Abstract: Objective To explore the current status of psychological distress in middle-aged and elderly patients with colorectal cancer(CRC) undergoing permanent stoma, and to further analyze its influencing factors. 
Methods A total of 560 middle-aged and elderly CRC patients undergoing permanent stoma who were diagnosed and treated in our hospital were enrolled in this study. Clinical data of patients were recorded. Distress thermometer(DT) and problem list(PL) were used to assess the degree of psychological distress. Multivariate linear regression was used to analyze the influencing factors of psychological distress in middle-aged and elderly CRC patients undergoing permanent stoma. 
Results A total of 560 middle-aged and elderly patients with permanent stoma of CRC had a DT score of（6.12±2.06), which was moderate to severe pain, and the positive rate of psychological pain symptoms was 52.3%. In the PL scale score, the score of communication problems (1.72±0.36) was the highest, followed by the score of physical problems(1.50±0.32), and religion/belief problems(1.03±0.25). Univariate analysis results showed that DT scores were different in patients with respect to different age groups, education level, time of stoma, means of payment for medical expenses, monthly household income, self-care degree of stoma, and presence or absence of depression, pain, sleep disorders, and stoma complications（P＜0.05). There was no significant difference in DT scores in patients of different genders, marital status, and daily nursing time for stoma（P＞0.05). The multiple linear regression analysis showed that age（β=-3.122, P=0.006), depression（β=2.380, P＜0.001), sleep disorders（β=1.189, P=0.012), combined pain（β=2.676, P＜0.001), ostomy complications（β=3.352, P＜0.001), family monthly income per capita（β=-2.067, P＜0.001) were the influencing factors of psychological distress. 
Conclusion The degree of psychological distress in elderly CRC patients undergoing permanent stoma is moderate to severe, and its occurrence is associated with the family's average monthly income, age, psychological status, sleep status, and presence of pain and stoma complications.

Key words: colorectal neoplasms； ostomy； elderly