Postoperative Anxiety and Depression and Use of a Novel Educational Tool in Patients Undergoing Stoma Creation: A Prospective Observational Study

<title>Abstract</title> <p>Patients undergoing stoma creation often experience significant psychological distress, including anxiety and depression. Preoperative education is considered beneficial; however, the impact of using interactive educational tools on psychological outcomes is unclear. This prospective observational study included 81 patients who underwent gastrointestinal stoma creation between April 2023 and August 2025. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale before and after preoperative education and at 3 months post-surgery. Patients received either booklet-based education or booklet-based education with an interactive tool. Factors associated with postoperative anxiety and depression were analyzed using multivariable logistic regression. Patient-reported outcomes were assessed using a 5-point Likert scale. Postoperative anxiety and depression were observed in 23.5% and 38.3% of patients, respectively. Preoperative chemoradiotherapy or neoadjuvant chemotherapy was independently associated with postoperative anxiety. Permanent stoma formation and family support absence were independently associated with postoperative depression. Using interactive video-based education did not significantly reduce anxiety or depression; however, patients in the video group demonstrated significantly better stoma care understanding and improved ability to imagine postoperative life. Distinct clinical and social factors influence postoperative anxiety and depression in patients with stomas. Comprehensive perioperative strategies incorporating psychological and social support are required to optimize patient outcomes.</p>