Nursing Support for Cancer Symptoms and Caregiver Burden in General Wards: Protocol for a Nationwide Cross-Sectional...

General ward nurses increasingly care for patients with advanced cancer; however, the implementation of evidence-based nursing support remains unclear. Multicenter palliative care unit (PCU) surveys quantified nursing practices for major cancer-related symptoms and caregiver burden using systematically developed item sets; however, findings from PCU settings may not directly generalize to general wards, given differences in staffing, patient populations, and resources.

To describe the frequency of nonpharmacological nursing for five cancer-related symptoms (pain, dyspnea, nausea/vomiting, constipation, and delirium) and family caregiver burden provided by general ward nurses in Japan.

We will conduct a multicenter, cross-sectional, web-based survey (Jan-Mar 2026) in designated cancer care hospitals nationwide. Registered nurses working in general wards will report their opportunities to provide symptom-related support in the past 12 months and the frequency of specific practices on a 5-point Likert scale. Item sets are based on scoping reviews and prior PCU surveys and will be refined through pretesting with general ward nurses. Primary outcomes are proportions reporting frequent use of each item; analyses will summarize overall and symptom-specific distributions, excluding respondents with no opportunity. Target sample size is 1,300-1,500, estimated using dyspnea and accounting for clustering.

This study will provide nationally representative evidence on nursing support practices in general wards. The findings will inform targeted educational strategies by identifying potential gaps suggested by the observed frequencies of reported practices and enabling contextual interpretation in relation to prior PCU findings, thereby supporting future interventions, strengthening evidence-based palliative care.