OBJECTIVES:To examine the relationships among adult attachment styles, symptom distress, and depressive symptoms in colorectal cancer (CRC) survivors, and to explore whether mindfulness moderates these associations. SAMPLE AND SETTING:A cross-sectional study was conducted with 90 CRC survivors aged 20 years or older who had completed treatment within the past three months at a medical center in northern Taiwan. METHODS AND VARIABLES:Participants completed validated questionnaires measuring depressive symptoms (Beck Depression Inventory-II [BDI-II]), attachment style (Experience in Close Relationships Scale-Short Form), mindfulness (Five Facet Mindfulness Questionnaire), and CRC-specific symptom distress (European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire-CRC Module). Data were analyzed using descriptive statistics, Pearson correlations, hierarchical regression, and the Hayes PROCESS macro. RESULTS:The mean BDI-II score was 4.96; 8% reported clinically significant depressive symptoms. Anxious attachment correlated with depression (r = 0.4, p < 0.001) and predicted depression in the initial regression model (beta = 0.5, p < 0.001). Avoidant attachment had an indirect effect through symptom distress (beta = 0.32, p = 0.002). Mindfulness moderated the anxious attachment-depression association (ΔR² = 0.03, p = 0.007), and acting with awareness moderated the avoidant attachment-depression association (ΔR² = 0.02, p = 0.02). IMPLICATIONS FOR NURSING:Findings suggest that routine assessment of attachment style and mindfulness traits may help identify CRC survivors at psychological risk. Incorporating mindfulness-based education into survivorship care may support emotional well-being.
OBJECTIVES:To characterize the severity of psychoneurological (PN) symptoms in cancer survivors who initiated immune checkpoint inhibitors (ICIs) at baseline and 12 weeks post-treatment and to examine the associations between PN symptoms and gut microbiome patterns. SAMPLE AND SETTING:15 patients (n = 9 males and n = 6 females, mean age = 70.9 years) with solid tumors who initiated ICIs were recruited from a cancer center. METHODS AND VARIABLES:PN symptoms were assessed using self-report questionnaires, and stool samples were analyzed using 16S rRNA sequencing. Alpha and beta diversity indices were calculated, and a least absolute shrinkage and selection operator regression model was fitted to assess associations between each symptom and the log-ratio of the genus abundance. RESULTS:Average fatigue levels increased during 12 weeks. The microbiome community varied by age, sex, and their interaction. At 12 weeks post-treatment, Oscillibacter (beta = -0.141), Limosilactobacillus (beta = 0.088), and Erysipelotrichaceae (beta = -0.021) were associated with average levels of fatigue, whereas Tannerellaceae (beta = -0.011), Bacteroides (beta = 0.474), and Acidaminococcus (beta = 0.193) were associated with pain severity (all p < 0.05). IMPLICATIONS FOR NURSING:Given the potential association between the gut microbiome and PN symptoms during ICI treatment, nurses are encouraged to assess dysbiosis risk, screen for treatment-related adverse symptoms, and educate patients about gut health while receiving ICIs.
PROBLEM IDENTIFICATION:Family caregivers of pediatric (aged 0-14 years) and adolescent and young adult (aged 15-39 years) patients with cancer face multifaceted financial toxicity involving multisource economic burdens, psychological distress, and unmet support needs, requiring evidence-based nursing and policy interventions. LITERATURE SEARCH:Systematic searches were performed across Wanfang Data, Web of Science, SINOMED, PubMed®, CNKI, EBSCO, VIP Chinese Science and Technology Periodicals Full-Text Database, and Cohrane Library from inception to April 15, 2025, to identify relevant qualitative studies. DATA EVALUATION:According to ENTREQ (Enhancing Transparency in Reporting the Synthesis of Qualitative Research) guidelines, two investigators independently screened studies, extracted data, and synthesized findings via JBI meta-aggregation. The ConQual (Confidence in the Output of Qualitative Research Synthesis) approach was used to rate conclusions. SYNTHESIS:The 24 included studies yielded 103 findings (98 unequivocal themes and 5 credible themes), which were aggregated into eight main themes. The two core findings were as follows: (a) Financial toxicity among family caregivers is multifaceted, involving substantial multisource economic burdens and severe perceived financial distress, and (b) despite adopting diverse coping strategies, caregivers consistently reported unmet needs and persistent expectations for additional support. IMPLICATIONS FOR RESEARCH:Future research can focus on mechanisms specific to the United States, nurse navigator interventions, and subgroup differences. Clinical and policy interventions should integrate insurance navigation, paid leave, and culturally competent support.
If the research process is disrupted, the science slows, affecting patients, workforce, leadership, and policy. Oncology nurse researchers must develop strategies to sustain research in a challenging environment, but those st.
OBJECTIVES:To evaluate the effect of yoga breathing exercise (YBE) on perceived stress and sleep quality in women with breast cancer undergoing chemotherapy. SAMPLE AND SETTING:This randomized, sham-controlled trial was conducted in the chemotherapy unit of a university hospital in Türkiye from November 2023 to April 2024 and involved 60 women with stage II-III breast cancer undergoing chemotherapy. METHODS AND VARIABLES:Participants were randomized to a YBE group or a sham breathing group. Both groups received standard oncology care, and the YBE group additionally practiced 4-4-4-4 yoga breathing twice daily for five minutes during 21 days. Data were collected at baseline and after the 21-day intervention period. Perceived stress and sleep quality were assessed using the Perceived Stress Scale and the Pittsburgh Sleep Quality Index. Data were analyzed using two-way repeated-measures analysis of variance. RESULTS:After 21 days, the YBE group showed significantly greater reductions in perceived stress (mean difference = -6.23, p < 0.001) and improved sleep quality (mean difference = -2.1, p < 0.001) compared with the sham group. No adverse events were reported. IMPLICATIONS FOR NURSING:YBE can be integrated into supportive oncology nursing care as a low-cost, nonpharmacologic intervention to address stress and sleep disturbances during chemotherapy.
