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在瘤学临床医生中探索化疗诱导的外周神经病管理实践模式
Grace Kanzawa-Lee1, John C Krauss2, Robert Knoerl1
1School of Nursing, University of Michigan, Ann Arbor, MI.
Seminars in oncology nursing
|June 27, 2024
概括
瘤学临床医生经常偏离化学疗法诱导的周围神经病变 (CIPN) 管理的基于证据的指南. 开发有针对性的教育和资源与临床医生的投入对于改善患者护理和CIPN结果至关重要.
科学领域:
- 瘤科 护理 护理专业
- 癌症幸存者 护理 护理
- 神经瘤学神经瘤学
背景情况:
- 化疗诱导的周围神经病变 (CIPN) 影响大约60%的接受神经毒性化疗的癌症幸存者,表现为麻木,或疼痛.
- 目前对CIPN的治疗指南包括有限的药理 (杜洛西丁) 和非药理 (运动) 选择,在实践中观察到低于最佳的坚持.
- 在了解瘤临床医生的实践和对CIPN预防和管理的看法方面存在着显著的差距.
研究的目的:
- 探索瘤临床医生关于预防和管理化疗诱导的外周神经病变 (CIPN) 的自我报告实践和看法.
- 发现当前临床实践与CIPN管理的基于证据的指导方针之间的差异.
- 了解影响临床医生实施CIPN评估,预防和管理策略的障碍和促进因素.
主要方法:
- 进行了一项融合混合方法研究,涉及三个癌症中心的瘤临床医生.
- 通过调查收集定量数据,评估临床医生对CIPN预防和管理的建议.
- 通过半结构面试收集定性数据,以探索临床医生的观点和动机,并使用诱导性内容分析进行分析.
主要成果:
- 临床医生经常建议将 gabapentin 用于 CIPN 管理,并利用冷疗法进行预防,尽管对副作用和疗效存在担忧.
- 临床医生认为CIPN是一个重大挑战,并表示需要加强信息和资源.
- 患者在CIPN上的教育可能受到患者保留和其他因素的限制,临床医生依赖主观评估来查症状.
结论:
- 建立的基于证据的指导方针与瘤临床医生在管理CIPN时的实际做法之间存在重大差异.
- 显然需要临床医生参与开发教育材料和资源,以促进基于证据的CIPN护理.
- 改善CIPN的预防和管理需要一种协作方法,以确保患者获得最佳的护理.
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