A study of the impact of psychological interventions in the application of nursing care to neurosurgical oncology patients: A systematic review
Abstract
Neurosurgical oncology patients face substantial psychological and cognitive burdens that complicate recovery and diminish quality of life. Nurses, through their continuous presence, are uniquely positioned to deliver psychological interventions that alleviate these challenges. This systematic review, conducted in line with PRISMA 2020, synthesized 20 studies published between 2010 and 2025 examining nurse-led psychological interventions, including cognitive-behavioural therapy, mindfulness, psychoeducation, supportive counselling, relaxation training, and multimodal approaches—in adults with brain tumours. Findings consistently demonstrated reductions in anxiety and depression, enhanced coping, resilience, and quality of life, and, in several cases, improvements in adherence, pain management, and hospital length of stay. Mechanisms of benefit included strengthened coping strategies, therapeutic alliance, and self-efficacy, while effects were moderated by patient characteristics, intervention design, and healthcare context. Interventions targeting cognitive decline, such as goal management training and digital rehabilitation tools, showed promise but were constrained by small samples and short follow-up. Despite methodological heterogeneity, the evidence supports embedding psychological interventions into nursing practice as a feasible, effective, and ethically essential component of neurosurgical oncology care. Future priorities include larger multicentre trials with standardized outcomes, extended follow-up, and evaluation of cultural and economic factors to guide implementation and ensure equitable access to psychosocial support.
Copyright (c) 2025 Author(s)
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
1. Gerritsen JKW, Arends L, Klimek M, et al. Impact of intraoperative stimulation mapping on high-grade glioma surgery outcome: A meta-analysis. Acta Neurochir (Wien). 2019; 161(1): 99-107. doi: 10.1007/s00701-018-3732-4
2. Rotim K, Splavski B, Vrban F, Rotim A. Strategies for the prevention of complications in brain glioma surgery. Journal of Applied Health Sciences. 2021; 7(2): 115-120. doi: 10.24141/1/7/2/1
3. Zetterling M, Elf K, Semnic R, et al. Time course of neurological deficits after surgery for primary brain tumours. Acta Neurochir (Wien). 2020; 162(12): 3005-3018. doi: 10.1007/s00701-020-04425-3
4. Sughrue ME, Rutkowski MJ, Shangari G, et al. Risk factors for the development of serious medical complications after resection of meningiomas. Journal of Neurosurgery. 2011; 114(3): 697-704. doi: 10.3171/2010.6.jns091974
5. De Witte E, Satoer D, Colle H, et al. Subcortical language and non-language mapping in awake brain surgery: The use of multimodal tests. Acta Neurochir (Wien). 2015; 157(4): 577-588. doi: 10.1007/s00701-014-2317-0
6. Zhao H, Li X, Zhou C, et al. Psychological distress among Chinese patients with breast cancer undergoing chemotherapy: Concordance between patient and family caregiver reports. Journal of Advanced Nursing. 2022; 78(3): 750-764. doi: 10.1111/jan.15004
7. Trevino KM, Prigerson HG, Maciejewski PK. Advanced cancer caregiving as a risk for major depressive episodes and generalized anxiety disorder. Psychooncology. 2018; 27(1): 243-249. doi: 10.1002/pon.4441
8. Shaffer KM, Jacobs JM, Coleman JN, et al. Anxiety and depressive symptoms among two seriously medically ill populations and their family caregivers: A comparison and clinical implications. Neurocrit Care. 2017; 27(2): 180-186. doi: 10.1007/s12028-016-0358-3
9. Mehnert A, Koch U. Psychosocial care of cancer patients—International differences in definition, healthcare structures, and therapeutic approaches. Supportive Care in Cancer. 2005; 13(8): 579-588. doi: 10.1007/s00520-005-0779-6
10. Grunfeld E, Coyle D, Whelan T, et al. Family caregiver burden: Results of a longitudinal study of breast cancer patients and their principal caregivers. CMAJ Canadian Medical Association Journal. 2004; 170(12): 1795-1801. doi: 10.1503/cmaj.1031205
11. Mosher CE, Jaynes HA, Hanna N, Ostroff JS. Distressed family caregivers of lung cancer patients: An examination of psychosocial and practical challenges. Supportive Care in Cancer. 2013; 21(2): 431-437. doi: 10.1007/s00520-012-1532-6
12. Katz LF, Fladeboe K, King K, et al. Trajectories of child and caregiver psychological adjustment in families of children with cancer. Health Psychology. 2018; 37(8): 725-735. doi: 10.1037/hea0000619
13. Carlson LE, Angen M, Cullum J, et al. High levels of untreated distress and fatigue in cancer patients. British Journal of Cancer. 2004; 90(12): 2297-2304. doi: 10.1038/sj.bjc.6601887
14. Araceli T, Fischl A, Haj A, et al. Psycho-oncological burden in patients with brain metastases undergoing neurological surgery. Frontiers in Oncology. 2024; 14: 1463467. doi: 10.3389/fonc.2024.1463467
15. Çınaroğlu M, Ahlatcıoğlu EN, Prins J, Nan M. Psychopathology in cancer patients and the role of cognitive behavioral therapy. Clinical Cancer Investigation Journal. 2024; 12(5): 49-59. doi: 10.51847/itcyotbqlp
16. Fjorback LO, Arendt M, Ørnbøl E, et al. Mindfulness-based stress reduction and mindfulness-based cognitive therapy—A systematic review of randomized controlled trials. Acta Psychiatrica Scandinavica. 2011; 124(2): 102-119. doi: 10.1111/j.1600-0447.2011.01704.x
17. Kaneko M, Ryu S, Nishida H, et al. Nurses’ recognition of the mental state of cancer patients and their own stress management—A study of Japanese cancer-care nurses. Psychooncology. 2013; 22(7): 1624-1629. doi: 10.1002/pon.3191
18. Cañadas-De la Fuente GA, Gómez-Urquiza JL, Ortega-Campos EM, et al. Prevalence of burnout syndrome in oncology nursing: A meta-analytic study. Psychooncology. 2018; 27(5): 1426-1433. doi: 10.1002/pon.4632
19. Chan EA, Tsang PL, Ching SSY, et al. Nurses’ perspectives on their communication with patients in busy oncology wards: A qualitative study. PLoS One. 2019; 14(10). doi: 10.1371/journal.pone.0224178
20. Ortega-Campos E, Vargas-Román K, Velando-Soriano A, et al. Compassion fatigue, compassion satisfaction, and burnout in oncology nurses: A systematic review and meta-analysis. Sustainability (Switzerland). 2020; 12(1): 1-12. doi: 10.3390/SU12010072
21. Banerjee SC, Manna R, Coyle N, et al. Oncology nurses’ communication challenges with patients and families: A qualitative study. Nurse Educ Pract. 2016; 16(1): 193-201. doi: 10.1016/j.nepr.2015.07.007
22. Duarte J, Pinto-Gouveia J. Effectiveness of a mindfulness-based intervention on oncology nurses’ burnout and compassion fatigue symptoms: A non-randomized study. Int J Nurs Stud. 2016; 64: 98-107. doi: 10.1016/j.ijnurstu.2016.10.002
23. Nixon AV, Narayanasamy A, Penny V. An investigation into the spiritual needs of neuro-oncology patients from a nurse perspective. BMC Nurs. 2013; 12(1). doi: 10.1186/1472-6955-12-2
24. Lv X. Psychological intervention on reducing stress of nurses caring for terminally ill cancer patients: A quasi-experimental study. Alpha Psychiatry. 2024; 24(6): 252-256. doi: 10.5152/alphapsychiatry.2023.231232
25. Barış Eren N. A stress management tool in nurses: Mindfulness-based stress reduction. Black Sea Journal of Health Science. 2023; 6(3): 508-510. doi: 10.19127/bshealthscience.1274065
26. Bazarko D, Cate RA, Azocar F, Kreitzer MJ. The impact of an innovative mindfulness-based stress reduction program on the health and well-being of nurses employed in a corporate setting. J Workplace Behav Health. 2013; 28(2): 107-133. doi: 10.1080/15555240.2013.779518
27. Salvarani V, Rampoldi G, Ardenghi S, et al. Protecting emergency room nurses from burnout: The role of dispositional mindfulness, emotion regulation and empathy. J Nurs Manag. 2019; 27(4): 765-774. doi: 10.1111/jonm.12771
28. Said Z, Kheng GL. A review on mindfulness and nursing stress among nurses. Analitika. 2018; 10(1): 31. doi: 10.31289/analitika.v10i1.1589
29. Molina Y, Yi JC, Martinez-Gutierrez J, et al. Resilience among patients across the cancer continuum: Diverse perspectives. Clin J Oncol Nurs. 2014; 18(1): 93-101. doi: 10.1188/14.CJON.93-101
30. Li M, Xie X, Xu H, Li H. A psychological nursing intervention for patients with breast cancer on inflammatory factors, negative emotions and quality of life. Iran J Public Health. 2022; 51(9): 2041-2047. doi: 10.18502/ijph.v51i9.10559
31. Seiler A, Jenewein J. Resilience in cancer patients. Front Psychiatry. 2019; 10: 208. doi: 10.3389/fpsyt.2019.00208
32. Liu S, Chai J, Jia Y, et al. The mediating role of perceived social support in the effect of the calm intervention on quality of life in patients following breast cancer surgery. Preprint posted online July 20, 2023. doi: 10.21203/rs.3.rs-3087962/v1
33. Cape J, Whittington C, Buszewicz M, et al. Brief psychological therapies for anxiety and depression in primary care: meta-analysis and meta-regression. BMC Med. 2010; 8: 38. doi: 10.1186/1741-7015-8-38
34. Liesto S, Sipilä R, Aho T, et al. Psychological resilience associates with pain experience in women treated for breast cancer. Scand J Pain. 2020; 20(3): 545-553. doi: 10.1515/sjpain-2019-0137
35. van Roij J, Brom L, Sommeijer D, et al. Self-care, resilience, and caregiver burden in relatives of patients with advanced cancer: Results from the eQuiPe study. Supportive Care in Cancer. 2021; 29(12): 7975-7984. doi: 10.1007/s00520-021-06365-9
36. Bennett M, Walters K, Drennan V, Buszewicz M. Structured pro-active care for chronic depression by practice nurses in primary care: A qualitative evaluation. PLoS One. 2013; 8(9). doi: 10.1371/journal.pone.0075810
37. Pettersen Sandtrø H, Glavin K, Størksen HT, et al. Mothers and public health nurses’ experiences of sleep problems in children aged 6 months to 3 years: A qualitative study. J Clin Nurs. 2023; 32(15-16): 4852-4867. doi: 10.1111/jocn.16586
38. Volgemute K, Vazne Z, Krauksta D. An intervention into imagery and self-efficacy: Enhancing athletic achievements of alpine skiers. Educ Sci (Basel). 2024; 14(5): 513. doi: 10.3390/educsci14050513
39. Thomas T, Althouse A, Sigler L, et al. Stronger therapeutic alliance is associated with better quality of life among patients with advanced cancer. Psychooncology. 2021; 30(7): 1086-1094. doi: 10.1002/pon.5648
40. Zugai JS, Stein-Parbury J, Roche M. Therapeutic alliance in mental health nursing: An evolutionary concept analysis. Issues Ment Health Nurs. 2015; 36(4): 249-257. doi: 10.3109/01612840.2014.969795
41. Hanney WJ, Dhalla F, Kelly C, et al. The influence of personality type on patient outcome measures and therapeutic alliance in patients with low back pain. NeuroSci. 2023; 4(3): 186-194. doi: 10.3390/neurosci4030017
42. Cookson A, Daffern M, Foley F. Relationship between aggression, interpersonal style, and therapeutic alliance during short-term psychiatric hospitalization. Int J Ment Health Nurs. 2012; 21(1): 20-29. doi: 10.1111/j.1447-0349.2011.00764.x
43. Somers TJ, Wren AA, Shelby RA. The context of pain in arthritis: Self-efficacy for managing pain and other symptoms. Curr Pain Headache Rep. 2012; 16(6): 502-508. doi: 10.1007/s11916-012-0298-3
44. Hsieh WL, Yeh ST, Liu WI, et al. Improving medication adherence in community-dwelling patients with schizophrenia through therapeutic alliance and medication attitude: A serial multiple mediation model. Patient Prefer Adherence. 2022; 16: 1017-1026. doi: 10.2147/PPA.S351848
45. Johansen R, Iversen VC, Melle I, Hestad KA. Therapeutic alliance in early schizophrenia spectrum disorders: A cross-sectional study. Ann Gen Psychiatry. 2013; 12: 14. doi: 10.1186/1744-859X-12-14
46. Weiss LA, Westerhof GJ, Bohlmeijer ET. Can we increase psychological well-being? The effects of interventions on psychological well-being: A meta-analysis of randomized controlled trials. PLoS One. 2016; 11(6). doi: 10.1371/journal.pone.0158092
47. Klein JP, Berger T, Schröder J, et al. The EVIDENT-trial: Protocol and rationale of a multicenter randomized controlled trial testing the effectiveness of an online-based psychological intervention. BMC Psychiatry. 2013; 13. doi: 10.1186/1471-244X-13-239
48. Holtmaat K, van der Spek N, Witte BI, et al. Moderators of the effects of meaning-centered group psychotherapy in cancer survivors on personal meaning, psychological well-being, and distress. Supportive Care in Cancer. 2017; 25(11): 3385-3393. doi: 10.1007/s00520-017-3757-x
49. de la Torre-Luque A, Gambara H, López E, Cruzado JA. Psychological treatments to improve quality of life in cancer contexts: A meta-analysis. International Journal of Clinical and Health Psychology. 2016; 16(2): 211-219. doi: 10.1016/j.ijchp.2015.07.005
50. Walker AL, Witteveen AB, Otten RHJ, et al. Resilience-enhancing interventions for antepartum depressive symptoms: Systematic review. BJPsych Open. 2022; 8(3): e89. doi: 10.1192/bjo.2022.60
51. Carolan S, Harris PR, Cavanagh K. Improving employee well-being and effectiveness: Systematic review and meta-analysis of web-based psychological interventions delivered in the workplace. J Med Internet Res. 2017; 19(7). doi: 10.2196/jmir.7583
52. Troy AS, Ford BQ, McRae K, et al. Change the things you can: Emotion regulation is more beneficial for people from lower than from higher socioeconomic status. Emotion. 2017; 17(1): 141-154. doi: 10.1037/emo0000210
53. Ahmadi Forooshani S, Izadikhah Z, Renzaho AMN, O’Connor PJ. Effectiveness of psychological interventions on young refugees’ social adjustment: A meta-analysis. J Refug Stud. 2021; 34(1): 976-992. doi: 10.1093/jrs/fez035
54. Ruiz Hernández C, Gómez-Urquiza JL, Pradas-Hernández L, et al. Effectiveness of nursing interventions for preoperative anxiety in adults: A systematic review with meta-analysis. J Adv Nurs. 2021; 77(8): 3274-3285. doi: 10.1111/jan.14827
55. Feng Y, Ma C, Feng Z, et al. Clinical effects of basic nursing combined with psychological intervention on treatment compliance of patients with Influenza-A(H1N1). Pak J Med Sci. 2024; 40(7). doi: 10.12669/pjms.40.7.8675
56. Joseph A, Jose TP. Coping with distress and building resilience among emergency nurses: A systematic review of mindfulness-based interventions. Indian Journal of Critical Care Medicine. 2024; 28(8): 785-791. doi: 10.5005/jp-journals-10071-24761
57. Zhang H, Xia Z, Yu S, et al. Interventions for compassion fatigue, burnout, and secondary traumatic stress in nurses: systematic review and network meta-analysis. Nurs Health Sci. 2025; 27(1). doi: 10.1111/nhs.70042
58. Lu Y, Xu MY, Lu L, et al. Quality of care combined with mindfulness-based stress reduction intervention in patients undergoing arterial interventional embolization for liver tumors. World J Gastrointest Surg. 2025; 17(6). doi: 10.4240/wjgs.v17.i6.105826
59. Zhang W, Wu HX, Zhong H, et al. Psychological and behavioral intervention improves the quality of life and mental health of patients suffering from differentiated thyroid cancer treated with postoperative radioactive iodine-131. Neuropsychiatr Dis Treat. Published online May 2016; 1055. doi: 10.2147/NDT.S105460
60. Bolier L, Haverman M, Westerhof GJ, et al. Positive psychology interventions: A meta-analysis of randomized controlled studies. BMC Public Health. 2013; 13(1). doi: 10.1186/1471-2458-13-119
61. Soklaridis S, Lin E, Lalani Y, Rodak T, Sockalingam S. Mental health interventions and supports during COVID-19 and other medical pandemics: A rapid systematic review of the evidence. Gen Hosp Psychiatry. 2020; 66: 133-146. doi: 10.1016/j.genhosppsych.2020.08.007
62. Buselli R, Corsi M, Veltri A, et al. Mental health of Health Care Workers (HCWs): A review of organizational interventions put in place by local institutions to cope with new psychosocial challenges resulting from COVID-19. Psychiatry Res. 2021; 299. doi: 10.1016/j.psychres.2021.113847
63. Warth M, Kessler J, Koehler F, et al. Brief psychosocial interventions improve quality of life of patients receiving palliative care: A systematic review and meta-analysis. Palliat Med. 2019; 33(3): 332-345. doi: 10.1177/0269216318818011
64. Wakefield S, Kellett S, Simmonds-Buckley M, et al. Improving Access to Psychological Therapies (IAPT) in the United Kingdom: A systematic review and meta-analysis of 10-years of practice-based evidence. British Journal of Clinical Psychology. 2021; 60(1): 1-37. doi: 10.1111/bjc.12259
65. Hooper JJ, Saulsman L, Hall T, Waters F. Addressing the psychological impact of COVID-19 on healthcare workers: Learning from a systematic review of early interventions for frontline responders. BMJ Open. 2021; 11(5). doi: 10.1136/bmjopen-2020-044134
66. Chen Q, Shen S, Liang Y, et al. Analysis of mental health of healthcare workers and its influencing factors in three consecutive years. WORK: A Journal of Prevention, Assessment & Rehabilitation. 2025; 80(3): 1296-1303. doi: 10.1177/10519815241289827
67. Gómez-Durán EL, Martin-Fumadó C, Forero CG. Psychological impact of quarantine on healthcare workers. Occup Environ Med. 2020; 77(10): 666-674. doi: 10.1136/oemed-2020-106587
68. Shi B, Wang L, Huang S. Effect of high-quality nursing on psychological status and prognosis of patients undergoing brain tumor surgery. 2021; 13(10): 11974-11980.
69. Ashery R, Asker A, Dardier R, et al. Effect of implementing a designed rehabilitation nursing intervention for brain surgery’s patients on their physical and psychological status. Egyptian Journal of Health Care. 2024; 15(1): 434-449.
70. Dong H, Zhang XL, Deng CX, Luo B. Effects of comprehensive nursing on postoperative complications, mental status and quality of life in patients with glioma. World J Clin Cases. 2022; 10(22): 7825-7831. doi: 10.12998/wjcc.v10.i22.7825
71. Zhao YH, Xu Y. Effect of comprehensive nursing based on cognitive behavior on psychological function of glioma patients. Neuropsychiatr Dis Treat. 2021; 17: 777-785. doi: 10.2147/NDT.S286164
72. Jiang R, Liu H, Jiang X, et al. Impact of Empowerment theory-based nursing intervention on the quality of life and negative emotions of patients diagnosed with brain metastasis post breast cancer surgery. J Multidiscip Healthc. 2024; 17: 2303-2312. doi: 10.2147/JMDH.S463044
73. Xiao N, Zhu D, Xiao S. Effects of continued psychological care toward brain tumor patients and their family members’ negative emotions. J Cancer Res Ther. 2018; 14(8): S202-S207. doi: 10.4103/0973-1482.181184
74. Caponnetto P, Schilirò G, Maglia M, et al. Psychological and neuropsychological clinical impact in brain cancer patients and evidence-based psychological intervention: A systematic review of the literature. Health Psychol Res. 2024; 12. doi: 10.52965/001c.91408
75. Mcdougall E, Breen LJ, Nowak AK, et al. Psychosocial interventions for personality and behavior changes in adults with a brain tumor: A scoping review. Neurooncol Pract. 2023; 10(5): 408-417. doi: 10.1093/nop/npad031
76. Abou Elazayiem Bayumi H, Mokhtar Mohamed Gaber E, Mostafa Shehata A, Omar Ibrahim Elmowafy A. Effect of Nurse-Led Intervention on Headache Pain, Anxiety, and Fatigue Levels among Patients with Brain Tumors. Egyptian Journal of Health Care. 2022;13(2):1843-1854. doi: 10.21608/ejhc.2022.270427
77. Mokhtar Mohamed Gaber E, Abou Elazayiem Bayumi H, Mostafa Shehata A, Omar Ibrahim Elmowafy A. Effect of nurse-led intervention on headache pain, anxiety, and fatigue levels among patients with brain tumors. Egytian Journal of Health Care. 2022; 13(4): 1431-1442.
78. Deng YH, Ruan J, Wang SQ, Yang YM, Mu L. Effects of nursing care in fast-track surgery on postoperative pain, psychological state, and patient satisfaction with nursing for glioma. World J Clin Cases. 2021; 9(20): 5435-5441. doi: 10.12998/wjcc.v9.i20.5435
79. Madu C, Mofiyinfoluwa AV. Patient-centered care in precision medicine and end-of-life care in neuro-oncology: The role of nursing in enhancing quality of life and treatment outcomes. World Journal of Biology Pharmacy and Health Sciences. 2025;22(3):230-238. doi: 10.30574/wjbphs.2025.22.3.0518
80. Boele FW, Weimer JM, Proudfoot J, et al. The effects of SmartCare© on neuro-oncology family caregivers’ distress: A randomized controlled trial. Supportive Care in Cancer. 2022; 30(3): 2059-2068. doi: 10.1007/s00520-021-06555-5
81. Young JS, Al-Adli N, Sibih YE, et al. Recognizing the psychological impact of a glioma diagnosis on mental and behavioral health: A systematic review of what neurosurgeons need to know. J Neurosurg. 2023; 139(1): 11-19. doi: 10.3171/2022.9.JNS221139
82. Mishaan M, Al Shamary M, Mulawwah W, et al. Nursing care for patients with brain tumors: A comprehensive approach. Letters in High Energy Physics. 2023; 23(2).
83. Ghadimi K, Abbas I, Karandish A, et al. Cognitive decline in glioblastoma (GB) patients with different treatment modalities and insights on untreated cases. Current Oncology. 2025; 32(3): 152. doi: 10.3390/curroncol32030152
84. Shah NZ, Masroor T, Zahid N, et al. Factors affecting well-being in brain tumor patients: An LMIC perspective. Front Psychol. 2023; 14. doi: 10.3389/fpsyg.2023.1117967
85. Najafi M, Jahanbakhshi A, Finocchi Ghersi S, et al. Clinical effects of immuno-oncology therapy on glioblastoma patients: A systematic review. Brain Sci. 2023; 13(2). doi: 10.3390/brainsci13020159
