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
biases. Therefore, when looking at compliance, researchers need to
understand that a completed diary card or indeed a quality of life
questionnaire may not always be a true representation of a patient’s
symptoms or experience.
Section 3: Psychological Issues
Anxiety
Many researchers have suggested that an increase in anxiety levels
pre chemotherapy and throughout treatment can contribute to
increased levels of nausea and vomiting (Blasco et al 2000;
Andrykowski ang Gregg 1992). Therefore, as a secondary objective
of this study, the anxiety and psychological distress levels were
measured using the HADS and the RSCL for patients in both the
intervention and the control groups. Detecting and managing
anxiety and depression in physically ill individuals, and especially
those with cancer, can be difficult. Normal fears of death,
disfigurement, pain and disruption of relationships may be
especially difficult to distinguish from severe, disabling distress far
beyond normal anxiety or depression. Receiving chemotherapy has
been likened to riding a ‘psychological roller coaster’ of alternating
sickness and health (Cohn 1982). The RSCL and the HADS
questionnaires which were used to measure psychological morbidity
included subscales such as irritability, worrying, depressed mood,
nervousness, despairing about the future, tension and anxiety.
Anxiety and depression were measured by both the RSCL and the
HADS in this study. The findings showed that there was a
statistically significant difference between the mean scores noted on
all the psychological factors of the intervention and control groups
following the first cycle of chemotherapy with the scores in the
intervention group being significantly lower than those in the control
group. This was surprising but may have been due to the fact that
all the patients in the intervention group were assessed and
supported throughout their treatment by a member of the research
nursing team whereas the patients in the control group were seen
routinely by the medical or chemotherapy nursing teams. In a study
conducted by Hope-Stone et al (1997) using the RSCL for patients
with advanced colorectal cancer undergoing phase I/II studies, it
was concluded that their quality of life was not adversely affected
and this in part was attributed to the high level and intensity of
support they received from the research nurses. In this study, the
support given to the intervention group of patients by the research
nursing team was more intensive than the control group and
perhaps this attributed to the difference in their psychological
scores.
The diagnosis, course and treatment of cancer has extensive
psychological repercussions for the individual and their family
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