Masumeh SaeidiHealth Providers2820-91926220261201Emotional Support Source and Time Since Diagnosis as Correlates of Anxiety Among Women with Breast Cancer Undergoing Chemotherapy: A Cross-Sectional Study14315925314110.22034/hp.2026.602902.1096ENZahraRezaei BorojerdiDepartment of Hematology and Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.HediyehBarkhordariNursing Research Center, Kerman University of Medical Sciences, Kerman, Iran.SajadAtaei AzimiDepartment of Hematology and Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Journal Article20260916<strong><em>Background:</em> </strong>Anxious preoccupation is common among Iranian women with stage I–III breast cancer receiving chemotherapy. This study examined sociodemographic, clinical, and interpersonal correlates of anxious preoccupation among women with stage I–III breast cancer receiving chemotherapy in Iran.<br><strong><em>Materials and Methods</em>: </strong>This cross-sectional analytical study enrolled 200 women with histologically confirmed stage I–III breast cancer receiving chemotherapy at oncology facilities in Kerman, Iran, using purposive convenience sampling. Cancer-related anxious preoccupation was assessed with the Mini-Mental Adjustment to Cancer Anxious Preoccupation subscale. Mean scores were compared across participant characteristics using independent-samples t tests and one-way ANOVA, with Fisher’s LSD post hoc testing for significant results.<br><strong><em>Results:</em> </strong>Among 200 participants, mean anxious-preoccupation scores differed significantly by primary emotional-support source (p = 0.003) and time since breast-cancer diagnosis (p < 0.001). Women identifying parents as their principal emotional supporters reported higher anxious-preoccupation scores than those primarily supported by spouses or children. Scores were highest among women assessed four months after diagnosis and significantly exceeded those reported at three, five, and six months. No significant differences were observed by educational level, marital status, health-insurance type, tumor histology, histological grade, or affected-breast laterality (all p > 0.05). Chemotherapy duration was perfectly collinear with time since diagnosis and produced identical results; therefore, its independent association with anxious preoccupation could not be estimated.<br><strong><em>Conclusion:</em></strong> Among women with stage I–III breast cancer receiving chemotherapy, anxious preoccupation was associated with support source and time since diagnosis. Scores were higher four months after diagnosis and among women primarily supported by parents. As chemotherapy duration was collinear with diagnosis timing, psychosocial assessment should consider support networks throughout treatment.https://www.health-providers.ir/article_253141_c210bbc9254b4585af470de850dc4009.pdfMasumeh SaeidiHealth Providers2820-91926220261201Online Mindfulness-Based Counseling for Cognitive Preoccupation and Future Anxiety in Women With Breast Cancer: A Randomized Controlled Trial16117425340810.22034/hp.2026.603588.1097ENZahraRezaei BorojerdiDepartment of Hematology and Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.HediyehBarkhordariNursing Research Center, Kerman University of Medical Sciences, Kerman, Iran.SaraNajibiReproductive and Family Health Research Center, Kerman University of Medical Sciences, Kerman, Iran.MaryamMirzaeiAssistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran.0000-0003-2758-853XMaryamMemardoostStudent Research Committee, Kerman University of Medical Sciences, Kerman, Iran.MahdiyehKarimiStudent Research Committee, Kerman University of Medical Sciences, Kerman, Iran.SajadAtaei AzimiDepartment of Hematology and Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Journal Article20260920<strong><em>Background:</em> </strong>Breast cancer and its treatment with chemotherapy can cause substantial psychological distress, including cognitive preoccupation and future anxiety/fear of recurrence. This study evaluated the association of online mindfulness-based counseling with these outcomes among women with breast cancer receiving chemotherapy, using the eight-item Breast Cancer Psychological Care Questionnaire (BC-PPCS-8).<br><strong><em>Materials and Methods</em>: </strong>In this two-arm, parallel-group randomized controlled trial conducted in Kerman, Iran, 70 women with stage I–III breast cancer receiving chemotherapy were randomly assigned to an eight-week online mindfulness-based counseling program or usual care. Cancer-related psychological distress was assessed using the eight-item Breast Cancer Psychological Care Questionnaire (BC-PPCS-8) at baseline, post-intervention, and one-month follow-up. Baseline characteristics were compared using t-tests, chi-square tests, or Fisher’s exact tests, as appropriate. Post-intervention outcomes were compared using the Mann–Whitney U test.<br><strong><em>Results:</em> </strong>Of 84 patients assessed for eligibility, 70 were randomized in equal numbers to mindfulness-based counseling or usual care. Post-intervention outcome data were obtained from 34 participants in the counseling group and 35 in the control group. Groups were comparable at baseline regarding demographic and clinical characteristics, including age, marital status, education, income, cancer type, time since diagnosis, and number of chemotherapy sessions (all p > 0.05). At post-intervention, participants receiving mindfulness-based counseling reported significantly lower cognitive preoccupation (mean vs. mean), future anxiety/fear of recurrence (mean vs. mean), and total BC-PPCS-8 scores (mean vs. mean) than control participants (all p < 0.05).<br><strong><em>Conclusion:</em></strong> Online mindfulness-based counseling was associated with lower post-intervention cognitive preoccupation, future anxiety/fear of recurrence, and psychological distress than usual care among women receiving chemotherapy for breast cancer. This accessible intervention may complement psychosocial care; larger longitudinal trials should confirm the magnitude and durability of effects.https://www.health-providers.ir/article_253408_83ff9359646924c70996e0472a7964c4.pdfMasumeh SaeidiHealth Providers2820-91926220261201Delayed Referral of Children with Cancer to the Pediatric Intensive Care Unit: The Need for a Shared Care Pathway Between Oncology and Critical Care17517725397910.22034/hp.2026.604792.1099ENAmirHesabiPediatric Hematology and Oncology, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.0000-0003-1789-1500Journal Article20260928Advances in childhood cancer treatment have substantially improved survival; however, intensive therapies may cause severe infections, organ dysfunction, and rapid clinical deterioration. In these situations, pediatric intensive care units (PICUs) play a crucial role in providing life-sustaining support and enabling the continuation of cancer-directed treatment. Nevertheless, referral of children with cancer to the PICU may be delayed when clinicians perceive the underlying prognosis as poor or consider intensive interventions unlikely to be beneficial. Evidence indicates that many children with cancer survive PICU admission and may subsequently continue curative treatment. This letter highlights the need for a structured, shared care pathway involving pediatric oncology, critical care, infectious diseases, and palliative care teams to facilitate earlier recognition of deterioration and timely PICU referral.https://www.health-providers.ir/article_253979_41c667bf5fc258c5ea737dab04e3112e.pdfMasumeh SaeidiHealth Providers2820-91926220261201Patient Safety and Quality of Emergency Care for Children with Hematologic Malignancies and Cancer: Challenges and Solutions in Iran and Globally17918325400110.22034/hp.2026.604823.1100ENHaniehSoltaniDepartment of Pediatrics, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.0000-0002-9750-2685Journal Article20260928Children with hematologic malignancies and other cancers are highly vulnerable to serious, rapidly progressive complications—including fever and neutropenia, bloodstream infection, bleeding, and metabolic disturbances—due to immunosuppression from the underlying disease or chemotherapy. The emergency department (ED) is often the first point of care for these children. Consequently, the quality of triage, timeliness of treatment initiation, medication and blood product safety, management of central venous catheters, and effective communication with the oncology team can decisively influence patient outcomes. In Iran, despite therapeutic advances, important challenges persist, including disparities in access to and quality of services across centers, delays in referral, and weaknesses in adverse event reporting systems. Establishing a dedicated triage pathway, ensuring timely administration of antibiotics for febrile neutropenia, implementing safe medication management, providing targeted staff training, strengthening error-reporting culture, and enabling rapid communication between EDs and referral centers can reduce preventable complications and improve the quality of care.https://www.health-providers.ir/article_254001_30546e1a4f099bc1fefaef76df7a478e.pdfMasumeh SaeidiHealth Providers2820-91926220261201Improving Treatment Outcomes in Pediatric Oncology Patients Admitted to Intensive Care Units: Current Challenges and Future Strategies in Iran18518825406610.22034/hp.2026.604940.1101ENAmirHesabiPediatric Hematology and Oncology, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.0000-0003-1789-1500Journal Article20260929Improvements in survival among children with cancer, together with increasingly complex treatment regimens, hematopoietic stem-cell transplantation, and targeted therapies, have increased the need for admission to pediatric intensive care units (PICUs). In Iran, overall survival among children with cancer has improved in recent years; however, mortality among children with cancer admitted to the PICU remains higher than that reported for the general PICU population. Sepsis, multi-organ dysfunction, central nervous system involvement, and high-risk hematologic malignancies are major contributors to mortality in this population. Delayed recognition of clinical deterioration, drug-resistant infections, late referral, and inequitable access to specialized services remain important challenges in the care of these patients in Iran. Effective strategies include the implementation of pediatric early warning systems, antimicrobial stewardship programs, strengthened collaboration between oncology and PICU teams, optimization of nutritional support, early integration of palliative care, and family-centered care. Developing local clinical guidelines, training healthcare personnel, and establishing multicenter databases may help reduce preventable mortality and improve the quality of care.https://www.health-providers.ir/article_254066_545d31ddd68d706691c9d5edcf9f05e2.pdfMasumeh SaeidiHealth Providers2820-91926220261201Integrated Care for Critically Ill Children with Cancer: The Need for a Shared PICU–Pediatric Oncology Pathway18919225415810.22034/hp.2026.605193.1102ENHaniehSoltaniDepartment of Pediatrics, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.0000-0002-9750-2685Journal Article20260930Children with cancer are vulnerable to life-threatening complications related to the malignancy itself, chemotherapy, hematopoietic stem-cell transplantation, and treatment-associated immunosuppression. Sepsis and septic shock, acute respiratory failure, hemorrhage, tumor lysis syndrome, neurologic complications, acute kidney injury, and multiple-organ dysfunction are among the principal indications for admission to the pediatric intensive care unit (PICU) in this population.<br><br>Despite substantial improvements in overall childhood cancer survival, outcomes during episodes of critical illness remain strongly dependent on early recognition of clinical deterioration, timely referral to the PICU, prompt initiation of time-sensitive treatment, and close coordination between pediatric critical care and oncology teams. This letter highlights the need for an integrated PICU–pediatric oncology clinical pathway. Such a pathway should incorporate early-warning systems, joint assessment of high-risk patients, oncology-adapted bundles for sepsis and respiratory failure, surveillance for oncologic emergencies such as tumor lysis syndrome, daily multidisciplinary rounds, and early integration of palliative-care principles.https://www.health-providers.ir/article_254158_7e50dd4e10a617fc9910fd4f372f103d.pdfMasumeh SaeidiHealth Providers2820-91926220261201Family History of Sudden Death among First-Degree Relatives of Individuals with Sickle Cell Disease or Other Hemoglobinopathies: A Narrative Review of Prevalence Evidence19320625465010.22034/hp.2026.606490.1109ENAmirHesabiPediatric Hematology and Oncology, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.0000-0003-1789-1500Journal Article20261008<strong><em>Background</em></strong><em>:</em> Evidence on the prevalence of a family history of sudden death in hemoglobinopathies is limited. This study synthesizes evidence concerning first-degree relatives of affected individuals and carriers and identifies gaps in understanding its clinical relevance.
<strong><em>Materials and Methods</em></strong>: We searched PubMed/MEDLINE, Scopus, Web of Science, the Cochrane Library, SID, Magiran, and CIVILICA for English- and Persian-language publications through June 2026. Two reviewers independently screened titles and abstracts. Evidence was classified as direct, comparative, or contextual and synthesized narratively. The primary outcome was the proportion of individuals with hemoglobinopathies or carriers with at least one first-degree relative with a history of sudden death.
<strong><em>Results</em></strong><em>:</em> No extractable prevalence estimate was identified in the included literature for individuals with hemoglobinopathies or carriers. The absence of adequate numerators, denominators, and verified family-history data precluded prevalence estimation and comparisons across hemoglobinopathy types, carrier status, and categories of first-degree relatives. Studies of hemoglobinopathies primarily focused on patient mortality, arrhythmias, and cardiopulmonary complications rather than sudden death among relatives. Comparative cardiac literature reported a family history of sudden cardiac death in 34.2% of ischemic sudden-death victims, 13.4% of nonischemic victims, and 17.6% of controls without heart disease; this history was significantly more common in the ischemic group. Although these findings provide contextual information, they do not establish prevalence among individuals with hemoglobinopathies or carriers.
<strong><em>Conclusion</em></strong><em>:</em> Evidence is insufficient to estimate the prevalence of a family history of sudden death among individuals with hemoglobinopathies, including carriers. Studies using standardized definitions, appropriate denominators, and validated family-history ascertainment are needed to establish prevalence and assess associations with patient outcomes. Its predictive value and screening utility remain uncertain.https://www.health-providers.ir/article_254650_b4ae89ad066f4294c9739b692452dcf9.pdf