Article

Chemotherapy-Induced Peripheral Neuropathy: Assessment of Oncology Nurses' Knowledge and Practice

Madelaine Binner

Diana Ross

Ilene Browner

chemotherapy-induced peripheral neuropathy, Assessment, nurse knowledge
ONF 2011, 38(4), 448-454. DOI: 10.1188/11.ONF.448-454

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.

Jump to a section

    References

    Armstrong, T., Almadrones, L., & Gilbert, M.R. (2005). Chemotherapy-induced peripheral neuropathy. Oncology Nursing Forum, 32, 305-311. doi:10.1188/05.ONF.305-311
    Backonja, M.M., & Galer, B.S. (1998). Pain assessment and evaluation of patients who have neuropathic pain. Neurologic Clinics, 16, 775-790.
    Bernardi, M., Catania, G., Lambert, A., Tridello, G., & Luzzani, M. (2007). Knowledge and attitudes about cancer pain management. European Journal of Oncology Nursing, 11, 272-279. doi:10.1016/j.ejon.2006.09.003
    Herr, K. (2004). Neuropathic pain: A guide to comprehensive assessment. Pain Management Nursing, 5(4, Suppl. 1), 9-18.
    Johnson, L. (2004). The nursing role in recognizing and assessing neuropathic pain. British Journal of Nursing, 13, 1092-1097.
    Mackrodt, K., & White, M. (2001). Nurses' knowledge within the context of pain management. Journal of Orthopaedic Nursing, 5, 15-21.
    Meintz, S.L., Yfantis, E.A., & Graebel, W.P. (1994). Future directions in computational nursing science. Mathematical and Computer Modeling, 19, 273-288. doi:10.1016/0895-7177(94)90199-6
    Oncology Nursing Society. (n.d.). Peripheral neuropathy: Guidelines and standards. Retrieved from http://www.ons.org/Research/NursingSensitive/Summaries/media/ons/docs/research/summaries/peripheral/guidelines.pdf
    Patiraki, E.I., Papathanassoglou, E.D., Tafas, C., Akarepi, V., Katsaragakis, S.G., Kampitsi, A., & Lemonidou, C. (2006). A randomized controlled trial of an educational intervention on Hellenic nursing staff's knowledge and attitudes on cancer pain management. European Journal of Oncology Nursing, 10, 337-352. doi:10.1016/j.ejon.2005.07.006
    Portenoy, R.K. (1997). The physical examination in cancer pain assessment. Seminars in Oncology Nursing, 13, 25-29.
    Postma, T.J., & Heimans, J.J. (2000). Grading of chemotherapy-induced peripheral neuropathy. Annals of Oncology, 11, 509-513.
    Puls-McColl, P.J., Holden, J.E., & Buschmann, M.T. (2001). Pain management: An assessment of surgical nurses' knowledge. MedSurg Nursing, 10, 185-191.
    Sapountzi-Krepia, D. (2001). The evolving essence of the science of nursing: A complexity integration nursing theory (the theory of Sharon L. Van Sell and Ioannis A. Kalofissudis). An introductory presentation. ICUs and Nursing Web Journal, 8, 17.
    Smith, E.M., Beck, S.L., & Cohen, J. (2008). The total neuropathy score: A tool for measuring chemotherapy-induced peripheral neuropathy. Oncology Nursing Forum, 35, 96-102. doi:10.1188/08.ONF.96-102
    Tafas, C.A., Patiraki, E., McDonald, D.D., & Lemonidou, C. (2002). Testing an instrument measuring Greek nurses' knowledge and attitudes regarding pain. Cancer Nursing, 25, 8-14.
    Tanabe, P., & Buschmann, M. (2000). Emergency nurses' knowledge of pain management principles. Journal of Emergency Nursing, 26, 299-305. doi:10.1067/men.2000.108402
    Van Sell, S., & Kalofissudis, I. (2001). The evolving essence of the science of nursing: A complexity integration nursing theory. Dallas, TX: Author.
    Van Sell, S., & Kalofissudis, I. (2002). Socialization into the nursing profession [Slide presentation]. Dallas, TX: Author.
    Visovsky, C., Meyer, R., Roller, J., & Poppas, M. (2008). Evaluation and management of peripheral neuropathy in diabetic patients with cancer. Clinical Journal of Oncology Nursing, 12, 243-247. doi:10.1188/08.CJON.243-247
    White, S. (2004). Assessment of chronic neuropathic pain and the use of pain tools. British Journal of Nursing, 13, 372-378.
    Wickham, R. (2007). Chemotherapy-induced peripheral neuropathy: A review and implications for oncology nursing practice. Clinical Journal of Oncology Nursing, 11, 361-376. doi: 10.1188/07.CJON.361-376
    Williams, H. (2006). Assessing, diagnosing and managing neuropathic pain. Nursing Times, 102, 22-24.
    Wilson, M. (2002). Overcoming the challenges of neuropathic pain. Nursing Standard, 16, 47-53.
    Xue, Y., Schulman-Green, D., Czaplinski, C., Harris, D., & McCorkle, R. (2007). Pain attitudes and knowledge among RNs, pharmacists, and physicians on an inpatient oncology service. Clinical Journal of Oncology Nursing, 11, 687-695.