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Coke L, Otten K, Staffileno B, Minarich L, Nowiszewski C. The impact of an oral hygiene education module on patient practices and nursing documentation. Clin J Oncol Nurs 2016; 19:75-80. [PMID: 25689652 DOI: 10.1188/15.cjon.75-80] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Oral hygiene is inconsistent among patients with cancer and is a national patient care issue. To promote comfort and nutritional status, oral hygiene for patients with cancer is important. OBJECTIVES The purpose of this study was to develop an evidence-based oral hygiene educational module (EM) for nursing and patient care technician (PCT) staff to promote consistent oral hygiene patient education; evaluate patient understanding of oral hygiene practices post-EM; and determine staff documentation frequency of oral hygiene care. METHODS Pre- and post-EM data were collected using a developed oral hygiene assessment tool; nursing documentation data were collected by chart review. Post-EM data were collected eight weeks post-EM. Data were analyzed using frequencies and the Mann-Whitney U test. FINDINGS Twenty-two patient documentation pairs were collected. Compared to pre-EM, admission teaching, patient education, and patient oral hygiene practices improved post-EM. Post-EM oral hygiene documentation and PCT teaching increased.
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Barkokebas A, Silva IHM, de Andrade SC, Carvalho AAT, Gueiros LAM, Paiva SM, Leão JC. Impact of oral mucositis on oral-health-related quality of life of patients diagnosed with cancer. J Oral Pathol Med 2014; 44:746-51. [PMID: 25345344 DOI: 10.1111/jop.12282] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2014] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Oral mucositis (OM) has been described as the oral complication most frequently associated with antineoplastic therapy. However, the influence on the quality of life of affected patients is still unclear. OBJECTIVE To evaluate the impact of OM on the oral-health-related quality of life (OHRQoL) of patients diagnosed with cancer, who developed chemotherapy- and/or radiotherapy-induced OM. METHODS This is a cross-sectional evaluation of QoL using oral health impact profile-14 (OHIP-14). The study group comprised a sample of 60 patients diagnosed with cancer, who developed OM during the treatment. The instrument (OHIP-14) composed of seven dimensions was used: functional limitation, physical pain, psychological discomfort, physical deficiency, psychological deficiency, social incapacity, and deficiency. RESULTS The internal consistency of OHIP-14 measured by the Cronbach's α coefficient was of 0.76. Physical pain attained the highest score (worst quality of life) among the studied dimensions 60.8% (292/480), followed by physical limitation 52.7% (253/480), and psychological discomfort 50.8% (244/480). The dimension 'social limitation' obtained the lowest score 27.2% (131/480). There was statistically significant difference as regards gender (P = 0.021) for physical pain, with greater impact among patients of the male gender. CONCLUSION Oral-health-related quality of life is significantly affected by OM in individuals diagnosed with cancer.
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Affiliation(s)
| | | | | | | | | | - Saul Martins Paiva
- Department of Paediatric Dentistry and Orthodontics, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Jair Carneiro Leão
- Department of Clinic and Preventive Dentistry, Federal University of Pernambuco, Recife, PE, Brazil
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HSV-1 as well as HSV-2 is frequent in oral mucosal lesions of children on chemotherapy. Support Care Cancer 2014; 22:1773-9. [DOI: 10.1007/s00520-014-2152-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 01/28/2014] [Indexed: 10/25/2022]
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Effects of laser irradiation at different wavelengths (660, 810, 980, and 1,064 nm) on mucositis in an animal model of wound healing. Lasers Med Sci 2013; 29:1807-13. [DOI: 10.1007/s10103-013-1336-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 04/22/2013] [Indexed: 10/26/2022]
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Clinical Update: Prevention and Management of Oral Mucositis in Patients with Cancer. Semin Oncol Nurs 2011; 27:e1-16. [DOI: 10.1016/j.soncn.2011.08.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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A systematic review of oral assessment instruments: what can we recommend to practitioners in children's and young people's cancer care? Cancer Nurs 2010; 33:E1-E19. [PMID: 20357654 DOI: 10.1097/ncc.0b013e3181cb40c0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Observing and recording the signs and symptoms of oral mucositis are an important part of oral care, essential to the prevention and treatment of mucositis. Structured oral assessment enables a more informed and accurate identification of signs and symptoms and will enable early and individualized interventions. OBJECTIVE A United Kingdom-based mouth-care group conducted a systematic review of the published literature through to March 2004 and repeated in 2008. The goal of this review was to identify and evaluate the range of instruments used to assess oral mucositis to recommend in evidence-based guidelines the "best" instrument to use in the field of children's and young people's cancer care. METHODS Search sources included the Cochrane Library, MEDLINE, EMBASE, and CINAHL. Studies were selected using defined criteria and reviewed by 3 pairs of group members. RESULTS Fifty-four individual oral assessment instruments were identified with only 15 reporting evidence of reliability and validity testing. Only 3 articles reported on oral assessment exclusively in our population. CONCLUSIONS The guidelines recommend only 1 assessment instrument, the Oral Assessment Guide, or adaptations of this instrument, to be used in clinical practice. Five factors influenced this recommendation: purpose of assessment, population, outcomes assessed, and quality of the instrument and ease of use. IMPLICATIONS FOR PRACTICE The Oral Assessment Guide has been consistently judged to be user-friendly and appropriate for everyday clinical practice with both adults and children, as well as a useful research tool.
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Glenny A, Gibson F, Auld E, Coulson S, Clarkson J, Craig J, Eden O, Khalid T, Worthington H, Pizer B. The development of evidence-based guidelines on mouth care for children, teenagers and young adults treated for cancer. Eur J Cancer 2010; 46:1399-412. [DOI: 10.1016/j.ejca.2010.01.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Revised: 01/04/2010] [Accepted: 01/15/2010] [Indexed: 10/19/2022]
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Challenges of mucositis assessment in children: Expert opinion. Eur J Oncol Nurs 2008; 12:469-75. [DOI: 10.1016/j.ejon.2008.05.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2008] [Accepted: 05/22/2008] [Indexed: 11/22/2022]
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Tomlinson D, Judd P, Hendershot E, Maloney AM, Sung L. Establishing Literature-Based Items for an Oral Mucositis Assessment Tool in Children. J Pediatr Oncol Nurs 2008; 25:139-47. [DOI: 10.1177/1043454208317235] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Although there are numerous instruments for oral mucositis (OM) assessment in adults, there is a lack of validated instruments for use in children. The objectives of this systematic review were to describe literature-based items that should be considered for a pediatric mucositis scale and other issues that should be considered when assessing mucositis in children. Literature search of PubMed and bibliography searches identified articles relevant to the assessment of mucositis and mucositis assessment studies in children. The elements established from the literature were grouped under objective, subjective, and functional items. Other issues that require consideration include the conditions for the assessment of the oral cavity and the etiology of OM. The resultant list included 23 items that have been used in mucositis assessment scales. This list of items may be used as an initial step in developing a new pediatric OM scale that particularly focuses on the unique issues in children.
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Affiliation(s)
| | - Peter Judd
- Paediatric Dentistry division, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Eleanor Hendershot
- Haematology/Oncology Department, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Anne-Marie Maloney
- Haematology/Oncology Department, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lillian Sung
- CHES, Hospital for Sick Children, Toronto, Ontario, Canada
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Abstract
OBJECTIVES To review current evidence that applies to the development of a nursing plan of care for the prevention and treatment of oral mucositis related to cytotoxic therapy. DATA SOURCES Research studies, review articles, evidence-based guidelines, web-based material, and clinical experience. CONCLUSION Although high-level research evidence regarding mucositis is limited, use of multiple types of evidence in developing a structured plan of care facilitates improved patient outcomes and the advancement of the current body of knowledge. IMPLICATIONS FOR NURSING PRACTICE Nurses play a key role in the identification and use of evidence to guide the care of patients at risk for cytotoxic therapy-related oral mucositis.
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Tomlinson D, Judd P, Hendershot E, Maloney AM, Sung L. Measurement of oral mucositis in children: a review of the literature. Support Care Cancer 2007; 15:1251-1258. [PMID: 17724620 DOI: 10.1007/s00520-007-0323-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2007] [Accepted: 07/19/2007] [Indexed: 10/22/2022]
Abstract
GOALS OF WORK The assessment of oral mucositis is important. There is a paucity of validated oral mucositis assessment instruments for use in children. This paper reviews the available mucositis measurement tools and their applicability to a paediatric population. MATERIALS AND METHODS Literature search of PUBMED and bibliography searches identified articles relevant to mucositis measurement tools and the measurement of mucositis in paediatrics. RESULTS The relevant issues in the literature could be grouped into three categories: (1) development and evaluation of oral assessment tools, (2) oral assessment in the paediatric population, and (3) challenges to the assessment of oral mucositis in children. There were numerous validated mucositis assessment scales for use in adults. Only three of these scales have received limited evaluation for use in the paediatric population. The unique challenges presented by the paediatric population are excluded from much of the discussion in the literature. CONCLUSION The paper demonstrates the need to consider the issues specific to children. It must be determined whether previously developed tools are ideally suited for children enrolled on mucositis clinical trials.
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Affiliation(s)
- Deborah Tomlinson
- CHES, Hospital for Sick Children, Room 424, 123 Edward Street, Toronto, ON, M5G 1E2, Canada.
| | - Peter Judd
- Paediatric Dentistry, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Eleanor Hendershot
- Haematology/Oncology Department, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Anne-Marie Maloney
- Haematology/Oncology Department, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Lillian Sung
- CHES, Hospital for Sick Children, Room 424, 123 Edward Street, Toronto, ON, M5G 1E2, Canada
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Jaroneski LA. The importance of assessment rating scales for chemotherapy-induced oral mucositis. Oncol Nurs Forum 2006; 33:1085-90; quiz 1091-3. [PMID: 17149392 DOI: 10.1188/06.onf.1085-1093] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To review the literature related to chemotherapy-induced oral mucositis and highlight four empirically supported oral mucositis rating scales that oncology nurses can use. DATA SOURCES CINAHL and MEDLINE databases, published articles, and supplemental publications. DATA SYNTHESIS Various oral mucositis rating scales have been developed; however, a lack of consensus exists regarding their use in clinical practice. CONCLUSIONS To date, standards of practice for the assessment of oral mucositis do not exist, yet clinical measures are necessary for oncology nurses to manage the side effect effectively. The selection of a valid and reliable rating tool is necessary for routine oral assessment and for facilitating optimal patient outcomes related to oral mucositis. IMPLICATIONS FOR NURSING Knowing patient risk factors and the circumstances that exacerbate oral mucositis are keys to performing quality oral assessments. Oncology nurses should make performing oral assessments with a valid and reliable rating scale a priority. Further research regarding oral mucositis rating scales is needed.
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Gibson F, Cargill J, Allison J, Begent J, Cole S, Stone J, Lucas V. Establishing content validity of the oral assessment guide in children and young people. Eur J Cancer 2006; 42:1817-25. [PMID: 16872825 DOI: 10.1016/j.ejca.2006.02.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2005] [Revised: 02/10/2006] [Accepted: 02/27/2006] [Indexed: 11/21/2022]
Abstract
There is a need for accurate and consistent oral assessment to measure mucosal changes and oral complications associated with cancer therapies. Mucositis is an important and common side effect of cancer therapies that merits the identification of improved health-care interventions. Developing appropriate and reliable oral assessment instruments for use with children is relevant to the evaluation of these interventions. The purpose of this study was to determine the content validity of the oral assessment guide (OAG) in children: an instrument that was designed to objectively assess the physiological changes of the oral cavity following administration of chemotherapy and radiotherapy to adults. This process is considered to be most effective when undertaken systematically. A judgement quantification process was used with health care professionals in paediatric oncology to establish content validity of items (n=9) and instrument (n=10). A revised OAG more pertinent to children and young people was produced in the light of this process.
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Affiliation(s)
- Faith Gibson
- Centre for Nursing and Allied Health Professions Research, 7th Floor Old Building, Great Ormond Street Hospital for Children NHS Trust and Institute of Child Health, Great Ormond Street, London WC1N 3JH, United Kingdom.
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McGuire DB, Johnson J, Migliorati C. Promulgation of guidelines for mucositis management: educating health care professionals and patients. Support Care Cancer 2006; 14:548-57. [PMID: 16775650 DOI: 10.1007/s00520-006-0060-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2006] [Accepted: 03/02/2006] [Indexed: 10/24/2022]
Abstract
BACKGROUND The Multinational Association for Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) Mucositis and Patient and Professional Education Study Groups are collaborating to improve the promulgation of the updated mucositis management guidelines. The initial step in the collaboration was to survey cancer care health professionals to determine their awareness of the original 2004 guidelines and their opinions on the usefulness of patient educational materials based on the guidelines. MATERIALS AND METHODS The authors surveyed four samples (three US and one European) of cancer health care professionals attending three cancer-related professional conferences between May and July 2005 using a ten-item questionnaire in both paper-and-pencil and web-based formats. Data were compiled and analyzed using descriptive statistics. RESULTS All respondents were generally aware of the importance of mucositis as a treatment-limiting toxicity with life-threatening complications and endorsed regular oral assessment and dental care practices. Only about one third of the US respondents were aware of the 2004 guidelines in contrast to 80% of the European respondents. A majority of respondents across all four surveys (66-93%) felt strongly that educational materials based on the guidelines were needed and that they would use them, while a smaller number (7-29%) indicated they might use them if a patient had a problem with mucositis. CONCLUSIONS Awareness of the guidelines remains limited in the US, and use of the guidelines worldwide is minimal. The Mucositis and Patient and Professional Education Study Groups have developed a set of strategies to enhance dissemination, awareness, and use of the updated guidelines and to promote patient education based on the guidelines. Future work will focus on implementation and evaluation of the guidelines in clinical practice.
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Affiliation(s)
- Deborah B McGuire
- School of Nursing, University of Maryland, 655 W. Lombard Street, Baltimore, 21201, USA.
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McGuire DB, Correa MEP, Johnson J, Wienandts P. The role of basic oral care and good clinical practice principles in the management of oral mucositis. Support Care Cancer 2006; 14:541-7. [PMID: 16775649 DOI: 10.1007/s00520-006-0051-8] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2006] [Accepted: 02/21/2006] [Indexed: 11/24/2022]
Abstract
BACKGROUND The Basic Oral Care Group is one of eight subcommittees functioning within the Mucositis Study Group Guidelines Panel of the Multinational Association of Supportive Care in Cancer and International Society for Oral Oncology (MASCC/ISOO). The Basic Oral Care Group, comprised of the four authors of this paper, represented the disciplines of nursing (DBM, JJ), dentistry (MEPC), and pediatric dentistry (PW). This group reviewed research and clinical literature to update the original 2004 Mucositis Management Guidelines in the areas of basic oral care, bland rinses, protocols and education, and good clinical practices such as pain management, oral assessment, oral care, and dental care. MATERIALS AND METHODS Over 100 articles published between 2000 and 2005 were identified, and 32 of these were useful for the analysis. Each article was rated by at least two authors using a structured rating form and systematic determination of levels of evidence, based on the American Society of Clinical Oncology criteria. Discussion at the 2005 MASCC/ISOO Geneva pre-conference meeting of the Guidelines Panel resulted in the development of consensus on the interpretation of the literature. RESULTS Based on the literature and on Panel discussions, a revision of the original guidelines for protocols and education was produced by the group, and they developed a set of recommendations related to good clinical practices. CONCLUSIONS Although research remains scanty for components of basic oral care, bland rinses, protocols, and education, the original 2004 guidelines with the help of newer literature from 2000 to 2005 and expert consensus among the Guidelines Panel enabled the development of useful clinical practice guidelines for managing oral mucositis in patients receiving cancer treatment with radiation and/or chemotherapy.
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Affiliation(s)
- Deborah B McGuire
- School of Nursing, University of Maryland, Baltimore, 655 West Lombard Street, Baltimore, 21201, USA.
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Wright J, Feld R, Knox J. Chemotherapy-induced oral mucositis: new approaches to prevention and management. Expert Opin Drug Saf 2005; 4:193-200. [PMID: 15794713 DOI: 10.1517/14740338.4.2.193] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Oral mucositis is a common and significant toxicity of cancer chemotherapy. It is under-reported and not well treated, particularly in patients that receive high-dose therapy with an autologous or allogenic stem cell transplant. Two recently published retrospective analyses of patient complaints following stem cell transplantation have identified oral mucositis as the worst toxicity reported by patients, and what is more important is that patients indicated that oncology healthcare team members do a poor job of managing and providing methods of symptom relief. Twenty percent of patients surveyed indicated they received no symptom relief at all.
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Affiliation(s)
- Janice Wright
- Princess Margaret Hospital, Department of Medical Oncology, 610 University Avenue, Toronto, Ontario, M5G 2M9, Canada
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Rubenstein EB, Peterson DE, Schubert M, Keefe D, McGuire D, Epstein J, Elting LS, Fox PC, Cooksley C, Sonis ST. Clinical practice guidelines for the prevention and treatment of cancer therapy-induced oral and gastrointestinal mucositis. Cancer 2004; 100:2026-46. [PMID: 15108223 DOI: 10.1002/cncr.20163] [Citation(s) in RCA: 487] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Oral and gastrointestinal (GI) mucositis can affect up to 100% of patients undergoing high-dose chemotherapy and hematopoietic stem cell transplantation, 80% of patients with malignancies of the head and neck receiving radiotherapy, and a wide range of patients receiving chemotherapy. Alimentary track mucositis increases mortality and morbidity and contributes to rising health care costs. Consequently, the Multinational Association of Supportive Care in Cancer and the International Society for Oral Oncology assembled an expert panel to evaluate the literature and to create evidence-based guidelines for preventing, evaluating, and treating mucositis. METHODS Thirty-six panelists reviewed literature published between January 1966 and May 2002. An initial meeting in January 2002 produced a preliminary draft of guidelines that was reviewed at a second meeting the same year. Thereafter, a writing committee produced a report on mucositis pathogenesis, epidemiology, and scoring (also included in this issue), as well as clinical practice guidelines. RESULTS Panelists created recommendations from higher levels of evidence and suggestions when evidence was of a lower level and there was a consensus regarding the interpretation of the evidence by the panel. Panelists identified gaps in evidence that made it impossible to recommend or not recommend use of specific agents. CONCLUSIONS Oral/GI mucositis is a common side effect of many anticancer therapies. Evidence-based clinical practice guidelines are presented as a benchmark for clinicians to use for routine care of appropriate patients and as a springboard to challenge clinical investigators to conduct high-quality trials geared toward areas in which data are either lacking or conflicting.
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Affiliation(s)
- Edward B Rubenstein
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
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Glenny AM, Gibson F, Auld E, Coulson S, Clarkson JE, Craig JV, Eden OB, Worthington HV, Pizer B. A survey of current practice with regard to oral care for children being treated for cancer. Eur J Cancer 2004; 40:1217-24. [PMID: 15110886 DOI: 10.1016/j.ejca.2004.01.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2003] [Revised: 12/16/2003] [Accepted: 01/13/2004] [Indexed: 11/28/2022]
Abstract
The aim of the study was to establish current UK oral care practice for children with cancer. A telephone survey of all 22 United Kingdom Children's Cancer Study Group (UKCCSG) centres was undertaken. Nineteen (86%) of the centres reported using guidelines/protocols for mouth care. The use of routine preventive oral care therapies showed the greatest variation between centres. Four centres (18%) did not use any prophylactic oral care therapy other than basic oral hygiene, whereas seven (32%) routinely used a combination of three or more agents. Chlorhexidine was the most frequently administered prophylactic therapy (17/22 centres, 77%), followed by nystatin (11/22 centres, 50%). There was little variation in advice given to parents/patients on basic oral hygiene. Regarding dental check-ups, 9/22 centres (41%) recommended children to attend a hospital-linked dental clinic. Only at 8/22 centres (36%) did children undergo a dental check-up before commencing cancer treatment. The survey identified significant variation in preventive oral care therapies and dental check-ups at the UKCCSG centres. Attention needs to be given to establishing evidence based, effective strategies.
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Affiliation(s)
- A M Glenny
- Cochrane Oral Health Group, MANDEC, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester M15 6FH, UK.
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Abstract
OBJECTIVES To discuss implementation of evidence-based clinical practice guidelines for mucositis. DATA SOURCE Published articles, book chapters, web sources, clinical experience, unpublished manuscripts. CONCLUSION Nurses can implement evidence-based guidelines but must include an evaluation component to determine effect on clinical outcomes. IMPLICATIONS FOR NURSING PRACTICE Nurses have an integral role implementing and evaluating evidence-based practice guidelines for managing mucositis. When evidence is lacking and guidelines have gaps, nurses can play important roles in research to overcome these gaps.
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McGuire DB. Mucosal tissue injury in cancer therapy. More than muscositis and mouthwash. CANCER PRACTICE 2002; 10:179-91. [PMID: 12100102 DOI: 10.1046/j.1523-5394.2002.104009.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE The purpose of this article is as follows: 1) to describe the characteristics and scope of mucosal tissue injury associated with cancer treatment; 2) to discuss recent advances in related basic and clinical science; and 3) to articulate research needs and opportunities to be addressed through collaborative interdisciplinary research. OVERVIEW Mucosal tissue injury is both a direct and indirect consequence of cancer therapy, with manifestations that include damage and a number of other potentially serious sequelae. Current research in mucosal tissue injury is focused on the biology, immunology, and genetics of mucosal injury; clinical problems; assessment and management; and processes and outcomes of care. CLINICAL IMPLICATIONS Results from these various areas of research enhance the understanding of the mechanisms of mucosal tissue injury, provide direction for the development of policy and for clinical practice, and help to define research needs and opportunities. Future research on the complex process of mucosal tissue injury will be interdisciplinary and will cross the boundaries among basic, translational, and clinical science.
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Affiliation(s)
- Deborah B McGuire
- Deborah B. McGuire, PhD, RN, FAAN, Associate Professor, University of Pennsylvania School of Nursing, Philadelphia,Pennsylvania 19104, USA
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Abstract
OBJECTIVES To discuss examples of the process for evidence-based practice (EBP) and suggest helpful mechanisms for its support. DATA SOURCES Published review and research articles, textbooks, guidelines, and web sites. CONCLUSIONS Evidence-based practice requires a step by step process. Obtaining resources for EBP is essential to identifying and implementing and/or sustaining clinical care based on the best evidence available. IMPLICATIONS FOR NURSING PRACTICE Finding resources to conduct EBP activities is one of the more challenging aspects of this approach to maintaining and improving quality of clinical care. However, nurses have found creative ways to obtain needed resources to implement EBP.
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Affiliation(s)
- Liz Cooke
- Department of Nursing Research and Education, City of Hope National Medical Center, 1500 E. Duarte Rd, Duarte, CA 91010, USA
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