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Reduction of chemotherapy-induced anorexia, nausea, and emesis through a structured nursing intervention: a cluster-randomized multicenter trial

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Abstract

Objectives

The purpose of this present study was to evaluate Self-care Improvement through Oncology Nursing (SCION) program to reduce distressing anorexia, nausea, and emesis (ANE) in cancer patients undergoing chemotherapy.

Methods

Two hundred eight patients receiving chemotherapy with moderate to high emetogenic potential participated in a cluster randomized trial on 14 wards in two German university hospitals. Additionally to standard antiemetic treatment, patients from the intervention wards received the SCION program consisting of four modules: advisory consultation, optimizing emesis prophylaxis, nutrition counseling, and relaxation. Patients from the control group received standard antiemetic treatment and standard care. Primary outcome was the group difference in ANE intensity assessed by Common Terminology Criteria for adverse events (CTCAE).

Main results

The SCION program did not result in a significant difference in the incidence of ANE symptoms as compared to standard care: mean difference on CTCAE scale was 0.24 pts (95%CI, −1.17 to 1.66 pts; P = 0.733). No difference could be found regarding patients’ knowledge of side effects, self-care interventions, and agency. Health-related quality of life was significantly better for patients in the control group (mean difference 10.2 pts; 95%CI, 1.9 to 18.5; P = 0.017).

Conclusions

Contrary to our expectations, the groups did not differ in ANE intensity caused by the overall low acute or delayed symptom intensity. Symptom hierarchy in cancer patients alters and challenges nursing interventions targeting the patients’ self-care strategies.

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Acknowledgements

Funding for this research was provided by the German Federal Ministry of Education and Research (BMBF)—Grant No. 01GT0301.

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Authors and Affiliations

  1. Institute for Health and Nursing Science, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Magdeburger Strasse 8, 06097, Halle, Germany

    Patrick Jahn, Petra Renz & Margarete Landenberger

  2. University Hospital rechts der Isar, Munich Technical University, Head Nurse Office, Ismaninger Str. 22, 81675, Munich, Germany

    Joerg Stukenkemper, Katrin Book & Anette Thoke-Colberg

  3. Institute for Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, 06097, Halle (Saale), Germany

    Oliver Kuss

  4. University Clinic and Polyclinic for Internal Medicine IV, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Head Nurse Office, Ernst-Grube-Straße 40, 06120, Halle (Saale), Germany

    Karin Jordan, Ingrid Horn & Hans-Joachim Schmoll

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  1. Patrick Jahn
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Correspondence to Patrick Jahn.

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Jahn, P., Renz, P., Stukenkemper, J. et al. Reduction of chemotherapy-induced anorexia, nausea, and emesis through a structured nursing intervention: a cluster-randomized multicenter trial. Support Care Cancer 17, 1543–1552 (2009). https://doi.org/10.1007/s00520-009-0698-z

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  • DOI: https://doi.org/10.1007/s00520-009-0698-z

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