ABSTRACT
Peripheral neuropathy is a known side effect of several chemotherapy agents, including vinca alkaloids and platinum-based chemotherapy. Early recognition and monitoring of this side effect is an important role of the pediatric oncology nurse. There are a variety of peripheral neuropathy assessment tools currently in use, but the usefulness of these tools in identifying and grading neuropathy in children varies, and there is currently no standardized tool in place to evaluate peripheral neuropathy in pediatric oncology. A systematic review was performed to identify the peripheral neuropathy assessment tools that best evaluate the early onset and progression of peripheral neuropathy in pediatric patients receiving vincristine. Because of the limited information available in pediatric oncology, this review was extended to any pediatric patient with neuropathy. A total of 8 studies were included in the evidence synthesis. Based on available evidence, the pediatric-modified Total Neuropathy Scale (ped-m TNS) and the Total Neuropathy Score-pediatric version (TNS-PV) are recommended for the assessment of vincristine-induced peripheral neuropathy in children 6 years of age and older. In addition, several studies demonstrated that subjective symptoms alone are not adequate to assess for vincristine-induced peripheral neuropathy. Nursing assessment of peripheral neuropathy should be an integral and regular part of patient care throughout the course of chemotherapy treatment.
Subject(s)
Antineoplastic Agents, Phytogenic/adverse effects , Antineoplastic Agents, Phytogenic/therapeutic use , Drug-Related Side Effects and Adverse Reactions/drug therapy , Neoplasms/drug therapy , Pediatric Nursing/methods , Peripheral Nervous System Diseases/chemically induced , Peripheral Nervous System Diseases/nursing , Vincristine/therapeutic use , Adolescent , Child , Child, Preschool , Disease Progression , Early Diagnosis , Female , Humans , Infant , Infant, Newborn , Male , Nursing AssessmentSubject(s)
Klinefelter Syndrome/complications , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/etiology , Sex Chromosome Disorders/complications , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Humans , Karyotyping , Klinefelter Syndrome/diagnosis , Klinefelter Syndrome/epidemiology , Male , Polymorphism, Single Nucleotide , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/epidemiology , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/therapy , Prevalence , Sex Chromosome Disorders/diagnosis , Sex Chromosome Disorders/epidemiology , XYY Karyotype/diagnosis , XYY Karyotype/epidemiology , Young AdultABSTRACT
PURPOSE: To evaluate an end-of-life (EOL) program related to specific outcomes (i.e., number of hospitalizations and place of death) for children with brain tumors. DESIGN AND METHODS: From 1990 to 2005, a retrospective chart review was performed related to specified outcomes for 166 children with admission for pediatric brain tumors. RESULTS: Patients who received the EOL program were hospitalized less often (n = 114; chi-square = 5.001 with df = 1, p <.05) than patients who did not receive the program. PRACTICE IMPLICATIONS: An EOL program may improve symptom management and decrease required hospital admissions for children with brain tumors.
