Roxanne W. McDaniel

A meta-analysis of exercise interventions among people treated for cancer

GoalThis review applied meta-analytic procedures to integrate primary research findings that tested exercise interventions among people treated for cancer.MethodsExtensive literature searching strategies located published and unpublished intervention studies that tested exercise interventions with at least five participants (k=30). Primary study results were coded. Meta-analytic procedures were conducted.Main resultsThe overall weighted mean effect size (ES) for two-group comparisons was 0.52 (higher mean for treatment than control) for physical function, 0.35 for symptoms other than fatigue, and 0.27 for body composition. More modest positive ESs were documented for mood (0.19), quality of life (0.14), fatigue (0.11), and exercise behavior (0.04). ESs were larger among single-group pre–post design studies. ESs among control group participants were typically negative and not (statistically) significantly different from 0.ConclusionsExercise interventions resulted in small positive effects on health and well-being outcomes among existing studies. Future research should examine intervention-specific characteristics that result in optimal results, such as dose.

Nausea, Vomiting, and Retching: Complex Problems in Palliative Care

Patients with advanced cancer commonly experience nausea, vomiting, and/or retching (NVR) as a result of the malignant process and its treatment. Recently, increasing attention is being focused on end‐of‐life care, which includes relief or reduction of symptoms such as NVR.

Putting evidence into practice: evidence-based interventions to prevent, manage, and treat chemotherapy-induced nausea and vomiting.

Chemotherapy-induced nausea and vomiting (CINV) continues to have a considerable effect on the physical and psychological well-being of patients with cancer, despite significant advances in antiemetic drugs since the 1990s. This article reviews and summarizes past and current empirical evidence related to interventions for CINV. A resource that summarizes evidence-based interventions for CINV is critical for effective management of this distressing symptom. Pharmacologic and nonpharmacologic interventions are appraised. Finally, gaps in the literature and opportunities for research, education, and practice changes are discussed.

Chemotherapy-Induced Nausea and Vomiting

Nausea and vomiting (N&V) is among the most distressing side effects of chemotherapy, despite the development of more efficacious antiemetic agents. As many as 60% of patients who receive cancer chemotherapy experience some degree of N&V. However, the actual incidence is difficult to determine with accuracy because of the variety of drugs, doses, and health conditions of the patients who receive cancer treatments. This article examines the state of the science related to chemotherapy-induced nausea and vomiting and reviews both pharmacologic and behavioral strategies that have demonstrated efficacy in managing these distressing symptoms.

Sensory perception of patients on selected antineoplastic chemotherapy protocols

Antineoplastic chemotherapy (ANCT) is a primary and adjuvant treatment modality for cancer. Although researchers have found that patients who are given preparatory sensory information before various healthcare procedures experience less discomfort, literature describing subjects sensory experience before, during, and after ANCT is lacking. The purpose of this study was to elicit sensory responses from subjects before, during, and after one of six cycles of their initial course of treatment on one of two emetogenic ANCT protocols. These descriptions will be used to develop a preparatory sensory nursing intervention that may promote self-care and help cancer patients cope with the distress of chemotherapy. The Sensory Information Questionnaire was administered to a sample of 44 subjects who had just completed a cycle of ANCT. Subjects provided descriptors of all senses. The senses for which subjects most frequently provided descriptors were taste, touch, and smell. Descriptors varied for some sensations according to the chemotherapy drug protocols.

Development of a preparatory sensory information videotape for women receiving chemotherapy for breast cancer.

This study describes the development and testing of a preparatory sensory information (PSI) videotape for women receiving chemotherapy for breast cancer. In telephone interviews, 40 women described the sensations they experienced before, during, and after receiving chemotherapy. Sensations described by the women were linked with procedural and temporal elements identified by certified advanced practice oncology nurses to develop a script for the PSI videotape. Women currently receiving chemotherapy or who had completed chemotherapy within the last 6 months were asked to share their experiences on videotape. After editing, a 20-minute PSI videotape was produced. Pilot testing with a group of 20 women demonstrated that the intervention helped to prepare them for the sensory experiences associated with chemotherapy and was helpful in developing anticipatory coping and self-care behaviors.

Nausea, vomiting, and retching: The management of the symptom experience

OBJECTIVES To examine the physiology of nausea, vomiting, and retching (NVR); the impact of NVR on the patient: current measures to control NVR; and selfcare interventions. DATA SOURCES Research studies, abstracts, and review articles relating to NVR associated with cancer treatment as well as pharmacological and nonpharmacological interventions. CONCLUSIONS Management of the individual symptoms of NVR require expert, ongoing assessment of the patients symptom experience that extends beyond the clinic or hospital visit. Although a number of pharmacological antiemetic agents are currently available and additional antiemetic drugs are in phase II or II trials, nonpharmacological interventions are essential to achieve effective management. IMPLICATIONS FOR NURSING PRACTICE Continual assessment of the individuals symptom experience is imperative. Effective management of the symptom experience depends on the oncology nursess ability to implement current knowledge of antiemetic, and other drugs; non-pharmacological interventions; and cost-effective and clinically useful patient outcomes.

Patient education: Self-care guides

Verna A. Rhodes, Roxanne W. McDaniel, and Mary H. Johnson T EACHI, NG is an integral part of nursing, yet today s rapidly changing health care arena with shortened hospital stays presents unique challenges for the nurse to provide appropriate patient requirements for self-care. Much care for this chronic multistage disease takes place in the home, which demands knowledge not only of what to do to prevent and/or manage the symptom experience but also what to report to the health care provider. These patient education self-care guides have been developed to assist nurses in designing and implementing individualized teaching. A variety of educational strategies based on individualized assessment for efficient effective teaching of self-care are essential because of the overwhelming emotional and physical obstacles surrounding the patient and family.t Appropriate patient education that provides proactive management of the symptom experience may alleviate fears, enhance quality of life, and be cost effective.