Chemo-brain in paediatric neurological disorders: Neuropsychological and nursing perspectives—A scoping review

Advances in paediatric oncology have improved survival, yet many children experience persistent neurocognitive and psychosocial sequelae also known as “Chemo-Brain”. These deficits, including slowed processing speed, reduced attention, and executive dysfunction, arise from both biological and contextual factors that jointly shape long-term quality of life. This scoping review synthesised recent evidence (2012–2024) on treatment-related cognitive and neuropsychological outcomes in paediatric cancer survivors, identifying mechanistic pathways, psychosocial correlates, and nursing interventions that promote cognitive resilience. Thirty eligible studies were reviewed across PubMed, PsycINFO, CINAHL, and Scopus. Data were extracted on cognitive domains, neurobiological mechanisms, emotional and educational correlates, and intervention effectiveness. Findings were mapped according to the PRISMA-ScR framework and integrated into a nursing-centred conceptual model. Between 25% and 75% of survivors exhibited measurable cognitive impairment, most commonly in processing speed and executive function. Mechanistic evidence implicated neuroinflammation, white-matter disconnection, and HPA-axis dysregulation. Psychosocial studies linked cognitive inefficiency with anxiety, depression, school difficulty, and social withdrawal, while intervention trials showed moderate benefits from cognitive training, mindfulness, and exercise programmes. The proposed Neuropsychological Nursing Support Framework outlines nurse-led screening, psychoeducation, and school liaison as central to integrated survivorship care. Paediatric oncology survivorship represents a dynamic continuum in which biological injury, psychosocial adaptation, and nursing coordination intersect. Embedding neurocognitive surveillance and family-centred rehabilitation into routine follow-up can transform survivorship from a period of vulnerability into one of developmental resilience.