Behavioral management of chemotheraphy related nausea and vomiting

Chemotherapy related nausea and vomiting constitutes a critical problem for cancer patients, and introduces both medical complications and psychological distress. For many patients, these adverse side effects become conditioned and occur in the absence of a chemotherapy administration. The lack of a completely acceptable antiemetic agent has stimulated the research of behavioral interventions. The objective of this study was to examine the potential for utilizing progressive muscle relaxation with guided imagery in treating hospitalized oncology patients for nausea and vomiting.

Eight subjects, ages 31 to 70, completed the control/baseline, intervention, and control/follow-up phases. All subjects either had a history of chemotherapy related nausea and vomiting, or were on a chemotherapy program that included: 1) agents with a high emetic potential, 2) plans to receive at least three more cycles, and 3) chemotherapy administration on the inpatient service. The three major components of the 30 minute relaxation training intervention included deep breathing, tensing and relaxing select muscle groups, and guided imagery.

The program of relaxation training was successfully implemented. Nonparametric statistical procedures were utilized solely for the purpose of summarizing and describing data across subjects. These were based on data generated by the six subjects who had previous experience with chemotherapy. According to them, the relaxation procedure helped to reduce their perceived anxiety, but made no difference regarding their overall experience of nausea or vomiting. The reduction in anxiety was again reported at one month follow-up. Discrepancies were noted between patient and nurse reports. The strengths and limitations of subjective self-report were discussed. It is possible that the two subjects without previous experience with chemotherapy did not perceive the need for the relaxation procedure given their lack of nausea and vomiting. Several trends emerged from the extensive qualitative data and were presented. Important differences (e. g. subject sample, environment) between this research and previous work were presented and the implications for relaxation training were discussed.