Objectives This study examined how holistic nursing competence is shaped in digitally mediated oncology practice by investigating the direct effect of quality climate, the mediating role of digital empathy, and the moderating role of nurses’ attitudes toward artificial intelligence (AI). Methods A cross-sectional study was conducted among 432 oncology nurses working in oncology departments of six hospitals in Egypt with fully implemented digital health systems. Nurses completed validated measures assessing quality climate, digital empathy, holistic nursing competence, and attitudes toward AI. A moderated mediation model was tested using PROCESS macro (Model 14) to examine direct, indirect, and conditional effects. Results Quality climate was positively associated with both digital empathy and holistic nursing competence. Digital empathy showed a strong positive relationship with holistic nursing competence and mediated the association between quality climate and holistic competence. Nurses’ attitudes toward AI moderated the relationship between digital empathy and holistic nursing competence, such that the association was stronger among nurses with more positive AI attitudes. The indirect effect of quality climate on holistic nursing competence through digital empathy was significantly amplified at higher levels of AI attitude, confirming a moderated mediation effect. Conclusion Holistic oncology nursing competence in the digital era is a sociotechnical outcome shaped by organizational culture, empathic capacity, and nurses’ orientations toward AI. Supportive quality climates foster digital empathy, while positive AI attitudes strengthen the translation of empathic engagement into holistic care. Implications for Nursing Practice Oncology nurse leaders should intentionally cultivate quality climates that prioritize psychological safety, integrate digital empathy into clinical education, and support ethically grounded AI adoption to preserve holistic, person-centered oncology nursing in technology-driven care environments.
Objectives Growing complexity in oncology care necessitates innovative organizational models in outpatient and home-based settings. While oncology advanced practice nurses (APNs) are integrated into the French healthcare system, evidence on their routine implementation remains limited. This study evaluated an oncology APN–led care pathway across Day Hospital (DH) and Hospital-at-Home (HaH) settings, describing patient profiles, treatment characteristics, and organizational determinants of HaH utilization. Methods We conducted a retrospective study of patients managed by an oncology APN between November 2019 and May 2025 across DH and HaH settings. Sociodemographic, cancer-related, treatment-related, and care delivery data were extracted from electronic medical records and APN activity logs. DH and HaH patients were compared for profiles, follow-up characteristics, and organizational constraints. Results Overall, 209 patients were included: 64% women, median age 64 years (range 21-93). The most frequent cancers were breast (41.6%), lung (29.8%), and glioma (6.7%). About 116 patients were managed in DH and 93 in HaH; HaH patients lived significantly closer to the hospital. Treatments were mainly immunotherapies (53.5%) and anti-HER2 therapies (36.3%), administered every 21 days. Adoption of the APN-led pathway increased progressively over time, with the APN managing 107 patients simultaneously in 2024. Main barriers to HaH access were organizational constraints related to provider availability and eligibility criteria. Conclusions This study provides real-world evidence on the organizational functioning of an oncology APN–led care pathway across hospital and home-based settings. The findings highlight adoption dynamics, organizational determinants of HaH access, and the central coordinating role of the APN.
Objectives To explore patterns of social participation among older men following radical prostatectomy and to construct distinct social participation personas based on their lived experiences. Methods An interpretive phenomenological study was conducted at a tertiary hospital in Wenzhou, China, from July to October 2025. Using purposive sampling, 20 older men (≥60 years) who had undergone radical prostatectomy were recruited. Data were analyzed inductively using a phenomenological-thematic approach. The Society-to-Cells Resilience Framework was subsequently applied as an interpretive lens to contextualize the multilevel influences reflected in the findings. Patient personas were developed through cross-case comparison of the inductively derived thematic patterns. Results A total of 20 participants were included. Five interrelated dimensions of postoperative social participation were identified inductively: postoperative symptoms, individual resilience construction, familial support and role cohesion, community resource utilization and integration, and social networks and resources. Cross-case comparison of these dimensions generated four social participation personas: Proactive Social Re-engagement, Symptom-Constrained Participation, Anxiety-Related Social Avoidance, and Family-Shaped Restricted Participation. Subsequent interpretation using the Society-to-Cells Resilience Framework highlighted the multilevel contextual influences reflected across these personas. Conclusions This study developed four distinct social participation personas among older men after radical prostatectomy, providing a conceptual basis for understanding heterogeneity in postoperative social reintegration. Implications for Nursing Practice These findings suggest that individualized, persona-based nursing approaches may help address the diverse psychosocial and functional needs of this population. Tailored strategies may promote effective social reintegration and improve quality of life in older men following radical prostatectomy.
Objective To examine the feasibility and preliminary efficacy of a 4-week digital intervention combining cognitive behavioral therapy (CBT) and expressive writing for reducing fear of cancer recurrence (FCR) among young breast cancer survivors (YBCSs). Methods A quasi-experimental, two-group repeated-measures design was employed. The intervention group (n = 14) participated in a 4-week online program with weekly CBT-based group sessions and 20-minute expressive writing sessions on four consecutive days each week (16 sessions in total), whereas the control group (n = 16) received weekly educational materials. Outcomes, including FCR, anxiety, depression, cancer coping, and post-traumatic stress symptoms, were assessed at baseline, immediately postintervention, and 4 weeks postintervention. Data were analyzed using repeated-measures ANOVA. Results Feasibility was supported by a 100% recruitment rate and 100% retention after baseline, with group session attendance (90%), expressive writing completion (95.6%), and weekly telephone consultation completion (80%) all exceeding benchmarks. A significant group × time interaction was observed for FCR (F = 4.888, P = .011), with greater reductions in the intervention group than in the control group over time. Group × time interactions did not reach statistical significance for anxiety, depression, cancer coping, or post-traumatic stress symptoms. Conclusions This study demonstrated high feasibility and provided preliminary evidence of a potential benefit of the intervention for reducing FCR among YBCSs. Future randomized controlled trials with larger samples are warranted to confirm these findings and further investigate the mechanisms underlying the intervention effects. Implication for Nursing Practice Oncology nurses may consider incorporating accessible, developmentally tailored digital interventions as a potential component of survivorship care for YBCSs.
