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 : 2026-02-01DOI: 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}
Pub Date : 2026-02-01DOI: 10.1016/j.ejon.2025.103078
Irem Ayvat, Azize Atli Ozbas
Purpose
Cancer is a journey that the patients and their families must undertake and navigate together, mutually influencing each other throughout the process. This qualitative study aimed to explore how older patients undergoing chemotherapy and their family caregivers experience the cancer and treatment process from a psychosocial perspective.
Methods
A descriptive, qualitative approach was employed. Data were collected between October 2022 and March 2023, through semi-structured, face-to-face interviews. Data were analyzed using thematic analysis, with the assistance of Maxqda software.
Results
Thirty participants (18 older patients and 12 family caregivers) were included. Three main themes were identified: (1) emerging role, (2) interpersonal dynamics, and (3) efforts to adapt. Subthemes varied between patients and caregivers, while five were shared across both groups: indirect communication, anger management difficulties, social disruption, avoidance, and process-oriented meaning-making.
Conclusion
This study demonstrated that older patients with cancer and their caregivers face significant emotional and social challenges, which often overlap. Tailored psychosocial interventions that focus on enhancing direct communication between patients and caregivers, supporting the management of anger and emotional strain, and reducing avoidant coping strategies may promote healthier adjustment and improve caregiving experiences. Interventions that maintain patient independence while alleviating caregiver burden should be prioritized in future research.
{"title":"Two sides of the cancer journey: A qualitative study on the psychosocial supportive care needs in older patients and family caregivers","authors":"Irem Ayvat, Azize Atli Ozbas","doi":"10.1016/j.ejon.2025.103078","DOIUrl":"10.1016/j.ejon.2025.103078","url":null,"abstract":"<div><h3>Purpose</h3><div>Cancer is a journey that the patients and their families must undertake and navigate together, mutually influencing each other throughout the process. This qualitative study aimed to explore how older patients undergoing chemotherapy and their family caregivers experience the cancer and treatment process from a psychosocial perspective.</div></div><div><h3>Methods</h3><div>A descriptive, qualitative approach was employed. Data were collected between October 2022 and March 2023, through semi-structured, face-to-face interviews. Data were analyzed using thematic analysis, with the assistance of Maxqda software.</div></div><div><h3>Results</h3><div>Thirty participants (18 older patients and 12 family caregivers) were included. Three main themes were identified: (1) emerging role, (2) interpersonal dynamics, and (3) efforts to adapt. Subthemes varied between patients and caregivers, while five were shared across both groups: indirect communication, anger management difficulties, social disruption, avoidance, and process-oriented meaning-making.</div></div><div><h3>Conclusion</h3><div>This study demonstrated that older patients with cancer and their caregivers face significant emotional and social challenges, which often overlap. Tailored psychosocial interventions that focus on enhancing direct communication between patients and caregivers, supporting the management of anger and emotional strain, and reducing avoidant coping strategies may promote healthier adjustment and improve caregiving experiences. Interventions that maintain patient independence while alleviating caregiver burden should be prioritized in future research.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"80 ","pages":"Article 103078"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077084","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.2025.103075
Kathrine Hoffmann Pii , Marie Høyer Lundh , Karin Brochstedt Dieperink , Dorthe Susanne Nielsen , Nausheen Christoffersen , Karin Piil
Purpose
This systematic review describes the content and outcomes of supportive care interventions targeting informal caregivers of ethnic minority cancer patients, including those involving both patients and caregivers.
Methods
Seven databases (PubMed, CINAHL, PsycINFO, Embase, Scopus, Web of Science, Cochrane Library) were searched using terms related to cancer, caregivers, ethnic minorities, and supportive interventions. The Mixed Methods Appraisal Tool assessed study quality. Narrative and thematic analyses identified intervention types, content, outcomes, and challenges.
Results
Inclusion criteria were informal caregivers (≥18 years) of patients with any cancer at any stage. Studies that only reported patient outcomes were excluded. From 7961 screened studies, 18 met inclusion criteria reporting on 13 unique interventions conducted in the USA and Australia. These included nine quantitative, six qualitative, and three mixed-method studies with 2014 participants from defined ethnic groups and various cancer diagnoses. Quantitative studies showed significant or medium-to-large effects, with only one reporting no significant impact. Qualitative studies described personal benefits and improved relationships with healthcare systems. Study design variability hindered generalizing challenges and recommendations.
Conclusion
Supportive interventions for caregivers of ethnic minority cancer patients, including those involving both caregiver and patient, show positive outcomes. However, heterogeneity in study designs and limited geographic scope challenge generalization and transferability. More research, particularly in Europe is needed.
目的本系统综述了针对少数民族癌症患者非正式照护者的支持性护理干预的内容和结果，包括患者和照护者双方参与的干预。方法检索PubMed、CINAHL、PsycINFO、Embase、Scopus、Web of Science、Cochrane Library等7个数据库中与癌症、护理人员、少数民族和支持性干预相关的关键词。混合方法评估工具评估研究质量。叙述和专题分析确定了干预的类型、内容、结果和挑战。结果纳入标准为任何分期癌症患者的非正式照顾者（≥18岁）。仅报道患者结果的研究被排除在外。从7961项筛选研究中，18项符合纳入标准，报告了在美国和澳大利亚进行的13项独特干预措施。其中包括9项定量研究，6项定性研究和3项混合方法研究，2014年参与者来自特定的种族和各种癌症诊断。定量研究显示了显著或中等到较大的影响，只有一项研究报告没有显著影响。定性研究描述了个人利益和与医疗保健系统关系的改善。研究设计的可变性阻碍了挑战和建议的普遍化。结论对少数民族癌症患者照顾者的支持性干预，包括照顾者和患者双方参与的支持性干预均有积极效果。然而，研究设计的异质性和有限的地理范围挑战了推广和可转移性。这需要更多的研究，尤其是在欧洲。
{"title":"Supporting ethnic minority caregivers and patients in cancer trajectories: A systematic review of supportive interventions","authors":"Kathrine Hoffmann Pii , Marie Høyer Lundh , Karin Brochstedt Dieperink , Dorthe Susanne Nielsen , Nausheen Christoffersen , Karin Piil","doi":"10.1016/j.ejon.2025.103075","DOIUrl":"10.1016/j.ejon.2025.103075","url":null,"abstract":"<div><h3>Purpose</h3><div>This systematic review describes the content and outcomes of supportive care interventions targeting informal caregivers of ethnic minority cancer patients, including those involving both patients and caregivers.</div></div><div><h3>Methods</h3><div>Seven databases (PubMed, CINAHL, PsycINFO, Embase, Scopus, Web of Science, Cochrane Library) were searched using terms related to cancer, caregivers, ethnic minorities, and supportive interventions. The Mixed Methods Appraisal Tool assessed study quality. Narrative and thematic analyses identified intervention types, content, outcomes, and challenges.</div></div><div><h3>Results</h3><div>Inclusion criteria were informal caregivers (≥18 years) of patients with any cancer at any stage. Studies that only reported patient outcomes were excluded. From 7961 screened studies, 18 met inclusion criteria reporting on 13 unique interventions conducted in the USA and Australia. These included nine quantitative, six qualitative, and three mixed-method studies with 2014 participants from defined ethnic groups and various cancer diagnoses. Quantitative studies showed significant or medium-to-large effects, with only one reporting no significant impact. Qualitative studies described personal benefits and improved relationships with healthcare systems. Study design variability hindered generalizing challenges and recommendations.</div></div><div><h3>Conclusion</h3><div>Supportive interventions for caregivers of ethnic minority cancer patients, including those involving both caregiver and patient, show positive outcomes. However, heterogeneity in study designs and limited geographic scope challenge generalization and transferability. More research, particularly in Europe is needed.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"80 ","pages":"Article 103075"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077023","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.2026.103104
Josefina Bertoli , Cecília Bertuol , Rômulo Ferreira Monteiro , Allana Andrade Souza , Marcela Cardoso de Oliveira , Micheli Carminatti , Carlos Eduardo Guimarães Moço , Cíntia de la Rocha Freitas , Ismael Forte Freitas Júnior
Purpose
Breast cancer survivors (BCS) undergoing hormone therapy often experience pain, anxiety, and depressive symptoms. Thus, this study aimed to explore the effects of 24 weeks of Mat Pilates on pain severity, pain interference, anxiety, and depressive symptoms in BCS undergoing hormone therapy, and to determine whether these effects differ according to the type of hormone therapy, Tamoxifen (TMX) or Aromatase Inhibitors (AIs).
Methods
This randomized controlled trial consisted of supervised 60-min Mat Pilates sessions three times per week for 24 weeks. Outcomes were assessed at baseline and post-intervention using the Brief Pain Inventory and Hospital Anxiety and Depression Scale. Generalized estimating equations were used to evaluate the effects of the intervention.
Results
Forty-three BCS were randomized into a control group (CG; 54.7 ± 6.6 years) and a Pilates group (PG; 55.2 ± 7.6 years). A significant group-time interaction was observed for pain severity (p = 0.031; Δ = −5.5; d = 0.50), with a reduction in the PG, and anxiety symptoms (p = 0.006; Δ = 1.7; d = 0.55), with an increase in the CG. Hormone therapy stratification showed group∗time interactions, among AI users for pain severity (p = 0.025; Δ = −6.1; d = 0.38), and anxiety symptoms (p = 0.02; Δ = −2.7; d = 0.37), with reductions in the PG for both variables. Depressive symptoms did not significantly improve.
Conclusion
Mat Pilates improved pain severity and anxiety symptoms in BCS, particularly among AI users. However, the modest sample size limits its generalizability. Mat Pilates is a feasible, low-cost, and clinically applicable strategy that can be incorporated into supportive care in BCS.
{"title":"The effects of 24 Weeks of mat pilates on pain, anxiety, and depressive symptoms in breast cancer survivors undergoing hormone therapy: A randomized controlled trial","authors":"Josefina Bertoli , Cecília Bertuol , Rômulo Ferreira Monteiro , Allana Andrade Souza , Marcela Cardoso de Oliveira , Micheli Carminatti , Carlos Eduardo Guimarães Moço , Cíntia de la Rocha Freitas , Ismael Forte Freitas Júnior","doi":"10.1016/j.ejon.2026.103104","DOIUrl":"10.1016/j.ejon.2026.103104","url":null,"abstract":"<div><h3>Purpose</h3><div>Breast cancer survivors (BCS) undergoing hormone therapy often experience pain, anxiety, and depressive symptoms. Thus, this study aimed to explore the effects of 24 weeks of Mat Pilates on pain severity, pain interference, anxiety, and depressive symptoms in BCS undergoing hormone therapy, and to determine whether these effects differ according to the type of hormone therapy, Tamoxifen (TMX) or Aromatase Inhibitors (AIs).</div></div><div><h3>Methods</h3><div>This randomized controlled trial consisted of supervised 60-min Mat Pilates sessions three times per week for 24 weeks. Outcomes were assessed at baseline and post-intervention using the Brief Pain Inventory and Hospital Anxiety and Depression Scale. Generalized estimating equations were used to evaluate the effects of the intervention.</div></div><div><h3>Results</h3><div>Forty-three BCS were randomized into a control group (CG; 54.7 ± 6.6 years) and a Pilates group (PG; 55.2 ± 7.6 years). A significant group-time interaction was observed for pain severity (p = 0.031; Δ = −5.5; <em>d</em> = 0.50), with a reduction in the PG, and anxiety symptoms (p = 0.006; Δ = 1.7; <em>d</em> = 0.55), with an increase in the CG. Hormone therapy stratification showed group∗time interactions, among AI users for pain severity (p = 0.025; Δ = −6.1; <em>d</em> = 0.38), and anxiety symptoms (p = 0.02; Δ = −2.7; d = 0.37), with reductions in the PG for both variables. Depressive symptoms did not significantly improve.</div></div><div><h3>Conclusion</h3><div>Mat Pilates improved pain severity and anxiety symptoms in BCS, particularly among AI users. However, the modest sample size limits its generalizability. Mat Pilates is a feasible, low-cost, and clinically applicable strategy that can be incorporated into supportive care in BCS.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"80 ","pages":"Article 103104"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077026","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.2025.103076
Birgül Erdoğan , Naime Altay
Purpose
This study aimed to explore the meaning-making processes of children and adolescents with cancer through Digital Storytelling (DS), grounded in Peplau's Interpersonal Relations Theory and a hermeneutic approach.
Methods
A qualitative study was conducted using a philosophical hermeneutic design in the pediatric hematology and oncology units of a university hospital in western Türkiye. A purposive sample of 17 children/adolescents (n = 17), aged 7–18 years and having received at least one cycle of chemotherapy, participated in a four-session DS program. Data were collected between January and July 2024 through digital stories, semi-structured interviews with children/adolescents and parents, and researcher reflection journals. Hermeneutic analysis was performed, following iterative interpretation of narratives and the hermeneutic circle.
Results
Participants created 17 digital stories reflecting their cancer experiences. The stories revealed six interrelated themes: (1) Illness and bodily experiences, (2) Social exclusion and societal perceptions, (3) Family relationships and responsibility sharing, (4) Hope, dreams, and future orientation, (5) Social support and friendship, and (6) Knowledge, sharing, and learning from experiences. DS facilitated children's engagement in symptom management, enhanced coping strategies, fostered emotional expression, and strengthened social connectedness. Parents reported increased motivation and improved family communication, while the researcher's reflections indicated mutual meaning-making and professional growth.
Conclusion
Digital Storytelling, integrated with Peplau's Interpersonal Relations Theory, is an innovative, holistic nursing approach that supports meaning-making, psychosocial adjustment, and symptom management in pediatric oncology care. The findings suggest DS as a feasible therapeutic communication tool for children and adolescents with cancer.
{"title":"Meaning-making through digital storytelling: Experiences of children and adolescents with cancer within Peplau's theory and a hermeneutic approach","authors":"Birgül Erdoğan , Naime Altay","doi":"10.1016/j.ejon.2025.103076","DOIUrl":"10.1016/j.ejon.2025.103076","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to explore the meaning-making processes of children and adolescents with cancer through Digital Storytelling (DS), grounded in Peplau's Interpersonal Relations Theory and a hermeneutic approach.</div></div><div><h3>Methods</h3><div>A qualitative study was conducted using a philosophical hermeneutic design in the pediatric hematology and oncology units of a university hospital in western Türkiye. A purposive sample of 17 children/adolescents (n = 17), aged 7–18 years and having received at least one cycle of chemotherapy, participated in a four-session DS program. Data were collected between January and July 2024 through digital stories, semi-structured interviews with children/adolescents and parents, and researcher reflection journals. Hermeneutic analysis was performed, following iterative interpretation of narratives and the hermeneutic circle.</div></div><div><h3>Results</h3><div>Participants created 17 digital stories reflecting their cancer experiences. The stories revealed six interrelated themes: (1) Illness and bodily experiences, (2) Social exclusion and societal perceptions, (3) Family relationships and responsibility sharing, (4) Hope, dreams, and future orientation, (5) Social support and friendship, and (6) Knowledge, sharing, and learning from experiences. DS facilitated children's engagement in symptom management, enhanced coping strategies, fostered emotional expression, and strengthened social connectedness. Parents reported increased motivation and improved family communication, while the researcher's reflections indicated mutual meaning-making and professional growth.</div></div><div><h3>Conclusion</h3><div>Digital Storytelling, integrated with Peplau's Interpersonal Relations Theory, is an innovative, holistic nursing approach that supports meaning-making, psychosocial adjustment, and symptom management in pediatric oncology care. The findings suggest DS as a feasible therapeutic communication tool for children and adolescents with cancer.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"80 ","pages":"Article 103076"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077022","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.2026.103106
Handan Eren , Yasemin Karacan
Purpose
Peripheral intravenous catheter access becomes difficult in patients diagnosed with breast cancer who receive chemotherapy treatment because vein visibility decreases. The study aims to determine the effect of arm massage on the success of peripheral intravenous catheter insertion in breast cancer patients undergoing intravenous chemotherapy.
Methods
This randomized controlled study included 60 breast cancer patients undergoing intravenous chemotherapy (experimental = 30, control = 30). The patients in the experimental group received arm massage before the procedure, while those in the control group did not receive any intervention. Data were collected using a record form for peripheral intravenous chemotherapy administration.
Results
Vein visibility was significantly improved in the massage group (p < 0.001). The effect size was calculated as Cohen's d = 1.24, with a 95 % confidence interval of [0.60, 1.46]. Successful peripheral intravenous catheter insertion time was statistically shorter in the experimental group (p = 0.000). Post-procedure anxiety levels were significantly lower in the experimental group (p = 0.000). While the level of satisfaction with the procedure increased statistically significantly in the experimental group (p = 0.000), it decreased statistically significantly in the control group (p = 0.012). The nurses in the groups stated that arm massage facilitated catheter insertion in 90 % of the procedures.
Conclusion
Massage shortened the peripheral intravenous catheter insertion process and positively affected the patients' anxiety of and satisfaction with the procedure. Cost-effective arm massage was recommended for use in patients undergoing intravenous chemotherapy.
{"title":"The effect of arm massage on the success of peripheral intravenous catheter insertion in breast cancer patients undergoing chemotherapy: A randomized controlled study","authors":"Handan Eren , Yasemin Karacan","doi":"10.1016/j.ejon.2026.103106","DOIUrl":"10.1016/j.ejon.2026.103106","url":null,"abstract":"<div><h3>Purpose</h3><div>Peripheral intravenous catheter access becomes difficult in patients diagnosed with breast cancer who receive chemotherapy treatment because vein visibility decreases. The study aims to determine the effect of arm massage on the success of peripheral intravenous catheter insertion in breast cancer patients undergoing intravenous chemotherapy.</div></div><div><h3>Methods</h3><div>This randomized controlled study included 60 breast cancer patients undergoing intravenous chemotherapy (experimental = 30, control = 30). The patients in the experimental group received arm massage before the procedure, while those in the control group did not receive any intervention. Data were collected using a record form for peripheral intravenous chemotherapy administration.</div></div><div><h3>Results</h3><div>Vein visibility was significantly improved in the massage group (p < 0.001). The effect size was calculated as Cohen's d = 1.24, with a 95 % confidence interval of [0.60, 1.46]. Successful peripheral intravenous catheter insertion time was statistically shorter in the experimental group (p = 0.000). Post-procedure anxiety levels were significantly lower in the experimental group (p = 0.000). While the level of satisfaction with the procedure increased statistically significantly in the experimental group (p = 0.000), it decreased statistically significantly in the control group (p = 0.012). The nurses in the groups stated that arm massage facilitated catheter insertion in 90 % of the procedures.</div></div><div><h3>Conclusion</h3><div>Massage shortened the peripheral intravenous catheter insertion process and positively affected the patients' anxiety of and satisfaction with the procedure. Cost-effective arm massage was recommended for use in patients undergoing intravenous chemotherapy.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"80 ","pages":"Article 103106"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077086","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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