School of Psychology, Vita-Salute San Raffaele University, Milan, Italy.
Division of Clinical Neurosciences, Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Support Care Cancer. 2020 Nov;28(11):5343-5351. doi: 10.1007/s00520-020-05377-1. Epub 2020 Mar 4.
Chemotherapy-induced nausea (CIN) is a relevant problem for gynaecological cancer patients. The evaluation of CIN is a key aspect in its management, along with the identification of associated risk factors. The objective of the study was to compare different measurements of nausea and to investigate personal risk factors in CIN development.
Eighty-one women treated for gynaecological cancers took part. The presence of CIN was evaluated using the MASCC Antiemesis Tool (MAT) and a patient's report to clinicians at the subsequent chemotherapy cycle. Personal risk factors were assessed using the State-Trait Anxiety Inventory and a self-report questionnaire.
The study shows that the agreement between patients' assessment of CIN with MAT and what they referred to clinicians was only moderate for acute nausea (Cohen's Kappa = 0.55; p < 0.001), while good for delayed nausea (Cohen's Kappa = 0.68; p < 0.001). At multiple logistic regression analysis, younger age, anticipatory nausea, patient medium-high expectations of CIN, and parity emerged as risk factors for the development of acute nausea (p = 0.0087, 0.0080, 0.0122 and 0.0021, respectively). Patient medium-high expectations of CIN and being single resulted to be risk factors for delayed nausea (p = 0.0397 and 0.0024, respectively).
Our findings confirm that personal factors contribute to individual differences in the development of CIN; moreover, we highlight the importance of CIN evaluation by clinicians, underlining the need to use reliable instruments.
化疗引起的恶心（CIN）是妇科癌症患者的一个相关问题。CIN 的评估是其管理的关键方面，同时还需要确定相关的风险因素。本研究的目的是比较恶心的不同测量方法，并研究 CIN 发展中的个人风险因素。
81 名接受妇科癌症治疗的女性参与了这项研究。使用 MASCC 止吐工具（MAT）和患者在下一个化疗周期向临床医生报告的方式评估 CIN 的发生。使用状态-特质焦虑量表和自我报告问卷评估个人风险因素。
研究表明，患者对 CIN 的评估与 MAT 以及他们向临床医生报告的结果之间的一致性仅在急性恶心方面中度一致（Cohen's Kappa = 0.55；p < 0.001），而在迟发性恶心方面良好（Cohen's Kappa = 0.68；p < 0.001）。在多因素逻辑回归分析中，年龄较小、预期性恶心、患者对 CIN 的中等高度期望以及产次被确定为急性恶心发展的风险因素（p = 0.0087、0.0080、0.0122 和 0.0021）。患者对 CIN 的中等高度期望和单身是迟发性恶心的风险因素（p = 0.0397 和 0.0024）。
我们的研究结果证实，个人因素导致 CIN 发展的个体差异；此外，我们强调了临床医生对 CIN 评估的重要性，强调需要使用可靠的工具。
