RESUMO
The purpose of this paper is to introduce the outline and describe the salient features of the "Joint Guidelines for Safe Handling of Cancer Chemotherapy Drugs" (hereinafter, "Guideline"), which were published in July 2015. The purpose of this Guideline is to provide guidance to protect against occupational exposure to hazardous drugs (HDs) to all medical personnel involved in cancer chemotherapy, including physicians, pharmacists, and nurses and home health-care providers. The Guideline was developed according to the Medical Information Network Distribution Service guidance for developing clinical practice guidelines, with reference to five authoritative guidelines used worldwide. PubMed, Cumulative Index to Nursing and Allied Health Literature, Ichushi-Web, and Cochrane Central Register of Controlled Trials were used for a systematic search of the literature. Eight clinical questions (CQs) were eventually established, and the strength of recommendation for each CQ is presented based on 867 references. The salient features of the Guideline are that it was jointly developed by three societies (Japanese Society of Cancer Nursing, Japanese Society of Medical Oncology, and Japanese Society of Pharmaceutical Oncology), contains descriptions including the definition of HDs and the concept of hierarchy of controls, and addresses exposure control measures during handling of chemotherapy drugs. Our future task is to collect additional evidence for the recommended exposure control measures and to assess whether publication of the Guideline has led to adherence of measures to prevent occupational exposure.
RESUMO
PURPOSE/OBJECTIVES: To develop an instrument to assess the specific symptoms of chemotherapy-induced taste alterations. DESIGN: Cross-sectional study. SETTING: Two outpatient chemotherapy centers in Kanto, Japan. SAMPLE: Convenience sample of 214 adult patients with chemotherapy-induced taste alterations. METHODS: Items on the chemotherapy-induced taste alteration scale (CiTAS) were developed by a qualitative study of patients with taste alterations, and the content validity of each item was assessed by a panel of specialized oncology nurses. Data were analyzed for item consistency using Cronbach alpha and construct validity using factor analysis. MAIN RESEARCH VARIABLES: Taste alterations, symptoms of discomfort, and impact of taste alterations on daily life. FINDINGS: An 18-item scale was developed with four dimensions identified through factor analysis: decline in basic taste, discomfort, phantogeusia and parageusia, and general taste alterations. The scale demonstrated excellent reliability (Cronbach alpha = 0.9) and test-retest reliability (r = 0.94, p < 0.001, n = 28), as well as good validity, which was indicated by its strong correlation with a visual analog scale of the impact of taste alterations on daily life (r = 0.62, p < 0.001) and by negative correlations with Short Form-8 quality-of-life measures (physical component summary, r = -0.33; mental component summary, r = -0.47). CONCLUSIONS: The CiTAS enabled valid, reliable measurement of specific symptoms of chemotherapy-induced taste alterations. The CiTAS has potential as a clinical tool and also could be used as a measure of chemotherapy-induced taste alterations in future studies. KNOWLEDGE TRANSLATION: The CiTAS may help evaluate the effectiveness of interventions to reduce the symptoms of taste alterations, such as administering zinc and self-care strategies.