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.
Purpose: Psycho-spiritual distress is prevalent and distressing among advanced cancer patients. While mind-body exercises have shown promise in alleviating psychological distress, their effectiveness in advanced cancer patients is still being explored. This study aimed to explore the feasibility and acceptability, and preliminary efficacy of two mind-body exercises-Tai Chi and mindful yoga-each rooted in distinct philosophies, compared to control among patients with advanced cancer.
Methods: We conducted a three-armed mixed-method pilot randomized control trial. Participants were randomized into Tai Chi, mindful yoga, or control groups. Over 12-week, 60-min Tai Chi classes were held twice a week, 120-min mindful yoga classes weekly, and control group received written exercise guidelines. Feasibility outcomes were assessed through questionnaires and semi-structured interviews at 12-week. Effect outcomes were assessed by questionnaire and physical functioning test at baseline, 12-week (post-intervention), and 24-week (12-week post-intervention).
Results: Forty-six patients with advanced cancer, with a mean age 61 years, were enrolled. Both Tai Chi and mindful yoga demonstrated satisfactory feasibility and acceptability, with attendance rates exceeding 86%, satisfactory levels of self-practice, and high satisfaction and credibility. Compared with control group, Tai Chi and mindful yoga groups showed preliminary reductions in depression and improvements in balance ability at 12 and 24 weeks. Additionally, mindful yoga showed additional preliminary enhancements in mindfulness and spiritual outcomes at 24-week. Qualitative interviews revealed three themes that contextualize and may underpin the improvements in depression, mindfulness, spiritual well-being, and physical functioning.
Conclusion: Tai Chi and mindful yoga were feasible, well-accepted, and showed promising trends in psycho-spiritual, mindfulness, and physical outcomes. A large-scale trial is warranted to confirm these findings.

