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
than those who did not suffer from motion sickness. However the
findings from this study did not confirm their findings. At the risk
assessment prior to treatment, twenty patients reported suffering
from motion sickness; eight of these were in the intervention group
and twelve in the control group, but the patients in the control
group reported less nausea and vomiting. Sixteen patients reported
suffering from emesis in pregnancy with equal numbers in each
group. Thirteen patients were identified as having moderate levels
of anxiety and only five of these were in the intervention group.
Many researchers suggest that anxiety increases the potential for
ANV (Love et al 1882; Andrykowski and Gregg 1992; Pickett 1991;
Morrow 2002) and higher levels of nausea and vomiting. The
findings from this study suggest that the patients in the control
group had higher levels of anxiety than those in the intervention
group but the patterns of nausea and vomiting reported by the
control group were lower. Eleven patients in total were under fifty
years, four of these were in the intervention group.
Considering the risk factors and the numbers of patients identified
as being at risk of developing ANV in both groups at preassessment,
the patterns of nausea and vomiting reported did not
reflect the potential numbers identified. There were more patients
identified as having potential tendencies to suffer from nausea and
vomiting in the control group, however the patterns for both nausea
and vomiting were lower in this group of patients. It may be that
the recording of symptoms in the DDCs produced a conditioned
response and therefore induced more episodes of nausea and
vomiting in the intervention group, or another explanation for this
may have been less reliable recording of symptoms by the patients
in the control group. Many patients receiving 5FU chemotherapy
(which is expected to induce much less sickness) described
incidence of nausea and vomiting and ANV throughout their
treatment, and some of the patients interviewed who had received
5FU chemotherapy described nausea as the most distressing
symptom of their treatment ‘and having to complete the DDC every
day did not help’.
Several patients in the intervention group reported taking extra
antiemetics to help combat their nausea. Anti-emetics do not
control ANV once it has developed, and indeed has been found by
some researchers to paradoxically increase symptoms (Harman
1996; Olver 2005) perhaps by causing a conditioned stimulus
themselves. As a learned phenomenon, ANV is treatable by means
of behavioural approaches based on learning principles such as
progressive muscle relaxation training, systematic desensitisation,
hypnosis and cognitive distraction.
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