Skip to content
DraconiticResearch
Search Sources API
203,203 studies31 sourcesUpdated 10 min ago
Peer-reviewedCC BY 4.0Frontiers in Public Health

Association between postoperative bowel symptoms and social isolation in patients with rectal cancer: the moderating effects of social support and psychological resilience

  • Yaolan Wang1
  • Lin Yao2
  • Xinlei Zhao3
  • Xiaodong Wang4
  • Mingjun Huang5
5 affiliations
  1. 1West China School of Nursing/Day Surgery Center, West China Hospital, Sichuan University
  2. 2Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, West China School of Medicine, Sichuan University
  3. 3West China School of Nursing/Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University
  4. 4Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University
  5. 5Day Surgery Center / West China School of Nursing, West China Hospital, Sichuan University
Read full textPDFDOICite

Abstract

Background: 60% ~ 90% of patients with rectal cancer undergoing sphincter-preserving surgery experience persistent bowel symptoms, and patients also report varying degrees of social isolation. Those bowel symptoms are often particularly pronounced during the first month after surgery, when patients may also experience substantial challenges in resuming social participation. However, evidence regarding the association between bowel symptoms and social isolation remains limited, and the potential moderating roles of psychosocial resources are not well understood.

Objective: To investigate the association between postoperative bowel symptoms and social isolation among patients with rectal cancer following sphincter-preserving surgery, and to further examine the moderating effects of perceived social support and psychological resilience.

Methods: This secondary analysis used data from an ongoing prospective observational cohort study of patients with rectal cancer undergoing sphincter-preserving surgery at a tertiary hospital in China. Demographic and clinical characteristics, perceived social support, and psychological resilience were assessed preoperatively, while bowel symptoms and social isolation were assessed at the 1-month postoperative follow-up. Baseline and 1-month postoperative data were used in this study. Spearman correlation analysis and hierarchical multiple linear regression analysis were performed to examine the association between postoperative bowel symptoms and social isolation. Simple slope analysis and Johnson–Neyman (J-N) analysis were conducted to evaluate the moderating roles of perceived social support and psychological resilience.

Results: A total of 351 patients were included in the final analysis. Postoperative bowel symptoms were significantly and positively correlated with social isolation ( r s = 0.595, p < 0.001). After adjusting for relevant demographic and clinical factors, bowel symptoms remained independently associated with higher levels of social isolation (B = 0.506, p < 0.001). Separate moderation analyses showed significant interactions for perceived social support (B = −0.020, 95% CI −0.032 to −0.009, ΔR ² = 0.018, p = 0.001) and psychological resilience (B = −0.011, 95% CI −0.019 to −0.004, ΔR ² = 0.013, p = 0.003), although the additional variance explained by the interaction terms was modest. Simple slope analyses indicated that the association between bowel symptoms and social isolation remained significant across low, mean, and high levels of both moderators. Johnson–Neyman analysis showed that the association became nonsignificant only within a narrow range at the upper end of the observed social support distribution (actual scores ≥ approximately 69), whereas it remained significant across the entire observed range of psychological resilience.

Conclusion: Postoperative bowel symptom burden was positively associated with social isolation among patients with rectal cancer following sphincter-preserving surgery. Higher perceived social support and psychological resilience were associated with weaker bowel symptom–social isolation relationships. These findings support an integrated supportive-care approach that combines bowel symptom management with psychosocial and social support to address postoperative social isolation and facilitate social functioning.

Related

  1. Adverse childhood experiences and cyber aggression among college students: the mediating role of psychological resilience and the moderating role of physical exercise.
    Luyao Xiang, Hao Gou, Qunqun Sun +2
    Frontiers in psychiatryPeer-reviewedCC BYFull text2 citedPsychiatry & mental healthEurope PMC
  2. Positive psychological capital and social support mediate the association between perceived stress and fear of disease progression in postoperative lung cancer patients
    Yirong Xia, Yu Zhu, Yunxia Zhu +2
    Scientific ReportsPeer-reviewedCC BY-NC-ND 4.0Full textOncologyCrossref
  3. Association between Resilience and Financial Toxicity: The Moderating Role of Age, Race and Socioeconomic Factors
    Y. Zhan, R. Wells, T. Knobf +3
    medRxivPreprintCC BY-NC-NDFull textGeneral medicinemedRxiv
  4. Latent psychological resilience profiles and their association with physical resilience in older patients after robot-assisted radical prostatectomy: a cross-sectional study
    Rong Liu, Xiang Xi, Xiao Ma +2
    Frontiers in oncologyPeer-reviewedCC BYFull textOncologyEurope PMCCrossref
  5. Association between psychological resilience and quality of life among middle-aged and older inpatients with chronic diseases: a cross-sectional study
    Jiashuang Xu, Fuzhuo Wang, Yi Chen +4
    Frontiers in Public HealthPeer-reviewedCC BY 4.0Full textPsychiatry & mental healthCrossrefEurope PMCPMC

Cite

BibTeXRIS
BibTeX
@article{wang2026association,
  title = {{Association between postoperative bowel symptoms and social isolation in patients with rectal cancer: the moderating effects of social support and psychological resilience}},
  author = {Yaolan Wang and Lin Yao and Xinlei Zhao and Xiaodong Wang and Mingjun Huang},
  journal = {Frontiers in Public Health},
  year = {2026},
  month = oct,
  doi = {10.3389/fpubh.2026.1963156},
  url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1963156/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Association between postoperative bowel symptoms and social isolation in patients with rectal cancer: the moderating effects of social support and psychological resilience
AU  - Yaolan Wang
AU  - Lin Yao
AU  - Xinlei Zhao
AU  - Xiaodong Wang
AU  - Mingjun Huang
PY  - 2026
DA  - 2026/10/14
JO  - Frontiers in Public Health
DO  - 10.3389/fpubh.2026.1963156
UR  - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1963156/full
AB  - Background: 60% ~ 90% of patients with rectal cancer undergoing sphincter-preserving surgery experience persistent bowel symptoms, and patients also report varying degrees of social isolation. Those bowel symptoms are often particularly pronounced during the first month after surgery, when patients may also experience substantial challenges in resuming social participation. However, evidence regarding the association between bowel symptoms and social isolation remains limited, and the potential moderating roles of psychosocial resources are not well understood.  Objective: To investigate the association between postoperative bowel symptoms and social isolation among patients with rectal cancer following sphincter-preserving surgery, and to further examine the moderating effects of perceived social support and psychological resilience.  Methods: This secondary analysis used data from an ongoing prospective observational cohort study of patients with rectal cancer undergoing sphincter-preserving surgery at a tertiary hospital in China. Demographic and clinical characteristics, perceived social support, and psychological resilience were assessed preoperatively, while bowel symptoms and social isolation were assessed at the 1-month postoperative follow-up. Baseline and 1-month postoperative data were used in this study. Spearman correlation analysis and hierarchical multiple linear regression analysis were performed to examine the association between postoperative bowel symptoms and social isolation. Simple slope analysis and Johnson–Neyman (J-N) analysis were conducted to evaluate the moderating roles of perceived social support and psychological resilience.  Results: A total of 351 patients were included in the final analysis. Postoperative bowel symptoms were significantly and positively correlated with social isolation ( r s = 0.595, p < 0.001). After adjusting for relevant demographic and clinical factors, bowel symptoms remained independently associated with higher levels of social isolation (B = 0.506, p < 0.001). Separate moderation analyses showed significant interactions for perceived social support (B = −0.020, 95% CI −0.032 to −0.009, ΔR ² = 0.018, p = 0.001) and psychological resilience (B = −0.011, 95% CI −0.019 to −0.004, ΔR ² = 0.013, p = 0.003), although the additional variance explained by the interaction terms was modest. Simple slope analyses indicated that the association between bowel symptoms and social isolation remained significant across low, mean, and high levels of both moderators. Johnson–Neyman analysis showed that the association became nonsignificant only within a narrow range at the upper end of the observed social support distribution (actual scores ≥ approximately 69), whereas it remained significant across the entire observed range of psychological resilience.  Conclusion: Postoperative bowel symptom burden was positively associated with social isolation among patients with rectal cancer following sphincter-preserving surgery. Higher perceived social support and psychological resilience were associated with weaker bowel symptom–social isolation relationships. These findings support an integrated supportive-care approach that combines bowel symptom management with psychosocial and social support to address postoperative social isolation and facilitate social functioning.
SN  - 2296-2565
ER  -