The goal of this randomized controlled trial is to learn if the Roy Adaptation Model (RAM) nursing program improves anxiety, depression, and quality of life in adults who have recently received a colostomy. It will also learn about changes in stress and inflammation-related blood markers. The main questions it aims to answer are:

Does 12-week RAM nursing lower anxiety and depression scores compared with routine nursing? Does RAM nursing raise quality-of-life scores and beneficially alter blood levels of cortisol, IL-6, TNF-α, serotonin, and dopamine? Researchers will compare RAM nursing (one-to-one education, cognitive-behavioral support, family training, and phone follow-up) to routine stoma-care education only.

Participants will:

Receive either RAM nursing or routine nursing for 12 weeks Complete anxiety, depression, and quality-of-life questionnaires at baseline and week 12 Provide blood samples at baseline and week 12 to measure stress and inflammation markers (which was a routine test for normal colostomy patients)

Inclusion Criteria:

• Underwent elective colostomy (permanent or temporary) due to colorectal cancer, inflammatory bowel disease, or intestinal obstruction;
• Postoperative time ≤ 1 week;
• Age 18-75 years;
• Consciousness clear, able to communicate normally and complete questionnaire surveys;
• Voluntarily participate in the study and sign informed consent.

Exclusion Criteria:

• Complicated with severe cardiovascular, liver, kidney, or mental diseases;
• History of anxiety, depression, or other mental disorders before surgery;
• Stoma complications (e.g., stoma prolapse, ischemia, infection) requiring reoperation;
• Loss to follow-up or refusal to cooperate with the study