Abstract / Summary
Abstract Objective To explore the symptom experiences and needs of patients with low anterior resection syndrome (LARS) and their caregivers after sphincter-preserving surgery for rectal cancer, clarify the temporal evolution pattern of symptoms and the optimal nursing intervention timing, identify relevant influencing factors, and provide evidence for precise clinical nursing. Methods A mixed-methods design was used. The qualitative phase employed a phenomenological approach with semi-structured interviews of 15 LARS patients and 15 family caregivers at a tertiary hospital in Anhui Province (February–May 2024), analyzed via Colaizzi’s seven-step method. The quantitative phase enrolled 168 patients undergoing sphincter-preserving surgery at the same hospital (June 2024–June 2025), with follow-ups at discharge (T0), 2 weeks (T1), 1 month (T2), 3 months (T3), and 6 months (T4) post-surgery using the LARS score, Social Support Rating Scale (SSRS), and Intestinal Symptom Self-Management Behavior Questionnaire. Statistical methods included descriptive statistics, repeated-measures ANOVA, and univariate analyses. Results The qualitative study identified three themes: (1) binary interaction and empathy dilemmas of symptom stress, including perception differences and emotional transmission; (2) binary collaboration and conflict in coping strategies; and (3) binary imbalance and complementarity of support needs. Quantitatively, the overall LARS incidence was 77.38%. Symptom evolution was dynamic: T1 had the highest incidence and the highest proportion of severe symptoms (29.76%), with symptoms gradually alleviating over time—by T4, 92.26% of patients had mild or no symptoms. T1 was the symptom peak (LARS score 24.470 ± 9.656), significantly higher than at other time points (p < 0.01); at this node, self-management ability was low (25.655 ± 8.917), and social support utilization was only 4.107 ± 2.805. Conclusion LARS incidence is high and dynamically evolves after sphincter-preserving surgery, with 2 weeks post-surgery identified as the critical intervention time node. Clinicians should address cognitive differences and dyadic coping needs, establish family-centered continuous nursing support, enhance self-management, and strengthen social support to improve rehabilitation outcomes and quality of life.