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Raiber L, Raff C, Thiele J, Kramer K. Integrative Nursing Interventions for Cancer-Related Symptoms in Oncology Inpatients: Results of a Descriptive Pilot Study. Integr Cancer Ther 2024; 23:15347354241239930. [PMID: 38680047 PMCID: PMC11057344 DOI: 10.1177/15347354241239930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 02/05/2024] [Accepted: 03/01/2024] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND Integrative nursing (IN) is an essential component of integrative medicine and integrative oncology. IN includes a range of external naturopathic, integrative nursing interventions, such as compresses, embrocation, and foot/hand baths, aimed at alleviating symptoms and side effects of conventional treatment. The project IMPLEMENT-UKU ("Implementation of IN at the University Hospital Ulm") was accompanied by a descriptive pilot study on the use of IN interventions on cancer-related symptoms in oncology inpatients, the characterization of these patients and the evaluation of the impact. METHODS A single-arm study was conducted using a paper-based questionnaire administered before the IN interventions (t0) and 24 hours after the IN interventions (t1). Topics included sociodemographic data, symptoms, quality of life, health status, psychological burden, attitudes, and experience and satisfaction with the IN interventions. Analyses were descriptive using absolute and relative frequencies. RESULTS During the 6-month study period out of 66 patients recommended for IN consultation by medical and nursing staff on 2 wards, 62 (93.9%) accepted the offer. Of those patients who received IN, 21 patients (33.9%) participated in the study. The number of IN interventions received per patient ranged from 1 to 3 during the 24-hour survey period. And a total of 36 IN interventions were performed: The most treated body region was the feet/legs (50.0%), followed by the back (25.0%), using oils such as solum oil (41.7%) and lavender oil (13.9%). Embrocation (77.8%) was the predominant type of IN intervention. For patients, the mean FACIT-F score was 29.2 ± 12.5. The mean PHQ-4 score was 3.0 ± 1.9. Regarding sleep quality in the last 4 weeks, 13 participants (61.9%) described it as rather or very poor. Satisfaction with the IN was high, with a large proportion of participants evaluating the IN interventions very positively. CONCLUSION The study's findings suggest that there is a great need for IN among oncology inpatients. These patients are open to and interested in IN interventions and evaluate them positively. IN provides a promising opportunity to provide non-pharmacological support to inpatients. The integration of IN in conventional oncology care settings may enhance patient-centered care and contribute to improved patient wellbeing.
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Affiliation(s)
- Lea Raiber
- University Hospital Ulm, Ulm, Germany
- Interprofessional Graduate School for Integrative Medicine and Health, Witten/Herdecke University, Germany
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Stolz R, Kaschdailewitsch E, Kröger B, Noack B, Mahler C. [Evidence-based naturopathic nursing interventions in pain management]. Schmerz 2023; 37:336-343. [PMID: 37039897 PMCID: PMC10511583 DOI: 10.1007/s00482-023-00705-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 04/12/2023]
Abstract
Nurses are confronted with patients suffering from acute and/or chronic pain in all nursing care settings and within all target groups. Although national and international guidelines on chronic pain emphasize the importance of non-pharmacological interventions (for example, hot and cold applications) and educational approaches such as teaching self-management strategies to deal with pain, the most common applied intervention for chronic and acute pain is a pharmacological therapy. The aim of this article is to provide an overview of the potential of naturopathic nursing interventions for the care of patients with chronic and/or acute pain, focusing on so-called external applications such as wraps and compresses, which are safe, have a low-risk profile and are easy to apply, thus making them suitable for self-application. The use of non-pharmacological interventions as well as the counselling and training of patients in naturopathic applications offer nurses the possibility to work in an autonomous field of nursing promoting nursing as an attractive health profession.
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Affiliation(s)
- Regina Stolz
- Institut für Allgemeinmedizin und Interprofessionelle Versorgung, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - Elke Kaschdailewitsch
- Institut für Allgemeinmedizin und Interprofessionelle Versorgung, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - Birgit Kröger
- Institut für Allgemeinmedizin und Interprofessionelle Versorgung, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - Bettina Noack
- Institut für Allgemeinmedizin und Interprofessionelle Versorgung, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - Cornelia Mahler
- Abteilung Pflegewissenschaft, Institut für Gesundheitswissenschaften, Universitätsklinikum Tübingen, Hoppe-Seyler-Str. 9, 72076, Tübingen, Deutschland.
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Klafke N, Bossert J, Kröger B, Neuberger P, Heyder U, Layer M, Winkler M, Idler C, Kaschdailewitsch E, Heine R, John H, Zielke T, Schmeling B, Joy S, Mertens I, Babadag-Savas B, Kohler S, Mahler C, Witt CM, Steinmann D, Voiss P, Stolz R. Prevention and Treatment of Chemotherapy-Induced Peripheral Neuropathy (CIPN) with Non-Pharmacological Interventions: Clinical Recommendations from a Systematic Scoping Review and an Expert Consensus Process. Med Sci (Basel) 2023; 11:medsci11010015. [PMID: 36810482 PMCID: PMC9944490 DOI: 10.3390/medsci11010015] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 12/14/2022] [Accepted: 12/23/2022] [Indexed: 01/31/2023] Open
Abstract
Background: Most individuals affected by cancer who are treated with certain chemotherapies suffer of CIPN. Therefore, there is a high patient and provider interest in complementary non-pharmacological therapies, but its evidence base has not yet been clearly pointed out in the context of CIPN. Methods: The results of a scoping review overviewing the published clinical evidence on the application of complementary therapies for improving the complex CIPN symptomatology are synthesized with the recommendations of an expert consensus process aiming to draw attention to supportive strategies for CIPN. The scoping review, registered at PROSPERO 2020 (CRD 42020165851), followed the PRISMA-ScR and JBI guidelines. Relevant studies published in Pubmed/MEDLINE, PsycINFO, PEDro, Cochrane CENTRAL, and CINAHL between 2000 and 2021 were included. CASP was used to evaluate the methodologic quality of the studies. Results: Seventy-five studies with mixed study quality met the inclusion criteria. Manipulative therapies (including massage, reflexology, therapeutic touch), rhythmical embrocations, movement and mind-body therapies, acupuncture/acupressure, and TENS/Scrambler therapy were the most frequently analyzed in research and may be effective treatment options for CIPN. The expert panel approved 17 supportive interventions, most of them were phytotherapeutic interventions including external applications and cryotherapy, hydrotherapy, and tactile stimulation. More than two-thirds of the consented interventions were rated with moderate to high perceived clinical effectiveness in therapeutic use. Conclusions: The evidence of both the review and the expert panel supports a variety of complementary procedures regarding the supportive treatment of CIPN; however, the application on patients should be individually weighed in each case. Based on this meta-synthesis, interprofessional healthcare teams may open up a dialogue with patients interested in non-pharmacological treatment options to tailor complementary counselling and treatments to their needs.
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Affiliation(s)
- Nadja Klafke
- Department of General Practice and Health Services Research, University Hospital Heidelberg, 69120 Heidelberg, Germany
- Correspondence:
| | - Jasmin Bossert
- Department of General Practice and Health Services Research, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Birgit Kröger
- Institute for General Practice and Interprofessional Care, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Petra Neuberger
- National Center for Tumor Diseases, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Ute Heyder
- Women’s Clinic, Community Hospital Karlsruhe, 76133 Karlsruhe, Germany
| | - Monika Layer
- Center for Integrative Medicine, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland
| | - Marcela Winkler
- Department of Naturopathy and Integrative Medicine, Robert-Bosch-Krankenhaus, 70376 Stuttgart, Germany
| | - Christel Idler
- Department of Naturopathy and Integrative Medicine, Robert-Bosch-Krankenhaus, 70376 Stuttgart, Germany
| | - Elke Kaschdailewitsch
- Center for Integrative Oncology, Die Filderklinik, 70794 Filderstadt-Bonlanden, Germany
| | - Rolf Heine
- Anthroposophic Nursing Network in Germany, Academy for Nursing Professions at the Filderklinik, Die Filderklinik, 70794 Filderstadt-Bonlanden, Germany
| | - Heike John
- Clinic for Radiation Therapy and Special Oncology, Hannover Medical School, 30625 Hannover, Germany
| | - Tatjana Zielke
- Clinic for Radiation Therapy and Special Oncology, Hannover Medical School, 30625 Hannover, Germany
| | - Beeke Schmeling
- Clinic for Radiation Therapy and Special Oncology, Hannover Medical School, 30625 Hannover, Germany
| | - Sosamma Joy
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, 45136 Essen, Germany
| | - Isabel Mertens
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, 45136 Essen, Germany
| | - Burcu Babadag-Savas
- Clinic for Radiation Therapy and Special Oncology, Hannover Medical School, 30625 Hannover, Germany
| | - Sara Kohler
- Department of Health, Zurich University of Applied Sciences, 8401 Winterthur, Switzerland
| | - Cornelia Mahler
- Department of Nursing Science, Institute of Health Sciences, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Claudia M. Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zürich and University of Zürich, 8091 Zürich, Switzerland
| | - Diana Steinmann
- Clinic for Radiation Therapy and Special Oncology, Hannover Medical School, 30625 Hannover, Germany
| | - Petra Voiss
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, 45136 Essen, Germany
| | - Regina Stolz
- Institute for General Practice and Interprofessional Care, University Hospital Tübingen, 72076 Tübingen, Germany
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