Title : Nursing interventions for pain and sleep management in cancer patients receiving immunotherapy: A scoping review
Abstract:
Background: Immunotherapy has transformed cancer management. Patients receiving immune checkpoint inhibitors frequently experience concurrent pain and sleep disturbances that affect quality of life, treatment adherence, and overall survival. Nursing interventions addressing both symptoms remain poorly defined.
Methods: This scoping review followed PRISMA-SCR guidelines and searched Scopus, ScienceDirect, PubMed, and CINAHL for English-language studies published between January 2019 and November 2025. Inclusion criteria encompassed quantitative, qualitative, or mixed-methods studies examining nursing interventions for pain and/or sleep management in cancer patients receiving immunotherapy. Of 485 records identified, 10 studies were included after removing duplicates and screening titles, abstracts, and full texts.
Results: Nurse-led interventions included education, physical therapies (massage, reflexology, acupressure), behavioral approaches, and digital platforms (telehealth, electronic patient-reported outcomes). The patients achieved moderate short-term pain reductions, significantly improved quality of life, enhanced treatment adherence, and reduced emergency department visits by up to 45%. However, only 2/10 studies used validated instruments to measure sleep quality, and none designed primary interventions specifically targeting sleep disturbances in immunotherapy patients. Long-term sustainability of pain interventions was questionable, with most effects attenuating beyond eight weeks except for psycho-educational approaches.
Conclusion: Future research should develop integrated, nurse-delivered interventions addressing pain and sleep as interconnected symptoms, with extended follow-up periods and enhanced accessibility across diverse healthcare settings. Validated instruments to measure sleep quality should be employed.
Keywords: Cancer, Immunotherapy, Immune Checkpoint Inhibitors, Pain Management, Sleep, Nursing Interventions, Sleep Quality, Psycho-Educational, Quality of Life.
