Latent profiles of physical and psychological symptoms in patients following rectal cancer surgery: Associated demographic and clinical characteristics

Patients following rectal cancer surgery frequently experience multiple co-occurring physical and psychological symptoms; however, heterogeneity in the patterns and severity of these symptoms remains insufficiently understood. This study aimed to identify latent profiles of postoperative physical and psychological symptoms and examine the demographic and clinical characteristics associated with profile membership. A single-center cross-sectional study was conducted among 272 patients who underwent rectal cancer surgery at a tertiary hospital in Nanjing, China, between November 2023 and March 2024.

Participants were recruited using convenience sampling. Symptom assessments were performed during postoperative hospitalization, generally on postoperative day 7 after patients’ clinical conditions had stabilized. Fatigue, pain, sleep disturbance, anxiety, and depression were assessed using the Chinese versions of the corresponding Patient-Reported Outcomes Measurement Information System short forms, and raw scores were converted into standardized T-scores.

Latent profile models containing one to six profiles were estimated using Mplus 8.3. Demographic and clinical characteristics were compared across profiles using univariate analyses, and factors associated with profile membership were examined using multinomial logistic regression in SPSS 26.0. Three distinct profiles were identified: a low physical and psychological symptom burden profile comprising 141 patients (Profile 1, 51.8%), an intermediate physical and psychological symptom burden profile comprising 81 patients (Profile 2, 29.8%), and an intermediate physical-high psychological symptom burden profile comprising 50 patients (Profile 3, 18.4%).

Compared with Profile 1, patients with a stoma, preoperative intestinal symptoms, or a first hospitalization for rectal cancer were more likely to be assigned to Profile 2, whereas patients who had received neoadjuvant therapy were less likely to be assigned to Profile 2. Compared with Profile 1, self-paying patients, patients with a family history of rectal cancer, patients with a stoma, and those hospitalized for the first time were more likely to be assigned to Profile 3. Patients undergoing laparoscopic surgery were less likely to be assigned to Profile 3 than those undergoing other surgical approaches.

These findings indicate substantial heterogeneity in physical and psychological symptoms during the early postoperative period among patients with rectal cancer. Concurrent assessment of physical and psychological symptoms, together with sociodemographic and clinical characteristics, may help healthcare professionals identify patients who could benefit from more comprehensive symptom assessment and individualized postoperative management. The authors would like to thank all the patients who volunteered to participate in this study and cooperated actively with the investigation.

This study was funded by the 2024 Clinical Research Special Funding Project of Nanjing Drum Tower Hospital (2024-LCYJ-PY-15) and the Nursing Department Research Project of Nanjing Drum Tower Hospital (2025-B2304). Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210000, China School of Nursing, Nanjing University of Chinese Medicine, Nanjing, 210000, China Yinjin Li, Chaonan Yang, Tingting Hu & Lijuan Yang Nursing Department, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China Department of the Jiangbei Outpatient, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China Department of Colorectal Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China Correspondence to Zumei Song or Niu Niu. The authors declare that there are no competing financial interests or personal relationships that could affect the conclusions of this study.