Assessment tools It has been established that there are at present no adequate forms of preventing CIPN (Cavaletti, 2014). Additionally, CIPN is often under-rated and under-reported particularly as patients do not like to miss treatments (Stubblefield et al., 2009). Therefore, comprehensive evaluations using standardized and sensitive assessment tools to prevent severe neurotoxicity are a critical step for early intervention. According to Stubblefield et al. (2012), it is essential a baseline assessment including any preexisting neuropathy and predisposing factors, such as diabetes, be performed prior to initiation of treatment. This baseline assessment should include not only subjective symptoms, but assessment of strength, reflexes and …show more content…
This is a patient questionnaire that uses a score of 0-4 to assess subjective neuropathic symptoms (Functional Assessment of Chronic Illness Therapy, 2007).
The Total Neuropathy Score (TNS), initially was used to assess diabetic neuropathy, utilizes objective criterion, such as pin prick, with a subjective account of all neuropathic areas including sensory, autonomic and motor (Curcio, 2016). However, it is too time consuming for nurses to use routinely (Curcio, 2016). The Total Neuropathy Score – clinical version (TNSc) was recommended for broader use (Curcio, 2016). This abbreviated version which was developed is more sensitive than other tools including the NCI-CTCAE (Curcio, 2016). In a systematic review by Haryani et al. (2017) similar conclusions were realized. They analyzed nineteen studies and twenty CIPN assessment tools and determined that both the FACT/GOG-Ntx and TNSc were recommended (Haryani et al., 2017). Further, since CIPN is more subjective than objective in nature, utilizing the FACT/GOG—Ntx first, followed by a provider validation using the TNSc is suggested (Haryani et al., 2017).
In the clinical setting, it would be advantageous to facilitate the use of a self-administered neurotoxicity portion of the FACT/GOG questionnaire. The at risk chemotherapy patient could complete it upon arrival to the infusion center. This could be followed by performing the abbreviated TNSc, which would consist of a
Patients are asked to rate their symptom for each question for a period of two weeks. The patient is the one who rates himself, therefore, this instrument’s results are subjective. The sum total is the calculated, and interpreted to
Importantly, in any patients with neuropathy and specifically patients with a severe form,it is essential to rule out any other causes apart from diabetes such as ,drug induced neuropathy (e.g. isoniazid) , alcohol abuse, nutritional deficiency like vitamin B12 deficiency(Wile DJ,et al 2010),vasculitis , inherited neuropathies, and renal disease (Freeman R.2009)
Validity: Overall the study is valid but limited as the study examined individual patients as a single case making the ability to generalize limited. The foremost dilemma with the study is the challenge in determining the difference in scores that correspond directly to a clinically important modification. The ability of the VAS to detect significant changes relies heavily on an established baseline as a standard to compare future data. Throughout the duration of the study, patients were asked frequently to complete the VAS and RMQ, this may possibly lead to learning effects which may impact the results of the pain and functional status
Most of the patients that I have encountered are diagnosed with Diabetic Neuropathy (DN). Diabetic Neuropathy is a brought about by a complication of Type 1 and Type 2 Diabetes. In 2012, there are about 29.1 million Americans, or 9.3% of the population, had diabetes (American Diabetes Association [ADA], 2016). Due to its increase
The discussion of improving the quality of life of these patients was also a bid discussion. Peripheral neuropathy can have a large impact on a person’s day-to-day activities, and disrupt sleep patterns. With this these patients are at risk for injury, decrease mobility, and isolative behaviors (Sibbald, G. 2012). What I learned most from this article was that there are many ways to treat the pain of this disease, and we need to look into the best option for our patients. By doing this we will have a greater chance of improving their quality of life.
They started by getting an overview of what was already being done to assess pain. “Only 60% of patients (n=923) were evaluated by a nurse using an accepted pain scale during their visit.” Surprised by the lack of pain assessment, they began the protocol in a community hospital. The beginning results were lower than most people want to see; only one third of the patients who had gone to the emergency room for pain related reasons got treated. Since there was a lack of pain documentation and
The participants recorded their pain during activity using the numerical rating scale (NRS) during the initial examination. The participants received three IASTM treatments a week
Health assessments are done by nurses every single time a patient walks into the clinical setting. The definition of health assessment is the collection of the patient’s data to have an understanding of one’s health and therefore determines what type of data should be collected (Forbes & Watt, 2012, pg 2). There are two major components of health assessment: the health interview and the physical examination (Forbes & Watt, 2012, pg 2). The health interview is (subjective data) is what the patient says about their health history during the health interview to the examiner (Forbes & Watt, 2012, pg 2). Subjective data then can be broken down into two categories, primary subject and secondary subjective data (Forbes & Watt, 2012, pg 2). Primary
Accurate therapeutic response assessment is of paramount importance in a clinical setting where decisions need to be taken about whether to continue or change a treatment regime. Validated methods of therapeutic response assessment also have a major role in the development of new drugs. Identification of potential responders or non-responders and identification of the at risk population for side effects
3. Family processes, altered, related to child’s illness or hospitalization as evidenced by illness of family member, separation from siblings and parents.
There is no doubt that neuropathy robs us some of the best moments in our life because we cannot anything because of pain. Honestly speaking, this
A VAS for pain intensity provides a quantitative measure of subjective pain and a total functional
In some instances, chronology of onset of behavioural, cognitive and Parkinsonian symptoms was not clear and it was difficult to differentiate PDD from DLB [29]. The duration of neuropsychiatric symptoms prior to the initiation of CHEI therapy varied largely from few months up to ten years. The presence and the degree of cognitive impairment and Parkinsonism also varied largely. The common symptoms prompted the CHEI treatment
Patients were followed up, mRS at 3 months was assessed. After that patients were followed up at one year. Outcome were categorized as neurologically excellent without any symptoms (modified Rankin Scale 0), good (modified Rankin Scale 1 or 2) and poor (modified Rankin Scale score >2).
Volovska (2016) highlighted that it is essential to use an appropriate assessment tools when evaluating patient’s pain to monitor whether the therapy that patient received is effective for early detection of regression.