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Widgren, Y., Silén, M., Wåhlin, I., Lindberg, M., Fransson, P. & Efverman, A. (2023). Chemotherapy-induced Emesis: Experienced Burden in Life, and Significance of Treatment Expectations and Communication in Chemotherapy Care. Integrative Cancer Therapies, 22
Open this publication in new window or tab >>Chemotherapy-induced Emesis: Experienced Burden in Life, and Significance of Treatment Expectations and Communication in Chemotherapy Care
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2023 (English)In: Integrative Cancer Therapies, ISSN 1534-7354, E-ISSN 1552-695X, Vol. 22Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objective: Because antiemetics have become more effective and integrative therapies such as acupuncture are used in combination with antiemetics, people receiving chemotherapy for cancer today might expect less emesis than in the past. It is not previously described if and how people receiving modern antiemetics during chemotherapy experience emesis. The objective of this study was to describe experiences regarding emesis among persons undergoing emetogenic chemotherapy, and how it affects their quality of life, daily life and work. A further aim was to describe views on the significance of treatment expectations and communication with healthcare personnel while undergoing chemotherapy for cancer.

Method: Fifteen participants (median age 62 years, n = 1 man and n = 14 women, with breast (n = 13) or colorectal (n = 2) cancer) undergoing adjuvant or neo-adjuvant highly or moderately emetogenic chemotherapy were interviewed individually. The data were then analyzed using inductive thematic analysis.

Results: Three themes described the participants’ experiences: “Your whole life is affected, or continues as usual,” covering descriptions of emesis limiting some participants’ everyday lives, while others experienced no emesis at all or had found ways to manage it. Overall, participants described satisfaction with their antiemetic treatment. “Experiences and expectations more important than information”, that is, the participants reported wanting all the information they could get about possible adverse effects of treatment, although they believed previous experiences were more important than information in creating expectations about treatment outcomes. The participants reported that being seen as a unique person was of utmost importance: “Meet me as I am.” This creates trust in healthcare personnel and a feeling of safety and security in the situation.

Conclusions: These findings underline the importance of person-centered care and support in creating positive treatment expectations. Future research is called for regarding the potential antiemetic effects of positive communication regarding strengthening positive treatment expectations during emetogenic chemotherapy.

Place, publisher, year, edition, pages
SAGE, 2023
National Category
Cancer and Oncology
Research subject
Health-Promoting Work, Inkluderande arbetsliv
Identifiers
urn:nbn:se:hig:diva-43484 (URN)10.1177/15347354231217296 (DOI)001125792800001 ()38098295 (PubMedID)2-s2.0-85179678460 (Scopus ID)
Available from: 2023-12-19 Created: 2023-12-19 Last updated: 2024-04-26Bibliographically approved
Widgren, Y., Silén, M., Wåhlin, I., Lindberg, M., Fransson, P. & Efverman, A. (2023). Patients’ experiences of emesis and the significance of treatment expectations and communication during chemotherapy for cancer. Paper presented at MASCC/JASCC/ISOO Annual Meeting 2023. Supportive Care in Cancer, 31(S1), s39, Article ID 399.
Open this publication in new window or tab >>Patients’ experiences of emesis and the significance of treatment expectations and communication during chemotherapy for cancer
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2023 (English)In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 31, no S1, p. s39-, article id 399Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Introduction

Since antiemetics have become more effective, it seems plausible that patients nowadays expect less emesis than in the past. To gain a deeper understanding of the patients’ caring needs during emetogenic chemotherapy used today, the aim was to describe patients’ experiences of chemotherapy-induced emesis and how it afects quality of life, daily life, and work. Further, to describe views of the signifcance of their treatment expectations and the communication with the health care personnel when undergoing chemotherapy for cancer.

Methods

Fifteen patients (median age 62 years, n=1 man and n=14 women, with breast (n=13) or colorectal (n=2) cancer), undergoing adjuvantor neo-adjuvant highly or moderately emetogenic chemotherapy were interviewed individually. The data were then analyzed using inductive thematic analysis.

Results

Three themes described the patients’ experiences: ”The whole life gets affected, or goes on as usual”, covering descriptions of how some patients experienced the emesis to limit their everyday lives, while others experienced no emesis at all or had found ways to manage it; ”Information is important for creating expectations, but experiences even more”, i.e., the patients expressed that they wanted all the information they could get about possible adverse efects from the treatment, even though they believed previous experiences to be more important than information for creating expectations about treatment outcomes. Overall, the participants described satisfaction with their antiemetic treatment; and ”Meet me as I am”, including the participants expressed being seen as a unique person to be the of utterly importance. It creates trust in the health care personnel and a feeling of safety and security in the situation.

Conclusions

These findings underline the importance of person-centered care ands upport in creating positive treatment expectations. Future research is welcomed regarding potential antiemetic efects of positive communication, strengthening positive treatment expectations during emetogenic chemotherapy

Place, publisher, year, edition, pages
Springer, 2023
National Category
Health Sciences
Identifiers
urn:nbn:se:hig:diva-43517 (URN)10.1007/s00520-023-07786-4 (DOI)
Conference
MASCC/JASCC/ISOO Annual Meeting 2023
Available from: 2024-01-05 Created: 2024-01-05 Last updated: 2024-01-05Bibliographically approved
Widgren, Y., Fransson, P. & Efverman, A. (2022). Acupuncture in patients undergoing cancer therapy: few users although high interest and belief in acupuncture. Paper presented at MASCC/ISOO Annual Meeting on Supportive Care in Cancer, 23-25 June 2022. Supportive Care in Cancer, 30(S1), 118
Open this publication in new window or tab >>Acupuncture in patients undergoing cancer therapy: few users although high interest and belief in acupuncture
2022 (English)In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 30, no S1, p. 118-Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Introduction

Since patients ask for acupuncture for cancer-therapy induced side-effects, and pre-existing expectations, i.e. beliefs, in a treatment may modify outcomes, the aim of this study was to investigate the use of acupuncture, interest, and belief in acupuncture effects among patients undergoing cancer therapy.

Methods

The study participants (n=457 of 507, 90% responded) cross-sectionally during radiotherapy answered a questionnaire regarding their use of, interest and belief in acupuncture treatment.

Results

Of the patients (mean age 65 years, 48% men, 37% had breast cancer, 32% prostate cancer), four (1%) patients used acupuncture during cancer therapy, while 368 (83%) expressed an interest in receiving acupuncture and (63%) believed acupuncture to be effective for at least one of 17 requested symptoms, most commonly pain (56% of the patients) and muscle tension(40%). They believed acupuncture to be effective for mean value 3 of 17 requested symptoms. Women (p<0.001), and patients 41-65 years (p<0.001), expressed a stronger belief in acupuncture effects than others.

Conclusions

Men and older patients expressed weaker beliefs in acupuncture effects than others, indicating the importance of collecting expectancy data in future acupuncture efficacy studies. The high interest and beliefs in acupuncture indicate that acupuncture should be available for side effects where acupuncture has proven effects. Older men might need more encouragement on positive expected outcomes of the acupuncture treatment than others.

Place, publisher, year, edition, pages
Springer, 2022
National Category
Health Sciences
Identifiers
urn:nbn:se:hig:diva-40865 (URN)
Conference
MASCC/ISOO Annual Meeting on Supportive Care in Cancer, 23-25 June 2022
Available from: 2023-01-23 Created: 2023-01-23 Last updated: 2023-01-23Bibliographically approved
Widgren, Y., Fransson, P. & Efverman, A. (2022). Acupuncture in patients undergoing cancer therapy: Their interest and belief in acupuncture is high, but few are using it. Integrative Cancer Therapies, 21, 1-11
Open this publication in new window or tab >>Acupuncture in patients undergoing cancer therapy: Their interest and belief in acupuncture is high, but few are using it
2022 (English)In: Integrative Cancer Therapies, ISSN 1534-7354, E-ISSN 1552-695X, Vol. 21, p. 1-11Article in journal (Refereed) Published
Abstract [en]

Objectives: Since pre-existing expectations, that is, beliefs, in a treatment may modify outcomes, and acupuncture studies often fail to measure expectations, we wanted to investigate the use of acupuncture, interest, and belief in acupuncture effects among patients undergoing cancer therapy.

Method: A cross-sectional design, where the participants answered a study-specific questionnaire with questions regarding their use of, interest and belief in acupuncture treatment.

Results: A total of 457 patients with cancer (48% men, mean age 65 years) answered the questionnaire. Acupuncture was used by 4 (1%) patients during their cancer therapy, and 368 (83%) expressed an interest in receiving acupuncture. Of the 457 patients, 289 (63%) believed acupuncture to be effective for at least 1 of 17 requested symptoms, most commonly pain (56% of the patients) and muscle tension (40%). They believed acupuncture to be effective for a mean value 3 of the 17 requested symptoms. Women (P < .001), and patients 41 to 65 years (P < .001), expressed a stronger belief in acupuncture effects than others.

Conclusions: Men and older patients expressed weaker beliefs in acupuncture effects than other patients, indicating the importance of collecting expectancy data in future randomized sham-controlled acupuncture studies to be able to treat expectancy as an effect-modifier. The high interest and beliefs in acupuncture effects found also indicate that acupuncture should be available for patients with cancer, for side effects where acupuncture has shown to be effective. In a clinical setting, older men might need more encouragement regarding positive expected outcomes of the acupuncture treatment than younger women.

Place, publisher, year, edition, pages
Sage, 2022
Keywords
acupuncture therapy; attitudes; cancer survivors; complementary and alternative medicine; expectations; oncology nursing
National Category
Health Sciences
Identifiers
urn:nbn:se:hig:diva-38046 (URN)10.1177/15347354221077277 (DOI)000765880900001 ()35212241 (PubMedID)2-s2.0-85125358001 (Scopus ID)
Available from: 2022-03-07 Created: 2022-03-07 Last updated: 2023-03-21Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-8764-9328

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