Date of Award

Spring 2019

Degree Type


Degree Name

Doctor of Philosophy (PhD)


Communication Studies



Committee Chair

Steven Venette

Committee Chair School


Committee Member 2

Kathryn Anthony

Committee Member 2 School


Committee Member 3

John Meyer

Committee Member 3 School


Committee Member 4

Eura Jung

Committee Member 4 School


Committee Member 5

Richard Mohn

Committee Member 5 School



More than 750,000 individuals in the United States live with an ostomy appliance, and additional 130,000 patients undergo ostomy surgery each year (United Ostomy Association of America, 2018). Although a life-saving procedure, patients confront significant physical (e.g., bowel routine and activity levels) and emotional (e.g., poor body image and depression) challenges that impede the adjustment process. When faced with health-related threats, the transactional action model of stress and coping argues that patients use strategies, such as seeking support, to effectively cope. However, because of perceptions of felt and enacted stigma and health-related uncertainty, some patients conceal ostomy-related issues and limit access to social support. Thus, patients struggle to effectively transition and adapt to life with an ostomy appliance.

While the transactional model accounts for patients’ self-disclosure practices, little theoretical development has been offered to explain the importance of others’ responsiveness in shaping health-related quality of life. The purpose of this study is to better understand the ways self-disclosure about one’s ostomy to others, and the perception of responsiveness to the disclosure affect ostomy patients’ perceptions of social support, coping, and health-related quality of life. Specifically, this study proposes a theoretical model that incorporates perceived partner responsiveness within the transactional model of stress and coping framework.

Survey data was collected from 375 ostomy patients. Path analysis was conducted to test the hypothesized model. Although the proposed model did not demonstrate adequate fit, analyses identified several direct and indirect factors influencing ostomy patients’ health-related quality of life. Most importantly, findings revealed that ostomates’ self-disclosure and health-related quality of life is mediated by perceived partner responsiveness. This study suggests that for patients perceived reactions that are responsive are paramount in improving health-related quality of life. To account for this relationship, this study this study proposes the disclosure-responsiveness theory