Family caregivers (FCGs) of cancer patients play a critical role in providing emotional and physical support. Mindfulness-based interventions (MBIs) have been increasingly explored as a potential approach to improving the psychological well-being of FCGs. However, the caregiving burden often results in significant psychological distress, including stress, anxiety, and depression. This systematic review and meta-analysis aims to evaluate the effects of MBIs on the stress, anxiety, and depression of FCGs of cancer patients. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 guidelines and was registered in PROSPERO. A comprehensive search was conducted in PubMed, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Cochrane Library, ERIC, and Google Scholar to identify relevant studies published between 2010 and 2024. Randomized controlled trials (RCTs) and quasi-experimental (QE) studies assessing MBIs' impact on psychological outcomes in FCGs were included. Risk of bias was evaluated using the Joanna Briggs Institute Critical Appraisal Checklists. A total of 10 studies (5 RCTs and 5 QE studies) met the inclusion criteria. Meta-analysis results demonstrated that MBIs significantly reduced anxiety and depression in FCGs of cancer patients compared to usual care or no intervention. Effect sizes varied across studies, with moderate to strong effects observed for anxiety, while depression showed smaller but significant improvements. However, the meta-analysis on stress yielded non-significant results with moderate-to-high heterogeneity. The heterogeneity across studies was moderate, suggesting variability in populations, measurements, intervention formats, duration, and delivery methods. MBIs are effectively improving the psychological well-being of FCGs by reducing anxiety and depression. Given the significant caregiving burden, integrating MBIs into caregiver support programs could enhance their resilience and overall mental health. Future research should explore culturally adapted mindfulness interventions to optimize their applicability in diverse caregiving populations.

Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disease marked by symptoms such as dyspnea and fatigue, which negatively affect patients' quality of life. Self-efficacy influences patients' ability to manage symptoms, while medication adherence is crucial for effective disease control. This study aimed to examine the impact of dyspnea and fatigue on medication adherence and self-efficacy in individuals with COPD. A descriptive, cross-sectional, and correlational study was conducted with 171 COPD patients receiving treatment in a tertiary hospital in eastern Turkiye between November 2024 and April 2025. Data were collected using validated scales measuring fatigue, dyspnea, medication adherence, and self-efficacy. Statistical analyses included correlation and regression to examine relationships and predictors. The findings revealed high levels of dyspnea and fatigue, which were significantly and negatively correlated with self-efficacy (p < .001). Both dyspnea and fatigue significantly predicted decreased self-efficacy, accounting for over 60% of the variance. Medication adherence levels were generally high; medication adherence decreased when dyspnea increased, while no relationship was observed between fatigue and medication adherence. Dyspnea and fatigue are prevalent symptoms in COPD patients that adversely affect self-efficacy. Enhancing self-efficacy may be critical in improving symptom management and quality of life. The complex nature of medication adherence requires further in-depth investigation. Nurses should prioritize interventions that strengthen self-efficacy and address symptom burden to optimize COPD management and patient outcomes.

Cancer is the second leading cause of death globally, following cardiovascular diseases. Radiotherapy (RT), a common cancer treatment modality, often induces both physical discomfort and psychological distress, including pain and anxiety. Although music interventions have shown promise in reducing such symptoms, most studies lack a theoretical foundation, limiting their generalizability and application in nursing practice. This study aimed to evaluate the effects of a music intervention on pain, anxiety, and vital signs in patients undergoing RT, using the Roy Adaptation Model (RAM) as the theoretical framework. A randomized controlled trial was conducted between May 2024 and April 2025 in the Radiation Oncology Department. A total of 120 patients were randomly assigned to either the intervention group (n = 60) or control group (n = 60). The intervention group listened to specially composed therapeutic music via speakers for 20 to 40 min during weekly RT sessions. Pain (Visual Analog Scale), anxiety (Facial Anxiety Scale), and vital signs (blood pressure, heart rate, and respiratory rate) were measured before and after RT sessions. Data were analyzed using paired-sample t-tests and Cohen's d for effect sizes. The music intervention significantly reduced pain and anxiety scores in the intervention group compared to the control group (p < .001). Additionally, positive changes in vital signs were observed, including decreased systolic blood pressure and heart rate. The findings support the regulatory and cognator adaptive responses described in RAM, indicating that music functions as an effective coping mechanism for physiological and psychological stressors during RT. Music intervention is a safe, non-pharmacological, and cost-effective strategy for enhancing patient adaptation during RT. This study contributes to the evidence base by integrating a theoretical model into clinical nursing practice and underscores the importance of model-based interventions in improving holistic patient care.

ICU survivors are at increased risk for persistent physical, cognitive, and psychological impairments, collectively known as Post-Intensive Care Syndrome (PICS). Critically ill patients, especially those on mechanical ventilation, experience increased oxidative stress burden, potentially contributing to telomere shortening. However, the relationship between oxidative stress, telomere attrition, and PICS-related outcomes remains unclear. Our objective was to examine associations among oxidative stress markers, telomere length, clinical characteristics, and PICS-related outcomes in mechanically ventilated ICU survivors. A cross-sectional study design was used. Blood samples were collected at two timepoints: study enrollment and within 48 hr of ICU discharge. PICS-related outcome measures were assessed within 48 hr of ICU discharge. Oxidative stress markers-including plasma protein carbonyls, vitamin C, reduced-to-oxidized glutathione ratio (GSH:GSSG), and total antioxidant capacity (TAC)-were quantified via ELISA. Three oxidative stress indices were calculated: vitamin C/GSH:GSSG, TAC/GSH:GSSG, and protein carbonyls/GSH:GSSG. Telomere length was determined using RT-qPCR. Clinical data included APACHE III and SOFA scores, ICU and hospital length of stay (LOS), and duration of mechanical ventilation. PICS-related outcomes included grip and foot strength, National Institutes of Health (NIH) Toolbox Cognition and Emotion assessments, and the Connor-Davidson Resilience Scale. Pearson's correlations were performed. Twenty-one participants were included in the final analysis. Plasma antioxidant status positively correlated with muscle strength and psychological resilience. Elevated plasma oxidant levels were associated with poorer cognitive outcomes. ICU LOS and duration of mechanical ventilation negatively correlated with muscle strength and cognitive performance. No significant correlations were observed between telomere length changes and PICS-related outcomes. Oxidative stress during acute critical illness may impede recovery and contribute to PICS. The lack of short-term associations with telomere length suggests that telomere-related effects on PICS may, possibly, become apparent over a longer post-ICU period.

Previous studies have shown that single symptoms are associated with self-management, and symptom clusters are still a sparsely investigated field. This study aimed to explore the possible symptom clusters after renal transplantation and investigate the correlation between symptom clusters and self-management. A cross-sectional survey was conducted on 381 renal transplant recipients (RTRs) from 2 tertiary hospitals in different regions. Sociodemographic and clinical characteristics, Symptom Experience Scale, and RTRs Self-Management Scale were used. Symptom clusters were created with exploratory factor analysis. Multiple regression analysis was used to explore the relationship between self-management and symptom clusters. Four symptom clusters were extracted, which were related to activity endurance, emotion, neuro-gastrointestinal, and hormone. Symptom clusters were negatively correlated with self-management (p < .001), and the activity endurance symptom cluster was the influencing factor of self-management (β = -.209, p < .001). The impact of symptom clusters on self-management among RTRs exhibits heterogeneity. Clinical therapies should prioritize the activity endurance symptom cluster since it is a substantial risk factor for impaired self-management ability.

Identifying the symptoms that most significantly deteriorate patient outcomes (i.e., quality of life [QoL] and daily activities) at specific treatment stages is important in caring for patients with hematologic cancer. Yet, few studies have examined symptom experiences and patient outcomes during the early phases of chemotherapy immediately after diagnosis. Hence, this study aimed to (a) evaluate symptom experience (prevalence, severity), QoL, and interference with daily activities before and 1 week after completing induction chemotherapy and (b) identify key symptoms affecting QoL and daily activities at each time point. The sample included 124 patients undergoing their first chemotherapy for hematologic cancer. We administered the Memorial Symptoms Assessment Scale, a single-item QoL scale, and the symptom-interference subscale of the Brief Pain Inventory. Statistical analyses included Wilcoxon rank-sum tests, Spearman's rho, and multiple-regression analysis. No significant changes emerged in QoL or interference with daily activity scores from pre- to postchemotherapy, suggesting that the impact of chemotherapy on patient outcomes was not instant. However, two items in interference with daily activities worsened following treatment, possibly due to hospitalization: "relationships with others" (p = .03), and "sleep" (p = .001). At both time points, interference with daily activities was highest for "enjoyment of life." Across time points, "lack of energy" most frequently and severely occurred. Symptom experience was strongly associated with interference in daily activities but not with QoL. Significant independent predictors of interference with daily activities were "being irritable" (β = .31, p < .001), "insomnia" (β = .18, p = .04), and "difficulty in concenting" (β = .18, p = .02) before chemotherapy; "difficulty in concentrating" (β = .30, p < .001), "worrying" (β = .30, p = .003), and "lack of energy" (β = .20, p = .02) 1 week after induction chemotherapy. In conclusion, psychological symptoms (e.g., lack of energy, difficulty in concentrating, being irritable, and worrying) were not only prevalent but also greatly influenced daily activities before and after treatment. Nurses should assess and manage these symptoms and be aware of pharmacological/nonpharmacological interventions to alleviate them. Interference in "enjoyment of life" is a notable patient outcome throughout treatment.

The COVID-19 pandemic necessitated a triad of therapies for patients: oxygen, nutrition, and patient positioning. In the progressive care units, patients were placed in a prone position while receiving continuous enteral nutrition (EN) to optimize healing and oxygenation. The study aimed to identify the rate of aspiration pneumonia in non-ventilated COVID-19 patients placed in a prone position while receiving continuous EN. This was a single-group, descriptive retrospective study. The study was conducted at a two-time Magnet® designated academic medical and health science center in the Southwestern United States. The sample included 97 electronic health records (EHRs) of patients diagnosed with COVID-19, receiving continuous EN, and placed in a prone position from March 15, 2020 to June 1, 2022. Data were extracted from EHRs using ICD-10 codes, including patient demographics, EN frequency, gastric tube placement, patient positioning, and incidence of aspiration pneumonia. Descriptive statistics and non-parametric tests were used. The Kruskal-Wallis rank sum test and Fisher's exact test were employed for comparisons. Statistical significance was set at p ≤ .05. Out of 97 patients, 8 (8.25%) developed aspiration pneumonia. The majority of patients (75%) had post-pyloric feeding tubes. All patients who developed aspiration pneumonia had post-pyloric tubes. Placing COVID-19 patients in a prone position while receiving continuous EN may be a safe practice. Diligent nursing assessment is crucial to minimize aspiration risk and optimize patient outcomes.

The identification of traumatic birth is becoming a major global health concern. Evaluating the existing research can help shape future directions for traumatic birth studies. This study aimed to provide a comprehensive and up-to-date summary of research articles on traumatic birth. We performed a bibliometric analysis using the Science Citation Index Expanded of the Web of Science Core Collection database, covering the period from January 1, 1985, to June 30, 2023. A total of 1,568 original articles were found, indicating a significant increase in traumatic birth research. The United States was the most prolific country, followed by Australia and Canada. The University of Sydney, the University of Toronto, and the University of Pittsburgh were the top 3 institutions in terms of published documents. The terms "infants," "perceptions," and "birth injuries" had the highest burst strengths. MeSH Bibliographic Item Co-Occurrence Matrix Builder analysis identified six major research topics, with birth injuries and their prevention and control, as well as brachial plexus/shoulder injuries and surgery, being the most concentrated areas. While traumatic birth is not yet universally recognized and its scope remains under discussion, it is increasingly becoming a significant issue. Understanding the priorities and trends of research can guide future academic endeavors, highlighting areas that require further investigation and development.

This study aimed to explore contextual elements of the cancer experience that are consistently distressing and/or psychologically traumatic, as well as explore perceptions of Accelerated Resolution Therapy® (ART®) and its influence on the cancer experience. Using a qualitative descriptive design, semi-structured interviews were completed by 12 participants following the completion of ART. Interview data were analyzed using content analysis to identify major themes and patterns. Four themes included: (a) Cancer as the straw that broke the camel's back, (b) ART® is different from previous therapy, (c) Don't need to always be looking in the rearview mirror, and (d) Importance of early psychological intervention. Participants perceived that ART® was different and potentially more effective than other types of therapy they had previously received. Results support the diagnosis of cancer and the cumulative effects of previous life events and cancer-related stressors as traumatic events.

Solid organ transplant (SOT) recipients now have widespread access to telehealth, but the factors influencing their satisfaction still need to be understood. This cross-sectional study explored potential contributors to telehealth satisfaction among SOT recipients, including liver, kidney, and simultaneous liver-kidney recipients. A total of 136 adult SOT recipients completed an online survey. The survey assessed telehealth satisfaction, previous telehealth experiences, including confidence levels and the need for assistance from others, electronic health literacy (eHealth literacy), perceived physical and mental health status, and cognitive function, along with demographic and clinical characteristics. The multivariate regression backward selection method was used to identify potential factors contributing to telehealth satisfaction. Participants had a mean age of 60.1 years (standard deviation [SD] = 10.5) and were, on average, 92 months post-transplant (SD = 99.9). The mean telehealth satisfaction score was 5.3 out of 7 (SD = 1.2), indicating positive satisfaction with telehealth. However, lower telehealth satisfaction was associated with poor confidence in communicating with providers via telehealth, lower eHealth literacy, better perceived cognitive function, and a prolonged time since SOT (adjusted R2 = 0.49). SOT recipients who perceive vulnerability in online technology, report better perceived cognitive function, and are farther out from their SOT may exhibit lower satisfaction with telehealth. When considering telehealth for transplant care, clinicians should prioritize addressing the specific concerns and challenges of SOT recipients who may perceive telehealth unfavorably.