Kemoterapi ilişkili periferal nöropati (KİPN) sık görülen, bireylerin fonksiyonel durumlarını ve yaşam kalitesini olumsuz yönde etkileyen bir tedavi komplikasyonudur. Tamamlayıcı tedaviler, farmakolojik tedavi seçeneklerinin sınırlı olması nedeniyle nöropati semptomlarını hafifletmek için hastalar tarafından sıklıkla tercih edilmektedir. Onkoloji alanında çalışan hemşirelerin, KİPN'nin erken tanılanması ve hastaların fonksiyonel durumlarındaki değişimlere adapte olmalarını kolaylaştırmada önemli rolleri bulunmaktadır. Bu nedenle bu derlemede, KİPN yönetiminde kullanılan meditasyon, reiki, yoga, akupunktur, aromaterapi, masaj, refleksoloji, kriyoterapi ve fiziksel aktivite gibi tamamlayıcı tedavi yaklaşımları, kanıta dayalı araştırma örnekleriyle birlikte ele alınmış ve alanda çalışan hemşirelerin hastalar tarafından kullanılan ve etkisi araştırılan tamamlayıcı tedavilere ilişkin farkındalıklarını artırmak hedeflenmiştir. Bu literatür derlemesi kapsamında incelenen deneysel, yarı deneysel araştırmalar, olgu sunumları ve sistematik derlemeler ele alındığında; KİPN'yi önlemek ya da semptomlarını hafifletmek amacıyla etkisi incelenen tamamlayıcı tedaviler içerisinde zihin beden temelli uygulamalar, akupunktur, aromaterapi, masaj, refleksoloji, kriyoterapi ve fiziksel aktivitenin nöropati semptomlarının önlenmesi veya hafifletilmesinde etkili olabileceği bildirilmiştir. Ancak bu yaklaşımlarla ilgili mevcut klinik araştırma sayısının ve örneklem büyüklüklerinin sınırlı olması, uygulama süresi ve sıklığı açısından farklılıklar içermesi, araştırmaların birbiri ile çelişkili sonuçlar içermesi, uzun süreli etkilerinin bilinmemesi ve kanıta dayalı klinik rehberlerde yer almaması nedeniyle kanıtların yetersiz olduğu düşünülmektedir. KİPN yönetiminde, tamamlayıcı tedavi yaklaşımlarının etkisini inceleyen ve geniş örneklem büyüklüğü ile yürütülen klinik araştırmaların tamamlayıcı tedavilerin klinik kullanımını destekleyecek güçlü kanıtların oluşturulmasına katkı sağlayacağı öngörülmektedir.
Anahtar Kelimeler: Kanser; kemoterapi ilişkili periferal nöropati; tamamlayıcı tedavi
Chemotherapy-induced peripheral neuropathy is a common complication of chemotherapy that limits functional status and negatively affects the quality of life. Due to limited pharmacological treatment options, complementary therapies have been commonly used by the patients to relieve symptoms of chemotherapy-induced peripheral neuropathy. Oncology nurses take an important role in early detection of chemotherapy-induced peripheral neuropathy and facilitating patients to adapt to functional limitations due to chemotherapy-induced peripheral neuropathy. Therefore, in this review complementary therapies, used in the management of chemotherapy-induced peripheral neuropathy, including reiki, yoga, meditation, acupuncture, aromatherapy, massage, reflexology, cryotherapy, and physical activity has been handled with evidence-based research examples, and it has been aimed to heighten awareness of the oncology nurses on this issue. Considering experimental, quasi-experimental research, case reports and systematic reviews examining within the scope of this literature review, mind-body based interventions, acupuncture, aromatherapy, massage, reflexology, cryotherapy, and physical activity have been reported as probably useful in prevention or alleviation of chemotherapy-induced peripheral neuropathy symptoms. On the other hand, clinical evidence is poor due to the limited number of existing studies, small sample size, differences between duration and frequency of applications, uncertainties in long-term effects of complementary therapies, contradictory results among available reports, and lack of recommendations in clinical guidelines on the use of these approaches. It is anticipated that clinical studies with a large sample size will contribute to the development of robust evidence that will support the clinical use of complementary therapies in the management of chemotherapy-induced peripheral neuropathy.
Keywords: Cancer; Chemotherapy-induced peripheral neuropathy; complementary therapy
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