Patient Expectations and Chemotherapy-Induced Nausea

患者期望和化疗引起的恶心

• 批准号: 7232037
• 负责人: JOSEPH A ROSCOE
• 金额: $ 15.9万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-07-01 至 2009-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7232037
• 关键词: Acupressure; Adverse effects; Antiemetics; Attention; Belief; Blinded; Clinical; Data; Development; Drops; Effectiveness; Expectancy; Intention; Intervention; Literature; Medical; Multicenter Studies; Nausea; Patients; Pharmaceutical Preparations; Pilot Projects; Prevention; Radiation therapy; Randomized; Randomized Clinical Trials; Research; Research Design; Stimulus; Symptoms; Upper arm; Work; Wrist; cancer therapy; chemotherapy; design; expectation; experience; health related quality of life; malignant breast neoplasm; patient expectation; size

DESCRIPTION (provided by applicant): Nausea is consistently cited as a frequent and troublesome side effect of treatments for cancer and remains a significant clinical problem despite the use of the best available antiemetic medications. Our previous work supports findings from the literature that patients' expectations of developing nausea is a significant determinant of whether or not they actually develop treatment-induced nausea. In a recently completed multicenter study (N = 465), we examined acupressure wristbands for control of chemotherapy-induced nausea, and found that patients who expected the acupressure wrist bands to be effective in nausea control experienced significantly less nausea than patients who did not expect them to be effective. This finding, suggests that the reduction in nausea was related to patients' expectations of nausea. In a subsequent study conducted with patients experiencing radiation therapy-induced nausea, we found that a 1-page handout designed to increase patients' expectations for efficacy of the acupressure bands resulted in a 20% decrease in average nausea compared to patients receiving the bands without the expectancy enhancing handout. The current application builds upon these intriguing findings through a pilot study designed to gather preliminary efficacy and feasibility data for the development of a planned R01 submission. We propose a 4-arm, randomized, blinded study to explore the effects of patient expectations on nausea control with an intervention specifically designed to decrease patients' expectations for experiencing nausea from chemotherapy. The stimulus vehicle for the intervention will be acupressure bands. These bands will be given to patients in all four treatment arms of the study. 2 types of expectancy enhancing materials will be used. The first will be in the form of a handout and the second in the form of an audio tape. Both the "active" handout and the "active" audio tape are designed to enhance patients' expectations of the usefulness of the acupressure wristbands, while the "control" handout and the "control" audio tape have only neutral information concerning the bands likely effectiveness. Patients in the 4 treatment arms will receive different combinations of these 2 items. We seek to find out if interventions that increase patients' positive expectancy for nausea prevention can enhance the efficacy of the wristbands and contribute to a reduction in patient nausea.

描述（由申请人提供）：恶心一直被认为是癌症治疗的常见且麻烦的副作用，尽管使用了最佳可用的抗过敏药物，但仍然是一个重大的临床问题。我们以前的工作支持了文献的发现，即患者对恶心的期望是他们是否实际发展治疗引起的恶心的重要决定因素。在最近完成的多中心研究（n = 465）中，我们检查了穴位疗法的腕带，以控制化学疗法引起的恶心，并发现预期穴位腕带在恶心控制中有效的患者比没有预期的患者没有明显的恶心。他们有效。这一发现表明，恶心的减少与患者对恶心的期望有关。在随后对经历放射治疗引起的恶心的患者进行的研究中，我们发现一页1页的讲义旨在提高患者对穴带疗效的期望，导致平均恶心下降20％预期增强讲义。当前的申请通过一项试点研究基于这些有趣的发现，旨在收集初步疗效和可行性数据，以开发计划的R01提交。我们提出了一项4臂，随机，盲目的研究，以探索患者期望对恶心控制的影响，该干预措施专门设计，以减少患者对化学疗法的恶心的期望。干预措施的刺激车辆将是穴带。这些乐队将在研究的所有四个治疗臂中给予患者。将使用2种预期材料的类型。第一个将以讲义的形式，第二个是录音带的形式。 “主动”讲义和“主动”录音带均设计旨在增强患者对穴位腕带有用性的期望，而“控制”讲义和“控制”录音带和“控制”录音带仅具有有关频段可能有效性的中性信息。 4个治疗臂中的患者将接受这2个项目的不同组合。我们试图找出增加患者对预防恶心的积极期望的干预措施是否可以提高腕带的疗效，并有助于减少患者恶心。