Objectives To describe the essential structure of pediatric oncology nurses’ lived experience of caring for children with cancer and to clarify how emotional involvement, professional meaning, contextual constraints, and personal-life spillover are integrated in that experience. Methods A descriptive phenomenological study guided by Giorgi’s approach was conducted with 11 pediatric oncology nurses from a specialized oncology hospital and a central hospital in Northern Portugal. Data were collected through face-to-face semistructured interviews and analyzed using Giorgi’s four-step procedure. Interviews and analysis were conducted in Portuguese; quotations selected for publication were translated into English and checked for conceptual and semantic equivalence. Results The essential structure of the experience was sustained relational presence under emotional and contextual pressure. Nurses remained affectively close enough to preserve trust with children and families while regulating distress to remain clinically and professionally available. Four interrelated constituents expressed this structure: emotional ambivalence in the nurse-child-family relationship; meaning-making and professional confirmation; practice demands and contextual constraints; and self-regulation and personal-life spillover. Conclusions Caring for children with cancer was experienced as a continuous balancing of relational closeness, professional responsibility, organizational limitations, and personal vulnerability. These findings suggest that the quality and sustainability of relational care depend not only on nurses’ individual self-regulation but also on supportive organizational conditions. Implications for Nursing Practice Pediatric oncology services should provide structured reflective debriefings after emotionally difficult events, simulation-based training for complex communication with children and families, and confidential peer and psychological support. Adequate staffing, protected time for communication, and team routines that support continuity and shared reflection may help nurses sustain relationally responsive care.
OBJECTIVES:A nurse navigation program can support individual patients' unsupported care needs and improve patient outcomes. This study, a nurse navigation program (LungCaNN) was developed to address the supportive care needs of patients newly diagnosed with non-small cell lung cancer (NSCLC). The primary aim of the study is to evaluate the effects of the LungCaNN program on patients' anxiety and depression levels, disease adaptation, and quality of life. Additionally, secondary outcome, the study investigates the impact of the program on emergency department admission rates. METHODS:A randomized controlled trial was conducted at a university hospital in Antalya, Turkey. Patients were randomly assigned to intervention (LungCaNN) (n = 42) and control (n = 42) groups. To support patients their individual needs, a 12-week nurse navigation program was implemented by the nurse navigator through regular telephone calls and monthly face-to-face sessions. The 42 patients in the control group received routine care. Data collected using standardized instruments, including DASS-21, Adaptation to Chronic Illness Scale, and EORTC QLQ-C30/LC-13. RESULTS:In both groups, the majority of patients were male, aged between 61 and 70 years, married, unemployed, and had a low income level. It was found that the LungCaNN intervention group had significantly lower average scores for depression and stress higher average scores for physical adaptation, social adaptation psychological adaptation and overall quality of life compared to the control group, with the differences between the groups being statistically significant. Additionally, secondary outcome, the rate of emergency department visits was found to be lower in the intervention group. CONCLUSION:LungCaNN was found to reduce depression, stress, and anxiety levels, and improve chronic disease adaptation and overall quality of life in newly diagnosed NSCLC patients. IMPLICATIONS FOR NURSING PRACTICE:Expanding nurse navigation programs with structured assessment algorithms and ensuring their integration into oncology units are essential for broader and sustained impact.
OBJECTIVES:Pediatric cancer survivorship is a complex and evolving process marked by persistent emotional, physical, and social challenges. Adolescents, in particular, experience heightened uncertainty regarding future health, fear of recurrence, and difficulties reintegrating into social and academic life. Despite increasing survival rates, empirical evidence capturing adolescents' lived survivorship experiences remains limited. This study aimed to explore the lived survivorship experiences and support needs of adolescents who had completed pediatric cancer treatment. METHODS:An exploratory qualitative design employing an AI-assisted photovoice methodology was used. The study was conducted with 14 adolescent cancer survivors aged 12 to 18 years at a university hospital between February and May 2025. Data were collected using a Characteristic Information Form, semi-structured interviews, and participant-generated AI-assisted visual narratives reflecting survivorship experiences. Data were analyzed using reflexive thematic analysis to identify core patterns of meaning. RESULTS:Participants, predominantly survivors of acute lymphoblastic leukemia, had a mean age of 14.86 ± 2.03 years. Three interrelated themes emerged: Silent Scars: Redefining Self After Pediatric Cancer, reflecting enduring physical and emotional sequelae; Reframing Hope and Meaning-Making after Survival, illustrating adolescents' reconstruction of future-oriented purpose; and Roots and Wings: The Power of Support, highlighting the central role of family, peers, and community in fostering empowerment, resilience, social reintegration, and psychosocial well-being. CONCLUSION:This study reveals survivorship as a complex journey characterized by invisible scars, emotional ambivalence, meaning-making, and the transformative power of connection, amplifying the voices of adolescent cancer survivors. The findings emphasize the pressing need for customized, developmentally appropriate, and relationship-focused survivorship care that not only promotes medical recovery but also psychological healing and identity reconstruction IMPLICATIONS FOR NURSING PRACTICE: Findings highlight the need for adolescent-centered, developmentally sensitive nursing interventions; age-appropriate psychosocial assessment, fear of recurrence management, identity-focused counseling, and peer reintegration support, to address ongoing psychosocial challenges in pediatric cancer survivorship. Empowerment-based and participatory approaches may support emotional expression, meaning-making, and resilient transitions into survivorship. AI-assisted photovoice may offer an innovative approach for facilitating adolescent self-expression and identifying psychosocial support needs.
OBJECTIVES:The transition to survivorship for prostate cancer (PCa) patients is a complex and multifaceted process, influenced by physical, emotional, and social challenges. This study aimed to explore the process of transition to survivorship in PCa patients, identifying challenges, coping strategies, and contextual influences affecting adaptation to life after treatment. METHODS:A grounded theory approach was used for this qualitative study. Data were collected through semistructured interviews with 15 PCa patients, 3 spouses, and 4 healthcare providers. Participants were selected through purposive and theoretical sampling to ensure diverse perspectives. Data analysis followed the constant comparative method, guided by Corbin and Strauss's grounded theory framework. RESULTS:The transition to survivorship in individuals with PCa was described as a complex, forward-moving process influenced nonlinearly by contextual factors. The main concern was the "threat to the integrity of life," stemming from "embodied disruption," "persistent uncertainty," and "psychological erosion." The core category, "striving for survival through the storm," captured the main response, encompassing "adaptive coping efforts" and "reclaiming normal life." Contextual factors such as "personal resources and constraints" and "relational and healthcare support" significantly shaped the process. Ultimately, patients described achieving a "relative restoration of normal life." CONCLUSIONS:Transition to survivorship in PCa patients was dynamic and nonlinear, and was influenced by recovery, psychological adaptation, and support. IMPLICATIONS FOR NURSING PRACTICE:Nurses can facilitate this transition by recognizing patients' main concerns, supporting coping strategies, and addressing contextual barriers. Tailored interventions that strengthen perceived support and recovery efforts can enhance adaptation and quality of life for PCa survivors.
Objectives Psychosocial challenges among adolescents and young adults with cancer are distinct and diverse. While researchers have collated these challenges to inform tailored support strategies and interventions, healthcare providers continue to report uncertainty and difficulty delivering psychosocial cancer care in this cohort. A growing body of qualitative research captures adolescents and young adults’ voices and elaborates on the challenges faced, yet this evidence remains fragmented. Synthesizing adolescents and young adults’ lived experiences could generate actionable insights and better equip healthcare providers to provide the care that is needed and wanted by adolescents and young adults. The purpose of this systematic review was to synthesize qualitative evidence covering the psychosocial challenges experienced among adolescents and young adults affected by cancer with a focus on informing recommendations for healthcare providers caring for this population. Methods This review was guided by Joanna Briggs Institute methodology for systematic reviews of qualitative evidence. Three electronic databases were searched for qualitative studies published between 2006 and 2024 that reported on psychosocial challenges among adolescents and young adults with cancer. Two researchers screened citations against predefined eligibility criteria, conducted quality appraisal, and extracted data using a standardized template. Data were analyzed using a meta-aggregation approach. Results In total, 7,762 references were identified and 56 articles were included. Four themes (with additional subthemes) were identified and organized into domains: physical, psychological, interpersonal, and daily living. Synthesized data highlighted that adolescents and young adults with cancer experience a loss of control across domains, leading to withdrawal and distress throughout the cancer continuum. Conclusions Findings afford an integrated and nuanced understanding of the psychosocial challenges adolescents and young adults affected by cancer experience—in their own words—and seek to better equip healthcare providers to address the psychosocial sequelae of this population. Implications for Nursing Practice Nurses can empower adolescents and young adults by promoting clear communication about side effects and consequences of cancer and treatment, involving adolescents and young adults in shared decision making, and adopting a strengths-based approach in care.
OBJECTIVES:To summarize symptom network characteristics in patients with solid tumors undergoing chemotherapy and synthesize evidence on core symptoms, bridge symptoms, and temporal associations. METHODS:We systematically searched eight databases through October 2025 to identify studies that applied symptom network analysis to adults with solid tumors receiving chemotherapy. Eligible studies assessed symptoms using cross-sectional, longitudinal, or interventional designs. Two reviewers independently screened articles and extracted data on study characteristics, symptom assessment, and network outcomes. Methodological quality was assessed using the National Institutes of Health Study Quality Assessment Tool. RESULTS:Twenty-seven studies involving 13,452 participants were included, yielding 79 symptom networks. Fatigue was the most frequently identified core symptom (10/20, 50%), whereas sadness, lack of appetite, and nausea each occurred in 10% of studies, with variation across cancer types, treatment phases, and latent classes. Bridge symptoms included disturbed sleep, lack of appetite, and dry mouth (2/7, 28.6%). Studies evaluating temporal associations found that symptoms such as sadness, dyspnea, somnolence, and dry mouth predicted subsequent changes in appetite, distress, nausea, and other outcomes. Strength metrics showed acceptable stability (correlation stability coefficients: 0.28-0.83). CONCLUSIONS:Fatigue was frequently identified as a central symptom across studies, largely reflecting evidence from breast cancer studies. Core symptoms varied across cancer types, treatment phases, and latent classes, suggesting heterogeneity. IMPLICATIONS FOR NURSING PRACTICE:These findings highlight the importance of considering relationships among symptoms in clinical care. Focusing on key symptoms such as fatigue, while tailoring management strategies to cancer-specific symptom patterns, may support more effective symptom management.
OBJECTIVES:This study aimed to identify distinct subgroups of nutrition impact symptoms among patients with gastric cancer undergoing chemotherapy, to explore factors associated with subgroup membership, and to determine core symptoms within the overall sample and each subgroup. METHODS:A cross-sectional design was used. A total of 379 patients with gastric cancer undergoing chemotherapy were recruited from oncology departments of six hospitals in China. Latent profile analysis was performed to identify symptom subgroups. Multivariable logistic regression was then applied to examine factors influencing each subgroup. Finally, symptom network analysis was conducted for each subgroup to identify core symptoms. RESULTS:Latent profile analysis revealed three distinct symptom burden subgroups: low (39%), moderate (38%), and high (23%). Multivariable analysis showed that gastric cancer stage I was a protective factor for the moderate burden group. For the high burden group, lower monthly income was a risk factor, whereas lower education level, earlier tumor stage (II-III), fewer chemotherapy cycles, and a lower systemic immune-inflammation index were protective factors (all P < .05). Symptom network analysis identified nausea as the core symptom in the low group, pain in the moderate group, and fatigue in the high group. CONCLUSIONS:Nutrition impact symptom in patients with gastric cancer undergoing chemotherapy is heterogeneous and can be classified into three distinct subgroups, each characterized by different core symptoms. These findings underscore the need for targeted, subgroup-specific symptom management interventions. IMPLICATIONS FOR NURSING PRACTICE:Healthcare professionals should design interventions that target the core symptoms and their interrelationships within each identified subgroup, thereby facilitating precise symptom management and improving clinical symptom control.
OBJECTIVES:To explore oncology nurses' experiences, perceptions, and practices regarding the integration of creative and expressive therapies into person-centred cancer nursing, and to develop a conceptual framework for assessment, symptom support, and therapeutic communication within a Saudi Arabian regional hospital context. METHODS:A qualitative interview study informed by reflexive thematic analysis was conducted in the Al-Ahsa region, Saudi Arabia. Thirty registered nurses and oncology-specialized nurses with direct patient care responsibilities were recruited through purposive and snowball sampling from XXX Hospital and affiliated oncology centers. Semistructured in-depth interviews were conducted between October and December 2025. Data were analyzed using Braun and Clarke's six-phase reflexive thematic analysis. Rigor was established through member checking, peer debriefing, thick description, and an audit trail; reflexivity was addressed through ongoing reflexive journaling and critical engagement with researcher positionality throughout the analytic process. RESULTS:Four overarching themes were generated: (1) "Bridging Silence with Creativity," which described how art and symbolic expression enabled patients to communicate distress that was difficult to verbalize; (2) "More Than Medication," which reflected nurses' perceptions that music, writing, movement, and art-making could support relief of anxiety, pain, fatigue, anticipatory nausea, and emotional distress; (3) "Navigating the Space Between Healing and Doing," which captured role ambiguity, limited training, time pressure, and insufficient institutional support; and (4) "Witnessing Transformation," which highlighted meaning-making, spiritual comfort, family involvement, and cultural attunement in the Saudi oncology context. These findings informed a five-domain conceptual framework comprising person-centred assessment, creative and expressive modality selection, therapeutic communication interface, symptom support outcomes, and cultural-contextual adaptation. CONCLUSIONS:Creative and expressive therapies represent a promising but underdeveloped dimension of person-centred cancer nursing. Oncology nurses perceived these approaches as valuable for facilitating emotional expression, strengthening therapeutic communication, supporting holistic symptom assessment, and promoting meaning-making and spiritual comfort. However, safe integration requires clearer professional boundaries, structured training, institutional support, and culturally responsive protocols. IMPLICATIONS FOR NURSING PRACTICE:The proposed framework provides oncology nurses with an empirically informed guide for assessing patient readiness, selecting appropriate creative or expressive modalities, using these approaches within therapeutic communication, and recognizing when referral to specialist psychosocial or creative arts therapy services is needed. TRIAL REGISTRATION:ClinicalTrials.gov. Not applicable; this was a qualitative interview study and did not involve a clinical trial.
AIM:To describe the rapid evolution of emerging digital technologies in oncology nursing and clarify the essential informatics competencies required by oncology nurses to advance safe, high-quality, and compassionate care across the cancer continuum. METHODS:A narrative review of use cases from peer-reviewed literature, national workforce policy documents, and professional nursing frameworks as they relate to emerging technologies and their integration into oncology care. RESULTS:Real-world implementations of artificial intelligence, telehealth, virtual nursing, remote patient monitoring (RPM), and medical device integration (MDI) demonstrate measurable clinical benefits, including enhanced symptom management, fewer emergency visits, and potential survival advantages. However, significant implementation gaps persist regarding algorithmic accountability, health equity, and a historic lack of direct nursing inclusion during technology design and validation. Nurse-led frameworks such as the Emerging Technology and AI Toolkit, which encompasses the 5 Rights of AI, the Innovation Inventory Heatmap, and Calculated INSIGHT provide practical scaffolding to educate nurses in evaluating and adopting emerging technologies. CONCLUSIONS/IMPLICATIONS:Grounded in caring science, emerging digital tools must function as intelligent partners that augment rather than replace human clinical judgment and the therapeutic nurse-patient relationship. As care models continuously evolve across inpatient and outpatient settings, investment in standardized oncology nursing informatics competencies remains critical. Nurse leaders must actively transition from passive technology recipients to informed advocates and architects of the digital ecosystem, ensuring that automated systems amplify the capacity for presence, equity, and individualized, compassionate cancer care.
OBJECTIVES:Adolescents and young adults (AYAs) with cancer may face unique developmental and psychosocial challenges that heighten vulnerability to depression, self‑harm, and suicide. This study aims to synthesize how self-harm and suicidal ideation are identified, measured, and documented among AYAs with cancer. METHODS:A mixed‑methods systematic review was conducted following PRISMA guidelines and registered with PROSPERO (CRD42024464198). Eight databases were searched to January 2026. Eligible quantitative, qualitative, and mixed‑methods studies were screened, appraised using MMAT, and synthesized using a convergent integrated approach. RESULTS:Five studies met the inclusion criteria: 3 cohort studies, 1 quantitative descriptive study, and 1 mixed‑methods study. Considerable variation existed in outcome definitions, measurement tools, and assessment timing. Three themes emerged: (1) elevated risk of suicidal ideation and behavior after cancer diagnosis especially in the first year and among subgroups such as men with testicular cancer; (2) persistent psychological vulnerability in survivorship, including long‑term depression, anxiety, loneliness, and substance use; (3) social isolation and unmet needs as drivers of distress, with loneliness and lack of age‑appropriate support strongly linked to suicidal ideation. All studies were rated as low methodological quality, limiting comparability and precluding meta‑analysis. CONCLUSIONS:AYAs with cancer may be at increased risk of suicidality and enduring psychological distress. Consistent assessment practices and targeted psychosocial interventions are needed to reduce risk and improve well‑being. IMPLICATIONS FOR NURSING PRACTICE:Routine, developmentally informed screening for suicidality is needed from diagnosis through survivorship. Interventions should prioritize social connectedness and tailored psychosocial support for AYAs.
OBJECTIVES:To discuss the contemporary challenges facing oncology nursing and examine how the Fundamentals of Care framework can support the delivery of coordinated, person-centered care across the cancer continuum. METHODS:This discussion paper draws on the current literature and contemporary perspectives in oncology nursing to critically examine the relevance and potential application of the Fundamentals of Care framework. RESULTS:Current challenges, including workforce shortages, increasing clinical complexity, and the erosion of relational care, threaten the quality and sustainability of cancer services. The Fundamentals of Care framework offers a structured and operational approach to strengthening person-centered care by supporting continuity of care, professional identity, and workforce resilience. CONCLUSIONS:Integrating the Fundamentals of Care framework into oncology nursing may strengthen care quality while supporting sustainable cancer services. IMPLICATIONS FOR NURSING PRACTICE:The Fundamentals of Care framework provides oncology nurses with a practical approach to delivering holistic, relationship-centered care and may guide clinical practice, professional development, and service improvement across the cancer continuum.
OBJECTIVE:To evaluate and summarize the psychometric properties of specific instruments for caregiving competence among family caregivers of cancer patients. METHODS:Systematically searched eight databases for studies published up to November 2025. The methodological quality and psychometric properties of the instruments were evaluated using COSMIN 2.0. Evidence grades were rated using the modified GRADE system (four grades: "High," "Moderate," "Low," and "Very Low"), and recommendations were formulated (Category A: recommended, Category B: potential with further validation, and Category C: not recommended). RESULTS:Seven studies were included, comprising three specific instruments: the Care Competency Scale for Family Caregivers in Home Palliative Care (CCSHPC) (n = 1), the Caregiver Caregiving Self-Efficacy Scale-Oral Cancer (CSES-OC) (n = 1), and the Caring Ability of Family Caregivers of Patients with Cancer Scale (CAFCPCS) (n = 5). Both the CCSHPC and CAFCPCS received Category B recommendations, demonstrating "adequate" content validity with evidence grades rated "very low" and "low," respectively. The CAFCPCS also shows good structural validity ("moderate") and internal consistency ("low") in some cultural contexts. The CSES-OC is a Category C recommendation, with high-quality evidence indicating "inadequate" criterion validity. CONCLUSION:Few specific instruments exist, and most did not strictly follow COSMIN guidelines. The CAFCPCS is provisionally recommended based on relative evidence superiority rather than complete psychometric validation. Further cross-cultural and localized instrument development is warranted. IMPLICATIONS FOR NURSING PRACTICE:Use well-validated specific instruments to identify strengths and weaknesses in the caregiving competencies of family caregivers of cancer patients, enabling them to deliver high-quality home-based cancer care.
OBJECTIVES:To explore oncology nurses' experiences of using expressive relational practices to support emotional processing among older adults with cancer and to develop a practice-oriented conceptual model intended to inform clinical practice and nursing education. METHODS:A qualitative interpretive descriptive study was conducted in two tertiary cancer services in Saudi Arabia. Eighteen oncology nurses with direct experience in geriatric cancer care participated in semi-structured interviews. Of 41 eligible nurses approached, 18 were enrolled. Data were audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis. Two researchers independently coded the first five transcripts and iteratively refined a shared codebook; remaining coding and theme development were discussed in regular analytic meetings. Rigor was enhanced through member reflection, peer debriefing, and reflexive journaling. RESULTS:Four interconnected themes emerged: (1) creating space for what cannot be said, reflecting nurses' attunement to silence and indirect distress; (2) expression beyond clinical dialogue, including storytelling, life review, and symbolic or sensory pathways; (3) holding emotional weight, capturing emotional containment and professional vulnerability; and (4) negotiating boundaries in expressive care, shaped by cultural mediation and institutional constraints. These findings informed an integrative model conceptualizing expressive care as a cyclical process of relational attunement, facilitated expression, emotional containment, and contextual negotiation. CONCLUSIONS AND IMPLICATIONS FOR NURSING PRACTICE:In this culturally specific setting, expressive relational care appears to function as an integral, rather than adjunct, dimension of person-centered geriatric oncology nursing. Structured expressive communication training, culturally responsive practice guidelines, and institutional recognition of emotional labor may enhance patient dignity and nurse resilience; patient- and family-focused research is needed to test the transferability of these findings.
OBJECTIVES:To explore the processes through which hospitalized patients with cancer experience and manage psychosocial needs to inform the development of Caritas-based care. METHODS:A grounded theory study guided by Corbin and Strauss was conducted across five oncology departments in Croatian public hospitals. Of 35 hospitalized patients with cancer participated in semi-structured interviews between February and June 2025. Data were analyzed using open, axial, and selective coding with theoretical sampling until saturation. RESULTS:Analysis identified the core category Navigating Psychosocial Challenges During Cancer Hospitalization. The central phenomenon, experiencing multidimensional psychosocial challenges, encompassed emotional struggles (fear, uncertainty, balancing hope with reality), social difficulties (financial burden, long waiting lists, and inadequate care coordination), and physical concerns (fatigue, body image distress, and treatment side effects) as causal conditions. Navigation occurred within contextual conditions, including environmental factors (noise, privacy, and outdated infrastructure), professional support, and nurse-patient relationships emphasizing both technical competence and emotional presence, the availability of psychological support, and autonomy in care decisions, while influenced by family and peer support as intervening conditions. Patients employed diverse coping strategies, including acceptance, optimism, and maintaining meaningful routines, resulting in varying degrees of psychosocial adaptation, with disease recurrence posing particular challenges. CONCLUSIONS:This study provides a conceptual framework for understanding how hospitalized patients with cancer navigate psychosocial challenges, offering a foundation for developing Caritas-based interventions that address holistic needs throughout the cancer trajectory. IMPLICATIONS FOR NURSING PRACTICE:Findings suggest important areas for clinical practice, including creating healing environments, developing nurse education programs integrating transpersonal caring competencies, establishing structured psychological support services, and strengthening patient participation in care decisions. System-level attention to infrastructure, psycho-oncology training, and adequate staffing may help create conditions for caring relationships and psychosocial well-being in oncology care.
Objectives This study explores the perspectives of health care and support professionals (HCSPs) in their experiences performing psychosocial work with adolescent and young adults (AYAs) with cancer on the island of Ireland. Methods A bespoke survey was developed to explore (1) demographics, (2) awareness of AYA psychosocial needs, (3) perceived competency and confidence in managing communication with AYA, (4) knowledge of support services available and patterns of referral to those services, (5) training and education for psychosocial work, and (6) barriers or challenges experienced when communicating with AYA. The survey captured responses from 28 HCSPs working with AYA. Data were analyzed using both quantitative and qualitative methods. Results Confidence of HSCPs in skills required for psychosocial work varied depending on their years of experience working with AYAs and whether they had specialized education or training relating to AYAs. All felt that they could have more training, especially regarding communication with AYAs. HCSPs had a good awareness of most support services, but 19 (67.9%) would like further information on support services. The primary concern among participants was how to determine AYA unmet needs (n = 18, 64.3%). Three themes with subthemes were developed from the vignette responses: (1) initial approach, (2) considerations for support, and (3) involving family or partner. Conclusion The findings highlight that a lack of time, lack of understanding of AYA psychosocial needs, and access to resources contribute to the difficulties HSCPs might encounter. Improving access to resources for HCSPs on the island could improve HSCPs’ skills, knowledge, and confidence in working with AYAs. Implications for Nursing Practice Development of further specialized education/training for understanding the psychosocial needs of AYAs with cancer and how to communicate effectively with AYAs would be beneficial to HSCPs working on the island of Ireland.
OBJECTIVES:This study explored oncology nurses' perceptions and experiences of professional boundaries in cancer care, including boundary violations, psychosocial consequences, and coping strategies. METHODS:A qualitative design using conventional content analysis was conducted. Five online focus group interviews were held between July and October 2025 with 25 oncology nurses working in inpatient oncology units and outpatient chemotherapy services in Türkiye. Participants were recruited via snowball sampling. Interviews were audio-recorded, transcribed verbatim, and analyzed independently by two researchers. Reporting followed the COREQ guideline. RESULTS:Five main themes and fourteen subthemes emerged. Nurses described boundaries through metaphors representing rigid, professional, and permeable boundaries, indicating boundaries are dynamic and context-dependent. Boundary erosion was influenced by long-term nurse-patient relationships, emotional closeness, cultural expectations, role ambiguity, limited experience, and insufficient institutional/legal clarity. Nurses reported violations related to privacy and physical space as well as professional role violations, including task overload and increased informational demands when physician communication was inadequate. Consequences included secondary traumatic stress (intrusive memories, sleep problems, fear of illness) and burnout (irritability, emotional distancing, reduced motivation). Coping strategies involved therapeutic communication and assertive limit-setting, self-care and cognitive reframing, and organizational supports such as protocols, education, and adequate staffing. CONCLUSION:Professional boundaries in oncology nursing are vulnerable to erosion, increasing psychosocial burden and challenging sustainable therapeutic care. IMPLICATIONS FOR NURSING PRACTICE:Training should strengthen boundary management and difficult conversations, supported by routine supervision/debriefing, clear roles, and workload and staffing arrangements that protect breaks.
OBJECTIVES:Generic cancer-related HRQoL instruments may not adequately reflect the multidimensional impact of cancer cachexia, leading to the development of the cachexia-specific Functional Assessment of Anorexia/Cachexia Therapy (FAACT). This study aimed to investigate the psychometric properties of the existing Turkish version of the FAACT in individuals with cancer cachexia. METHODS:One hundred individuals with cancer cachexia participated. Validity and reliability were assessed using factor analysis, construct validity, known-group comparisons, Cronbach's alpha, test-retest, and intraclass correlation coefficients (ICCs). Construct validity examined through correlations between FAACT and Body Mass Index (BMI), Karnofsky Performance Status (KPS), Edmonton Symptom Assessment Scale (ESAS), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTCQLQ-C30). Known-group comparisons were based on cancer stage, BMI and KPS. RESULTS:Factor analysis supported the five-factor structure of the Turkish FAACT, confirming its adequacy. FAACT showed significant weak-to-high correlations with EORTCQLQ-C30, BMI, KPS, and ESAS (P < .05). FAACT also discriminated between different clinical groups. Cronbach's alpha coefficients were 0.935 for FAACT and ranged from 0.684 to 0.865 for FAACT subscales. ICCs for the FAACT total score (0.939) and subscales (0.896-0.971), indicated high to excellent reliability, with strong test-retest agreement. CONCLUSION:The Turkish version of the FAACT is valid, reliable and suitable tool for assessing cancer cachexia in clinical and research settings. IMPLICATIONS FOR NURSING PRACTICE:Cancer cachexia impairs quality of life by causing a high symptom burden and progressive loss of physical function. The cancer cachexia-specific Functional Assessment of Anorexia/Cachexia Therapy (FAACT) demonstrates strong validity and reliability in individuals with cancer cachexia, with significant correlations to body composition, performance status, and symptom severity. In routine nursing practice, the Turkish version of the FAACT can facilitate a comprehensive assessment of cancer cachexia, support individualized care planning, and enhance nurse-patient communication regarding cachexia-specific concerns.
OBJECTIVES:This study examined how Chinese couples facing a cancer diagnosis during pregnancy engage in dynamic meaning-making processes to transition from family stress to resilience. METHODS:This longitudinal interpretive phenomenological study involved four Chinese couples experiencing cancer diagnosed during pregnancy (CDP). Dyadic interviews were conducted across different phases of the illness trajectory and analyzed using the interpretive process proposed by Crist and Tanner. RESULTS:Family experiences of cancer diagnosed during pregnancy (CDP) unfolded across four stages: prenatal diagnosis, prenatal treatment, postpartum treatment, and postpartum maintenance. Couples experienced stress in deciding on pregnancy continuation and cancer treatment while under pressure to protect the fetus and confront the risk of recurrence. Fear of death and guilt persisted as central forms of emotional distress throughout the illness trajectory, with cultural factors shaping emotional expression and communication patterns. Resilience emerged through engagement with external resources, mothers' child-inspired inner strength, and the development of couple-level resilience, ultimately deepening emotional intimacy and fostering spiritual growth. CONCLUSION:This dyadic study demonstrates that cancer diagnosed during pregnancy (CDP) is a dynamic meaning-making process within couples' family belief systems. Family resilience evolves from reliance on external support to individual- and couple-level adaptation, transforming suffering into hope, family cohesion, and a shared sense of relational purpose. IMPLEMENTATIONS FOR NURSING PRACTICE:Developing a dyadic perspective that integrates resilience and cultural sensitivity is essential for psychosocial oncology care. Additionally, integrative perinatal-oncology nursing support systems are needed to address both obstetric and cancer-related challenges.
