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

Yıl 2019, Cilt: 17 Sayı: 1, 170 - 182, 01.04.2019

Meltem Gürcan Sevcan Atay Turan

Öz

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

Öz

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.

Anahtar Kelimeler

Cancer, children, nausea-vomiting, symptom management

Kaynakça

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