European Journal of Oncology Nursing最新文献

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.

Background: Chemotherapy drugs, due to their cytotoxic properties, pose significant occupational health risks to nurses. Despite the availability of established safety guidelines, evidence suggests that adherence to protective standards among oncology nurses remains suboptimal. This study aimed to assess safe handling practices and their associated factors among oncology nurses working in hospitals in Mashhad, Iran.

Methods: This multicenter cross-sectional descriptive study was conducted among 252 nurses employed in oncology wards of six hospitals in Mashhad, Iran, between May and December 2024. Data were collected using a structured questionnaire covering demographic characteristics, safe performance, knowledge, self-efficacy, workplace safety, and work-related barriers. Statistical analyses were performed using SPSS version 25, including independent t-tests, one-way ANOVA, Pearson correlation coefficients, and multivariate regression analyses.

Results: Overall, 81.7% of nurses reported having experienced skin contact with chemotherapy drugs, while only 23% demonstrated optimal safe performance. Significant positive correlations were observed between safe performance and psychological factors, including self-efficacy (r = 0.516, p < 0.001) and workplace safety (r = 0.493, p < 0.001). In contrast, work-related barriers showed significant negative correlations with all dimensions of performance. The association between knowledge and safe performance was weak and statistically significant only in the domains of safety in the drug preparation room and cytotoxic waste management.

Conclusion: The findings indicate a substantial gap in the safe handling of chemotherapy drugs among oncology nurses. Theoretical training alone, without addressing self-efficacy, organizational support, environmental infrastructure, and workplace barriers, is insufficient to improve safety performance. Implementing comprehensive training programs, strengthening organizational and managerial support, and enhancing psychological factors may contribute to improved occupational safety among nurses.