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The extant literature identifies low breast cancer literacy as a major reason for the low uptake of breast cancer screening among women in sub-Saharan Africa (SSA). Recognizing the potential of health education interventions to improve breast cancer literacy, researchers in SSA have implemented varied interventions. However, evidence on the effectiveness of these interventions in SSA is limited and fragmented, with variations in educational strategies, delivery methods, and cultural contexts. A systematic review is needed to synthesize existing evidence, assess the effectiveness of health education interventions in improving breast cancer literacy and screening uptake, and guide the development of culturally appropriate interventions aimed at improving breast cancer outcomes in SSA. The aim of the study is to review empirical evidence on the effectiveness of health education interventions on breast cancer literacy and breast screening uptake in SSA. Specifically, the review seeks to identify the methods of delivering breast cancer education in SSA, determine the effectiveness of educational interventions on breast cancer literacy, and assess the effectiveness of educational interventions on breast cancer screening uptake. This systematic review will include randomized controlled trials and quasi-experimental studies conducted among women aged 15 years and older in sub-Saharan Africa. Studies evaluating health education interventions designed to improve breast cancer literacy, awareness, or screening uptake will be eligible. Searches will be conducted in PubMed, Web of Science, Scopus, CINAHL, PsychInfo, and selected grey literature sources. Two reviewers will independently screen studies, assess eligibility, extract data, and evaluate methodological quality using the Cochrane Risk of Bias Tool (RoB 2) and the Joanna Briggs Institute Critical Appraisal Checklist, as appropriate. Findings will be synthesized narratively and, where sufficient methodological homogeneity exists, pooled using random-effects meta-analysis. It is envisioned that this study will provide evidence of the various health education interventions implemented across SSA to improve breast cancer literacy and screening uptake. It is also anticipated that the study will provide a means of comparing the effectiveness of the different interventions to inform policy and intervention scaling funds decisions in SSA. The protocol is prospectively registered in Open Science Framework (https://doi.org/10.17605/OSF.IO/XWKU9).

Red blood cells (RBCs) possess distinct biomechanical properties that enable their survival and efficient oxygen delivery. Cancer-associated anemia, frequently compounded by chemotherapy, is a major clinical challenge, yet little is known about how RBC biomechanics contribute to its pathophysiology. This study evaluates the biomechanical properties of RBCs in patients with cancer compared to controls and within patients before and after chemotherapy. Biomechanical properties of RBCs were assessed in 110 women with breast, ovarian, or endometrial cancer, measured before and after chemotherapy, and compared findings with 35 healthy female controls. Thirteen biomechanical parameters were assessed using the MIZAR automated rheometer. Relative to controls, pre-chemotherapy cancer patients exhibited significantly higher RBC aggregation and elasticity. Within the cancer cohort, anemic patients demonstrated more deformable and elastic RBCs, with increased aggregation compared to non-anemic patients. Following chemotherapy, patients displayed reduced RBC deformability but further increased elasticity, consistent with chemotherapy-induced alterations to membrane structure and function; these effects were most pronounced in anemic patients. We report novel rheological observations indicating that both cancer and chemotherapy are associated with alterations in RBC biomechanics, and that anemia further amplifies these changes. Importantly, cancer-associated anemia appears to involve impaired RBC quality. Recognition of biomechanical dysfunction may provide new insights into the mechanisms of cancer-related anemia and support the development of more comprehensive diagnostic and management strategies.

Anemia is a prevalent but under-recognized cancer complication, particularly in low-resource countries like Ethiopia. It significantly impacts treatment outcomes, fatigue, quality of life, and mortality rates. This review aims to estimate the prevalence of anemia and its risk factors among cancer patients in Ethiopia for clinical decision-making and public health strategies. This study employed a systematic review and meta-analysis design, sourcing evidence from various electronic databases until August 03, 2025. The data were extracted from June 01 to 30 and analyzed from July 01 to 25, with report generation till August 03, 2025, using R software. Meta-analysis was performed using a random-effects model, with forest plots illustrating pooled prevalence and associated factors. Heterogeneity was assessed using the I2 statistic, and study quality was evaluated using a validated tool. Eleven studies involving diverse cancer populations across Ethiopia were included. The pooled prevalence of anemia among cancer patients was 39.5% (95% CI: 26.9%-52.1%). Advanced cancer stage, female sex, older age, poor nutritional status, rural residence, presence of comorbidities, hematologic malignancies, ≥ six cycles of chemotherapy, bone metastasis, and history of bleeding were factors associated with the development of cancer in patients who received treatment. Anemia is common among Ethiopian cancer patients, driven by both disease- and treatment-related factors. Routine screening and targeted interventions are needed to improve outcomes.

Background: Pancreatic cancer is characterized by increasing incidence and high mortality in Poland and worldwide. The aim of this study was to assess the relationship between selected risk factors and the age-standardized incidence rate of pancreatic cancer at the voivodeship level in Poland, and to evaluate the accuracy of a prediction model. Methods: Age-standardized incidence rate data for 16 Polish voivodeships in 2011-2023 were obtained from the Polish National Cancer Registry. The risk factor burden for 2011-2019, expressed as disability-adjusted life years (DALYs) per 100,000 population, was obtained from the System Analysis and Implementation Database of the Polish Ministry of Health. A generalized estimating equation model was constructed to predict the age-standardized incidence rate, with multicollinearity addressed using variance inflation factor analysis. Predictions for 2020-2023 were validated against observed data, and forecasts for 2024-2030 were subsequently calculated. Results: The number of new pancreatic cancer cases in Poland increased in eight out of 16 voivodeships. The highest burden was recorded in the Masovian, Subcarpathian, Świętokrzyskie and Greater Poland voivodeships. Air pollution was positively associated with pancreatic cancer incidence. Predictions for 2020-2023 showed satisfactory agreement with observed data, with the largest discrepancy being equal to 4.1 in terms of the age-standardized incidence rate. Based on the models, the incidence of pancreatic cancer was projected for all of 16 voivodeships through to 2030. Conclusions: Air pollution is associated with the regional burden of pancreatic cancer in Poland. The generalized estimating equation prediction approach demonstrated acceptable accuracy and can support monitoring and public health planning at the voivodeship level.

Although exercise has been proven effective in alleviating cancer-related fatigue (CRF), traditional face-to-face programs may not be accessible due to physical, temporal, or geographical barriers. Digital health interventions (DHIs) offer scalable alternatives for promoting physical activity; however, evidence synthesizing DHI-based physical activity interventions specifically targeting CRF and their intervention characteristics remains limited. This scoping review aimed to map the types of digital health-based physical activity interventions for managing CRF, to summarize the key characteristics of DHI modalities and CRF outcomes, and to identify knowledge gaps for future research. A systematic literature search was conducted across 4 databases (PubMed, EMBASE, Cochrane, and PsycINFO) up to December 2025. Inclusion criteria comprised experimental studies involving adults with a history of cancer, digital exercise interventions, a control group, and fatigue outcomes. Screening and data extraction followed the Joanna Briggs Institute Manual for Evidence Synthesis and PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review) standards. The protocol was registered in PROSPERO (International Prospective Register of Systematic Reviews; CRD42022304285). Interventions were classified using the Evidence Standards Framework (ESF). Thirty-three studies comprising 3443 participants were included, representing 32 interventions. Most were randomized controlled trials (n=30, 91%). Interventions were delivered primarily via mobile apps (11/32, 34%) and wearable devices (8/32, 25%), followed by web-based platforms, videoconferencing, exergaming, and augmented reality. Eighteen interventions (reported in 19 studies) demonstrated statistically significant between-group CRF reductions, predominantly at immediate postintervention assessments. Evidence for sustained benefit beyond 12 months was limited, and only one study evaluated ultra-long-term outcomes, which did not demonstrate maintained improvement. Populations with breast cancer accounted for the largest proportion of participants. Fatigue measurement tools varied substantially, potentially contributing to heterogeneity in effect estimates. Most interventions were classified as ESF tier C, indicating a predominant focus on clinical outcome improvement rather than individual-level self-management and system-level implementation. Wearable device-based interventions showed the highest proportion of significant CRF improvement, whereas mobile app-based interventions reported both significant and nonsignificant results. DHIs lasting more than 12 weeks appeared to be associated with more effective CRF outcomes compared to shorter programs. Direct comparisons between in-person and digital delivery were scarce. Digital health-based physical activity interventions can reduce CRF in people with a history of cancer, with wearable device and longer-duration interventions showing the most favorable outcomes. However, the current evidence is concentrated in populations with breast cancer, and system-level integration remains unexplored. Future research should prioritize diverse populations with cancer, longer follow-up periods, standardized fatigue measurement, and systematic examination of specific intervention components that contribute to CRF reduction. Ultimately, advancing from individual efficacy trials toward scalable, workflow-integrated digital solutions will be key to sustainable CRF management across diverse oncology settings.

Nurses' health anxiety and their attitudes towards cancer screenings are interrelated. While high health anxiety shapes risk perception and health behaviours, negative attitudes towards screenings may create barriers to early diagnosis and treatment. This study aimed to examine nurses' health anxiety and attitudes towards cancer screenings. A descriptive, cross-sectional and correlational study was conducted with 310 nurses working in a university hospital. Data were collected using the Personal Information Form, Health Anxiety Inventory and Attitude Scale Towards Cancer Screenings. Multiple linear regression analysis was used to determine predictors of health anxiety. The mean score on the Attitude Scale Towards Cancer Screenings was 78.7&#x2009;&#xb1;&#x2009;13.6, and the Health Anxiety Inventory mean score was 15.8&#x2009;&#xb1;&#x2009;6.3. Subscale averages were 13.1&#x2009;&#xb1;&#x2009;5.1 for Excessive Sensitivity to Somatic Symptoms and Anxiety, and 2.6&#x2009;&#xb1;&#x2009;2.0 for Negative Consequences of Disease. Regression analysis indicated that the duration of employment in the current hospital and attitudes towards cancer screenings significantly predicted health anxiety (F&#x2009;=&#x2009;8.0, p&#x2009;<&#x2009;0.001), explaining 15.1% of the variance. Health anxiety and attitudes towards cancer screenings were significantly associated among nurses. The duration of employment and screening attitudes were identified as predictors of health anxiety.

Sleep disorders are highly prevalent among lung cancer patients and seriously affect their quality of life and mental health. This systematic review and meta-analysis aimed to assess the effects of non-pharmacological interventions on sleep quality, quality of life, and anxiety in lung cancer patients. PubMed, Web of Science, Cochrane Library, CINAHL, Embase, CNKI, Wanfang Data, and VIP databases for studies published between 2015 and February 2025. The primary outcome was sleep quality, with quality of life and anxiety levels as secondary outcomes. We assessed the risk of bias using the Cochrane tool and synthesized data using meta-analysis. Twenty-four studies involving 2604 patients were included. Non-pharmacological interventions were compared with usual care, placebo, or standard oncology care. After excluding studies with inappropriate content and methods, 20 studies evaluated sleep quality, and 12 studies evaluated quality of life and anxiety levels, respectively. The quality of the evidence was low to moderate; the promotion results should be interpreted with caution, but they may have a positive effect on the sleep quality, quality of life, and anxiety levels of lung cancer patients. Diverse non-pharmacological interventions can improve sleep quality, quality of life, and anxiety in lung cancer patients. However, high-quality, rigorously designed randomized controlled trials are still needed to confirm these findings. Future research should focus on personalized interventions tailored to lung cancer patients' characteristics and integrate digital health interventions to better support clinical decision-making.

This study aimed to investigate the dynamic temporal associations among postoperative symptoms in patients with liver cancer using a cross-lagged panel network (CLPN) model, and to identify stage-specific core symptoms to inform targeted clinical interventions. A longitudinal study was conducted involving 230 patients with liver cancer. Symptoms were assessed using the MD Anderson Symptom Inventory (MDASI) and the Symptom Module Specific to Primary Liver Cancer (SM-PLC) at five time points: 2 days (T1), 1 week (T2), 3 weeks (T3), 1 month (T4), and 3 months (T5) postoperatively. A CLPN model was applied to estimate cross-lagged associations among symptoms. Out-expected influence (out-EI) and in-expected influence (in-EI) were calculated to identify central symptoms within the dynamic network. From T1 to T2, jaundice exhibited the highest out-EI and significantly predicted vomiting (OR = 1.94, 95% CI [1.70, 2.14]). Pruritus predicted numbness (OR = 1.41, 95% CI [1.31, 1.52]), and pain predicted sadness (OR = 1.35, 95% CI [1.05, 1.47]). From T2 to T3, vomiting showed the highest out-EI and predicted jaundice (OR = 2.64, 95% CI [2.17, 2.84]), while bidirectional associations were observed between numbness and pruritus (OR = 2.64, 95% CI [2.17, 2.74]; OR = 1.21, 95% CI [1.00, 1.71]). From T3 to T4, vomiting predicted bloating (OR = 1.57, 95% CI [1.00, 1.64]) and loss of appetite (OR = 1.41, 95% CI [1.07, 1.62]), while fever predicted loss of appetite (OR = 1.28, 95% CI [1.14, 1.42]). From T4 to T5, sadness exhibited the highest out-EI and predicted disturbed sleep (OR = 1.35, 95% CI [1.22, 1.47]), loss of appetite (OR = 1.21, 95% CI [1.15, 1.46]), and fatigue (OR = 1.26, 95% CI [1.15, 1.51]). Postoperative symptom dynamics in patients with liver cancer demonstrate clear stage-specific patterns. Jaundice and vomiting dominate early postoperative phases, whereas sadness becomes the central symptom in later stages. These findings may inform time-sensitive and symptom-targeted nursing interventions to improve postoperative symptom management.

This study aimed to determine the factors affecting body esteem and sexual life among Turkish individuals diagnosed with cancer, exploring the relationship between treatment-related physical changes and psychosexual well-being. A descriptive and correlational design was employed. The sample consisted of 103 patients receiving treatment in an oncology unit of a medical faculty. Data were collected between November 2022 and January 2023 using a personal information form, the Body-Esteem Scale (BES), and the Arizona Sexual Experiences Scale (ASEX). The mean age of participants was 54.72&#x2009;&#xb1;&#x2009;9.39&#xa0;years. Findings showed that body self-esteem scores were below average (39.06&#x2009;&#xb1;&#x2009;11.97) and mean ASEX scores (18.34&#x2009;&#xb1;&#x2009;6.37) were well above the clinical threshold of 11. Multiple regression analysis showed that there were variables predicting body self-esteem (R2&#x2009;=&#x2009;0.199, p&#x2009;<&#x2009;0.001). Sexual life was significantly affected by gender, BMI, and cancer stage, and women reported higher levels of dysfunction (p&#x2009;<&#x2009;0.001). A significant negative correlation was found between the BES "attribution" subscale and total ASEX scores (r&#x2009;=&#x2009;-0.284, p&#x2009;=&#x2009;0.004). Cancer treatment and its complications are significant determinants of both body image and sexual health in Turkish patients. This study shows that clinical factors such as cancer-related weight loss, edema, and catheter presence significantly affect body self-esteem, while sexual dysfunction is primarily influenced by gender, BMI, and disease stage. Addressing these psychosexual challenges is essential for improving the overall quality of life for individuals progressing through the cancer process.

To investigate the current status of couple communication among patients with colorectal cancer and to identify the key factors influencing communication patterns, thereby providing a reference for clinically targeted communication interventions. Based on Walsh's family resilience theory and the Interpersonal Process Model of Intimacy (IPMI), a theoretical framework of "resource-motivation-activation" for couple communication was developed. Participants were recruited through convenience sampling and included 306 hospitalized colorectal cancer patients from a Grade A tertiary hospital in Anhui Province between July 2023 and September 2024. Data were collected using a general information questionnaire, the Communication Pattern Questionnaire, the Chinese version of the Family Resilience Questionnaire, the Quality of Relationship Index, and the Distress Disclosure Index. Multiple linear regression analysis was performed to identify factors influencing couple communication patterns. The level of constructive communication among couples affected by colorectal cancer was relatively low, while the demand-withdraw pattern was the most prevalent communication style. Among demographic and disease-related variables, age, primary caregiver, ostomy status, and pathological stage were found to be significantly associated with couple communication patterns. Family resilience, intimacy, and self-disclosure were identified as variables positively associated with constructive communication. Intimacy was negatively associated with both demand-withdraw and mutual avoidance communication patterns, whereas self-disclosure was negatively associated with mutual avoidance communication. These results provide preliminary support for the "resource-motivation-activation" theoretical framework. Couple communication patterns among patients with colorectal cancer are influenced by multiple factors. Family resilience, intimacy, and self-disclosure may play important roles in shaping communication behaviors. Clinical intervention strategies may consider patients' demographic and disease characteristics, with particular emphasis on strengthening family resilience, enhancing intimacy, and encouraging patient self-disclosure, which may help improve couple communication among colorectal cancer patients.

Background/Objectives: Older adults with cancer in the postoperative environment face complex vulnerability, exacerbated by the frailty of ageing and the aggressiveness of surgical treatment. In this highly demanding context, nurses play a crucial role as patient advocates. However, there is a knowledge gap regarding how advocacy is perceived and experienced by the nurse-patient dyad. This qualitative study aims to explain the practice of advocacy by comparing the perspectives of nurses and patients in order to construct part of a substantive theory on the subject. Methods: The Grounded Theory methodological approach was adopted. The sample included 6 specialist nurses and 10 older cancer patients from the ICU. Data collection consisted of participant observation and semi-structured interviews with both groups of participants. The analysis followed the constant comparison method, using MAXQDA software (version 24.10.0; VERBI Software; Berlin, Germany), allowing for the systematic and comparative identification of codes and categories from the two data sources. Results: The core process, defined as The Advocacy-Adjustment Dyad, reveals how older adult cancer patients navigate critical care through a symbiotic interplay of coping and support. Patients autonomously deploy Internal Adjustment mechanisms namely, Shielding the Emotional Self, to mitigate disease stress. Concurrently, the nurse operationalizes the Dynamic Expert Nurse Advocacy Cycle through a Therapeutic Alliance that prioritizes the patient's best interest, integrates the Family as an anchor, and ensures a meaningful understanding of information. This dyadic interaction transforms the ICU from a purely technological setting into a therapeutic space, ensuring the Preservation of Personhood and the safeguarding of the patient's self-determination. Conclusions: This study is pioneering in integrating the patient's voice into the construction of a theory on advocacy in critical care, demonstrating that its effectiveness is a process of mutual interaction and not merely a unilateral function of the nurse. The findings emphasise the need to actively include the patient's perspective in training and policy, offering valuable implications for optimizing older adult-centered care.

Nursing students in their training process often suffer from anxiety due to stressful situations, and emotional intelligence can help them to manage these situations. The aim of this study is to analyse the associations between the dimensions of perceived emotional intelligence and anxiety in students undergoing their training cycles in different special services in order to check if there are differences between them. It is an observational, cross-sectional and correlational study with a sample of 85 nursing students who had not received training in emotional intelligence. Two measurement instruments were used: the Trait-State Anxiety Inventory (STAI) to assess anxiety and the Trait Meta-Mood Scale (TMMS-24) to measure EI. Data were analysed using Pearson's coefficient when the distribution was normal, and Spearman's coefficient in the non-normal distribution. The results showed in the group-ER-Emergency and Oncology-there was a significant negative relationship between state and trait anxiety and emotional understanding and regulation. In contrast, in the Primary Care setting there was also a positive relationship between emotional perception and trait anxiety. The study concludes that nursing students who understand and manage their emotions may have a lower risk of anxiety. Furthermore, if they identify emotions appropriately, the risk of suffering from anxiety in the long term may be lower. This finding was observed when the student did the internship in Primary Care. So there is a difference depending on the clinical context.

Globally, several patients prefer home as the place of death, making home-based palliative care (HBPC) an important component of holistic palliative care delivery. In China, where many patients receive palliative care at home, HBPC is constrained by limited resources, fragmented services and death-avoidant cultural norms. This study aimed to explore how urban patients with advanced cancer experience HBPC within family and cultural contexts in China. We conducted a focused ethnographic study in Beijing, China. Twelve urban patients with advanced cancer receiving HBPC were purposively recruited via two outpatient departments and four community health centers and all participated in the study. Data were generated through semi-structured interviews, participant observation, and field notes. Data were analyzed using content analysis with iterative coding and constant comparison to refine themes; team discussion and analytic memos were used to enhance rigor. Content analysis generated four interrelated themes: (1) Being the focus of the family - patients sought to regain visibility in family life and embed care in daily routines; (2) Guarding my boundaries - patients defined personal limits, managed social exposure and articulated autonomy to preserve dignity; (3) The final safety net - patients sought external care and institutional support as illness progressed to enhance comfort and reduce family burden; (4) Preserving the value of life - patients affirmed meaning by reflecting on their life course, staying connected with family and aspiring to be remembered. For urban Chinese patients with advanced cancer, HBPC is experienced as a process of maintaining personhood within intersecting domains of care, identity and family ethics. Care should address not only symptom relief, but also dignity, meaning and culturally embedded family relationships.

Peritoneal metastasis is a common and adverse pattern of disease spread in patients with advanced gastric cancer, yet its clinicopathological determinants are not fully clarified. This retrospective observational study included 154 patients with histopathologically confirmed advanced gastric cancer treated at a single tertiary center between January 2020 and December 2024. Patients were categorized into a peritoneal metastasis group (n&#x2005;=&#x2005;38) and a non-peritoneal metastasis group (n&#x2005;=&#x2005;116) according to predefined diagnostic criteria based on contrast-enhanced computed tomography, staging laparoscopy, cytology, and intraoperative findings. Demographic, clinical, pathological, imaging, and intraoperative variables were extracted from electronic medical records, and comparisons between groups were performed using t tests and &#x3c7;2 tests. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for peritoneal metastasis. Baseline characteristics, including age, sex, body mass index, and major comorbidities, were comparable between groups, whereas Eastern Cooperative Oncology Group performance status&#x2005;&#x2265;&#x2005;2 was more frequent in the peritoneal metastasis group. In multivariate analysis, tumor size&#x2005;&#x2265;&#x2005;5&#x2009;cm (odds ratio [OR]&#x2005;=&#x2005;3.49, 95% confidence interval [CI]: 1.63-7.50), diffuse Lauren type (OR&#x2005;=&#x2005;3.32, 95% CI: 1.49-7.42), lymphovascular invasion (OR&#x2005;=&#x2005;2.59, 95% CI: 1.23-5.45), and peritoneal thickening or nodules on computed tomography (OR&#x2005;=&#x2005;4.95, 95% CI: 2.17-11.28) were independently associated with peritoneal metastasis. These findings indicate that combining routine histopathological features with standard imaging signs may improve preoperative risk stratification and help select candidates for staging laparoscopy and individualized treatment strategies in advanced gastric cancer.

Advanced diffusion MRI techniques, particularly intravoxel incoherent motion (IVIM) and diffusion tensor imaging (DTI), have emerged as promising functional imaging tools for improving cervical cancer assessment beyond conventional anatomical MRI. This narrative review summarizes current evidence on the clinical utility of these diffusion-based techniques for tumor characterization, local staging, parametrial invasion, lymph node evaluation, treatment response monitoring, and emerging radiomics applications. Across studies, diffusion-related parameters, especially the apparent diffusion coefficient (ADC) and pure molecular diffusion coefficient (D), tend to be lower in malignant cervical tissues and correlate with increased cellularity, higher tumor grade, and more aggressive disease features. IVIM metrics appear especially useful for differentiating cervical cancer from normal tissue, predicting pelvic lymph node involvement, and detecting early treatment response to chemoradiotherapy or neoadjuvant chemotherapy before substantial morphological regression occurs. In contrast, DTI remains less extensively investigated; however, preliminary findings suggest potential value for evaluating parametrial invasion, stromal disruption, tumor grade, and lymph node metastasis, particularly when integrated with IVIM-derived indices. Although diffusion-derived radiomics may further support risk stratification and treatment-response prediction, the evidence base remains limited by small cohorts, single-center designs, methodological heterogeneity, and insufficient external validation. Overall, IVIM and DTI provide valuable non-invasive insight into cervical cancer biology, but standardized acquisition protocols, reproducible thresholds, and multicenter validation are needed before routine clinical implementation.

Despite the prevalence of applications which offer remote patient monitoring (RPM) in chronic illness management, the use of RPM in healthcare systems remains low. There is limited use of data generated in an RPM, to describe the work of clinicians. The study's aim was the use a novel evaluation method to characterise the nurse work in an RPM intervention. A convergent mixed methods design was used to perform secondary analysis on feasibility trial data. Data sets: (1) RPM data set: data generated by usage, and (2) Interview data set: nurse user interviews. In the RPM data set, patient entered data, software data labelling, and nurse responses were defined as data strings. Quantitative variables were summarized using descriptive statistics. Both data sets were analysed using systematic text condensation. In the RPM data set themes were translated into quantitative data enabling reportable links to RPM functionality. Themes converged and narrative integration triangulated the data. Seven patients (heart failure (n=4); colorectal cancer (n=3)) and eight nurses were selected. Their RPM intervention engagement generated a mean of 97 data strings. Converging themes included: (1) intervention technical and operational work, (2) digitally enabled care management and coordination, and (3) educational and relational work. The evaluation method provided a detailed characterization of the digital nurse work performed in the RPM intervention. While data presented is foundational, it highlights the potential of how evaluation of nurse engagement with RPM application may provide essential feedback to refine digital interventions to ensure efficient integration in healthcare systems. Our study looked at how nurses use remote patient monitoring (RPM) app to support people with long-term health conditions. Our goal was to better understand the types of work nurses do in digital health interventions to improve the design of future RPM systems. There are lots of new RPM apps being created, but the use of them in healthcare systems outside of research studies is limited. Rarely is the data generated using apps used to describe the work of nurses around such digital health tools. We re-analysed data from a feasibility study of an RPM intervention. We combined two types of information: data automatically recorded by the RPM app when patients and nurses used it and interviews from the nurses. We called each occurrence of patient-entered information, app labels and nurse responses as a &#x201c;data string&#x201d;. We used both simple counts and detailed text analysis to describe the work nurses did around the app. Seven patients and eight nurses took part and on average generated 97 data strings per patient. By combing the data, we observe three types of digital nursing work: technical and operational tasks to keep the intervention running; digitally enabled care management and coordination; and educational and relational work to support patients. Our new way of evaluating digital health applications provided clearer pictures of the work nurses do around an RPM app. These findings are early stage, but they show that analysing detailed usage data together with nurse interviews can give important feedback which will improve digital health tools. These improvements will better support nurses and increase adoption in healthcare services.

Background and Objectives: Quality of life (QoL) is an important issue for breast cancer (BC) survivors. The objective of this study was to assess health-related QoL (HRQoL) of BC patients and investigate the impact of different demographic and clinical factors on physical and social functioning and BC-related symptoms. Materials and Methods: In this cross-sectional study, 107 BC patients undergoing chemotherapy in Greece completed a questionnaire collecting sociodemographic and clinical information and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) in order to assess HRQoL. Descriptive statistics and multiple linear regression analyses were used to identify factors linked to HRQoL outcomes. Results: Overall, participants reported moderate HRQoL, with high physical and social functioning and moderate emotional, cognitive, and role functioning. Fatigue was the most common symptom, whereas other symptoms were generally uncommon. Multiple regression analyses showed that marital status, place of residence, time since diagnosis, and type of surgery were significantly associated with the global QLQ-C30 score (R2 = 0.337, p < 0.001). Physical functioning was associated with comorbidity burden, time since diagnosis, and employment status (R2 = 0.155, p = 0.035), and social functioning with marital status and type of surgery (R2 = 0.171, p = 0.011). Emotional functioning showed exploratory associations with place of residence and type of surgery; however, the overall regression model for emotional functioning did not reach statistical significance. No symptom model reached overall significance, but time since diagnosis, treatment type, and surgery were linked to distinct symptoms. Conclusions: BC patients undergoing chemotherapy in Greece report an overall moderate level of HRQoL, which is significantly influenced by a combination of demographic and clinical factors; physical and social functioning were high, with moderate emotional, cognitive, and role functioning. These findings highlight the importance of individualized supportive care strategies in order to improve QoL of BC patients.

Liver cancer poses a serious global health burden, with China experiencing particularly high incidence and mortality rates. Treatment complexity and severe side effects often impair patients' quality of life, leading to self-perceived burden (SPB) stemming from care dependency, financial pressure, and emotional distress. This cross-sectional study of 139 patients with liver cancer explored predictors of SPB using multiple linear regression. Results showed that 97.82% of the participants experienced SPB (mean&#x2009;=&#x2009;63.58&#x2009;&#xb1;&#x2009;15.33). Unemployment before illness, chemotherapy, use of confrontation, and fantasy coping strategies were significant predictors of SPB. Findings highlight the urgent need for targeted interventions to alleviate SPB and enhance patients' quality of life.

Colorectal cancer (CRC) is a major global health burden characterized by progressive genetic and metabolic alterations, with iron metabolism being increasingly recognized as a key contributor to tumorigenesis. This review provides an integrated synthesis of current evidence on iron metabolism across the continuum of colorectal cancer development, from preneoplastic lesions to advanced disease. We analyzed data from epidemiological, experimental, and mechanistic studies addressing systemic and cellular iron homeostasis, including the hepcidin-ferroportin axis, as well as iron handling within tumor cells and the tumor microenvironment. Available data indicate that colorectal epithelial cells progressively develop an iron-retentive phenotype, characterized by increased iron uptake and reduced export, leading to expansion of the intracellular labile iron pool. This imbalance contributes to oxidative stress, DNA damage, metabolic adaptation, and activation of oncogenic signaling pathways while also influencing immune responses. However, epidemiological findings on dietary iron and CRC risk remain inconsistent, highlighting the context-dependent nature of iron-related effects. In conclusion, iron metabolism represents a dynamic regulator of CRC progression and a mechanistic framework for understanding stage-specific tumor evolution, although further studies are needed to clarify how iron-dependent pathways differ across colorectal tumor subtypes and microenvironmental contexts.