{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:14:46Z","timestamp":1792109686548,"version":"4.4.0"},"reference-count":43,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"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":["Psycho-Oncology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To develop a theoretical framework for understanding the adaptation process to altered bowel function in patients with rectal cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a constructivist grounded theory study using theoretical sampling to select 24 patients who experienced low anterior resection syndrome, and were followed\u2010up at a cancer centre in Northern Taiwan. Data were collected using interviews until theoretical saturation was reached. During the interview, field notes synchronously were written as a memo to capture what was seen, heard, felt, and thought. Data were analysed using iterated constant comparisons, initial coding, focused coding, and theoretical coding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A substantive theory was developed that describes how participants adapted to altered bowel functioning. These categories encompassed experiences of altered bowel functioning, distress from altered bowel functioning, tolerance of distress fuels motivation for self\u2010empowerment, dynamic self\u2010regulation styles, and \u201cliving with\u201d altered bowel functioning. From this process, a core category emerged: \u201cThe journey from painful struggles toward self\u2010empowerment.\u201d<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings could guide healthcare professionals to comprehensively evaluate patients\u2019 distress from altered bowel functioning, witness those who are motivated to govern their situation, and provide timely information and tailored resources to sustain the growth of compassionate self\u2010care strategies that enable them to deal with, and live with, their altered bowel function. In future research, the findings could help researchers to develop a tool to comprehensively evaluate distress from altered bowel function and design a timely, ongoing, individual, and cost\u2010effective protocol that guides patients on a healing pathway.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pon.70574","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T12:44:45Z","timestamp":1786711485000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Process of Adapting to Altered Bowel Function in Patients With Rectal Cancer: A Grounded Theory Study"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3785-3659","authenticated-orcid":false,"given":"Ling\u2010Chun","family":"Lu","sequence":"first","affiliation":[{"name":"College of Medicine National Taiwan University  Taipei Taiwan"},{"name":"Department of Nursing National Taiwan University Hospital Yunlin Branch  Yunlin Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Long","sequence":"additional","affiliation":[{"name":"School of Nursing Ulster University  Northern Ireland UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0228-7936","authenticated-orcid":false,"given":"Fan\u2010Ko","family":"Sun","sequence":"additional","affiliation":[{"name":"College of Medicine National Taiwan University  Taipei Taiwan"},{"name":"Department of Nursing National Taiwan University Hospital Yunlin Branch  Yunlin Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12957\u2010021\u201002306\u20102"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/20503121211034366"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejon.2023.102467"},{"key":"e_1_2_10_6_1","volume-title":"Anorectal Disorders","author":"Lu L. 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