European Journal of Oncology Nursing最新文献

Purpose: To describe the illness perception, dyadic coping, and marital quality of cervical cancer patient-husband dyads. In addition, we explore the direct effects of illness perception on marital quality, and whether dyadic coping acts as a mediator in this process.

Methods: A cross-sectional design was employed. The Revised Illness Perception Questionnaire for Cervical Cancer, the Dyadic Coping Inventory, and the Marital Adjustment Test were used to assess illness perception, dyadic coping, and marital quality. Dyadic analysis was conducted by constructing the actor‒partner interdependence mediation model.

Results: A total of 175 dyads of postoperative cervical cancer patients and their husbands completed the questionnaires. The dyads reported suboptimal scores for both marital quality and dyadic coping. For direct effects of illness perception on marital quality, our model indicated that the positive illness perception of patients and negative illness perception of husbands can negatively impact their own marital quality. With respect to the indirect effects of dyadic coping acting as a mediator, both positive illness perception and negative illness perception of husbands can impact their own marital quality through their own dyadic coping and can also impact patients' marital quality through patients' dyadic coping.

Conclusions: This study highlights that the level of marital quality and dyadic coping in dyads need to be improved, demonstrates the significance of illness perception for influencing dyads' marital quality and reveals the underlying mediating mechanism of dyadic coping. This study provides guidance for illness perception-based dyadic interventions to improve marital quality among cervical cancer patients and husbands.

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.

Background: The incidence of haematological malignancy is increasing, and the bone marrow biopsy plays a key role in the diagnostic process. Due to the increasing demand, haematology clinics are frequently operating beyond their capacity. In response to this challenge, a nurse-led bone marrow clinic was established by a Health and Social Care Trust (HSCT) in 2014. However no formal evaluation of this service had been conducted.

Aim: To explore the experience and satisfaction among patients who have attended the bone marrow biopsy clinic and identify areas for service improvement.

Method: Semi-structured interviews were conducted over a 3-month period. All participants were recruited from the Trust who had undertaken a bone marrow biopsy procedure within the last 3 months. Analysis was conducted, using a content analysis approach.

Findings: Nine participants took part (six female, three male), ages ranged from 56 to 83 years. Four themes were identified: "influence of personality type on stress and coping before the procedure," "interplay between experience and expectations"," impact of person-centred nursing care" and "potential areas for improvement". All participants positively evaluated the nurse-led clinic, expressing a high level of satisfaction with the care they received. Of note was that the procedure was much less painful than participants had expected as well as the positive impact of person-cent red care on the patient experience. Suggested improvements included better information about car parking and clinic location, and a change in the bone marrow biopsy clinic environment which participants felt lacked the privacy required for this invasive procedure.

Conclusions: This evaluation's findings serve as an important reminder of the significance of connecting with patients on a human level to enable them to feel safe and supported during their procedure.

Purpose: Transitions from hospital to home in palliative care are emotionally and organisationally complex, influencing patients' dignity, safety, and continuity of care. Although previous studies have focused largely on professionals and informal caregivers, patients' own perspectives remain insufficiently understood. This study aimed to explore the lived experience of adults receiving palliative care during the transition from hospital to home.

Methods: A descriptive phenomenological design guided by Giorgi's method was used. Twenty adults (n = 20) recently discharged from hospital and receiving home-based palliative care were purposively recruited from three specialised community palliative care teams in northern Portugal and participated in in-depth individual interviews.

Results: Four essential themes described the transition experience: reconstructing home as a place of care and meaning; transforming relationships, highlighting the role of family and professionals; navigating loss and adaptation, where dependence evokes fear yet promotes acceptance; and system fragilities, including limited continuity and coordination, contributing to insecurity and distress. Overall, the transition was experienced as a tension between autonomy and vulnerability as patients reconstructed daily life in the context of serious illness.

Conclusions: Improving transitional palliative care requires integrated and relationally attuned models that ensure continuity and timely support across care settings. Nursing practices should actively involve patients and families, strengthen home-based support, and promote dignity and safety during the transition from hospital to home.

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.

Purpose: This study used cross-lagged panel network analysis to examine longitudinal symptom networks in patients with esophageal cancer undergoing chemotherapy, aiming to identify stage-specific influential symptoms and directed temporal associations across treatment stages.

Method: This longitudinal study was conducted from January to September 2025 in four Grade III Level A hospitals in Henan, China. Patients receiving chemotherapy for esophageal cancer were assessed at three time points using the M.D. Anderson Symptom Inventory Gastrointestinal Cancer Module (MDASI-GI). Cross-lagged panel network models were applied to estimate symptom-to-symptom temporal associations and quantify symptom influence using network centrality indices.

Results: A total of 339 participants completed all three assessments. During the T1→T2 interval, S1 (Pain) and S18 (Difficulty Swallowing) exhibited the highest out-expected influence (out-EI = 1.825 and 1.717, respectively), with the strongest temporal association observed from S1 (Pain) to S6 (Shortness of Breath) (β = 0.282). During the T2→T3 interval, S2 (Fatigue) and S3 (Nausea) emerged as the most influential symptoms (out-EI = 2.172 and 1.937, respectively), with the strongest association identified from S2 (Fatigue) to S6 (Shortness of Breath) (β = 0.454).

Conclusions: This study identified stage-specific influential symptoms and directed temporal associations within symptom networks among patients with esophageal cancer undergoing chemotherapy. Pain and difficulty swallowing were most influential early, whereas fatigue and nausea became more influential later. These findings support a network-based, stage-sensitive perspective on symptom management and may inform time-specific supportive care prioritization.

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.