Nursing Practice Today

Improving early detection of breast cancer in Iran: Identifying barriers and proposing policy solutions

2026-05-04T12:23:36+0430

Background & Aim: Delays in early breast cancer detection increase late-stage presentation, treatment burden, mortality, and costs. Barriers are systemic (access, affordability), individual (fear, awareness), and socio-cultural (stigma, beliefs). This policy brief aims to improve early detection in Iran by identifying barriers and proposing solutions.
Methods & Materials: This policy brief was developed through a multi-phase, evidence-informed study with a multidisciplinary panel. Phase 1 employed a scoping review to identify factors contributing to delayed breast cancer diagnosis globally. Phase 2 utilized semi-structured qualitative interviews with Iranian patients and healthcare providers to explore real-world barriers to early detection. Phase 3 applied an expert consensus approach to prioritize evidence-based, context-specific policy recommendations for improving early breast cancer diagnosis in Iran. The expert panel in Phase 3 comprised specialists from Radiation Oncology, Public Health, Health Education & Promotion, Medical Oncology, and Nursing.
Results: Policy recommendations were derived across five key priority areas: Enhancing equitable access to screening services; Strengthening follow-up and continuity of care systems; Improving health education and awareness; Promoting intersectoral coordination and multisectoral governance; and Ensuring sustainability of resources and digital infrastructure.
Conclusion: Initiating strategies to address these public health recommendations could substantially improve early breast cancer detection rates, reduce mortality, improve patient quality of life, and enhance the overall efficiency of the health system. Moreover, this framework may serve as a scalable model for managing non-communicable diseases in resource-limited settings.

Effects of oropharyngeal colostrum and minimal enteral nutrition on respiratory morbidity and necrotizing enterocolitis in preterm infants: A systematic review of randomized trials

2026-04-26T17:59:57+0430

Background & Aim: Necrotizing enterocolitis is one of the most severe gastrointestinal complications in premature infants, characterized by acute intestinal inflammation and progressive mucosal damage. This systematic review aimed to evaluate the effects of minimal enteral nutrition and oropharyngeal or buccal colostrum administration on respiratory morbidity and the incidence of necrotizing enterocolitis in preterm neonates.
Materials & Methods: A comprehensive search was conducted using PubMed, Web of Science, Scopus, ProQuest, and Google Scholar databases. From 10,460 identified records, twelve randomized controlled trials published between 2015 and 2024 met inclusion criteria and were incorporated into the qualitative synthesis. Data were extracted regarding early growth, feeding tolerance, immune biomarkers, and safety outcomes.
Results: Minimal enteral nutrition was associated with improved early growth and reduced feeding intolerance. Oropharyngeal or buccal exposure to colostrum increased mucosal immune biomarkers, including immunoglobulin A, immunoglobulin M, and lactoferrin, and promoted early colonization of beneficial intestinal microorganisms. Some trials reported reductions in late‑onset sepsis and retinopathy of prematurity. However, neither minimal enteral nutrition nor colostrum‑based interventions significantly reduced the incidence of necrotizing enterocolitis (p > 0.05). Both approaches showed favorable safety profiles without increased adverse effects or clinical instability.
Conclusion: Minimal enteral nutrition and oropharyngeal or buccal colostrum administration appear to be safe, feasible, and biologically plausible strategies for enhancing early nutrition and mucosal immunity in premature infants. Larger, multicenter, and standardized clinical trials are warranted to determine their definitive impact on necrotizing enterocolitis prevention.

The experience of double stigma among LGBT people living with HIV in Lampung, Indonesia: A qualitative study

2026-05-05T16:04:35+0430

Background & Aim: Lesbian, gay, bisexual, and transgender (LGBT) people living with HIV in Indonesia experience double stigma related to HIV status and sexual or gender identity across family, community, and health-care settings. Sociocultural and religious norms in Indonesia reinforce moral judgment and social exclusion, and these pressures reduce psychological well-being, social safety, and continuity of HIV care. Indonesian studies mostly examine HIV-related stigma and LGBT-related stigma separately, so evidence remains limited on how both forms of stigma interact as double stigma.
Materials & Methods: A qualitative study with a descriptive phenomenological design used purposive sampling to recruit 18 LGBT people living with HIV from community-based settings in Lampung, Indonesia. Data were collected using semi-structured interviews between August and October 2025. The researchers conducted in-depth face-to-face interviews and analyzed manually using Colaizzi’s method to identify core themes of lived experience.
Results: The analysis identified three main themes and eight interrelated subthemes reflecting participants’ experiences of dual stigma. The themes included Identity Struggles Under HIV and LGBT Stigma, Family Responses to HIV and LGBT Identity, and Community Reactions to HIV and LGBT Identity.
Conclusion: Individuals living with HIV from LGBT backgrounds experience intersecting forms of stigma that affect their identity, family dynamics, and community participation. Addressing both HIV-related and identity-based stigma is essential to reduce psychosocial distress and promote inclusive support systems. These findings underscore the urgent need for family- and community-engaged interventions to safeguard holistic well-being and sustain HIV care among LGBT people living with HIV.

Emerging digital health approaches for the detection of undiagnosed type 2 diabetes mellitus in underserved populations: A scoping review

2026-04-10T04:24:33+0430

Background & Aim: Undiagnosed type 2 diabetes mellitus continues to pose a major global health challenge, especially in underserved populations facing limited access to screening. Digital health technologies present scalable alternatives to improve early detection and prevent complications. This scoping review aims to map digital health approaches for detecting undiagnosed type 2 diabetes mellitus in underserved adult communities and analyze screening outcomes, feasibility, and key implementation factors.
Materials & Methods: The review followed the Arksey and O’Malley scoping framework and was reported using PRISMA-ScR guidelines. Systematic searches were performed in PubMed/MEDLINE, Scopus, Web of Science, and CINAHL for studies published in English from 2015 onward. Two reviewers independently screened articles, with conflicts resolved through consensus. Data were synthesized narratively to identify digital modalities, screening strategies, effectiveness indicators, and enablers or barriers.
Results: Nineteen studies were included, identifying five categories of digital interventions. Electronic health record–driven screening was reported in 5 of 19 studiesand was the most frequently reported modality, alongside mHealth applications, SMS-based detection support, telehealth platforms, and wearable tools. Digital risk-based screening integrated within community or primary care pathways demonstrated the widest reach and highest identification of undiagnosed dysglycemia. Simpler digital solutions showed greater acceptability and feasibility than complex systems, particularly in settings with limited digital literacy or connectivity.
Conclusion: Digital health technologies show strong potential to expand early detection of undiagnosed type 2 diabetes mellitus in underserved populations. System-integrated, low-burden, and equity-centered screening models are most promising. Strengthening linkage to care and improving digital accessibility remainpriorities for future research.

The ABC process of gradual erosion of intimacy among Filipino women: A qualitative study

2026-04-10T04:10:17+0430

Background & Aim: Intimate partner relationships are often idealized as sources of love and security; however, for many women, they become contexts of coercion, betrayal, and harm. In the Philippines, intimate partner violence and relational instability remain prevalent, yet the gradual and symbolic processes through which intimacy erodes remain underexplored in nursing and public health. This study explored how Filipino women experience and interpret the gradual erosion of intimacy in their intimate partner relationships.
Materials & Methods: Using a constructivist grounded theory–inspired design, this study involved thirteen Filipino women aged 22-54 who had experienced the dissolution of a significant romantic relationship. In-depth semi-structured interviews were conducted across two analytic phases. Data were analyzed through iterative coding, constant comparison, and memo writing until thematic saturation was reached.
Results: Intimacy erosion was identified as a cumulative, nonlinear process rather than a single rupture. Six interconnected subcategories described this process: (1) abuse and coercive control, (2) behavioral shifts and emotional distancing, (3) cheating and betrayal of trust, (4) disregard and alienation, (5) extended family interference, and (6) frightening and threats to safety. These experiences progressively undermined trust, emotional safety, and commitment, often shifting relationships from endurance to survival-driven separation.
Conclusion: Intimacy erosion among Filipino women reflects a layered process of symbolic loss and relational disempowerment. Early recognition of these patterns is essential. Nurses play a critical role in assessing relational health, validating experiences, and advocating for trauma-informed, culturally responsive interventions that address relational well-being as a public health priority.