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Supportive Care / Symptom Management (Prevention of Cancer Morbidity)

Projects and Investigators

Patient Expectations and Chemotherapy-Induced Nausea

Program Description:

Nausea is consistently cited as a frequent and troublesome side effect of treatments for cancer and remains a significant clinical problem despite the use of the best available antiemetic medications. Our previous work supports findings from the literature that patients' expectations of developing nausea is a significant determinant of whether or not they actually develop treatment-induced nausea. In a recently completed multicenter study (N = 465), we examined acupressure wristbands for control of chemotherapy-induced nausea, and found that patients who expected the acupressure wrist bands to be effective in nausea control experienced significantly less nausea than patients who did not expect them to be effective. This finding, suggests that the reduction in nausea was related to patients' expectations of nausea. In a subsequent study conducted with patients experiencing radiation therapy-induced nausea, we found that a 1-page handout designed to increase patients' expectations for efficacy of the acupressure bands resulted in a 20% decrease in average nausea compared to patients receiving the bands without the expectancy enhancing handout. The current application builds upon these intriguing findings through a pilot study designed to gather preliminary efficacy and feasibility data for the development of a planned R01 submission. We propose a 4-arm, randomized, blinded study to explore the effects of patient expectations on nausea control with an intervention specifically designed to decrease patients' expectations for experiencing nausea from chemotherapy. The stimulus vehicle for the intervention will be acupressure bands. These bands will be given to patients in all four treatment arms of the study. 2 types of expectancy enhancing materials will be used. The first will be in the form of a handout and the second in the form of an audio tape. Both the "active" handout and the "active" audio tape are designed to enhance patients' expectations of the usefulness of the acupressure wristbands, while the "control" handout and the "control" audio tape have only neutral information concerning the bands likely effectiveness. Patients in the 4 treatment arms will receive different combinations of these 2 items. We seek to find out if interventions that increase patients' positive expectancy for nausea prevention can enhance the efficacy of the wristbands and contribute to a reduction in patient nausea.