Roscoe J A, Hickok J T, Morrow G R
University of Rochester Cancer Center, Behavioral Medicine Unit, NY 14642, USA.
Ann Behav Med. 2000 Spring;22(2):121-6. doi: 10.1007/BF02895775.
We examined the relationship between patients' pretreatment expectations for nausea and vomiting and their subsequent development in a homogeneous group of 29 female cancer patients receiving platinum-containing chemotherapy as inpatients (Study 1) and in 81 subjects with any of a variety of cancer diagnoses treated largely as outpatients (Study 2). Each study found a significant relationship between patients' expectations for nausea development measured prior to their first treatment and their mean postchemotherapy nausea severity (both, p < 0.05). Patients' expectations accounted for unique variance in nausea severity in each study even after controlling for known pharmacological and physiological predictors of nausea (Study 1: delta R2 = .18, p < .04; Study 2: delta R2 = .05, p < .03). By contrast, we found no significant relationships between expectations for vomiting and subsequent vomiting. Our results support the view that patients' expectations for nausea affect its subsequent development, indicating the presence of a significant psychological component in treatment-related nausea. Implications of this are discussed.
我们研究了29名接受含铂化疗的住院女性癌症患者(研究1)以及81名主要接受门诊治疗的各种癌症诊断患者(研究2)的预处理恶心和呕吐预期与随后发生情况之间的关系。每项研究均发现,患者首次治疗前对恶心发生的预期与化疗后平均恶心严重程度之间存在显著关系(均为p < 0.05)。即使在控制了已知的恶心药理学和生理学预测因素后,患者的预期在每项研究中仍占恶心严重程度的独特方差(研究1:ΔR2 = 0.18,p < 0.04;研究2:ΔR2 = 0.05,p < 0.03)。相比之下,我们发现呕吐预期与随后的呕吐之间没有显著关系。我们的结果支持这样一种观点,即患者对恶心的预期会影响其随后的发生,表明与治疗相关的恶心存在显著的心理成分。对此的影响进行了讨论。