Reduction of chemotherapy-induced anorexia, nausea, and emesis through a structured nursing intervention: a cluster-randomized multicenter trial.
OBJECTIVE
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
Two hundred eight patients receiving chemotherapy with moderate to high emetogenic potential participated in a cluster randomized trial on 14 wards in two German university hospitals. Additionally to standard antiemetic treatment, patients from the intervention wards received the SCION program consisting of four 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).


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 to 1.66 pts; P = 0.733). No difference could be found regarding patients' knowledge of side effects, self-care interventions, and agency. Health-related 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).


CONCLUSIONS
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.
Jahn
Patrick
P
Institute for Health and Nursing Science, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Magdeburger Strasse 8, 06097, Halle, Germany. patrick.jahn@medizin.uni-halle.de
Renz
Petra
P
Stukenkemper
Joerg
J
Book
Katrin
K
Kuss
Oliver
O
Jordan
Karin
K
Horn
Ingrid
I
Thoke-Colberg
Anette
A
Schmoll
Hans-Joachim
HJ
Landenberger
Margarete
M
D000328:Adult; D000368:Aged; D000855:Anorexia / Q000139:chemically induced / Q000188:drug therapy / Q000451:nursing*; D000932:Antiemetics / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016000:Cluster Analysis; D005260:Female; D005858:Germany; D007722:Health Knowledge, Attitudes, Practice; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000188:drug therapy / Q000451:nursing*; D009369:Neoplasms / Q000188:drug therapy / Q000451:nursing; D009859:Oncology Nursing / Q000379:methods*; D010353:Patient Education as Topic; D011788:Quality of Life; D012648:Self Care / Q000379:methods*; D012720:Severity of Illness Index; D016037:Single-Blind Method; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced / Q000188:drug therapy / Q000451:nursing*
D000932:Antiemetics; D000970:Antineoplastic Agents