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化疗引起的周围神经病变:肿瘤护理人员知识与实践的评估

Chemotherapy-induced peripheral neuropathy: assessment of oncology nurses' knowledge and practice.

作者信息

Binner Madelaine, Ross Diana, Browner Ilene

机构信息

Department of Oncology, Johns Hopkins University, Baltimore, MD, USA.

出版信息

Oncol Nurs Forum. 2011 Jul;38(4):448-54. doi: 10.1188/11.ONF.448-454.

Abstract

PURPOSE/OBJECTIVES: To explore oncology nurses' practice behaviors and knowledge of chemotherapy-induced peripheral neuropathy (CIPN) in the assessment of patients with cancer.

DESIGN

Cross-sectional, exploratory.

SETTING

Two hospital-based outpatient chemotherapy clinics in Baltimore, MD.

SAMPLE

Self-selected convenience sample of 39 oncology nurses.

METHODS

Completion of the principal investigator-developed questionnaire consisting of 16 knowledge and 16 practice-behavior items, 8 instruction and perception items, and a 9-item demographic survey.

MAIN RESEARCH VARIABLES

CIPN assessment practice behaviors and knowledge; tool reliability.

FINDINGS

The mean CIPN knowledge score of 12.6 (SD=1.7) demonstrated knowledge deficits (maximum score of 16). All respondents indicated CIPN assessment is essential in their oncology role, but 75% rated their CIPN assessment skills as fair to poor. Assessment practices did not routinely include neurologic physical assessment. In addition, 82% believed CIPN is a significant problem for patients. Cronbach alpha for the tool was 0.84.

CONCLUSIONS

Results indicated participants had knowledge deficits pertaining to CIPN and lacked training, proficiency, and confidence in neurologic physical assessment. Education and training programs are needed to improve knowledge and neurologic assessment skills.

IMPLICATIONS FOR NURSING

To date, CIPN nursing assessment guidelines do not exist. Practice guidelines for CIPN nursing assessment and management should be efficient and appropriate to the role of the chemotherapy infusion oncology nurse working in a busy setting where chair turnover time, accuracy, safety, and quality service are competing priorities.

摘要

目的/目标:探讨肿瘤护理人员在癌症患者评估中关于化疗引起的周围神经病变(CIPN)的实践行为和知识。

设计

横断面探索性研究。

地点

马里兰州巴尔的摩市的两家医院门诊化疗诊所。

样本

39名肿瘤护理人员的自我选择便利样本。

方法

完成由主要研究者编制的问卷,问卷包括16项知识和16项实践行为项目、8项指导和认知项目以及一项9项的人口统计学调查。

主要研究变量

CIPN评估实践行为和知识;工具可靠性。

结果

CIPN知识平均得分为12.6(标准差=1.7),表明存在知识缺陷(满分16分)。所有受访者均表示CIPN评估在其肿瘤护理工作中至关重要,但75%的人将其CIPN评估技能评为一般至较差。评估实践通常不包括神经体格检查。此外,82%的人认为CIPN对患者来说是一个重大问题。该工具的Cronbach α系数为0.84。

结论

结果表明参与者在CIPN方面存在知识缺陷,并且在神经体格检查方面缺乏培训、熟练度和信心。需要开展教育和培训项目以提高知识水平和神经评估技能。

对护理的启示

迄今为止,不存在CIPN护理评估指南。CIPN护理评估和管理的实践指南应高效且适合在繁忙环境中工作的化疗输液肿瘤护理人员的角色,在这种环境中,座椅周转时间、准确性、安全性和优质服务是相互竞争的优先事项。

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