Self-Care Knowledge and Associated Factors Among Adult Patients With Colostomy in Northwest Amhara, Ethiopia: A Cross-Sectional Study.

Background: Colostomy, a surgically necessary procedure, requires rigorous self-care to prevent complications and improve patients' quality of life. In Ethiopia, the rising demand for colostomies is met with a lack of localized data on patient self-care knowledge, leading to insufficient support and increased stoma-related complications and healthcare burdens. Objectives: This study aimed to assess self-care knowledge and its associated factors among adult patients with colostomy in Northwest Amhara Comprehensive Specialized Hospitals, Ethiopia October-November 2024. Methods: A hospital-based cross-sectional study involving 423 adult patients (aged ≥18) who were consecutively recruited from five hospitals (October 15- November 10, 2024) was conducted. Data were collected via structured interviews. Multivariable binary logistic regression was employed to identify factors associated with knowledge. Because participants were recruited from five hospitals, hospital site was considered as a potential clustering variable; its effect was examined in sensitivity analyses. Results: Only 39.24% (95% CI: 34.57-43.92) of the participants (n=423, 68.3% male) demonstrated good colostomy self-care knowledge. Factors significantly associated with better knowledge included colostomy education (AOR = 8.72; 95% CI: 4.58-16.60), higher educational status (Elementary AOR = 3.48; Secondary AOR = 2.58; College and above AOR = 2.04), private employment (AOR = 3.45), and medium social support (AOR = 2.48). Government employment was associated with lower odds of good knowledge (AOR = 0.38). In a sensitivity analysis using stricter knowledge cut-off (≥6 of 9 items correct), only secondary education, colostomy education, and medium social support remained statistically significant, indicating that the findings for occupation and the remaining educational categories were not stable across alternative cut-offs. Conclusion: Despite 75.4% of patients receiving preoperative teaching and 60.76% receiving colostomy-specific education, the prevalence of good self-care knowledge is suboptimal. Educational status, colostomy-specific education, and social support are significantly associated with self-care knowledge; however, only secondary education, colostomy education, and medium social support remain robust across alternative cut-offs, whereas the associations of occupation and other educational categories depended on the chosen threshold. These findings necessitate targeted, culturally sensitive educational programs to bridge knowledge gaps and improve patient outcomes in this resource-limited setting.