Association Between Nurses' Knowledge and Practice Regarding Chemotherapy Induced Peripheral Neuropathy and its Development in Cancer Patients

The adverse effects of peripheral neuropathy caused by chemotherapy include numbness, tingling, irritation, burning, di�culty keeping balance, and a chilling sensation. CIPN is one of the symptoms that has the potential to negatively impact the patient's quality of life (QoL), the treatment plan, and their overall safety. Objectives: To determine oncology nurses' knowledge and practice regarding chemotherapy-induced peripheral neuropathy (CIPN) and its development in cancer patient. Methods: In a descriptive cross-sectional study, 172 registered nurses from two public hospitals were chosen with convenient sampling to see if there was an association between their knowledge and practice about chemotherapy-induced peripheral neuropathy in regard with its development in cancer patients. Three revised questioners were used to get information about nurses' knowledge, practice and 1 questioner from patient about neuropathy development. (Knowledge, practice and neuropathy devolvement). Results : Knowledge showed that 56.4 % of participants had fair knowledge and Practice showed that 49.4 % of participants had fair practice, while 47.1% of patient had developed mild neuropathy. Chi square test was performed to see the association which showed a signi�cant association between neuropathy development with nurses' knowledge and practice as results were 0.000 (p-value is <0.005 taken as signi�cant). Conclusions: There is a critical need to enhance oncology nurses' abilities in neurological assessment, and a reliable method of CIPN evaluation is essential. Guidelines for the treatment and evaluation of CIPN, as well as further studies in different health institutions to generalize the results across Pakistan, are urgently needed.


Original Article
Cancer is the most common cause of death in people.It is a debilitating condition that has an extremely high morbidity and fatality rate [1].Cancer is a disease that does not target a particular age group but rather can strike people at any point in their lives.Cancer is ranked as the second leading cause of mortality worldwide [2].It is anticipated that there are 443.4new cases of cancer for every 100,000 men and women.In addition to this, the death rate due to cancer is 158.3 for every 100,000 men and women [3].Cancer patients' chances of survival are directly in uenced by how quickly the disease is diagnosed and by the treatment options that are made available to them.Chemotherapy and radiation therapy are the two most signi cant and widely used treatments for cancer, however there are only a few options available to treat the disease.Chemotherapy is the most successful treatment option for patients diagnosed with cancer [4].In the early part of the 20th century, cytotoxic medications were rst used for the treatment of cancer.Since then, these drugs have been successfully used to treat a wide variety of cancers [5].Cytotoxic drugs (CDs) are one of the important groups of medicines which are used for the treatment of cancer.These drugs are also known as antineoplastic, anticancer or cancer chemotherapy drugs [6].The prevalence of cancer patients in Pakistan was projected to be 329,547 according to a survey conducted between the years 2016 and 2020 [7].And it is reasonable to anticipate that the number of cancer cases will rise by 2.3 million per year.Out of the total number of nurses in the world, there are 28 million, and 5.5 million of them interact with cytotoxic The adverse effects of peripheral neuropathy caused by chemotherapy include numbness, tingling, irritation, burning, di culty keeping balance, and a chilling sensation.CIPN is one of the symptoms that has the potential to negatively impact the patient's quality of life (QoL), the treatment plan, and their overall safety.Objectives: To determine oncology nurses' knowledge and practice regarding chemotherapy-induced peripheral neuropathy (CIPN) and its development in cancer patient.Methods: In a descriptive cross-sectional study, 172 registered nurses from two public hospitals were chosen with convenient sampling to see if there was an association between their knowledge and practice about chemotherapy-induced peripheral neuropathy in regard with its development in cancer patients.Three revised questioners were used to get information about nurses' knowledge, practice and 1 questioner from patient about neuropathy development.(Knowledge, practice and neuropathy devolvement).Results: Knowledge showed that 56.4 % of participants had fair knowledge and Practice showed that 49.4 % of participants had fair practice, while 47.1% of patient had developed mild neuropathy.
Chi square test was performed to see the association which showed a signi cant association between neuropathy development with nurses' knowledge and practice as results were 0.000 (p-value is <0.005 taken as signi cant).Conclusions: There is a critical need to enhance oncology nurses' abilities in neurological assessment, and a reliable method of CIPN evaluation is essential.Guidelines for the treatment and evaluation of CIPN, as well as further studies in different health institutions to generalize the results across Pakistan, are urgently needed.

A R T I C L E I N F O A B S T R A C T
chemotherapy and adjuvant medication-induced peripheral neuropathy (CIPN) [14].As a typical side effect of neurotoxic chemotherapy, treatment-induced peripheral neuropathy is a prevalent problem for cancer patients.Depending on the length of chemotherapy and the usage of platinum-based drugs, plant alkaloids, taxanes, and bortezomib, the incidence of CIPN among cancer patients is estimated to be around 38% [15].There is a chance that patients will not report experiencing pain from CIPN until they are pushed to do so.Thus, oncologists should often check their patients for neuropathy and neuropathic pain [16].The contributions of nurses to scienti c inquiry and the evaluation of the e cacy of treatments and management improve the QoL of CIPN patients.If oncology nurses had greater knowledge of various pharmacological and non-pharmacological treatments, the effects of CIPN could be prevented and reduced, according to the study [17].Nurses in many different practice settings carry out the majority of CIPN screening.As a result, nurses are in a prime position to identify the earliest symptoms of peripheral neuropathy while the patient is receiving treatment [11].

D I S C U S S I O N
were implemented and p-value less than or equal to 0.05 were taken as signi cant.

R E S U L T PJHS VOL. 3 Issue. 7 December 2022
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The current study demographics that were male nurses just 8.1% and age of participants from ages between 22-27 years of were 22.7% that are contrary to the study that revealed that (31.4 %) of the sample was between the ages of (25-29 years) and that (52.1 %) of the sample was male     .Another study showed that more than half of the nurses had 1-5 years oncology experience 72.7%, half of the participants just had diploma degree in nurses 49.4% and most alarming was that two third of the nurses had no oncology certi cate 89% which resulted as inadequate practice by half of the nurses.These results of this study were different from another study who found that the oncology nurses had adequate nursing practice regarding chemotherapy induced peripheral neuropathy and assessment practices did not routinely include neurologic physical assessment [11].In another study conducted in Jordan, on the oncology nurse's knowledge and practices showed the mean CIPN knowledge score of 8.98+1.9 which indicates poor knowledge.Despite the fact that only 58.8% of respondents stated that CIPN assessment is required for their oncology practices, the majority of respondents evaluated their skills as inadequate.The neurologic physical exam is only occasionally included in the practice evaluation.57.1% of respondents, including patients and their relatives, expressed anxiety about CIPN [20].Another study repor ted that the sur vey's nurses lacked understanding of the neurotoxicity of certain drugs and e m p i r i c a l l y s u p p o r te d t re at m e n t s .R a re l y we re standardized measurement instruments and physical examinations with a CIPN focus employed during assessment [21].
This is especially true due to the fact that there is no one foolproof way to prevent CIPN, and the treatment options for this syndrome are extremely restricted.To be able to develop effective CIPN prevention and treatment techniques, a deeper understanding of the underlying risk factors and mechanisms that contribute to the condition is required[10].Oncology nurses play a key role in the diagnosis and treatment of CIPN.Despite broad consensus among nurses regarding the need of CIPN evaluation, research indicates that many practitioners lack c o n d e n c e i n t h e i r a s s e s s m e n t a b i l i t i e s [ 1 1 ] .nurses in the treatment of CIPN is essential.Assessing CIPN at baseline and before each cycle of chemotherapy is crucial, and nurses have a lot of insight on how to do so.The quality of life of cancer patients can be improved via the education of oncology nurses on the warning signals of It was a Descriptive Cross-sectional study conducted in Jinnah Hospital Lahore and services hospital Lahore with score between 51% to 74% will be considered as "moderate" and below 50% of the score will be considered as "mild"[18].The quantitative data were measure by SPPS Statistical Package of Social Sciences (SPSS) software version 26.The qualitative data was measure by frequency.Chi-square DOI: https://doi.org/10.54393/pjhs.v3i07.473Sohail MA et al.,

Table 1 :
Demographic data of the participants

Table 2 :
Categorical knowledge, practice and neuropathy development scores

Table 3 :
Association between knowledge with neuropathy development & practice with neuropathy devolvement