Evaluation of Oncology/Hematology Nurses' Proficiency in Assessing Lower-Extremity Skin and Edema in Patients with Cancer: An Observational Study.

Objective: To assess the competency of oncology/hematology nurses in evaluating the lower extremities of patients with cancer for skin conditions and edema.

Methods: This prospective and descriptive observational study was conducted with patients in a university hospital's 48-bed oncology/hematology service. Patients with cancer admitted to the oncology/hematology service were examined independently by three evaluators (two nurse researchers and the patient's primary nurse) daily. Interrater reliability for assessing patients' right and left legs was determined using Fleiss κ statistics for categorical variables.

Results: The study revealed a high degree of agreement among the three evaluators in the assessment of skin surface, skin color, and presence of petechiae and rashes on the right and left leg, as well as itching on the left leg. However, only moderate agreement was found for temperature assessment, ecchymoses edema on the left and right leg, and itching on the right leg. The reliability of the two researcher nurses' assessment of edema on the right and left legs was excellent.

Conclusions: Although the agreement between the two researcher nurses was near excellent, only moderate agreement was observed among all evaluators in the edema assessment. The result underscores the importance of healthcare providers' knowledge and enhancing clinical skills through innovative training strategies.