Graduation Year

2010

Document Type

Thesis

Degree

M.S.

Degree Granting Department

Nursing

Major Professor

Susan C. McMillan

Co-Major Professor

Cindy Tofthagen

Committee Member

Janine Overcash

Keywords

Paresthesias, Neurotoxic, Nursing, Assessment, Skill

Abstract

Chemotherapy induced peripheral neuropathy (CIPN) remains one of the most serious and challenging symptoms oncology nurses encounter in caring for patients receiving neurotoxic chemotherapy. CIPN is under-addressed, under-reported, and symptoms are minimized by healthcare providers, which adversely affect patient quality of life, physical function, and emotional well-being. There is an absence of research examining nurses’ knowledge and practice behaviors related to CIPN. The purpose of this study was to explore oncology nurses knowledge, practice behaviors, confidence, and the relationship between education, experience, and knowledge specific to CIPN.

Data was collected at Oncology Nursing Society (ONS) Chapter meetings throughout central and south Florida. The sample consisted of 70 oncology nurses who provide direct care to patients with cancer. Participants completed the CIPN: Assessment of Oncology Nurses’ Knowledge and Practice–Revised questionnaire. Demographic data revealed the overall years of nursing experience mean to be 24.7 (SD=12.2), mean years of oncology experience to be 13.5 (SD=7.5), and mean age to be 50.3 years (SD=9.5). The participants varied in highest attained level of education with the majority having Bachelor of Science degrees (40.0%).

The results of this study revealed adequate nursing knowledge pertaining to CIPN 13.0 (SD=1.9) (81%). Fifty-percent of nurses reported always or frequently screening for CIPN. The majority of participants reported always or frequently; evaluating fine motor skills (68.6%), documenting findings (64.3%), assessing risk factors (55.7%), assessing motor function (52.9%), performing assessment prior to each neurotoxic chemotherapy infusion (58.6%), eliciting patient symptoms (65.7%), teaching strategies for adaptation (57.1%), and teaching safety precautions (74.3%). Nurses less frequently reported always or frequently assessing deep tendon reflexes (17.2%) and assessing muscle strength (35.7%). The majority reported confidence in sharp vs. dull sensation testing (62.8%), and manual muscle strength testing (52.9%), while the majority lacked confidence performing deep tendon reflex testing (71.5%), tuning fork vibration sensation testing (72.8%), and Romberg testing (72.8%). There was a significant relationship between highest educational level achieved and knowledge of CIPN (r=.252, p=.037).

This is one of two studies documenting oncology nurses’ knowledge, practice behaviors, and confidence specific to CIPN. Findings lay the foundation in documenting the need for providing oncology nurses with continued education, and the need to teach oncology nurses the skills necessary to confidently assess for CIPN and interpret the findings.

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