الفهرس 
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Abstract
SUMMARY
Breast cancer is the most common cancer and the second leading cause of cancer death in women. Occurring most commonly in post-menopausal women, risk increases with age. Yet early-onset breast cancer (i.e., breast cancer diagnosed in women younger than 45 and below the routine screening age) still occurs. In fact, 11 % of all new breast cancer case are early-onset. Early-onset breast cancers tend to have the most aggressive tumors and poorer survival, including in early-stage diseases than in cancers in screening age women (Huq et al., 2023).
Chemotherapy is an aggressive form of chemicals drug therapy meant to destroy rapidly growing cells in the body. It is usually used to treat cancer, reduce likelihood of cancer spreading, reduce current symptoms and shrink tumor size. Also it used in combination with other therapies such as surgery, radiation, or hormone therapy this depend on: stage of cancer, overall health status and previous treatment the patient had (Himmat & Ajinath, 2020).
Peripheral neuropathy refers to the many conditions that involve damage to the peripheral nervous system, which is a vast communications network that sends signals between the central nervous system (the brain and spinal cord) and all other parts of the body. Peripheral neuropathy, according to the National Institute of Neurological Disorders, is a condition involving damage to the peripheral nervous system, with symptoms such as muscle weakness, painful cramps, muscle shrinking and uncontrolled muscle twitching (Hammi and Yeung, 2022).
Chemotherapy-induced peripheral neuropathy (CIPN) might manifest minutes after chemotherapy and disappear within 2–3 days, or it can persist decades after chemotherapy has ended. The use of freezing gloves and socks reduced the likelihood of docetaxel-induced CIPN. Cryotherapy not only inhibits the release of vasodilation chemicals, hence decreasing the sensitivity of pain receptors, but it also decreases muscle spasms by decreasing nerve conduction velocity and muscle excitability. Regional hypothermia therapy can reduce regional perfusion, metabolic rate, and cell chemical activity in order to alleviate chemotherapy-related symptoms (Xu et al., 2023).
Aim of the study:
The aim of this study was to assess the effect of cryotherapy on peripheral neuropathy among patients with breast cancer during chemotherapy through the following:
Assessing patients complain pre application of cryotherapy technique.
Designing and implementing cryotherapy technique based on needs and assessment.
Evaluating the effect of cryotherapy application on patient with peripheral neuropathy pre and post intervention.
Research hypotheses:
This study was hypothesized the following:
Patients with breast cancer, who exposed to cryotherapy have alleviation of pain intensity, numbness, tingling and muscles weakness than those who don’t exposed.
Patients with breast cancer, who exposed to cryotherapy have improvement in their daily life activities than those who don’t exposed.
A- Research Design
Quasi experimental design (pre-posttest) was utilized to perform the study.
B- Study Setting
The study was conducted at national cancer institute affiliated to Cairo University (breast hospital in the first settlement), Cairo government, Egypt.
C- Study Subjects
The study subjects included a purposive sample of (n=77) patients from the previously mentioned department:
Tools of Data Collection
Data for this study was collected by using the following tools:
Tool (1): Patient Assessment Interview Questionnaire: it was designed to assess the data as clear in the following parts:
Part (1): Patients characteristics: it was concerned with adult patient’s personal data such as age, gender, occupation, level of education and residence.
Part (2): Medical Data: it was concerned with collect data regarding diagnosis, medical history, weight, height, grade of breast cancer, type of chemotherapy, and dose schedule.
Tool (2): Neuropathic Pain Symptom Inventory (NPSI)
Tool (3) Brief Pain Inventory: The BPI score was used to assess the patient’s pain experience
Tool (4) Kendall chart: It was used to assess muscles strength of patient pre and post cryotherapy application
Results:
The current study result showed that about half of the studied patients were more than 45 years old while only one tenth of them were from 20 to 30 years old. Regarding gender, the majority of them were females. As regards level of education, less than two thirds of them were literates. According to occupation, most of them were not working.
Describeed levels pain severity of the studied patients, more than two thirds of them had moderate level of pain severity pre application of cryotherapy technique, while more than two thirds of them had low level of pain severity post application of cryotherapy technique
General activity, more than two thirds of patients had sever interfere before application of cryotherapy technique, while more than two fifths of them had moderate interfere post application of cryotherapy technique with p=.000.
Regarding to mood, slightly more than two fifths of patients had moderate interfere before application of cryotherapy technique, while less than half of them had mild interfere post application of cryotherapy technique
According to walking ability, less than half of patients had moderate interfere before application of cryotherapy technique, while more than two fifths of them had mild interfere post application of cryotherapy technique.
As regard to normal work, more than half of patients had moderate interfere before application of cryotherapy technique, while slightly more than half of them had mild interfere post application of cryotherapy technique.
According to relations with other people, less than two thirds of patients had mild interfere before application of cryotherapy technique, while less than two thirds of them had mild interfere post application of cryotherapy technique.
As regard to sleep, more than half of patients had sever interfere before application of cryotherapy technique, while more than two fifths of them had mild interfere post application of cryotherapy technique.
Regarding to Enjoyment of life, less than half of patients had sever interfere before application of cryotherapy technique, while half of them had moderate interfere post application of cryotherapy technique
Revealed pain interference levels of the studied patients, less than three quarters of them had moderate level of pain interference pre application of cryotherapy technique, while less than two thirds of them had low level of pain interference post application of cryotherapy technique.
Revealed total pain inventory levels of the studied patients, more than three quarters of them had moderate level of total pain inventory pre application of cryotherapy technique, while more than two thirds of them had low level of total pain inventory post application of cryotherapy technique.
Regarding total neuropathic pain symptom inventory levels pre and post application of cryotherapy technique, less than two thirds of them had moderate level pre application of cryotherapy technique, while most of them had low level post application of cryotherapy technique.
Conclusion
In the light of the current study findings, it can be concluded that:
Cryotherapy improved symptoms of peripheral neuropathy and daily life activities among patients with breast cancer during chemotherapy
Recommendations
Based on the current study finding the following recommendations were proposed:
Larger trials that utilize consistent cryotherapy administration techniques, is necessary to further define the role of cryotherapy for the prevention of Chemotherapy induced peripheral neuropathy
Healthcare professionals should consider it in the clinical practice to contribute to patients’ quality of life, as monitoring the symptoms of Chemotherapy induced peripheral neuropathy is a fundamental requirement to contribute to wellbeing.
Increase high risk patients’ awareness toward cryotherapy therapy regarding Chemotherapy induced peripheral neuropathy through educational programs
Replication of the study with large number to generalize the result