Abstract
BACKGROUND: Intestinal stoma formation alters patient lifestyle and psychological well-being, especially in resource-limited settings lacking perioperative support. This study assessed the quality of life (QoL) and prevalence of depression in Pakistani patients with stomas, identifying key demographic and clinical correlates. METHODS: A descriptive cross-sectional study was conducted among 136 patients with intestinal stomas at a tertiary care surgical clinic in Karachi. Structured interviews were conducted using a five-part questionnaire assessing demographics, stoma-related experiences, impact on daily life, QoL (7-45 scale), and depression (PHQ-9, Urdu-translated). Associations between variables were analyzed using chi-square tests. RESULTS: Most participants were male (73.5%) and married (80.9%). Temporary stomas were present in 66.9%, with 52.9% formed during emergency surgery. Only 25.7% received preoperative counseling. QoL scores were rated as "best" in 41.9% of participants, "good" in 55.9% of participants, and "poor" in 2.2% of participants. Marital status (p<0.001), employment (p=0.006), stoma permanence (p=0.036), and time since surgery (p=0.009) were significantly associated with QoL. Depression was absent in 41.2% of participants, mild in 39.7% of participants, and moderate to moderately severe in 19.1% of participants. Depression correlated with marital status, occupation, stoma type, and surgical urgency. CONCLUSION: Most stoma patients adapt well over time, particularly with stable social and occupational conditions. However, gaps in preoperative counseling and somatic presentations of depression highlight the need for structured psychosocial support and culturally adapted tools.