{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T05:07:11Z","timestamp":1792040831657,"version":"4.4.0"},"reference-count":72,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T00:00:00Z","timestamp":1752451200000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To examine the changing trajectories of symptom clusters within 3\u2009months following surgery in patients with colorectal cancer (CRC) and identify their predictive factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A prospective longitudinal observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Convenience sampling was used to recruit inpatients with CRC who were scheduled for surgical treatment at the Sichuan Provincial People's Hospital between October 2022 and September 2023. The Chinese version of the MD Anderson Symptom Inventory Gastrointestinal Cancer Module was utilized. The prevalence and severity of patients' symptoms were assessed at 7\u2009days (T1), 6\u2009weeks (T2), and 3\u2009months (T3). Before the operation, a total of 240 patients with CRC were recruited. There were 203, 164, and 139 patients participating in T1, T2, and T3, respectively. Exploratory factor analysis identified symptom clusters. Latent class growth modeling determined the developmental trajectories of symptom clusters, and binomial logistic regression analyzed predictors of trajectory classification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Two clinical subgroups were identified: a \u201chigh symptom\u2014decreases and then increases\u201d (17.2%) and a \u201clow symptoms\u2014continuous decline\u201d (82.8%). The latter exhibited significantly lower and progressively declining symptom severity compared to the former. Predictive factors for the \u201chigh symptom\u2014decreases and then increases\u201d subgroup included multimorbidity (\u2265\u20092 chronic conditions), chronic lung disease, preoperative frailty, severe anxiety\/depression, open surgery, and postoperative chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Targeted management of the mood\u2010sleep disorder cluster (T1) and the activity intolerance cluster (T2\/T3) may significantly improve patients' quality of life. The \u201chigh symptom\u2014decreases then increases\u201d subgroup warrants prioritized clinical attention, as early intervention for its predictive factors (e.g., frailty, anxiety, and depression) could enhance postoperative outcomes. Integrating these factors into routine preoperative assessments is recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71025","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T12:05:37Z","timestamp":1752494737000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Trajectories of Symptom Clusters and Their Predictive Factors in Patients With Colorectal Cancer 3\u2009Months After Surgery: A Longitudinal Study"],"prefix":"10.1002","volume":"14","author":[{"given":"Yue","family":"Li","sequence":"first","affiliation":[{"name":"Department of Nursing, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenwen","family":"Gan","sequence":"additional","affiliation":[{"name":"Department of Nursing, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Nursing, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongying","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Nursing, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Nursing, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Nursing, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4407-2471","authenticated-orcid":false,"given":"Xiaorong","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Nursing, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/03000605211063105"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejon.2022.102170"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/JNC.0000000000000166"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9394"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn115610\u201020230526\u201000236"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102702.2009.03099.x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/2193-1801-3-276"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2648.2001.01697.x"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00012272-199703000-00003"},{"issue":"3","key":"e_1_2_10_12_1","first-page":"465","article-title":"Symptom Clusters and Their Effect on the Functional Status of Patients With Cancer","volume":"28","author":"Dodd M. 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