Intensive nursing interventions for post-treatment anxiety and depression in bladder cancer: A systematic review and...

Post-treatment anxiety and depression are prevalent but often underrecognized among bladder cancer patients. This systematic review and meta-analysis aimed to estimate the pooled prevalence of these symptoms and to evaluate the effectiveness of intensive nursing interventions.

A comprehensive search of PubMed, EMBASE, the Cochrane Library, and Web of Science was conducted through October 18, 2025. Eligible studies included those reporting the prevalence or severity of anxiety and/or depression in bladder cancer patients, as well as studies comparing intensive nursing interventions with routine care. Data were synthesized using Stata/MP version 14.0. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Heterogeneity was assessed using the I² statistic, and subgroup analyses were performed to explore potential sources of variability.

Sixteen studies involving 1,791 patients were included. The pooled prevalence of anxiety was 25.3% (95% CI: 22.2-28.6%) and that of depression was 29.4% (95% CI: 23.3-35.9%). Higher prevalence rates were observed in non-Western populations and among patients receiving multimodal treatment. Compared with routine care, intensive nursing interventions were associated with significant reductions in anxiety (SMD = -4.52; 95% CI: -6.07 to -2.96) and depression (SMD = -4.51; 95% CI: -5.96 to -3.07) (both P < 0.001). These findings remained robust in sensitivity analyses despite substantial heterogeneity.

Anxiety and depression are common among bladder cancer survivors. Intensive nursing interventions are associated with meaningful improvements in psychological outcomes and may be considered for integration into post-treatment supportive care.

PROSPERO registration number: CRD42024590858.