Chan, C.W., Lam, L.W., Li, C.K., Cheung, J.S., Cheng, K.K., Chik, K.W., . . . Tang, W.P. (2015). Feasibility of psychoeducational interventions in managing chemotherapy-associated nausea and vomiting (CANV) in pediatric oncology patients. European Journal of Oncology Nursing, 19, 182–190.
To determine the feasibility of using a combination of relaxation techniques and patient education (multidimensional psychoeducational intervention package) to alleviate (chemotherapy-induced nausea and vomiting (CINV) while estimating the effect size and assessing the research design feasibility and stability of the Morrow Assessment of Nausea and Emesis (MANE) and the Chinese version of the State-Trait Anxiety Inventory (STAI) in children
Two intervention groups and two matching control groups were followed for 60 days. Patients randomly were assigned to the relaxation (progressive muscle relaxation [PMR] and guided imagery [GI]) or the education group. Patients in the relaxation group received six sessions of daily PMR and GI training (days 0–5, 30 minutes per session) and daily self-practice for two months with a PMR and GI audiotape. Patients in the education group received two 30-minute sessions of patient and parent education on days 1 and 2 (risk assessment, antiemetic use, and meal planning). The usual care also was given to participating patients, which included antiemetic ondansetron intravenously as needed and diet advice (i.e., avoid spicy and greasy food, eat easily swallowed and digested food).
Exploratory pre- and post-test control group pilot study
Because of the small sample size, the findings were not confirmatory. A significant reduction in vomiting as a possible result of the relaxation exercise was reported on day 3 (the day most patients in the study experienced CINV and a lowered performance status and satisfaction with care). From days 2–7, fewer patients in both intervention groups vomited compared with the control groups. Anticipatory nausea and vomiting was experienced by 40% of patients prior to chemotherapy. The study was feasible, but it took 18 months to recruit 20 patients. Patients and parents prefered relaxation to the education intervention. MANE and STAI scales were easy to understand in Chinese, and there were no difficulties with completion.
Relaxation and education could reduce vomiting. Anticipatory nausea and vomiting also may be alleviated with relaxation techniques. The early intake of antiemetics controlled and decreased patients' experience of CINV.
Relaxation and patient education (major components of a combined psychoeducational interventions) are potential helpful for CINV and are accepted techniques. However, preventive measures provided before the commencement of chemotherapy are more helpful. Patients preferred relaxation for anxiety reduction over education.