Development of evidence-based nursing recommendations for hand-foot syndrome in breast cancer chemotherapy patients

Objective To develop evidence-based nursing recommendations for managing hand-foot syndrome (HFS) in breast cancer patients undergoing chemotherapy. Methods Based on the JBI evidence-based healthcare model, relevant literature was systematically reviewed. Following group analysis and discussion, preliminary nursing recommendations were drafted. Subsequently, two rounds of Delphi expert consultation were conducted two weeks apart with twenty experts from breast surgery, dermatology, and pharmacy departments across ten tertiary Grade A hospitals located in Beijing, Shanghai, Guangzhou, Henan, Qinghai, and other regions. Expert feedback was used to revise and refine the recommendations, resulting in a final version. Results The response rate for both rounds of expert consultation was 100%. The expert authority coefficients were 0.854 and 0.862, respectively, indicating strong expertise and reliable judgments. The coefficients of variation for expert ratings across the indicators ranged from 0.00 to 0.41 in the first round and from 0.00 to 0.13 in the second round. Kendall’s coefficients of concordance among experts across all indicators were 0.214 and 0.312, respectively (P<0.001), indicating a satisfactory level of expert consensus. The finalized nursing recommendations comprise 6 first-level domains (Assessment, Basic Prevention, Care During Treatment, Health Education, Psychosocial Support, and Follow-up) and 29 second-level items. Conclusion The evidence-based nursing recommendations developed in this study demonstrate strong scientific rigor and practical applicability. It can serve as a reference for managing HFS in breast cancer patients undergoing chemotherapy and have potential for clinical implementation and broader dissemination.