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.
目的：癌症治疗性骨质流失（Cancer treatment-induced bone loss， CTIBL）是接受内分泌治疗的乳腺癌患者常见的不良反应，对患者的康复和生活质量产生负面影响。在这一人群中，骨骼健康管理很重要。本研究旨在评估通过运动重建骨力量（ROSE）项目对乳腺癌患者的可行性和初步结果。方法：对72例接受内分泌治疗的乳腺癌患者进行非随机对照试验。参与者自行选择进入干预组或对照组，接受ROSE计划或强化健康教育。这个为期12周的在线ROSE项目包括健康教育、运动干预和行为改变策略。通过招募、保留和锻炼坚持率来评估可行性。初步的骨健康结果包括骨密度（BMD）、身体健康、骨质疏松相关症状、知识、自我效能和生活质量的变化。结果：入职率为78.3%，3个月留职率75%，6个月留职率50%。观察到运动计划的高依从性：有氧运动92%，冲击运动91.7%，阻力运动58%。尽管骨密度和生活质量变化有限，但在身体健康、骨质疏松相关症状、知识和自我效能方面发现了小到中等程度的积极趋势。结论：ROSE计划似乎是促进乳腺癌幸存者骨骼健康的一种可行且安全的方法。未来的研究需要更长的随访时间和更大的样本来验证其长期疗效和机制。
{"title":"Feasibility and preliminary outcomes of a Rebuilding Osteo Strength with Exercise (ROSE) program for women with breast cancer undergoing endocrine therapy.","authors":"Lu Chen, Yue Zhao, Ailing Yang, Lixiao Bai, Teresa Hagan Thomas, Fuyun Zhao, Yu Liu, Jun-E Liu, Fengli Gao","doi":"10.1016/j.ejon.2026.103120","DOIUrl":"https://doi.org/10.1016/j.ejon.2026.103120","url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"81 ","pages":"103120"},"PeriodicalIF":2.7,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-02DOI: 10.1016/j.ejon.2026.103122
Sujin Kim , Sunki Kim , Hye-Ja Park
Purpose
To determine the statistically mediating roles of cancer stigma and resilience in the relationship between Type D personality and quality of life (QoL) in patients with breast cancer undergoing chemotherapy.
Methods
This cross-sectional correlational study included 129 inpatients with breast cancer recruited from a university hospital-affiliated cancer center ward. Participants completed questionnaires assessing their Type D personality, cancer stigma, resilience, and QoL. Data were analyzed using Pearson's correlation, hierarchical regression, and PROCESS Macro-mediation analysis (Model 4, 50,000 bootstrap samples).
Results
Type D personality negatively correlated with resilience (r = −0.493, p < 0.001) and QoL (r = −0.407, p < 0.001) and positively correlated with cancer stigma (r = 0.387, p < 0.001). Cancer stigma negatively correlated with resilience (r = −0.257, p = 0.003) and QoL (r = −0.455, p < 0.001). Meanwhile, resilience was positively associated with QoL (r = 0.514, p < 0.001). Regression analysis showed that cancer stigma and resilience significantly predicted QoL (β = −0.305, p < 0.001; β = 0.326, p < 0.001), accounting for 26.4% of the variance. Bootstrapped mediation analysis indicated that cancer stigma and resilience explained the link between type D personality and QoL (B = −0.0128, 95% BootCI [−0.0194, −0.0070]). Two significant indirect pathways between type D personality and QoL were identified: perceived cancer stigma (B = −0.0058, 95% BootCI [−0.0104, −0.0018]) and resilience (B = −0.0070, 95% BootCI [−0.0130, −0.0025]).
Conclusion
Reducing cancer stigma and enhancing resilience may help improve QoL among patients with breast cancer receiving chemotherapy, particularly those with Type D personality. These findings underscore the importance of targeted psychosocial nursing interventions.
目的探讨癌症耻感和心理韧性在乳腺癌化疗患者D型人格与生活质量（QoL）关系中的中介作用。方法采用横断面相关性研究纳入129例来自某大学附属肿瘤中心病房的乳腺癌住院患者。参与者完成了问卷调查，评估他们的D型人格、癌症耻辱、恢复力和生活质量。数据分析采用Pearson’s correlation、分层回归和PROCESS宏观中介分析（模型4,50,000个bootstrap样本）。结果D型人格与恢复力（r = - 0.493, p < 0.001）、生活质量（r = - 0.407, p < 0.001）呈负相关，与癌症耻感（r = 0.387, p < 0.001）呈正相关。癌症耻感与恢复力（r = - 0.257, p = 0.003）和生活质量（r = - 0.455, p < 0.001）呈负相关。同时，弹性与生活质量呈正相关（r = 0.514, p < 0.001）。回归分析显示，癌症柱头和恢复力显著预测生活质量（β = - 0.305, p < 0.001; β = 0.326, p < 0.001），占方差的26.4%。bootstrap中介分析表明，癌症耻感和心理弹性解释了D型人格与生活质量之间的关系（B = - 0.0128, 95% BootCI[- 0.0194, - 0.0070]）。发现了D型人格与生活质量之间的两个显著间接途径：感知癌症耻辱（B = - 0.0058, 95% BootCI[- 0.0104, - 0.0018]）和恢复力（B = - 0.0070, 95% BootCI[- 0.0130, - 0.0025]）。结论减少癌症耻辱感，增强适应能力有助于改善乳腺癌化疗患者的生活质量，尤其是D型人格患者。这些发现强调了有针对性的社会心理护理干预的重要性。
{"title":"Mediating roles of cancer stigma and resilience in the relationship between type D personality and quality of life among patients with breast cancer undergoing chemotherapy","authors":"Sujin Kim , Sunki Kim , Hye-Ja Park","doi":"10.1016/j.ejon.2026.103122","DOIUrl":"10.1016/j.ejon.2026.103122","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the statistically mediating roles of cancer stigma and resilience in the relationship between Type D personality and quality of life (QoL) in patients with breast cancer undergoing chemotherapy.</div></div><div><h3>Methods</h3><div>This cross-sectional correlational study included 129 inpatients with breast cancer recruited from a university hospital-affiliated cancer center ward. Participants completed questionnaires assessing their Type D personality, cancer stigma, resilience, and QoL. Data were analyzed using Pearson's correlation, hierarchical regression, and PROCESS Macro-mediation analysis (Model 4, 50,000 bootstrap samples).</div></div><div><h3>Results</h3><div>Type D personality negatively correlated with resilience (r = −0.493, <em>p</em> < 0.001) and QoL (r = −0.407, <em>p</em> < 0.001) and positively correlated with cancer stigma (r = 0.387, <em>p</em> < 0.001). Cancer stigma negatively correlated with resilience (r = −0.257, <em>p</em> = 0.003) and QoL (r = −0.455, <em>p</em> < 0.001). Meanwhile, resilience was positively associated with QoL (r = 0.514, <em>p</em> < 0.001). Regression analysis showed that cancer stigma and resilience significantly predicted QoL (β = −0.305, <em>p</em> < 0.001; β = 0.326, <em>p</em> < 0.001), accounting for 26.4% of the variance. Bootstrapped mediation analysis indicated that cancer stigma and resilience explained the link between type D personality and QoL (B = −0.0128, 95% BootCI [−0.0194, −0.0070]). Two significant indirect pathways between type D personality and QoL were identified: perceived cancer stigma (B = −0.0058, 95% BootCI [−0.0104, −0.0018]) and resilience (B = −0.0070, 95% BootCI [−0.0130, −0.0025]).</div></div><div><h3>Conclusion</h3><div>Reducing cancer stigma and enhancing resilience may help improve QoL among patients with breast cancer receiving chemotherapy, particularly those with Type D personality. These findings underscore the importance of targeted psychosocial nursing interventions.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"81 ","pages":"Article 103122"},"PeriodicalIF":2.7,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.ejon.2026.103113
Tzu-Yun Chiu , Wei-Shu Lai , Sheng-Yu Fan , Su-Ying Fang , Yu-Hsuan Liu
Purpose
This study assessed the cultural acceptability and clinical effectiveness of dignity therapy (DT) among terminal cancer patients in Taiwan, addressing a significant gap in evidence regarding its applicability in East Asian contexts.
Methods
A quasiexperimental, nonrandomized controlled design with integrated qualitative feedback analysis was employed. Twenty-four terminal cancer patients were assigned to either an intervention group (DT plus comfort care, n = 12) or a control group (comfort care only, n = 12). Dignity-related distress was measured using the Patient Dignity Inventory–Mandarin Version (PDI-MV) at baseline, postintervention, and at the two-week follow-up. Acceptability was assessed using the Dignity Therapy Patient and Family Feedback Questionnaires (DTPFQ/DTFFQ). Quantitative data were analyzed using t tests and repeated-measures ANOVA, while qualitative responses were analyzed thematically.
Results
Participants in the intervention group experienced a significant reduction in dignity-related distress over time (F = 10.08, P < 0.001), whereas no significant change was observed in the control group (F = 0.70, P = 0.50). High acceptability was reported by participants who received DT (M = 4.21/5) and their family members (M = 4.28/5). Qualitative analysis revealed three overarching themes: (1) emotional catharsis and relief, (2) meaning-making and restoration, and (3) mutual understanding and reconciliation.
Conclusion
This study provides preliminary evidence supporting the feasibility, cultural relevance, and potential efficacy of DT in Taiwan. Integrating DT into culturally responsive palliative care may preserve patient dignity, reduce existential distress, and enhance meaningful family communication at the end of life in East Asian contexts.
目的本研究评估台湾晚期癌症患者对尊严疗法的文化接受度和临床效果，以弥补其在东亚环境下适用性的证据差距。方法采用准实验、非随机对照设计，结合定性反馈分析。24例晚期癌症患者被分配到干预组（DT加舒适护理，n = 12）或对照组（仅舒适护理，n = 12）。在基线、干预后和两周随访时，使用患者尊严量表-普通话版（PDI-MV）测量尊严相关的痛苦。采用尊严治疗患者和家属反馈问卷（DTPFQ/DTFFQ）评估可接受性。定量数据采用t检验和重复测量方差分析进行分析，定性反应采用主题分析。结果干预组受试者的尊严相关困扰随着时间的推移显著降低（F = 10.08, P < 0.001），而对照组无显著变化（F = 0.70, P = 0.50）。接受DT治疗的参与者（M = 4.21/5）及其家庭成员（M = 4.28/5）的接受度较高。定性分析揭示了三个主要主题：(1)情绪的宣泄和缓解；(2)意义的创造和恢复；(3)相互理解与和解。结论本研究提供初步证据，支持台湾地区DT疗法的可行性、文化相关性及潜在疗效。在东亚地区，将DT纳入文化响应性姑息治疗可以维护患者尊严，减少存在的痛苦，并在生命末期加强有意义的家庭沟通。
{"title":"Cultural acceptability and potential effectiveness of dignity therapy for patients with terminal cancer in Taiwan: A Quasi-Experimental study","authors":"Tzu-Yun Chiu , Wei-Shu Lai , Sheng-Yu Fan , Su-Ying Fang , Yu-Hsuan Liu","doi":"10.1016/j.ejon.2026.103113","DOIUrl":"10.1016/j.ejon.2026.103113","url":null,"abstract":"<div><h3>Purpose</h3><div>This study assessed the cultural acceptability and clinical effectiveness of dignity therapy (DT) among terminal cancer patients in Taiwan, addressing a significant gap in evidence regarding its applicability in East Asian contexts.</div></div><div><h3>Methods</h3><div>A quasiexperimental, nonrandomized controlled design with integrated qualitative feedback analysis was employed. Twenty-four terminal cancer patients were assigned to either an intervention group (DT plus comfort care, n = 12) or a control group (comfort care only, n = 12). Dignity-related distress was measured using the Patient Dignity Inventory–Mandarin Version (PDI-MV) at baseline, postintervention, and at the two-week follow-up. Acceptability was assessed using the Dignity Therapy Patient and Family Feedback Questionnaires (DTPFQ/DTFFQ). Quantitative data were analyzed using t tests and repeated-measures ANOVA, while qualitative responses were analyzed thematically.</div></div><div><h3>Results</h3><div>Participants in the intervention group experienced a significant reduction in dignity-related distress over time (F = 10.08, <em>P</em> < 0.001), whereas no significant change was observed in the control group (F = 0.70, <em>P</em> = 0.50). High acceptability was reported by participants who received DT (M = 4.21/5) and their family members (M = 4.28/5). Qualitative analysis revealed three overarching themes: (1) emotional catharsis and relief, (2) meaning-making and restoration, and (3) mutual understanding and reconciliation.</div></div><div><h3>Conclusion</h3><div>This study provides preliminary evidence supporting the feasibility, cultural relevance, and potential efficacy of DT in Taiwan. Integrating DT into culturally responsive palliative care may preserve patient dignity, reduce existential distress, and enhance meaningful family communication at the end of life in East Asian contexts.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"80 ","pages":"Article 103113"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.ejon.2026.103099
Mohsen Arefian
Purpose
This study investigated the 1- and 2-year efficacy of two brief interventions, Mindfulness-integrated Cognitive Behavioral Therapy (MiCBT) and an Observational Learning and Acceptance-based pain management program (POLA), compared to Treatment-As-Usual (TAU), on pain, psychological distress, and post-traumatic growth (PTG).
Methods
BC survivors (n = 54) who had participated in two randomized controlled trials during primary treatment were followed up to 2 years post-diagnosis. Participants were assigned to MiCBT, POLA, or TAU. Outcome measures (pain, psychological distress, depression, anxiety, stress, PTG) were assessed at baseline, 1-year, and 2-year follow-ups.
Results
The control group exhibited persistent morbidity, with high rates of moderate-to-severe symptoms across both follow-ups (e.g., pain: 44 % at 1-year, 33 % at 2-years; anxiety: 32 % at 1-year, 39 % at 2-years). Both interventions demonstrated significant but time-dependent benefits. While pain reduction was significant only at 1-year for both groups, MiCBT showed broader psychological efficacy, reducing depression and psychological distress at 1-year and maintaining anxiety reduction across both follow-ups. POLA significantly reduced anxiety at 1-year follow-up. Both interventions produced sustained improvements in stress and PTG across all assessments.
Conclusion
The findings suggest that providing psychological interventions during chemotherapy is associated with significant long-term benefits, with specific advantages varying by the type of intervention. In contrast, the control group exhibited persistent symptoms across both follow-up periods. These results support the integration of targeted psychological support into standard oncology care to address the long-term needs of survivors.
{"title":"Efficacy of two psychological interventions on pain, distress, and post-traumatic growth in breast cancer survivors: A 2-year follow-up of two randomized controlled trials","authors":"Mohsen Arefian","doi":"10.1016/j.ejon.2026.103099","DOIUrl":"10.1016/j.ejon.2026.103099","url":null,"abstract":"<div><h3>Purpose</h3><div>This study investigated the 1- and 2-year efficacy of two brief interventions, Mindfulness-integrated Cognitive Behavioral Therapy (MiCBT) and an Observational Learning and Acceptance-based pain management program (POLA), compared to Treatment-As-Usual (TAU), on pain, psychological distress, and post-traumatic growth (PTG).</div></div><div><h3>Methods</h3><div>BC survivors (n = 54) who had participated in two randomized controlled trials during primary treatment were followed up to 2 years post-diagnosis. Participants were assigned to MiCBT, POLA, or TAU. Outcome measures (pain, psychological distress, depression, anxiety, stress, PTG) were assessed at baseline, 1-year, and 2-year follow-ups.</div></div><div><h3>Results</h3><div>The control group exhibited persistent morbidity, with high rates of moderate-to-severe symptoms across both follow-ups (e.g., pain: 44 % at 1-year, 33 % at 2-years; anxiety: 32 % at 1-year, 39 % at 2-years). Both interventions demonstrated significant but time-dependent benefits. While pain reduction was significant only at 1-year for both groups, MiCBT showed broader psychological efficacy, reducing depression and psychological distress at 1-year and maintaining anxiety reduction across both follow-ups. POLA significantly reduced anxiety at 1-year follow-up. Both interventions produced sustained improvements in stress and PTG across all assessments.</div></div><div><h3>Conclusion</h3><div>The findings suggest that providing psychological interventions during chemotherapy is associated with significant long-term benefits, with specific advantages varying by the type of intervention. In contrast, the control group exhibited persistent symptoms across both follow-up periods. These results support the integration of targeted psychological support into standard oncology care to address the long-term needs of survivors.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"80 ","pages":"Article 103099"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146068433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-27DOI: 10.1016/j.ejon.2026.103118
Jing-Yu Benjamin Tan
{"title":"A new chapter for the European Journal of Oncology Nursing.","authors":"Jing-Yu Benjamin Tan","doi":"10.1016/j.ejon.2026.103118","DOIUrl":"10.1016/j.ejon.2026.103118","url":null,"abstract":"","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":" ","pages":"103118"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Occupational safety performance in handling chemotherapy drugs and their association with self-efficacy, risk perception, workplace safety, and work-related barriers among oncology nurses: A multicenter cross-sectional study.","authors":"Mahdieh Razi, Elahe Ramezanzade Tabriz, Najmeh Golmakani, Farideh Khosravi, Fatemeh Kavoosi","doi":"10.1016/j.ejon.2026.103112","DOIUrl":"10.1016/j.ejon.2026.103112","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"80 ","pages":"103112"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.ejon.2026.103110
Yiwen Hu , Hongxia Xie , Zheqing Hu , Dihui Luo , Jiaen Hu , Feiyang Huang , Chaoqun Dong
Objective
To explore symptom clusters and their association with frailty among older lung cancer patients during chemotherapy using electronic nursing records.
Methods
This retrospective study analyzed 5591 electronic nursing records from 120 older lung cancer patients (≥60 years) undergoing chemotherapy. Natural language processing (NLP) was used to extract 39 symptoms from nursing records. Electronic frailty index was developed using 32 health-related variables. Exploratory factor analysis identified symptom clusters, and Spearman correlation analysis examined associations between symptom clusters and frailty.
Results
Among 120 older lung cancer patients (74.2 % male, mean age 70.02 ± 6.12 years), 36 distinct symptoms were identified during chemotherapy, with fatigue (85 %), poor appetite (74.1 %), and pain (60 %) being most prevalent. Principal component analysis revealed five symptom clusters: lung cancer-specific, physical, emotional, perceptual, and skin-related. Physical and emotional symptom clusters showed significant positive correlations with frailty status.
Conclusions
Five symptom clusters were identified in older lung cancer patients during chemotherapy, with physical and emotional clusters significantly correlated with frailty. NLP-based electronic health record analysis demonstrates feasibility for symptom identification, providing foundation for future big data-driven symptom management research.
{"title":"Symptom clusters and their association with frailty in older patients with lung cancer during chemotherapy: An analysis based on electronic nursing records","authors":"Yiwen Hu , Hongxia Xie , Zheqing Hu , Dihui Luo , Jiaen Hu , Feiyang Huang , Chaoqun Dong","doi":"10.1016/j.ejon.2026.103110","DOIUrl":"10.1016/j.ejon.2026.103110","url":null,"abstract":"<div><h3>Objective</h3><div>To explore symptom clusters and their association with frailty among older lung cancer patients during chemotherapy using electronic nursing records.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 5591 electronic nursing records from 120 older lung cancer patients (≥60 years) undergoing chemotherapy. Natural language processing (NLP) was used to extract 39 symptoms from nursing records. Electronic frailty index was developed using 32 health-related variables. Exploratory factor analysis identified symptom clusters, and Spearman correlation analysis examined associations between symptom clusters and frailty.</div></div><div><h3>Results</h3><div>Among 120 older lung cancer patients (74.2 % male, mean age 70.02 ± 6.12 years), 36 distinct symptoms were identified during chemotherapy, with fatigue (85 %), poor appetite (74.1 %), and pain (60 %) being most prevalent. Principal component analysis revealed five symptom clusters: lung cancer-specific, physical, emotional, perceptual, and skin-related. Physical and emotional symptom clusters showed significant positive correlations with frailty status.</div></div><div><h3>Conclusions</h3><div>Five symptom clusters were identified in older lung cancer patients during chemotherapy, with physical and emotional clusters significantly correlated with frailty. NLP-based electronic health record analysis demonstrates feasibility for symptom identification, providing foundation for future big data-driven symptom management research.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"80 ","pages":"Article 103110"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146068392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.ejon.2025.103077
Dandan Zhang , Ying Huang , Huan Li , Yuzhi Yao , Mengyan Hao , Ting Liu
Purpose
Effective cardiovascular health (CVH) management plays a crucial role in preventing cardiovascular disease and promoting both longevity and quality of life. However, its implementation among breast cancer (BC) patients remains challenging, particularly for those at high risk of cardiotoxicity due to cancer therapy. This study aimed to explore the factors influencing CVH management among BC patients at high risk for cardiotoxicity.
Methods
Face-to-face semi-structured individual interviews were conducted with BC patients at high risk of cardiotoxicity. Thematic analysis method was used for data analysis.
Results
A total of 24 participants aged 33 to 72 were included. Four key themes influencing CVH management were identified: (1) Knowledge and beliefs: Barriers included limited understanding of CVH, inconsistent confidence in sustaining management, and conflicts between health goals and role obligations; while high outcome expectancy served as a key motivator; (2) Self-regulation skill and ability: Challenges occurred in setting goals and action plans, self-monitoring, and prioritizing cancer care over CVH; though effective emotional regulation facilitated management; (3) Social facilitation: Emotional support promoted CVH management; whereas insufficient supervision and limited professional guidance acted as barriers; (4) Other dimensions: Physical discomfort, information-related stress, financial strain and sociocultural constraints further hindered CVH management.
Conclusions
These findings highlight the complex and interconnected factors shaping CVH management among BC patients at high risk for cardiotoxicity. Understanding these influences can inform the design of tailored interventions and sustained support systems to improve CVH management, thereby optimizing survivorship care and enhancing quality of life.
{"title":"Determinants of cardiovascular health management in patients with breast cancer at high risk for cardiotoxicity: A qualitative study","authors":"Dandan Zhang , Ying Huang , Huan Li , Yuzhi Yao , Mengyan Hao , Ting Liu","doi":"10.1016/j.ejon.2025.103077","DOIUrl":"10.1016/j.ejon.2025.103077","url":null,"abstract":"<div><h3>Purpose</h3><div>Effective cardiovascular health (CVH) management plays a crucial role in preventing cardiovascular disease and promoting both longevity and quality of life. However, its implementation among breast cancer (BC) patients remains challenging, particularly for those at high risk of cardiotoxicity due to cancer therapy. This study aimed to explore the factors influencing CVH management among BC patients at high risk for cardiotoxicity.</div></div><div><h3>Methods</h3><div>Face-to-face semi-structured individual interviews were conducted with BC patients at high risk of cardiotoxicity. Thematic analysis method was used for data analysis.</div></div><div><h3>Results</h3><div>A total of 24 participants aged 33 to 72 were included. Four key themes influencing CVH management were identified: (1) Knowledge and beliefs: Barriers included limited understanding of CVH, inconsistent confidence in sustaining management, and conflicts between health goals and role obligations; while high outcome expectancy served as a key motivator; (2) Self-regulation skill and ability: Challenges occurred in setting goals and action plans, self-monitoring, and prioritizing cancer care over CVH; though effective emotional regulation facilitated management; (3) Social facilitation: Emotional support promoted CVH management; whereas insufficient supervision and limited professional guidance acted as barriers; (4) Other dimensions: Physical discomfort, information-related stress, financial strain and sociocultural constraints further hindered CVH management.</div></div><div><h3>Conclusions</h3><div>These findings highlight the complex and interconnected factors shaping CVH management among BC patients at high risk for cardiotoxicity. Understanding these influences can inform the design of tailored interventions and sustained support systems to improve CVH management, thereby optimizing survivorship care and enhancing quality of life.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"80 ","pages":"Article 103077"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-30DOI: 10.1016/j.ejon.2026.103111
Naomi Takemura, Jojo Yan-Yan Kwok, Wing Lok Chan, Daniel Yee-Tak Fong
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.
{"title":"Feasibility, acceptability, and preliminary efficacy of Tai Chi versus mindful yoga on psycho-spiritual distress in patients with advanced cancer: A mixed-method pilot randomized controlled trial.","authors":"Naomi Takemura, Jojo Yan-Yan Kwok, Wing Lok Chan, Daniel Yee-Tak Fong","doi":"10.1016/j.ejon.2026.103111","DOIUrl":"10.1016/j.ejon.2026.103111","url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"80 ","pages":"103111"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.ejon.2026.103107
S. Batool , R. Suhonen , R. Gul , S. Yasmeen , M. Stolt
Purpose
To synthesize evidence on nurse-led interventions for improving self-care behaviors in patients living with cancer, to examine methods and tools used to measure the effectiveness of nurse-led interventions, and to evaluate the impact of nurse-led interventions on self-care behavior outcomes.
Methods
Following PRISMA guidelines, a systematic review was conducted using the MEDLINE, PsycINFO, CINAHL, and Cochrane Library databases, covering the period from January 2014 to March 2025. To ensure transparency, the review protocol was registered on PROSPERO. The study selection, data extraction, and synthesis were performed independently by two reviewers. The screening of studies was managed using Rayyan software. A deductive approach was followed to identify self-care behaviors from the selected studies, using the definition of self-care behaviors as outlined in Riegel's Middle-Range Theory of Self-Care.
Results
This review included nine nurse-led intervention studies that aimed to improve self-care behaviors in patients living with cancer. Following Riegel's framework, several self-care behaviors were identified under three domains that are: self-care maintenance, monitoring, and management. These behaviors included medication adherence; dietary adjustments; engagement in exercise, sleep, and rest routines; symptom monitoring; and seeking advice when needed. This review identified several key features of nurse-led interventions, which contributed to the improvements in self-care behaviors and health outcomes. Teaching and education, skills-building and motivational coaching, continuous support, an individualized approach, family involvement, and pragmatic feasibility of the implemented strategies were the key features of the nurse-led interventions that supported the self-care behaviors of patients living with cancer. Most of the interventions were delivered face-to-face. A range of assessment tools were used to evaluate the outcomes of the interventions.
Conclusion
Nurse-led interventions demonstrated a positive influence on self-care behaviors and health outcomes, including improved medication adherence, reduction in pain, fatigue and symptom burden, enhanced physical functioning, and better quality of life. Interventions appeared to be effective when they incorporated multiple strategies and targeted specific symptoms or behaviors.
{"title":"Effectiveness of nurse-led interventions on self-care behaviors of patients living with cancer: A systematic review","authors":"S. Batool , R. Suhonen , R. Gul , S. Yasmeen , M. Stolt","doi":"10.1016/j.ejon.2026.103107","DOIUrl":"10.1016/j.ejon.2026.103107","url":null,"abstract":"<div><h3>Purpose</h3><div>To synthesize evidence on nurse-led interventions for improving self-care behaviors in patients living with cancer, to examine methods and tools used to measure the effectiveness of nurse-led interventions, and to evaluate the impact of nurse-led interventions on self-care behavior outcomes.</div></div><div><h3>Methods</h3><div>Following PRISMA guidelines, a systematic review was conducted using the MEDLINE, PsycINFO, CINAHL, and Cochrane Library databases, covering the period from January 2014 to March 2025. To ensure transparency, the review protocol was registered on PROSPERO. The study selection, data extraction, and synthesis were performed independently by two reviewers. The screening of studies was managed using Rayyan software. A deductive approach was followed to identify self-care behaviors from the selected studies, using the definition of self-care behaviors as outlined in Riegel's Middle-Range Theory of Self-Care.</div></div><div><h3>Results</h3><div>This review included nine nurse-led intervention studies that aimed to improve self-care behaviors in patients living with cancer. Following Riegel's framework, several self-care behaviors were identified under three domains that are: self-care maintenance, monitoring, and management. These behaviors included medication adherence; dietary adjustments; engagement in exercise, sleep, and rest routines; symptom monitoring; and seeking advice when needed. This review identified several key features of nurse-led interventions, which contributed to the improvements in self-care behaviors and health outcomes. Teaching and education, skills-building and motivational coaching, continuous support, an individualized approach, family involvement, and pragmatic feasibility of the implemented strategies were the key features of the nurse-led interventions that supported the self-care behaviors of patients living with cancer. Most of the interventions were delivered face-to-face. A range of assessment tools were used to evaluate the outcomes of the interventions.</div></div><div><h3>Conclusion</h3><div>Nurse-led interventions demonstrated a positive influence on self-care behaviors and health outcomes, including improved medication adherence, reduction in pain, fatigue and symptom burden, enhanced physical functioning, and better quality of life. Interventions appeared to be effective when they incorporated multiple strategies and targeted specific symptoms or behaviors.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"80 ","pages":"Article 103107"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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