Seminars in Oncology Nursing最新文献

Objective: This study aimed to explore adolescent cancer survivors' experiences of fear of cancer recurrence, its impact on their lives, and the coping mechanisms they adopt to manage this fear.

Methods: This qualitative study was conducted with 20 adolescent cancer survivors. Individual face-to-face semi-structured interviews were performed to explore adolescents' experiences of fear of cancer recurrence. Interviews were conducted during routine hospital follow-up visits in a private outpatient clinic room. Data were audio-recorded, transcribed verbatim, and analyzed using content analysis to identify themes related to adolescents' experiences.

Results: The study included 20 adolescents (14 males and 6 females) aged 14 to 17 years, with a mean age of 15.75 ± 1.12 years at the time of interview. Participants were, on average, 13.13 ± 1.92 years old at treatment completion. Three main themes emerged: factors triggering fear of recurrence, psychosocial impact of fear, and coping strategies for fear of recurrence. Triggers included physical symptoms perceived as signs of relapse, medical follow-up visits, and witnessing peers' recurrence or loss. The psychosocial impact theme reflected a persistent psychological burden, lifestyle changes motivated by health concerns, and uncertainty regarding future academic and life plans. Coping strategies included distraction, seeking social support, transforming fear into hope and future goals.

Conclusion: Fear of cancer recurrence is a multifaceted experience that influences both daily life and psychological well-being among adolescent cancer survivors. Understanding adolescents' experiences and coping strategies may inform the development of targeted psychosocial interventions during survivorship care.

Objectives: We sought to provide an evidence review of the rapidly expanding technologies and sciences that have moved the field of hereditary cancers from niche to mainstream in current cancer care. This shift mandates that all oncology clinicians have foundational knowledge regarding the identification, testing, and management of patients and families at risk for hereditary cancer. Many cancers have established germline biomarker testing recommendations (breast, ovarian, pancreatic, metastatic prostate, colon), and in many of these cancer types, somatic biomarker tests are also considered standard of care. Unfamiliarity with the complexity of care in hereditary cancer leads to missed opportunities for cancer prevention and guideline-concordant genomic-informed care. Indeed, appropriately ordered, interpreted, and applied germline biomarker testing is a critical quality care indicator. Moreover, preventing harm from overlooked or inappropriate germline biomarker testing and incorrect result interpretation leads to optimal cancer prevention and effective cancer treatment. This is a central safety aspect in this rapidly changing landscape.

Methods: A review of peer-reviewed literature.

Results: Based on the literature review, the Five Rights of Germline Biomarker Testing for Hereditary Cancer is offered as a quality and safety framework. Accurate construction and interpretation of the pedigree continue to be a critical risk assessment tool. A comprehensive view of patient factors, family history, tumor pathology, and somatic biomarker test results is essential for quality care in hereditary cancers.

Conclusion: Oncology clinicians must be familiar with and refer to the most recent and updated versions of guidelines from reputable authorities, as the testing criteria shift frequently.

Implications for nursing practice: The five rights framework offers clinicians a guide to safe practice in this ever-changing landscape.

Objective: This study aimed to determine the time between the onset of initial symptoms and the decision to seek medical help, identify patient-related factors contributing to delays, and assess the relationship between diagnostic delays and illness perception among patients with colorectal cancer.

Methods: A cross‑sectional study at a medical oncology outpatient clinic included 114 patients with colorectal cancer. Data collection instruments included a structured questionnaire and the Brief Illness Perception Scale.

Results: The mean time from symptom onset to seeking medical help was 7.3 ± 11.0 months (range: 1-62.5). A delay of more than one month was observed in 60.6% of patients, with 31.6% experiencing a significantly prolonged delay. Most participants (76.3%) reported being unaware of the signs and symptoms of colorectal cancer, and only 16.7% had undergone a screening test. The most common reported complaints included changes in bowel habits (22.0%), rectal bleeding (15.3%), fatigue (13.1%), and abdominal pain (11.2%). Diagnostic delay was significantly associated with lower educational levels and changes in bowel habits (P < .05). The mean Brief Illness Perception Scale score was 21.7 ± 11.4, indicating moderate perceived threat. No statistically significant association was found between patients' illness perceptions and the duration of delay in seeking medical care (P > 05). Patients most often attributed their illness to stress (56.7%), diet (43.1%), and sadness (23.5%).

Conclusions: Despite experiencing symptoms indicative of colorectal cancer, many individuals delayed seeking medical help, primarily due to a lack of awareness of early signs.

Implications for nursing practice: Findings underscore the need for public education and early screening efforts to promote timely diagnosis and improve outcomes in colorectal cancer.

Objectives: To examine the educational and practice gaps that limit genomic competency among oncology nurses and to propose strategies to strengthen workforce preparedness. Genomically informed cancer care has redefined oncology practice by enabling precision prevention, diagnosis, and treatment through germline and somatic biomarker testing. However, the oncology nursing workforce remains insufficiently prepared to deliver this care safely and effectively.

Methods: A review of peer-reviewed literature.

Results: Based on the literature review, despite more than two decades of national initiatives to integrate genomics into nursing education, genomic content remains inconsistently embedded in both prelicensure and graduate curricula. Faculty often report limited readiness to teach this rapidly evolving science, while licensure and certification examinations rarely assess genomic competencies, perpetuating its de-emphasis in nursing curricula.

Conclusions: Oncology nurses may misinterpret germline biomarker results, misunderstand inheritance patterns, or overlook opportunities for cascade testing, compromising both individual treatment and family risk reduction. Given their pivotal role in patient and family communication, oncology nurses must develop genomic literacy that supports a family-centered model of care for hereditary cancer syndromes.

Implications for nursing practice: Strengthening genomic competency across the oncology nursing continuum requires deliberate competency-based curricula, sustained faculty development, and national efforts to realign educational and regulatory frameworks to support the safe, evidence-based, and family-centered delivery of genomically informed cancer care.

Objectives: Prostate cancer (PC) is the second most diagnosed cancer in men worldwide, causing specific physical, psychosocial, and supportive care needs. In Australia, over 120 PC Specialist Nurses (PCSNs) provide comprehensive, personalized care and support to people dealing with PC. PCSNs require specialized education to optimize knowledge of PC diagnosis and management, enabling them to provide high-quality, person-centered care. Electronic learning courses are vital for enhancing the knowledge and skills of these skilled practitioners. This study aimed to evaluate the effectiveness of seven eLearning modules for improving PCSNs' knowledge of PC diagnosis, treatment, and care.

Methods: This article presents a nonexperimental evaluation study using pre- and post-tests. PCSNs completed pre-post knowledge and attitudes surveys about the eLearning modules. Knowledge acquisition and learning progress were assessed with bespoke scales and surveys, developed by researchers for each module. Responses were matched and compared using, respectively, McNemar's statistic (n range: 10-36) and Wilcoxon signed rank tests (n range: 41-61). Satisfaction was measured using the Satisfaction with Asynchronous eLearning Scale (n range: 15-118).

Results: Participants demonstrated significant improvements in knowledge against learning outcomes for all modules and satisfaction. In particular, knowledge of specific aspects of PC symptoms, treatment, and care, including patient's sexual concerns, increased. The results indicated a high level of satisfaction with the modules' format, content, and relevance.

Conclusions: Engaging, targeted eLearning courses can significantly enhance PCSNs' knowledge and learner satisfaction. Learner confidence and clinical preparedness were also noted to be improved.

Implications for nursing practice: The findings reinforce the need for specific education for specialist nurses to address the distinct clinical and psychosocial challenges faced by people with PC and their families. Further research should examine the longer-term impact of similar codesigned, online professional education.

Objectives: To explore the lived experiences of individuals with hereditary cancer syndromes and identify implications for oncology nursing practice.

Methods: We invited individuals with hereditary cancer syndromes to contribute first-person narratives describing their experiences. Narratives were thematically analyzed and triangulated with existing literature on patient experiences and the role of oncology nurses in hereditary cancer syndrome care.

Results: Across the narratives, co-authors described the psychological burden of living with uncertainty, marked by anticipatory anxiety surrounding surveillance, symptoms, and potential diagnoses. The analysis allowed us to identify key themes defining the experience of living with hereditary cancer syndromes: psychological and emotional impact, difficulties in communication of genetic risk information, navigating the health care system, patient empowerment and self-management, and the role of nurses.

Conclusions: Findings from this article highlight the lived experiences of individuals with hereditary cancer syndromes, consistent with existing evidence, showing persistent unmet needs that are not adequately addressed within the current health care system.

Implications for nursing practice: The narratives highlight several areas where nurses play a critical role in supporting individuals with hereditary cancer syndromes, underscoring the need for comprehensive, personalized, and lifelong care in which nurses tailor interventions to individual syndromes, life stages, and coping styles.

Objectives: This scoping review aimed to investigate the current knowledge regarding healthy parents' experiences of parenting children and young adults in families affected by parental cancer.

Methods: Following the Joanna Briggs Institute framework, a systematic search was conducted in MEDLINE, Embase, CINAHL, and PsycINFO. Eligible studies included qualitative and mixed-methods research involving healthy parents of children and young adults (0-28 years) in families where the other parent was diagnosed with cancer, without restrictions on publication year. Studies involving healthy partners of patients in curative and palliative stages were included. Screening was performed independently by two researchers, and data were charted and synthesized, following the thematic analysis approach of Braun and Clarke.

Results: Of 3,652 screened articles, 21 articles met the inclusion criteria; qualitative (n = 19), mixed-methods (n = 1), and a qualitative PhD dissertation (n = 1). Four themes emerged: (1) Family Dynamics and Relationships, (2) The Emotional Impact of the Healthy Parent, (3) Coping Strategies and Illness Adaptation, and (4) Support Systems and Everyday Challengers.

Conclusion: Healthy parents in families affected by parental cancer play a pivotal role in sustaining family functioning during parental cancer. They experience dual burdens of caregiving and parenting and emotional strain, including insufficient support. Their unmet needs may compromise their parenting capacity and family well-being, underscoring the importance of integrating healthy parents' experiences into family-centered health care and support structures and services.

Implications for nursing practice: While healthy parents carry the dual responsibilities of caregiving and parenting during parental cancer, their needs and perspectives are often overlooked in oncological care. Recognizing and addressing their needs are essential to protect their parenting capacities and the family's well-being. Integrating healthy parents into family-centered care may enhance experienced resilience and strengthen support for the whole family.

Objectives: This article is a detailed exploration of the clinical utility, strengths, and limitations of traditional serum tumor markers with emerging circulating cell-free DNA (cfDNA) technologies in the monitoring of breast, ovarian, pancreas, and prostate cancers. It highlights how integrated biomarker strategies can advance precision oncology, particularly in the context of hereditary breast, ovarian, pancreas, and prostate cancer syndrome.

Methods: A review was conducted of current literature and practice guidelines, including the latest updates from the National Comprehensive Cancer Network (NCCN). The clinical performance, diagnostic value, and monitoring roles of serum tumor markers (eg, CA 15-3, CA 125, PSA, CA 19-9) and cfDNA were discussed descriptively across these four malignancies. Emphasis was placed on evidence relevant to hereditary cancer risk assessment, therapeutic decision-making, and disease surveillance.

Results: Serum tumor markers remain a cornerstone in oncology nursing practice because of the accessibility and utility in assessing treatment response and tracking disease burden over time. Yet, their limited sensitivity and specificity, especially for early detection, underscore the need for complementary tools. Circulating cell-free DNA (cfDNA) technologies provide real-time molecular information on tumor biology, offering earlier detection of recurrence, identification of germline-related actionable mutations, and dynamic assessment of therapeutic resistance. In hereditary cancer syndromes such as those associated with BRCA1/2, cfDNA has shown value for detecting minimal residual disease, informing targeted therapy selection (eg, PARP inhibitors), and supporting noninvasive longitudinal monitoring across the cancer care continuum.

Conclusions: Integrating cfDNA analysis with traditional serum tumor marker monitoring strengthens the ability to perform comprehensive risk assessment, tailor treatment decisions, and refine disease surveillance for individuals with hereditary cancer risk. This combined approach enables person-centered, evidence-based care while educating patients about the purpose and limits of each test, coordinating timely follow-up, and supporting adherence to surveillance protocols thereby ultimately improving outcomes for high-risk populations.

Implications for nursing practice: Oncology nurses play a critical role in supporting the integration of advanced biomarker technologies into personalized care. Understanding the evolving applications of cfDNA and serum tumor markers is essential for patient education, shared decision-making, and advocacy for equitable access to precision oncology innovations. Nurses are key partners in implementing biomarker-informed care pathways that promote individualized, high-quality cancer care.

Objective: This systematic review and meta-analysis aimed to synthesize the available evidence on the effectiveness of yoga and relaxation-based interventions in improving psychological well-being, coping capacity, and quality of life among caregivers of children with cancer.

Methods: A comprehensive literature search was conducted across seven electronic databases (PubMed, Cochrane Library, MEDLINE, ScienceDirect, CINAHL Complete, EBSCOhost, and Scopus) for studies published between January 2010 and July 2025. Outcomes of interest were anxiety, depression, stress, and quality of life, assessed using validated instruments. Data were extracted independently by two reviewers, and pooled effect sizes were calculated using Hedges' g with random- or mixed-effects models depending on heterogeneity.

Results: Six studies were included in the meta-analysis, with sample sizes ranging from 15 to 60 participants. The yoga and relaxation-based interventions showed favorable tendencies but did not yield statistically significant effects across psychological outcomes. For state anxiety, five studies were analyzed, resulting in a non-significant effect size under the mixed-effects model (Hedges' g = -1.687, P = .092). Similarly, four studies examining trait anxiety reported a non-significant pooled effect (Hedges' g = -1.701, P = .089). Two studies assessed depression, which also demonstrated a non-significant effect size (Hedges' g = 0.747, P = .455). For stress, two studies indicated a non-significant pooled effect (Hedges' g = 0.973, P = .331). Three studies investigating quality of life found no significant effect (Hedges' g = 0.714, P = .475).

Conclusions: Yoga and relaxation-based interventions may provide psychological benefits for parents of children with cancer, although the current evidence remains insufficient and inconsistent due to small sample sizes, methodological variability, and substantial heterogeneity.

Implications for practice: Given their feasibility, safety, and low cost, yoga and relaxation-based interventions should be considered as supportive strategies to help parents cope with the psychological demands of caregiving.