Hereditary colorectal cancer (CRC) syndromes, including Lynch syndrome and the adenomatous and hamartomatous polyposis conditions, account for up to 10% of CRC cases. Advances in molecular diagnostics and tumor-based testing have improved identification, yet access to genetic testing and lifelong surveillance remains inconsistent worldwide. This narrative review examines the evolving role of nurses in identifying, managing, and supporting individuals and families affected by hereditary CRC. A narrative synthesis of international literature, clinical guidelines, and examples of nurse-led models of care from Europe, the United Kingdom, Canada, the United States, Australia, and other health systems was conducted. Articles were included if they addressed hereditary CRC epidemiology, genomic workforce issues, nursing roles, service delivery, or patient experience. A narrative approach was selected to integrate policy documents, and practice models not suited to systematic review methods. Five themes emerged: previvorship and living with inherited risk, genomics workforce capacity, evolving nursing roles, lifelong surveillance, and genomics education. Across health systems, nurses, particularly advanced nurse practitioners (ANPs), clinical nurse specialists (CNSs), and oncology nurses, play an increasingly significant role in hereditary CRC pathways. Their contributions include family history assessment, mainstreaming genetic testing, surveillance coordination, psychosocial support, and patient navigation. Nurse-led models improve access to testing, reduce diagnostic delays, and enhance surveillance adherence. However, roles remain inconsistent across jurisdictions, and challenges persist, including workforce shortages, variable genomics education, limited funding, and an uneven evidence base across the full spectrum of hereditary CRC syndromes. Nurses act as coordinators across gastroenterology, surgery, oncology, genetics, and primary care- supporting equitable access and continuity throughout the hereditary CRC care trajectory. Despite their growing impact, nursing roles remain under-recognized in guidelines and under-evaluated in research. Systematic investment in genomics education, structured role development, and nurse-led models is required to deliver consistent, patient-centered hereditary CRC care. Embedding genomics in nursing education, strengthening structured roles, and supporting nurse-led services within multidisciplinary frameworks are essential to improving equitable access and outcomes.
To synthesize current educational approaches to AI literacy in oncology nursing, identify key competency domains along with barriers and enablers, and offer clinically oriented recommendations for the safe and effective integration of AI into clinical practice. Structured search of MEDLINE via PubMed (2015-2025) using MeSH and free-text terms, complemented with free sources (Google Scholar, OpenAlex/Lens), handsearching of key journals, and backward/forward citation chasing. Study selection was performed by two independent reviewers, with disagreements resolved by consultation with a third author; the process is summarized in a PRISMA 2020 flow diagram. Findings confirm that digital and AI literacy are fundamental for oncology nurses. Effective use of AI requires a grasp of basic ML principles, data interpretation, and ethics. Educational strategies include integration into formal curricula and innovative formats such as microlearning, simulations, and virtual reality. Key barriers are uneven digital skills, resistance to technology, and lack of structured programs. Successful education is further supported by multidisciplinary collaboration and patient involvement. Evidence suggests that AI enhances clinical decision-making, personalized care, safety, and nurse autonomy. Incorporating AI competencies into nursing education is crucial for improving safety and quality in oncology care. Educational reforms should foster critical thinking, ensure ongoing evaluation, and preserve empathy towards patients. Verified and flexible programs enable sustainable literacy development aligned with technological and ethical standards. Nurses educated in AI can improve clinical decision-making, reduce errors, and provide empathetic, individualized care. AI should be regarded solely as a tool that supports nurses' work, not as a replacement. Interdisciplinary and patient-centered approaches support the safe integration of AI into daily oncology nursing practice. This review uniquely focuses on oncology nursing, integrates peer-reviewed and professional/grey sources, and offers practical curriculum and clinical integration recommendations that complement recent reviews.
This article is a detailed exploration of the clinical utility, strengths, and limitations of traditional serum tumor markers with emerging circulating cell-free DNA (cfDNA) technologies in the monitoring of breast, ovarian, pancreas, and prostate cancers. It highlights how integrated biomarker strategies can advance precision oncology, particularly in the context of hereditary breast, ovarian, pancreas, and prostate cancer syndrome. A review was conducted of current literature and practice guidelines, including the latest updates from the National Comprehensive Cancer Network (NCCN). The clinical performance, diagnostic value, and monitoring roles of serum tumor markers (eg, CA 15-3, CA 125, PSA, CA 19-9) and cfDNA were discussed descriptively across these four malignancies. Emphasis was placed on evidence relevant to hereditary cancer risk assessment, therapeutic decision-making, and disease surveillance. Serum tumor markers remain a cornerstone in oncology nursing practice because of the accessibility and utility in assessing treatment response and tracking disease burden over time. Yet, their limited sensitivity and specificity, especially for early detection, underscore the need for complementary tools. Circulating cell-free DNA (cfDNA) technologies provide real-time molecular information on tumor biology, offering earlier detection of recurrence, identification of germline-related actionable mutations, and dynamic assessment of therapeutic resistance. In hereditary cancer syndromes such as those associated with BRCA1/2, cfDNA has shown value for detecting minimal residual disease, informing targeted therapy selection (eg, PARP inhibitors), and supporting noninvasive longitudinal monitoring across the cancer care continuum. Integrating cfDNA analysis with traditional serum tumor marker monitoring strengthens the ability to perform comprehensive risk assessment, tailor treatment decisions, and refine disease surveillance for individuals with hereditary cancer risk. This combined approach enables person-centered, evidence-based care while educating patients about the purpose and limits of each test, coordinating timely follow-up, and supporting adherence to surveillance protocols thereby ultimately improving outcomes for high-risk populations. Oncology nurses play a critical role in supporting the integration of advanced biomarker technologies into personalized care. Understanding the evolving applications of cfDNA and serum tumor markers is essential for patient education, shared decision-making, and advocacy for equitable access to precision oncology innovations. Nurses are key partners in implementing biomarker-informed care pathways that promote individualized, high-quality cancer care.
Cultural diversity is a defining feature of very high Human Development Index countries of the Western world. Asian immigrants represent a growing demographic in these countries and are a vulnerable group at risk of experiencing health disparities, including individuals surviving cancer. We synthesized available research evidence to evaluate the unmet needs, cancer care experience and factors affecting health-related quality of life of Asian immigrant cancer survivors living in countries in the Western world ranked as very high Human Development Index. This systematic review is reported in accordance with Preferred Reporting Item for Systematic Reviews and Meta-Analyses guidelines. Three electronic databases (MEDLINE, EMBASE, and CINAHL) were systematically searched in September 2023 and again in May 2024 to identify research studies of any design. Predefined inclusion criteria were applied, and findings from the included studies were synthesized narratively. Of 515 records identified, 31 studies met the inclusion criteria: 19 qualitative, 10 quantitative, and two mixed-methods studies. Thirty studies reported on samples of Chinese origin (25 studies with exclusive focus on Chinese immigrants). Six studies reported on samples of Arab origin (one study with exclusive focus on Arab immigrants). Frequently reported unmet needs for both Chinese and Arab immigrants included access to high-quality information, psychological and social support services, and professional interpreter services. Communication with healthcare professionals was often reported as problematic. Psychological burden was commonly reported and negatively affected health-related quality of life in both groups. Cultural beliefs strongly influenced cancer experiences, particularly among Chinese immigrants, who often reported experiencing stigma. While our findings apply predominantly to Chinese and Arab immigrant cancer survivors, it is evident that wealthy living environments and well-developed healthcare systems/services are not panacea. Addressing the unique needs of immigrant cancer survivors, as well as barriers experienced in accessing supportive cancer care in the host country is essential to promoting equitable cancer care. Improving accessibility, navigation, and health literacy are key strategies to optimize outcomes for these populations, together with a need to re-shape supportive care approaches to suit cultural norms and preferences. To promote equity, nurses are required to demonstrate cultural sensitivity and proactive awareness of how immigrant status might influence how cancer as a personal and family illness can be experienced. Nurses should carefully assess the specific needs of immigrant cancer survivors and enable bespoke navigation within the health care system and in the community to effectively respond to these needs.
This systematic review and meta-analysis aimed to evaluate the effectiveness of interventions particularly psychoeducational and physical activity-based approaches on sexual function and satisfaction among individuals diagnosed with prostate cancer. A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and CINAHL databases to identify relevant studies published between 2010 and 2023. Studies were included if they involved interventions targeting sexual health in prostate cancer patients. Data were synthesized using random-effects meta-analysis models, and the quality of included studies was assessed using standardized criteria. A total of 14 studies met the inclusion criteria. Meta-analytic findings indicated that psychoeducational interventions, especially when combined with physical activity or counseling, significantly improved sexual function (SMD = 0.31, 95% CI: 0.03-0.60, P = .03) and satisfaction (SMD = 0.27, 95% CI: 0.04-0.50, P = .02). These interventions demonstrated moderate heterogeneity but consistently showed beneficial outcomes. The findings support the integration of nurse-led psychoeducational and behavioral interventions into routine care for prostate cancer patients. Such approaches can enhance patients' sexual well-being, quality of life, and psychological resilience during survivorship. Oncology nurses play a pivotal role in delivering holistic care to prostate cancer patients. Incorporating structured sexual health counseling, exercise-based rehabilitation, and psychoeducational support into survivorship programs can significantly improve sexual outcomes. This evidence reinforces the need for oncology nursing practices that prioritize sexual health as a key component of quality cancer care. These findings support integrating structured nurse-led sexual health interventions into survivorship care and highlight sexual wellbeing as a core component of holistic oncology nursing.
This scoping review aimed to investigate the current knowledge regarding healthy parents' experiences of parenting children and young adults in families affected by parental cancer. Following the Joanna Briggs Institute framework, a systematic search was conducted in MEDLINE, Embase, CINAHL, and PsycINFO. Eligible studies included qualitative and mixed-methods research involving healthy parents of children and young adults (0-28 years) in families where the other parent was diagnosed with cancer, without restrictions on publication year. Studies involving healthy partners of patients in curative and palliative stages were included. Screening was performed independently by two researchers, and data were charted and synthesized, following the thematic analysis approach of Braun and Clarke. Of 3,652 screened articles, 21 articles met the inclusion criteria; qualitative (n = 19), mixed-methods (n = 1), and a qualitative PhD dissertation (n = 1). Four themes emerged: (1) Family Dynamics and Relationships, (2) The Emotional Impact of the Healthy Parent, (3) Coping Strategies and Illness Adaptation, and (4) Support Systems and Everyday Challengers. Healthy parents in families affected by parental cancer play a pivotal role in sustaining family functioning during parental cancer. They experience dual burdens of caregiving and parenting and emotional strain, including insufficient support. Their unmet needs may compromise their parenting capacity and family well-being, underscoring the importance of integrating healthy parents' experiences into family-centered health care and support structures and services. While healthy parents carry the dual responsibilities of caregiving and parenting during parental cancer, their needs and perspectives are often overlooked in oncological care. Recognizing and addressing their needs are essential to protect their parenting capacities and the family's well-being. Integrating healthy parents into family-centered care may enhance experienced resilience and strengthen support for the whole family.
The aim of the study is to explore how nurses document the nursing processes within a cancer care setting using digital health record (DHR). How do nurses document the nursing processes within a cancer care setting using DHR? A cross-sectional study. Twenty clinical care records were randomly selected from a large metropolitan hospital in a single medical oncology inpatient ward in Australia. The audit was conducted using the D-Catch instrument to assess the completeness and quality of nursing record using the five elements of the nursing process. Data analysis was conducted in IBM SPSS Statistics version 29. The findings from the study showed evidence of high scores across all aspects of the nursing process, both in the completeness of record and an overall positive outcome for the quality of nursing documentation. However, documentation relating to assessment of patients' holistic care needs showed low to zero evidence of any documented record. This study provided important insight into the documentation of the nursing processes within DHR. The concerns around limited documentation in capturing holistic care needs require attention. The application of D-Catch tool in assessing the nursing process remains useful, as shown in this study; however, its usability within a digital context needs further investigation.
Electromyography (EMG) is increasingly applied in oncology to monitor neuromuscular impairment, treatment toxicities, and rehabilitation outcomes. However, reliance on maximal voluntary contraction (MVC) normalization limits scalability, as many patients cannot perform safe and reliable MVCs due to fatigue, pain, or treatment-induced impairments. This narrative review evaluates the feasibility and clinical utility of machine learning (ML)-predicted MVCs as an alternative normalization method in oncology care. Peer-reviewed articles published between 2015 and 2025 were retrieved from PubMed, IEEE Xplore, ScienceDirect, SpringerLink, and open-access repositories. Search terms included electromyography, oncology, maximum voluntary contraction, machine learning, sarcopenia, cachexia, and rehabilitation. Thirty-eight studies were included. Findings highlight that traditional MVC-based normalization is frequently infeasible in cancer populations due to neuromuscular compromise, variability in body composition, and safety risks. ML approaches, leveraging demographic, anthropometric, and submaximal EMG data, show promise for estimating MVC indirectly. Predictive models such as artificial neural networks and ensemble learners demonstrate potential to improve accuracy, reduce patient burden, and enable broader EMG integration into rehabilitation and survivorship monitoring. Clinical applications include safer exercise prescription, individualized progress tracking, and remote continuous monitoring through wearable sensors. ML-predicted MVCs may overcome longstanding barriers to EMG standardization in oncology. By reducing dependence on direct maximal efforts, these approaches can improve functional assessment accuracy, optimize rehabilitation strategies, and enhance patient-centered care. Oncology nurses and rehabilitation specialists could incorporate ML-supported EMG assessments into clinical and home-based programs, supporting adaptive, real-time interventions that promote safety, engagement, and quality of life for individuals with cancer.
This study aimed to examine the mediating role of depression in the relationship between pain and self-reported cognitive symptoms among gynecological oncology patients undergoing brachytherapy. The present study employed a descriptive, cross-sectional, correlational design. The present study sample comprised 130 gynecological cancer patients receiving brachytherapy at a city hospital. The data were collected using the following instruments: the Participant Information Form, the Pain Frequency Intensity and Burden Scale (P-FIBS), the Cognitive Failures Questionnaire (CFQ; a self-report measure of cognitive failures), and the Beck Depression Inventory (BDI). In order to evaluate the potential mediating effect of depression, correlation analyses and regression-based mediation path analysis with bootstrapping were applied. The mean scores of the participants were 12.11 ± 4.44 for P-FIBS, 51.62 ± 13.89 for CFQ, and 38.44 ± 9.37 for BDI, indicating high levels of pain, self-reported cognitive failures, and depressive symptoms. A significant positive correlation was identified between pain and depression, as well as between cognitive failures and depression (P < .01). Mediation analysis showed evidence consistent with partial mediation, with depression accounting for approximately 17% of the total effect of pain on cognitive symptoms. Regression analyses indicated a statistically significant association between pain and depression (B = 0.68, P < .001), and between depression and cognitive symptoms (B = 0.30, P = .015). The findings suggest that depression may represent an important pathway linking pain and cognitive symptoms in gynecological oncology patients undergoing brachytherapy. However, these results should be interpreted cautiously due to the cross-sectional study design and the reliance on self-report measures. Addressing depressive symptoms alongside pain management may be clinically important in this population. Nurses play a central role in identifying and monitoring pain, depression, and cognitive changes. Incorporating systematic screening, psychoeducation, and psychosocial support into nursing care may improve treatment adherence, enhance quality of life, and foster holistic, patient-centered care in gynecological oncology settings.
Oncology nurses provide relational care with patients and families that require high levels of skill and empathy. This emotionally demanding work can lead to compassion fatigue, burnout, and unprocessed grief. Strategies to support oncology nurses are crucial for maintaining their well-being and delivering high-quality care. The purpose of this study was to analyze stories written by oncology nurses to understand the emotional experiences of caring for people with cancer. A secondary qualitative analysis of 35 oncology nurses' stories was conducted using Braun and Clarke's thematic analysis framework. The nurses were participants in two Storytelling Through Music intervention studies, which included writing stories to process work-related emotions. Themes were developed to identify patterns and shared experiences across the narratives. The meta-theme of "Seeking Emotional Balance" emerged and was interwoven throughout the six themes: emotional labor, above and beyond, connections and mutual healing, cumulative grief and loss, coping and remembrance, and finding meaning. Nurses described the challenges of maintaining emotional balance while navigating professional and personal emotional demands. Oncology nurses face unique relational and emotional challenges. While some found resilience in patient connections, others experienced chronic distress and burnout. Storytelling provides a reflective outlet to process emotions, strengthen resilience, and foster shared understanding among peers. Storytelling interventions show promise as tools for emotional regulation and professional sustainability. Deep nurse-patient connections foster meaning and resilience but can blur boundaries, increasing risks like countertransference. Reflective practices help safeguard nurses' well-being and care quality. At the individual level, nurses should adopt self-care strategies and engage in reflective practices. Organizational support is vital. Institutions can provide emotional resilience training, implement bereavement overload policies, and offer group storytelling opportunities to reduce stress, enhance regulation, and build supportive peer connections.
The demand for hereditary breast cancer genetic services is outpacing workforce capacity, creating barriers to timely diagnosis and prevention. This paper discusses the role of the Breast Advanced Nurse Practitioner (ANP) as a strategic solution to these challenges, focusing on how ANPs can deliver a patient-centered approach to genetic care. Peer reviewed articles and international guidelines focused on hereditary breast cancer were used for this discussion paper to examine the management of women at risk of hereditary breast cancer and how ANPs can impact the evolving field of genetics. ANPs are uniquely positioned to bridge the gap between oncology and genetics. By integrating clinical expertise with genomic competencies, ANPs can effectively manage risk assessment, mainstream genetic testing, and long-term surveillance. ANP role emphasizes holistic support, addressing the psychosocial impact of genetic risk, and ensuring continuity of care for patients and their families. However, some challenges remain regarding the lack of formal training and the inconsistent implementation of the ANPs role in different settings. Integrating ANPs into hereditary breast clinics is not just a workforce solution but a quality improvement strategy. To sustain this role, an innovative approach is needed. Advanced training and funding for education programs in genetics is crucial for nurses in order to develop the skills and knowledge needed to expand their role. Clear role definition, robust protocols and clinical supervision in order to work within their scope of practice are required for ANPs. Nurses working with patients at risk of hereditary breast cancer require continuous training, access to genetic education programs and clinical supervision to keep their skills up to date with this rapidly evolving area in cancer and genetics. Highly skilled and educated nurses in genetics such as Breast ANPs can provide mainstream genetic testing and offer pre and post genetic counselling improving patient outcomes and access to timely care.
Cancer nurses face heavy workloads and emotional strain, making missed nursing care (MNC)-the omission or delay of necessary care-a growing concern, particularly in oncology settings in which patient vulnerability is high. While professional quality of life (ProQOL), including compassion fatigue (CF), burnout (BO), and compassion satisfaction (CS), is known to affect care quality, its link to MNC in cancer units remains underexplored. This study aimed to examine the extent of missed nursing care in cancer clinics, as well as how CF, BO, and CS influence MNC. A cross-sectional study was conducted with 147 nurses working in inpatient and outpatient oncology units in Türkiye. Data were collected via an online survey using the Professional Quality of Life Scale (ProQOL IV) and the Missed Nursing Care Survey. Analyses included descriptive statistics, nonparametric tests, correlation, and multiple linear regression. Nurses reported moderate-to-high CF and BO, and low-to-moderate CS. The most frequently missed care practice was emotional support for patients and their families. Key reasons for MNC included staffing shortages and limited resources. No significant relationship was found between CF or BO and MNC. However, lower CS was significantly associated with higher MNC. Regression analysis showed that working in public hospitals and low perceived social support significantly predicted MNC. Missed nursing care is influenced by low CS, inadequate support, and challenging work environments, particularly in public hospitals. Enhancing compassion satisfaction and institutional support may reduce missed care and improve cancer care quality.
This study aimed to explore pediatric oncology nurses' perspectives on the integration of artificial intelligence (AI) into pediatric oncology care, focusing on its potential advantages, implementation challenges, and ethical considerations. A hermeneutically informed descriptive phenomenological qualitative design was employed. One-to-one, semistructured interviews were conducted with 18 pediatric oncology nurses between April and June 2025. All interviews were audio-recorded, transcribed verbatim, and analyzed thematically in MAXQDA using Braun and Clarke's six-phase framework (2006). Reporting followed the COREQ checklist. Participants' mean age was 36.8 ± 6.9 years, and most had >10 years of professional experience. Thematic analysis identified five main themes with related subthemes: (1) the potential of AI in pediatric oncology care; (2) implementation challenges and concerns; (3) nurse-AI collaboration; (4) ethical considerations; and (5) competence and training needs. Nurses highlighted AI's potential to accelerate diagnostic/treatment processes, reduce error, and enhance patient safety, while also noting barriers related to infrastructure, ethics, and professional skills. Pediatric oncology nurses perceived AI as a valuable tool to support clinical decision-making, improve patient safety, and increase care efficiency; however, ethical concerns, infrastructural limitations, and insufficient training constrain effective integration. Strengthening technological competencies, ensuring ethical safeguards, and providing continuous training are essential for successful AI integration. Combining clinical expertise with AI competence may promote safer, more effective pediatric oncology care.
Fear of cancer recurrence (FCR) is among the most common and debilitating psychological issues affecting breast cancer survivors. With technological advances, e-health interventions have emerged as cost-effective tools to manage psychosocial challenges such as FCR. This study aimed to systematically review and synthesize evidence from randomized controlled trials assessing the effectiveness of e-health interventions in reducing FCR among breast cancer survivors. This systematic review and meta-analysis were conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD42025645734). Comprehensive searches were performed in Web of Science, PubMed, Scopus, Medline, and Taylor & Francis Online up to January 2025. Risk of bias was evaluated using the Cochrane RoB 2 tool. A random-effects model with Hedge's g effect sizes and I² statistics was applied in the meta-analysis. Ten randomized controlled trials involving 1,565 participants were included. Interventions included online cognitive behavioral therapy, mobile applications, tele-coaching, and online mindfulness-based interventions. Although some individual studies reported reductions in FCR, the overall pooled effect size was not statistically significant (Hedge's g = -0.076, 95% CI: -0.183 to 0.031, P = .163). Considerable heterogeneity was observed among studies (I² = 87.39%). No significant publication bias was detected. E-health interventions show promise in supporting the psychological well-being of breast cancer survivors. However, current evidence does not demonstrate a significant effect in reducing FCR. Future research should explore ways to enhance intervention design, improve user engagement, and examine how factors such as age, digital literacy, and adherence influence outcomes. Nurses can play a key role in identifying patients receptive to digital interventions and supporting their engagement and adherence. Tailoring e-health content to individual needs, providing guidance on digital literacy, and integrating digital tools with face-to-face care approaches may enhance intervention effectiveness.
To synthesize current evidence on shared decision-making (SDM) processes that guide the choice of curative-intent treatment among patients with prostate or bladder cancer. Following PRISMA 2020 guidelines, we searched seven databases from inception to November 2024 for randomised, observational, and qualitative studies evaluating SDM in treatment selection for localized prostate or bladder cancer. Two reviewers independently screened, extracted data, and appraised quality using the Mixed-Methods Appraisal Tool. Ten studies (n = 11,506) met inclusion criteria: eight on prostate cancer, one on muscle-invasive bladder cancer, and one mixed cohort. Designs included three randomized controlled trials, five quantitative observational, and two qualitative studies. Structured interventions, decision aids, and joint consultations consistently reduced decisional conflict, improved satisfaction, and sometimes shifted choices toward preference-sensitive options. Nonetheless, reported "involvement" often masked gaps, including limited discussion of long-term side-effects and insufficient clarification of patient preference. Seven studies were rated minimal risk of bias, though many had small samples, restricted blinding, or lacked real-time quality-of-life data. Evidence for bladder cancer was limited to one exploratory study. Structured SDM interventions and multidisciplinary counselling generally improve decision quality in curative-intended prostate or bladder cancer treatment. Yet, critical elements remain underutilized despite being highly valued by patients. Future work should extend to bladder cancer, incorporate patient-reported outcomes, and test scalable multidisciplinary SDM models to ensure informed, value-concordant care. Oncology nurses are central to SDM by clarifying patient preferences, addressing side effects, and supporting decision aid use. Their sustained patient relationships foster trust and communication, while nurse-led roles-such as preference elicitation clinics, toxicity prehabilitation counselling, and survivorship navigation-offer structured opportunities to embed SDM. Scripts, checklists, and well-timed consultations can make these approaches consistent and sustainable in everyday practice.
This scoping review aimed to identify the barriers and facilitators of prognostic communication experienced by oncology nurses in low and middle-income countries (LMICs). A scoping review was conducted using Arksey and O'Malley's framework. Searches of MEDLINE, Scopus, Embase, CINAHL, and ScienceDirect (2015-2025), plus grey literature, identified empirical studies focusing on oncology nurses' prognostic communication in LMICs. Two reviewers independently screened the articles and charted the data. The findings were synthesized thematically using line-by-line coding (Registered in PROSPERO: CRD420251239353). From 1,784 records, nine studies met the inclusion criteria, most were qualitative (6), and the others were a mixed methods (1) and quantitative cross-sectional (2) studies. The review identified and classified barriers and facilitators to prognostic communication into three categories: (1) health system and environmental factors, (2) nurse-related factors, and (3) patient and family-related factors. The facilitators were also summarized into three categories of health system/environment, nurse, and patient and family facilitators. Multiple barriers and facilitators influence prognostic communication among oncology nurses in LMICs. However, some of the health system/environmental and nurse-related factors are amenable to improvement using nurse-led interventions designed to strengthen nurses' competencies in prognostic communication. Strengthening oncology nurses' prognostic communication competencies is essential because it ensures patient-centered care, patient safety, and ethical safeguards. Thus, providing training in prognostic communication enhances clinical expertise and effectiveness, and may promote safer, more effective oncology nursing care.
The aim of this study was to explore the ruminative thoughts experienced by oncology nurses, examine their impact on both personal and professional life, and identify the coping strategies employed in the context of cancer care. This inductive qualitative study employed in-depth interviews with 20 oncology nurses, conducted between March and July 2021, and utilized content analysis for data analyze. The main theme identified was Ruminative thoughts and coping strategies of oncology nurses. It highlighted how oncology nurses' ruminative thoughts, driven by patient losses, fears of inadequacy, and cancer-related anxieties, affect their mental well-being and personal growth. The main theme is built upon the subthemes "Confronting professional and personal realities," "Redefining self and values," and "Overcoming strategies." This study reveals that oncology nurses' ruminative thoughts, driven by patient deaths, treatment inadequacy, and cancer fears, lead to mental fatigue but also foster personal growth. Coping strategies like distraction, thought suppression, and adopting a commitment to excellence mindset help them manage these challenges. Awareness of ruminative thoughts and the implementation of interventions such as resilience training, mindfulness-based practices, and team-based care approaches can reduce mental fatigue among nurses, enhancing their well-being and the quality of care they provide.
To examine the educational and practice gaps that limit genomic competency among oncology nurses and to propose strategies to strengthen workforce preparedness. Genomically informed cancer care has redefined oncology practice by enabling precision prevention, diagnosis, and treatment through germline and somatic biomarker testing. However, the oncology nursing workforce remains insufficiently prepared to deliver this care safely and effectively. A review of peer-reviewed literature. Based on the literature review, despite more than two decades of national initiatives to integrate genomics into nursing education, genomic content remains inconsistently embedded in both prelicensure and graduate curricula. Faculty often report limited readiness to teach this rapidly evolving science, while licensure and certification examinations rarely assess genomic competencies, perpetuating its de-emphasis in nursing curricula. Oncology nurses may misinterpret germline biomarker results, misunderstand inheritance patterns, or overlook opportunities for cascade testing, compromising both individual treatment and family risk reduction. Given their pivotal role in patient and family communication, oncology nurses must develop genomic literacy that supports a family-centered model of care for hereditary cancer syndromes. Strengthening genomic competency across the oncology nursing continuum requires deliberate competency-based curricula, sustained faculty development, and national efforts to realign educational and regulatory frameworks to support the safe, evidence-based, and family-centered delivery of genomically informed cancer care.
This review aimed to examine the inequalities in access to genetic counseling and testing services among individuals with Hereditary Breast and Ovarian Cancer Syndrome (HBOC) using bibliometric and thematic analysis methods. In this mixed methods study, conducted using an explanatory sequential design, 421 articles published in the Web of Science database between 1997 and 2025 were first analyzed bibliometrically. In the second stage, thematic analysis was conducted on the 10 most cited studies. Bibliometric findings indicate that scientific production in this field has increased significantly since 2013, with studies conducted primarily by US-based institutions and supported by strong international collaborations. Thematic analysis identified four main themes: (1) inequities in access to and participation in services, (2) differences in clinical outcomes, (3) changes in service delivery models, and (4) communication barriers. Findings revealed that inequities in access to genetic services under HBOC are related not only to individual awareness or economic status but also to systemic and cultural factors. Furthermore, remote (telephone) genetic counseling has been shown to have the potential to reduce geographic and structural barriers. Consequently, culturally tailored, accessible, and multidisciplinary approaches to addressing health disparities in HBOC are needed. Future research is recommended to compare experiences across countries using multiple data sources. This study demonstrates that nurses play a crucial role in facilitating access to genetic counseling and testing services for individuals at risk for hereditary cancer. Strengthening nurses' genetic literacy, cultural sensitivity, and equity-based care approaches will increase service accessibility and the effectiveness of holistic care.
About 75% of newly diagnosed bladder cancers are non-muscle invasive bladder cancer (NMIBC). NMIBC and its treatments affect patient functioning and quality of life. Exercise is feasible, safe, and beneficial for many cancer patient groups, however, no studies have examined exercise for NMIBC. We aimed to examine the feasibility, safety, and preliminary efficacy of high-intensity interval training (HIIT) for patients with NMIBC during or after intravesical therapy. The Bladder cancer and exeRcise trAining during or after intraVesical thErapy (BRAVE) trial randomized 25 NMIBC patients scheduled for or on surveillance after intravesical therapy to either usual care (n = 12) or HIIT (n = 13). The HIIT group performed thrice-weekly, supervised HIIT for 12 weeks. In 39 months, 293 patients were screened, 177 (60.4%) were eligible, and 25 (14.1%) were randomized. Median exercise attendance was 100%. From baseline to 12 weeks, VO2peak increased by 1.2 mL/kg/min in the HIIT group compared to a decrease of 0.7 mL/kg/min in the usual care group (adjusted between-group difference, 2.0 mL/kg/min; 95% CI: -0.4 to 4.4; P = .10; d = 0.37). Compared to the usual care group at 12 weeks, the HIIT group significantly improved 6-minute walk distance (adjusted between-group difference, 41 meters; 95% CI: 6-77; P = .025; d = 0.32) and the timed 8-foot up-and-go (adjusted between-group difference, -1.0 second; 95% CI: -1.9 to -0.2; P = .019; d = -0.44). Despite modest accrual, the BRAVE trial demonstrated that HIIT during or after intravesical therapy was safe and feasible for most NMIBC patients and resulted in meaningful improvements in several indicators of physical functioning. Oncology nurses can inform NMIBC patients that high-intensity interval training may be safe, feasible, and potentially effective in improving physical functioning during or after intravesical therapy.