Development of clinical practice assessment guideline of chemotherapy-induced peripheral neuropathy for gynecologic cancer patients

• Main Authors: Ching-LinWu, 吳青琳
• Other Authors: Yu-Yun Hsu
• Format: Others
• Language: zh-TW
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/h6dhs5

碩士 === 國立成功大學 === 護理學系 === 104 === Standard chemotherapy drugs, including paclitaxel and platinum-based drugs, lead to chemotherapy-induced peripheral neuropathy (CIPN), affecting patients’ sensory or motor peripheral nerves, physical activities, quality of life, and functional status. We aimed to develop evidence-based clinical guidelines to evaluate the severity of and changes in CIPN. The guidelines were developed through the following steps: forming clinical questions with PICO; conducting systematic literature reviews and evidence appraisal; drafting CIPN assessment clinical guidelines; conducting the Delphi process for developing CIPN guidelines; evaluating clinical practice of the guidelines; external evaluation of CIPN clinical guidelines; and publicizing clinical guidelines into execution. Seventeen studies met the inclusion criteria. CIPN clinical guidelines were drafted based on the studies. After a two-step Delphi process, a consensus of the clinical guidelines was archived. The guidelines for CIPN assessment included numbness, tingling or burning sensation, light touch, pin sensibility, vibration sensibility, tendon reflex, muscle strength, automatic functions, and instrumental activities of daily living. The gold standard for the assessments of numbness in the extremities assessed (R2=0.367) and ankle reflex assessed (R2=0.065) by neurologist. The interrater reliability of CIPN assessments by two nurses showed a kappa value of 0.62. The guidelines were externally reviewed by experts who recommended applying the guidelines for gynecologic cancer cases, albeit with certain modifications. Practical clinical guidelines for CIPN assessment are feasible, accessible, and integrated tools that may help in the early detection of CIPN symptoms by oncology nurses.