Gaps exist between patients’ experience and clinicians’ awareness of symptoms after chemotherapy: CINV and accompanying symptoms

SunYoung Rha, Su Kyung Song, Chung Eun Lee, Yeonhee Park, Jiyeon Lee

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: Correlating patients’ chemotherapy-induced nausea and vomiting (CINV) experience with clinicians’ understanding of the symptom severity and the patients’ and clinicians’ symptom management goals would aid in advancing symptom management. Identifying rankings of symptom severity after chemotherapy would help prioritizing symptom management. Objective: The purpose of this study was to investigate and compare patients’ CINV experience and clinicians’ awareness of symptoms and symptom management goals. The study also aimed to identify and compare rankings of the severity of symptoms after chemotherapy by patients and clinicians. Methods: A prospective observational study was conducted. Cancer patients starting the first adjuvant highly emetogenic chemotherapy (HEC) or moderately emetogenic chemotherapy (MEC) (n = 313), and oncology clinicians at two university hospitals (n = 73) in Korea participated in the study. The Multinational Association of Supportive Care in Cancer Antiemesis Tool (MAT) items and 20-symptom list were used to generate a symptom diary and survey questions. Descriptive statistics with a 95 % confidence interval and the Mann-Whitney U test were used to analyze the data. Results: In general, clinicians overestimated the patients’ CINV experience. Patients’ symptom experiences and clinicians’ estimates only corresponded for delayed nausea after the second cycle MEC. For symptom management goals, patients aimed for absolute vomiting control and avoiding significant nausea. Patients’ symptom management goals exceeded the clinicians’ goals for CINV control except for the goal for delayed nausea control. Clinicians rated chemotherapy-induced nausea as the most problematic symptom followed by vomiting; however, fatigue and loss of appetite were the top rated symptoms by patients. Conclusions: Gaps exist between patients’ symptom experience and clinicians’ symptom awareness. Clinicians overestimated the patients’ CINV experience and set less stringent symptom control goals. Enhancing clinicians’ understanding of patients’ symptom experience and retargeting the CINV management goals are the next steps for advancing symptom management. Symptoms other than CINV require more attention to set symptom management priorities reflecting patient experience and clinical significance.

Original languageEnglish
Pages (from-to)4559-4566
Number of pages8
JournalSupportive Care in Cancer
Volume24
Issue number11
DOIs
Publication statusPublished - 2016 Nov 1

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Nausea
Vomiting
Drug Therapy
Appetite
Korea
Nonparametric Statistics
Observational Studies
Fatigue
Neoplasms
Prospective Studies
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Oncology

Cite this

Rha, SunYoung ; Song, Su Kyung ; Lee, Chung Eun ; Park, Yeonhee ; Lee, Jiyeon. / Gaps exist between patients’ experience and clinicians’ awareness of symptoms after chemotherapy : CINV and accompanying symptoms. In: Supportive Care in Cancer. 2016 ; Vol. 24, No. 11. pp. 4559-4566.
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abstract = "Introduction: Correlating patients’ chemotherapy-induced nausea and vomiting (CINV) experience with clinicians’ understanding of the symptom severity and the patients’ and clinicians’ symptom management goals would aid in advancing symptom management. Identifying rankings of symptom severity after chemotherapy would help prioritizing symptom management. Objective: The purpose of this study was to investigate and compare patients’ CINV experience and clinicians’ awareness of symptoms and symptom management goals. The study also aimed to identify and compare rankings of the severity of symptoms after chemotherapy by patients and clinicians. Methods: A prospective observational study was conducted. Cancer patients starting the first adjuvant highly emetogenic chemotherapy (HEC) or moderately emetogenic chemotherapy (MEC) (n = 313), and oncology clinicians at two university hospitals (n = 73) in Korea participated in the study. The Multinational Association of Supportive Care in Cancer Antiemesis Tool (MAT) items and 20-symptom list were used to generate a symptom diary and survey questions. Descriptive statistics with a 95 {\%} confidence interval and the Mann-Whitney U test were used to analyze the data. Results: In general, clinicians overestimated the patients’ CINV experience. Patients’ symptom experiences and clinicians’ estimates only corresponded for delayed nausea after the second cycle MEC. For symptom management goals, patients aimed for absolute vomiting control and avoiding significant nausea. Patients’ symptom management goals exceeded the clinicians’ goals for CINV control except for the goal for delayed nausea control. Clinicians rated chemotherapy-induced nausea as the most problematic symptom followed by vomiting; however, fatigue and loss of appetite were the top rated symptoms by patients. Conclusions: Gaps exist between patients’ symptom experience and clinicians’ symptom awareness. Clinicians overestimated the patients’ CINV experience and set less stringent symptom control goals. Enhancing clinicians’ understanding of patients’ symptom experience and retargeting the CINV management goals are the next steps for advancing symptom management. Symptoms other than CINV require more attention to set symptom management priorities reflecting patient experience and clinical significance.",
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Gaps exist between patients’ experience and clinicians’ awareness of symptoms after chemotherapy : CINV and accompanying symptoms. / Rha, SunYoung; Song, Su Kyung; Lee, Chung Eun; Park, Yeonhee; Lee, Jiyeon.

In: Supportive Care in Cancer, Vol. 24, No. 11, 01.11.2016, p. 4559-4566.

Research output: Contribution to journalArticle

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