Effects of a web-based decision aid on breast cancer patients considering a breast reconstruction: a randomized controlled trial

PURPOSE

Due to the variety of surgical methods, breast cancer patients may face dilemmas regarding decision-making. Web-based decision aids (WDAs) are interactive tools that help patients make informed decisions by meeting their needs both inside and outside the hospital, providing real-time decision assistance, and being more practical and convenient. Although the incidence of breast cancer ranks first among female cancers in China, studies focusing specifically on the use of WDAs in breast cancer patients have not been conducted in the country. The objective of this study was to determine the effects of WDAs on breast cancer patients considering a breast reconstruction.

METHODS

A total of 70 patients with breast cancer were randomized, with 63 completing the whole trial. The control group used paper-based decision aids, which they could use freely in the ward to obtain health information support. The intervention group used web-based decision aids, including decision assessment, decision support, and decision evaluation, which they could use anytime and anywhere on their mobile phones. The study measured decision conflict, preferred decision-making roles, unmet needs, and decision satisfaction at baseline and before and after the intervention.

RESULTS

No differences were found in the demographic and clinical features between the two groups. Compared with the control group, the intervention group had lower scores for the dimensions of decision support and decision effectiveness, decision uncertainty, total score of decision conflict and information needs, work and financial needs, access and continuity of care, coping, sharing and emotional needs, and total score of unmet information needs (P all < 0.05). Patients in the intervention group had a higher proportion of active and collaborative roles, higher scores in the information, deliberation, decision, and global satisfaction and confidence dimensions, and a higher total score for decision satisfaction (P all < 0.05).

CONCLUSION

WDAs are a convenient tool for promoting collaborative decision making, satisfying information needs, reducing decision conflict, and improving decision satisfaction. In addition, the development of WDAs avoids the limitations of region and time, and provides sufficient knowledge for patients to improve their medical experience.

TRIAL REGISTRATION

Registration Number: ChiCTR2400092924 Dated: 26.11.2024.

Influence of Digital Competence on Participation and Retention of Patients with Advanced Cancer and Their Family Caregivers in a Randomized Controlled Trial with an e-Health Component: Findings from the DIAdIC Trial

Background: e-Health programs to empower patients with advanced cancer and their family caregivers can improve their quality of life. Successful engagement with e-Health programs requires digital competence. People with lower digital competence might be less likely to participate and complete e-Health trials, affecting trial validity. The objective of this work was to explore how digital competences differ between individuals according to sociodemographic characteristics and how it influences participation and retention in a trial with an e-Health component. Methods: We analyzed data collected as part of the Dyadic Psychoeducational Interventions for patients with advanced cancer and their Informal Caregivers DIAdIC (DIAdIC) trial, in which a psychoeducational web and face-to-face program for patients with advanced cancer and their family caregivers were developed and tested. Recruitment log files were quantitatively assessed for nonparticipation reasons. Descriptive statistics outlined sociodemographic factors and digital competence. Multivariable linear regressions assessed digital competence. We reported unstandardized coefficients, 95% confidence intervals, and p-values. Logistic regressions examined retention rates. We reported odds ratios and 95% confidence intervals. Results: Among those refusing participation in the trial (N = 1752), 2.1% (n = 37) cited information and communication technology (ICT)-related factors. Enrolled patients reported lower digital competence than family caregivers (mean 3.07, SD 0.94 vs. 3.17, SD 0.090; p = 0.046). While digital competence varied by sociodemographic characteristics of patients and their family caregivers, digital competence did not significantly predict dropout. Conclusion: ICT-related factors were rarely mentioned as a reason for nonparticipation. Digital competence is associated with sex, age, trial location, educational attainment, and perception of income. e-Health-related factors or digital competence are no reasons for nonparticipation in studies with an e-Health component.

Strengthening Cancer Nursing Workforce to Overcome Inequities in Cancer Care for People Living in Remote, Border, and Outer Island Areas of Indonesia

OBJECTIVES

Promoting equitable cancer care is a tremendous challenge in Indonesia. This report highlights the Indonesian government's efforts to establish equitable cancer care service for people living in remote, border, and outer island areas in Indonesia and the aspects of cancer nursing workforce that support the agenda.

METHODS

This opinion paper integrates the critical aspects of cancer nurses' strengthening into the Indonesian government's policy on equitable cancer care. Insights were drawn from the situational analysis of the cancer nursing workforce and 1-year evaluation of the national cancer care referral network program. The program will enable every regency/city, including those in the remote areas of Indonesia, to deliver specialist cancer care.

RESULTS

A significant expansion of cancer care services that also cover remote areas requires strengthening the local cancer nursing workforce. Nurses should be equipped with extra capacities in terms of clinical competencies, professional competencies, communication skills, cultural awareness, and community engagement skills to effectively serve people in remote areas.

CONCLUSIONS

Overcoming inequities in cancer care requires comprehensive policies and programs, with strengthening the nursing workforce as one of the foundational pillars.

IMPLICATIONS FOR NURSING PRACTICE

Cancer nurses working in remote areas should seize the educational opportunities coming from the national cancer care program. On the other hand, cancer nurses from more developed regions in Indonesia should also play an active role as preceptors to those in the least developed regions.

Cancer Symptom Clusters in Children and Adolescents with Cancer Undergoing Chemotherapy: A Systematic Review

Objective: To synthesize and analyze the prevalence, composition, longitudinal stability, and predictors of cancer symptom clusters in children and adolescents undergoing chemotherapy. Method: A systematic literature review was conducted in accordance with the PRISMA 2020 guidelines. Evidence was sourced from MEDLINE/PubMed, Cochrane Library, Embase, PsycINFO, and Web of Science, as well as clinical trial registries (Clinical Trials WHO-ICTRP) and gray literature. The search was performed in February 2025, with no restrictions on publication date or language. Two independent reviewers screened and selected the studies. The methodological quality of the included studies was assessed using design-specific tools, and the findings were synthesized narratively. Results: A total of 6221 records were identified, with 12 studies meeting the inclusion criteria. These studies were published between 2010 and 2024 in the United States, Brazil, China, and Turkey. Cancer symptom clusters in children and adolescents followed well-defined patterns, with the gastrointestinal, emotional, fatigue-related, somatic, and self-image clusters being the most prevalent. Conclusions: Early identification of these cancer symptom clusters is essential for guiding interprofessional teams in delivering personalized, evidence-based care to children and adolescents with cancer and their families.

Advances in mRNA vaccine therapy for breast cancer research

Breast cancer represents the most prevalent cancer among women globally, constituting approximately 30% of newly diagnosed female malignancies and serving as the second leading cause of cancer-related mortality, accounting for 11.6% of deaths. Despite notable advancements in survival rates and quality of life for breast cancer patients over recent decades-achieved through interventions such as surgery, chemotherapy, radiotherapy, and endocrine therapy-there remains an urgent need for novel therapeutic strategies. This necessity arises from challenges associated with recurrence, metastasis, and drug resistance. The COVID-19 pandemic has accelerated the development of Messenger RNA (mRNA) vaccines at an unprecedented pace, and as a novel form of precision immunotherapy, mRNA vaccines are increasingly being recognized for their potential in cancer treatment. mRNA vaccines efficiently produce antigens within the cytoplasm, specifically activating the immune system to target tumor cells while minimizing the risk of T-cell tolerance. Therefore, mRNA vaccines have emerged as a promising approach in cancer immunotherapy. This review systematically examines the principles, mechanisms, advantages, key targets, and recent progress in mRNA vaccine therapy for breast cancer. Furthermore, it discusses current challenges and suggests potential directions for future research.

Nursing Research Capacity-Building Programmes in AcuteCare Hospitals: A Scoping Review

BACKGROUND

Research and evidence-based practice in nursing have a direct impact on the quality of care to patients. Its enactment in daily practice remains challenging, with nurses' insufficient research capacity and capability being one challenge, and the limited current state of knowledge another.

AIM

To map the knowledge landscape around capacity-building programmes aiming to increase evidence-based nursing practice and research activity in acutecare hospitals.

DESIGN

Scoping review using Joanna Briggs Institute methodology and PRISMA-ScR reporting guidelines.

METHOD

Articles from 2013 to 2023 were searched on PubMed, CINAHL, Medline/OVID, Cochrane Library, PsycINFO, Scopus and Web of Science. Two researchers screened their eligibility independently. To be eligible, studies needed to focus on nursing/midwifery in acute care settings, address research capacity-building practices and be either an empirical, review or theoretical publication. Data were extracted in a structured format and synthesised narratively.

RESULTS

Twenty-four articles were included, consisting of 12 empirical, 6 reviews and 6 non-data-based articles. Our analysis identified two dimensions of research capacity: (1) individual research capability and (2) organisational research capacity, each influenced by various determinants. Findings suggest that four key elements are required to build a research capacity programme: (1) context assessment, (2) multilevel leadership and management engagement, (3) programme tailored to context and (4) clear outcome indicators. We found nursing research capacity programmes lacked clear definitions and a consensus on a conceptual framework.

CONCLUSION

This review systematically synthesised the knowledge landscape on nursing research capacity building programmes in acute care hospitals, bringing clarity regarding concepts, dimensions, determinants and structural key elements.

IMPACT

The conceptual model developed through this review encourages comprehensive and comparable research capacity-building programmes, which can accelerate enhancement of research skills, literacy, activities and evidence-based practice among nurses, thereby improving quality of care and patient outcomes.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

"Your whole life is turned upside down": a reflexive thematic analysis identifying recommendations for designing and conducting qualitative research with cancer caregivers

PURPOSE

There is an increasing need to improve access to person-centered support for cancer caregivers. Qualitative research methods can gather rich insights into the lived experiences of cancer caregivers, providing important information about their unique needs, preferences, and experiences in accessing support for themselves.

METHODS

This secondary analysis of a qualitative interview study with cancer caregivers aimed to understand how the design and conduct of interviews can be optimized to center caregivers' voices and lived experiences. Data from 20 semi-structured interviews with cancer caregivers were analyzed using reflexive thematic analysis to explore underlying patterns in how the interviews were conducted and how caregivers shared their needs and experiences.

RESULTS

Three themes were developed: (1) cancer caregivers' health and wellbeing was inherently linked to the survivor's health and wellbeing, (2) question wording and design can perpetuate the "patient focus" that cancer caregivers experience in other settings, and (3) participating in qualitative research can be a meaningful experience for caregivers and provide an avenue to connect them with community-based support.

CONCLUSIONS

Researchers should include interview questions which explore dyadic interactions between caregivers and survivors, as well as caregivers' individual experiences. Practicing reflexivity can increase researchers' awareness of implicit biases that inform the design and conduct of their research, such as questions that inadvertently shift the focus to the patient rather than the caregiver. Finally, with deeply personal information often disclosed during qualitative interviews, researchers should be equipped to respond with empathy and connect caregivers to professional support as needed.

Prevalence and incidence of falls in older adults with cancer: a systematic review with meta-analysis

PURPOSE

To determine the prevalence and incidence of falls and fall-related injuries in community-dwelling older adults with a diagnosis of cancer and examine whether falls prevalence varies with specific cancer characteristics.

METHODS

A systematic search of five databases was conducted. Studies that included community-dwelling adults with a mean age ≥ 60 years with a current or past diagnosis of cancer and that reported data on the prevalence and/or incidence of falls and/or fall-related injuries were included. Prevalence and incidence rates of falls were pooled for meta-analysis, and meta-regression was used to investigate associations between cancer characteristics (e.g. cancer type and cancer treatment received) and prevalence of falls.

RESULTS

Fifty-seven studies with sample sizes ranging from 51-146,959 participants were included. The pooled prevalence of older adults with cancer who fell in the last 6 months (25%; 95% CI 19%, 32%) and 12 months (29%; 95% CI 24%, 34%) was similar. Subgroup analysis showed that the pooled prevalence of falls for older adults with breast cancer was higher (26%; 95% CI 22%, 30%) compared to those with prostate (14%; 95% CI 9%, 20%) or colorectal cancer (13%; 95% CI 11%, 16%).

CONCLUSIONS

The overall prevalence of falls amongst community-dwelling older adults with cancer is relatively similar compared to the general older adult population, noting that fall events may have been under-reported.

IMPLICATIONS FOR CANCER SURVIVORS

Falls are common amongst older adults with cancer, but the link between cancer characteristics and exposure to falls risk requires further investigation to better understand the risk factors specific to cancer survivors.

The relationship between suffering, loneliness, social interaction, and perceived symptoms in advanced cancer patients

PURPOSE

Understanding how different factors contribute to suffering, particularly social ones, enables designing more comprehensive and evidence-based interventions. This study examined the relationship between suffering, loneliness, social interaction, and symptom distress in patients with advanced cancer.

METHODOLOGY

The authors conducted a quantitative, observational, analytical cross-sectional study. Patients with advanced cancer attending a pain and palliative care unit of an oncology institution participated. Assessment instruments included PRISM (suffering), the UCLA Loneliness Scale, the Edmonton Symptom Assessment Questionnaire, and Cohen's Social Network Index (SNI). Univariate, bivariate, and multiple regression analyses were performed.

RESULTS

One-hundred forty-four patients participated, mostly women (68.1%), with a median age of 62 years, and 48.6% lived with a partner. About 75% reported moderate to severe suffering, 33% had clinically significant loneliness, and half reported a large social network and frequent interactions. Fatigue as the most common problem and well-being had a median score of 5. Suffering was significantly correlated with loneliness, pain, fatigue, depression, and anxiety, but not with levels of social interaction. According to the Multiple Regression Analysis, only loneliness showed a positive and significant contribution to suffering.

CONCLUSIONS

A high percentage of patients show significant suffering, and almost a third show clinical levels of loneliness. This contrasts with a relatively large social network with frequent interactions and a generally low symptomatic burden. Our findings indicate that loneliness influences the experience of illness, contributing to suffering. Future studies should delve deeper into the relationship between suffering and loneliness.

The Association Between Vulnerability and Taste Changes in Older Cancer Patients Undergoing Chemotherapy

This study aimed to examine the association between taste changes and vulnerability in elderly cancer patients undergoing chemotherapy. A cross-sectional study was conducted among older cancer patients undergoing chemotherapy in Wuxi, China. The Chemotherapy-induced Taste Alteration Scale (CiTAS) was used to measure taste alteration. The Vulnerable Elders Survey (VES) was used to measure vulnerability status. The univariate, correlation, and hierarchical regression analyses were applied to assess the association between taste changes and vulnerability. Of 200 older cancer patients, 123 (61.5%) participants were non-vulnerable. The univariate analysis revealed significant distribution differences of vulnerability in education level, smell abnormalities, drinking history, chemotherapy cycle, and taste changes. The level of taste changes was positively correlated with vulnerability (r = 0.401, p < 0.01). Results of the regression analysis indicated that vulnerability in older cancer patients was significantly associated with higher odds of "phantogeusia and parageusia" (OR = 4.505, p < 0.001). Taste changes may be an important influencing factor of vulnerability in older cancer patients.

Quality cancer survivorship care: a modified Delphi study to define nurse capabilities

PURPOSE

To establish capabilities required by nurses to deliver quality cancer survivorship care in Australia.

METHODS

A two-round online modified Delphi involving Australian cancer nurses. Initial domains and capability statements were based on the Quality of Cancer Survivorship Care Framework and supplemented by national and international nursing frameworks. In Round 1 (R1), experts categorised the applicability of 53 capabilities for cancer nurses, across eight domains, in relation to Australian National Professional Development Framework for Cancer Nursing (EdCaN) groups: 'All', 'Many', 'Some', and 'Few' nurses, or not relevant. In Round 2 (R2), experts rated agreement with capabilities allocated to the nurse groups. A priori consensus was set at ≥ 80%.

RESULTS

Surveys were distributed to 51 experts, with a response rate of 92% (47/51) for R1 and 75% (38/51) for R2. Following R1, ten capabilities were added, resulting in 63 capabilities for R2 to establish consensus allocation to EdCaN groupings. Fifty-seven capabilities reached consensus; four capabilities were moved from 'many' to 'some' nurses; one capability was moved from 'some' to 'few' nurses; and one capability was retained in 'all' nurses following Delphi feedback and research team discussion.

CONCLUSIONS

Sixty-three capabilities across eight cancer survivorship care domains were identified and allocated to different nursing groupings. This study provides important foundational work by identifying the capabilities of cancer nurses to deliver quality cancer survivorship care in Australia.

IMPLICATIONS FOR CANCER SURVIVORS

The identification of clearly defined capabilities may improve the quality of cancer survivorship care through the enrichment and standardisation of educational curricula and continuing professional education, and through improved workforce planning.

Inequities and Inequalities Affecting Cancer Nursing Care for Adults in Afghanistan: "Many Patients Have Given Up Hope"

OBJECTIVES

Afghanistan is one of the poorest countries in the world, beset by decades of war. The aim of this opinion paper is to highlight the intersecting factors that contribute to inequity and inequality in cancer care in Afghanistan with a focus on nursing.

METHODS

An environmental scan was carried out for multiple sources of information collection including relevant literature, global organization reports and reflections from two senior nurses working in cancer services in Kabul. Thematic analysis of the data was undertaken. Attainable actions for supporting cancer care and cancer nursing, are proposed.

RESULTS

Cancer nursing is in a dire state reflecting the political instability in the country, exacerbated by a collapsed economy, limited investment in health services, gender apartheid, educational restrictions and the environment. Of the nurses still in employment, many desire to migrate to high-income countries, primarily for their safety. Currently, the large support that the World Health Organization, relevant non-governmental organizations, donors and international nursing organizations offer, often falls short of improving health equity.

CONCLUSIONS

Many inequities in cancer care in Afghanistan are revealed, negatively affecting access to care, treatment options and ultimately, outcomes for people with cancer. Approaches to improve cancer care and services, are proposed.

IMPLICATIONS FOR NURSING PRACTICE

Nurses globally can support colleagues in Afghanistan by listening to their needs, providing tailored educational opportunities, and advocating for change to challenging working conditions. Additional financial, humanitarian and cancer control support from international agencies, led and informed by Afghanistan healthcare professionals and policy makers, is urgently needed.

The effect of unmet needs on the health-related Quality of life of family caregivers of cancer patients in South Korea

This study was conducted to explore the unmet needs and health-related quality of life (QOL) of family caregivers who support cancer patients, and to determine the impact of these unmet needs on their health-related QOL. A descriptive study was conducted from July 1 to July 30, 2023, in which a survey was administered to 129 family caregivers of cancer patients undergoing outpatient treatment at a general hospital of South Korea. The effect of unmet needs on health-related QOL was analyzed using stepwise multiple regression analysis, while controlling for covariates such as the general characteristics of the participants. Stepwise multiple regression analysis revealed that unmet needs significantly impacted health-related QOL. The final regression model explained a substantial portion of the variance in health-related QOL, with an R-squared value of.466 (46.6%). Unmet needs of health and psychological problems (β = -.37) as well as religious/spiritual support (β = -.20) had a significant independent effect on the health-related QOL of family caregivers of cancer patients. Additionally, the health-related QOL of caregivers was significantly better when they did not live with the patient (β = .29) and when they had higher income levels (β = .18) for incomes between 300-500 million won, and β = .29 for incomes of 500 million won or more, compared to those earning less than 100 million won). The health-related QOL of family caregivers for cancer patients can be adversely affected by unmet needs, including health and psychological problems as well as religious and spiritual support. It is therefore necessary to develop and implement support programs or systems that promote physical, psychological, and spiritual health for these caregivers.

Tailoring information for adults over 50 living with cancer in the age of social media: A systematic review

BACKGROUND

Cancer often requires patients to make swift, informed, treatment decisions. Despite their engagement with healthcare providers and digital resources, cancer patients over 50 often experience high levels of unmet information needs during these critical times. However, there is a lack of evidence-based information on their supportive-care information needs.

OBJECTIVE

To examine cancer patients' (aged 50 +) information and health literacy needs and their motivations for using social media (i.e Twitter/X, Facebook, YouTube and Instagram) during decision-making.

METHODS

A systematic literature review, following the PRISMA guidelines, was conducted using electronic databases (Scopus, Web of Science and PubMed/MEDLINE) and grey literature. All original articles published from January 2002 to October 2023 were extracted and analysed within COVIDENCE and NVIVO14 for themes following narrative and tabular analysis. Risk of bias was assessed using the Newcastle-Ottawa Quality Assessment scale.

RESULTS

Of 761 articles identified, six were included. Patients' health literacy was determined to be moderate to low. At decision-making points, cancer patients over 50 needed personalised, supportive and disease-related information. They preferred holistically tailored information and were satisfied with how their doctors met their needs. Complimentary therapies and dietary recommendations were well received by patients of Chinese, Vietnamese, and Australian backgrounds. Patients over 50 accessed social media throughout their cancer. Although useful for obtaining support and information, social media raised patients' concern around misinformation.

CONCLUSION

Our findings highlight the importance of meeting the information needs of cancer patients over 50 and incorporating a holistic approach to information delivery. Social media sites targeting consumers can be useful tools for healthcare institutions to supply accurate, user-friendly information.

TRIAL REGISTRATION

PROSPERO registration number - CRD42022358710.

Impact of COVID-19 on place of death for disease-related causes: a population-based study in Nanchang, China

Little is known about the place of death at the regional level in China. Furthermore, the impact of COVID-19 on the place of death remains unclear. We aimed to examine the place of death before and during COVID-19 in Nanchang, China, focusing on changes in home death across different causes, to determine whether these changes were disproportionately experienced among patients with different diseases. Using data from the National Death Registration System, Nanchang, China, this population-based, observational study examined all non-accidental deaths from 1 January 2014 to 31 December 2019 (pre-COVID-19), and 25 January 2020 to 31 December 2022 (during COVID-19). Modified Poisson regression models were employed to assess the association between underlying cause of death and home death, and interaction terms added to evaluate changes over periods. We used R version 4.2.2 for all analyses. The analysis included 198,383 deaths, with a median age of 78 years (IQR: 66-85); 58.2% were male and 41.8% were female. Home deaths rose from 72.7% pre-COVID-19 to 75.6% during COVID-19 (p < 0.0007). Before COVID-19, patients with renal failure (adjusted PR 0.74 [95% CI, 0.67-0.81]), liver disease (0.81 [0.76-0.86]), and hematological cancer (0.88 [0.84-0.92]) were less likely to die at home compared to those with solid cancer. During COVID-19, these disparities diminished, with a significant increase in home deaths among renal failure (1.32 [1.19-1.48]), liver disease (1.19 [1.10-1.29]), and hematological cancer (1.12 [1.05-1.20]). The majority of non-accidental deaths occurred at home, with a notable rise during COVID-19, underscoring the urgent need to strengthen community- and home-based end-of-life care services. Although home death rates for patients with renal failure, liver disease, and hematological cancer were lower before COVID-19, they increased significantly during the pandemic, highlighting disparities in end-of-life care that necessitate targeted improvements.

Information Needs and Attributes of Breast Cancer Radiotherapy Patients Based on the Kano Model: A Cross-Sectional Study

BACKGROUND

Identifying the core information needs of breast cancer radiotherapy patients serves as the foundation for delivering targeted information services. The Kano model, a qualitative tool for classifying service needs, is increasingly being employed to prioritise patient needs and enhance healthcare quality.

OBJECTIVE

This study aims to examine the informational needs of breast cancer patients undergoing radiotherapy using the Kano model as the analytical framework.

METHODS

Between October 2024 and February 2025, 260 patients with breast cancer undergoing radiotherapy were recruited as study participants. A cross-sectional survey was conducted using the Information Needs Questionnaire. Kano analysis was applied to identify and assess the information needs of these patients. This study adhered to the STROBE guidelines.

RESULTS

Among the 36 items analysed, 15 items (41.7%) were classified as one-dimensional attributes, primarily related to adverse reaction identification and self-management information. 11 items (30.5%) were identified as attractive attributes, mainly concerning the impact of radiation therapy and social-emotional needs five items (13.9%) were must-be attributes, focusing on basic radiotherapy information. Five items (13.9%) were indifference attributes, including the impact of radiotherapy on breast reconstruction, and guidance on image-related concerns during radiotherapy. The quadrant chart findings revealed that 15 needs were predominant in Area I, five in Improving Area II, five in Secondary Improving Area III and 11 in Reserving Area IV.

CONCLUSION

The information needs of breast cancer radiotherapy patients are diverse. Kano model analysis aids medical staff in developing health guidance and meeting patients' informational needs.

RELEVANCE TO CLINICAL PRACTICE

Understanding the differentiated informational needs of patients with breast cancer undergoing radiotherapy provides valuable insights for developing targeted educational interventions, ultimately improving patient engagement and outcomes.

PATIENT OR PUBLIC CONTRIBUTION

The contributions of patients/members of the public were limited solely to data collection.

The lived experience of therapeutic intimacy among Filipino palliative care nurses

BACKGROUND

Therapeutic intimacy is a cornerstone of palliative care nursing, requiring nurses to balance emotional connection and professional boundaries. Filipino palliative care nurses, influenced by their collectivist cultural values, offer unique perspectives on this phenomenon.

METHODS

A phenomenological design employed using a adopted and validated semi-structured interviews were conducted and analysed using Colaizzi's method.

FINDINGS

Among the 12 participating Filipino palliative care nurses, four themes emerged: (1) building therapeutic relationships, emphasising trust and holistic care; (2) navigating emotional and ethical complexities, highlighting challenges in balancing compassion and professionalism; (3) personal and professional growth, showcasing enhanced emotional resilience and fulfillment; and (4) cultural foundations in care, reflecting the role of Filipino values in caregiving. Nurses stressed the importance of trust, holistic care and familial bonds, while also confronting challenges, such as burnout and ethical conflict. The findings underscore the interplay of empathy, cultural values and reflective practice in shaping therapeutic care.

CONCLUSION

This study demonstrates that therapeutic intimacy-rooted in trust, holistic care and reflective practice-significantly enriches palliative care by improving patient outcomes and bolstering nurse resilience.

Effect of third-wave cognitive behavioural interventions on biopsychosocial outcomes in people diagnosed with advanced cancer: A systematic review and meta-analysis of randomised controlled trials

OBJECTIVE

People with advanced cancer experience elevated psychological morbidity and poor quality of life (QoL). The role of third-wave cognitive-behavioural therapy (CBT) interventions in addressing these needs has been examined, but not synthesised in a systematic review. The aim of this review is to systematically identify, analyse and review randomised controlled trials (RCTs) which examined the effect of third-wave CBT interventions on biopsychosocial outcomes (e.g., anxiety, pain, QoL) in this population.

METHODS

A systematic search was undertaken on MEDLINE, PsycInfo, CINAHL, Embase and Cochrane CENTRAL. Studies were included if they examined the effect of third-wave CBT interventions on biopsychosocial outcomes in adults living with advanced cancer in RCTs. The Cochrane Risk of Bias tool assessed risk of bias for each study. A random-effects model was fitted to the data and the restricted maximum-likelihood estimator was applied. The standardised mean differences (SMD) between control and experimental groups at short- and long-term follow up were used.

RESULTS

Twelve RCTs with 782 participants were identified. Meta-analyses demonstrated that third-wave CBT interventions were only more effective than comparator groups in the short-term improvement of QoL (SMD = 0.19, 95 % CI [0.00, 0.37], p < 0.05). The results of the 11 other meta-analyses did not reach statistical significance. Eight studies were classified as having unclear risk, and four were classified as high risk of bias.

CONCLUSIONS

Third-wave CBT interventions may be effective in enhancing QoL in people with advanced cancer. However, more rigorous RCTs are needed to establish their efficacy in this population.

Effect of enhanced recovery after radiotherapy (ERAR) on the quality of life in patients with nasopharyngeal carcinoma after radiotherapy: A randomized controlled trial

Nasopharyngeal carcinoma is prevalent in Southern China and Southeast Asia, which is effectively managed through chemoradiotherapy for locoregionally advanced cases (LA-NPC). Despite current guidelines endorsing various rehabilitation regimens for surgery, evidence supporting the benefits of rehabilitation during systemic radiotherapy is scarce. Thus we introduce the Enhanced Recovery After Radiotherapy (ERAR) concept. We enrolled patients with stage III to IVA LA-NPC in this study. The ERAR group received comprehensive interventions encompassing nursing, oral care, psychology support, rehabilitation, nutrition, and skin health throughout their radiotherapy. The standard care group received conventional radiotherapy rehabilitation. Outcomes were evaluated at baseline, the 17th and 33rd radiotherapy sessions. Generalized estimating equations were used to evaluate group by time effects on the outcomes, controlling for key covariates. A total of 104 LA-NPC patients with a mean age of 49.2 ± 10.9 years were enrolled in the study group from August 2021 to September 2023. The ERAR group showed significant improvements in quality of life (P = 0.014), Hospital Anxiety and Depression Scale (HADS) anxiety (P < 0.001), HADS depression (P < 0.001), distress thermometer (P = 0.049), NRS2002 (P = 0.040), weight loss (P < 0.001), and Oral Health Impact Profile-14 (OHIP-14) (P = 0.040) scores outperforming the standard care group at all measured time points. The ERAR protocol significantly mitigates acute radiation-induced toxicities in LA-NPC patients. This study is anticipated to serve as a reference for clinicians and encourage the adoption of a standardized protocol aimed at facilitating rapid recovery post-radiotherapy.

Self-management Behaviors and Associated Factors in Adult Cancer Survivors: An Integrative Review

BACKGROUND

Despite numerous systematic reviews on self-management interventions for cancer survivors, little is known about survivors' daily self-management practices and the influencing factors.

OBJECTIVE

To identify self-management behaviors and related factors among cancer survivors.

METHODS

Six databases were searched for primary quantitative, qualitative, and mixed-methods studies on self-management behaviors in cancer survivors that were published in English-language, peer-reviewed journals between 2012 and July 2022. The methodological quality of the included studies was evaluated using the Mixed Methods Appraisal Tool. The data extracted using a predetermined form were analyzed using qualitative content analysis.

RESULTS

A total of 22 articles were included in the review; the majority were qualitative research, and half had moderate to high quality of evidence. Nine domains of self-management behaviors were identified, namely, physical activity/exercise, diet, emotional management, complementary and alternative medicine, symptom management, religiosity/spirituality, attending regular follow-ups, adjustment of other lifestyles, and medication management. Four categories of factors were associated with self-management behaviors in cancer survivors: (1) personal factors (demographic and psychological), (2) health status, (3) family factors, and (4) healthcare system. However, the relationships between self-management behaviors and these factors were mainly identified from qualitative studies or addressed in single studies.

CONCLUSIONS

Self-management behaviors in cancer survivors are multifaceted. There is an urgent need for quantitative exploration of factors associated with self-management in cancer survivors.

IMPLICATIONS FOR PRACTICE

This review provides nurses with a comprehensive basis for designing self-management support interventions for cancer survivors.

Mediating Role of Evidence-Based Nursing Competence Between Specialist Nurses' Information Literacy and Innovative Behaviour: A Multicentre Cross-Sectional Study

AIM

To investigate the levels of information literacy, evidence-based nursing competence and innovative behaviour in specialist nurses, determine the impact of information literacy and evidence-based nursing competence on the innovative behaviour of specialist nurses and to analyse the mediating role of evidence-based nursing competence between information literacy and innovative behaviour among specialist nurses.

DESIGN

A multicenter cross-sectional design.

METHODS

In March 2024, a survey was conducted on 313 specialist nurses in four tertiary Grade A comprehensive hospitals in China. Data collection involved the utilization of general demographic questionnaire, the Information Literacy Questionnaire, the Evidence-Based Nursing Competence Scale and the Nurse Innovation Behaviour Scale. The data were analysed using IBM SPSS26 and Amos28 software.

RESULTS

Specialist nurses scored above average in information literacy, evidence-based nursing competence and innovative behaviour. Information literacy significantly positively correlated with innovative behaviour. Evidence-based nursing competence also positively affected innovative behaviour and partially mediated the relationship between information literacy and innovative behaviour.

CONCLUSION

This research indicated that specialist nurses exhibited above-average levels of evidence-based nursing competence, information literacy and innovative behaviour. Both information literacy and evidence-based nursing competence positively impacted innovative behaviour, with evidence-based nursing competence playing a significant mediating role between information literacy and innovative behaviour.

IMPACT

The findings suggest that nursing managers should focus on enhancing information literacy and evidence-based nursing competence in specialist nurses. Improving these abilities will support the implementation of innovative practices and advance the nursing field.

REPORTING METHOD

The research findings were presented in strict accordance with the STROBE statement.

PATIENT OR PUBLIC CONTRIBUTION

Not applicable.

CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY

It provides reference guidance and theoretical basis for global nursing managers to formulate targeted interventions, so as to effectively enhance the innovative behaviour of specialist nurses.

Parents care needs with epileptic children: a hybrid model concept analysis

BACKGROUND

The care needs of epileptic children are a multidimensional concept that varies based on the experience and understanding of family caregivers. This study aimed to analyze the concept of parental care needs for children with epilepsy.

METHODS

This study was conducted using the hybrid method in three phases. In the theoretical phase, a systematic literature review was performed. In the fieldwork phase with a qualitative approach, 13 parents caring for epileptic children were investigated with individual and semi-structured interviews at the Besat Teaching-Treatment Center (Hamadan, Iran) in 2024. In the final phase, the concept of parental care needs was defined based on the findings of the theoretical and fieldwork phases.

RESULTS

The common antecedents identified in both the theoretical and fieldwork phases included low education levels and poor economic status. Additionally, the fieldwork phase highlighted the role of ineffective support systems. The common consequences were care quality improvement, financial burden reduction, care knowledge acquisition, and psychosocial status improvement, and the consequence of increasing stability in the family structure appeared in the fieldwork phase. The care needs of epileptic children's parents included comprehensive support, therapeutic needs, and psychological needs, while financial constraints and inadequate care knowledge were identified as major challenges. These needs are influenced by factors such as low socioeconomic status and limited education, and their fulfillment leads to an improved quality of life and more effective disease management.

CONCLUSION

Concentration on parental care needs and provision of appropriate support through education, financial resources, and social support can help reduce psychosocial pressures on families.

Qualitative Findings From a Survey Measuring Informational Needs and Quality of Life of Women Living With Metastatic Breast Cancer

BACKGROUND

People living with metastatic breast cancer (MBC) may have different support requirements to those with early stage breast cancer (EBC). These differences can be substantial, particularly as care pathways and information are often designed around the latter. There is limited understanding of how these discrepancies impact patients with MBC.

AIMS

In the LIMBER study (Living with Metastatic Breast Cancer), we explored the distinct and unmet needs of people living with MBC.

METHODS

In collaboration with people living with MBC and healthcare professionals (HCPs), we developed an online survey comprising fixed and free text responses. Fixed responses and overall study demographics from the main LIMBER study have been published elsewhere. A framework analysis of the free text comments is reported here.

RESULTS

The resulting thematic map has seven main themes - friends and family, reactions of others, healthcare professionals, systems & processes, knowledge & information, outlook & goals and wellbeing. Participants reflected that comments made by friends and family were often well-meaning but showed misunderstanding of the disease. This was particularly noticeable in understanding the difference between MBC and EBC. There were references to the lack of support and information from HCPs.

CONCLUSIONS

The analysis of free text comments from this survey demonstrates the impact that MBC can have, particularly without robust support or accessible information. Understanding areas where patients have outstanding needs provides insight into how best to promote coping strategies and improved quality of life, while informing those who provide informal and formal care.

Knowledge, Attitude, and Practice of Palliative Care Among Physicians and Nurses in Intensive Care Units in Shanghai, China

Purpose

The growing need for palliative care in China's aging population highlights the intensive care unit (ICU) staff's crucial role and need for specialized training and improved knowledge, attitude, and practice (KAP). The study aims to assess the KAP of palliative care ICU physicians and nurses and identify influencing factors.

Patients and Methods

A cross-sectional survey was conducted among ICU physicians and nurses at three Shanghai hospitals. A self-developed structured online questionnaire was used to collect participant characteristics and KAP data related to palliative care. Pathway analysis explored associations among knowledge, attitude, and practice.

Results

Among 203 participants, median scores for knowledge, attitude, and practice were 8/18, 39/50, and 35/45, respectively. Multivariable analysis revealed that 10-15 years (OR=0.06) and >15 years (OR=0.19) of experience in the ICU and the lack of palliative care experience (OR=0.29) were associated with poor knowledge. Positive attitudes (OR=1.22) and palliative care training (OR=3.25) were associated with proactive practice. Knowledge directly impacted attitude (β=0.260; P=0.012) and practice (β=0.320, P<0.001), while attitude directly influenced practice (β=0.278, P<0.001).

Conclusion

The study reveals a low KAP level of palliative care among ICU physicians and nurses in Shanghai. Pathway analysis underscores the crucial role of knowledge in shaping attitudes and practices, emphasizing the urgency of improving knowledge and attitudes toward palliative care among physicians and nurses.

Assessing barriers to adjuvant therapy among patients with head and neck cancer in Arkansas

Advanced head and neck cancer (HNC) requires multimodal treatment and in the setting of primary curative intent surgery, adjuvant radiation with pathology-based chemotherapy is necessary for best outcomes. HNC treatment guidelines and best evidence support adjuvant radiation initiated within 6 weeks of surgery [1]. Over half of HNC patients face obstacles delaying adjuvant therapy, especially in rural areas [2]. This study assesses barriers to timely adjuvant therapy, specifically radiation in a rural tertiary setting. The study conducted was a retrospective mixed-methods analysis. The initial cohort consists of patients referred for adjuvant radiation therapy after curative intent head and neck surgery at a tertiary referral center, University of Arkansas for Medical Sciences, between 2020 and 2022. Demographic and socioeconomic data were collected and analyzed. Inclusion criteria for the study: patients referred for adjuvant therapy facing delays in treatment (> than 6 weeks) or deferring adjuvant treatment altogether. These patients and/or proxies were surveyed via telephone. Contact was made with 28 of the 46 patients meeting inclusion. 7 declined participation; 21 patients completed the survey personally, by proxy, or via family member. Among the respondents, the primary reasons for delaying adjuvant therapy include travel requirements/distance, general medical health, and financial constraints, with travel requirements/distance rated as the highest concern. Numerous obstacles to timely adjuvant therapy exist within our patient population. Understanding these barriers is crucial for improving timely access to adjuvant therapy and ultimately enhancing patient survivorship. Through individualized risk assessment, patient education, and resource management, we anticipate mitigating barriers to adjuvant therapy.

Clinical Implications of the C-Reactive Protein-Albumin Ratio as a Prognostic Marker in Terminally Ill Patients with Cancer

Background: Few studies investigated the clinical implications of C-reactive protein-albumin ratio (CAR) in palliative care. Objectives: To determine the association of CAR with overall survival among terminally ill patients with cance. Design: Datasets were obtained through two multicenter prospective cohort studies. Setting/Subjects: Patients newly referred to palliative care. Measurements: Physicians recorded measures at the baseline. Patients were followed up to their death or observed for 6 months. The patients in cohort 2 were divided using the CAR cutoffs detected using a piecewise linear hazards model in cohort 1. We performed time-to-event analyses using the Kaplan-Meier method and log-rank tests and univariate and multivariate Cox regression analyses for patients in cohort 2. Results: A total of 1554 patients in cohort 1 and 1517 patients in cohort 2 were eligible. The cutoffs were 0.1, 1.2, and 6.4. The patients in cohort 2 were divided into four categories (<0.1 [n = 103], 0.1-1.2 [n = 433], 1.2-6.4 [712], and ≥6.4 [n = 269]). The adjusted p values of the log-rank tests were <0.001. Significantly higher risks of mortality were observed in the Cox proportional hazard model for the higher categories than in the lowest category (CAR 0.1-1.2: adjusted hazard ratio [HR] 1.49, 95% confidence interval [CI] 1.18-1.89; CAR 1.2-6.4: adjusted HR 2.08, 95% CI 1.65-2.62; CAR ≥6.4: adjusted HR 2.94, 95% CI 2.29-3.79). Conclusions: Patients with a higher CAR had significantly higher risks of mortality than those with a lower CAR.

Start With the Body or the Mind? Differential Benefits of Mindfulness and Qigong Practices for Colorectal Cancer Survivors: A Qualitative Study

BACKGROUND

Mindfulness and qigong are 2 distinct forms of mind-body practice that have been well-received by cancer survivors. Although there is evidence supporting the effectiveness of mindfulness or qigong in promoting wellness of cancer survivors, little is known about the differential benefits of these common forms of mind-body practices among survivors.

OBJECTIVE

To compare the potential biopsychosocial-spiritual impacts of mindfulness and Baduanjin (BDJ) qigong on colorectal cancer survivors.

METHODS

Sixty cancer survivors who participated in a mindfulness intervention (n = 38) and BDJ qigong (n = 22) intervention were invited to provide qualitative feedback for their experiences. Content analyses were conducted to identify emerging themes from the data, and χ2 tests were conducted to compare the responses of the mindfulness and BDJ groups in the major categories.

RESULTS

Both practices positively influenced psychosocial wellness. The practice of BDJ qigong led to more prominent improvements in physical well-being, whereas mindfulness worked best in enhancing spiritual growth and intrapersonal connectedness.

CONCLUSIONS

Survivors of colorectal cancer who are looking for ways to enhance their vitality and rejuvenate their physical body may find the practice of BDJ helpful, whereas survivors who are looking for spiritual comfort or growth may consider practicing mindfulness as an entry point toward mind-body unity.

IMPLICATIONS FOR PRACTICE

Mindfulness and BDJ may be helpful for survivors of colorectal cancer to improve their holistic wellness. Oncology nurses can consider prescription of mindfulness and/or BDJ for patients recovering from colorectal cancer.

Prospective Evaluation of Multimodal Prehabilitation in Esophagogastric Cancer Surgery: Enhancing Patient Outcomes

BACKGROUND

The significance of prehabilitation in contemporary esophagogastric surgical procedures is yet to be fully understood, due to heterogeneity in the available research. This research was conducted to assess the impact of a structured home-based multimodal prehabilitation approach on the postsurgical outcomes of patients undergoing surgery for esophagogastric cancer.

METHODS

This study was a prospective, nonrandomized investigation carried out on individuals scheduled for curative esophagogastric cancer surgery. Participants underwent a home-based, multimodal prehabilitation regimen that incorporated structured physical exercises, nutritional support, psychological counseling, and assistance in quitting smoking and alcohol use. The primary outcome measured was the incidence of postoperative pneumonia, defined according to the revised Uniform Pneumonia Scoring system from day 1 to day 4 post-surgery.

RESULTS

A total of 94 patients were analyzed. A total of 50 patients underwent multimodal prehabilitation for a minimum of 2 weeks with a compliance rate of more than 60% and were included in the intervention group, whereas the rest 44 with compliance less than 60% or unwilling to undergo prehabilitation were included in the control group. A statistically significant difference was seen in the incidence of postoperative pneumonia between the two groups.

CONCLUSION

Structured multimodal prehabilitation done for 2 weeks before surgery improves outcomes in patients undergoing esophagogastric cancer surgery.

Palliative nurses' empathic tendencies, quality of life, individualized care perceptions

Background: Palliative care is an important part of health services. The individualized care perceptions are is critical for supporting individuality during care and providing quality nursing care. Individualized care not only has, as well as having foundation of the philosophy of nursing but also, is also related to the nurses' empathic tendencies and professional quality of life of nurses.Aim: This study was conducted to examine the relationships between the empathic tendencies, professional quality of life, and individualized care perceptions of palliative care nurses.Research design: This is a cross-sectional study.Participants and research context: The study was conducted with 141 nurses working in palliative care between December 2023 and February 2024. The data of the study were collected using a "Participant Information Form," the "Emphatic Tendency Scale (ETS)," the "Professional Quality of Life Scale (ProQOL R-IV)," and the "Individualized Care Scale-Nurse Version A (ICS-Nurse-A)."Ethical considerations: Ethics committee approval was obtained to conduct the study. Individuals who agreed to participate in the study were informed of the purpose of the study, and their written consent was obtained.Findings: The participants had moderate levels of empathic tendencies, compassion satisfaction, and burnout, while their compassion fatigue and individualized care perceptions were high. There was a positive correlation between empathic tendencies and individualized care perceptions (p < .01). Empathic tendency and compassion satisfaction were significant positive predictors of the individualized care perceptions of the participants and respectively explained 13% and 20% of the total variance in their individualized care perceptions. On the other hand, burnout was a significant negative predictor of their individualized care perceptions and explained 5% of the total variance in their individualized care perceptions.Conclusions: High levels of empathic tendencies and compassion satisfaction had positive effects on the individualized care perceptions of palliative care nurses, whereas high levels of burnout had a negative effect on the same variable.

Knowledge and health literacy related to human papillomavirus infection, cervical cancer, and cervical cancer screening among nursing students in rural and urban areas of Thailand

BACKGROUND

Cervical cancer is the second leading cause of death among women in Thailand. Understanding health literacy and knowledge of HPV, cervical cancer, and their screening is vital for nursing students as they prepare for professional practice.

OBJECTIVES

To identify factors influencing health literacy and knowledge of HPV infection, cervical cancer, and screening among Thai nursing students at rural and urban universities.

DESIGN

A cross-sectional descriptive comparative study.

PARTICIPANTS/SETTINGS

Current undergraduate nursing students from rural and urban universities in Thailand.

METHODS

A self-administered survey assessed health literacy and knowledge related to HPV infection, cervical cancer, and their screening. Descriptive and logistic regression analyses were used to identify factors associated with these variables.

RESULTS

Among 641 nursing students (255 rural students and 386 urban students), rural students had significantly higher mean scores in cervical cancer screening knowledge (t = -4.86, p < 0.001) and health literacy compared to urban students (t = -2.57, p = 0.01). Rural students using the internet more than three days per week were 1.92 times more likely to have better knowledge of HPV and cervical cancer (95 % CI: 1.10-7.73). Awareness of HPV (ORa = 2.51, 95 % CI: 1.31-4.80) and frequent internet use (ORa = 2.31, 95 % CI: 1.04-5.12) were associated with higher knowledge about cervical cancer screening and health literacy among rural nursing students.

CONCLUSIONS

Rural students exhibit higher health literacy and knowledge about cervical cancer screening than urban students. These findings highlight the need for diverse teaching strategies to enhance students' understanding and competency.

Mediating Role of Psychological Status in the Association Between Resiliency and Quality of Life Among Older Malaysians Living with Knee Osteoarthritis

Resilience increases the ability of an individual to overcome adversity. It has not yet been determined how resilience is linked to quality of life among individuals experiencing knee osteoarthritis symptoms. To explore the inter-relationships of psychological distress, resilience and quality of life among older individuals with knee osteoarthritis. The study examined older adults in Kuala Lumpur and Selangor, identifying osteoarthritis through verified physician diagnosis. Various factors, including resilience, psychological status, and quality of life, were measured. In the study with 338 older adults, 50.9% had knee osteoarthritis. Higher resilience was linked to lower depression, anxiety, and stress, and better quality of life in both groups with and without knee osteoarthritis. Psychological factors consistently mediated the link between resilience and quality of life even after controlling potential confounders. Analysis showed that depression, anxiety, and stress mediate the relationship between resilience and quality of life, indicating a significant influence even when considering various factors. Resilience appears to influence psychological well-being and quality of life among older adult with knee osteoarthritis.

The Multidisciplinary Team in Head and Neck Cancer Reconstruction: A Reference Manual for the Plastic Surgeon

Head and neck cancers (HNCs) require a multidisciplinary team (MDT) approach to address their complex functional, aesthetic, and psychological impacts. This manuscript highlights the central role of plastic surgeons in the MDT, emphasizing their collaboration with other MDT members to align aesthetic and functional surgical outcomes with oncologic and rehabilitative goals. Our intention is for this to be used as a practical guide for plastic surgeons detailing the roles of key MDT members and their contributions across the preoperative, intraoperative, and postoperative phases. We will also highlight how MDTs improve survival, functional outcomes, and quality of life for HNC patients.

Interventions in the Sexuality of Men With Stomas: A Scoping Review

AIMS

To map interventions in the sexuality of men with stomas.

DESIGN

Scoping review, following JBI and PRISMA-ScR guidelines to report results.

METHODS

Databases consulted were PubMed, via National Library of Medicine, Latin American and Caribbean Health Sciences Literature, Web of Science, Scopus, Embase, Scientific Electronic Library Online, Brazilian Electronic Library of Thesis and Dissertations, CAPES Catalogue of Thesis and Dissertations and Open Access Scientific Repository of Portugal. Texts were read by independent reviewers, with no time or language restrictions.

RESULTS

The final sample included 10 studies. Data were synthesised and grouped for its similarity to approach models, preoperative orientations, self-care promotion, collecting pouch hygiene and safety, sexual health discussion and education, construction of bonds and sexual function evaluation.

CONCLUSION

Interventions in the sexuality of men with stomas included adherence to models for approaching sexuality, focusing on the permission and coparticipation of the patient, open conversations on the topic, self-care promotion, collecting pouch hygiene and safety, encouragement to the creation of bonds, sexual function evaluation in pre- and postoperative periods and individual and/or collective sexual health education.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

This study contributes to the sexuality of men with stomas. It identified recommendations to approach and conduct the topic at hand, addressing the rehabilitation process since the surgery to place the stoma is considered.

IMPACT (ADDRESSING)

This study addressed scientific literature on the sexuality of men with stomas. Most were from Europe and results demonstrated a gap in knowledge. This research will impact the stoma therapy research, affecting teams involved in the care to men with stomas, encouraging reflections on the sexuality of these patients.

REPORTING METHOD

This study complies with the PRISMA-ScR.

PATIENT OR PUBLIC CONTRIBUTION

There was no patient or public contribution.

PROTOCOL REGISTRATION

The protocol of this scoping review was registered in the Open Science Framework, registered under DOI 10.17605/OSF.IO/X9DSC. It can be accessed through the following link: https://osf.io/x9dsc/?view_only=a9c62ef6c11f44499f7b2bfe1fe379f9.

Death Anxiety and Its Influencing Factors Among Family Caregivers of Cancer Patients: A Cross-Sectional Study

BACKGROUND

In China, caregiving for cancer patients is primarily the responsibility of family members. This role often exposes family caregivers to the contemplation of mortality. Death anxiety among family caregivers may influence the care they offer to cancer patients.

OBJECTIVE

This study aims to evaluate the prevailing level of death anxiety among Chinese family caregivers of cancer patients and identify its influencing factors.

DESIGN

This cross-sectional study followed the STROBE statement.

METHODS

A total of 220 family caregivers of cancer patients were recruited from a prominent tertiary hospital in southern China. The survey included a general information questionnaire, the Collett-Lester Fear of Death Scale, the Social Support Rating Scale and the Simple Coping Style Questionnaire. In addition to descriptive statistics, ANOVA, mean differences, correlations and regression analyses were computed.

RESULTS

The average score for death anxiety among family caregivers of cancer patients was 104.27 ± 21.02. Death anxiety was negatively correlated with a positive coping style and social support. Multiple linear regression analysis revealed that marital status, death education, patients' fear of death and coping style accounted for 41.0% of the variance in death anxiety among family caregivers.

CONCLUSIONS

Family caregivers of cancer patients experienced a moderate level of death anxiety. Individuals who were unmarried or divorced, lacked death education, had negative coping styles or cared for patients with fear of death tended to have high levels of death anxiety.

RELEVANCE TO CLINICAL PRACTICE

Healthcare providers should act as credible educators to reduce caregivers' death anxiety by imparting positive coping styles and accurate knowledge and values about death so caregivers can provide high-quality care to patients.

Exploring Patient Experiences With and Perceptions of Robotic-Assisted Surgery in Denmark

Although the use of robotic-assisted surgery (RAS) is increasing worldwide, qualitative research on the patient experience with RAS is lacking. To understand patients' perioperative experiences, the authors conducted semi-structured interviews with five elective surgical patients from two regional hospitals. The interviews were structured to explore patient experiences that may reflect the implementation of enhanced recovery after surgery protocols. The transcribed interviews were analyzed, coded, and interpreted within a hermeneutic framework. Findings revealed three themes: perceptions of RAS as a surgical modality, preoperative preparation was soothing, and health care professionals influence the patient experience. The authors noted that although the participants reported limited knowledge of RAS, they generally felt positive about its use. The competence and demeanor of health care professionals may influence patients' experiences and perceptions of outcomes, and positive clinical outcomes may overcome negative perioperative experiences.

The Effects of Workplace Spirituality and Self-Efficacy on Quality of Life Among Cancer Survivors: Empirical Quantitative Research

AIMS

To investigate the impact of workplace spirituality and self-efficacy (SE) on cancer survivors' quality of life (QOL) and develop nursing interventions.

DESIGN

Descriptive survey.

METHODS

Participants were cancer survivors treated at Chung-Ang hospital in Seoul. They were administered a questionnaire covering general and clinical characteristics, workplace spirituality, SE and QOL. Data were analysed using hierarchical multiple regression analyses.

RESULTS

Workplace spirituality, SE and QOL were positively correlated. Higher education level, work in the health/medical sector, higher monthly income, undetermined cancer stage or not currently undergoing cancer treatment and absence of physical impairments or comorbidities due to cancer influenced QOL. Regression analysis revealed that SE enhanced QOL.

CONCLUSION

Workplace spirituality and SE correlated with QOL. Notably, SE actively enhanced QOL by providing inner strength regardless of the type of treatment or its physical damage.

IMPLICATIONS FOR THE PROFESSION

The findings have practical implications for the development of nursing interventions that aim to boost the confidence and positive assurance of employed cancer survivors in managing their condition and to enhance QOL.

IMPACT

Problem addressed: Understanding the impact of workplace spirituality and SE on cancer survivors' QOL.

MAIN FINDINGS

Positive correlations between workplace spirituality, SE and QOL; SE as a primary determinant of QOL. Impact location and population: Relevant to cancer patients managing treatment and work responsibilities, contributing to improved QOL.

REPORTING METHOD

Adhered to relevant EQUATOR guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No contribution.

TRIAL AND PROTOCOL REGISTRATION

Not applicable.

Factors associated with Intensive care nurses' use of non-pharmacological methods of pain management: A multinomial logistic regression analysis

BACKGROUND

Although there are numerous studies in the literature on the roles, methods used and attitudes of nurses in pain management, the factors related to the use of non-pharmacological methods (NPMs) are not well-documented.

AIM

This research aims to determine the factors related to the use of NPMs by intensive care nurses in Turkey.

STUDY DESIGN

This descriptive and cross-sectional study was conducted with the participation of 385 intensive care unit nurses. Data were collected by using the 'Sociodemographic Data Form', 'Non-Pharmacological Methods Form' and 'Pain Beliefs Questionnaire' (PBQ) between January-December 2022. Multiple multinomial logistic regression analysis was used to identify factors associated with non-pharmacological methods. Pain management was categorized as pharmacological, non-pharmacological and both. The use of pharmacological methods (PMs) was taken as the reference category. The STROBE checklist was adhered to in this study.

RESULTS

It was found that in pain management in the ICU, 33% used pharmacological methods, and 62.1% used both methods. The most frequent barriers experienced in the use of NPMs were 'heavy workload' (82.9%), 'inadequate time' (82.9%) and 'patients being unstable' (69.6%). Receiving pain management training increased the nurses' use of NPMs by 237% compared to pharmacological methods (RRR = 2.377, 95% CI = 1.200-4.707; p = .013). Regarding the barriers to the use of NPMs, 'the lower priority of NPMs compared to emergency practices (RRR=0.333, 95% CI=0.191-0.579; p=.000) and Deficiency in resources (materials and equipment)' (RRR = 0.454, 95% CI = 0.244-0.846; p = .013) decreased the use of NPMs. The Psychological Beliefs subscale of the PBQ increased the use of NPMs (RRR = 2.094, 95% CI = 1.152-3.803; p = .015).

CONCLUSION

Nurses should be provided with training on non-pharmacological methods as well as pharmacological methods in pain management, barriers to the use of non-pharmacological methods should be eliminated and psychological beliefs regarding pain should also be addressed.

RELEVANCE TO CLINICAL PRACTICE

There is a need to solve the problems of lack of education, legal barriers and lack of resources in increasing the use of non-pharmacological pain methods by nurses in intensive care units.

Is the state anxiety level of inpatient children associated with nursing care quality? A cross-sectional study

AIM

The aim of the research was to investigate the predictive effect of nursing care quality perceived by inpatient children aged 9 to 12 on state anxiety levels.

METHODS

The research was conducted with 201 inpatient children. Data were gathered using "The Scale for Evaluating the Quality of Care from Children's Point of View (psychosocial care, physical care, and information)" and "The State Anxiety Inventory for Children."

RESULTS

In the study, statistically significant, negative, and weak correlations were found between the sub-dimension mean scores of psychosocial care, physical care, information, and the mean scores of state anxiety levels. "Information" was found to have a statistically significant and negative predictive effect on state anxiety levels. It was found that the satisfaction of inpatient children with nursing care quality was related to their state anxiety levels, and particularly, the information provided by nurses significantly influenced their state anxiety levels.

CONCLUSION

Therefore, it was concluded that to minimize anxiety during children's hospitalization, nursing care quality should be improved in terms of psychosocial care, physical care, and information provision. Pediatric nurses providing care in the clinic should pay attention to meeting the care needs of children, as satisfying nursing care can reduce their state anxiety levels.

PRACTICE IMPLICATIONS

The study's findings underscore the critical role of nursing care quality in managing anxiety levels among pediatric inpatients. The negative correlations found between psychosocial care, physical care, and information provision with state anxiety levels underscore the significance of a holistic approach and family-centered care in nursing.

Psychometric properties of the caregiver contribution to self-care of oral anticancer agents index: Longitudinal study

BACKGROUND

The use of oral anticancer agents (OAAs) has increased in recent decades. Despite the advantages of OAAs, people with cancer face challenges such as adherence, prevention, recognition, and management of OAA side effects. Informal caregivers can help their patients who take OAAs by facing the above challenges with the implementation of behaviours to maintain stability (Caregiver contribution to self-care maintenance), monitoring (Caregiver contribution to self-care monitoring) and managing (Caregiver contribution to self-care management) the conditions of their patients.

OBJECTIVE

To develop and test the psychometric properties of the Caregiver Contribution to self-care in the Oral Anticancer Agents Index (CC-SCOAAI).

METHODS

A longitudinal study was conducted. Factorial validity was tested using Confirmatory Factor Analysis (CFA). Furthermore, we also tested the internal consistency and validity of the CC-SCOAAI construct. The Mann-Whitney U test was used to demonstrate associations between CC-SCOAAI scores and patient's re-hospitalizations, emergency-room attendances, and mortality.

RESULTS

We enrolled 318 caregivers, mostly female (63.52 %), with an age of <44 (39.94 %) and spouse of the patient (54.66 %). The CFA demonstrated the factorial validity of the CC-SCOAAI. Caregivers of patients with more re-hospitalizations had a lower contribution to self-care maintenance (U = 2933.500; p = .04), while caregivers of patients with more emergency room admissions (U = 1392.500; p < .001) and re-hospitalizations (U = 2385.500; p < .001) had a lower contribution to self-care management. Caregivers of patients with emergency-room admissions (U = 1392.500; p = .005), re-hospitalisations (U = 2322.500; p < .001) and mortality (U = 515.500; p = .001) had lower contribution to self-care monitoring.

CONCLUSIONS

CC-SCOAAI is a valid and reliable tool. Given that caregivers are crucial in supporting these patients, the CC-SCOAAI may help clinicians improve caregiver efficacy and researchers using CC-SCOAAI to determine better self-care outcomes in patients with OAA.

Symptom appraisal and help- seeking before a cancer diagnosis during pregnancy: a qualitative study

BACKGROUND

The estimated incidence of a cancer diagnosis during or shortly after pregnancy is 1 in 1000 pregnancies in England. Pregnancy can have an impact on symptom appraisal and help-seeking for symptoms subsequently diagnosed as cancer. Little is known about the pathway to cancer diagnosis in pregnancy or delays that women can encounter.

AIM

To explore symptom appraisal, help-seeking decisions, and experience of receiving a cancer diagnosis during pregnancy.

DESIGN AND SETTING

Semi-structured interviews were conducted with women diagnosed with cancer during or shortly after pregnancy in the previous 4 years in the UK, recruited between January and May 2022 via the charity Mummy's Star.

METHOD

This study used reflexive thematic analysis of 20 interviews. Analysis was largely inductive and the themes generated were mapped onto the intervals of the Model of Pathways to Treatment.

RESULTS

Symptoms were often interpreted through the lens of pregnancy by both participants and most of the healthcare professionals from whom they sought help. Participants who found breast lumps were likely to suspect cancer and be referred promptly for tests in secondary care. Although most participants sought timely help for their symptoms, some subsequently encountered health system delays, partly owing to both the vague nature of their symptoms and the COVID-19 pandemic.

CONCLUSION

Health services need to better support women presenting with possible cancer symptoms during pregnancy to ensure timely diagnosis. Recommendations include prioritising symptoms over attributing them solely to pregnancy, ensuring timely referrals to rule out serious conditions, and emphasising clear communication alongside robust safety-netting practices. A full assessment is essential before dismissing symptoms as pregnancy related.

Symptom clusters and their impacts on the quality of life of patients with lung cancer receiving immunotherapy: A cross-sectional study

AIM

The objective of this study was to identify symptom clusters in lung cancer patients receiving immunotherapy and explore their impact on the quality of life of patients.

BACKGROUND

Immunotherapy is widely used in lung cancer; however, there is little understanding of symptom clusters and their impacts on the quality of life of this population.

DESIGN

Cross-sectional study.

METHODS

The survey contained the Memorial Symptom Assessment Scale (MSAS), Quality of Life Questionnaire-Lung Cancer 43 and a self-designed General Information Evaluation Form. Symptom clusters were identified using exploratory factor analysis (EFA) based on the symptom scores. Spearman correlation analysis was performed to evaluate the associations between each symptom cluster and the patients' quality of life. Multiple linear regression analysis was employed to examine the impact of the symptom clusters on quality of life. This study adhered to the STROBE guidelines.

RESULTS

In total, 240 participants completed the survey. Five symptom clusters were identified and named according to their characteristics: emotional-related symptom cluster, lung cancer-related symptom cluster, physical symptom cluster, skin symptom cluster and neural symptom cluster. All symptom clusters, except for the neural symptom cluster, had a significantly detrimental impact on patient quality of life.

CONCLUSION

Lung cancer patients undergoing immunotherapy experience a range of symptoms, which can be categorized into five clusters. These symptom clusters have a negative impact on patients' quality of life. Future research should focus on developing interventions for each symptom cluster and their influencing factors.

PATIENT OR PUBLIC CONTRIBUTION

In the data collection phase, lung cancer patients undergoing immunotherapy were recruited to participate in the survey.

The Perspectives of Older People With HIV (OPWH) on Advance Care Planning (ACP): A Qualitative Study in Primary Care Clinics in Kuala Lumpur

Introduction: In Malaysia, delivering advance care planning (ACP) for older people with HIV (OPWH) presents unique challenges, compounded by the country's multiracial and multicultural beliefs. ACP allows OPWH to discuss their future care with practitioners and their appointed proxy, ensuring that future care aligns with their preferences. However, many are still unaware about ACP, and little is known about ACP in OPWH. This study aims to explore the perspectives of OPWH on ACP to tailor ACP deliverance based on their needs and values. Material and methods: Face-to-face in-depth interviews with OPWH, aged 50 years and above, were conducted from March to May 2023 in two primary care clinics in Kuala Lumpur. Data was coded and analyzed using thematic analysis. Results: Seventeen OPWH participated. Four themes emerged: normalization of HIV negates the need for ACP, view on death didacts the relevance of ACP, fear of HIV disclosure and the desire for dedicated ACP service. Some participants perceived HIV as a stable condition and regarded death as less significant than other life priorities, making ACP less favorable. On the contrary, OPWH considered ACP important when they believed that death is better than futile treatment. However, concerns about confidentiality in ACP and limited care options further contributed to their disinterest in ACP. A tailored ACP approach should address these unique challenges to enhance OPWH participation. Conclusion: ACP delivery should provide continuous services tailored to the unique needs of OPWH. Confidentiality must be upheld and communicated to OPWH throughout all ACP engagements.

Bridging the gap: Normalising spiritual care in undergraduate nursing education: A review of qualitative research

AIM

To summarise the qualitative evidence exploring the attitudes and experiences of undergraduate nursing students involving spiritual care.

BACKGROUND

Understanding patients' spiritual needs allows nurses to provide support and comfort during illness and recovery. However, no consensus exists on how to teach and deliver spiritual care in the undergraduate nursing curriculum.

DESIGN

A review of qualitative research METHODS: Systematic database searches included CINAHL Plus with full text, EMBASE, PubMed and Medline. The review was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The reviewers independently conducted study selection, quality appraisal and data extraction. The included studies were appraised using the Critical Appraisal Skills Programme tool. Thematic analysis guided by Thomas and Harden was used.

RESULTS

Twelve papers were included in this review. Thematic analysis revealed three overarching themes: (1) a complex understanding of spirituality and spiritual care, (2) a lack of comprehensive education on spirituality and spiritual care and (3) a quest to normalise spirituality and spiritual care among nursing students.

CONCLUSIONS

This systematic review affirms the need to include the subject of spiritual care in the early stages of undergraduate nursing programs. More research is needed to examine how new nursing graduates incorporate spiritual care in their clinical practice and the barriers they face. Like other literature, there is a need for a clear definition of spirituality and spiritual care to allow student nurses to understand spirituality and spiritual care better and will enable them to integrate them into their future practice fully.

The Relationship Between Perception of Good Death With Clinical Competence of End-Of-Life Care in Critical Care Nurses

Providing a good death can be one of the most important goals of end-of-life care. This study aimed to investigate the relationship between the concept of good death with clinical end-of-life care competence among intensive care nurses. The participants were 279 nurses in southeast Iran. The data were collected using the Nurses' Concept of Good Death Questionnaire and the Clinical Competency of End-of-Life Care Questionnaire. There was a positive, moderate, and significant correlation between nurses' concept of good death and their clinical competence in end-of-life care. Nurses who got higher scores on the concept of good death showed higher levels of clinical competence in end-of-life care. It is possible to take steps to improve nurses' concepts and knowledge through specialized educational interventions.

Palliative Care Needs in Adult Patients with Acute Leukemia: A Prospective Observational Study

Background: Acute leukemia (AL) affects patients' well-being and inflicts substantial symptom burden. We evaluated palliative care needs and symptom burden in adult patients with AL from diagnosis through fourth week of induction chemotherapy. Methods: Newly diagnosed adult patients with AL scheduled for curative-intent treatments, prospectively completed Functional Assessment of Cancer Therapy-Leukemia questionnaire at diagnosis and postinduction therapy. Subscale scores identified domains with major needs, with lower scores signifying higher needs, while Leu-subscale assessed leukemia-specific symptom burden. Results: One hundred patients were enrolled. Upon diagnosis and four weeks into induction phase, respectively, patients exhibited the lowest scores in physical (17 ± 8.75; 16 ± 11; p < 0.05), functional (16.5 ± 10.75; 11 ± 12.2; p < 0.05), and leukemia-specific (43 ± 16.75; 41.48 ± 11.68; p > 0.05) domains. Predominant symptoms were "getting tired easily" (91%) at diagnosis and "unable to do usual activities" (92.3%) after induction. Conclusion: Patients with AL demonstrated substantial physical, functional, and leukemia-specific symptom needs at diagnosis, which intensified postinduction, highlighting the necessity for palliative care integration from diagnosis.

Exercise interventions for older adults with advanced cancer: A scoping review

INTRODUCTION

The feasibility, safety, acceptability, and perceptions of exercise in older adults with advanced disease are not well understood due to the scarcity of evidence. This scoping review aimed to (1) summarize evidence on the feasibility, acceptability, and safety of exercise interventions for older adults with advanced cancer and (2) explore this population's perceptions on participating in exercise programs.

MATERIALS AND METHODS

A systematic search was conducted by an expert research librarian in Medline, CINAHL, EMBASE, Cochrane CENTRAL, and SPORTDiscus (inception through November 2023). Eligible studies included older adults with advanced (stage IV or receiving treatment with non-curative intent) solid cancers and intervention or qualitative studies on physical activity/exercise in older adults pertaining to our objectives.

RESULTS

A total of 36 studies were included: 28 (78 %) intervention studies, seven (19 %) qualitative studies, and one (3 %) cross-sectional study. The Frequency/Intensity/Time/Type (FITT) principle was described in 18 studies (64 %). Feasibility was examined in 15 of the 28 intervention studies (54 %) using various definitions. Four studies had predetermined feasibility thresholds, yielding mixed results. One intervention study reported on two intervention-related severe adverse events. Nineteen of the 28 intervention studies (68 %) examined acceptability, reporting high levels of participant satisfaction. Qualitative data revealed several barriers and facilitators to exercise.

DISCUSSION

Exercise appears to be feasible, acceptable, and safe in older adults with advanced cancer. Consistent reporting on the FITT principle and feasibility operationalization are areas of improvement in exercise studies in older adults with advanced disease.

Concurrent immunotherapy improves progression-free survival but increases toxicity in unresectable stage III NSCLC

BACKGROUND

The PACIFIC trial established consolidation immunotherapy (IO) after concurrent chemoradiotherapy as the standard treatment for unresectable stage III non-small cell lung cancer (NSCLC) by improving survival. However, the optimal timing of IO remains debated. This study analyzes the survival benefits and risks of IO concurrent with radiotherapy (RT) versus IO following RT.

METHODS

A systematic search of multiple databases identified studies comparing IO concurrent with RT and IO following RT in unresectable stage III NSCLC. Data on overall survival (OS), progression-free survival (PFS), and adverse events (AEs) were analyzed using the "meta" package in R, along with a single-center cohort study.

RESULTS

The meta-analysis showed improved PFS with IO concurrent with RT, with significant differences at 1 year (69.5 % vs 57.6 %) and 1.5 years (56.3 % vs 45.7 %). OS was slightly better with IO following RT, with fewer severe AEs (≥grade 3: 52.6 % vs 37.2 %). A single-center cohort validated superior PFS for the concurrent group (HR = 2.039, 95 % CI: 1.014-4.322, P = 0.046). Shorter intervals between RT and IO were associated with better PFS in the following group (HR = 1.002, 95 % CI: 1.001-1.003, P = 0.002).

CONCLUSION

Concurrent IO with RT during chemoradiotherapy significantly improved PFS in unresectable stage III NSCLC, though OS did not benefit due to a higher incidence of severe AEs. Earlier IO initiation after RT was associated with better PFS. Our findings suggest the potential benefits of concurrent IO for selected patients.

Add-On Treatment with Gliclazide for Cancer Patients with Type 2 Diabetes Undergoing Cyclic Glucocorticoid-Containing Chemotherapy

Aims: Despite its high prevalence, studies on glucocorticoid-induced hyperglycemia are lacking. We examined the glucose profiles of patients with type 2 diabetes undergoing dexamethasone-containing chemotherapy using continuous glucose monitoring (CGM). We also investigated the effects of gliclazide on the management of hyperglycemia in these patients. Materials and Methods: Seventeen patients with type 2 diabetes who received cyclic chemotherapy with dexamethasone were enrolled in this study. During the first cycle, iPro2, a blinded CGM device, was applied for 7 days. If a patient's CGM data exhibited an increase of 20% or more in the mean glucose level after dexamethasone administration, they received the second cycle, unless they had already received sulfonylurea or their chemotherapy regimen had changed. During the second cycle, the patients were treated with gliclazide as an add-on to their routine diabetic medication. Results: Dexamethasone treatment significantly increased glucose levels, especially in patients with a longer diabetes duration (8.4 years vs. 1.2 years, p = 0.009). For the nine patients who proceeded to the second cycle, gliclazide treatment significantly ameliorated hyperglycemia. Time in range increased from 33.11% to 45.22% (p = 0.020), and time above range significantly decreased from 66.89% to 52.78% (p = 0.003). The glucose management indicators were 9.52% and 8.40% for pre- and post-gliclazide treatment, respectively. One patient visited the emergency department because of symptomatic hypoglycemia. Conclusions: Chemotherapy regimens containing dexamethasone result in high blood glucose levels even after the last dexamethasone dose in patients with pre-existing diabetes. Adding gliclazide could be beneficial in managing hyperglycemia during dexamethasone-containing chemotherapy.

Potential drug-drug interactions among geriatric oncology patients: a retrospective study in Saudi Arabia

BACKGROUND

Drug-drug interactions (DDIs) are significant causes of adverse drug reactions among patients with cancer. We aimed to identify the prevalence, severity, and predictors of potential DDIs among geriatric oncology patients.

METHODS

A cross-sectional, retrospective study was conducted at two tertiary medical centers. Geriatric patients (≥ 65 years) who were diagnosed with solid tumors and received outpatient prescriptions with a minimum of two drugs between January 2018 and December 2022 were included in the study. Patients' medications were screened for DDIs using Lexi-Interact. Univariate and multivariable logistic regression models were used to explore factors associated with DDIs.

RESULTS

The study included 247 geriatric patients with a mean age of 74.0 ± 7.3 years, and 48.6% of the patients were female. The most common type of cancer was gastrointestinal cancer (35.6%), followed by genitourinary cancer (20.6%), and 50.6% of the patients had metastasized tumors. Approximately one-half of the patients (49.0%) received anticancer therapy, and hormonal therapy (21.9%) or chemotherapy (16.6%) was the most common therapy. The mean number of medications used per patient was 6.9 ± 3.5. The majority of patients (79.4%) had at least one DDI, with a mean of 5.6 ± 5.3 DDIs per patient. Most of the interactions were classified as moderate (58.9%), and only 19.3% were classified as major. Multiple logistic regression revealed that females were more vulnerable to DDIs than their male counterparts were (adjusted odds ratio (AOR) = 37.4; 95% CI 4.13-338.3). The number of medications used was significantly associated with the risk of DDIs (AOR = 4.07; 95% CI 2.53-6.54). Compared with patients with gastrointestinal cancers, patients with breast or gynecologic cancers had lower odds of experiencing DDI (AOR = 0.02; 95% CI < 0.01-0.24 and AOR = 0.04; 95% CI < 0.01-0.29, respectively).

CONCLUSION

This study revealed a high prevalence of DDIs among geriatric oncology patients, with most interactions classified as moderate. Female patients and patients taking multiple medications had a greater risk of experiencing DDIs. Routine screening for potential DDIs is essential for this vulnerable population, and the factors identified in this study should be carefully considered.