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Opioid Tedavisi Alan Onkoloji Hastalarında Konstipasyon Yönetimi: Hemşirelerin Tutum ve Uygulamaları

Year 2024, Issue: 9, 47 - 53, 30.08.2024
https://doi.org/10.58252/artukluhealth.1493277

Abstract

Giriş: Bu çalışmanın amacı; opioid tedavisi kullanılan onkoloji hastalarının, konstipasyon yönetiminde hemşirelerin tutum ve uygulamalarını incelemektir.
Yöntem: Araştırmanın örneklemini; Haziran 2021-Temmuz 2021 tarihleri arasında Onkoloji Hemşireliği Derneği’ne üye olan ve onkoloji servisinde çalışan, dahil edilme kriterlerine uyan 143 hemşire oluşturmuştur. Çalışma verileri, literatür doğrultusunda oluşturulan anket formu ile toplanmıştır.
Bulgular: Çalışmaya katılan hemşirelerin %93.7’si kadın ve yaş ortalamaları 36.63+8.39 yıldır. Hemşirelerin %64.3’ü lisans mezunudur. Meslekteki çalışma yılı ortalaması; 14.9+9.43 yıl ve onkoloji servisindeki çalışma süresi ise 8.3+6.49 yıldır. Hemşirelerin %48.3’ünün onkoloji hemşireliği sertifikasının bulunduğu, %52.4’ünün onkoloji hastalarında semptom yönetimini içeren eğitim aldığı ve %83.9’unun ise konstipasyon değerlendirmesi yaparken geçerli-güvenilir bir ölçek kullanmadığı saptanmıştır. Hemşirelerin %50.3’ü opioid kullanmaya başlayan hastalarına konstipasyonu önlemeye yönelik hemşirelik girişimi uyguladıklarını ve girişim uygulayan hemşirelerin %45.4’ü ise diyet değişikliği önerilerinde bulunduklarını bildirmişlerdir.
Sonuç: Kanser hastalarında semptom yönetimini kapsayan hizmet içi eğitimlerin düzenlenmesinin ve hastanelerde konstipasyonun değerlendirilmesine ilişkin standart form ve/veya ölçek kullanılmasının faydalı olabileceği düşünülmektedir.

Ethical Statement

Çalışmanın yapılabilmesi için Ege Üniversitesi Tıbbi Araştırmalar Etik Kurulu’ndan izin alınmıştır (Tarih: 11.06.2021, Sayı: 22-5T/5). Katılımcılara gönderilen formların giriş bölümüne; çalışmanın amacı, türü ve araştırmacının adı dahil edilmiştir. Çalışmada katılımcılara araştırmanın amacı ve içeriği online formun ilk sayfasında açıklanmış olup, formun ilk sorusunda çalışmaya katılmayı kabul edip etmedikleri sorularak izinleri alınmıştır

Thanks

Çalışmaya katkı sunan tüm meslektaşlarımıza teşekkür ederiz.

References

  • Andrews, A., and Morgan, G. (2013). Constipation in palliative care: treatment options and considerations for individual patient management. International journal of Palliative Nursing, 19(6), 266–273. https://doi.org/10.12968/ijpn.2013.19.6.266
  • Bennett, M. I., Kaasa, S., Barke, A., Korwisi, B., Rief, W., Treede, R. D., and IASP Taskforce for the Classification of Chronic Pain (2019). The IASP classification of chronic pain for ICD-11: chronic cancer-related pain. Pain, 160(1), 38–44. https://doi.org/10.1097/j.pain.0000000000001363
  • Bıçak Ayık, D. ve Gülbeyaz, C. (2020). Palyatif bakım hastalarında konstipasyonun yönetimi ve akupresürün etkinliği. Sağlık Akademisyenleri Dergisi, 7(2), 141-148.
  • Boland, J. W., Allgar, V., Boland, E. G., Bennett, M. I., Kaasa, S., Hjermstad, M. J., and Johnson, M. (2020). The relationship between pain, analgesics and survival in patients with advanced cancer; a secondary data analysis of the international European palliative care Cancer symptom study. European Journal of Clinical Pharmacology, 76(3), 393–402. https://doi.org/10.1007/s00228-019-02801-2
  • Chokhavatia, S., John, E. S., Bridgeman, M. B., and Dixit, D. (2016). Constipation in Elderly Patients with Noncancer Pain: Focus on Opioid-Induced Constipation. Drugs and Aging, 33(8), 557–574. https://doi.org/10.1007/s40266-016-0381-2
  • Clemens, K. E., Faust, M., Jaspers, B., and Mikus, G. (2013). Pharmacological treatment of constipation in palliative care. Current Opinion in Supportive and Palliative Care, 7(2), 183–191. https://doi.org/10.1097/SPC.0b013e32835f1e17
  • Coombs, L. A., Noonan, K., Diane Barber, F., Mackey, H., Peterson, M. E., Turner, T., and LeFebvre, K. B. (2020). Oncology nurse practitioner competencies: Defining best practices in the oncology setting. Clinical Journal of Oncology Nursing, 24(3), 296–304. https://doi.org/10.1188/20.CJON.296-304
  • Deniz, K. (2022). Opioid kullanan kanser hastalarında konstipasyonun konfor düzeyine etkisi (Master's thesis, Ege Üniversitesi). Https://Tez.Yok.Gov.Tr/Ulusaltezmerkezi/Tezsorgusonucyeni.Jsp
  • De Groef, A., Evenepoel, M., Van Dijck, S., Dams, L., Haenen, V., Wiles, L., Catley, M., Vogelzang, A., Olver, I., Hibbert, P., Morlion, B., Moseley, G. L., Heathcote, L. C., and Meeus, M. (2023). Feasibility and pilot testing of a personalized eHealth intervention for pain science education and self-management for breast cancer survivors with persistent pain: a mixed-method study. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer, 31(2), 119. https://doi.org/10.1007/s00520-022-07557-7
  • Hanai, A., Ishiguro, H., Sozu, T., Tsuda, M., Arai, H., Mitani, A., and Tsuboyama, T. (2016). Effects of a self-management program on antiemetic-induced constipation during chemotherapy among breast cancer patients: a randomized controlled clinical trial. Breast Cancer Research and Treatment, 155(1), 99–107. https://doi.org/10.1007/s10549-015-3652-4
  • Kumar, L., Barker, C., and Emmanuel, A. (2014). Opioid-induced constipation: pathophysiology, clinical consequences, and management. Gastroenterology Research and Practice, 141737. https://doi.org/10.1155/2014/141737
  • Larkin, P. J., Cherny, N. I., La Carpia, D., Guglielmo, M., Ostgathe, C., Scotté, F., Ripamonti, C. I., and ESMO Guidelines Committee (2018). Diagnosis, assessment and management of constipation in advanced cancer: ESMO Clinical Practice Guidelines. Annals of Oncology: Official Journal of the European Society for Medical Oncology, 29(Suppl 4), iv111–iv125. https://doi.org/10.1093/annonc/mdy148
  • Mesía, R., Virizuela Echaburu, J. A., Gómez, J., Sauri, T., Serrano, G., and Pujol, E. (2019). Opioid-induced constipation in oncological patients: New strategies of management. Current treatment options in oncology, 20(12), 91. https://doi.org/10.1007/s11864-019-0686-6
  • Mestdagh, F., Steyaert, A., and Lavand'homme, P. (2023). Cancer pain management: A narrative review of current concepts, strategies, and techniques. current oncology (Toronto, Ont.), 30(7), 6838–6858. https://doi.org/10.3390/curroncol30070500
  • Öztürk, N., Kocabıyık, B. Ç., Arıkan, F., ve Coşkun, H. Ş. (2020). Kanser hastalarında konstipasyon sıklığı ve gelişme riskinin incelenmesi. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi, 13(3), 178-184.
  • Sheldon, L. K., and Booker, R. (2023). Growth and development of oncology nursing in North America. Annals of Palliative Medicine, 12(5), 1016–1025. https://doi.org/10.21037/apm-22-1121
  • Shen, Q., Zhu, H., Jiang, G., and Liu, X. (2018). Nurse-led self-management educational intervention improves symptoms of patients with functional constipation. Western Journal of Nursing Research, 40(6), 874–888. https://doi.org/10.1177/0193945917701128
  • Snijders, R. A. H., Brom, L., Theunissen, M., and van den Beuken-van Everdingen, M. H. J. (2023). Update on prevalence of pain in patients with cancer 2022: A systematic literature review and meta-analysis. Cancers, 15(3), 591. https://doi.org/10.3390/cancers15030591
  • Sullivan, K. M., Dean, A., and Soe, M. M. (2009). OpenEpi: A web-based epidemiologic and statistical calculator for public health. Public Health Reports (Washington,D.C.:1974), 124(3), 471–474. https://doi.org/10.1177/003335490912400320
  • Sözeri E, Kutluturkan S. (2018). Kanser ağrısının yönetiminde opioidlerin kullanımına bağlı gelişen konstipasyonun yönetimi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, (2), 105-109.
  • Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., and Bray, F. (2021). Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 71(3), 209–249. https://doi.org/10.3322/caac.21660
  • Tarakçıoğlu Çelik, GH. (2016). Onkoloji hemşireliğinde semptom yönetimi. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 5(4), 93-100.
  • Wang, W., Liu, Y., Yang, X., Sun, J., Yue, Z., Lu, D., Zhou, K., Sun, Y., Hou, A., Zang, Z., Jin, X., Liu, C., Wang, Y., Yu, J., Zhu, L., and Liu, Z. (2023). Effects of electroacupuncture for opioid-induced constipation in patients with cancer in China: A randomized clinical trial. JAMA Network Open, 6(2), e230310. https://doi.org/10.1001/jamanetworkopen.2023.0310
  • Who. Pain Management: An Overview. 2016. 04.04.2024. Https://Applications.Emro.Who.İntİmemrf/Hamdard_Med/Hamdard_Med_2016_59_4_33_42.Pdf
  • Wickham R. J. (2017). Managing constipation in adults with cancer. Journal of the Advanced Practitioner in Oncology, 8(2), 149–161.
  • Yıldırım, D., ve Can, G. (2019). Opioid ilaç kullanan hastalarda gelişen konstipasyonun yönetimi. Balıkesir Sağlık Bilimleri Dergisi, 8(1), 27-32.
  • Yıldırım, Y., ve Fadıloğlu, Ç. (2017). Palyatif Bakım Semptom Yönetimi ve Yaşam Sonu Bakım. Baskı Ankara, Nobel Tıp Kitabevi.

Management of Constipation in Oncology Patients Using Opioids: Attitudes and Practices of Nurses

Year 2024, Issue: 9, 47 - 53, 30.08.2024
https://doi.org/10.58252/artukluhealth.1493277

Abstract

Introduction: The aim of this study is to evaluate the attitudes and practices of nurses in the management of constipation in oncology patients using opioids.
Methods: The study sample consisted of 143 nurses who were members of the Oncology Nursing Association between June 2021 and July 2021 and who worked in the oncology service and met the inclusion criteria. The study data were collected with a questionnaire form created in line with the literature.
Results: Among the nurses who participated in the study, 93.7% were female and the mean age was 36.63±8.39 years. 64.3% of the nurses had bachelor’s degree. The mean number of years in the profession was 14.9±9.43 years and the mean number of years in the oncology service was 8.3±6.49 years. It was found that 48.3% of the nurses had an oncology nursing certificate, 52.4% had received training on symptom management in oncology patients, and 83.9% do not use a valid and reliable scale when assessing constipation. 50.3% of the nurses reported that they implemented nursing interventions to prevent constipation in patients who started using opioids, and 45.4% of the nurses who implemented interventions recommended dietary changes.
Conclusion: It is thought that organizing in-service trainings covering symptom management in cancer patients and using a standard form or scale for assessing constipation in hospitals would be beneficial.

Ethical Statement

Permission was obtained from Ege University Medical Research Ethics Committee for the study (Date: 11.06.2021, REF: 22-5T/5). The purpose and type of the study and the name of the researcher were included in the introduction section of the forms sent to the participants. The purpose and content of the study were explained to the participants on the first page of the online form, and their consent was obtained by asking whether they agreed to participate in the study in the first question of the form.

Thanks

We would like to thank all our colleagues who contributed to the study.

References

  • Andrews, A., and Morgan, G. (2013). Constipation in palliative care: treatment options and considerations for individual patient management. International journal of Palliative Nursing, 19(6), 266–273. https://doi.org/10.12968/ijpn.2013.19.6.266
  • Bennett, M. I., Kaasa, S., Barke, A., Korwisi, B., Rief, W., Treede, R. D., and IASP Taskforce for the Classification of Chronic Pain (2019). The IASP classification of chronic pain for ICD-11: chronic cancer-related pain. Pain, 160(1), 38–44. https://doi.org/10.1097/j.pain.0000000000001363
  • Bıçak Ayık, D. ve Gülbeyaz, C. (2020). Palyatif bakım hastalarında konstipasyonun yönetimi ve akupresürün etkinliği. Sağlık Akademisyenleri Dergisi, 7(2), 141-148.
  • Boland, J. W., Allgar, V., Boland, E. G., Bennett, M. I., Kaasa, S., Hjermstad, M. J., and Johnson, M. (2020). The relationship between pain, analgesics and survival in patients with advanced cancer; a secondary data analysis of the international European palliative care Cancer symptom study. European Journal of Clinical Pharmacology, 76(3), 393–402. https://doi.org/10.1007/s00228-019-02801-2
  • Chokhavatia, S., John, E. S., Bridgeman, M. B., and Dixit, D. (2016). Constipation in Elderly Patients with Noncancer Pain: Focus on Opioid-Induced Constipation. Drugs and Aging, 33(8), 557–574. https://doi.org/10.1007/s40266-016-0381-2
  • Clemens, K. E., Faust, M., Jaspers, B., and Mikus, G. (2013). Pharmacological treatment of constipation in palliative care. Current Opinion in Supportive and Palliative Care, 7(2), 183–191. https://doi.org/10.1097/SPC.0b013e32835f1e17
  • Coombs, L. A., Noonan, K., Diane Barber, F., Mackey, H., Peterson, M. E., Turner, T., and LeFebvre, K. B. (2020). Oncology nurse practitioner competencies: Defining best practices in the oncology setting. Clinical Journal of Oncology Nursing, 24(3), 296–304. https://doi.org/10.1188/20.CJON.296-304
  • Deniz, K. (2022). Opioid kullanan kanser hastalarında konstipasyonun konfor düzeyine etkisi (Master's thesis, Ege Üniversitesi). Https://Tez.Yok.Gov.Tr/Ulusaltezmerkezi/Tezsorgusonucyeni.Jsp
  • De Groef, A., Evenepoel, M., Van Dijck, S., Dams, L., Haenen, V., Wiles, L., Catley, M., Vogelzang, A., Olver, I., Hibbert, P., Morlion, B., Moseley, G. L., Heathcote, L. C., and Meeus, M. (2023). Feasibility and pilot testing of a personalized eHealth intervention for pain science education and self-management for breast cancer survivors with persistent pain: a mixed-method study. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer, 31(2), 119. https://doi.org/10.1007/s00520-022-07557-7
  • Hanai, A., Ishiguro, H., Sozu, T., Tsuda, M., Arai, H., Mitani, A., and Tsuboyama, T. (2016). Effects of a self-management program on antiemetic-induced constipation during chemotherapy among breast cancer patients: a randomized controlled clinical trial. Breast Cancer Research and Treatment, 155(1), 99–107. https://doi.org/10.1007/s10549-015-3652-4
  • Kumar, L., Barker, C., and Emmanuel, A. (2014). Opioid-induced constipation: pathophysiology, clinical consequences, and management. Gastroenterology Research and Practice, 141737. https://doi.org/10.1155/2014/141737
  • Larkin, P. J., Cherny, N. I., La Carpia, D., Guglielmo, M., Ostgathe, C., Scotté, F., Ripamonti, C. I., and ESMO Guidelines Committee (2018). Diagnosis, assessment and management of constipation in advanced cancer: ESMO Clinical Practice Guidelines. Annals of Oncology: Official Journal of the European Society for Medical Oncology, 29(Suppl 4), iv111–iv125. https://doi.org/10.1093/annonc/mdy148
  • Mesía, R., Virizuela Echaburu, J. A., Gómez, J., Sauri, T., Serrano, G., and Pujol, E. (2019). Opioid-induced constipation in oncological patients: New strategies of management. Current treatment options in oncology, 20(12), 91. https://doi.org/10.1007/s11864-019-0686-6
  • Mestdagh, F., Steyaert, A., and Lavand'homme, P. (2023). Cancer pain management: A narrative review of current concepts, strategies, and techniques. current oncology (Toronto, Ont.), 30(7), 6838–6858. https://doi.org/10.3390/curroncol30070500
  • Öztürk, N., Kocabıyık, B. Ç., Arıkan, F., ve Coşkun, H. Ş. (2020). Kanser hastalarında konstipasyon sıklığı ve gelişme riskinin incelenmesi. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi, 13(3), 178-184.
  • Sheldon, L. K., and Booker, R. (2023). Growth and development of oncology nursing in North America. Annals of Palliative Medicine, 12(5), 1016–1025. https://doi.org/10.21037/apm-22-1121
  • Shen, Q., Zhu, H., Jiang, G., and Liu, X. (2018). Nurse-led self-management educational intervention improves symptoms of patients with functional constipation. Western Journal of Nursing Research, 40(6), 874–888. https://doi.org/10.1177/0193945917701128
  • Snijders, R. A. H., Brom, L., Theunissen, M., and van den Beuken-van Everdingen, M. H. J. (2023). Update on prevalence of pain in patients with cancer 2022: A systematic literature review and meta-analysis. Cancers, 15(3), 591. https://doi.org/10.3390/cancers15030591
  • Sullivan, K. M., Dean, A., and Soe, M. M. (2009). OpenEpi: A web-based epidemiologic and statistical calculator for public health. Public Health Reports (Washington,D.C.:1974), 124(3), 471–474. https://doi.org/10.1177/003335490912400320
  • Sözeri E, Kutluturkan S. (2018). Kanser ağrısının yönetiminde opioidlerin kullanımına bağlı gelişen konstipasyonun yönetimi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, (2), 105-109.
  • Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., and Bray, F. (2021). Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 71(3), 209–249. https://doi.org/10.3322/caac.21660
  • Tarakçıoğlu Çelik, GH. (2016). Onkoloji hemşireliğinde semptom yönetimi. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 5(4), 93-100.
  • Wang, W., Liu, Y., Yang, X., Sun, J., Yue, Z., Lu, D., Zhou, K., Sun, Y., Hou, A., Zang, Z., Jin, X., Liu, C., Wang, Y., Yu, J., Zhu, L., and Liu, Z. (2023). Effects of electroacupuncture for opioid-induced constipation in patients with cancer in China: A randomized clinical trial. JAMA Network Open, 6(2), e230310. https://doi.org/10.1001/jamanetworkopen.2023.0310
  • Who. Pain Management: An Overview. 2016. 04.04.2024. Https://Applications.Emro.Who.İntİmemrf/Hamdard_Med/Hamdard_Med_2016_59_4_33_42.Pdf
  • Wickham R. J. (2017). Managing constipation in adults with cancer. Journal of the Advanced Practitioner in Oncology, 8(2), 149–161.
  • Yıldırım, D., ve Can, G. (2019). Opioid ilaç kullanan hastalarda gelişen konstipasyonun yönetimi. Balıkesir Sağlık Bilimleri Dergisi, 8(1), 27-32.
  • Yıldırım, Y., ve Fadıloğlu, Ç. (2017). Palyatif Bakım Semptom Yönetimi ve Yaşam Sonu Bakım. Baskı Ankara, Nobel Tıp Kitabevi.
There are 27 citations in total.

Details

Primary Language Turkish
Subjects Oncology Nursing
Journal Section Research Article
Authors

Kezban Şahin 0000-0002-4197-3568

Yağmur Artan 0000-0002-9723-9127

Figen Bay 0000-0002-0702-2654

Yasemin Yıldırım 0000-0002-8970-3743

Publication Date August 30, 2024
Submission Date May 31, 2024
Acceptance Date August 10, 2024
Published in Issue Year 2024 Issue: 9

Cite

APA Şahin, K., Artan, Y., Bay, F., Yıldırım, Y. (2024). Opioid Tedavisi Alan Onkoloji Hastalarında Konstipasyon Yönetimi: Hemşirelerin Tutum ve Uygulamaları. Artuklu Health(9), 47-53. https://doi.org/10.58252/artukluhealth.1493277