{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T20:25:31Z","timestamp":1790022331717,"version":"4.0.1"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100013061","name":"Jilin Provincial Scientific and Technological Development Program","doi-asserted-by":"publisher","award":["YDZJ202201ZYTS227"],"award-info":[{"award-number":["YDZJ202201ZYTS227"]}],"id":[{"id":"10.13039\/501100013061","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing &amp;amp; Health Sciences"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Colorectal cancer (CRC) is one of the most common cancers globally. CRC is the second most prevalent form of cancer in China. The study aimed to construct symptom networks, identify core and sentinel symptoms and analyses the relationship between influencing factors and symptom clusters in CRC patients. We identified symptom clusters and their sentinel symptoms using exploratory factor analysis and the A priori Algorithm in 789 colorectal cancer patients (Yanji City, Jan 2020\u2013Mar 2024). Core symptoms were determined according to the centrality index of the symptom network, while univariate and multifactorial analyses explored factors influencing core and sentinel symptoms in first\u2010diagnosed patients. Four symptom clusters were identified: colorectal cancer\u2010specific, gastrointestinal (feeling bloated as sentinel), insufficient energy (shortness of breath as sentinel), and disease symptom clusters. Core symptoms included changes in bowel habits, influenced by alcohol history and carcinoembryonic antigen (CEA). Feeling bloated was influenced by alcohol history and shortness of breath by alcohol history and marital status. These findings emphasize the importance of early screening and symptom management for at\u2010risk individuals.<\/jats:p>","DOI":"10.1111\/nhs.70122","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T19:00:13Z","timestamp":1746730813000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Symptom Clusters and Sentinel Symptoms in Patients With Colorectal Cancer: A Network Analysis"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1083-5498","authenticated-orcid":false,"given":"Jiaqi","family":"Shi","sequence":"first","affiliation":[{"name":"School of Nursing Yanbian University  Yanji China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiani","family":"Luo","sequence":"additional","affiliation":[{"name":"School of Nursing Yanbian University  Yanji China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihao","family":"Liu","sequence":"additional","affiliation":[{"name":"Yanbian University  Yanji China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huijing","family":"Xu","sequence":"additional","affiliation":[{"name":"College of Nursing Seoul National University  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingjin","family":"Li","sequence":"additional","affiliation":[{"name":"School of Nursing Yanbian University  Yanji China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingai","family":"Jin","sequence":"additional","affiliation":[{"name":"The Affiliated Hospital of Yanbian University  Yanji China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanyu","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Nursing Yanbian University  Yanji China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toufeng","family":"Jin","sequence":"additional","affiliation":[{"name":"The Affiliated Hospital of Yanbian University  Yanji China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.49.6489"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2014.579"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/CEJ.0000000000000076"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.3724\/SP.J.1042.2020.00178"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.2174\/1872208312666180731104244"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.outlook.2016.05.008"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291719003817"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1037\/met0000555"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdq653"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.2174\/1574887111666160815103251"},{"key":"e_1_2_14_12_1","unstructured":"Gu M.2019.\u201cDevelopment and Application of the Colorectal Cancer Module Based on M.D. Anderson Symptom Inventory\u201d. Master's Degree thesis Shanghai University of Traditional Chinese Medicine Shanghai.https:\/\/doi.org\/10.27320\/d.cnki.gszyu.2019.000683."},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000972"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.2097\u20101826.2024.02.008"},{"key":"e_1_2_14_15_1","unstructured":"Hu F. Y.2018.\u201cInvestigation on Symptoms and Quality of Life in Patients With Stage II~III Rectal Cancer undergoing Preoperative Chemoradiotherapy\u201d. Master's Degree thesis Nanchang University Nanchang Jiangxi."},{"issue":"5","key":"e_1_2_14_16_1","first-page":"729","article-title":"A Longitudinal Study of Symptom Clusters in Patients After Low Anterior Resection for Rectal Cancer","volume":"25","author":"Hua Y. J.","year":"2023","journal-title":"Zhejiang Clinical Medicine Journal"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010022\u201021140\u20104"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002820\u2010200507000\u201000005"},{"issue":"20","key":"e_1_2_14_19_1","first-page":"3698","article-title":"Investigation of Symptom Clusters and Sentinel Symptoms in Patients With Cervical Cancer During Concurrent Chemoradiotherapy","volume":"38","author":"Li L.","year":"2024","journal-title":"Chinese Nursing Research"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.21037\/jgo\u201021\u2010904"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21731"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.16821\/j.cnki.hsjx.2024.06.002"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm.2013.19.4.433"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_14_25_1","unstructured":"Ting D.2022.\u201cStudy on the Correlation Between Symptoms and Quality of Life in Patients With Colorectal Cancer During Chemotherapy \u201dPhD diss."},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2011.12.007"},{"issue":"3","key":"e_1_2_14_27_1","first-page":"368","article-title":"Latent Class Analysis of Symptom Groups of Patients With Colorectal Cancer Undergoing Chemotherapy","volume":"39","author":"Zeng M. 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