Introduction: Although cancer is the second leading cause of death globally, scientific progress has made possible a steady improvement in its therapeutic strategies. Alongside the evolution of conventional cancer treatments, there is an increasing use of CAM (from Complementary and Alternative Medicine), especially in the area of symptom management in the cancer patient. CAM includes nonpharmacological treatments. These, although still uncommon in nursing, have found considerable success as a supplement to traditional care in the cancer patient, proving to be a viable option in treating symptoms such as pain. Objective: The paper, through an analysis of the scientific literature, aims to ascertain the effectiveness of nonpharmacological therapies for the management of cancer pain, identifying the most effective treatments. Further objective of the review is to raise awareness of the use of these practices among healthcare professionals, with the aim of improving patient care. Method: A research question was formulated using the PIO method. Articles and reviews concerning the use of nonpharmacological therapies, published in the past five years, in full text, in English or Italian, and related to adult patients were selected. The search, conducted between June and October 2024, included biomedical sources published in PubMed, searched through the use of free terms, MESH and Boolean operators (AND/OR). Some articles were identified by hand searching, analyzing sources cited in bibliographies of publications previously selected by scanning methodology. Results: The reviewed studies highlight the effectiveness of nonpharmacological therapies, especially Complementary and Alternative Medicine, in pain management in cancer patients. Treatments such as acupuncture, massage, music therapy and exercise provide physical and psychological benefits, reducing the use of opioid drugs and improving overall well-being. In addition, the review highlights the importance of the role of nurses, who must ensure continuous and effective communication with patients, informing them about complementary therapies that can be integrated into the care pathway. Conclusions: Further studies to validate the efficacy of the nonpharmacological therapies analyzed and to evaluate their applicability on a large scale are essential. However, current evidence suggests that these practices can be integrated into cancer care, helping to significantly improve patients' quality of life and offering valuable support to traditional pharmacological treatments. Key words: “cancer,” “medical oncology,” “complementary therapies,” “pain management,” “nursing,” “nurse,” “nonpharmacological.”
Introduzione: Sebbene il cancro rappresenti la seconda causa di morte a livello globale, il progresso scientifico ha reso possibile un costante miglioramento delle sue strategie terapeutiche. Accanto all’evoluzione dei trattamenti oncologici convenzionali, si osserva un crescente ricorso alla CAM (dall’inglese Complementary and Alternative Medicine, Medicina Complementare e Alternativa), specialmente nell’ambito della gestione dei sintomi nel paziente oncologico. Della CAM fanno parte i trattamenti non farmacologici. Questi, benché ancora poco diffusi in ambito infermieristico, hanno riscontrato notevole successo come integrazione alle cure tradizionali nel paziente oncologico, dimostrandosi un’opzione valida nel trattamento di sintomi come il dolore. Obiettivo: L’elaborato, attraverso l’analisi della letteratura scientifica, si propone di appurare l’efficacia delle terapie non farmacologiche per la gestione del dolore oncologico, individuando i trattamenti più efficaci. Ulteriore obiettivo della revisione è sensibilizzare il personale sanitario in merito all’utilizzo di queste pratiche, con il fine di migliorare l’assistenza ai pazienti. Metodo: È stato formulato un quesito di ricerca utilizzando il metodo PIO. Sono stati selezionati articoli e revisioni riguardanti l’utilizzo delle terapie non farmacologiche, pubblicati negli ultimi cinque anni, in full text, in inglese o italiano, e relativi a pazienti adulti. La ricerca, condotta tra giugno e ottobre del 2024, ha incluso fonti biomediche pubblicate in PubMed, ricercate tramite l’utilizzo di termini liberi, MESH e operatori booleani (AND/OR). Alcuni articoli sono stati individuati mediante hand searching, analizzando fonti citate nelle bibliografie di pubblicazioni precedentemente selezionate mediante la metodologia scanning. Risultati: Gli studi esaminati evidenziano l’efficacia delle terapie non farmacologiche, in particolare modo della Medicina Complementare e Alternativa, nella gestione del dolore nei pazienti oncologici. Trattamenti come agopuntura, massaggio, musicoterapia ed esercizio fisico offrono benefici fisici e psicologici, riducendo l'impiego di farmaci oppioidi e migliorando il benessere generale. La revisione, inoltre, mette in luce l’importanza del ruolo del personale infermieristico, il quale deve garantire una comunicazione continua ed efficace con il paziente, informandolo riguardo alle terapie complementari integrabili nel percorso di cura. Conclusioni: Risultano fondamentali ulteriori studi per validare l'efficacia delle terapie non farmacologiche analizzate e per valutarne l'applicabilità su larga scala. Tuttavia, le evidenze attuali suggeriscono che queste pratiche possano essere integrate nella cura oncologica, contribuendo a migliorare significativamente la qualità della vita dei pazienti e offrendo un valido supporto ai trattamenti farmacologici tradizionali. Parole chiave: “cancro”, “oncologia medica”, “terapie complementari”, “gestione del dolore”, “nursing”, “infermiere”, “non farmacologico”.
Il dolore oncologico: l'efficacia dei trattamenti non farmacologici. Revisione della letteratura.
VALENTINI, DENISE
2023/2024
Abstract
Introduction: Although cancer is the second leading cause of death globally, scientific progress has made possible a steady improvement in its therapeutic strategies. Alongside the evolution of conventional cancer treatments, there is an increasing use of CAM (from Complementary and Alternative Medicine), especially in the area of symptom management in the cancer patient. CAM includes nonpharmacological treatments. These, although still uncommon in nursing, have found considerable success as a supplement to traditional care in the cancer patient, proving to be a viable option in treating symptoms such as pain. Objective: The paper, through an analysis of the scientific literature, aims to ascertain the effectiveness of nonpharmacological therapies for the management of cancer pain, identifying the most effective treatments. Further objective of the review is to raise awareness of the use of these practices among healthcare professionals, with the aim of improving patient care. Method: A research question was formulated using the PIO method. Articles and reviews concerning the use of nonpharmacological therapies, published in the past five years, in full text, in English or Italian, and related to adult patients were selected. The search, conducted between June and October 2024, included biomedical sources published in PubMed, searched through the use of free terms, MESH and Boolean operators (AND/OR). Some articles were identified by hand searching, analyzing sources cited in bibliographies of publications previously selected by scanning methodology. Results: The reviewed studies highlight the effectiveness of nonpharmacological therapies, especially Complementary and Alternative Medicine, in pain management in cancer patients. Treatments such as acupuncture, massage, music therapy and exercise provide physical and psychological benefits, reducing the use of opioid drugs and improving overall well-being. In addition, the review highlights the importance of the role of nurses, who must ensure continuous and effective communication with patients, informing them about complementary therapies that can be integrated into the care pathway. Conclusions: Further studies to validate the efficacy of the nonpharmacological therapies analyzed and to evaluate their applicability on a large scale are essential. However, current evidence suggests that these practices can be integrated into cancer care, helping to significantly improve patients' quality of life and offering valuable support to traditional pharmacological treatments. Key words: “cancer,” “medical oncology,” “complementary therapies,” “pain management,” “nursing,” “nurse,” “nonpharmacological.”File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/76125