化疗所致味觉改变评估及护理的最佳证据应用

Evaluation of taste changes induced by chemotherapy and application of best evidence in nursing care

目的将化疗所致味觉改变(Chemotherapy-induced taste alteration,CITA)评估及护理的最佳证据应用于临床实践并评价其效果。方法遵循Joanna Briggs Institute(JBI)临床证据实践应用模式,根据前期研究获得的最佳证据制订相应的临床审查指标及审查方法,逐条审查并进行障碍因素分析,制订行动策略。比较最佳证据应用前后肿瘤内科护士对味觉改变评估及护理的认知水平、患者味觉改变的发生率以及肿瘤内科护士对质量审查指标的执行率。结果最佳证据应用前后,肿瘤内科护士对味觉改变评估及护理的相关知识合格率由基线时的8%增加到100%;基线审查时CITAs评分≤18分时即完全无味觉改变,仅占比0.2%,而审查后CITAs评分≤18分占比2%;肿瘤内科护士对部分审查指标的执行率从0上升到100%。结论味觉改变症状评估及护理的最佳证据在化疗患者这一适宜人群中应用后,能够规范肿瘤内科护士临床实践行为,提高护士对化疗相关症状管理的执行依从性,并不同程度的降低化疗患者味觉改变的发生率。

Objective To apply the best evidence of evaluation and nursing of chemotherapy-induced taste alteration(CITA)to clinical practice,and to evaluate its effect.Methods Following the practical application models of Joanna Briggs institute(JBI)clinical evidence,formulate the corresponding clinical review indicators and review methods based on the best evidence obtained in previous research,review detailed,and analyze obstacles factors and formulate action strategies.Comparing the oncology nurses'assessment of taste alteration and their cognitive levels of nursing,the incidence of patients'taste alternation,and the implementation rate of quality review indicators by oncology nurses before and after the application of the best evidence.Results Before and after the application of the best evidence,the qualification rate of taste alteration assessment and nursing related knowledge of oncology nurses increased from 8%at baseline to 100%;When CITAs score≤18 in baseline examination,there was no taste alternation at all,accounting for only 0.2%,while after examination,CITAs score≤18 accounted for 2%.Before and after the application of the best evidence,the implementation rate of partial review indicators by oncology nurses increased from 0 to 100%.Conclusion When the best evidence of taste alteration symptom evaluation and nursing is applied in such an appropriate population of chemotherapy patients,it can standardize the clinical practice behavior of oncology nurses,improve the compliance of nurses to the management of chemotherapy-related symptoms and reduce the incidence of taste alteration in chemotherapy patients to varying degrees.