Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
J Natl Compr Canc Netw. 2012 Feb;10(2):149-57. doi: 10.6004/jnccn.2012.0018.
Despite recent progress, chemotherapy-induced nausea and vomiting (CINV), especially delayed CINV, continues to be a problem. Delayed CINV is underestimated and perceived differently by providers and patients. Communication between providers and patients about this side effect may help improve outcomes. This study identifies patients' and providers' perceptions of management and barriers to quality CINV care. Provider and patient versions of a Nausea and Vomiting Management Barriers Questionnaire were developed to address potential barriers. Providers and patients were given opportunities to add detail in open-ended questions. Providers were recruited through the NCCN and the Oncology Nursing Society mailing lists. Patients who received at least 2 cycles of chemotherapy and experienced CINV were recruited through a consortium of advocacy groups. Both providers (n = 141) and patients (n = 299) completed the survey. Providers (41%) and patients (42%) agreed medication side effects were a concern, but more patients (63%) than providers (36%) tried to limit the number of medications taken (P < .0001). Many providers (67%) spontaneously reported barriers to managing CINV, with financial and patient-related factors among the most common. Few patients (10%) reported cost as a barrier, but 37% endorsed the desire "to be strong by not complaining." Barriers to communication and quality care of CINV differ between caregivers and patients. Addressing misconceptions and establishing mutually consistent goals will lead to more effective overall care.
尽管最近取得了进展，但化疗引起的恶心和呕吐（CINV），特别是延迟性 CINV，仍然是一个问题。延迟性 CINV 被低估了，提供者和患者对其的看法也不同。提供者和患者就这种副作用进行沟通可能有助于改善结果。本研究确定了患者和提供者对管理和 CINV 优质护理障碍的看法。为了解决潜在的障碍，制定了提供者和患者版本的恶心和呕吐管理障碍问卷。为提供者和患者提供了在开放式问题中添加详细信息的机会。通过 NCCN 和肿瘤护理学会的邮件列表招募提供者。通过一个倡导团体联盟招募接受至少 2 个周期化疗且经历 CINV 的患者。共有 141 名提供者和 299 名患者完成了调查。提供者（41%）和患者（42%）都认为药物副作用是一个问题，但与提供者（36%）相比，更多的患者（63%）试图限制服用药物的数量（P<0.0001）。许多提供者（67%）自发报告了管理 CINV 的障碍，其中经济和患者相关因素是最常见的。很少有患者（10%）报告费用是一个障碍，但 37%的患者表示希望“不抱怨以保持坚强”。CINV 护理的沟通和质量障碍在护理人员和患者之间存在差异。解决误解并建立相互一致的目标将导致更有效的整体护理。
