{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:30:19Z","timestamp":1791822619760,"version":"4.3.4"},"reference-count":60,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T00:00:00Z","timestamp":1788652800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Breast cancer is the most commonly diagnosed malignancy in women and a leading cause of cancer\u2010related mortality. Beyond the physical burden, the disease significantly impacts emotional well\u2010being and quality of life (QoL). Telenursing, as a nurse\u2010led telemedicine intervention, has emerged as a promising strategy to support patients remotely.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effectiveness of nurse\u2010led telenursing interventions on QoL in women with breast cancer and to compare the impact of different technological delivery modes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review and meta\u2010analysis was conducted following PRISMA 2020 and the Cochrane Handbook. Studies were identified through five databases. Randomized controlled trials (RCTs) and quasi\u2010experimental studies comparing nurse\u2010led telenursing to usual care were included. The primary outcome was QoL. Risk of bias was assessed using RoB 2.0 and ROBINS\u2010I; GRADE was used to rate the certainty of evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventeen studies (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094199) were included in the systematic review. Seven studies provided sufficient quantitative data for meta\u2010analysis. Overall, telenursing interventions showed a small to moderate pooled effect on quality of life (SMD\u2009=\u20090.40, 95% CI [0.09, 0.70];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019); however, after trim\u2010and\u2010fill correction for potential publication bias, the adjusted estimate was attenuated and did not reach statistical significance (adjusted SMD\u2009=\u20090.14, 95% CI [\u22120.17, 0.45];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.376). Subgroup analyses\u2014to be interpreted as exploratory\u2014suggested a larger effect for mobile application\u2013based interventions (SMD\u2009=\u20090.63, 95% CI [0.46, 0.80],\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%,\n                      <jats:italic>k<\/jats:italic>\n                      \u2009=\u20093) compared to telephone follow\u2010up (SMD\u2009=\u20090.21, 95% CI [\u22120.34, 0.76],\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200985.2%,\n                      <jats:italic>k<\/jats:italic>\n                      \u2009=\u20094), though the small number of contributing studies limits the reliability of this comparison.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings provide preliminary evidence that nurse\u2010led telenursing may be associated with improvements in quality of life in women with breast cancer, though the certainty of the evidence is low (GRADE: Low). Results should be interpreted with caution given the attenuation of the pooled effect to non\u2010significance after trim\u2010and\u2010fill adjustment, substantial methodological heterogeneity, and the exploratory nature of subgroup comparisons. High\u2010quality randomized trials are needed to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72098","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T03:39:25Z","timestamp":1788752365000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Telenursing to Improve Quality of Life in Women With Breast Cancer: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"15","author":[{"given":"Serena","family":"Ricchiuto","sequence":"first","affiliation":[{"name":"Humanitas University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4822-5001","authenticated-orcid":false,"given":"Diego","family":"Lopane","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital  Milan 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