Best evidence summary for management of pruritus in patients with cholestasis
Objective To evaluate and summarize the best evidence for the management of pruritus in patients with cholestasis,and to provide reference for clinical nursing practice in the treatment of pruritus caused by cholestasis.Methods An evidence-based nursing approach and the"5S"evidence model were employed to search for relevant evidence on the management of pruritus in cholestatic patients,including clinical decision-making,guidelines,expert consensus,evidence summaries,and systematic reviews from both domestic and international sources.Two researchers with background in evidence-based medicine independently assessed the quality of the literature and rated the evidence level,extracting the evidence meeting the criteria.Results A total of 18 articles were collected,including 4 clinical decision-makings,2 guidelines,2 evidence summaries,6 systematic reviews,and 4 expert consensuses.Twenty-three pieces of best evidence were summarized into eight areas:pruritus assessment,management of pruritus etiology,skin care,topical treatments,systemic medications,surgical treatments,adjunctive therapies,and psychological interventions.A management protocol for pruritus in cholestatic patients was developed.Conclusion In clinical practice,healthcare professionals should consider patient conditions and preferences to develop personalized treatment plans so as to improve the quality of life for patients.