Komal Singh1,2, Keenan Pituch1, Qiyun Zhu3, Haiwei Gu4, Brenda Ernst2, Cindy Tofthagen5, Melanie Brewer1,6, Kord M Kober7, Bruce A Cooper7, Steven M Paul7, Yvette P Conley8, Marilyn Hammer9, Jon D Levine10, Christine Miaskowski7,10. 1. Edson College of Nursing and Health Innovation, Arizona State University, Phoenix. 2. Cancer Center, Mayo Clinic, Phoenix, Arizona. 3. Biodesign Center for Fundamental and Applied Microbiomics, Arizona State University, Tempe. 4. Department of Environmental Health Sciences, Florida International University, Port Saint Lucie. 5. Department of Nursing, Mayo Clinic, Jacksonville, Florida. 6. HonorHealth Research Institute, Scottsdale, Arizona. 7. School of Nursing, University of California, San Francisco. 8. School of Nursing, University of Pittsburgh, Pennsylvania. 9. The Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana Farber Cancer Institute, Boston, Massachusetts. 10. School of Medicine, University of California, San Francisco.
Abstract
Background: Unrelieved chemotherapy-induced nausea (CIN) occurs 48% of patients undergoing chemotherapy and is one of the most debilitating symptoms that patients report. Objective: The aims of this study were to identify subgroups of patients with distinct CIN profiles and determine how these subgroups differed on demographic and clinical characteristics; severity, frequency, and distress of CIN; and the co-occurrence of common gastrointestinal symptoms. Methods: Patients (n = 1343) completed demographic questionnaire and Memorial Symptom Assessment Scale 6 times over 2 cycles of chemotherapy. Latent class analysis was used to identify subgroups of patients with distinct CIN profiles. Differences among these subgroups were evaluated using parametric and nonparametric statistics. Results: Four distinct CIN profiles were identified: none (40.8%), increasing-decreasing (21.5%), decreasing (8.9%), and high (28.8%). Compared with the none class, patients in the high class were younger, had a lower annual household income, had child care responsibilities, had a lower Karnofsky Performance Status score and a higher Self-administered Comorbidity Questionnaire score, and were more likely to have received chemotherapy on a 14-day cycle and a highly emetogenic chemotherapy regimen. In addition, patients in the high class reported high occurrence rates for dry mouth, feeling bloated, diarrhea, lack of appetite, abdominal cramps, difficulty swallowing, mouth sores, weight loss, and change in the way food tastes. Conclusions: That 60% of the patients reported moderate to high CIN occurrence rates confirms that this unrelieved symptom is a significant clinical problem. Implications for Practice: Nurses need to evaluate patients' level of adherence to their antiemetic regimen and make appropriate referrals for physical therapy, psychological services, and dietary counseling. Copyright (C) 2022 Wolters Kluwer Health, Inc. All rights reserved.
Background: Unrelieved chemotherapy-induced nausea (CIN) occurs 48% of patients undergoing chemotherapy and is one of the most debilitating symptoms that patients report. Objective: The aims of this study were to identify subgroups of patients with distinct CIN profiles and determine how these subgroups differed on demographic and clinical characteristics; severity, frequency, and distress of CIN; and the co-occurrence of common gastrointestinal symptoms. Methods: Patients (n = 1343) completed demographic questionnaire and Memorial Symptom Assessment Scale 6 times over 2 cycles of chemotherapy. Latent class analysis was used to identify subgroups of patients with distinct CIN profiles. Differences among these subgroups were evaluated using parametric and nonparametric statistics. Results: Four distinct CIN profiles were identified: none (40.8%), increasing-decreasing (21.5%), decreasing (8.9%), and high (28.8%). Compared with the none class, patients in the high class were younger, had a lower annual household income, had child care responsibilities, had a lower Karnofsky Performance Status score and a higher Self-administered Comorbidity Questionnaire score, and were more likely to have received chemotherapy on a 14-day cycle and a highly emetogenic chemotherapy regimen. In addition, patients in the high class reported high occurrence rates for dry mouth, feeling bloated, diarrhea, lack of appetite, abdominal cramps, difficulty swallowing, mouth sores, weight loss, and change in the way food tastes. Conclusions: That 60% of the patients reported moderate to high CIN occurrence rates confirms that this unrelieved symptom is a significant clinical problem. Implications for Practice: Nurses need to evaluate patients' level of adherence to their antiemetic regimen and make appropriate referrals for physical therapy, psychological services, and dietary counseling. Copyright (C) 2022 Wolters Kluwer Health, Inc. All rights reserved.
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