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Abstract
Purpose
Chemotherapy-induced nausea and vomiting (CINV) can cause severe malnutrition. However, relationships between CINV levels, nonpharmacological coping methods, and nutritional status of female cancer patients have rarely been investigated. Therefore, this study aimed to analyze their relationships in gynecologic cancer patients.
Methods
Participants receiving a highly and moderately emetogenic chemotherapy were recruited. The level of CINV was assessed using a numeric rating scale. Coping methods were determined using multiple-choice self-report questionnaires and categorized into seven types for statistical analysis. Nutritional status was evaluated using biochemical and anthropometric parameters.
Results
Among all the 485 patients, 200 eligible inpatients were included. Despite the administration of prophylactic antiemetics, 157 patients (78.5%) still experienced CINV, and several used nonmedically recommended coping methods, such as just enduring the symptom or rejecting food intake. A total of 181 patients (90.5%) had nutritional disorders. Although the level of CINV was indirectly related to the occurrence of nutritional disorders, patients who rejected food (b=1.57, p=.023) and did not use physical measures (b= -1.23, p=.041) as coping methods were under the high risk of nutritional disorders.
Conclusion
Korean gynecologic cancer patients had high levels of CINV and were at high risk of nutritional disorders, which may be related to the use of nonscientific coping methods, possibly due to cultural backgrounds and lack of proper nutritional program. Therefore, developing a culturally appropriate educational program for the cancer patients with CINV is urgently needed.
References
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Table 1.
Level of CINV according to General and Clinical Characteristics of the Subject (N=200)
CC=Combination of cyclophosphamide and carboplatin; CINV=Chemotherapy-induced nausea and vomiting; CTx=Chemotherapy; GTS=Granisetron tansdermal system; HEC=Highly emetogenic chemotherapy; MEC=Moderately ematogenic chemotherapy; NK1=Neurokinin1; NRS=Numeric rating scale.
†Dunnett T3 test; ††The subjects with unknown cancer stage were excluded in the analysis; §The number of the subjects who were diagnosed at the other hospital is 8 and who received neoadjuvant chemotherapy is 7; ||The subjects had been pregnant and the number of them was 180.
Table 2.
Factors influencing CINV on Multiple Linear Regression Analysis (N=200)
Table 3.
Factors Influencing the Type of Coping Methods (N=154)
CI=confidence interval; CINV=Chemotherapy-induced nausea and vomiting; OR=Odds ratio; S=Patients’ responses reported on the previous studies;
P=Patients’ own responses not reported on the previous studies.
†Allowed to select multiple contents of coping methods if they usually had used them (range 1~6); ††Mean level of CINV of the total subjects.
Table 4.
Factors Influencing Nutritional Disorder (N=200)
CI=Confidence interval; CINV=Chemotherapy-induced nausea and vomiting; MEC=Moderately emetogenic chemotherapy; NRS=Numeric rating scale; OR=Odds ratio.
†Fisher’s exact test; ††The subjects were the person who had been pregnant and the number of the subjects was 180; §Mean level of CINV of the total subjects; ||The subjects who had used Coping methods and whose number was 154 were allowed to select multiple contents of coping meth od if they usually had used them (range 1~6).
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