{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T06:28:12Z","timestamp":1787120892916,"version":"build-2736575974"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify distinct trajectories of psychological distress from pre-discharge to 6\u202fmonths post-discharge in patients with low- and mid-rectal cancer with postoperative LARS and to explore factors associated with different trajectory classes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A longitudinal study was conducted among patients with low- and mid-rectal cancer with postoperative LARS recruited from a tertiary hospital in Anhui, China, between March 2024 and June 2025. Psychological distress was assessed using the Kessler Psychological Distress Scale (K10) within 3\u202fdays before discharge and at 1, 3, and 6\u202fmonths after discharge. Of the 205 patients who completed the baseline assessment, 178 completed all follow-up assessments and were included in the final analysis. Latent Growth Mixture Modeling (LGMM) was applied to identify distinct trajectories of psychological distress, and multinomial logistic regression was used to examine factors associated with trajectory class membership.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, psychological distress declined over time; however, substantial heterogeneity in developmental trajectories was observed. Three trajectory classes were identified: (1) mild-high distress with sustained relief (50.0%), (2) moderate-low distress with fluctuating improvement (28.1%), and (3) severe-persistent high distress (21.9%). Primary caregiver, tumor stage, LARS score, and stigma (SIS score) were significantly associated with trajectory class membership (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Psychological distress among patients with postoperative LARS demonstrates significant heterogeneity over time. Early identification of patients at high risk of persistent distress, particularly those with severe bowel dysfunction, advanced tumor stage, non-family caregivers, and high levels of stigma, is essential. These findings may inform risk stratification and support the development of individualized nursing interventions targeting symptom management, stigma reduction, family support, and psychological adaptation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2026.1919395","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T05:48:57Z","timestamp":1787118537000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Trajectories of psychological distress and associated factors in patients with postoperative Low Anterior Resection Syndrome: a longitudinal latent class analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Xiangdong","family":"Hu","sequence":"first","affiliation":[{"name":"Department of General Surgery, Lu'an Hospital of Anhui Medical University (Lu'an People's Hospital)","place":["Lu'An, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiushi","family":"Yin","sequence":"additional","affiliation":[{"name":"Graduate College, Wannan Medical University","place":["Wuhu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Lu'an Hospital of Anhui Medical University (Lu'an People's Hospital)","place":["Lu'An, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changcui","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Urology, Affiliated Hospital of West Anhui Health Vocational College","place":["Lu'An, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Yang","sequence":"additional","affiliation":[{"name":"Residency Training and Education Department, Lu'an Hospital of Anhui Medical University (Lu'an People's Hospital)","place":["Lu'An, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"ref26","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1007\/S10151-022-02594-0","article-title":"The impact of bowel dysfunction on health-related quality of life after rectal cancer surgery: a systematic review","volume":"26","author":"Al Rashid","year":"2022","journal-title":"Tech Coloproctol."},{"key":"ref1","doi-asserted-by":"publisher","first-page":"e72772","DOI":"10.7759\/cureus.72772","article-title":"A systematic review of comparative effectiveness of interventions for low anterior resection syndrome: impacts on bowel function and quality of life","volume":"16","author":"Ansar","year":"2024","journal-title":"Cureus."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1030","DOI":"10.1007\/s00520-025-10075-x","article-title":"The impact of ostomy on colorectal cancer patients and caregivers: a qualitative study","volume":"33","author":"Asefa","year":"2025","journal-title":"Support Care Cancer"},{"key":"ref3","first-page":"395","article-title":"Psychosocial issues in colorectal cancer survivorship: the top ten questions patients may not be asking","volume":"5","author":"Averyt","year":"2014","journal-title":"J Gastrointest Oncol."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. 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