Evaluating the effectiveness of an educational program on chemotherapy-induced peripheral neuropathy in enhancing competence among nurses in cancer care

Can Oncol Nurs J. 2025 Jul 1;35(4):533-553. doi: 10.5737/23688076354533. eCollection 2025.
[Article in English, French]

Abstract

Introduction: Chemotherapy-Induced Peripheral Neuropathy (CIPN) is a significant side effect that profoundly affects patients' quality of life (QOL). Nurses play a critical role to enhance CIPN care through assessments, patient education and symptom management This study aimed to evaluate the effectiveness of an educational program on CIPN in improving the competency of nurses in managing CIPN at Kenyatta National Hospital (KNH) in Kenya.

Methodology: Ethical approvals were obtained from the institutions' ethics and research committees. A pretest-posttest quasi-experimental design was utilized, involving 43 nurses at the Cancer Treatment Centre (CTC). Structured self-administered questionnaires were used for data collection in April 2023 (baseline) to February 2024 (6-month follow-up). A two-day training program was conducted in July/August 2023. Descriptive statistics and paired sample t-test were used for analysis. These findings yielded a comparison of an overall competency score with p < 0.005 as significant.

Results: There were 43 participants, of which 67.4% were females, 62.8% held diplomas in nursing, 27.9% had a Bachelor of Science in Nursing (BScN) degree. More than half (58.1%) had 5 years or less of oncology experience, and 83.7% lacked formal oncology training. Awareness of risk factors for CIPN significantly improved after the educational program, with knowledge of older patient age rising from 67.4% to 97.4% (P = 0.0005) and recognition of a history of smoking increasing from 60.5% to 92.3% (P = 0.0003). Knowledge of specific chemotherapy agents associated with CIPN surged from 16.3% to 56.4% (P = 0.0006). For knowledge about symptoms, muscle weakness awareness improved from 62.8% to 94.9% (P = 0.0008). Regarding treatment awareness, knowledge of duloxetine's effectiveness increased from 60.5% to 100% (P = 0.0001). For nurses' practices, responses for screening at baseline of "Never" decreased from 9.3% to 0%, and "Frequently" increased from 4.7% to 69.2%. Overall, the mean score for frequency of CIPN screening rose from 4.1 (standard deviation [SD] = 2.0) to 6.8 (SD = 1.4) (P = 0.0000). Both the overall CIPN knowledge score (p < 0 .0001) and practice scores (p < 0.0001) increased significantly. The overall competency score rose from a mean of 32.5 (SD = 7.8) to 46.1 (SD = 5.6) (p < 0.0001).

Conclusion and recommendation: CIPN education program was effective in improving competencies of nurses. There is need to establish a continuous medical education program on CIPN and chemotherapy effects and staff mentorship for better care. Additionally, the CIPN training needs to be integrated into the Ministry of Health's educational program.

Keywords: cancer care; chemotherapy-induced peripheral neuropathy; competence; education; nurses.