Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
number of factors that could impact on the care that oncology
nurses provide to patients undergoing chemotherapy.
This study has clearly demonstrated that using DDCs to collect
information from patients undergoing chemotherapy, especially in
relation to their nausea and vomiting symptoms, can provide useful
information. The information obtained from the DDCs, the QOL
questionnaires and the semi-structured interviews indicate that the
range of side-effects experienced by patients can be extensive.
Patients reported and described a range of both psychological and
physical symptoms as being problematic at some stage of their
chemotherapy treatment. In an attempt to cope with the sideeffects
of the chemotherapy treatment, complementary therapies
were used by several patients to assist them in combating some of
the difficult symptoms such as nausea.
Section 1: Patterns of nausea and vomiting
Cytotoxic chemotherapy has a reputation for causing severe and
unpleasant side-effects. Those most frequently reported by patients
are nausea and vomiting (Lee et al 2005; Kaye 1991). Patients
have reported that nausea and vomiting are their first concern when
receiving chemotherapy (Dibble et al 2004; Morrow 2002) and it
was an issue raised by most of the participants in this study.
The most dramatic development in recent years has been the
introduction of highly selective antagonists of the type three
serotonin receptor anti-emetics. These anti-emetics are now used
widely in the prevention of nausea and vomiting in cancer patients
with variable success (Grunberg et al 2004) and all patients in this
study received them. Patterns of nausea and vomiting from the
DDCs and nausea and vomiting scores from the RSCL were explored
in this study and the results suggest that nausea and vomiting is
still a problem for patients undergoing chemotherapy. The nausea
and vomiting scores from the RSCL from baseline and between
courses showed that the patients in the intervention group had
more nausea and vomiting episodes than the patients in the control
group.
The characteristics of the patients in both groups were similar at
baseline so perhaps the daily reporting of nausea and vomiting
episodes in the DDCs reminded patients in the intervention group of
their chemotherapy and induced more nausea, but particularly more
vomiting episodes. As in Pavlov’s classical conditioning paradigm,
the injection of chemotherapy drugs (unconditioned stimulus)
produced physiological nausea and vomiting (unconditioned
response). The pairing of neutral stimuli, the daily diary cards, with
the injection of the drugs (unconditioned stimulus) results in these
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