Seminars in Oncology Nursing最新文献

Objectives: The purpose of this study was to explore the relationships between mindfulness, sleep quality, anxiety, and depression in adult leukemia patients, and to test whether anxiety and depression play a mediating role between mindfulness level and sleep quality.

Methods: This study was a cross-sectional study, conducted in China from June 2023 to December 2024. A total of 200 patients diagnosed with acute leukemia (AL) were surveyed. Data collection utilized the Mindful Attention Awareness Scale, Pittsburgh Sleep Quality Index (PSQI), and Hospital Anxiety and Depression Scale. Statistical analyses employed SPSS 27.0 for descriptive and inferential statistics, and AMOS 24 for mediation analysis.

Results: The mean scores for mindfulness levels, sleep quality, anxiety, and depression were (63.90 ± 14.40), (7.88 ± 3.94), (5.77 ± 3.89), and (5.55 ± 3.99), respectively. Notably, the mindfulness level exhibited a significant negative correlation with the PSQI score, as well as with the levels of anxiety and depression (r = -0.436, -0.348, -0.179, respectively; all P < .01). Moreover, the PSQI scores were positively correlated with both anxiety and depression (r = 0.471, 0.395, respectively; P < .01), and anxiety and depression were positively correlated with each other (r = 0.671, P < .01). Regarding the impact on sleep quality, the direct effect value of mindfulness was -0.179, while the indirect effect values of anxiety and depression were -0.174 and -0.082, respectively. These indirect effects accounted for 40.00% and 18.85% of the total effect, respectively.

Conclusions: The results of this study suggest that the mindfulness levels, sleep quality, and the states of anxiety and depression among AL patients all require improvement. Mindfulness was shown to directly affect patients' sleep quality and can also exert an indirect influence through the pathways of anxiety and depression.

Implications for nursing practice: In clinical practice, in addition to taking measures to alleviate the emotional distress experienced by these patients, enhancing their level of mindfulness emerges as a viable and promising approach to significantly improve their sleep quality. Nurses should integrate mindfulness-based interventions into the daily care routine of AL patients, providing structured programs to help patients cultivate mindfulness skills. Additionally, establishing a regular assessment mechanism for patients' mindfulness levels, anxiety, depression, and sleep quality can enable nurses to adjust care plans in a timely manner, ensuring that interventions are personalized and effective in promoting patients' psychological well-being and sleep quality.

Objectives: The demand for hereditary breast cancer genetic services is outpacing workforce capacity, creating barriers to timely diagnosis and prevention. This paper discusses the role of the Breast Advanced Nurse Practitioner (ANP) as a strategic solution to these challenges, focusing on how ANPs can deliver a patient-centered approach to genetic care.

Methods: Peer reviewed articles and international guidelines focused on hereditary breast cancer were used for this discussion paper to examine the management of women at risk of hereditary breast cancer and how ANPs can impact the evolving field of genetics.

Results: ANPs are uniquely positioned to bridge the gap between oncology and genetics. By integrating clinical expertise with genomic competencies, ANPs can effectively manage risk assessment, mainstream genetic testing, and long-term surveillance. ANP role emphasizes holistic support, addressing the psychosocial impact of genetic risk, and ensuring continuity of care for patients and their families. However, some challenges remain regarding the lack of formal training and the inconsistent implementation of the ANPs role in different settings.

Conclusions: Integrating ANPs into hereditary breast clinics is not just a workforce solution but a quality improvement strategy. To sustain this role, an innovative approach is needed. Advanced training and funding for education programs in genetics is crucial for nurses in order to develop the skills and knowledge needed to expand their role. Clear role definition, robust protocols and clinical supervision in order to work within their scope of practice are required for ANPs.

Implication for nursing: Nurses working with patients at risk of hereditary breast cancer require continuous training, access to genetic education programs and clinical supervision to keep their skills up to date with this rapidly evolving area in cancer and genetics. Highly skilled and educated nurses in genetics such as Breast ANPs can provide mainstream genetic testing and offer pre and post genetic counselling improving patient outcomes and access to timely care.

Introduction: Fear of cancer recurrence (FCR) is among the most common and debilitating psychological issues affecting breast cancer survivors. With technological advances, e-health interventions have emerged as cost-effective tools to manage psychosocial challenges such as FCR.

Objectives: This study aimed to systematically review and synthesize evidence from randomized controlled trials assessing the effectiveness of e-health interventions in reducing FCR among breast cancer survivors.

Methods: This systematic review and meta-analysis were conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD42025645734). Comprehensive searches were performed in Web of Science, PubMed, Scopus, Medline, and Taylor & Francis Online up to January 2025. Risk of bias was evaluated using the Cochrane RoB 2 tool. A random-effects model with Hedge's g effect sizes and I² statistics was applied in the meta-analysis.

Results: Ten randomized controlled trials involving 1,565 participants were included. Interventions included online cognitive behavioral therapy, mobile applications, tele-coaching, and online mindfulness-based interventions. Although some individual studies reported reductions in FCR, the overall pooled effect size was not statistically significant (Hedge's g = -0.076, 95% CI: -0.183 to 0.031, P = .163). Considerable heterogeneity was observed among studies (I² = 87.39%). No significant publication bias was detected.

Conclusions: E-health interventions show promise in supporting the psychological well-being of breast cancer survivors. However, current evidence does not demonstrate a significant effect in reducing FCR. Future research should explore ways to enhance intervention design, improve user engagement, and examine how factors such as age, digital literacy, and adherence influence outcomes.

Implications for nursing practice: Nurses can play a key role in identifying patients receptive to digital interventions and supporting their engagement and adherence. Tailoring e-health content to individual needs, providing guidance on digital literacy, and integrating digital tools with face-to-face care approaches may enhance intervention effectiveness.

Objectives: This study aimed to evaluate the effects of a nurse-led supportive care program on caregiver burden and family resilience of caregivers of patients with lung cancer.

Methods: A parallel-group, pragmatic randomized controlled trial with a repeated-measures design was conducted with 46 family caregivers of patients with lung cancer. Participants were randomly assigned to either the intervention group (n = 23), which received a nurse-led supportive care program once a week for 8 weeks in addition to routine education, or the control group (n = 23), which received only routine education. Data were collected at baseline, at the end of the 8th week, and at the 12th week of the study.

Results: Caregiver burden in the intervention group significantly decreased in the 8th and 12th weeks compared to the baseline and the difference in the mean scores of the groups according to the measurement weeks was statistically significant (P < .001). Similarly, the resilience of family caregivers in the intervention group significantly increased in the 8th and 12th weeks compared to the baseline and the difference in the mean scores of the groups according to the measurement weeks was statistically significant (P < .001).

Conclusion: The results of this study demonstrate that the nurse-led supportive care program can effectively reduce caregiver burden and enhance resilience among family caregivers over time.

Implications for nursing practice: The nurse-led supportive care program can be integrated into routine care as an evidence-based nursing practice may contribute to holistic and sustainable caregiver support, ultimately enhancing patient care outcomes as well.

Registration number: NCT06204289.

Objectives: This review aimed to examine the inequalities in access to genetic counseling and testing services among individuals with Hereditary Breast and Ovarian Cancer Syndrome (HBOC) using bibliometric and thematic analysis methods.

Methods: In this mixed methods study, conducted using an explanatory sequential design, 421 articles published in the Web of Science database between 1997 and 2025 were first analyzed bibliometrically. In the second stage, thematic analysis was conducted on the 10 most cited studies.

Results: Bibliometric findings indicate that scientific production in this field has increased significantly since 2013, with studies conducted primarily by US-based institutions and supported by strong international collaborations. Thematic analysis identified four main themes: (1) inequities in access to and participation in services, (2) differences in clinical outcomes, (3) changes in service delivery models, and (4) communication barriers. Findings revealed that inequities in access to genetic services under HBOC are related not only to individual awareness or economic status but also to systemic and cultural factors. Furthermore, remote (telephone) genetic counseling has been shown to have the potential to reduce geographic and structural barriers.

Conclusions: Consequently, culturally tailored, accessible, and multidisciplinary approaches to addressing health disparities in HBOC are needed. Future research is recommended to compare experiences across countries using multiple data sources.

Implications for nursing practice: This study demonstrates that nurses play a crucial role in facilitating access to genetic counseling and testing services for individuals at risk for hereditary cancer. Strengthening nurses' genetic literacy, cultural sensitivity, and equity-based care approaches will increase service accessibility and the effectiveness of holistic care.

Objectives: This article examines how participating in a cervical cancer prevention program affects women's social lives.

Methods: A generic qualitative study was carried out in a gynecology unit of a public hospital in the northwestern region of Spain. Using purposive sampling, 21 women aged between 21 and 52 years diagnosed with cervical intraepithelial neoplasia of varying degrees, were recruited. Semi-structured interviews were audio recorded and transcribed. The data was analyzed using thematic analysis, based on a poststructuralist feminist perspective. Verification of doubts during data collection, triangulation of researchers' perspectives in data analysis and reflexivity and positionality strategies were employed to ensure study rigor.

Results: Two significant themes were identified: (a) the social effects of a cervical intraepithelial neoplasia diagnostic and subsequent follow-up for heterosexual couples within a biomedical healthcare system in a patriarchal society and (b) the social effects of a cervical intraepithelial neoplasia diagnostic and subsequent follow-up for relationships with family members and friends in a patriarchal society.

Conclusions: Participants' relationships with partners, relatives and friends were impacted by cervical cancer prevention, revealing an emphasis on the treatment of the physical body and disregard for other dimensions of human life. Two dominant discourses, biomedicine and patriarchy, intersected the care delivery processes, adversely affecting patients' lives.

Implications for nursing practice: Nurses should broaden their understanding of the social dimensions of cervical cancer prevention and treatment to encompass the multifaceted impact on various individuals, including patients, their partners, family members and friends. The social effects of the diagnostic and treatment of cervical intraepithelial neoplasia should be included in care plans.

Objectives: This systematic review and meta-analysis aimed to evaluate the effectiveness of interventions particularly psychoeducational and physical activity-based approaches on sexual function and satisfaction among individuals diagnosed with prostate cancer.

Methods: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and CINAHL databases to identify relevant studies published between 2010 and 2023. Studies were included if they involved interventions targeting sexual health in prostate cancer patients. Data were synthesized using random-effects meta-analysis models, and the quality of included studies was assessed using standardized criteria.

Results: A total of 14 studies met the inclusion criteria. Meta-analytic findings indicated that psychoeducational interventions, especially when combined with physical activity or counseling, significantly improved sexual function (SMD = 0.31, 95% CI: 0.03-0.60, P = .03) and satisfaction (SMD = 0.27, 95% CI: 0.04-0.50, P = .02). These interventions demonstrated moderate heterogeneity but consistently showed beneficial outcomes.

Conclusions: The findings support the integration of nurse-led psychoeducational and behavioral interventions into routine care for prostate cancer patients. Such approaches can enhance patients' sexual well-being, quality of life, and psychological resilience during survivorship.

Implications for nursing practice: Oncology nurses play a pivotal role in delivering holistic care to prostate cancer patients. Incorporating structured sexual health counseling, exercise-based rehabilitation, and psychoeducational support into survivorship programs can significantly improve sexual outcomes. This evidence reinforces the need for oncology nursing practices that prioritize sexual health as a key component of quality cancer care. These findings support integrating structured nurse-led sexual health interventions into survivorship care and highlight sexual wellbeing as a core component of holistic oncology nursing.

Objectives: Caregivers of patients undergoing ambulatory cancer surgery frequently experience heightened anxiety while having limited access to real-time psychosocial support. This study evaluated the feasibility, acceptability, and preliminary effects of a brief, self-guided mindfulness-based audio intervention delivered in the surgical waiting room.

Methods: This pilot feasibility study used a primarily quantitative pre-post design. Informal caregivers were recruited via QR code with support from perioperative nurse liaisons. Participants completed the Visual Analogue Scale for Anxiety (VAS-A) immediately before and after a 5-minute guided mindfulness meditation and rated satisfaction, perceived effectiveness, and likelihood of future use. Feasibility was assessed using enrollment and completion rates. Brief open-ended survey responses were collected to descriptively contextualize feasibility and acceptability findings.

Results: Of 73 caregivers who accessed the study, 49 (67.1%) enrolled. Among enrolled participants, 44 (89.8%) completed the preintervention assessment and meditation, and 27 (55.1%) completed both pre- and postintervention assessments, meeting predefined feasibility thresholds. Mean anxiety scores decreased significantly from pre- to postintervention (5.67 to 4.41; t(26) = 4.49, P < .001). Acceptability ratings exceeded the neutral midpoint (>3.0) on a five-point scale. Descriptive feedback highlighted the calming quality of the guided audio and appreciation for self-care messaging, alongside minor technical challenges related to volume, background noise, and audio playback.

Conclusions: A brief, self-administered mindfulness meditation delivered via personal devices was feasible, acceptable, and associated with reduced caregiver anxiety in an ambulatory oncology setting.

Implications for practice: Ultra-brief, technology-enabled mindfulness interventions can be integrated into perioperative workflows to address acute caregiver distress without disrupting care delivery. Oncology nurses are well positioned to facilitate implementation of such low-burden supports, which may enhance caregiver well-being and preparedness for postoperative care. Future studies should evaluate effectiveness across diverse settings and optimize delivery to minimize technical barriers.

Objectives: The use of multigene panel testing to identify hereditary cancer susceptibility has led to a growing number of individuals receiving a variant of uncertain significance (VUS) result. This qualitative study aimed to describe the experiences of individuals with a VUS, with a focus on their communication with healthcare providers (HCPs) and family members.

Methods: This study employed a constructivist grounded theory approach. Participants (N = 20) were recruited between January and July 2021 through social media and nonprofit organizations. Data were collected using semistructured interviews and verified transcripts.

Results: Categories identified included motivations, communication with family, family characteristics, communication with HCPs, other factors affecting the testing experiences, feelings about having a VUS, recall and understanding of the test result and its implications, coping strategies used, and risk management strategies used.

Conclusions: The proposed theoretical model included the key themes impacting the experience: context; decision-making; communication with HCPs and family; and the need for knowledgeable and trustworthy providers; met emotional needs; and open lines of communication. This model provides a framework to be used to meet the needs of individuals with VUS from pre- to post-testing process.

Implications for nursing practice: The proposed theoretical model offers guidance for structuring patient-centered care, emphasizing the importance of trust, continuity, and accessible support from pre- to post-testing. Integrating this framework into nursing practice can enhance patient understanding, reduce uncertainty, and promote informed decision-making regarding risk management.

Objectives: This study aimed to compare the prevalence and predictors of post-traumatic stress disorder (PTSD) among cancer patients and intensive care unit (ICU) survivors in Jordan.

Methods: A descriptive cross-sectional study was conducted in three major hospitals, including 200 cancer patients and 200 ICU survivors. PTSD symptoms were measured using the PTSD Checklist for DSM-5 (PCL-5). Data on sociodemographic and clinical characteristics were collected. Nurses supported recruitment, enrollment, and coordination of data collection across three hospitals.

Results: The prevalence of PTSD was 49.5% among cancer patients and 85.5% among ICU survivors (χ² = 59.08, P < .001), with ICU survivors being six times more likely to meet the PTSD criteria (odds ratio [OR] = 6.02, 95% confidence interval = 3.72-9.74). For patients with cancer, advanced disease stage (OR = 3.98), longer hospitalization (OR = 1.07 per day), and receipt of palliative care (OR = 5.15) or radiotherapy (OR = 4.49) were significant predictors. For ICU survivors, higher education level was the only independent predictor (OR = 4.00).

Conclusions: PTSD was highly prevalent among both cancer patients and ICU survivors in Jordan, with predictors differing between groups. These findings highlight the need for tailored psychosocial interventions within oncology and ICU aftercare and underscore how gaps in psychosocial and mental health services contribute to inequities in patient outcomes in low- and middle-income country settings.

Implications for nursing practice: The findings emphasize the need for routine PTSD screening and psychosocial support in oncology and ICU follow-up care in Jordan. Nurses are key to early detection and intervention for psychological distress. Strengthening trauma-informed nursing practice can ensure holistic patient recovery.