{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T06:06:02Z","timestamp":1790057162360,"version":"4.0.1"},"reference-count":57,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100012400","name":"Sigma Theta Tau International","doi-asserted-by":"publisher","award":["20427"],"award-info":[{"award-number":["20427"]}],"id":[{"id":"10.13039\/100012400","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["U01 CA206110"],"award-info":[{"award-number":["U01 CA206110"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01 AG083580"],"award-info":[{"award-number":["R01 AG083580"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Research in Nursing &amp;amp; Health"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      Colorectal cancer (CRC) is a leading cause of cancer mortality in the United States. Many patients with CRC experience physical and psychological symptoms that diminish quality of life and are shaped by social determinants of health (SDOH) and diet quality. This study aimed to (a) identify distinct symptom occurrence subgroups among patients with CRC, and (b) examine differences in SDOH characteristics and diet quality across these symptom occurrence subgroups. We conducted a secondary analysis of the ColoCare Study dataset from the Huntsman Cancer Institute, including CRC patients 6 months postdiagnosis. Latent class analysis identified subgroups based on the presence of symptoms. Chi\u2010square tests and ANOVA examined subgroup differences in SDOH and diet quality, measured by the Healthy Eating Index (HEI)\u20102020. Logistic regression adjusted for cancer stage, comorbidity status, neoadjuvant or adjuvant therapy. Among 256 patients, three subgroups emerged: low (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200984), moderate (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009123), and high symptom occurrence (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200949). Patients with high symptom occurrence were younger (F\u2009=\u20094.48,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), more often Hispanic (\u03c7\u00b2\u2009=\u20099.10,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), had lower income (\u03c7\u00b2\u2009=\u200912.92,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), and more frequently received neoadjuvant therapy (\u03c7\u00b2\u2009=\u200910.30,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006). They reported lower total social support (F\u2009=\u20095.60,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004) and poorer diet quality (F\u2009=\u20099.58,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0001). After adjustment, high symptom occurrence group had lower odds of adequate income (OR\u2009=\u20090.28,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0312), social support (OR\u2009=\u20090.886,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0100), and diet quality (OR\u2009=\u20090.94,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0156). Distinct CRC symptom profiles highlight the need for personalized dietary interventions and enhanced social support to improve symptom management.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>Findings emphasize care strategies that address SDOH to optimize outcomes and quality of life for patients with CRC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nur.70083","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T13:05:10Z","timestamp":1779800710000},"page":"595-611","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Distinct Symptom Occurrence Subgroups Among Patients With Colorectal Cancer: Differences in Social Determinants of Health and Diet Quality"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8831-7229","authenticated-orcid":false,"given":"Youran","family":"Lee","sequence":"first","affiliation":[{"name":"School of Nursing Duke University Durham North Carolina USA"},{"name":"School of Nursing University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4844-4690","authenticated-orcid":false,"given":"Qing","family":"Yang","sequence":"additional","affiliation":[{"name":"School of Nursing Duke University Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9695-3126","authenticated-orcid":false,"given":"Melissa","family":"Kay","sequence":"additional","affiliation":[{"name":"School of Medicine Wake Forest University Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5678-8533","authenticated-orcid":false,"given":"Donald E.","family":"Bailey","sequence":"additional","affiliation":[{"name":"School of Nursing Duke University Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8085-2072","authenticated-orcid":false,"given":"Biljana","family":"Gigic","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, and Transplantation Surgery Heidelberg University Hospital Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0292-6168","authenticated-orcid":false,"given":"Sheetal","family":"Hardikar","sequence":"additional","affiliation":[{"name":"Huntsman Cancer Institute University of Utah Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1079-2606","authenticated-orcid":false,"given":"Adetunji T.","family":"Toriola","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences, Department of Surgery Washington University School of Medicine and Siteman Cancer Center St Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Shibata","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Tennessee Health Science Center Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1543-0743","authenticated-orcid":false,"given":"Christopher I.","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences Fred Hutchinson Cancer Research Center Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doratha A.","family":"Byrd","sequence":"additional","affiliation":[{"name":"H. Lee Moffitt Cancer Center and Research Institute Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8040-3341","authenticated-orcid":false,"given":"Jane C.","family":"Figueiredo","sequence":"additional","affiliation":[{"name":"Samuel Oschin Comprehensive Cancer Institute Cedars\u2010Sinai Medical Center Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ildiko","family":"Strehli","sequence":"additional","affiliation":[{"name":"Huntsman Cancer Institute University of Utah Salt Lake City Utah USA"},{"name":"Department of Population Health Sciences University of Utah Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0328-5249","authenticated-orcid":false,"given":"Megan","family":"Mclaws","sequence":"additional","affiliation":[{"name":"Huntsman Cancer Institute University of Utah Salt Lake City Utah 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