Design and Validation of Evidence-Based Peripheral Chemotherapy-Induced Neuropathy Guideline Among the Children with Cancer

Pouy, Somaye; Taheri Ezbarami, Zahra; Darbandi, Bahram; Baghersalimi, Adel; Bidabadi, Elham; Enshaei, Mercedeh; Ashoobi, Mohammad Taghi; Javadi-Pashaki, Nazila

doi:10.31557/APJCP.2026.27.10.3669

Design and Validation of Evidence-Based Peripheral Chemotherapy-Induced Neuropathy Guideline Among the Children with Cancer

Document Type : Research Articles

Authors

¹ Social Determinants of Health Research Center, Trauma Institute, Guilan University of Medical Sciences, Rasht, Iran.

² Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.

³ Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.

⁴ Department of Surgery, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran.

⁵ Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University, Rasht, Iran.

10.31557/APJCP.2026.27.10.3669

Abstract

Objective: Chemotherapy induced peripheral neuropathy (CIPN) is a frequent and debilitating complication among children receiving chemotherapy, yet evidence based clinical guidance specific to pediatrics remains limited. This study aimed to develop and validate a clinical guideline for managing CIPN in children using the Stetler model. Methods: This methodological study applied the five phase Stetler model (Preparation, Validation, Decision Making, Application, and Evaluation) to develop the guideline. A systematic search was performed in multiple databases, including PubMed, Cochrane Library, and Scopus, without time restrictions, and 89 studies met the inclusion criteria. Content validity was assessed using the Content Validity Ratio (CVR) and Content Validity Index (CVI). A panel of experts (physicians and nurses) evaluated the guideline using the AGREE II tool. The final guideline included three components: protocol, diagnosis/treatment, and patient education. Results: The guideline achieved high scores in Purpose and Scope (92%), Stakeholder Involvement (84%), and Rigor of Development (81%). Evidence supported the use of Pyridoxine and Pyridostigmine for pediatric CIPN management. The TNS-PV and ped-mTNS tools were identified as appropriate for neuropathy assessment in children aged 5–18 years. Identified implementation challenges included workforce shortages and the need for specialized training. Conclusion: This evidence-based guideline provides structured recommendations for the assessment and management of pediatric CIPN. While both pharmacological and non-pharmacological strategies show promise, further research across diverse pediatric populations is recommended.

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