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Individuals harboring breast cancer gene 1/2 (BRCA1/2) pathogenic variants are at increased lifetime risk for developing cancer. Learning one's BRCA1/2 carrier status is a watershed moment that can result in psychological distress, anxiety, and depression, as well as feelings of vulnerability and stigma. However, emotional and coping responses to learning one's BRCA1/2 carrier status and after risk-reducing interventions (i.e., preventative bilateral mastectomy) are variable, and existing literature reveals mixed and sometimes contradictory results. Drawing on the concept of narrative identity from the field of psychology, we sought to examine if "identity theft" (the sudden overtaking of one's narrative agency by an external force) may help explain the heterogeneity of emotional and coping responses following the revelation of BRCA carrier status and the subsequent medical intervention one may receive. This Perspective explores BRCA related identity theft using two case studies. Narrative analysis of qualitative interviews uncover the ways that patients experience the disintegration (theft) of their identity as well as their efforts to build and reintegrate a new BRCA carrier identity. This initial qualitative exploration provides preliminary support for the relevance of narrative identity and identity theft to hereditary cancer. We posit that applying the lens of identity theft may hold promise as a unifying concept, integrating across the variable emotional and coping responses among BRCA carriers. Employing a lens of identity theft may help inform the development of tailored narrative interventions as part of precision healthcare to support active coping and psychosocial wellbeing. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To evaluate associations among social determinants of health (SDOH), stress, interleukin-6 (IL-6), and quality of life among non-Hispanic Black and Hispanic cancer survivors. SAMPLE & SETTING: Individuals who had completed cancer treatment and did not identify as White (N = 46) were recruited through community partnerships in western Massachusetts and a state cancer registry. METHODS & VARIABLES: This descriptive crosssectional study used questionnaires and morning salivary samples to collect data between June 2022 and September 2023. RESULTS: Most participants were breast cancer survivors, were female, identified as African American or Black, and reported moderate levels of stress and low physical activity. Cortisol levels were higher among African American or Black participants, those with lower body mass index, and those with less consumption of fruit and vegetables. Higher symptom experience was associated with higher IL-6 levels. No associations were identified between IL-6 and cortisol or perceived stress and cortisol levels. IMPLICATIONS FOR NURSING: Incorporating SDOH in self-reported outcomes, including health behaviors and associated biologic indicators, can facilitate early identification and interventions to improve symptom experience and health outcomes of cancer survivors. [ABSTRACT FROM AUTHOR]

Simple Summary: Genetic testing for BRCA1/2 is recommended for individuals at high risk of hereditary breast and ovarian cancer, yet racial and ethnic disparities persist. Diverse and mutually influencing factors contribute to BRCA health disparities, including socially constructed identities (e.g., gender, race, and ethnicity), sociodemographic factors (e.g., income and education), and societal factors (discrimination). Such factors can be additive and multiplicative. Viewing BRCA health disparities through an intersectional lens may provide a more nuanced, comprehensive understanding of lived experience by considering individuals' unique, intersecting identities. A deeper understanding of the individual can inform more person-centered approaches to genomic healthcare and help bridge BRCA health disparities. Significant health disparities exist in relation to pathogenic variants in BRCA1/2. This study aimed to better understand the barriers and facilitators to BRCA1/2 genetic testing and intrafamilial communication of risk in racially and ethnically diverse individuals. We conducted qualitative interviews with non-Hispanic White (n = 11) and Black, Indigenous, People of Color (BIPOC) individuals (n = 14) who underwent testing for pathogenic BRCA1/2 variants. We employed template analysis, case study analysis, and comparative case study analysis to examine healthcare experiences related to genetic testing as well as intrafamilial communication of risk. Applying an intersectional lens, we sought to inform more person-centered approaches to precision healthcare and help dismantle disparities in genomic healthcare. Template analysis revealed salient factors at the individual (psychosocial well-being), interpersonal/familial, and healthcare system levels. A two-part case study analysis provided insights into how race/ethnicity, cultural norms, and socioeconomic status interact with systemic and structural inequities to compound disparities. These findings underscore the need for person-centered, tailored, and culturally sensitive approaches to understanding and addressing the complexities surrounding testing and the communication of BRCA risk. Applying an intersectional lens can inform more person-centered approaches to precision healthcare and may help to surmount existing disparities. [ABSTRACT FROM AUTHOR]

Pathogenic and likely pathogenic variants in BRCA1 and BRCA2 (BRCA1/2) are medically actionable and may inform hereditary breast and ovarian cancer (HBOC) treatment and prevention. However, rates of germline genetic testing (GT) in people with and without cancer are suboptimal. Individuals' knowledge, attitudes, and beliefs may influence GT decisions. While genetic counseling (GC) provides decision support, the supply of genetic counselors is insufficient to meet demand. Accordingly, there is a need to explore the evidence on interventions that aim to support BRCA1/2 testing decisions. We conducted a scoping review of PubMed, CINAHL, Web of Science, and PsycINFO using search terms related to HBOC, GT, and decision making. First, we screened records to identify peer‐reviewed reports that described interventions to support BRCA1/2 testing decisions. Next, we reviewed full‐text reports and excluded studies that lacked statistical comparisons or enrolled previously tested individuals. Finally, we extracted study characteristics and findings into a table. All records and reports were reviewed independently by two authors; decisions were tracked in Rayyan, and discrepancies were resolved through discussion. Of 2116 unique citations, 25 met the eligibility criteria. Articles were published between 1997 and 2021 and described randomized trials and nonrandomized, quasi‐experimental studies. Most studies tested technology‐based (12/25, 48%) or written (9/25, 36%) interventions. Nearly half (12/25, 48%) of interventions were designed to complement traditional GC. Of the interventions compared to GC, 75% (6/8) increased or had a noninferior effect on knowledge, and 67% (4/6) decreased or had a noninferior effect on decisional conflict. Intervention effects on GT uptake were mixed, which may reflect evolving eligibility criteria for GT. Our findings suggest novel interventions may promote informed GT decision making, but many were developed to complement traditional GC. Trials that assess the effects of decision support interventions in diverse samples and evaluate implementation strategies for efficacious interventions are warranted. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To evaluate the effects of social network characteristics of individuals with a family history of cancer on the use of cancer-related services (e.g., screening, genetic counseling/testing). SAMPLE & SETTING: 170 family members of individuals with the most common hereditary or familial cancers. METHODS & VARIABLES: Data collection occurred between March and September 2021 using an online survey. RESULTS: Having strong within--immediate family relationships and family members who underwent more screening procedures was associated with increased breast cancer screening, and having more family members with cancer was associated with colorectal cancer screening. Having a large family, having family members who underwent screening for more cancers, and having strong social cohesion among families were associated with an increased rate of genetic testing. IMPLICATIONS FOR NURSING: Nurses working with families affected by cancer should focus on strategies to strengthen relationships among family members to improve knowledge of cancer screening and available genetic services. [ABSTRACT FROM AUTHOR]

Significance: Elevated survival rates in young adult cancer survivors (YACS) are accompanied by high morbidity levels resulting in an array of unmet needs limiting full life potential. Physical activity (PA) improves physical, psychological, and social aspects of health after a cancer diagnosis. There are no standardized PA guidelines tailored to YACS. Therefore, there is a critical need to understand areas of clinical relevance/agreement on PA use and implementation in young adult (YA) survivorship care. Aim: To identify expert consensus areas on the assessment, prescription, and implementation of PA in YA survivorship care; identify areas of clinical relevance and endorsement of PA as a health optimization strategy in YA survivorship care. Methods: A four-round modified Delphi study of international multidisciplinary experts (Round I/II n = 18; Round III n = 57, Round IV n = 45) in exercise oncology, symptom management, survivorship care, youth cancer care was conducted. Qualitative content analysis, descriptive statistics (% agreement, standard deviation, mean), and inter-rater reliability (Kappa) were calculated. Results: Experts reached a consensus on clinical providers needed to assess, refer, and provide PA interventions, the need for guidelines, and essential care delivery system components to foster the integration of PA integration in YA survivorship care as a health optimization activity. Conclusions/Implications: Cancer care integration models should optimize the unique preferences, strengths, and developmental stage of YA affected by cancer. The study adds to the existing literature on multidisciplinary teams needed to provide clinical expertise and organizational support to foster PA integration into YA survivorship care. [ABSTRACT FROM AUTHOR]

AIM: The study aims to explore the predictors of the quality of life of caregivers of women receiving cancer treatment in Turkey. METHOD: This study was conducted in a Medical-Oncology inpatient clinic of a University Hospital in Istanbul, Turkey, between February and June 2020. Descriptive data were collected from 128 family caregivers using caregiver and patient identification forms and the quality of life scale-family version. Bivariate analyses and multiple regression were used to analyze the data. RESULTS: The mean score of the quality of life was 4.41 (standard deviation = 0.63). A backward multiple regression revealed that being female caregivers, increased time spent for care per day, and caring for women with metastatic cancer were factors associated with poor quality of life. CONCLUSION: Although caregiving responsibilities bring challenges to every caregiver, those who are at high risk for impaired quality of life during caregiving need further support in their caregiving to maintain quality of life. Further research should focus on finding solutions to better support caregivers who are experiencing impairment in their quality of life. [ABSTRACT FROM AUTHOR]

The article discusses precision health symptom science in oncology nursing, emphasizing its role in personalized symptom management through genetic and -omic data analysis alongside clinical and environmental factors. Topics include identifying patient subgroups with varying symptom burdens, the influence of genetics on symptom severity, and strategies for developing tailored interventions to optimize cancer care.

OBJECTIVES: To evaluate the effect of a symptom management mobile application on quality of life and symptom severity in women with breast cancer undergoing chemotherapy. SAMPLE & SETTING: This parallel randomized pilot study consisted of women with breast cancer admitted to oncology outpatient clinics between November 2019 and January 2021 in Turkey. METHODS & VARIABLES: Participants (N = 40) were randomly assigned to the intervention (n = 20) or control group (n = 20). The intervention group used the mobile application in conjunction with usual care. The control group received usual care. Participants were assessed during the first, third, and last chemotherapy cycles. Data were collected using the European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire-Core 30 and the Edmonton Symptom Assessment System. RESULTS: During the study, the decrease in general health and physical functioning and the increase in the severity of depression/sadness in the intervention group were statistically lower than in the control group. IMPLICATIONS FOR NURSING: The use of a mobile application for symptom management may promote general well-being and physical function and may alleviate symptoms of depression/sadness in women with breast cancer undergoing chemotherapy. Further studies are needed to evaluate the application in clinical settings with larger groups. [ABSTRACT FROM AUTHOR]