Kanser Tedavisi Alan Çocuklarda Bulantı-Kusmaya Yönelik Semptom Yönetimi: Kanıt Temelli Uygulamalar

Kemoterapiye bağlı oluşan bulantı-kusma kanser tedavisi alan çocuklarda en yaygın görülen ve multidisipliner yaklaşım gerektiren semptomlar arasındadır. Son yıllarda antiemetik tedavi protokolleriyle ilgili gelişmelere rağmen, bulantı-kusmayla baş etme güçlükleri günümüzde hala devam etmektedir. Kontrol altına alınamayan bulantı-kusma deneyimleyen çocuklar, tedavi sürecinde uzama, yaşam kalitesinde azalma, sıvı-elektrolit dengesizliği, yetersiz beslenme ve tedaviye uyumda azalma gibi birçok sorun yaşamaktadır. Bu derlemede, çocuklarda bulantı-kusmaya yönelik kanıta dayalı, güncel ve güvenilir bilgilerin hemşireler için rehber niteliği taşıması amaçlanmıştır. Bulantı-kusmayı azaltmak için farmakolojik yöntemlerin yanında integratif sağlık yaklaşımları da tercih edilmektedir. Hemşireler bulantı-kusmanın optimal düzeyde yönetilmesini sağlamak için yeterli bilgiye ve donanıma sahip olmalıdır. Bu doğrultuda, kanıta dayalı tedavileri uygulama ve integratif yöntemlerle ilgili rehberlik/danışmanlık yapmalı ve eğitim vermelidir. Bunun yanında, uygulama rehberlerini takip ederek, değişen bilgiler doğrultusunda klinik uygulamalarını güncelleştirmelidir. Kemoterapi protokollerine uygun standart, güncel antiemetik tedavilerin uygulanması çocukların yaşadığı bulantı-kusma semptomunun önlenmesini/azaltılmasını sağlayarak çocuk ve ebeveynlerin yaşam kalitesini arttıracaktır. Bu derlemede, bulantı-kusma yönetiminde uygulanan değerlendirme araçları ve standart tedavi yöntemlerinin yetersiz olduğu belirlenmiştir. Bu nedenle, bulantı-kusmanın etkin yönetilmesi için hem farmakolojik hem integratif yöntemlerle ilgili daha fazla deneysel ve kanıta dayalı çalışmaların yapılması önerilmektedir.

Anahtar Kelimeler:

Kanser, çocuk, bulantı-kusma, semptom yönetimi

Symptom Management for Nausea-Vomiting in Children Receiving Cancer Treatment: Evidence-Based Practices

Chemotherapy-induced nausea and vomiting which require multidisciplinary approaches are among the most common symptoms in children receiving cancer treatment. Despite advances in antiemetic protocols, difficulties in coping with nausea and vomiting are still ongoing in recent years. Children experiencing uncontrolled nausea and vomiting have many problems such as prolongation of treatment, the decrease in quality of life, fluid-electrolyte imbalance, insufficient nutrition and reduction of adaptation to treatment. In the present review, it is aimed to provide current evidence-based information as a guide for nurses. In addition to pharmacological methods, integrative health approaches are preferred to reduce nausea and vomiting. Nurses should have sufficient knowledge and skills to ensure optimal management of nausea and vomiting. In this respect, it is suggested that nurses should provide guidance/counseling and training on the application of evidence-based therapies and integrative methods. Nurses who work in the pediatric oncology/hematology units should follow the guidelines and transfer this current evidence-based information to their practice. The standardized and current antiemetic treatments based on chemotherapy protocols will improve the quality of life of children and parents by preventing/reducing the nausea-vomiting symptom experienced by children. In this review, it was determined that the assessment tools and standard treatment methods used in the management of nausea and vomiting were insufficient. Therefore, more experimental and evidence-based studies on both pharmacological and integrative methods are recommended for effective management of nausea and vomiting.

Keywords:

Cancer, children, nausea-vomiting, symptom management,

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