Article
Effects of a structured evidence-based nursing intervention for reduction of chemotherapy-induced Anorexia, Nausea and Emesis: Results of a cluster-randomized multi-centre trial
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Published: | September 2, 2009 |
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Objectives: The purpose of this present study was to evaluate Self Care Improvement through Oncology Nursing - SCION program to reduce distressing anorexia, nausea and emesis (ANE) in cancer patients undergoing chemotherapy.
Methods: 208 patients receiving chemotherapy with moderate to high emetogenic potential participated in a cluster randomized trial on 14 wards in 2 German university hospitals. Additionally to standard antiemetic treatment, patients from the intervention wards received, the SCION program consisting of 4 modules: advisory consultation, optimizing emesis prophylaxis, nutrition counseling, and relaxation. Patients from the control group received standard antiemetic treatment and standard care. Primary outcome was the group difference in ANE intensity assessed by Common Terminology Criteria for adverse events (CTCAE).
Main Results: The SCION program did not result in a significant difference in the incidence of ANE-Symptoms as compared to standard care: mean difference on CTCAE-Scale was 0.24 pts (95%CI, -1.17 pts. to 1.66 pts; P=0.733). No difference could be found regarding patients knowledge of side effects, self care interventions and -agency. Quality of life was significantly better for patients in the control group, mean difference 10.2 pts (95%CI, 1.9 to 18.5; P=0.017).
Conclusion: Contrary to our expectations, the groups did not differ in ANE intensity, caused by the overall low acute or delayed symptom intensity. Symptom hierarchy in cancer patients alters and challenges nursing interventions targeting the patients’ self care strategies.