patients, few published studies have measured the economic burden on patients with enterostomies This study showed that the financial toxicity score of enterostomy patients was (21.52 ± 7.80), and 72.63% of patients presented with financial toxicity, defined as a COST-PROM score of less than 26. The results of this study were lower than those of the study of ureterostomy patients by Shen Yalin (Shen Yalin et al., 2022). This discrepancy may be attributed to several factors. First, patients need to rely on the enterostomy for a long period of time to excrete the body's wastes and digestive matter after stoma surgery, which often requires the purchase of stoma-care related products for a long period of time such as ostomy pouches, leakage-proof creams, and stoma skin-care powders, and so on. The survey showed that permanent stoma patients spent $ 2,396.57 on stoma-related consumables, with a monthly average of $ 199.71 (Zhu Bifan et al., 2020 ), and for some patients with poorer family finances this long-term behaviour can add to the financial burden; Second, Intestinal stoma will cause certain difficulties to the work and life of patients, and some patients may need to adjust their working hours or work content to adapt to the needs of intestinal stoma, which will also have a certain impact on their income and career development. Therefore, we need to pay attention to the current state of financial toxicity of patients with enterostomies, provide them with necessary support and assistance, and at the same time strengthen the relevant policies and measures to alleviate the state of high economic pressure on patients and improve their quality of life and sense of well-being. This study showed that residence status was an influential factor in the level of financial toxicity in patients with enterostomies ( P < 0.05), and the financial toxicity scores of patients with enterostomies who lived with their spouses were lower, which is consistent with the results of the study on the factors influencing financial toxicity in patients with stroke conducted by Zhang Yiyou (Zhang Yiyou et al., 2023). Living with a spouse can bring many benefits, such as mutual care, appropriate social support, reduced burden of living and enhanced quality of life. A qualitative study of Chinese couples' cancer experiences indicated that the sick spouse has a higher need for intimacy, and for patients with enterostomies, assistance with defecation and changing the stoma bag, which are highly private behaviours, often require the assistance of someone in a close relationship, and therefore patients with enterostomies need to rely on their spouses for a long period before they can achieve stoma self-management. In addition, it has been shown that the husband-wife relationship of patients with enterostomies can have an impact on each other's emotions (Zhang Huan et al., 2021 ), and the increase of supportive behaviours from the spouses can satisfy the patients' self-worth and self-needs, which can reduce negative emotions such as depression (Regana et al., 2014). Therefore, living with a spouse not only provides help from life and care, but also supports each other emotionally, shares stress, and solves problems together, which improves the quality of life and reduces the financial burden. This study showed that the lowest financial toxicity scores were found in patients with enterostomies whose primary companion was the spouse ( p < 0.05). Enterostomy is a more serious disease that requires long-term treatment and care. Patients need to change their stoma bags regularly every day, clean the skin around the stoma, pay attention to eating and defecation, and so on, which is a great burden to both patients and family members. For patients whose main companion is the spouse, the patient's condition may have a greater impact on the family's financial situation as the spouse is usually the breadwinner in the family. When one of the spouses is ill, the need for the spouse to take time off work to care for the patient can lead to a reduction in income, thus affecting the livelihood of the family. In addition, the patient and family members have to bear higher medical costs, including the cost of treatment, medicines, ostomy bags and related products, which can also put some pressure on the family's finances. Therefore, for patients with colostomy whose primary carer is their spouse, the financial toxicity is greater and may affect the livelihood and quality of life of the family. The medical sector and the community should enhance their concern and support for such patients and families by providing the necessary medical and livelihood assistance to alleviate the financial burden on the families, thereby promoting the health and well-being of the patients and families. This study showed that enterostomy patients with stoma-related complications had the highest financial toxicity score ( p < 0.05). The study showed that 37.2% of post-colorectal patients were readmitted to the hospital within 90 days of discharge and that patients with stoma complications had higher hospitalisation costs than those without (Taneja et al., 2017 ), with a mean total medical cost of approximately $ 58,32 (Taneja et al., 2019 ). This is because such patients need to go to hospitals frequently for check-ups and treatment, which will often increase medical expenses. If the stoma complications are more serious, they will need to undergo surgery or be hospitalised, in which case the medical expenses will be even higher. Secondly, as the condition of the patients is more serious and they need long-term nursing and care, their family members need to take leave to take care of the patients, thus affecting the income of the family and exerting pressure on the family's finances. In addition, Electrolyte disturbances are commonly seen in post-colonization patients, especially if there are complications, leading to protein malabsorption as well as calcium, potassium and zinc deficiencies (Fulham et al.,2008), which require the use of special nutritional diets that can additionally increase the family's expenses. Therefore, enterostomy patients with stoma complications have higher financial toxicity scores, which can put a great deal of financial pressure on both the patients and their families. The medical sector and society should strengthen their concern and support for such patients and families, to alleviate their financial burden and improve their quality of life. This study showed that the higher the social support score, the lower the financial toxicity score of enterostomy patients ( P < 0.05), which is consistent with the findings of Nguyen (Nguyen et al.,2021). Enterostomy patients with high scores of social support are more likely to receive social support and help, which reduces their economic burden, and therefore their financial toxicity scores are lower. Social support includes support from family, friends, community, charitable organisations, etc., which can be financial, psychological or practical. Studies have shown that for patients with enterostomies, encouragement and support from family members, especially spouses, is crucial for patients to confront their body image and reduce psychological distress (Hu Jiaojiao et al.,2023; Son et al., 2020; Petersén et al., 2021). In addition, enriching daily life, such as attending book club meetings regularly can give enterostomy patients more mental strength. Therefore, to improve the social support situation of enterostomy patients, a multi-pronged approach can be adopted. On the part of the Government, measures can be taken, such as the establishment of specialised agencies or organisations to provide professional medical care, psychological counselling and other services, and to encourage the community to participate in the provision of assistance and support to patients. In addition, social organisations can play an active role in carrying out public welfare activities and social services for patients with intestinal stoma, to increase their social and communication opportunities and raise their level of social support. Individuals can also take measures to obtain corresponding social support, such as actively participating in social activities, taking the initiative to communicate, and cultivating good interpersonal relationships, all of which can help to increase their social support. In conclusion, improving the social support score of enterostomy patients can effectively reduce their economic burden and improve their quality of life. Limitations This study has several limitations. First, the cross-sectional design precludes the establishment of causal relationships. Second, the use of a convenience sample from a coastal city in Shandong Province, China, may limit the generalizability of the findings to other regions with different socioeconomic backgrounds or healthcare systems. Third, we lacked detailed information on several potential confounding variables, such as the time since enterostomy surgery (for a significant portion of the cohort), the specific type of enterostomy (e.g., colostomy vs. ileostomy), cancer stage, and whether the stoma was intended to be permanent or temporary. Future longitudinal studies with more diverse samples and comprehensive data collection are warranted to confirm our findings and explore the causal pathways of financial toxicity in this patient population 5 CONCLUSION The results of various studies have shown that financial toxicity is common in patients with enterostomies. Residence status, primary caregivers, ostomy complications, and social support are the influencing factors of financial toxicity in patients with enterostomies. Healthcare professionals and relevant administrators should identify the influencing factors of financial toxicity promptly when developing strategies for managing financial toxicity in patients to reduce the adverse effects of financial toxicity on patients. Declarations Conflict of interest statement The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. Ethics approval and consent to participate All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was approved by the Yantai Yuhuangding Hospital Ethics Committe. Informed consent was obtained from all individual participants included in the study. Consent for publication Not applicable. Competing interests The authors have no conflicts of interest to declare. Funding No funding was received for conducting this study. Author Contribution All authors contributed to the study's conception and design. Material preparation, data collection and analysis were performed by Wen Li, Minghao Zou. The first draft of the manuscript was written by Wen Li, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. Acknowledgements We thank the hospitals and public health services for providing the data. Data Availability The datasets generated and/or analyzed during the current study are not publicly available due to protecting participant confidentiality but are available from the corresponding author on reasonable request. References Alenezi, A., McGrath, I., Kimpton, A., & Livesay, K. (2021). 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J., Laversanne, M., ... & Bray, F. (2023). Global burden of colorectal cancer in 2020 and 2040: incidence and mortality estimates from GLOBOCAN. Gut , 72(2), 338-344. Mudaranthakam, D. P., Hughes, D., Johnson, P., Mason, T., Nollen, N., Wick, J., ... & Calhoun, E. (2023). Career disruption and limitation of financial earnings due to cancer. JNCI Cancer Spectrum , 7(4), pkad044. Mudaranthakam, D. P., Nollen, N., Wick, J., Hughes, D., Welch, D., & Calhoun, E. (2023). Evaluating work impairment as a source of financial toxicity in cancer healthcare and negative impacts on health status. Cancer Research Communications , 3(7), 1166-1172. Nguyen, N. H., Khera, R., Ohno-Machado, L., Sandborn, W. J., & Singh, S. (2021). Prevalence and effects of food insecurity and social support on financial toxicity in and healthcare use by patients with inflammatory bowel diseases. Clinical Gastroenterology and Hepatology , 19(7), 1377-1386. 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. Regan, T. W., Lambert, S. D., Kelly, B., McElduff, P., Girgis, A., Kayser, K., & Turner, J. (2014). Cross-sectional relationships between dyadic coping and anxiety, depression, and relationship satisfaction for patients with prostate cancer and their spouses. Patient education and counseling , 96(1), 120-127. Shen Yalin, Tang Liping, Caoying. (2022). Financial toxicity status and its influencing factors among patients undergoing cutaneous ureterostomy. Journal of Nursing , 37(10):26-29. Son, H., & Kang, Y. (2020). Coping Processes of Patients with Ostomies in South Korea: A Focus Group Study†. Healthcare 2021, 9, 21. Syn, N. L., Teng, M. W., Mok, T. S., & Soo, R. A. (2017). De-novo and acquired resistance to immune checkpoint targeting. The Lancet Oncology , 18(12), e731-e741. Taneja, C., Netsch, D., Rolstad, B. S., Inglese, G., Eaves, D., & Oster, G. (2019). Risk and economic burden of peristomal skin complications following ostomy surgery. Journal of Wound Ostomy & Continence Nursing , 46(2), 143-149. Taneja, C., Netsch, D., Rolstad, B. S., Inglese, G., Lamerato, L., & Oster, G. (2017). Clinical and economic burden of peristomal skin complications in patients with recent ostomies. Journal of Wound Ostomy & Continence Nursing , 44(4), 350-357. Taneja, C., Netsch, D., Rolstad, B. S., Inglese, G., Lamerato, L., & Oster, G. (2017). Clinical and economic burden of peristomal skin complications in patients with recent ostomies. Journal of Wound Ostomy & Continence Nursing , 44(4), 350-357. Wang Zhe, Xu Huijing, Wang Yuyu, Gao Ge, Wang Xiaohui, Wu Yuanhong, Wu Shanyu. (2023). Advances in the study of the effects of financial toxicity on adverse health outcomes in patients with chronic diseases. Journal of Nursing , 30(17):34-38. Xi, Y., & Xu, P. (2021). Global colorectal cancer burden in 2020 and projections to 2040. Translational oncology , 14(10), 101174. Yu Huihui, Bi Xue, Liu Yunyong. (2017). Reliability and validity of the Chinese version of the Financial toxicity Scale for Cancer Patient-Reported Outcomes. Chinese Journal of Epidemiology , 38(8):1118-1120. Zafar, S. Y., & Abernethy, A. P. (2013). Financial toxicity, part I: a new name for a growing problem. Oncology (Williston Park, NY) , 27(2), 80. Zhang Huan, Yan Rong, Cheng Fangfang, Xue Hongfan, Li Rong. (2021). A dichotomous study of the relationship between coping strategies and current status of depression in patients with permanent enterostomies and their spouses. Chinese General Practice Nursing , 19(22):3121-3124. Zhang Yiyou, Tian Yuan, Pazileti·Saideng, Wang Ying. (2023). The current situation of financial toxicity among stroke patients and its influencing factors. China Clinical Nursing, 15(3):183-186. Zhou Xiong, Hu Ming, Li Zishuai, Cao Guangwen, Tan Xiao. (2020). Colorectal cancer in the world and China in 2020: an analysis of epidemic status. Journal of Naval Military Medical University, 43(12):1356-1364. Zhu Bifan, Yue Qiuying, Li Xiujuan. (2020). Analysis of the cost burden of consumables and health insurance policy for ostomates in Shanghai, China. Soft sciences for health , 34 (10):69-73+79. Additional Declarations No competing interests reported. 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University","correspondingAuthor":false,"prefix":"","firstName":"Meng","middleName":"","lastName":"Wang","suffix":""},{"id":545817287,"identity":"f9c31710-6118-4742-8868-5404e6f1f0cd","order_by":2,"name":"Hui Zheng","email":"","orcid":"","institution":"Yantai Yuhuangding Hospital of Qingdao University","correspondingAuthor":false,"prefix":"","firstName":"Hui","middleName":"","lastName":"Zheng","suffix":""},{"id":545817288,"identity":"49d17eb3-06cb-4c2f-9ec7-5c13e80429eb","order_by":3,"name":"Minghao Zou","email":"","orcid":"","institution":"Longkou People's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Minghao","middleName":"","lastName":"Zou","suffix":""},{"id":545817289,"identity":"2957a01a-306e-4c38-add5-14627e94a8a6","order_by":4,"name":"Kim Lam 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World Health Organization, colorectal cancer is the third most common cancer worldwide, accounting for approximately 10% of all cancer cases and is the second leading cause of cancer-related deaths worldwide. In 2020, more than 1.9\u0026nbsp;million new cases of colorectal cancer and more than 940,000 deaths due to colorectal cancer were estimated to have occurred worldwide (Yue Xi et al., 2021). The incidence rates were highest in Europe, Australia and New Zealand, and the mortality rates were highest in Eastern Europe. In China, colorectal cancer is the second most common type of cancer, accounting for 28.8% of all colorectal cancer cases worldwide (Zhou Xiong et al., 2022). By 2040 the burden of colorectal cancer will increase to 3.2\u0026nbsp;million new cases per year (an increase of 63%) and 1.6\u0026nbsp;million deaths per year (an increase of 73%) (Eileen Morgan et al.,2023).\u003c/p\u003e\u003cp\u003eEnterostomy is a common surgical procedure for the clinical treatment of colorectal cancer, which involves connecting the intestinal lumen to the outside of the body through an incision in the abdominal wall after the removal of the tumour, anus and surrounding tissues, and replacing its secretory function with the anus (Nicholas L Syn et al.,2017). The number of enterostomy patients in China has exceeded 1\u0026nbsp;million, with about 100,000 new patients added each year, and the trend is still growing (Gao Wenjun et al.,2017). Ostomy surgery negatively impacts patient's physical activity, psychological performance and social relationships and can lead to reduced quality of life (Alenezi et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2021\u003c/span\u003e)\u003c/p\u003e\u003cp\u003eWhile an enterostomy alleviates disease symptoms, it introduces new challenges, including financial difficulties associated with long-term stoma care. Patients with enterostomies need stoma care for a short period of several months or even for a lifetime, and the long-term use of stoma products such as ostomy bags and anti-leakage creams makes them consumable, which will undoubtedly increase the financial burden on patients and their families (Jiang Hua et al., 2022). Studies have shown that approximately one-third of patients with enterostomies develop stoma-related complications within 90 days of surgery and that the occurrence of complications increases the average cost of care for the patient, which on the other hand adds to the patient's financial burden (Taneja et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2017\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eYousuf Zafar introduced the term \"financial toxicity\" in 2013, a new term that refers to the high cost of cancer treatment caused by high economic stress that bankrupts patients and their families (Zafar et al., 2013). Several studies show that people with cancer and survivors are more likely to have financial toxicity than people without cancer (Mudaranthakam et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Mudaranthakam et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). This is because when a patient is diagnosed with cancer, the patient and his or her family face a reduction in income and assets, debts incurred as a result of the treatment, and even difficulty in paying rent and food, and eventually bankruptcy. Patients with financial toxicity have a lower quality of life, more symptoms, and more pain. One study suggests that some patients consider financial toxicity to be more serious than physical, emotional, social or family pain (McLoone et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eChina is the world's largest developing country, and although a health insurance system covering nearly 96% of the population and benefiting more than 1.36\u0026nbsp;billion people has been established, the gap between supply and demand for health care is widening as the problem of an ageing population in society becomes more and more prominent, and it is challenging for the Government to set up a large and effective health care system (Xinxin Chen et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). For patients with chronic diseases such as enterostomies, if they do not have an organization to pay for their medical insurance, they cannot enjoy the corresponding national reimbursement system, which undoubtedly adds to their financial burden.\u003c/p\u003e\u003cp\u003eCurrently, studies on financial toxicity are mainly focused on patients with various types of cancer and chemotherapy (Wang Zhe et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2023\u003c/span\u003e), and in China, stoma patients are only involved in patients with ureteral dermal stoma (Cheng Wenyu et al., 2023), and the study of financial toxicity in patients with enterostomies has still not been addressed. This study examined the factors contributing to the presence of financial toxicity in Chinese enterostomy patients.\u003c/p\u003e"},{"header":"2 MATERIAL AND METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1 Objectives\u003c/h2\u003e\u003cp\u003eThe purpose of this study was to investigate the factors affecting the presence of financial toxicity in Chinese enterostomy patients and to provide direction for future reforms of the health insurance system.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2 Design\u003c/h2\u003e\u003cp\u003eThe cross-sectional survey method was used in this study, which was a multicenter study conducted across three tertiary A hospitals in Shandong Province, in the period between November 2022 and February 2023. This study was employed The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e2.3 Participants\u003c/h2\u003e\u003cp\u003eA convenience sample of patients with enterostomies was used in this study. The eligibility criteria for participation in this study were as follows: (a) pathologically diagnosed as rectal or colorectal cancer; (b) surgically treated patients with intestinal stoma; (c) age\u0026thinsp;\u0026ge;\u0026thinsp;16 years; (d) informed consent and voluntary participation in the research project. Exclusion criteria: (a) severe psychiatric history; (b) cognitive dysfunction, no basic reading and writing ability. After obtaining informed consent from the patients, during the patient's follow-up visit to the outpatient clinic after discharge, the researcher distributed the questionnaires and instructed the patients to fill them out independently by using a uniform instruction. For those who had poor reading ability, the researcher read aloud the items one by one to assist them in filling them out, avoiding the use of suggestive language. The questionnaires were filled out and collected on the spot to ensure their reliability.\u003c/p\u003e\u003cp\u003eA convenience sample of patients who underwent enterostomy surgery between November 2022 and February 2023 at the participating hospitals was screened for eligibility. Data collection occurred during the patients' scheduled follow-up visits to the outpatient clinic after discharge.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003e2.4 Data collection\u003c/h2\u003e\u003cp\u003eQuantitative data were collected using the Chinese versions of the Comprehensive Scores for Financial Toxicity based on the Patient-Reported Outcome Measures, the Social Support Scale, and the Psychological Resilience Scale for patients with enterostomies.\u003c/p\u003e\u003cdiv id=\"Sec7\" class=\"Section3\"\u003e\u003ch2\u003e2.4.1 General Information Questionnaire\u003c/h2\u003e\u003cp\u003eAccording to the purpose of the study, the members of the study group designed their own questionnaire based on a review of the literature, including the patient's gender, age, education level, marital status, state of residence, main companion, monthly income, mode of payment for treatment, and the presence of complications of the stoma. Stoma-related complications were assessed based on patient self-report and clinical examination during the follow-up visit, and included conditions such as peristomal skin irritation, leakage, stenosis, retraction, or parastomal hernia.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec8\" class=\"Section3\"\u003e\u003ch2\u003e2.4.2 Comprehensive Scores for Financial Toxicity Based on the Patient-Reported Outcome Measures (COST-PROM)\u003c/h2\u003e\u003cp\u003eThe scale was used to assess the patient's understanding of the financial stress in the questionnaire, and consisted of 11 items in 3 dimensions, i.e., financial expenditure (1 item), financial resources (2 items), and psychosocial reactions (8 items), and was scored on a 5-point Likert scale from \"not at all\" to \"very much\" in order of 0\u0026ndash;4. The Likert 5-point scale was used, with scores ranging from \"not at all\" to \"very much\" in the order of 0 to 4. The lower the total score, the greater the financial toxicity of the patient due to the disease, and a total score of \u0026lt;\u0026thinsp;26 was defined as the cut-off point for the presence of financial toxicity. In this study, the Chinese version of the scale, which was Chineseised by Yu Huihui et al, was used, and its Cronbach's alpha coefficient was tested to be 0.889 (Yu Huihui et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2017\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec9\" class=\"Section3\"\u003e\u003ch2\u003e2.4.3 Social Support Scale\u003c/h2\u003e\u003cp\u003eThis scale is used to assess the degree of understanding of social support, including family support (4 entries), friend support (4 entries) and other support (4 entries) in 3 dimensions, with a total of 12 entries. A 7-point Likert scale was used, with 1 indicating \"strongly disagree\" and 7 indicating \"strongly agree\", and the total score ranged from 12 to 84, with higher scores indicating higher social support. According to the study, it can be divided into low support (12\u0026ndash;36 points), intermediate support (37\u0026ndash;60 points) and high support (61\u0026ndash;84 points), and the Cronbach's alpha coefficient of each dimension of the scale is greater than 0.8 (Chen Ke et al., 2023).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec10\" class=\"Section3\"\u003e\u003ch2\u003e2.4.4 Psychological Resilience Scale\u003c/h2\u003e\u003cp\u003eThis scale is used to assess whether subjects can adapt well to stress and adversity and can maintain and restore their psychological health, including change, personal problems, illness, stress, failure and pain, etc. 10 entries, using the Likert 5-point scale, with a score of 0 indicating \"never\", 4 indicating \"Almost always\", with a total score of 0\u0026ndash;40, the higher the score, the better the psychological resilience (Dong Ao et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). The Cronbach's alpha coefficient of this scale has been shown to be 0.89 (Shen Yalin et al., 2022).\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003e2.5 Ethical review\u003c/h2\u003e\u003cp\u003e The study complied with the Declaration of Helsinki and \"Good Clinical Practice\" guidelines and was approved by the Ethics Committee of Yantai Yuhuanding Hospital. Informed consent was obtained from all individual participants included in the study. Any information obtained in connection with this research that can identify participants remains confidential.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003e2.6 Data analysis\u003c/h2\u003e\u003cp\u003eThis study used SPSS 27.0 statistical software package for statistical analysis. Measured data obeying normal distribution were described using mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation; intergroup comparisons were made using t-test or one-way ANOVA; data conforming to normal distribution were analysed using Pearson's correlation analysis; multiple linear regression was used to analyse the influencing factors of financial toxicity of patients with intestinal stoma, and differences were considered to be statistically significant at \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003c/div\u003e"},{"header":"3 RESULTS","content":"\u003cp\u003eCompleted survey instruments were obtained from 190 participants across the three sites, representing a 95% (190/200) response rate. Most of the participants were male N\u0026thinsp;=\u0026thinsp;110 (57.89%), Participants in the age\u0026thinsp;\u0026gt;\u0026thinsp;60 years old were the highest group with N\u0026thinsp;=\u0026thinsp;94 (49.47%), Most enterostomy patients spend 100\u0026thinsp;~\u0026thinsp;500 yuan per month on ostomy products N\u0026thinsp;=\u0026thinsp;124 (65.26%) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSociodemographic and clinical characteristics of the participants (n\u0026thinsp;=\u0026thinsp;190)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCharacteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNo.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePercentage\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSex\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e110\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e57.89%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e42.11%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e16\u0026thinsp;~\u0026thinsp;20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.00%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e21\u0026thinsp;~\u0026thinsp;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3.16%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e31\u0026thinsp;~\u0026thinsp;40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6.32%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e41\u0026thinsp;~\u0026thinsp;50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20.00%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e51\u0026thinsp;~\u0026thinsp;60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e21.05%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e49.47%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003eEducational level\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eElementary school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e21.05%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eJunior high school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e42.11%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHigh school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17.89%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eJunior college\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8.42%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBachelor's degree and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10.53%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e\u003cp\u003eOccupation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eInstitutions\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12.63%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eProfessionals and technicians\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8.42%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCommerce and services\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.21%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAgriculture, forestry, animal husbandry, fisheries, and water production\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13.68%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOperators of production and transportation equipment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9.47%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSelf-employed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e51.58%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eMarital status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUnmarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.11%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e152\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e80%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDivorced\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3.16%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWidowed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14.74%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHome location\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRural\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e51.58%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUrban\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e48.42%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eResidence status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLiving with spouse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e114\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e60.00%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLiving with children\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10.53%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLiving with spouse and children\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18.95%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLiving alone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10.53%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003ePrimary caregivers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eParents\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7.37%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSpouse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e114\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e60.00%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eChildren\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e27.37%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBrothers and sisters\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.05%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.21%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eMonthly per capita family income\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;1000 yuan\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e28.42%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1000\u0026thinsp;~\u0026thinsp;2999 yuan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e24.21%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3000\u0026thinsp;~\u0026thinsp;4999 yuan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e27.37%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;5000 yuan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20.00%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eTime after surgery\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;6 months\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e106\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e55.79%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6 months\u0026thinsp;~\u0026thinsp;1 year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14.74%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1 year\u0026thinsp;~\u0026thinsp;5 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e29.47%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eType of medical insurance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUrban workers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e48.42%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUrban residents\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e45.26%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOut-of-pocket expenses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.21%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.11%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eMonthly cost of purchasing stoma products\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;100 yuan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.11%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e100\u0026thinsp;~\u0026thinsp;500 yuan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e124\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e65.26%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e500\u0026thinsp;~\u0026thinsp;1,000 yuan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15.79%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;1,000 yuan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16.84%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eStatus of self-care\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCompletely self-care\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17.89%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePartially self-care\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e47.37%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCompletely unable to care for themselves\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e34.74%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eOstomy complications\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e128\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e67.37%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePresence\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e32.63%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eIn this study, the total score on the financial toxicity scale for enterostomy patients was (21.52\u0026thinsp;\u0026plusmn;\u0026thinsp;7.80), 72.63% of patients (score less than 26) presented positive for financial toxicity (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e); the total score on the social support scale was (63.16\u0026thinsp;\u0026plusmn;\u0026thinsp;12.68), the highest scores came from friend support (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e); and the psychological resilience scale total score was (25.35\u0026thinsp;\u0026plusmn;\u0026thinsp;8.09).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eScores on the Financial Toxicity Scale (COST-PROM) for Patients with Enterostomies\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eScale / Subscale\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eItems, n\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSD\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCOST-PROM Total Score\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e21.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7.80\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFinancial Expenditure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.34\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFinancial Resources\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2.60\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePsychosocial Reactions\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.83\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eScores on the Social Support Scale for Patients with Enterostomies\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eScale / Subscale\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eItems, n\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSD\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSocial Support Total Score\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e63.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e12.68\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFamily Support\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3.42\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFriend Support\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e21.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4.45\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOther Support\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4.81\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eIn exploring the factors influencing the dependent variable, financial toxicity, we first conducted a one-way analysis of factors. The results showed that the educational level, marital status, residence status, primary caregivers, monthly per capita family income, type of medical insurance, and ostomy complications showed statistically significant differences (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of total financial toxicity scores in patients with different characteristics of enterostomies (n\u0026thinsp;=\u0026thinsp;190)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCharacteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNo.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCOST-PROM score\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eF\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eP\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSex\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e110\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e21.05\u0026thinsp;\u0026plusmn;\u0026thinsp;7.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.912\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.341\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e22.15\u0026thinsp;\u0026plusmn;\u0026thinsp;8.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e16\u0026thinsp;~\u0026thinsp;20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.575\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.681\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e21\u0026thinsp;~\u0026thinsp;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e19.67\u0026thinsp;\u0026plusmn;\u0026thinsp;8.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e31\u0026thinsp;~\u0026thinsp;40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e22.17\u0026thinsp;\u0026plusmn;\u0026thinsp;2.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e41\u0026thinsp;~\u0026thinsp;50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e20.00\u0026thinsp;\u0026plusmn;\u0026thinsp;6.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e51\u0026thinsp;~\u0026thinsp;60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e21.85\u0026thinsp;\u0026plusmn;\u0026thinsp;9.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e22.02\u0026thinsp;\u0026plusmn;\u0026thinsp;7.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003eEducational level\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eElementary school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e22.55\u0026thinsp;\u0026plusmn;\u0026thinsp;9.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2.497\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.032\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eJunior high school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e22.73\u0026thinsp;\u0026plusmn;\u0026thinsp;7.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHigh school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e17.94\u0026thinsp;\u0026plusmn;\u0026thinsp;6.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eJunior college\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e19.13\u0026thinsp;\u0026plusmn;\u0026thinsp;6.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBachelor's degree and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e23.13\u0026thinsp;\u0026plusmn;\u0026thinsp;4.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e\u003cp\u003eOccupation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eInstitutions\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e18.42\u0026thinsp;\u0026plusmn;\u0026thinsp;6.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1.877\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.100\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eProfessionals and technicians\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e21.63\u0026thinsp;\u0026plusmn;\u0026thinsp;6.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCommerce and services\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e22.00\u0026thinsp;\u0026plusmn;\u0026thinsp;5.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAgriculture, forestry, animal husbandry, fisheries, and water production\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e21.85\u0026thinsp;\u0026plusmn;\u0026thinsp;6.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOperators of production and transportation equipment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e18.33\u0026thinsp;\u0026plusmn;\u0026thinsp;5.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSelf-employed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e22.71\u0026thinsp;\u0026plusmn;\u0026thinsp;8.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eMarital status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUnmarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e25.00\u0026thinsp;\u0026plusmn;\u0026thinsp;5.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e6.439\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e152\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e20.64\u0026thinsp;\u0026plusmn;\u0026thinsp;7.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDivorced\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e33.33\u0026thinsp;\u0026plusmn;\u0026thinsp;8.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWidowed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e23.21\u0026thinsp;\u0026plusmn;\u0026thinsp;7.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHome location\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRural\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e21.39\u0026thinsp;\u0026plusmn;\u0026thinsp;7.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.054\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.816\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUrban\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e21.65\u0026thinsp;\u0026plusmn;\u0026thinsp;8.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eResidence status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLiving with spouse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e114\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e20.54\u0026thinsp;\u0026plusmn;\u0026thinsp;7.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e51.549\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.034\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLiving with children\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e22.40\u0026thinsp;\u0026plusmn;\u0026thinsp;4.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLiving with spouse and children\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e20.72\u0026thinsp;\u0026plusmn;\u0026thinsp;5.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLiving alone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e27.60\u0026thinsp;\u0026plusmn;\u0026thinsp;10.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003ePrimary caregivers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eParents\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e20.57\u0026thinsp;\u0026plusmn;\u0026thinsp;6.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e15.404\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.002\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSpouse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e114\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e19.79\u0026thinsp;\u0026plusmn;\u0026thinsp;6.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eChildren\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e23.92\u0026thinsp;\u0026plusmn;\u0026thinsp;9.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBrothers and sisters\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e32.00\u0026thinsp;\u0026plusmn;\u0026thinsp;13.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e27.50\u0026thinsp;\u0026plusmn;\u0026thinsp;3.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eMonthly per capita family income\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;1000 yuan\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e23.26\u0026thinsp;\u0026plusmn;\u0026thinsp;8.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e94.245\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.008\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1000\u0026thinsp;~\u0026thinsp;2999 yuan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e23.43\u0026thinsp;\u0026plusmn;\u0026thinsp;9.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3000\u0026thinsp;~\u0026thinsp;4999 yuan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e20.38\u0026thinsp;\u0026plusmn;\u0026thinsp;4.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;5000 yuan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e18.26\u0026thinsp;\u0026plusmn;\u0026thinsp;7.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eTime after surgery\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;6 months\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e106\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e21.15\u0026thinsp;\u0026plusmn;\u0026thinsp;7.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2.953\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.055\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6 months\u0026thinsp;~\u0026thinsp;1 year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e19.21\u0026thinsp;\u0026plusmn;\u0026thinsp;6.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1 year\u0026thinsp;~\u0026thinsp;5 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e23.36\u0026thinsp;\u0026plusmn;\u0026thinsp;8.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eType of medical insurance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUrban workers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e21.04\u0026thinsp;\u0026plusmn;\u0026thinsp;8.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e7.604\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUrban residents\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e20.95\u0026thinsp;\u0026plusmn;\u0026thinsp;6.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOut-of-pocket expenses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e22.67\u0026thinsp;\u0026plusmn;\u0026thinsp;5.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e35.67\u0026thinsp;\u0026plusmn;\u0026thinsp;9.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eMonthly cost of purchasing stoma products\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;100 yuan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e23.50\u0026thinsp;\u0026plusmn;\u0026thinsp;8.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.372\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.774\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e100\u0026thinsp;~\u0026thinsp;500 yuan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e124\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e21.19\u0026thinsp;\u0026plusmn;\u0026thinsp;8.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e500\u0026thinsp;~\u0026thinsp;1,000 yuan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e22.67\u0026thinsp;\u0026plusmn;\u0026thinsp;5.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;1,000 yuan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e21.44\u0026thinsp;\u0026plusmn;\u0026thinsp;8.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eStatus of self-care\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCompletely self-care\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e23.24\u0026thinsp;\u0026plusmn;\u0026thinsp;9.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e80.423\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.135\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePartially self-care\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e20.80\u0026thinsp;\u0026plusmn;\u0026thinsp;6.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCompletely unable to care for themselves\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e20.06\u0026thinsp;\u0026plusmn;\u0026thinsp;7.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eOstomy complications\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e128\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e19.91\u0026thinsp;\u0026plusmn;\u0026thinsp;7.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e18.210\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePresence\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e24.84\u0026thinsp;\u0026plusmn;\u0026thinsp;8.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eCorrelation analyses between the subscales of financial toxicity and social support were conducted to provide a more nuanced understanding of the relationships between specific dimensions of these constructs. The normality test for each variable in the survey of enterostomy patients revealed that the data conformed to a normal distribution, so the correlation analysis was performed using Pearson correlation analysis. The results showed that there was a negative correlation between social support and financial toxicity (r=-0.308, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and a positive correlation between social support and psychological resilience (r\u0026thinsp;=\u0026thinsp;0.164, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) in patients with enterostomies, and the difference was statistically significant, but there was no correlation between psychological resilience and financial toxicity (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCorrelation analysis between variables and financial toxicity in patients with enterostomies\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"10\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFinancial expenditure\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFinancial resources\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePsychosocial reactions\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eFinancial toxicity\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eFamily support\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eFriend support\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eOther support\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003eSocial support\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u003cp\u003ePsychological resilience\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFinancial expenditure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFinancial resources\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.244\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePsychosocial reactions\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.178\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.571\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFinancial toxicity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.223\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.718\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.968\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFamily support\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.022\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.191\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.265\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.265\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFriend support\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.098\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.338\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.346\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.354\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.787\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOther support\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.157\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.230\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.231\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.222\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.652\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.826\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSocial support\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.086\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.278\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.308\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.308\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.885\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.955\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.904\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003epsychological resilience\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.341\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.016\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.006\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.049\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.138\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.153\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.160\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.164\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"10\"\u003e**. At the 0.01 level (two-tailed), the correlation is significant\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"10\"\u003e*. Significant at 0.05 level (two-tailed)\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe financial toxicity score was used as the dependent variable, and the statistically significant variables (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) in the univariate analysis as well as the social support scale were used as the independent variables to enter the multiple linear regression model. The results showed that four variables, residence status, primary caregivers, ostomy complications, and social support, entered the regression equation, and explained a total of 24.7% of the total variance (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eMultiple linear regression analysis of financial toxicity in patients with enterostomies\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eUnstandardized coefficient\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eStandardized coefficient\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003eCovariance statistics\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eB\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eStandard error\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eBeta\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eTtolerances\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eVIF\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e(Constant)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e18.786\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4.399\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e4.271\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eResidence status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1.022\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.513\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.142\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1.991\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.048\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.782\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1.278\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrimary caregivers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2.394\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.748\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.252\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e3.199\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.002\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.641\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1.560\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOstomy complications\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3.689\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.135\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.222\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e3.250\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.852\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1.174\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSocial support\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.119\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.041\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.193\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-2.860\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.005\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.876\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1.142\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"4. DISCUSSION","content":"\u003cp\u003eAlthough many studies have examined the financial toxicity of cancer patients, few published studies have measured the economic burden on patients with enterostomies\u003c/p\u003e\u003cp\u003eThis study showed that the financial toxicity score of enterostomy patients was (21.52\u0026thinsp;\u0026plusmn;\u0026thinsp;7.80), and 72.63% of patients presented with financial toxicity, defined as a COST-PROM score of less than 26. The results of this study were lower than those of the study of ureterostomy patients by Shen Yalin (Shen Yalin et al., 2022). This discrepancy may be attributed to several factors. First, patients need to rely on the enterostomy for a long period of time to excrete the body's wastes and digestive matter after stoma surgery, which often requires the purchase of stoma-care related products for a long period of time such as ostomy pouches, leakage-proof creams, and stoma skin-care powders, and so on. The survey showed that permanent stoma patients spent \u003cspan\u003e$\u003c/span\u003e2,396.57 on stoma-related consumables, with a monthly average of \u003cspan\u003e$\u003c/span\u003e199.71 (Zhu Bifan et al., \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2020\u003c/span\u003e), and for some patients with poorer family finances this long-term behaviour can add to the financial burden; Second, Intestinal stoma will cause certain difficulties to the work and life of patients, and some patients may need to adjust their working hours or work content to adapt to the needs of intestinal stoma, which will also have a certain impact on their income and career development. Therefore, we need to pay attention to the current state of financial toxicity of patients with enterostomies, provide them with necessary support and assistance, and at the same time strengthen the relevant policies and measures to alleviate the state of high economic pressure on patients and improve their quality of life and sense of well-being.\u003c/p\u003e\u003cp\u003eThis study showed that residence status was an influential factor in the level of financial toxicity in patients with enterostomies (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and the financial toxicity scores of patients with enterostomies who lived with their spouses were lower, which is consistent with the results of the study on the factors influencing financial toxicity in patients with stroke conducted by Zhang Yiyou (Zhang Yiyou et al., 2023). Living with a spouse can bring many benefits, such as mutual care, appropriate social support, reduced burden of living and enhanced quality of life. A qualitative study of Chinese couples' cancer experiences indicated that the sick spouse has a higher need for intimacy, and for patients with enterostomies, assistance with defecation and changing the stoma bag, which are highly private behaviours, often require the assistance of someone in a close relationship, and therefore patients with enterostomies need to rely on their spouses for a long period before they can achieve stoma self-management. In addition, it has been shown that the husband-wife relationship of patients with enterostomies can have an impact on each other's emotions (Zhang Huan et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), and the increase of supportive behaviours from the spouses can satisfy the patients' self-worth and self-needs, which can reduce negative emotions such as depression (Regana et al., 2014). Therefore, living with a spouse not only provides help from life and care, but also supports each other emotionally, shares stress, and solves problems together, which improves the quality of life and reduces the financial burden.\u003c/p\u003e\u003cp\u003eThis study showed that the lowest financial toxicity scores were found in patients with enterostomies whose primary companion was the spouse (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Enterostomy is a more serious disease that requires long-term treatment and care. Patients need to change their stoma bags regularly every day, clean the skin around the stoma, pay attention to eating and defecation, and so on, which is a great burden to both patients and family members. For patients whose main companion is the spouse, the patient's condition may have a greater impact on the family's financial situation as the spouse is usually the breadwinner in the family. When one of the spouses is ill, the need for the spouse to take time off work to care for the patient can lead to a reduction in income, thus affecting the livelihood of the family. In addition, the patient and family members have to bear higher medical costs, including the cost of treatment, medicines, ostomy bags and related products, which can also put some pressure on the family's finances. Therefore, for patients with colostomy whose primary carer is their spouse, the financial toxicity is greater and may affect the livelihood and quality of life of the family. The medical sector and the community should enhance their concern and support for such patients and families by providing the necessary medical and livelihood assistance to alleviate the financial burden on the families, thereby promoting the health and well-being of the patients and families.\u003c/p\u003e\u003cp\u003eThis study showed that enterostomy patients with stoma-related complications had the highest financial toxicity score (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The study showed that 37.2% of post-colorectal patients were readmitted to the hospital within 90 days of discharge and that patients with stoma complications had higher hospitalisation costs than those without (Taneja et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2017\u003c/span\u003e), with a mean total medical cost of approximately \u003cspan\u003e$\u003c/span\u003e58,32 (Taneja et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). This is because such patients need to go to hospitals frequently for check-ups and treatment, which will often increase medical expenses. If the stoma complications are more serious, they will need to undergo surgery or be hospitalised, in which case the medical expenses will be even higher. Secondly, as the condition of the patients is more serious and they need long-term nursing and care, their family members need to take leave to take care of the patients, thus affecting the income of the family and exerting pressure on the family's finances. In addition, Electrolyte disturbances are commonly seen in post-colonization patients, especially if there are complications, leading to protein malabsorption as well as calcium, potassium and zinc deficiencies (Fulham et al.,2008), which require the use of special nutritional diets that can additionally increase the family's expenses. Therefore, enterostomy patients with stoma complications have higher financial toxicity scores, which can put a great deal of financial pressure on both the patients and their families. The medical sector and society should strengthen their concern and support for such patients and families, to alleviate their financial burden and improve their quality of life.\u003c/p\u003e\u003cp\u003eThis study showed that the higher the social support score, the lower the financial toxicity score of enterostomy patients (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), which is consistent with the findings of Nguyen (Nguyen et al.,2021). Enterostomy patients with high scores of social support are more likely to receive social support and help, which reduces their economic burden, and therefore their financial toxicity scores are lower. Social support includes support from family, friends, community, charitable organisations, etc., which can be financial, psychological or practical. Studies have shown that for patients with enterostomies, encouragement and support from family members, especially spouses, is crucial for patients to confront their body image and reduce psychological distress (Hu Jiaojiao et al.,2023; Son et al., 2020; Peters\u0026eacute;n et al., 2021). In addition, enriching daily life, such as attending book club meetings regularly can give enterostomy patients more mental strength. Therefore, to improve the social support situation of enterostomy patients, a multi-pronged approach can be adopted. On the part of the Government, measures can be taken, such as the establishment of specialised agencies or organisations to provide professional medical care, psychological counselling and other services, and to encourage the community to participate in the provision of assistance and support to patients. In addition, social organisations can play an active role in carrying out public welfare activities and social services for patients with intestinal stoma, to increase their social and communication opportunities and raise their level of social support. Individuals can also take measures to obtain corresponding social support, such as actively participating in social activities, taking the initiative to communicate, and cultivating good interpersonal relationships, all of which can help to increase their social support. In conclusion, improving the social support score of enterostomy patients can effectively reduce their economic burden and improve their quality of life.\u003c/p\u003e\u003cp\u003eLimitations\u003c/p\u003e\u003cp\u003eThis study has several limitations. First, the cross-sectional design precludes the establishment of causal relationships. Second, the use of a convenience sample from a coastal city in Shandong Province, China, may limit the generalizability of the findings to other regions with different socioeconomic backgrounds or healthcare systems. Third, we lacked detailed information on several potential confounding variables, such as the time since enterostomy surgery (for a significant portion of the cohort), the specific type of enterostomy (e.g., colostomy vs. ileostomy), cancer stage, and whether the stoma was intended to be permanent or temporary. Future longitudinal studies with more diverse samples and comprehensive data collection are warranted to confirm our findings and explore the causal pathways of financial toxicity in this patient population\u003c/p\u003e"},{"header":"5 CONCLUSION","content":"\u003cp\u003eThe results of various studies have shown that financial toxicity is common in patients with enterostomies. Residence status, primary caregivers, ostomy complications, and social support are the influencing factors of financial toxicity in patients with enterostomies. Healthcare professionals and relevant administrators should identify the influencing factors of financial toxicity promptly when developing strategies for managing financial toxicity in patients to reduce the adverse effects of financial toxicity on patients.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eConflict of interest statement\u003c/h2\u003e\n\u003cp\u003eThe authors declare that no funds, grants, or other support were received during the preparation of this manuscript.\u003c/p\u003e\n\u003ch2\u003eEthics approval and consent to participate\u003c/h2\u003e\n\u003cp\u003eAll procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was approved by the Yantai Yuhuangding Hospital Ethics Committe. Informed consent was obtained from all individual participants included in the study.\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003ch2\u003eCompeting interests\u003c/h2\u003e\n\u003cp\u003eThe authors have no conflicts of interest to declare.\u003c/p\u003e\n\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eNo funding was received for conducting this study.\u003c/p\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003eAll authors contributed to the study\u0026apos;s conception and design. Material preparation, data collection and analysis were performed by Wen Li, Minghao Zou. The first draft of the manuscript was written by Wen Li, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003ch2\u003eAcknowledgements\u003c/h2\u003e\n\u003cp\u003eWe thank the hospitals and public health services for providing the data.\u003c/p\u003e\n\u003ch2\u003eData Availability\u003c/h2\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are not publicly available due to protecting participant confidentiality but are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAlenezi, A., McGrath, I., Kimpton, A., \u0026amp; Livesay, K. (2021). Quality of life among ostomy patients: A narrative literature review. \u003cem\u003eJournal of Clinical Nursing\u003c/em\u003e, 30, 3111\u0026ndash;3123.\u003c/li\u003e\n\u003cli\u003eChen Wenyu, Gao Kaixiao, Wang Jing, Zhao Qi, Zhang Busheng, Gao Junping. (2023). 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De-novo and acquired resistance to immune checkpoint targeting. \u003cem\u003eThe Lancet Oncology\u003c/em\u003e, 18(12), e731-e741.\u003c/li\u003e\n\u003cli\u003eTaneja, C., Netsch, D., Rolstad, B. S., Inglese, G., Eaves, D., \u0026amp; Oster, G. (2019). Risk and economic burden of peristomal skin complications following ostomy surgery. \u003cem\u003eJournal of Wound Ostomy \u0026amp; Continence Nursing\u003c/em\u003e, 46(2), 143-149.\u003c/li\u003e\n\u003cli\u003eTaneja, C., Netsch, D., Rolstad, B. S., Inglese, G., Lamerato, L., \u0026amp; Oster, G. (2017). Clinical and economic burden of peristomal skin complications in patients with recent ostomies. \u003cem\u003eJournal of Wound Ostomy \u0026amp; Continence Nursing\u003c/em\u003e, 44(4), 350-357.\u003c/li\u003e\n\u003cli\u003eTaneja, C., Netsch, D., Rolstad, B. S., Inglese, G., Lamerato, L., \u0026amp; Oster, G. (2017). 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Analysis of the cost burden of consumables and health insurance policy for ostomates in Shanghai, China. \u003cem\u003eSoft sciences for health\u003c/em\u003e, 34 (10):69-73+79.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Enterostomy, Financial toxicity, Influencing factor","lastPublishedDoi":"10.21203/rs.3.rs-7821894/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7821894/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eAim and Objective\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe aim of this study is to explore the financial toxicity status of enterostomy patients and analyse the influencing factors in Shandong Province, China.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePost-enterostomy patients require long-term use of stoma products, which presents significant financial challenges for patients. Identifying the factors contributing to this burden is crucial for developing targeted interventions and health insurance policies to improve patients' quality of life.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study used the general data questionnaire, the comprehensive financial toxicity score scale of patient-reported outcomes, the understanding social support scale and the psychological resilience scale, 190 patients with enterostomy from three tertiary A hospitals in Yantai were selected for investigation. Univariate and multivariate linear regression analyses were employed to identify factors associated with financial toxicity.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFinancial toxicity was present in 72.63% of enterostomy patients. Social support was negatively correlated with financial toxicity (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.001). Multivariate regression analysis identified residential status, primary caregiver, stoma-related complications, and social support as significant factors contributing to financial toxicity.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe results of the study showed that more than half of the patients with enterostomies face financial difficulties. Those living alone, experiencing stoma-related complications, and with low social support require greater attention from healthcare providers. This provides a reference for the future development of appropriate health insurance systems.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRelevance to clinical practice\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study identifies the factors that contribute to the high financial burden of patients with enterostomies and can assist in planning and delivering needed care, which may help reduce predictable problems. It points to relevant future research directions for the Medicare system.\u003c/p\u003e","manuscriptTitle":"Current Financial Toxicity Status and Influencing Factors in Patients Undergoing Enterostomy: A Cross-sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-20 18:13:36","doi":"10.21203/rs.3.rs-7821894/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-01-07T13:00:03+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-01T10:50:52+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-25T14:12:11+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"150799757595593797248678177857708424531","date":"2025-11-16T15:31:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"44513310408747671674214275375366648489","date":"2025-11-16T09:34:44+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-11-10T20:42:44+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-21T11:27:48+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-21T01:34:08+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Health Services Research","date":"2025-10-21T01:31:08+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4a3b0212-a376-464e-8a00-477861349946","owner":[],"postedDate":"November 20th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-02-07T17:38:35+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-20 18:13:36","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7821894","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7821894","identity":"rs-7821894","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}