European Journal Of Oncology Nursing[JOURNAL]
Sun
200 papers
Acceptance and commitment therapy for psychosomatic outcomes and quality of life in adults with cancer: Systematic review and meta-analysis.
Kang Z, Xu Y, Li H … +4 more , Arbing R, Chen WT, Ke X, Huang F
Eur J Oncol Nurs · 2026 Apr · PMID 41712974 · Publisher ↗
PURPOSE: Acceptance and commitment therapy (ACT) is widely used for cancer patients, yet its effects are not well understood with respect to psychosomatic outcomes and quality of life (QoL). This review aims to explore t...
PURPOSE: Acceptance and commitment therapy (ACT) is widely used for cancer patients, yet its effects are not well understood with respect to psychosomatic outcomes and quality of life (QoL). This review aims to explore the effects of ACT on the psychosomatic outcomes and QoL of cancer patients. METHODS: Eleven electronic databases were searched from inception to December 2025. Two authors independently extracted the data. RevMan 5.4 was used for data analysis and RoB 2.0 and GRADE were used for quality assessment. RESULTS: Forty studies were included, 30 of which were eligible for meta-analysis. The meta-analysis revealed that compared with the control, ACT used alone had significant effects on hope [SMD = 3.01, 95% CI (0.69, 5.34)], psychological flexibility [SMD = -1.42, 95% CI (-1.96, -0.87)], psychological distress [SMD = -0.79, 95% CI (-1.45, -0.13)], anxiety [SMD = -0.92, 95% CI (-1.70, -0.14)], depressive symptoms [SMD = -0.95, 95% CI (-1.50, -0.39)], fatigue [SMD = -0.81, 95% CI (-1.55, -0.06)] and QoL [SMD = 1.07, 95% CI (0.14, 2.00)] in cancer patients. ACT used in combination can relieve depressive symptoms [SMD = -2.04, 95% CI (-2.44, -1.65)], anxiety [SMD = -2.10, 95% CI (-2.78, -1.41)] and fatigue [SMD = -2.49, 95% CI (-2.90, -2.08)]. CONCLUSION: ACT can improve hope, psychological flexibility, psychological distress, anxiety, depressive symptoms and the QoL of cancer patients. Future studies should expand sample sizes and optimize designs to advance research with cancer patients.
Relational experiences and meaning-making with significant others in patients with hematopoietic malignancies at end of life: A phenomenological study.
Matsuyama N, Masujima M
Eur J Oncol Nurs · 2026 Apr · PMID 41712973 · Publisher ↗
PURPOSE: Patients with hematopoietic malignancies face uncertain disease trajectories and meaning-making through relationships at end of life (EOL), but this remains underexplored. This study aimed to describe how patien...
PURPOSE: Patients with hematopoietic malignancies face uncertain disease trajectories and meaning-making through relationships at end of life (EOL), but this remains underexplored. This study aimed to describe how patients (N = 18) with recurrent or refractory hematopoietic malignancies experience living with significant others at EOL and to elucidate the essential structures of these relational experiences. METHODS: Semi-structured interviews were conducted with 18 patients (aged 40-79 years) with recurrent or refractory hematopoietic malignancies between April and September 2017. Data were analyzed using Giorgi's descriptive phenomenological method. Ethical approval was obtained from Chiba University. RESULTS: Eight themes emerged, revealing that relationships formed the foundation of patients' identity and meaningful living. These themes encompassed recognizing life as sustained through others' generosity, finding emotional grounding in relationships, striving to remain contributive, recognizing mortality through relational responses, reciprocating kindness, preserving authenticity, balancing closeness and distance, and relying on healthcare professionals as partners. The themes were organized into a relational model comprising four concentric contexts (Self, Family and Fundamental Bonds, Active Reciprocal Relationships, and Mortality and Meaning-Making Context) and two dialectical dimensions (Sustained by Others ↔ Being Oneself; Receiving ↔ Contributing). CONCLUSION: Patients actively construct meaning through relationships across multiple contexts while navigating dialectical tensions between dependence and selfhood. This relational model may guide nurses in assessing relational needs and supporting meaningful living at EOL. Limitations include the single-site design in Japan and the cross-sectional nature of data collection.
A formative service evaluation exploring the experience and levels of satisfaction of patients attending a nurse led bone marrow clinic in one Health and Social Care Trust in Northern Ireland.
Lyons L, Lyttle D, McCloy K
Eur J Oncol Nurs · 2026 Apr · PMID 41702289 · Publisher ↗
BACKGROUND: The incidence of haematological malignancy is increasing, and the bone marrow biopsy plays a key role in the diagnostic process. Due to the increasing demand, haematology clinics are frequently operating beyo...
BACKGROUND: The incidence of haematological malignancy is increasing, and the bone marrow biopsy plays a key role in the diagnostic process. Due to the increasing demand, haematology clinics are frequently operating beyond their capacity. In response to this challenge, a nurse-led bone marrow clinic was established by a Health and Social Care Trust (HSCT) in 2014. However no formal evaluation of this service had been conducted. AIM: To explore the experience and satisfaction among patients who have attended the bone marrow biopsy clinic and identify areas for service improvement. METHOD: Semi-structured interviews were conducted over a 3-month period. All participants were recruited from the Trust who had undertaken a bone marrow biopsy procedure within the last 3 months. Analysis was conducted, using a content analysis approach. FINDINGS: Nine participants took part (six female, three male), ages ranged from 56 to 83 years. Four themes were identified: "influence of personality type on stress and coping before the procedure," "interplay between experience and expectations"," impact of person-centred nursing care" and "potential areas for improvement". All participants positively evaluated the nurse-led clinic, expressing a high level of satisfaction with the care they received. Of note was that the procedure was much less painful than participants had expected as well as the positive impact of person-cent red care on the patient experience. Suggested improvements included better information about car parking and clinic location, and a change in the bone marrow biopsy clinic environment which participants felt lacked the privacy required for this invasive procedure. CONCLUSIONS: This evaluation's findings serve as an important reminder of the significance of connecting with patients on a human level to enable them to feel safe and supported during their procedure.
A qualitative study of patient perspectives for a mindfulness-based intervention in lung cancer.
Chen J, Huang D, Luo Q … +5 more , Qin Y, Wang W, Knobf MT, Zhou Y, Ye Z
Eur J Oncol Nurs · 2026 Apr · PMID 41702288 · Publisher ↗
PURPOSE: This study aimed to explore the psychological experience of patients with early-stage lung cancer in the postoperative period, including their perceptions and attitudes, expectations of potential benefits, and b...
PURPOSE: This study aimed to explore the psychological experience of patients with early-stage lung cancer in the postoperative period, including their perceptions and attitudes, expectations of potential benefits, and barriers to engagement of an eight-week mindfulness-based intervention (MBI) on psychological recovery. METHODS: This study was conducted as part of the Be Resilient to Lung Cancer (BRLC) research program, registered in the Chinese Clinical Trial Registry (ChiCTR2400080459). Participants were purposively recruited from the thoracic surgery wards and outpatient follow-up clinics of a tertiary hospital in Guangzhou, China. Eligible participants were early-stage lung cancer patients who had undergone curative resection and were interviewed prior to participation in a MBI. Data were collected through semi-structured, in-depth interviews and analyzed using Braun and Clarke's six-phase framework for thematic analysis, guided by the Consolidated Criteria for Reporting Qualitative Research checklist. RESULTS: Twenty-four participants (mean age = 50.6 ± 16.7 years) completed the interviews. Three themes were identified: (1) Perceptions and attitudes toward mindfulness; (2) Expectations of potential benefits; and (3) Barriers to engagement. The findings indicate that psychological recovery lags behind physical recovery, and a MBI is viewed as an acceptable, non-pharmacological approach to enhance emotional recovery. CONCLUSIONS: Patients with lung cancer following curative intent surgery perceive a MBI as a promising strategy to address ongoing distress and promote psychological adjustment. Addressing misconceptions, self-efficacy concerns, and cultural barriers may optimize engagement in future patient-centered, culturally adapted MBI programs.
Health literacy in patients with colorectal liver metastases: A cross-sectional study.
Brekke FK, Helseth S, Vidnes TK … +5 more , Wahl AK, Larsen MH, Fretland ÅA, Hansen IS, Andersen MH
Eur J Oncol Nurs · 2026 Apr · PMID 41698272 · Publisher ↗
PURPOSE: Health literacy influences surgical outcomes by affecting patients' ability to understand information, manage their health and navigate the healthcare system. Yet, little is known about health literacy in patien...
PURPOSE: Health literacy influences surgical outcomes by affecting patients' ability to understand information, manage their health and navigate the healthcare system. Yet, little is known about health literacy in patients with colorectal liver metastases. This study assessed health literacy across different domains and explored associations with sociodemographic and clinical factors aiming to identify knowledge gaps within this population. DESIGN: Cross-sectional. METHODS: A total of 122 patients with colorectal liver metastases were recruited between December 2021 and December 2024. Health literacy was assessed using the Health Literacy Questionnaire. Descriptive statistics were used to characterize the sample and to present the overall health literacy profiles. Associations between health literacy and selected sociodemographic and clinical variables were examined using, both univariate and multivariate linear regression analyses. RESULTS: Participants reported the greatest challenges in the Health Literacy Questionnaire domains "ability to find good health information" (mean score 3.98 ± 0.56, range 1-5) and "appraisal of health information" (mean score 2.63 ± 0.55, range 1-4). Lower health literacy scores were significantly associated with male gender, lower educational attainment, living alone, and the presence of comorbidity. CONCLUSION: This study provides novel insights into the health literacy of patients with colorectal liver metastases and highlights the importance of identifying and addressing health literacy challenges in clinical care. Tailored communication and support may enhance treatment outcomes, particularly to vulnerable patient groups. Further research is needed to explore how health literacy impacts decision-making and treatment adherence in complex cancer care.
The chain mediating effect of illness acceptance, body compassion, and post-traumatic growth on hope in cancer patients: A multicenter serial mediation analysis.
Karaaslan Eser A, Avci Isik S, Ercivan S
Eur J Oncol Nurs · 2026 Apr · PMID 41698271 · Publisher ↗
PURPOSE: This study aimed to investigate how illness acceptance, body compassion, and post-traumatic growth interact to influence hope in cancer patients, by identifying the sequential mediating pathways among these psyc...
PURPOSE: This study aimed to investigate how illness acceptance, body compassion, and post-traumatic growth interact to influence hope in cancer patients, by identifying the sequential mediating pathways among these psychosocial variables. METHODS: This cross-sectional study recruited 226 cancer patients from three hospitals in Turkey between April and July 2025. The data were obtained through the administration of the Acceptance of Illness Scale, the Body Compassion Scale, the Posttraumatic Growth Scale-Short Form, and the Herth Hope Scale. Descriptive statistics, reliability analyses, and mediation analyses based on the bootstrap method (5000 samples, 95% confidence interval) were conducted, and results with p < 0.05 were considered statistically significant. RESULTS: All study variables were positively correlated (p < 0.05). Illness acceptance was significantly associated with body compassion (β = 0.382, p = 0.003) but not with posttraumatic growth (β = -0.010, p = 0.922), whereas body compassion was positively associated with posttraumatic growth (β = 0.128, p = 0.018). When hope was the outcome, illness acceptance (β = 0.397, p = 0.004), body compassion (β = 0.311, p < 0.001), and posttraumatic growth (β = 0.528, p < 0.001) showed significant positive effects. Mediation analyses revealed significant indirect effects of illness acceptance on hope via body compassion and via body compassion and posttraumatic growth in sequence, but not via posttraumatic growth alone. CONCLUSIONS: Illness acceptance enhances hope in cancer patients directly and indirectly through body compassion and a sequential pathway involving post-traumatic growth, supporting acceptance- and body-focused interventions in oncology nursing care.
Trajectory of treatment decision-making willingness to behavior conversion level in lymphoma patients: a growth mixture model method.
Zhong W, Ge Y, Gu F … +3 more , Zhu X, Tang F, Xu L
Eur J Oncol Nurs · 2026 Apr · PMID 41691741 · Publisher ↗
PURPOSES: Treatment decision-making willingness and the actual degree of participation in treatment decisions in lymphoma patients are crucial factors influencing clinical outcomes and are closely related to disease prog...
PURPOSES: Treatment decision-making willingness and the actual degree of participation in treatment decisions in lymphoma patients are crucial factors influencing clinical outcomes and are closely related to disease prognosis. This study aimed to identify trajectories of treatment decision-making willingness to behavior conversion (TDMWTBC) level among lymphoma patients. METHODS: A total of 278 lymphoma patients hospitalized in the hematology department of the First Affiliated Hospital of Soochow University were selected as the study population. Longitudinal surveys were conducted at four time points (time of diagnosis, second treatment cycle, mid-treatment evaluation, and end-of-treatment evaluation) using the Patient Willingness/Actual Participation in Treatment Decision-Making Questionnaire and the Family APGAR Index Questionnaire. Growth Mixture Model analysis was used to identify TDMWTBC trajectories, and their predictors were analysed using multinomial logistic regression. RESULTS: Three distinct TDMWTBC trajectories were identified: the "Low Conversion Level - Fluctuating Group" (45.58%), the "Moderate Conversion Level - Continuously Rising Group" (30.53%), and the "High Conversion Level - Gradually Declining Group" (23.89%). Univariate analysis indicated that age, gender, educational level, place of residence, comorbidities, and family care level (P < 0.05) were associated with trajectory classes. Multinomial logistic regression further demonstrated that gender, place of residence, educational level, and family care level were predictors of different TDMWTBC trajectories. CONCLUSIONS: Lymphoma patients exhibit three distinct TDMWTBC trajectories. Relevant predictive indicators can forecast future TDMWTBC levels. It is necessary to screen patients and develop targeted interventions for those with different trajectories at specific stages.
Living the transition: Experiences of patients receiving palliative care from hospital to home - A phenomenological study.
Cruz S, Magalhães B, Fernandes C
Eur J Oncol Nurs · 2026 Apr · PMID 41691740 · Publisher ↗
PURPOSE: Transitions from hospital to home in palliative care are emotionally and organisationally complex, influencing patients' dignity, safety, and continuity of care. Although previous studies have focused largely on...
PURPOSE: Transitions from hospital to home in palliative care are emotionally and organisationally complex, influencing patients' dignity, safety, and continuity of care. Although previous studies have focused largely on professionals and informal caregivers, patients' own perspectives remain insufficiently understood. This study aimed to explore the lived experience of adults receiving palliative care during the transition from hospital to home. METHODS: A descriptive phenomenological design guided by Giorgi's method was used. Twenty adults (n = 20) recently discharged from hospital and receiving home-based palliative care were purposively recruited from three specialised community palliative care teams in northern Portugal and participated in in-depth individual interviews. RESULTS: Four essential themes described the transition experience: reconstructing home as a place of care and meaning; transforming relationships, highlighting the role of family and professionals; navigating loss and adaptation, where dependence evokes fear yet promotes acceptance; and system fragilities, including limited continuity and coordination, contributing to insecurity and distress. Overall, the transition was experienced as a tension between autonomy and vulnerability as patients reconstructed daily life in the context of serious illness. CONCLUSIONS: Improving transitional palliative care requires integrated and relationally attuned models that ensure continuity and timely support across care settings. Nursing practices should actively involve patients and families, strengthen home-based support, and promote dignity and safety during the transition from hospital to home.
Exploring the dynamics of symptom networks in esophageal cancer patients during chemotherapy: a cross-lagged panel network analysis.
Sun C, Sun D, Yang H … +5 more , Liu Y, Chen R, Wang D, Liu Z, Zhang P
Eur J Oncol Nurs · 2026 Apr · PMID 41690163 · Publisher ↗
PURPOSE: This study used cross-lagged panel network analysis to examine longitudinal symptom networks in patients with esophageal cancer undergoing chemotherapy, aiming to identify stage-specific influential symptoms and...
PURPOSE: This study used cross-lagged panel network analysis to examine longitudinal symptom networks in patients with esophageal cancer undergoing chemotherapy, aiming to identify stage-specific influential symptoms and directed temporal associations across treatment stages. METHOD: This longitudinal study was conducted from January to September 2025 in four Grade III Level A hospitals in Henan, China. Patients receiving chemotherapy for esophageal cancer were assessed at three time points using the M.D. Anderson Symptom Inventory Gastrointestinal Cancer Module (MDASI-GI). Cross-lagged panel network models were applied to estimate symptom-to-symptom temporal associations and quantify symptom influence using network centrality indices. RESULTS: A total of 339 participants completed all three assessments. During the T1→T2 interval, S1 (Pain) and S18 (Difficulty Swallowing) exhibited the highest out-expected influence (out-EI = 1.825 and 1.717, respectively), with the strongest temporal association observed from S1 (Pain) to S6 (Shortness of Breath) (β = 0.282). During the T2→T3 interval, S2 (Fatigue) and S3 (Nausea) emerged as the most influential symptoms (out-EI = 2.172 and 1.937, respectively), with the strongest association identified from S2 (Fatigue) to S6 (Shortness of Breath) (β = 0.454). CONCLUSIONS: This study identified stage-specific influential symptoms and directed temporal associations within symptom networks among patients with esophageal cancer undergoing chemotherapy. Pain and difficulty swallowing were most influential early, whereas fatigue and nausea became more influential later. These findings support a network-based, stage-sensitive perspective on symptom management and may inform time-specific supportive care prioritization.
The impact of illness perception on marital quality among patients with cervical cancer and their husbands: based on actor-partner interdependence mediation model.
Mei J, Yang Z, Li M … +10 more , Xiong C, Chen J, Li X, Xie Y, Guan S, Qiu Y, Huang Y, Shen F, Wang Y, Yan J
Eur J Oncol Nurs · 2026 Apr · PMID 41690162 · Publisher ↗
PURPOSE: To describe the illness perception, dyadic coping, and marital quality of cervical cancer patient-husband dyads. In addition, we explore the direct effects of illness perception on marital quality, and whether d...
PURPOSE: To describe the illness perception, dyadic coping, and marital quality of cervical cancer patient-husband dyads. In addition, we explore the direct effects of illness perception on marital quality, and whether dyadic coping acts as a mediator in this process. METHODS: A cross-sectional design was employed. The Revised Illness Perception Questionnaire for Cervical Cancer, the Dyadic Coping Inventory, and the Marital Adjustment Test were used to assess illness perception, dyadic coping, and marital quality. Dyadic analysis was conducted by constructing the actor‒partner interdependence mediation model. RESULTS: A total of 175 dyads of postoperative cervical cancer patients and their husbands completed the questionnaires. The dyads reported suboptimal scores for both marital quality and dyadic coping. For direct effects of illness perception on marital quality, our model indicated that the positive illness perception of patients and negative illness perception of husbands can negatively impact their own marital quality. With respect to the indirect effects of dyadic coping acting as a mediator, both positive illness perception and negative illness perception of husbands can impact their own marital quality through their own dyadic coping and can also impact patients' marital quality through patients' dyadic coping. CONCLUSIONS: This study highlights that the level of marital quality and dyadic coping in dyads need to be improved, demonstrates the significance of illness perception for influencing dyads' marital quality and reveals the underlying mediating mechanism of dyadic coping. This study provides guidance for illness perception-based dyadic interventions to improve marital quality among cervical cancer patients and husbands.
Effect of therapeutic play intervention on early-phase nausea, vomiting, and quality of life in children receiving chemotherapy: A randomized controlled study.
Polat Köse D, Kobya Bulut H
Eur J Oncol Nurs · 2026 Apr · PMID 41690161 · Publisher ↗
PURPOSE: This randomized controlled study aimed to evaluate the effect of a therapeutic play intervention on early-onset nausea, vomiting, and quality of life in children receiving chemotherapy. METHODS: The study includ...
PURPOSE: This randomized controlled study aimed to evaluate the effect of a therapeutic play intervention on early-onset nausea, vomiting, and quality of life in children receiving chemotherapy. METHODS: The study included 62 children undergoing chemotherapy between December 2023 and February 2025. Participants were randomly assigned to a therapeutic play intervention group (n = 32) or a control group receiving standard care (n = 30). In addition to routine care, children in the intervention group participated in a single 30-min therapeutic play session, whereas the control group received routine care alone. The primary outcome was the severity of nausea and vomiting assessed 24 h after chemotherapy. Secondary outcomes included nausea-vomiting severity measured at baseline and at 6 h post-chemotherapy, as well as quality of life evaluated at baseline and 24 h. Between-group comparisons were conducted using non-parametric statistical methods, with effect sizes reported as Hodges-Lehmann median differences and 95% confidence intervals. RESULTS: Baseline nausea-vomiting severity did not differ significantly between the groups. At 6 h post-chemotherapy, nausea-vomiting severity was significantly lower in the therapeutic play group compared with the control group (HL median difference = -1.00, 95% CI:-1.00 to 0.00; p = 0.002). This difference was more pronounced at 24 h (HL median difference = -1.00, 95% CI:-1.00 to -1.00; p < 0.001). Quality of life at 24 h was also significantly higher in the intervention group (HL median difference = -2.00, 95% CI:-4.00 to 0.00; p = 0.005). CONCLUSION: Therapeutic play appears to be an effective supportive care intervention for reducing early chemotherapy-induced nausea and vomiting and for improving quality of life in pediatric patients.
Integrating physical activity into chemotherapy care: Recommendations from a qualitative analysis using the behaviour change wheel.
Cesnik R, Kunstler B, Toohey K … +2 more , Freene N, Semple S
Eur J Oncol Nurs · 2026 Apr · PMID 41687208 · Publisher ↗
INTRODUCTION: It is established that physical activity (PA) during chemotherapy confers many benefits to patients, however engagement in PA is generally limited. The study objectives are to analyse the barriers to PA dur...
INTRODUCTION: It is established that physical activity (PA) during chemotherapy confers many benefits to patients, however engagement in PA is generally limited. The study objectives are to analyse the barriers to PA during chemotherapy and provide recommendations for integrating PA into clinical practice. METHODS: This study utilised data from 40 cancer care clinicians, ten carers and 23 people undergoing chemotherapy in the 'Experiences of PA during Chemotherapy (EPAC)' study. Barriers and facilitators to PA were extracted from ten focus group transcripts and 37 interviews, and mapped to the theoretical domains framework and behaviour change wheel (BCW). Following the BCW process supported the development of intervention design to facilitate increased PA across the socio-ecological layers of the health system. RESULTS: This study identified 54 barriers that cross all domains of capability, opportunity and motivation, theoretical domains framework and socio-ecological model; demonstrating the broadness and complexity of integrating PA into standard chemotherapy care. The study proposes two broad and connected interventions that may support increased PA during chemotherapy: organisational led support to improve skills, knowledge and confidence of PA for clinicians; and embedding exercise specialists into the multidisciplinary cancer care team. CONCLUSION: Integrating PA into oncology at the treatment stage is a complex process requiring a multi-level approach. Increasing access to exercise specialists and supporting all members of the MDT to provide individual PA education and support will address many of the barriers to integrating PA into standard chemotherapy care.
Support interventions for patients with primary high-grade brain tumours and their relatives: a scoping review.
Ståhl P, Henoch I, Schenell R … +3 more , Rydenhag B, Smits A, Ozanne A
Eur J Oncol Nurs · 2026 Apr · PMID 41687207 · Publisher ↗
PURPOSE: The aim of this review was to systematically map support interventions for patients with primary high-grade brain tumours and their relatives. METHODS: Searches were conducted in electronic databases and referen...
PURPOSE: The aim of this review was to systematically map support interventions for patients with primary high-grade brain tumours and their relatives. METHODS: Searches were conducted in electronic databases and reference lists of included articles. Articles published between 2013 and 2025 were included. Extracted data was condensed, compared, and categorised. RESULTS: The final sample comprised 34 articles, including 15 (44%) full-scale and 19 (56%) feasibility/pilot studies. Interventions included individualised support (n = 11), care planning (n = 6), rehabilitation (n = 6), mind-body care (n = 6), and education (n = 5). They targeted patients (n = 5; 15%), relatives (n = 11; 32%), or both (n = 18; 53%). Full-scale studies reported positive effects in primary outcomes for both patients and relatives. Among patients, improvements were noted in symptoms, cognition, communication, psychosocial functioning, and self-care. Relatives showed improved health-related quality of life and psychosocial outcomes, with increased mastery and preparedness, though decision-making needs remained. Timely and repeated outreach was valued. For both patients and relatives, interventions enhanced quality of life made patients feeling understood, prepared, strengthened, and more confident in decision-making during consultations. Patients and relatives preferred active involvement in care, decisions, and information, with particular emphasis on encouraging hope. Caregiver mastery remained high, and structured, cohesive, and well-facilitated support groups were most valued. All feasibility and pilot studies reported positive outcomes. CONCLUSION: Support interventions for patients with primary high-grade brain tumours and their relatives show promising results with positive effects on outcome measures across different areas. Despite their potential advantages, many interventions are still in early implementation phases.
Feasibility and preliminary outcomes of a Rebuilding Osteo Strength with Exercise (ROSE) program for women with breast cancer undergoing endocrine therapy.
Chen L, Zhao Y, Yang A … +6 more , Bai L, Thomas TH, Zhao F, Liu Y, Liu JE, Gao F
Eur J Oncol Nurs · 2026 Apr · PMID 41679121 · Publisher ↗
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...
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.
Contact nurses' experiences of using the BETTER model to address sexuality issues with cancer patients - A study based on the normalization process theory.
Åkerström Wenneberg L, Olsson C, Eklund AJ … +2 more , Larsson M, Ringnér A
Eur J Oncol Nurs · 2026 Apr · PMID 41679120 · Publisher ↗
BACKGROUND: Contact Nurses in Cancer Care (CNCCs) are well-positioned to address patients' concerns regarding sexual health, but many lack the tools and confidence to initiate such conversations. AIM: To explore how CNCC...
BACKGROUND: Contact Nurses in Cancer Care (CNCCs) are well-positioned to address patients' concerns regarding sexual health, but many lack the tools and confidence to initiate such conversations. AIM: To explore how CNCCs perceive the use of the BETTER model as a new practice for integrating discussions of sexuality into cancer care. METHODS: Data were collected from 37 CNCCs through video-recorded educational seminars, written reflections, and focus group interviews. A directed qualitative content analysis was conducted, guided by the four constructs of the Normalization Process Theory: coherence, cognitive participation, collective action, and reflexive monitoring. RESULTS: The BETTER model was perceived as a valuable tool for initiating conversations about sexuality. The CNCCs highlighted the importance of personal reflection, peer support, and managerial backing. Time constraints and structural barriers were identified as key challenges to implementation. Many CNCCs viewed themselves as clinical champions, advocating for the sustained integration of the model into practice. CONCLUSION: Communication tools such as the BETTER model can enhance CNCCs' confidence and competence in addressing sexual health. Successful implementation requires organizational support and recognition of CNCCs' roles as facilitators of change. The Normalization Process Theory proved useful in understanding the implementation process, even across diverse clinical settings.
The cascade of disadvantage: A qualitative study of treatment burden in older adults with lung cancer alongside comorbidity.
Yang J, Zou S, Wang Y … +3 more , Wu B, Zhang D, Tang S
Eur J Oncol Nurs · 2026 Apr · PMID 41679119 · Publisher ↗
PURPOSE: The treatment burden experienced by older adults with lung cancer and comorbidity adversely affects their well-being and quality of life. However, it remains unclear how specific burdens interact to create a sel...
PURPOSE: The treatment burden experienced by older adults with lung cancer and comorbidity adversely affects their well-being and quality of life. However, it remains unclear how specific burdens interact to create a self-reinforcing system. This study aimed to explore the systemic and dynamic process. METHOD: This study used purposive sampling to recruit 15 participants aged 65 years or older with lung cancer and at least one comorbidity from a tertiary hospital in China. Data were collected through in-depth, semi-structured interviews and analyzed using the Colaizzi phenomenological method. RESULTS: This study developed the "Cascade of Disadvantage" model to elucidate the cumulative interaction of five core burdens in this population. The model proposes three interconnected mechanistic pathways driving this process: (1) the sequential pathway, outlining a discernible, staged sequence where burdens trigger one another from the Symptom Storm through Self-Management Overload, Financial Toxicity, and Decisional Paralysis to the Internalization of Disadvantage; (2) the dynamic pathway, characterized by immediate, multidirectional interactions among burdens that drive fluctuating crises independent of sequence; and (3) the amplifying pathway, defined by vicious feedback loops where burdens mutually intensified. These pathways integrate isolated burdens into a self-reinforcing system that progressively erodes patients' capacity to manage and tolerate treatment. CONCLUSION: The "Cascade of Disadvantage" model conceptualizes treatment burden as a self-reinforcing system. Consequently, nursing care should evolve from managing isolated burdens to actively intercepting its three core pathways. This shift positions nurses as essential "Cascade Interceptors" for safeguarding patients' dignity and well-being.
Effects of aromatherapy inhalation on chemotherapy-induced nausea and vomiting: A controlled trial.
Anglade D, Diaz C, Laporte RR … +7 more , Gattamorta K, Sheikh-Wu SF, Granados YD, Ng-Chen H, Alvarez J, Rosen LF, Pizzolato J
Eur J Oncol Nurs · 2026 Apr · PMID 41671893 · Publisher ↗
PURPOSE: This study aimed to determine whether aromatherapy inhalation would reduce chemotherapy-induced nausea and vomiting (CINV) among cancer patients receiving moderate to high emetogenic chemotherapy (HEC) regimen....
PURPOSE: This study aimed to determine whether aromatherapy inhalation would reduce chemotherapy-induced nausea and vomiting (CINV) among cancer patients receiving moderate to high emetogenic chemotherapy (HEC) regimen. METHODS: One hundred participants (control = 48; intervention = 52) receiving moderate to HEC treatment were enrolled in a two-arm control trial design. Participants in the control group followed physician-prescribed antiemetic treatment. Participants in the intervention group followed physician-prescribed antiemetic treatment and received an aromatherapy inhaler intervention for use at the first sign of CINV and as needed. Consented study participants were seen by a study team member over four time points during which the participants would complete the established instruments with scoring procedures and validity evidence. RESULTS: The use of the aromatherapy inhaler resulted in a reduction in CINV and antiemetic medication in the intervention group. The control group reported 522 instances of medication usage at visit one; 417 instances of medication usage at visit two; and 409 instances of medication usage at visit three. The intervention group reported 136 instances of medication use at visit one; 145 instances of medication use at visit two; and 142 instances of medication use at visit three. Similar to the patterns observed for pharmacological interventions, the control group also reported higher rates of the use of non-pharmacological interventions including tea, water/electrolytes, soup, and food compared to the intervention group. CONCLUSION: The findings from this randomized clinical trial highlight the potential benefits of aromatherapy inhalation as a complementary therapy for managing CINV.
Nurse-supported hybrid home-based pulmonary rehabilitation improves psychological distress, quality of life, and functional performance in advanced lung cancer: A randomized controlled trial.
Liu WL, Chien JY, Lu YY … +1 more , Liu KF
Eur J Oncol Nurs · 2026 Apr · PMID 41666769 · Publisher ↗
PURPOSE: This study aimed to evaluate the effectiveness and safety of a nurse-supported hybrid home-based pulmonary rehabilitation program (PRP) in reducing psychological distress and preserving quality of life (QoL) and...
PURPOSE: This study aimed to evaluate the effectiveness and safety of a nurse-supported hybrid home-based pulmonary rehabilitation program (PRP) in reducing psychological distress and preserving quality of life (QoL) and functional performance in patients with advanced lung cancer. METHODS: A randomized controlled trial was conducted with 104 patients with stage III-IV lung cancer randomly assigned to an intervention group (n = 52) or a control group (n = 52). The intervention group received home-based aerobic, resistance, and breathing exercises three times weekly after an initial supervised session. Anxiety and depression were primary outcomes, while QoL and functional performance were secondary outcomes. Outcomes were assessed at baseline, week 4, and week 8 and analyzed using generalized estimating equations under an intention-to-treat approach. RESULTS: Groups were comparable at baseline. At week 8, the intervention group showed significantly greater reductions in anxiety (β = -1.72, 95% CI [-3.04, -0.40], p = .01) and depression (β = -1.21, 95% CI [-2.35, -0.07], p = .04) compared with the control group. QoL and functional performance were maintained in the intervention group but declined in the control group. Program adherence was 63.5%, and no exercise-related serious adverse events occurred, including among participants with bone metastases. CONCLUSIONS: A nurse-supported hybrid PRP is an effective intervention for reducing psychological distress and preserving functional status in patients with advanced lung cancer. The observed safety profile further supports its clinical applicability, including for high-risk populations. TRIAL REGISTRATION: Clinical trial ID: NCT05279521; First patient enrolled: April 14, 2022.
Impact of cancer-related fatigue on quality of life and psychological health among patients with breast cancer undergoing adjuvant therapy in Taiwan.
Huang CH, Huang LL, Konara Mudiyanselage SP … +2 more , Tsai CS, Ku HC
Eur J Oncol Nurs · 2026 Apr · PMID 41653560 · Publisher ↗
PURPOSE: Breast cancer patients undergoing adjuvant therapy commonly experience cancer-related fatigue (CRF) and multiple psychological symptoms that significantly affect quality of life (QoL). This study examined the pr...
PURPOSE: Breast cancer patients undergoing adjuvant therapy commonly experience cancer-related fatigue (CRF) and multiple psychological symptoms that significantly affect quality of life (QoL). This study examined the prevalence and severity of CRF and explored its associations with multidimensional QoL and psychological distress among Taiwanese women with breast cancer. METHODS: A cross-sectional study was conducted at a regional hospital in southern Taiwan from September 2023 to August 2024. Eighty-four BC patients receiving chemotherapy or targeted therapy completed the Brief Fatigue Inventory-Taiwan (BFI-T), Brief Symptom Rating Scale (BSRS-5), and WHOQOL-BREF. Data were analyzed using descriptive statistics, chi-square tests, t-tests, ANOVA, and Pearson's correlations. RESULTS: CRF affected 60.7% of patients (mean BFI-T = 2.38 ± 2.09). QoL was moderate (WHOQOL-BREF = 56.91 ± 9.21), with psychological health scoring the lowest. Sleep disturbances occurred in 72.6% and suicidal ideation in 19.0% of patients. CRF was negatively correlated with QoL (r = -0.572, p < 0.01) and positively with psychological distress (r = 0.481, p < 0.001). Happiness level correlated with QoL (r = 0.652) and inversely with CRF (r = -0.528). CONCLUSIONS: CRF significantly impairs quality of life and psychological well-being in Taiwanese breast cancer patients during adjuvant therapy. To improve survivorship outcomes, routine CRF screening integrated with psychosocial care should be prioritized in oncology nursing practice, and multidisciplinary supportive care should be implemented as part of comprehensive oncology services.
Self-regulation in patients with cancer-related lymphedema: A concept analysis.
Takagai J, Kanda K
Eur J Oncol Nurs · 2026 Apr · PMID 41653559 · Publisher ↗
PURPOSE: Although sustained self-management behaviors are important for improving or preventing the worsening of cancer-related lymphedema (CRL), the definition of self-regulation, a core element of self-management behav...
PURPOSE: Although sustained self-management behaviors are important for improving or preventing the worsening of cancer-related lymphedema (CRL), the definition of self-regulation, a core element of self-management behavior, remains unclear. These findings provide a foundation for the development of self-management behavior measurement scales, research advancements, and the development of effective interventions. This study aimed to define the concept of self-regulation in patients with CRL. METHODS: Walker and Avant's eight-step concept analysis method was used to clarify the attributes, antecedents, and consequences of self-regulation in patients with CRL. Literature searches were conducted using PubMed, CINAHL, Scopus, and Ichushi-Web (Japan Medical Abstracts Society Database). Related articles were searched using the search terms self-management, self-care, lymphedema, and self-regulation. RESULTS: The attributes defining self-regulation in patients with CRL were Motivational and emotional internal regulation, utilization of social resources, self-monitoring, Adjusting self-management behaviors, and Integrating self-management behaviors. Antecedents were the presence of emotional motivation and goals, Acceptance of lymphedema as a chronic condition, recognition of the necessity for self-management, understanding of self-management strategies and their effectiveness. The consequences were gaining a sense of control, symptom control, and life reconstruction and stabilization. CONCLUSION: This concept analysis clarifies self-regulation in patients with CRL and provides a theoretical foundation for the development of measurement tools and support strategies that reflect the continuity of self-management behaviors. The findings may facilitate future research and interventions aimed at improving the quality of life of patients with CRL.
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