Latent profile analysis of health-related quality of life in patients with bladder cancer and abdominal wall stomas: a multicenter cross-sectional study.

Abdominal wall stomas in bladder cancer patients can severely impact physical, psychological, and social adjustment. However, individual differences in patients' self-reported outcomes and their influencing factors require further investigation. This multicenter cross-sectional study aimed to identify latent profiles of health-related quality of life among bladder cancer patients with abdominal wall stomas and to examine demographic and clinical factors associated with profile membership.We evaluated 598 patients who underwent radical cystectomy with an abdominal wall stoma between September 2020 and September 2023 in the urology departments of five tertiary hospitals in Beijing, Henan and Jiangxi, China. Data were collected via a self-designed general profile questionnaire and the Chinese Patient Self-Reported Outcome Scale for Bladder Cancer with Abdominal Wall Stoma (PROS-BCAS). Latent profile analysis identified three patient subgroups: "Balanced high-quality type" (n = 339, 56.7%), "Unbalanced type" (n = 148, 24.7%), and "Low-level type" (n = 111, 18.6%). Significant differences were observed across the physical, psychological, social, and treatment-related domains among the three profiles. Multinomial logistic regression showed that lower monthly household income, out-of-pocket medical payment, limited stoma self-care ability, younger age, and complications were associated with membership in poorer health-status profiles. These findings indicate substantial heterogeneity in patient-reported outcomes among bladder cancer patients with abdominal wall stomas. Clinicians should prioritize vulnerable patients with socioeconomic disadvantage, insufficient stoma self-care ability, and complications, and provide targeted economic, educational, psychological, and social support to improve health-related quality of life.