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The diagnosis of cancer results in psychophysiological distress in patients, significantly reducing quality of life (QoL). Currently, self-management interventions based on e-health have been used to improve QoL among cancer patients, but the overall effects remain inconsistent.
To assess the impact of self-management interventions based on e-health on the QoL of cancer patients.
Studies were retrieved from six databases up to November 6, 2024. The methodological quality assessment was performed via ROB 2. Data synthesis and subgroup analyses were performed in Review Manager 5.3. Meta-regression was conducted using Stata 15.0.
Thirty RCTs were included. The results of meta-analysis revealed self-management interventions based on e-health significantly improved QoL (SMD = 0.18, 95% CI: 0.08 to 0.28, p < 0.01). Subgroup analyses showed that long-term, mixed-mode, theory-supported, or facilitator-supervised interventions were more effective, with greater improvements in QoL observed among patients with breast cancer than among other types.
Self-management interventions based on e-health were valuable supplements for enhancing the QoL of cancer patients. Intervention duration, delivery modes, cancer types, theoretical frameworks, and facilitators' involvement should be considered in the design of future interventions. However, additional high-quality studies are needed to confirm these findings.
The protocol was registered on PROSPERO (Registration number: CRD420251017709)
Non-pharmacological interventions (NPIs) have been shown to be effective in reducing fatigue, depression, and improving quality of life (QoL) in patients with lung cancer. However, given the diversity of NPIs, the most effective intervention remains to be confirmed.
To compare the efficacy of different NPIs in reducing fatigue, depression, and improving QoL in patients with lung cancer.
Six databases were searched from inception to May 10, 2025. Two reviewers independently screened studies and extracted data. A pairwise meta-analysis and a network meta-analysis were performed sequentially to determine the efficacy of different NPIs in improving fatigue, depression, and QoL in patients with lung cancer.
A total of 58 studies involving 13 NPIs were included. The top three NPIs for reducing fatigue were acupuncture, acceptance and commitment therapy (ACT), and nutritional intervention. Meanwhile, ACT, cognitive behavioral therapy, and body–mind-spirit intervention ranked among the top three in improving depression. ACT emerged as the most effective intervention in improving QoL, followed by nutritional intervention and mind–body exercise.
This study revealed the efficacy ranking of different NPIs in reducing fatigue, depression, and improving QoL in patients with lung cancer. Clinical healthcare professionals should be encouraged to utilize these potentially effective NPIs to improve health outcomes in patients with lung cancer.
Registration Number: PROSPERO (CRD420251087360)
by Guohui Wang, Lu Liu, Hanshu Zhang, Panpan Mao, Saijuan Lu, Xiaofang Zhang, Xingde Li, Cangsang Song
BackgroundLiver transplantation (LT) is an effective treatment for patients with end-stage liver disease. In recent years, more and more evidence has supported the association between gut microbiota dysbiosis and the pathogenesis and progression of liver diseases.
MethodsThe study included 36 patients who received tacrolimus treatment after liver transplantation. Patients were stratified into subgroups according to three key variables: tacrolimus treatment duration, whole-blood tacrolimus concentration, and tacrolimus concentration-to-dose (C/D) ratio. Fecal samples and whole-blood specimens were collected from all participants. The Illumina HiSeq X platform was used to detect the gut metagenome, analyzing the composition and characteristics of the gut microbiota. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) technology was employed to detect metabolites of the gut microbiota, revealing their metabolic profiles.
ResultsAs the duration of tacrolimus use increased, the diversity of the gut microbiota also increased, and the abundance of Escherichia coli_D and Bacteroides stercoris rose. Additionally, the abundance of Brunovirus and Uetakevirus tended to decrease. The abundance of gene functions related to chemical carcinogenesis and bacterial invasion of epithelial cells significantly decreased. In the gut microbiota metabolites, 16 substances like Astragaloside A and Acetyl-L-carnitine significantly increased, while 108 substances like Capsaicin and TLK significantly decreased. Within a certain range, as the concentration of tacrolimus in whole blood increased, the diversity of the gut microbiota increased. The abundance of Phocaeicola and Klebsiella increased, and the abundance of Peduovirus among viruses also rose. However, excessively high concentrations may lead to a decrease in the diversity of the gut microbiota and a decrease in the abundance of Phocaeicola. With respect to the C/D ratio, increased ratios were linked to significantly higher levels of 57 fecal metabolites (e.g., PC 34:2, 5-Methyl-2’-deoxycytidine), whereas 13 metabolites (e.g., FAHFA 2:0/16:0) showed substantial declines.
ConclusionsTacrolimus treatment is associated with distinct alterations in gut microbiota and metabolites among LT recipients. These findings provide a preliminary framework for future investigations aimed at optimizing immunosuppressive regimens, although their clinical translational potential requires validation in larger-scale, prospective cohort studies.
Cancer is a major social, public health and economic problem worldwide, causing physical and psychological distress to patients. The emerging telemedicine model in healthcare delivery has garnered significant interest because of its potential effectiveness.
To assess the effects of telemedicine on distress, physical function, and self-efficacy in cancer patients.
This meta-analysis was conducted and reported in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 checklist.
Six databases were searched for relevant studies published from inception to October 2024. The literature search and data collection were conducted by two separate researchers. The quality of the methodologies in the studies included was evaluated using the Cochrane Risk of Bias Tool. Data analysis was conducted using Review Manager (version 5.4).
Compared with the control group, patients who received telemedicine experienced significant reductions in distress (SMD = −0.44, 95% CI: −0.62 to −0.25, p < 0.00001, I 2 = 46%) and significant increases in physical function (SMD = 0.11, 95% CI: 0.01–0.22, p = 0.04, I 2 = 0%) and self-efficacy (SMD = 0.46, 95% CI: 0.23–0.69, p < 0.0001, I 2 = 0%).
Telemedicine can effectively enhance the psychological health and physiological function of cancer patients, as well as their self-efficacy, suggesting a sustainable approach to the clinical care of cancer patients. Future studies are needed to further investigate the effectiveness of telemedicine interventions in different types of cancer patients and in different cultural contexts and to conduct long-term follow-up studies to evaluate their long-term effectiveness and cost-effectiveness.
This systematic review and meta-analysis provides evidence to offer effective and sustainable telemedicine care among cancer patients.
No patient or public contribution.
This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (Registration number: CRD42024604929) under the title ‘The effectiveness of death education on death anxiety, depression and quality of life in patients with advanced cancer: A meta-analysis of randomised controlled trials’. The full study protocol could be obtained at https://www.crd.york.ac.uk/PROSPERO/view/CRD42024604929
In clinical oncology nursing practice, the preservation of quality of life is an essential component. E-health interventions have been proven effective in improving quality of life in patients with cancer, but the optimal content and delivery format remain undetermined.
To compare the efficacy of e-health interventions with varying contents and delivery formats in improving quality of life in patients with cancer.
Network meta-analysis of randomized controlled trials.
Six databases, including Medline, Web of Science, Embase, CINAHL, the Cochrane Central Register of Controlled Trials, and PsycINFO, were searched from inception to October 25, 2025.
Two reviewers independently screened studies and extracted data. A pairwise meta-analysis and a network meta-analysis were performed sequentially to determine the efficacy of different contents and delivery formats of e-health interventions in improving quality of life in patients with cancer.
A total of 50 studies included e-health interventions with eight contents and five delivery formats. The results identified health education (SUCRA = 82.2%), symptom management (SUCRA = 72.2%), and rehabilitation interventions (SUCRA = 71.1%) as the three most effective e-health intervention contents for improving quality of life in patients with cancer. Among delivery formats, app-based (SUCRA = 82.1%), internet/web-based (SUCRA = 71.5%), and telephone-based e-health interventions (SUCRA = 53.3%) ranked among the top three.
This study explored the efficacy of different contents and delivery formats of e-health interventions in improving quality of life in patients with cancer. These results are expected to provide an evidence-based basis for clinical oncology nursing practice.
PROSPERO number: CRD42025638829
Nurses commonly experience negative experiences after experiencing a patient safety event, triggering a domino effect on the nurses themselves, subsequent patients, and healthcare organisations, thus requires urgent attention.
To explore the mediating role of psychological capital and coping styles between neurotic personality and negative experiences of nurses' second victims, and to provide theoretical guidance for nursing administrators to develop targeted strategies to mitigate negative experiences of nurses' second victims.
In June–July 2023, a general information questionnaire, a neurotic personality subscale, the Chinese version of the Second Victim Experience and Support Scale, the Nurses' Psychological Capital Questionnaire, and the Coping Styles Questionnaire were used to conduct an online survey of 213 nurses' second victims and structural equation modelling was constructed to clarify the relationship between these elements.
Psychological capital and coping styles partially mediated the relationship between neurotic personality and negative experiences in the nurses' second victims, with a total indirect effect value of 0.203 and a total effect value of 0.303, for a mediating effect of 33.00%.
Neurotic personality and immature coping styles negatively predict the degree of negative experience, while psychological capital and mature coping styles positively predict the degree of negative experience. Psychological capital and coping styles play a partial mediating role between neurotic personality and negative experience.
After a patient safety incident, nursing managers can mitigate the negative experiences of nurses' second victims in patient safety incidents by reducing their neurotic personality tendencies, enhancing their level of psychological capital, and guiding them to adopt mature coping styles.
No patient or public contribution.
Patients with advanced cancer can suffer from serious distress like death anxiety and depression, in addition to facing a reduced quality of life. Death education interventions have been shown to improve these outcomes, but their effectiveness remains unclear, especially in the advanced stages.
This meta-analysis aimed to examine the efficacy of death education interventions on death anxiety, depression, and quality of life in advanced cancer sufferers, and to explore the influence of the intervention site, duration, the age of participants, and dyadic relationships with caregivers on the effectiveness of these interventions.
A meta-analysis of randomized controlled trials was performed.
A systematic search of 10 electronic databases identified 19 eligible RCTs with 1531 participants. Data were extracted and analyzed via Review Manager 5.4. Subgroup analyses were performed on the basis of the intervention site, duration, age of participants, and presence of caregivers.
In comparison to the control intervention, the death education intervention notably alleviated death anxiety (SMD = −2.11, 95% CI: −5.91 to −0.89, p = 0.008) and depression (SMD = −0.45, 95% CI: −0.72 to −0.18, p = 0.001). Quality of life (SMD = 0.86, 95% CI: 0.39–1.33, p = 0.0003) was also significantly improved. Subgroup analyses revealed that interventions with longer durations, conducted in professional settings, and targeting younger patients were more likely to be effective in reducing depression and enhancing the quality of life. Interventions without family companionship were more effective in improving depression, while interventions with family companionship were more effective in improving quality of life.
Death education interventions are effective at improving death anxiety, depression, and quality of life in patients with advanced cancer. Tailoring interventions to individual features and cultural backgrounds is crucial to achieving the best effect.
Death education is an effective and important intervention measure that can help patients with advanced cancer better cope with death anxiety and depressive emotions and improve their quality of life. Clinical medical workers should select appropriate death education programs based on the specific conditions of patients and provide necessary support and guidance.
CRD42024565376
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