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
the other difficulties that patients experience when undergoing
adjuvant chemotherapy for breast or colorectal cancer were also
explored. In addition, strategies for adaptation that patients used
throughout their treatment were explored further in interviews and
it was therefore valuable to use qualitative methods to complement
the RCT.
Seventy-one patients were recruited into this study. Thirty-three
patients were randomised to the intervention group and they
completed DDCs. From this group of patients ten were purposely
chosen to take part in semi-structured interviews. The qualitative
interviews revealed specific issues of importance for the patients.
This study has demonstrated that using DDCs to collect information
from patients undergoing chemotherapy, especially in relation to
their nausea and vomiting symptoms, is useful to health care
professionals.
The patterns of nausea and vomiting varied between the groups,
the patients in the intervention group documenting more vomiting
episodes than the patients in the control group. The overall
incidence of vomiting reported by patients was low and it appears to
be controlled by the 5-HT3 antagonists. However, most patients still
reported nausea as being problematic despite the improvements
made over the years in the management of vomiting. Anticipatory
nausea and vomiting was recorded on the DDCs as being
problematic for some patients especially females receiving FEC
chemotherapy for breast cancer. However, overall there was no
significant difference noted from the nausea and vomiting scores
from the RSCL between the two groups. Therefore, the research
hypothesis that DDCs cause an increase in symptoms and evokes a
conditioned response to treatment was not supported and the null
hypothesis stands.
Compliance with the completion of the DDCs was found to be an
issue with some patients in that they did not complete them as
instructed. Health care professionals and researchers need to be
aware of this as it could lead to serious biases whose magnitude is
difficult to assess. The completion of the DDCs had different effects
on patients with some describing how completing them made them
feel better and gave them some control over their treatment.
Others, however, said the DDCs reminded them of their illness and
they described how they hid them from their families as they did
not want them to be reminded either. One patient was very
distressed that the word cancer appeared on the DDCs. She
suggested that it was such a scary word it should not have been
included on it. Perhaps for some patients completing the DDCs was
similar to a classical conditioning response in that each time they
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