title: Overshadowing as prevention of anticipatory nausea and vomiting in pediatric cancer patients: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Emesis and nausea are side effects induced by chemotherapy. These effects lead to enormous stress and strain on cancer patients. Further consequences may include restrictions in quality of life, cachexia or therapy avoidance. Evidence suggests that cancer patients develop the side effects of nausea and vomiting in anticipation of chemotherapy. Contextual cues such as smell, sounds or even the sight of the clinic may evoke anticipatory nausea and vomiting prior to infusion. Anticipatory nausea and vomiting are problems that cannot be solved by administration of antiemetica alone.The purpose of the proposed randomized placebo-controlled trial is to use an overshadowing technique to prevent anticipatory nausea and vomiting and to decrease the intensity and duration of post-treatment nausea and vomiting. Furthermore, the effect on anxiety, adherence and quality of life will be evaluated.
  
  
  METHODS
  Fifty-two pediatric cancer patients will be evenly assigned to two groups: an experimental group and a control group. The participants, hospital staff and data analysts will be kept blinded towards group allocation. The experimental group will receive during three chemotherapy cycles a salient piece of candy prior to every infusion, whereas the control group will receive flavorless placebo tablets.
  
  
  CONCLUSIONS
  If an effectiveness of the overshadowing technique is proven, implementation of this treatment into the hospitals' daily routine will follow. The use of this efficient and economic procedure should aid a reduced need for antiemetics.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN30242271/
authors.affiliation: Department of Pediatrics, University Medical Center Schleswig-Holstein, Campus Kiel, Schwanenweg 20, Kiel 24105, Germany. f.geiger@uksh.de
authors.forename: Friedemann
authors.initials: F
authors.lastname: Geiger
authors.forename: Levke
authors.initials: L
authors.lastname: Wolfgram
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000367:Age Factors; D000932:Antiemetics / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001007:Anxiety / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D002182:Candy; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D002985:Clinical Protocols; D003214:Conditioning, Classical; D003463:Cues; D004193:Discrimination Learning; D005858:Germany; D006801:Humans; D055118:Medication Adherence; D009325:Nausea / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D011788:Quality of Life; D012107:Research Design; D013997:Time Factors; D016896:Treatment Outcome; D014840:Vomiting, Anticipatory / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents