European Journal of Oncology Nursing最新文献

Background: Contact Nurses in Cancer Care (CNCCs) are well-positioned to address patients' concerns regarding sexual health, but many lack the tools and confidence to initiate such conversations.

Aim: To explore how CNCCs perceive the use of the BETTER model as a new practice for integrating discussions of sexuality into cancer care.

Methods: Data were collected from 37 CNCCs through video-recorded educational seminars, written reflections, and focus group interviews. A directed qualitative content analysis was conducted, guided by the four constructs of the Normalization Process Theory: coherence, cognitive participation, collective action, and reflexive monitoring.

Results: The BETTER model was perceived as a valuable tool for initiating conversations about sexuality. The CNCCs highlighted the importance of personal reflection, peer support, and managerial backing. Time constraints and structural barriers were identified as key challenges to implementation. Many CNCCs viewed themselves as clinical champions, advocating for the sustained integration of the model into practice.

Conclusion: Communication tools such as the BETTER model can enhance CNCCs' confidence and competence in addressing sexual health. Successful implementation requires organizational support and recognition of CNCCs' roles as facilitators of change. The Normalization Process Theory proved useful in understanding the implementation process, even across diverse clinical settings.

Purpose: The treatment burden experienced by older adults with lung cancer and comorbidity adversely affects their well-being and quality of life. However, it remains unclear how specific burdens interact to create a self-reinforcing system. This study aimed to explore the systemic and dynamic process.

Method: This study used purposive sampling to recruit 15 participants aged 65 years or older with lung cancer and at least one comorbidity from a tertiary hospital in China. Data were collected through in-depth, semi-structured interviews and analyzed using the Colaizzi phenomenological method.

Results: This study developed the "Cascade of Disadvantage" model to elucidate the cumulative interaction of five core burdens in this population. The model proposes three interconnected mechanistic pathways driving this process: (1) the sequential pathway, outlining a discernible, staged sequence where burdens trigger one another from the Symptom Storm through Self-Management Overload, Financial Toxicity, and Decisional Paralysis to the Internalization of Disadvantage; (2) the dynamic pathway, characterized by immediate, multidirectional interactions among burdens that drive fluctuating crises independent of sequence; and (3) the amplifying pathway, defined by vicious feedback loops where burdens mutually intensified. These pathways integrate isolated burdens into a self-reinforcing system that progressively erodes patients' capacity to manage and tolerate treatment.

Conclusion: The "Cascade of Disadvantage" model conceptualizes treatment burden as a self-reinforcing system. Consequently, nursing care should evolve from managing isolated burdens to actively intercepting its three core pathways. This shift positions nurses as essential "Cascade Interceptors" for safeguarding patients' dignity and well-being.

Purpose: The aim of this review was to systematically map support interventions for patients with primary high-grade brain tumours and their relatives.

Methods: Searches were conducted in electronic databases and reference lists of included articles. Articles published between 2013 and 2025 were included. Extracted data was condensed, compared, and categorised.

Results: The final sample comprised 34 articles, including 15 (44%) full-scale and 19 (56%) feasibility/pilot studies. Interventions included individualised support (n = 11), care planning (n = 6), rehabilitation (n = 6), mind-body care (n = 6), and education (n = 5). They targeted patients (n = 5; 15%), relatives (n = 11; 32%), or both (n = 18; 53%). Full-scale studies reported positive effects in primary outcomes for both patients and relatives. Among patients, improvements were noted in symptoms, cognition, communication, psychosocial functioning, and self-care. Relatives showed improved health-related quality of life and psychosocial outcomes, with increased mastery and preparedness, though decision-making needs remained. Timely and repeated outreach was valued. For both patients and relatives, interventions enhanced quality of life made patients feeling understood, prepared, strengthened, and more confident in decision-making during consultations. Patients and relatives preferred active involvement in care, decisions, and information, with particular emphasis on encouraging hope. Caregiver mastery remained high, and structured, cohesive, and well-facilitated support groups were most valued. All feasibility and pilot studies reported positive outcomes.

Conclusion: Support interventions for patients with primary high-grade brain tumours and their relatives show promising results with positive effects on outcome measures across different areas. Despite their potential advantages, many interventions are still in early implementation phases.

Introduction: It is established that physical activity (PA) during chemotherapy confers many benefits to patients, however engagement in PA is generally limited. The study objectives are to analyse the barriers to PA during chemotherapy and provide recommendations for integrating PA into clinical practice.

Methods: This study utilised data from 40 cancer care clinicians, ten carers and 23 people undergoing chemotherapy in the 'Experiences of PA during Chemotherapy (EPAC)' study. Barriers and facilitators to PA were extracted from ten focus group transcripts and 37 interviews, and mapped to the theoretical domains framework and behaviour change wheel (BCW). Following the BCW process supported the development of intervention design to facilitate increased PA across the socio-ecological layers of the health system.

Results: This study identified 54 barriers that cross all domains of capability, opportunity and motivation, theoretical domains framework and socio-ecological model; demonstrating the broadness and complexity of integrating PA into standard chemotherapy care. The study proposes two broad and connected interventions that may support increased PA during chemotherapy: organisational led support to improve skills, knowledge and confidence of PA for clinicians; and embedding exercise specialists into the multidisciplinary cancer care team.

Conclusion: Integrating PA into oncology at the treatment stage is a complex process requiring a multi-level approach. Increasing access to exercise specialists and supporting all members of the MDT to provide individual PA education and support will address many of the barriers to integrating PA into standard chemotherapy care.

Purpose: This study aimed to evaluate the effectiveness and safety of a nurse-supported hybrid home-based pulmonary rehabilitation program (PRP) in reducing psychological distress and preserving quality of life (QoL) and functional performance in patients with advanced lung cancer.

Methods: A randomized controlled trial was conducted with 104 patients with stage III-IV lung cancer randomly assigned to an intervention group (n = 52) or a control group (n = 52). The intervention group received home-based aerobic, resistance, and breathing exercises three times weekly after an initial supervised session. Anxiety and depression were primary outcomes, while QoL and functional performance were secondary outcomes. Outcomes were assessed at baseline, week 4, and week 8 and analyzed using generalized estimating equations under an intention-to-treat approach.

Results: Groups were comparable at baseline. At week 8, the intervention group showed significantly greater reductions in anxiety (β = -1.72, 95% CI [-3.04, -0.40], p = .01) and depression (β = -1.21, 95% CI [-2.35, -0.07], p = .04) compared with the control group. QoL and functional performance were maintained in the intervention group but declined in the control group. Program adherence was 63.5%, and no exercise-related serious adverse events occurred, including among participants with bone metastases.

Conclusions: A nurse-supported hybrid PRP is an effective intervention for reducing psychological distress and preserving functional status in patients with advanced lung cancer. The observed safety profile further supports its clinical applicability, including for high-risk populations.

Trial registration: Clinical trial ID: NCT05279521; First patient enrolled: April 14, 2022.

Purpose: Breast cancer patients undergoing adjuvant therapy commonly experience cancer-related fatigue (CRF) and multiple psychological symptoms that significantly affect quality of life (QoL). This study examined the prevalence and severity of CRF and explored its associations with multidimensional QoL and psychological distress among Taiwanese women with breast cancer.

Methods: A cross-sectional study was conducted at a regional hospital in southern Taiwan from September 2023 to August 2024. Eighty-four BC patients receiving chemotherapy or targeted therapy completed the Brief Fatigue Inventory-Taiwan (BFI-T), Brief Symptom Rating Scale (BSRS-5), and WHOQOL-BREF. Data were analyzed using descriptive statistics, chi-square tests, t-tests, ANOVA, and Pearson's correlations.

Results: CRF affected 60.7% of patients (mean BFI-T = 2.38 ± 2.09). QoL was moderate (WHOQOL-BREF = 56.91 ± 9.21), with psychological health scoring the lowest. Sleep disturbances occurred in 72.6% and suicidal ideation in 19.0% of patients. CRF was negatively correlated with QoL (r = -0.572, p < 0.01) and positively with psychological distress (r = 0.481, p < 0.001). Happiness level correlated with QoL (r = 0.652) and inversely with CRF (r = -0.528).

Conclusions: CRF significantly impairs quality of life and psychological well-being in Taiwanese breast cancer patients during adjuvant therapy. To improve survivorship outcomes, routine CRF screening integrated with psychosocial care should be prioritized in oncology nursing practice, and multidisciplinary supportive care should be implemented as part of comprehensive oncology services.

Purpose: Although sustained self-management behaviors are important for improving or preventing the worsening of cancer-related lymphedema (CRL), the definition of self-regulation, a core element of self-management behavior, remains unclear. These findings provide a foundation for the development of self-management behavior measurement scales, research advancements, and the development of effective interventions. This study aimed to define the concept of self-regulation in patients with CRL.

Methods: Walker and Avant's eight-step concept analysis method was used to clarify the attributes, antecedents, and consequences of self-regulation in patients with CRL. Literature searches were conducted using PubMed, CINAHL, Scopus, and Ichushi-Web (Japan Medical Abstracts Society Database). Related articles were searched using the search terms self-management, self-care, lymphedema, and self-regulation.

Results: The attributes defining self-regulation in patients with CRL were Motivational and emotional internal regulation, utilization of social resources, self-monitoring, Adjusting self-management behaviors, and Integrating self-management behaviors. Antecedents were the presence of emotional motivation and goals, Acceptance of lymphedema as a chronic condition, recognition of the necessity for self-management, understanding of self-management strategies and their effectiveness. The consequences were gaining a sense of control, symptom control, and life reconstruction and stabilization.

Conclusion: This concept analysis clarifies self-regulation in patients with CRL and provides a theoretical foundation for the development of measurement tools and support strategies that reflect the continuity of self-management behaviors. The findings may facilitate future research and interventions aimed at improving the quality of life of patients with CRL.

Purpose: Cancer treatment-induced bone loss (CTIBL) is a common adverse effect among women with breast cancer receiving endocrine therapy, which negatively affects recovery and quality of life. Bone health management is important in this population. This study aimed to evaluate the feasibility and preliminary outcomes of the Rebuilding Osteo Strength with Exercise (ROSE) program for women with breast cancer.

Methods: A non-randomized controlled trial was conducted among 72 women with breast cancer receiving endocrine therapy. Participants self-selected into the intervention or control group, receiving either the ROSE program or enhanced health education. The 12-week, online-delivered ROSE program comprised health education, exercise interventions, and behavior change strategies. Feasibility was evaluated through recruitment, retention, and exercise adherence rates. Preliminary bone-health outcomes included changes in bone mineral density (BMD), physical fitness, osteoporosis-related symptoms, knowledge, self-efficacy, and quality of life.

Results: Recruitment rate was 78.3%, with retention rates of 75% at 3 months and 50% at 6 months. High adherence to the exercise plan was observed: 92% for aerobic exercise, 91.7% for impact exercise, and 58% for resistance exercise. Small to moderate positive trends were found in physical fitness, osteoporosis-related symptoms, knowledge, and self-efficacy, though BMD and quality of life showed limited changes.

Conclusions: The ROSE program appears to be a feasible and safe approach for promoting bone health in breast cancer survivors. Future studies with longer follow-up and a larger sample are warranted to validate its long-term efficacy and mechanisms.