{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T04:46:12Z","timestamp":1782794772723,"version":"3.54.5"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"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. Public Health"],"abstract":"\n Background<\/jats:title>\n Cancer is a disease with a high fatality rate. In recent years, patients\u2019 psychological problems associated with cancer have attracted much attention. Identifying the psychological distress of cancer patients, formulating and implementing psychological interventions, and satisfying the humanistic care needs of patients have become popular topics in cancer nursing research.<\/jats:p>\n <\/jats:sec>\n \n Aims<\/jats:title>\n The purpose was to investigate relationships among rumination, somatic symptoms and psychological distress in cancer patients and to explore the mediating role of rumination in the relationship between somatic symptoms and psychological distress.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A total of 473 cancer patients admitted to the oncology department of a Grade A general hospital in Shandong Province from January 2023 to December 2023 were investigated via convenience sampling. The data were collected and examined via a general demographic data questionnaire, Ruminative Responses Scale (RRS), the Health Questionnaire-15 (PHQ-15) and the Kessler Psychological Distress Scale (K10).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The mean total psychological distress score in cancer patients was 21.77\u202f\u00b1\u202f7.49. The 473 patients were divided into two groups for univariate analysis according to whether they experienced psychological distress (K10\u202f\u2265\u202f16). There were statistically significant differences in the marital status (\n p<\/jats:italic>\n \u202f&lt;\u202f0.05), education level (\n x<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f6.623,\n p<\/jats:italic>\n \u202f&lt;\u202f0.05), cancer classification (\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), and symptom rumination (\n x<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f\u221213.737,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001) and brooding (\n x<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f\u221211.763,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001) subscores between the two groups. The reflective pondering subscore (\n x<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f\u221212.726,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), total RRS score (\n x<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f\u221214.056,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001) and PHQ-15 score (\n x<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f\u221212.161,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001) were compared between the two groups. Psychological distress was positively correlated with the RRS score (\n r<\/jats:italic>\n \u202f=\u202f0.841,\n p<\/jats:italic>\n \u202f&lt;\u202f0.05), the symptom rumination (\n r<\/jats:italic>\n \u202f=\u202f0.828,\n p<\/jats:italic>\n \u202f&lt;\u202f0.05), brooding (\n r<\/jats:italic>\n \u202f=\u202f0.742,\n p<\/jats:italic>\n \u202f&lt;\u202f0.05), and reflective pondering (\n r<\/jats:italic>\n \u202f=\u202f0.742,\n p<\/jats:italic>\n \u202f&lt;\u202f0.05) subscores, and the PHQ-15 score (\n r<\/jats:italic>\n \u202f=\u202f0.743,\n p<\/jats:italic>\n \u202f&lt;\u202f0.05). Rumination partially mediated the relationship between physical symptoms and psychological distress, with a mediating effect of 70.69%.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n There are close correlations among physical symptoms, rumination and psychological distress in cancer patients. Rumination plays a mediating role in the relationship between physical symptoms and psychological distress. Findings suggest that to alleviate patients\u2019 psychological distress and improve their physical and mental health, medical personnel can not only address the physical discomfort symptoms of patients in time but also intervene in their negative cognitive thinking as observed by rumination.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1853232","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T04:24:32Z","timestamp":1782793472000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Physical symptoms and psychological distress among cancer patients: a moderated mediation model involving rumination"],"prefix":"10.3389","volume":"14","author":[{"given":"Qiuxiang","family":"Sun","sequence":"first","affiliation":[{"name":"School of Nursing, Shandong Second Medical University","place":["Weifang, China"]},{"name":"Oncology Department, Weifang Hospital of Traditional Chinese Medicine, Shandong Second Medical University","place":["Weifang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiping","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Nursing, Shandong Second Medical University","place":["Weifang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Zuo","sequence":"additional","affiliation":[{"name":"School of Nursing, Shandong Second Medical University","place":["Weifang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junyi","family":"Wei","sequence":"additional","affiliation":[{"name":"School of Nursing, Shandong Second Medical University","place":["Weifang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengjia","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Nursing, Shandong Second Medical University","place":["Weifang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Integrated Neuropsychiatry Clinic, Shandong Mental Health Center, Shandong University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Psychology, Shandong Provincial Hospital Affiliated to Shandong First Medical University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinghua","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Infection Management, Shandong Mental Health Center, Shandong University","place":["Jinan, 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