Bowel symptoms Colorectal cancer Experiences Losing controlLower anterior resection Sphincter-saving surgery Background: Rectal cancer patients who have undergone lower anterior resection with sphincter-saving surgery often experience loss of bowel control. We currently do not have suitable treatment regimens for such patients. Objective: The aim of this study was to explore the experiences of losing bowel control in patients who have undergone lower anterior resection with sphincter-saving surgery for rectal cancer in Taiwan. Methods:A descriptive phenomenological study design was adopted. Purposive sampling and one-on-one semistructured interviews were conducted for data collection. Narratives were analyzed using Colaizzi's method. Results: Data saturation was achieved after interviewing 12 patients (8 men, 4 women) whose average age was 61 years. Three themes and 11 subthemes emerged: physical problems (pain from broken perianal skin, insomnia, decreased physical strength, and body weight loss), adverse psychological reactions (worries, helplessness, and social isolation), and the use of coping strategies (avoidance of inappropriate foods to reduce bowel irritation and peristalsis, reduction of food intake, and use of antidiarrheal drugs and perianal skincare products). Conclusion:The study supports the importance of having a good understanding of patient experiences by healthcare professionals to provide more effective healthcare. Furthermore, awareness of the cultural issue of social isolation was deemed important for providing individualized healthcare. Implications for Practice: Education, counseling, and psychological support can enhance patients' abilities to use coping strategies to overcome the physical and mental challenges of bowel symptoms. For

Aim: Converging symptoms of cervical spine and shoulder pathologies can lead to misdiagnosis and unsatisfying outcomes of corresponding surgical interventions, as those seen in published research on hip-spine syndrome. In addition, the intricate biomechanical interdependence between these two sites may be altered after surgery at either site, potentially putting the untreated site at danger of further injury. Thus, this study will examine whether certain surgeries at cervical spine and shoulder joint can be a risk factor for each other. Method: Reimbursement claims of certain shoulder-related and cervical-related surgery from January 1st 2000 to December 31st 2016 were included according to their diagnosis and treatment codes via Taiwan National Health Insurance Research Database (NHIRD) service. Collected subjects in both groups will be matched with control subjects who did not have that surgery based on age, gender, index date and Charlson Comorbidity Index (CCI). Odds ratio and hazard ratio of having surgeries at the other site between patients with and without surgery at one site will be calculated with logistic regression model. Result: The odds ratios of having certain cervical spine surgeries between shoulder surgery subjects and matched controls within 3, 6 and 12 months are 1.78(1.27-2.49), 2.19(1.75-2.75) and 2.55(2.17-3.00), respectively. The odds ratios of having certain shoulder surgeries between cervical subjects and matched controls are 2.08(1.48-2.94), 2.88(2.30-3.61) and 3.32(2.82-3.90), respectively. Hazard ratio of having certain surgeries at the other site between subjects and controls is 3.36(2.86-3.96) for cervical group, and 2.54(2.16-2.98) for shoulder group. Conclusion: Certain cervical surgeries are risk factors of certain shoulder surgeries and vice versa. Detailed physical examinations should be regularly conducted at both sites before arranging surgeries for either one. Preventative measures and early screening for pathologies at the other site should be initiated as soon as allowed to reduce further medical expenses.