Congress Abstracts 2005

38

HAND-FOOT SYNDROME: WHATS NEW IN 2005? AN UPDATE ON CURRENT MANAGEMENT STRATEGIES. Gail Wilkes, RNC, ANP, MS, AOCN^®, Boston Medical Center, Boston, MA.

Hand foot syndrome (HFS) continues to challenge patients and their nurses. Etiology and standards of practice are unclear, as evidence based practice recommendations for nurses are lacking. This poster will provide an update that reflects the state of the science and best practice in 2005.

The purpose of this poster is to present potential pathophysiologic mechanisms in the development of HFS, and the strength of evidence of current and newly studied prevention/management strategies. HFS is a dose-limiting toxicity of liposomal doxorubicin and the 5-FU prodrug, capecitabine, and can severely impair quality of life. Many nursing strategies are based on anecdotal evidence, such as teaching patients to use emollients on the skin and to avoid heat. Three new interventions have been tested to prevent HFS: celecoxib, dexamethasone, and local cooling. The conceptual model of evidence based practice will be used to develop the poster.

This poster will identify potential mechanisms in the pathophysiology of HFS, the evidence base of strategies used in the prevention and management of HFS, and an evidence-based decision tree to assist oncology nurses in their practice and patient education.

1. Describe potential mechanisms of HFS
2. Discuss the evidence base for currently used nursing interventions
3. Describe the strength of evidence for the use of dexamethasone or local cooling in the prevention of HFS related to liposomal doxorubicin, and celecoxib in the prevention of HFS related to capecitabine.

Nurses are experts in symptom management, and HFS can cause symptoms that severely compromise a patient’s quality of life. Nurses must be current in their knowledge about the pathophysiology of HFS, as well as the evidence base for interventions to prevent or minimize the development of HFS, and to manage HFS if it occurs. Nurses use this knowledge to empower patients and their families to prevent or minimize the development of HFS, and to manage it if it occurs. Finally, this is an evolving science, so specific areas that require nursing research will be identified.