Cancer Nursing最新文献

{"title":"Risk for Loneliness and Social Isolation: Potentially Underestimated Nursing Diagnoses in Onco-Hematology Inpatients.","authors":"Luca Bertocchi, Giorgia Franzoi, Giulia Zamagni, Noemi De Martino, Gianfranco Sanson","doi":"10.1097/NCC.0000000000001618","DOIUrl":"10.1097/NCC.0000000000001618","url":null,"abstract":"<p><strong>Background: </strong>Loneliness and social isolation are recognized as serious psychosocial issues for inpatients with onco-hematologic diseases, negatively affecting well-being, treatment adherence, and clinical outcomes. However, the prevalence of loneliness and social isolation remains understudied, particularly when assessed using standardized nursing diagnoses.</p><p><strong>Objective: </strong>To describe the prevalence and 1-week changes of the nursing diagnoses Risk for Loneliness and Social Isolation in patients hospitalized with onco-hematologic diseases, and to identify variables associated with their presence at admission.</p><p><strong>Methods: </strong>This was a prospective longitudinal study. Adult inpatients with onco-hematologic diseases admitted for at least 7 days were assessed within 48 hours of admission (T 0 ) and reassessed 1 week later (T 1 ). Changes in diagnostic indicators were analyzed, and multivariable analyses were used to identify variables associated with their presence at T 0 .</p><p><strong>Results: </strong>One hundred patients participated. At T 0 , the prevalence of Risk for Loneliness and Social Isolation was 73% and 15%, respectively. The incidence of both diagnoses increased over the 1-week follow-up. For Risk for Loneliness, the related factors affectional deprivation and social isolation increased at T 1 . For Social Isolation, most defining characteristics and several related factors increased at follow-up. Self-esteem, age, and single-room accommodation were associated with Risk for Loneliness, whereas only self-esteem was associated with Social Isolation.</p><p><strong>Conclusion: </strong>High and increasing levels of loneliness and social isolation were documented, indicating the need for systematic assessment and timely intervention.</p><p><strong>Implications for oncology nursing practice: </strong>Flexible, patient-centered visiting policies and targeted psychosocial nursing interventions may help reduce loneliness and social isolation, thereby improving patient outcomes.</p>","PeriodicalId":50713,"journal":{"name":"Cancer Nursing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatigue and Fear of Cancer Recurrence in Colorectal Cancer Survivors: Mediating Effects of Illness Perception and Maladaptive Cognitive Emotion Regulation.","authors":"Shirui He, Rui Gao, Zhuoxing Li, Xiunan Liu, Yun Sun","doi":"10.1097/NCC.0000000000001575","DOIUrl":"https://doi.org/10.1097/NCC.0000000000001575","url":null,"abstract":"<p><strong>Background: </strong>Survivors living with colorectal cancer may have fear of cancer recurrence after surgery. Improving the disease perception and cognitive emotional coping style of patients with colorectal cancer may help to relieve fatigue symptoms and reduce the fear of cancer recurrence.</p><p><strong>Objective: </strong>To explore the chained mediating effect of disease perception and nonadaptive cognitive emotion regulation between fatigue and the fear of cancer recurrence after colorectal cancer surgery.</p><p><strong>Methods: </strong>Employing a cross-sectional design and recruiting participants via convenience sampling from 3 Chinese tertiary hospitals, this study collected data from 290 colorectal cancer survivors who were within 5 years postsurgery. The research utilized validated self-report measures to assess fatigue, illness perception, cognitive emotion regulation, and fear of progression.</p><p><strong>Results: </strong>Participants were 63% male, with a mean age of 64.26 ± 11.79 years, and 81% within 6 months of cancer diagnosis. 55.86% exhibited psychological maladjustment from fear of cancer recurrence. Mediation analysis showed fatigue, illness perception, and maladaptive cognitive emotion regulation positively correlated with fear (P < .001). Fatigue had a 16.9% direct effect, while illness perception (52.2%) and maladaptive cognitive emotion regulation (12.3%) demonstrated independent mediating effects, with an 18.6% chain mediation effect.</p><p><strong>Conclusion: </strong>Fatigue influences the fear of cancer recurrence in colorectal cancer survivors through the chained mediating effect of disease perception and nonadaptive cognitive emotion regulation.</p><p><strong>Implication for practice: </strong>Targeted nursing and interdisciplinary interventions are needed to address fatigue, optimize disease perception, and reduce nonadaptive emotion regulation for better psychological adaptation in colorectal cancer survivors.</p>","PeriodicalId":50713,"journal":{"name":"Cancer Nursing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Perspectives on Actionable Risk Factors for Deterioration in Acute Myeloid Leukemia: Implications for Clinical Decision Support.","authors":"Sena Chae, Alaa Harb, Nayung Youn, Priscilla A M Annan, Karen Dunn Lopez","doi":"10.1097/NCC.0000000000001606","DOIUrl":"10.1097/NCC.0000000000001606","url":null,"abstract":"<p><strong>Background: </strong>Acute myeloid leukemia (AML) is associated with high complication rates following induction chemotherapy, yet clinicians lack tools that anticipate deterioration and support proactive care. Preliminary predictive modeling using structured electronic health record data and symptoms extracted through natural language processing identified key risk factors for deterioration within 30 days of discharge. How clinicians interpret these risk factors in practice remains unclear.</p><p><strong>Objective: </strong>This study aimed to explore how hematology clinicians understand actionable risk factors for deterioration in AML and how these factors should inform the design of clinical decision support.</p><p><strong>Interventions/methods: </strong>Seven hematology clinicians-including hematologist-oncologists, a nurse practitioner, and physician assistants-at a Midwestern academic medical center participated in individual or group semistructured interviews. Interview questions addressed perceived risk factors, actionability, and needs for clinical decision support. Data were analyzed using conventional content analysis.</p><p><strong>Results: </strong>Three themes emerged: (1) generic tools do not adequately support the complexity of AML care; (2) actionability is context‑dependent, with both nonmodifiable and modifiable factors influencing discharge decision‑making; and (3) clinical decision support must integrate predictive risk scoring with user‑centered design features such as intuitive displays, timely alerts, and transparency about contributing factors.</p><p><strong>Conclusions: </strong>Clinicians expressed strong support for a clinical decision support tool that anticipates deterioration, provides individualized and interpretable risk alerts, and aligns with existing workflows to reduce preventable complications and readmissions.</p><p><strong>Implications for oncology nursing practice: </strong>Clinical decision support tools that integrate dynamic clinical data with intuitive, workflow‑aligned interfaces may enhance risk communication, strengthen discharge decision‑making, and support proactive monitoring in AML care.</p>","PeriodicalId":50713,"journal":{"name":"Cancer Nursing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise Experiences and Behavioral Adaptation During the Inter-Chemotherapy Interval Among Patients With Lung Cancer Receiving Platinum-Based Chemotherapy: A Qualitative Study.","authors":"Lingling Pan, Jiayue Wu, Qianyun Jiang, Linyan Wang, Yumei Li","doi":"10.1097/NCC.0000000000001620","DOIUrl":"https://doi.org/10.1097/NCC.0000000000001620","url":null,"abstract":"<p><strong>Background: </strong>Symptoms and physical capacity cycle during the inter-chemotherapy interval, yet patients' exercise experiences and behavioral adaptation remain unclear.</p><p><strong>Objective: </strong>To explore exercise experiences, behavioral adaptation strategies, and professional support needs among patients with lung cancer during the inter-chemotherapy interval, informing cyclical exercise management.</p><p><strong>Methods: </strong>Descriptive phenomenological study. Semi-structured interviews were conducted with 11 patients with lung cancer receiving platinum-based chemotherapy at a Shanghai teaching hospital. All interviews occurred upon return for the next chemotherapy cycle. The Health Action Process Approach guided the interview outline; Colaizzi's seven-step method was used for analysis.</p><p><strong>Results: </strong>Three main themes and six subthemes emerged: (1) Physical sensations during the chemotherapy interval (negative experiences triggered by treatment-related symptoms; positive feedback from exercise); (2) The complex process of behavioral adaptation (conflict between disease fluctuation and behavior maintenance; synergy between autonomous decision-making and self-efficacy); (3) Expectations for professional support during the interval (knowledge needs; emotional needs). Although derived from inductive phenomenological analysis, these themes inherently map onto the dual-phase structure of the Health Action Process Approach model.</p><p><strong>Conclusions: </strong>The inter-chemotherapy interval is characterized by cyclical fluctuations in exercise capacity. Patients tend toward passive rest during symptom peaks and engage in autonomous, flexible activity during recovery windows. Clinical support should respect this natural rhythm.</p><p><strong>Implications for oncology nursing practice: </strong>Oncology nurses should assess the patient's position in the chemotherapy cycle to distinguish symptom‑peak days from recovery windows and provide stage‑specific exercise guidance. In addition, they should strengthen autonomous decision‑making and self‑efficacy to reduce conflict between disease fluctuation and behavior maintenance.</p>","PeriodicalId":50713,"journal":{"name":"Cancer Nursing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating Clinical Trial Decisions in Pediatric Oncology: An Integrative Review of Qualitative Studies.","authors":"Anna Sparrow, Jennifer Yost, Michelle M Kelly","doi":"10.1097/NCC.0000000000001613","DOIUrl":"https://doi.org/10.1097/NCC.0000000000001613","url":null,"abstract":"<p><strong>Background: </strong>Pediatric cancer clinical trials are key to advancing treatment and improving survival rates. However, participation relies on complex family decision-making influenced by emotional, relational, and systemic factors. Understanding these influences is crucial for supporting informed decision-making processes.</p><p><strong>Objective: </strong>To synthesize the qualitative evidence on influencers of the decision to pursue treatment in a pediatric cancer clinical trial.</p><p><strong>Methods: </strong>Following Whittemore and Knafl's framework, databases were systematically searched for qualitative studies on decision-making regarding trial participation in pediatric cancer populations. Twenty-six studies were included. Data were extracted using the Joanna Briggs Institute Qualitative Assessment and Review Instrument tool, appraised with the Critical Appraisal Skills Programme Qualitative Checklist, and synthesized.</p><p><strong>Results: </strong>Included studies examined the perspectives of patients, caregivers, and clinicians. Six main themes emerged: emotional distress and vulnerability, altruism and meaning-making, therapeutic risks and benefits, relationships and power dynamics, communication, and systemic barriers. Families often described trial enrollment as happening during emotional distress, with hope and trust in clinicians sometimes influencing decisions as much as clinical information. Adolescents wanted more involvement but were sometimes sidelined.</p><p><strong>Conclusions: </strong>Trial decisions are embedded in emotional, relational, and structural contexts that complicate informed consent. Findings highlight tensions between hope and understanding, and voluntariness and trust.</p><p><strong>Implications for oncology nursing practice: </strong>Clinical care should prioritize staged, plain-language, developmentally appropriate trial discussions, active inclusion of adolescents, and proactive attention to logistical burdens. Much existing evidence predates the rise of social media and remains limited to Western contexts. New research must explore digital influences, global experiences, and child-centered methods to better inform equitable, family-centered trial enrollment practices.</p>","PeriodicalId":50713,"journal":{"name":"Cancer Nursing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"School Reentry Experiences of Children With Leukemia and Their Parents: A Qualitative Study.","authors":"Gizem Çakir, Naime Altay, Namik Yaşar Özbek","doi":"10.1097/NCC.0000000000001612","DOIUrl":"https://doi.org/10.1097/NCC.0000000000001612","url":null,"abstract":"<p><strong>Background: </strong>Needs and facilitating factors should be identified for children with cancer to receive effective transitional care services during school reintegration.</p><p><strong>Objective: </strong>This study examined the experiences of children with leukemia and their parents during the process of returning to school.</p><p><strong>Methods: </strong>This qualitative research, designed as a descriptive phenomenological study, was based on semistructured, in-depth interviews with children with leukemia and their parents.</p><p><strong>Results: </strong>Three main themes were identified from the analysis for both children and parents: perceived difficulties, comprehensive support needs, and facilitators. For children, the analysis identified 3 main themes. The first theme focused on emotional and behavioral aspects, the process of returning to school, and social life. The second theme highlighted the importance of both academic and social support, while the third emphasized the need for professional guidance and improvements to the school's physical environment. For parents, similar themes emerged: emotional and behavioral aspects, as well as school reentry, formed the first theme; academic support, along with communication and collaboration, constituted the second; and professional support and attention to physical conditions made up the third theme.</p><p><strong>Conclusions: </strong>The emotional, social, and academic support needs of children with cancer are critical for the successful management of their school reentry.</p><p><strong>Implications for oncology nursing practice: </strong>Oncology nurses should incorporate structured school reentry support into follow-up care, collaborating with families, teachers, and school staff. They should monitor children's anxiety, coping skills, and treatment-related effects, and provide guidance and support to promote smoother school reintegration.</p>","PeriodicalId":50713,"journal":{"name":"Cancer Nursing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic Trajectory of Quality of Life Among Children With Acute Lymphoblastic Leukemia From a Parental Proxy Perspective: A Repeated-Measure Design Using a Kernel Smoothing Method.","authors":"Thu Hang Tran Thi, Chung-Ying Lin, Jung-Der Wang, Mei-Chih Huang","doi":"10.1097/NCC.0000000000001610","DOIUrl":"https://doi.org/10.1097/NCC.0000000000001610","url":null,"abstract":"<p><strong>Background: </strong>Quality of life (QoL) among children with acute lymphoblastic leukemia (ALL) exhibits dynamic changes during various treatment periods.</p><p><strong>Objective: </strong>This study explores the longitudinal trends in and determinants of QoL among children with ALL postdiagnosis.</p><p><strong>Methods: </strong>We conducted this study using repeated measurements with a kernel smoothing mean. We consecutively recruited ALL patients aged 5-18 years and their parental proxies from 3 hospitals in Vietnam. They reported their children's QoL by the PedsQL Generic Core Scales and the PedsQL Cancer Module.</p><p><strong>Results: </strong>We collected a total of 277 repeated assessments for 186 children, and their proxies had a mean age of 38.21 ± 9.01 years. Different age groups experienced distinct QoL problems across various time periods: poor physical functioning (5-7 years: first 5 months; 8-12 years: first year; 13-18 years: second year), pain (5-7 years: first 3 months, 13-18 years: second year), nausea (5-12 years: first 3 months; 13-18 years: second year), procedural anxiety (5-7 years: first 3 months; 8-12 years: first 9 months, 13-18 years: second year), appearance concerns (5-7 years: second year). Duration-to-date, proxy characteristics (education, relationship to the patient) exhibited independent effects on various QoL domains.</p><p><strong>Conclusions: </strong>Impairments in QoL functioning and problems emerged and changed across different age groups over time. Several factors, including duration to date and proxy characteristics (education, relationship to the patient), were found to be associated with various QoL domains.</p><p><strong>Implications for practice: </strong>A comprehensive program focusing on physical or psychological problems among children with ALL should be developed.</p>","PeriodicalId":50713,"journal":{"name":"Cancer Nursing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Emotion Regulation and Depression Among Oncology Patients Receiving Chemotherapy.","authors":"Zeynep Eroğlu, Sibel Polat Olca","doi":"10.1097/NCC.0000000000001605","DOIUrl":"https://doi.org/10.1097/NCC.0000000000001605","url":null,"abstract":"<p><strong>Background: </strong>Emotion regulation skills play a key role in psychological adjustment during cancer treatment and may influence vulnerability to depression.</p><p><strong>Objective: </strong>This study aimed to examine depressive symptoms and emotion regulation skills among patients receiving chemotherapy and to explore the relationship between these variables.</p><p><strong>Methods: </strong>This descriptive and correlational study was conducted with 100 patients undergoing chemotherapy in 2 oncology centers. Data were collected through face-to-face interviews using a personal information form, the Beck Depression Inventory, and the Emotion Regulation Skills Questionnaire. Statistical analyses included descriptive statistics, Pearson correlation, and multiple linear regression.</p><p><strong>Results: </strong>Half of the participants exhibited clinically significant depressive symptoms. A significant, moderate negative correlation was found between depressive symptoms and emotion regulation skills (r = -0.666; P <.01). Emotion regulation skills emerged as the strongest predictor of depressive symptoms (β = -0.562; P <.001). Higher levels of depressive symptoms were associated with lower emotion regulation skills, with depression emerging as the strongest predictor in the model (β = -0.535; P <.001).</p><p><strong>Conclusion: </strong>Patients undergoing chemotherapy are at high risk for depression, and their ability to regulate emotions plays a central role in psychological well-being. Increasing depressive symptoms were associated with marked reductions in emotion regulation capacity.</p><p><strong>Implications for oncology nursing practice: </strong>Findings underscore the importance of integrating routine depression screening and emotion regulation-focused interventions into standard oncology care. Mindfulness-based approaches, brief psychoeducational programs, and supportive counseling may strengthen emotional resilience, enhance coping during chemotherapy, and improve overall quality of life for oncology patients.</p>","PeriodicalId":50713,"journal":{"name":"Cancer Nursing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Moral Resilience Shapes Oncology Nurses' Responses to Ethical Challenges: A Mixed-Methods Study.","authors":"Shanshan Zhan, Naying Yu, Jie Wang, Shiyi Li, Jiaxian Xu, Yubei Chen, Zhihui Zheng","doi":"10.1097/NCC.0000000000001602","DOIUrl":"https://doi.org/10.1097/NCC.0000000000001602","url":null,"abstract":"<p><strong>Background: </strong>Oncology nurses frequently face ethically complex situations that place them at risk for moral distress. Moral resilience may serve as a protective resource, yet its heterogeneous patterns and clinical relevance remain unclear.</p><p><strong>Objective: </strong>This study aimed to identify latent profiles of moral resilience among oncology nurses and examine their relationships with moral distress, hospital ethical climate, and social support.</p><p><strong>Methods: </strong>A convergent mixed-methods design was used. Quantitative data from 264 oncology nurses were analyzed using latent profile analysis and a moderated mediation model. Qualitative data from 17 interviews and 2 focus groups were analyzed thematically.</p><p><strong>Results: </strong>Three moral resilience profiles emerged: low resilience-efficacy-oriented, relationship-oriented distressed, and high resilience-integrated. Moral distress differed across profiles, with the low resilience-efficacy-oriented group reporting the highest levels. Hospital ethical climate partially mediated the association between resilience and distress, and social support enhanced nurses' perceptions of ethical climate. Qualitative findings revealed coping patterns including avoidance, relational accommodation, and adaptive reframing.</p><p><strong>Conclusions: </strong>Moral resilience is multidimensional and shapes distinct pathways for responding to ethical challenges. Supportive ethical climates consistently reduced moral distress, while social support influenced nurses' ability to access ethical resources.</p><p><strong>Implications for oncology nursing practice: </strong>Findings support developing tailored interventions that strengthen moral efficacy and communication during ethically sensitive care. Implementing structured ethics debriefings and accessible support systems may help nurses navigate complex treatment decisions. Enhancing ethical climate and team dialogue could reduce moral distress and promote sustainable oncology nursing practice.</p>","PeriodicalId":50713,"journal":{"name":"Cancer Nursing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Decision Aids for Breast Cancer Treatment: A Systematic Review and Meta-Analysis.","authors":"Ying Hua, Yinying Huang, Yaofeng Han, Ka Ming Chow, Xuefen Yu, Xiaojing Su, Anqi Qiu, Jiemin Zhu","doi":"10.1097/NCC.0000000000001574","DOIUrl":"10.1097/NCC.0000000000001574","url":null,"abstract":"<p><strong>Background: </strong>Decision aids (DAs) have been developed to support decision-making for breast cancer treatments, but evidence regarding their effectiveness remains inconclusive.</p><p><strong>Objectives: </strong>To systematically identify and synthesize evidence on the effectiveness of DAs for breast cancer treatment on decision conflict, decision regret, shared decision-making (SDM), quality of life (QoL), health-related quality of life (HRQoL), and surgical choices.</p><p><strong>Methods: </strong>A systematic search across 9 databases from inception to October 2025 included randomized and nonrandomized controlled trials in English or Chinese. Methodological quality was assessed using design-specific tools. Certainty of evidence was evaluated using the GRADE approach. Meta-analyses and narrative syntheses were conducted based on data availability.</p><p><strong>Results: </strong>Forty-eight articles evaluating 46 DAs were included. Pooled analysis suggested that DAs significantly reduce decision conflict (standardized mean difference = -0.70; 95% CI, -0.93 to -0.46) and decision regret (-0.71; -1.03 to -0.40) and improved SDM (0.41; 0.31-0.50) and HRQoL (0.17; 0.05-0.29). However, the effects of DAs on QoL, breast conservation rate, and reconstruction rate remain inconclusive. The study quality varied from low to high risk of bias. The certainty of evidence ranged from very low to moderate, primarily because of substantial heterogeneity.</p><p><strong>Conclusions: </strong>This review demonstrates significant benefits of DAs in reducing decision conflict and decision regret and in promoting SDM and HRQoL. However, variability in study quality and low certainty of evidence highlight the need for further rigorous investigations.</p><p><strong>Implications for practice: </strong>More rigorous trials and economic evaluations are needed to strengthen the evidence base and validate their cost-effectiveness, ensuring sustainable implementation.</p>","PeriodicalId":50713,"journal":{"name":"Cancer Nursing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}