Cancer inequities among vulnerable populations in rural areas remain a public health challenge in Canada. Rural populations are defined as vulnerable due to geographic isolation, limited access to specialized oncology care, and socioeconomic barriers such as transportation and financial toxicity. Professional navigation offers a potential solution to bridge these gaps, yet there is a lack of evidence on the barriers to and facilitators of its adoption in breast cancer survivorship. The objective of this study is to evaluate the effectiveness of a cancer navigation intervention using professional navigators compared to the standard of care (medical care) in improving the quality of life and functional outcomes of newly diagnosed survivors of breast cancer in interior British Columbia. A single-center, parallel-group, open-cohort randomized controlled trial is being conducted over 3 years. Ethics approval was obtained for the study. Participants who provide informed consent are randomized into 2 groups: the intervention group receives the cancer navigation intervention and the control group receives the standard of care (the usual medical care offered by health care practitioners). The baseline study time point spanned January to March 2025, the first follow-up spanned April to June 2025 at 3 months after enrollment, and the second follow-up spanned July to September 2025 at the end of 6 months after enrollment. The cancer navigation intervention comprises direct psychosocial and educational webinars, coordinated telephone support services, and community-based cancer care resources. Professional navigators are qualified registered nurses who facilitate information and connect participants with available supportive resources, services, and programs. The main outcomes are financial distress, quality of life, and satisfaction with navigation and interpersonal relationships. The Comprehensive Score for Financial Toxicity-Functional Assessment of Chronic Illness Therapy, Functional Assessment of Cancer Therapy-Breast, Breast Cancer Navigation Survey, Participant Satisfaction With Navigation Scale, Satisfaction With Interpersonal Relationships Survey, and Breast Cancer Navigation Interview are used in the study. Steps are being taken to ensure the trustworthiness of the qualitative data. With a 5% level of significance (2 tailed) and 90% power, the sample size was calculated as 108. Data collection took place from January 2 to September 30, 2025. A total of 164 participants were recruited. This study aims to demonstrate effectiveness and satisfaction with professional navigation and knowledge translation for future implementation of a cancer navigation intervention in British Columbia.
Hand-foot syndrome (HFS) is a common side effect of chemotherapy drugs such as 5-fluorouracil and capecitabine, impairing daily function and quality of life. This study aimed to compare international clinical guidelines regarding assessment and management of HFS to identify areas of consensus and divergence and evidence gaps. Guidelines were identified through PubMed (from inception to February 2025), with a supplementary search on Google. Only the most recent versions of English guidelines were included. Data extraction focused on the guideline methodology and recommendations on the prevention, assessment, and management of HFS. Each guideline was critically appraised using the AGREE II checklist. Six guidelines were identified authored by the following cancer agencies: British Columbia Cancer (BCC), European Society of Medical Oncology (ESMO), Cancer Institute NSW (eviQ), Oncology Nursing Society (ONS), United Kingdom Oncology Nursing Society and Acute Oncology (UKONS AO), and United Kingdom North Cancer Alliance (UKNCA). Regarding prevention, five of six guidelines (83%) advised avoiding chemical and physical stressors to the hands and feet and using alcohol-free moisturizer. Only ESMO, BCC, and eviQ recommended oral celecoxib to prevent capecitabine-induced HFS. ESMO and ONS recommended cooling procedures to prevent taxane-induced HFS. Likewise, BCC and eviQ recommend cooling procedures for all agents. All guidelines except ONS recommended dose suspension with grade 2 or 3 HFS and continuation when resolved or improved. ESMO and BCC recommended topical corticosteroids for grade 1 HFS, ESMO for grade 2 or 3, and eviQ for prophylactic use. Finally, BCC and ESMO suggested to consider oral dexamethasone for PEGylated doxorubicin-induced HFS. While general skin care and dose modification guideline recommendations were consistent, pharmacological recommendations varied. Guidelines are key for healthcare professionals in supporting patients with HFS. Therefore, regular updates with emerging evidence for interventions such as topical diclofenac are needed to ensure the quality of care.
Older adults with cancer frequently experience high symptom burden, psychological distress, and reduced quality of life. Integrating palliative nursing interventions into routine oncology care has the potential to improve these outcomes, yet evidence examining their measurable effects remains limited. This study aimed to examine the effects of integrated palliative nursing interventions on quality of life, psychological outcomes, and symptom burden among older adults with cancer. A quasi-experimental one-group pre-test-post-test design was conducted at King Khaled Hospital, Al-Kharj, Saudi Arabia, including 80 older adults (≥60 years) with confirmed cancer diagnosis. Participants received a structured 6-week integrated palliative nursing intervention comprising 12 sessions (2 sessions/week) addressing physical, psychological, social, functional, and spiritual needs. Outcome measures included the Functional Assessment of Cancer Therapy-General (FACT-G) for quality of life, the National Comprehensive Cancer Network (NCCN) Distress Thermometer for psychological outcomes, and the Edmonton Symptom Assessment System (ESAS-r) for symptom burden. Pre- and post-intervention assessments were conducted, and data were analyzed using paired t-tests, Pearson correlations, and multiple linear regression. All 80 participants completed the study, and no attrition was observed during the 6-week intervention period. Post-intervention, participants demonstrated significant improvements in overall quality of life (FACT-G total: 39.65 ± 5.51 → 66.41 ± 6.25, p < .001) and all subscales. Distress scores (NCCN) decreased from 21.93 ± 2.49 to 6.99 ± 2.37 (p < .001), and total symptom burden (ESAS) declined from 63.56 ± 6.31 to 41.09 ± 6.88 (p < .001). Regression analysis identified baseline scores as significant predictors of post-intervention outcomes: pre-intervention FACT-G scores and cancer type for quality of life [R2 = 0.660, F (8, 71) = 17.199, p < .001), pre-intervention NCCN scores for distress (R2 = 0.219, F (8, 71) = 2.487, p = .019), and pre-intervention ESAS scores for symptom burden (R2 = 0.757, F (8, 71) = 27.697, p < .001). These results indicated that baseline status strongly predicts post-intervention outcomes, while demographic and clinical variables had minimal impact. Structured integrated palliative nursing interventions significantly enhance quality of life and reduce psychological distress and symptom burden in older adults with cancer. Incorporating multidimensional, patient-centered palliative care within routine oncology practice can improve clinical outcomes, with baseline status serving as an important determinant of intervention effectiveness.
The peripherally inserted central catheter (PICC) has been widely used in clinical practice, but there are also high risks in the use process. With the development of intravenous therapy technology, it is possible to reduce PICC related adverse events. This study aims to explore the effect of specialized nursing intervention of intravenous therapy in patients with PICC and the feasibility of preventing/reducing complications. Subjects 23 to 75 years treated with PICC catheterization concluded. A total of 96 subjects were assigned to a control group (n = 48), which performed routine care, a study group (n = 48), which received 2-week intravenous therapy specialist nursing therapy based on routine care. After 2 weeks for PICC nursing therapy, Chi square test analyses showed significant differences between routine care (75.00%) and intravenous therapy specialist nursing therapy (93.75%) in treatment compliance rate, as well as the scores of Cancer Patients PICC Sell management and the core scale of quality of life of cancer patients. Significantly lower incidence of complications for study group (8.33%) versus control group (27.08%). Intravenous therapy specialist nursing intervention has a significant effect on patients with PICC catheterization, which can improve patients' treatment compliance, improve their quality of life, and effectively reduce the occurrence of related complications.
The 2023 iteration of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) estimated prevalence, incidence, and health burden for 375 diseases and injuries, including 12 mental disorders. We assess past, current, and emerging trends in the prevalence and burden of mental disorders across sexes and age groups, for 21 regions, 204 countries and territories, and by Socio-demographic Index (SDI) quintile, from 1990 to 2023. Mental disorders included in GBD 2023 were anxiety disorders, major depressive disorder, dysthymia, bipolar disorder, schizophrenia, autism spectrum disorders, conduct disorder, attention-deficit hyperactivity disorder, anorexia nervosa, bulimia nervosa, idiopathic developmental intellectual disability, and a residual category of other mental disorders. A literature review identified epidemiological data for each disorder. These were analysed via a Bayesian meta-regression to estimate prevalence by disorder, sex, age, location, and year. Disorder-specific prevalence was multiplied by disability weights representing the severity of health loss associated with each disorder to estimate years lived with disability (YLDs). Deaths due to anorexia nervosa were assessed with a Cause of Death Ensemble modelling strategy to estimate deaths by sex, age, location, and year, and then multiplied by the standard life expectancy at age of death to estimate years of life lost (YLLs). YLDs equalled disability-adjusted life-years (DALYs) for all mental disorders except anorexia nervosa (the only mental disorder considered as an underlying cause of death in GBD), for which DALYs represented the sum of YLDs and YLLs. We presented prevalence, deaths, YLDs, YLLs, and DALYs as counts, age-specific rates per 100 000 population, and age-standardised rates per 100 000 population. We estimated 1·17 billion (95% uncertainty interval 1·06-1·31) prevalent cases of mental disorders globally in 2023, equivalent to an age-standardised prevalence rate of 14 210·7 cases (12 849·5-15 940·1) per 100 000 population. These estimates represented a 95·5% (75·0-121·2) increase in prevalent cases and 24·2% (11·4-41·4) increase in age-standardised prevalence rate between 1990 and 2023. All mental disorders showed increases in prevalent cases between 1990 and 2023, while notable increases were seen in age-standardised prevalence rates for anxiety disorders, major depressive disorder, dysthymia, anorexia nervosa, bulimia nervosa, schizophrenia, and conduct disorder. There were an estimated 171 million (127-228) DALYs due to mental disorders globally across sex and age in 2023, equivalent to an age-standardised DALY rate of 2070·5 DALYs (1519·1-2750·5) per 100 000 population. Mental disorders contributed to 6·1% (4·8-7·6) of all-cause DALYs in 2023, making them the fifth leading cause of global DALYs (up from 12th in 1990). DALYs were almost entirely composed of YLDs. Mental disorders were the leading cause of YLDs in 2023 (up from second in 1990), explaining 17·3% (14·8-20·6) of all-cause global YLDs. Leading causes of mental disorder DALYs were anxiety disorders (ranked 11th among the 304 diseases and injuries at Level 4 of the GBD cause hierarchy), major depressive disorder (15th), and schizophrenia (41st). Globally in 2023, mental disorder age-standardised DALY rates were higher among females (2239·6 [1643·7-3014·1] per 100 000) than among males (1900·2 [1399·8-2510·8] per 100 000), and peaked in the 15-19 years age group (2617·3 [1850·6-3696·8] per 100 000). All locations showed increased mental disorder DALY rates in 2023 compared with 1990, ranging across countries and territories from 1302·4 (952·7-1683·7) per 100 000 in Viet Nam to 3555·8 (2661·9-4715·0) per 100 000 in the Netherlands. Across SDI quintiles, DALY rates ranged from 1853·0 (1352·1-2469·3) per 100 000 for middle SDI to 2184·1 (1606·1-2890·3) per 100 000 for high SDI. A significant health burden was imposed by mental disorders in all countries and territories in 2023, irrespective of the health resources available. In some instances, this burden has increased over time and is unevenly distributed across populations. Stronger surveillance systems, particularly in low-income and middle-income countries, are required. Additionally, we need more coordinated and inclusive policies to reduce the burden through early treatment and prevention, tailored to sex and age differences across locations. Responding to the mental health needs of our global population, especially those most vulnerable, is an obligation, not a choice. Gates Foundation, Queensland Health, and University of Queensland.
Children undergoing cancer treatment experience a range of treatment-related toxicities that significantly affect quality of life and adherence to therapy. Current methods for symptom reporting rely heavily on clinician interpretation of caregiver or child verbal reports, which can result in incomplete or inaccurate records. The Pediatric Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (Pediatric PRO-CTCAE; National Cancer Institute) provides a validated mechanism for direct symptom reporting by children and caregivers, yet its traditional administration and preselection of questions limit the breadth of symptom capture. This research aimed to co-design and conduct formative usability testing of the Smart Pediatric Oncology Tracker of Symptoms (SPOTS), a novel, web-based interface for the Pediatric PRO-CTCAE to allow children with cancer and their caregivers to comprehensively report symptoms. The research comprised 2 sequential phases: co-design and usability testing. Guided by child-computer interaction theory and participatory design methods, child-caregiver dyads collaborated with the research team to iteratively design and refine the SPOTS prototype. Nine participant dyads engaged in up to 3 co-design sessions that informed system features, layout, and content. During the usability phase, 12 additional dyads (6 with children aged 7-12 years and 6 with adolescents aged 13-17 years, each with a caregiver) completed structured usability tasks using the SPOTS prototype. Task completion, pathway efficiency, and user feedback were recorded through screen capture, field notes, and think-aloud protocols. Quantitative data were analyzed descriptively, and qualitative feedback was analyzed thematically. SPOTS was described by users as "very clear" and "easy to navigate." Participants valued the visual design, the use of a customizable character, and the opportunity for children to report symptoms independently. Key usability challenges included confusing terminology, navigation redundancy, and visual complexities. Quantitative task analyses indicated that while most structured tasks were completed successfully, many required excess steps or assistance. When not directed to use a specific screen, participants' symptom reporting methods varied, with caregivers and adolescents preferring the Body Parts Screen and younger children favoring the Search Screen. The formative development of SPOTS demonstrates the feasibility and value of co-designing pediatric health technologies directly with children and caregivers. SPOTS has the potential to enhance the implementation of the Pediatric PRO-CTCAE by offering an engaging, child-friendly digital format that facilitates more direct symptom reporting. Future work will include a pilot study to further assess real-world usability, the quality of symptom capture (ie, completeness and accuracy), and integration with clinical workflows.
This study examined the effectiveness of a virtual reality-based cancer precision medicine (VR-CPM) training program on oncology nurses' learning attitude, motivation, self-confidence, self-efficacy and clinical performance. CPM requires oncology nurses to develop advanced conceptual understanding and clinical competence. VR provides immersive and interactive learning environments that may enhance engagement and applied skills beyond traditional didactic approaches. A cluster randomized controlled trial. Between October 2023 to May 2024, 68 oncology nurses from a medical center in northern Taiwan were assigned by cluster to either a VR-CPM course (n = 29) or a lecture-based course (n = 39). Outcomes were assessed at baseline, immediately post-intervention and at 3- and 6-month follow-ups using validated instruments. Generalized estimating equations were used as the primary analytic approach, adjusting for baseline covariates. Effect size were calculated to estimate the magnitude of differences. Both groups showed significant improvements over time. The VR group demonstrated significantly greater immediate post-intervention improvements in learning attitude, self-confidence and clinical performance, as well as higher course satisfaction. However, between-group differences were not sustained at 3 and 6 months. VR-CPM training enhances short-term affective and behavioral outcomes among oncology nurses. However, the absence of sustained long-term effects suggests that single-session VR interventions may require reinforcement or integration into longitudinal educational designs to support durable learning.
This study aimed to determine whether an Effort Re-education Programme (ERP) delivered after hospital discharge yields greater improvements in functionality than Conventional Clinical Practice (CCP) in oncology patients with associated respiratory symptoms. A stratified randomised clinical trial was conducted including 65 oncology patients recruited during hospitalisation and followed after discharge. Participants were allocated to either CCP or CCP plus a home-based functional Effort Re-education Programme. Functionality (Barthel Index) was the primary outcome. Secondary outcomes included dyspnoea severity (mMRC), general performance status (ECOG), and caregiver burden (Zarit scale). Assessments were performed at discharge (baseline), 15 days, and one month post-discharge. Patients receiving ERP showed significantly greater improvements in functionality compared with the control group (mean change: + 20.3 vs. + 6.6 points; p < 0.001). Significant between-group differences were also observed for dyspnoea (p = 0.002), performance status (p < 0.001), and caregiver burden (p < 0.001). No hospital readmissions were recorded in the intervention group during follow-up. Length of hospital stay was shorter in the intervention group prior to discharge. A home-based Effort Re-education Programme initiated at hospital discharge significantly improves functional outcomes, respiratory symptoms, and caregiver burden in oncology patients, supporting its integration into discharge planning and continuity-of-care models. The clinical trial was registered in ClinicalTrials.gov (NCT06035263). Registration Date: 2023-11-01; 04:11 h.
Quality of life and symptom burden of patients with myelofibrosis are well recognized and compounded in those with anemia; however, the effects of transfusion burden or anemia severity on quality of life have not been comprehensively characterized. This post hoc descriptive analysis explored the association between transfusion status or hemoglobin improvement and patient-reported outcomes (PROs). The analysis used pooled populations across treatment arms from 3 clinical trials (SIMPLIFY-1, SIMPLIFY-2, MOMENTUM); sample sizes for each PRO measure were dependent on the trials in which they were administered. At both baseline and week 24, transfusion independence was associated with umerically greater mean SF-36v2 and EORTC QLQ-C30 scores than transfusion dependence; in the subgroup that was transfusion dependent at baseline, those who achieved transfusion independence at week 24 had greater PRO improvements than those who remained reliant on transfusions. Regardless of transfusion status, patients who achieved a hemoglobin improvement ≥ 1, ≥ 1.5, or ≥ 2 g/dL from baseline also had clinically meaningful improvements in quality of life (assessed via mean EQ-5D-5L or SF-36v2 scores) and symptoms (assessed via PGIC or MPN-SAF/MFSAF Total Symptom Score) at week 24 compared with those who did not. Collectively, these results provide preliminary insights into the associations of transfusion status and anemia severity with quality of life in myelofibrosis; as current PRO measures do not directly evaluate the relationship between symptoms such as fatigue and anemia, development of new measures to more comprehensively capture the patient experience for those with anemia in myelofibrosis may be warranted. NCT01969838, NCT02101268, NCT04173494.
Venous thromboembolism (VTE) is a major cause of maternal morbidity and mortality, and nursing plays a central role in prevention, patient education, and follow-up. Large language models (LLMs) have attracted increasing attention in healthcare; however, their comparative performance in maternal VTE nursing contexts remains insufficiently explored. Five representative LLMs-DeepSeek, GPT-4.1, Claude 3.7, Huatuo, and Kimi-were evaluated across six clinical domains (etiology, diagnosis, treatment, prognostic assessment, home care, prevention) and five performance dimensions (accuracy, comprehensibility, logical coherence, reliability, safety). An expert-informed Delphi framework comprising 41 items guided the evaluation. Three nursing experts independently rated each model's responses, and inter-rater reliability was assessed using Fleiss's Kappa. GPT-4.1, Claude 3.7, and DeepSeek demonstrated superior overall performance, particularly in patient education, individualized care planning, and preventive guidance. Huatuo and Kimi showed limitations in treatment and prognostic reasoning. Inter-rater reliability was excellent (Kappa = 0.892). The findings highlight relative strengths and limitations of different LLMs across nursing-relevant domains in maternal VTE care. While certain models performed better in educational and supportive contexts, the current study does not assess clinical adequacy or readiness for real-world nursing deployment. Future research incorporating patient perspectives and real-world validation is needed to inform the safe and appropriate integration of LLMs into nursing practice.
Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease, is one of the most prevalent liver diseases globally, contributing to both economic and health-related challenges. We aimed to evaluate the global, regional, and national burden of MASLD from 1990 to 2023, quantify the contribution of identified modifiable risk factors, and project future prevalence up to the year 2050. Estimates of MASLD prevalence and disability-adjusted life-years (DALYs) were produced by age, sex, region, Socio-demographic Index (SDI), and Healthcare Access and Quality (HAQ) index across 204 countries and territories from 1990 to 2023 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023. The MASLD burden attributable to three risk factors (smoking, high BMI, and high fasting plasma glucose) was assessed as part of the GBD comparative risk assessment. As a secondary analysis, we used these estimates to forecast MASLD prevalence up to 2050 using fasting plasma glucose and mean BMI as predictors. Furthermore, to examine the relative contributions of population ageing, population growth, and changes in MASLD prevalence rate to the forecasted changes in case counts from 2023 to 2050, we conducted a decomposition analysis. In 2023, approximately 1·3 billion (95% uncertainty interval [UI] 1·2 to 1·4) individuals were estimated to be living with MASLD (ie, 16·1% of the global population), with an age-standardised prevalence rate of 14 429·3 (95% UI 13 268·3 to 15 990·6) per 100 000 population, representing a percentage increase of 142·7% (95% UI 139·2 to 146·7) in crude numbers from 1990 (0·5 billion [0·5 to 0·6]) and of 28·6% (27·8 to 29·5) in the rate (11 217·2 [10 276·8 to 12 467·0] per 100 000 in 1990). An estimated 3·6 million (2·8 to 4·5) total DALYs were attributable to MASLD worldwide in 2023, corresponding to an age-standardised DALY rate of 39·6 (31·2 to 49·9) per 100 000 population. Despite a 116·3% (93·3 to 139·4) increase in crude DALYs (from 1·7 million [1·3 to 2·1] in 1990), its age-standardised estimate remained consistent (1·8% [-8·6 to 12·8]) from 1990 (38·9 [30·1 to 49·8] per 100 000) to 2023. There was substantial variation in age-standardised estimates across regions. North Africa and the Middle East had the highest prevalence rate (29 246·1 [26 848·3 to 32 048·7] per 100 000) and Andean Latin America showed the highest DALY rate (152·3 [114·1 to 194·7] per 100 000). By contrast, the high-income Asia Pacific region had the lowest prevalence rate (8653·5 [7923·7 to 9592·8] per 100 000) and east Asia had the lowest DALY rate (16·3 [13·5 to 19·9] per 100 000) among all GBD regions. North Africa and the Middle East showed disproportionately higher prevalence rates relative to other regions with similar SDIs. Lower SDIs and HAQs were associated with higher age-standardised DALY rates. The age-standardised prevalence rate was consistently higher in males (15 616·4 [14 349·2 to 17 263·3] per 100 000 people in 2023) than in females (13 245·2 [12 132·0 to 14 692·6] per 100 000 people), and peaked at age 80-84 years in both sexes. The number of MASLD prevalent cases was the highest in younger adults, peaking at age 35-39 years for males and age 55-59 years for females. Among the risk factors for MASLD, high fasting plasma glucose presented the largest contribution to the age-standardised DALY rate of total MASLD in 2023 (2·2 [95% UI 1·6 to 3·1] per 100 000 people), followed by high BMI (1·4 [0·6 to 2·4] per 100 000 people) and smoking (1·0 [0·3 to 1·8] per 100 000 people). Our forecasting model estimates that 1·8 billion (95% UI 1·6 to 2·0) individuals are likely to have MASLD by 2050, representing a 42·0% increase from 2023. The age-standardised prevalence rate is expected to increase to 15 774·9 (95% UI 14 613·9 to 17 336·2) per 100 000 people in 2050, representing an average annual percentage change of 0·3% (95% UI 0·3-0·3). According to our decomposition analysis, this change will be primarily due to population growth, particularly in sub-Saharan Africa and North Africa and Middle East, and less by population ageing or epidemiological change. With a global prevalence of 16·1% and approximately 1·3 billion people already living with MASLD in 2023, the condition has and will continue to have substantial health and economic impacts worldwide. An inverse association between the HAQ Index and age-standardised DALY rates suggests that countries with lower health-care access and quality might be less well positioned to manage the growing MASLD burden, underscoring the need for strengthened health-system capacity in these settings. Gates Foundation.
Chemotherapy-induced nausea and vomiting, together with depression and anxiety, are common and distressing complications in patients with colorectal cancer that seriously impair quality of life and treatment adherence. This study explored the efficacy of mindfulness-based stress reduction (MBSR) in relieving chemotherapy-related physical and psychological distress. This retrospective cohort study included 301 patients with colorectal cancer undergoing chemotherapy. The control group received routine nursing care, whereas the MBSR group completed an 8-week intervention including mindful breathing, body scan, and meditation. FLIE, PHQ 9 and GAD 7 were used to assess symptoms over four chemotherapy cycles. Compared to the control group, the MBSR group had significantly higher FLIE nausea and vomiting scores (all p < 0.001), indicating that MBSR could effectively mitigate the severity of CINV. PHQ-9 and GAD-7 scores were significantly lower in the MBSR group (all p < 0.001). The MBSR group exhibited a clear ameliorative trend with both baseline and post-intervention scores declining throughout the treatment course, confirming its efficacy in alleviating depressive and anxiety symptoms. MBSR effectively relieves chemotherapy-induced nausea, vomiting, depression, and anxiety, and is worthy of clinical application to improve the physical and psychological status and quality of life of patients with colorectal cancer. Chemotherapy is an important treatment for people with colorectal cancer, but it often causes uncomfortable side effects such as nausea, vomiting, anxiety, and low mood. These problems can seriously affect daily life and treatment tolerance. In this study, we looked at whether mindfulness-based stress reduction (MBSR) can help relieve these issues. We reviewed the medical records of 301 patients undergoing chemotherapy. Patients in the MBSR group received an 8-week mindfulness program including mindful breathing and body relaxation, while the control group received standard nursing care. All patients used the same chemotherapy and anti-sickness drugs. Results showed that patients who practiced MBSR had much less nausea and vomiting, and lower levels of anxiety and depression during treatment compared with the control group. These benefits became clearer as chemotherapy continued. Our study suggests that MBSR is a safe and helpful non-drug method to reduce physical and emotional distress for colorectal cancer patients during chemotherapy and improve their quality of life.
Enjoying food is related to the taste, smell and texture of food, ambience during meals, presentation of the meals, and freedom to choose meals. A decrease in food enjoyment can lead to decreased food intake, undesired weight loss, and reduced quality of life. Cancer and cancer treatment can induce symptoms that affect food enjoyment. To optimise food enjoyment and intake, insight in the experiences and preferences of hospitalised patients with cancer is essential. This qualitative study aimed to explore the perspectives of patients with cancer on the experience of food and drinks, ambience during meals, timing of the meals, and the freedom to choose one's own meals, during hospital admission. In hospitalised patients with cancer treated with systemic therapy, 12 semi-structured interviews were performed. Nutritional status was subjectively assessed, and taste and smell objectively to characterise the study population. Thematic analysis was used to identify key themes. Three selective codes emerged: (1) the quality of hospital food and drinks, (2) the presentation of hospital food and drinks, and (3) meeting patients' preferences. Patients described hospital food, and in particular main meals, as bland, overcooked, and repetitive. Autonomy in meal choices and flexibility in portion sizes were appreciated but inconsistently facilitated. Ambiance was moderately important, with suggestions for communal dining areas. Presentation issues, including plastic odours and inconsistent meal temperatures, were mentioned. Patients valued personalised options such as additional seasonings or sauces. The eating experience of hospitalised cancer patients is shaped by various factors including quality of food, its presentation, and the ability to cater to individual preferences. By addressing these aspects and implementing a patient-centred food service, care could be optimised in oncology wards.
Despite significant advancements in oncology, early diagnosis of pulmonary cancer poses a clinical challenge, thus making it a leading cause of cancer-related mortality and a focal point for the development of data-driven prediction models. The objective of the study was to predict pulmonary cancer using hybrid machine learning models. This study presents a comprehensive review of machine learning (ML) algorithms to facilitate early prediction of pulmonary carcinoma using electronic medical records (EMRs) data. The dataset comprising 1000 patient records and 25 predictor variables, was subjected to rigorous pre-processing, including label correction, multicollinearity assessment, and dimensionality reduction. Eighteen statistically significant features, encompassing symptoms, lifestyle factors, and environmental exposures were identified through variance inflation factor (VIF) analysis and chi-square testing. Multiple ML models, including Support Vector Machine (SVM), Random Forest (RF), Logistic Regression (LR), and Deep Learning (DL) classifiers, were trained and evaluated using precision, recall, F1 score, specificity, and AUC metrics. The chi-square test revealed that age (χ²=44.187, p<0.001), passive smoking (χ²=752.960, p<0.001), obesity (χ²=712.088, p<0.001), smoking (χ²=671.006, p<0.001), and symptoms like coughing blood (χ²=818.669, p<0.001) were significantly associated with pulmonary Carcinoma. The performance metrics indicate that most basic and ensemble models, including DT, SVM, LR, KNN, AdaBoost, and RF, achieved perfect scores (accuracy, precision, recall, F1, AUC = 1.000), demonstrating optimal classification. DL and SVM Bagging showed 97% accuracy, while NN and MLP performed well with accuracy above 96%, though slightly less than the ensemble models. These findings accentuate the potential of ML, especially SVM, for early prediction of pulmonary carcinoma using structured EMR data. These findings support the integration of ML-based tools into clinical workflows, supporting data-driven, personalized cancer screening and decision-making in health care.
To investigate how early manual lymphatic drainage can prevent lower limb lymphedema (LLL) following real-world gynecological cancer surgery. A total of 342 patients with gynecological cancers underwent radical surgery at a Guangxi cancer hospital between January 3 and February 15, 2025 were included. In order to ascertain the implementation of preventive manual lymphatic drainage (MLD) following surgery, patients were categorized into a prophylaxis group and a control group according to their selection. To control for potential confounding factors, a 1:1 propensity score-matching (PSM) method was used. Using the gynecological lymphedema questionnaire (GLQ) at least 6 months after surgery, we investigated the incidence of LLL and the status of preventive strategies after the intervention. After PSM, 111 pairs of score-matched patients were generated. The prophylaxis group's LLL incidence was 10.81%, substantially lower than the control group's 21.62% (P = 0.04). 15.6% of patients in the control group and 38.9% of patients in the prophylaxis group engaged in preventive activities (P < 0.001). 71.7% of patients with GCLQ scores ≥ 4 took action to prevent LLL progression. The prophylaxis group showed a significantly reduced risk of LLL (risk ratio, 0.50; 95% confidence interval (CI) [0.263-0.949]; P = 0.034). The occurrence of postoperative lower limb lymphedema is reduced in gynecologic cancer patients who undergo early manual lymphatic drainage. This offers compelling evidence to inform clinical treatment decisions.
Survivors of nasopharyngeal carcinoma (NPC) frequently suffer from a prolonged reduction in quality of life (QoL) following successful treatment. This study investigates the determinants of QoL among NPC survivors, with a focus on the temporal evolution post-treatment and the influence of socioeconomic and clinical factors. In this cross-sectional study, NPC patients who received treatment in the last 10 years and underwent follow-up at our institute from 2021 to 2023 were enrolled. They completed the EuroQol five-dimension (EQ-5D), World Health Organization Quality of Life-Brief (WHOQOL-BREF), Sinonasal Outcome Test 22 (SNOT-22), Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7), and Eating Assessment Tool-10 (EAT-10). Kernel smoothing techniques were applied to delineate the trends in QoL scores, and linear mixed models were utilized for evaluating the unadjusted and adjusted influences of household income and other predictors on QoL. Out of 248 participants, 355 QoL evaluations were performed. Kernel-smoothed trajectories revealed that higher household income correlated with superior QoL scores throughout the majority of the post-treatment timeline. Although initial analyses showed that both higher household income and Karnofsky Performance Scale (KPS) scores were predictive of better generic and condition-specific QoL, the effect of income was attenuated upon adjusting for KPS in the multivariate analysis. Mediation analysis indicated that the association between income and QoL was partly mediated by the patients' performance status. Performance status is a pivotal mediator in the interplay between socioeconomic status and QoL outcomes in NPC survivors. These insights underscore the need for prospective studies to confirm these relationships.
Being familiar with the care of patients with breast cancer who are receiving abemaciclib, including adverse event (AE) management, supports care. This article describes the care of patients with breast cancer receiving abemaciclib, including AE data from clinical trials and nonpharmacologic interventions in real-world practice through a survey of healthcare providers. Safety data from the monarchE, MONARCH 1, MONARCH 2, and MONARCH 3 trials were reviewed. A quantitative survey of advanced practitioners, oncologists, and pharmacists was also conducted to better understand nonpharmacologic interventions to manage patient-felt AEs and support patients receiving abemaciclib. The most common AEs across all MONARCH trials were diarrhea, fatigue, nausea, and neutropenia; most events were grade 1-2. Of 282 survey respondents, more than 90% recommended nonpharmacologic interventions to manage AEs.
Financial toxicity is increasingly recognized as a consequential dimension of cancer care, yet multicenter evidence in China remains limited for patients with gynecologic cancers undergoing radiotherapy, a treatment pathway that often entails repeated visits and substantial non-medical costs. This study estimated the prevalence and severity of financial toxicity and examined its association with quality of life and psychological distress. A multicenter cross-sectional survey was conducted in three tertiary hospitals in China, led by West China Second University Hospital, Sichuan University. Adult patients with gynecologic cancers receiving external beam radiotherapy and or brachytherapy with definitive, adjuvant, or curative-intent salvage or consolidation intent were consecutively recruited. Financial toxicity was assessed using the COmprehensive Score for financial Toxicity (COST, 0 to 44; lower scores indicate worse toxicity). Quality of life was measured using the EORTC QLQ-C30, and psychological distress using the Distress Thermometer (DT, 0 to 10; clinically significant distress defined as DT ≥ 4). Multivariable regression models included hospital fixed effects to account for measured differences across centers and adjusted for sociodemographic, access-burden, and clinical covariates. Among 1,533 returned questionnaires, 1,303 were valid and analyzed (85.0%). Mean COST score was 21.6 (SD 7.4); 17.5% had severe financial toxicity (COST ≤ 14), 48.0% moderate (15 to 24), and 34.5% mild (≥25). Mean QLQ-C30 global health status was 61.3 (SD 14.2). Mean DT score was 4.3 (SD 2.1), and 65.2% met criteria for clinically significant distress. In adjusted analyses, each 5-point decrease in COST was associated with lower global health status (β -4.17, 95% CI -4.62 to -3.72), lower emotional functioning (β -4.68, 95% CI -5.20 to -4.16), higher fatigue (β 4.47, 95% CI 3.93 to 5.01), and higher DT score (β 0.32, 95% CI 0.23 to 0.40), all p < 0.001. Each 5-point decrease in COST was associated with higher odds of clinically significant distress (OR 1.34, 95% CI 1.22 to 1.47; p < 0.001). Financial toxicity was common among gynecologic radiotherapy patients in China and was independently associated with poorer quality of life and higher psychological distress. Integrating financial toxicity screening with supportive care pathways during radiotherapy may help identify high-risk patients and guide targeted assistance.
Chemotherapy for lymphoma often induces distressing toxicities that impair treatment adherence and quality of life (QoL). With increasing demand for decentralized cancer care, nurse-led telehealth interventions offer a promising approach to support symptom management. This study aimed to evaluate the effectiveness of a nurse-led remote symptom management model in reducing chemotherapy-related toxicities and improving QoL among patients with newly diagnosed lymphoma in China. A quasi-experimental study was conducted in a tertiary oncology center. Patients newly diagnosed with lymphoma and undergoing ≥ 6 cycles of chemotherapy were enrolled between July 2022 and December 2023. Participants receiving care between July 2022 and June 2023 formed the intervention group (N = 286), while those from July to December 2023 constituted the control group (N = 143). The intervention comprised structured telephone follow-ups by oncology nurses using CTCAE v5.0 criteria and a graded management protocol. Primary outcomes were incidences of grade ≥ 2 toxicities. Secondary outcomes included changes in QoL measured by the EORTC QLQ-C30. Generalized estimating equations (GEE) were used to analyze longitudinal data. Compared to the control group, the intervention group demonstrated significantly lower odds of fatigue (OR = 0.62), nausea (OR = 0.56), vomiting (OR = 0.34), and constipation (OR = 0.30; all P < 0.01). No significant differences were observed for diarrhea, fever, or pain. QoL analysis showed improvements in global health status (β = 3.73), social functioning (β = 6.02), and financial difficulties (β = -6.07). Nurse-led remote symptom management significantly reduced core chemotherapy-related toxicities and enhanced QoL in patients with lymphoma. These findings support the integration of structured remote symptom management into oncology care models in resource-constrained settings.
Medical device-related pressure injuries are a significant and largely preventable patient safety problem, yet existing pressure injury risk scales do not adequately capture device-specific risk factors in adults. This methodological study developed and psychometrically evaluated a standardized risk assessment scale to identify medical device-related pressure injury risk in hospitalized adult patients. An initial item pool was generated from an extensive literature review and clinical expertise, and content validity was assessed by seven experts using the Davis technique (content validity index = 0.96). The scale was administered to 160 adults receiving at least one medical device in medical, surgical and oncology wards and intensive care units of a university hospital. Construct validity was evaluated using binary logistic regression, exploratory factor analysis, and receiver operating characteristic curve analysis, demonstrating strong discrimination (area under the curve = 0.844, 95% confidence interval 0.728-0.961) with an optimal cut-off score of 14.5 (sensitivity 70.6%, specificity 88.8%). Exploratory factor analysis of the final version of the MedRAS (Kaiser-Meyer-Olkin = 0.792) revealed a two-factor structure (Device and Mechanical Factors; Patient and Tissue Factors) explaining 50.92% of the total variance, with all factor loadings above 0.30. The scale showed good internal consistency (Cronbach's alpha = 0.80) and very good inter-rater reliability (Cohen's kappa = 0.806, p < 0.001). This device-focused scale may support early risk identification and targeted preventive nursing interventions, with potential to improve patient safety and quality of care in inpatient/critical care settings.