Potential Categories and Influencing Factors of Social Participation Among Colorectal Cancer Patients

Abstract

Objective: To explore the characteristics of potential categories of social participation among colorectal cancer patients, analyze the influencing factors associated with different categories, and provide empirical evidence for the development of precision-based social functional rehabilitation intervention plans. Methods: A cross-sectional study design was employed. A total of 368 colorectal cancer patients from the Department of Gastrointestinal Surgery, Department of Medical Oncology, and Stoma Clinic of a tertiary hospital between January and December 2024 were selected as study subjects. Data were collected using a demographic questionnaire, the Social Participation Scale for Chronic Patients, the Hospital Anxiety and Depression Scale, the Social Support Rating Scale, the Barthel Index, and the Piper Fatigue Scale. Latent class analysis of social participation was conducted using Mplus 8.3 software, and SPSS 26.0 was used to explore the factors influencing class membership through univariate analysis and multinomial logistic regression models. Results: Social participation among colorectal cancer patients can be classified into three latent categories: the group with good social participation (32.07%), the group with partially restricted social participation (45.11%), and the group with severely restricted social participation (22.82%). Multiclass logistic regression analysis revealed that age, TNM stage, stoma presence, number of comorbid chronic diseases, anxiety level, social support level, activities of daily living (ADL) ability, and cancer-related fatigue were independent factors influencing patients’ social participation categories (P < 0.05), while depression level was a specific independent risk factor for the severely restricted social participation category (P < 0.05). Conclusion: Significant heterogeneity exists in the social participation of colorectal cancer patients. Clinicians should prioritize high-risk patients, including the elderly, those with a stoma, advanced-stage disease, multiple comorbidities, and negative emotions. By developing stratified and precise rehabilitation intervention strategies tailored to the characteristics and core influencing factors of different subgroups, clinicians can promote the restoration of patients’ social functioning and improve their long-term quality of life.