Levels of anxiety and pain during chemotherapy with peripheral versus central vascular access: an experimental evaluation.

ABSTRACT

PURPOSE: The purpose of this research was to evaluate pain and anxiety levels in patients undergoing chemotherapy via central venous catheter (CVC) and peripheral venous access (PVA). METHOD: The sample consisted of 56 cancer patients undergoing at least one chemotherapy treatment cycle. They were divided into two groups based on the administration method of the chemotherapeutic drug the experimental group (patients with CVC) and the control group (patients with PVA). The instruments used were the following for multidimensional pain evaluation the Italian Pain Questionnaire (QUID, devised by De Benedettis et al), and the Visual Analogue Scale (VAS) Chart of Pain. To evaluate the state and anxiety traits, the State-Trait Anxiety Inventory (STAI questionnaire, by D. Spielberg) was used, and we used structured interviews for the statistical survey. RESULTS: Analyzing the data from the STAI questionnaire, it appeared that the state-trait anxiety levels of the experimental group and the control group were not significantly different (analysis of the mean difference made using the Student's t-test). The average scores of the STAI questionnaire for both groups fell within the normal range. This indicated that the anxiety level was unaffected by the introduction of the device (the CVC). The data collected with the QUID questionnaire and subsequent statistical analysis demonstrated that the difference between the means (Student's t-test) of the experimental group and the control group was significantly lower, as regards perception of the sensorial and evaluative quality of pain (p=0.05) in the experimental group. From the evaluation of the VAS method, it appeared that the difference between the means was not significant in either group, although the distribution of frequency tended towards lower values in the experimental group with respect to the control group. This confirms previous QUID research where a lower pain level is recorded. CONCLUSIONS: Analysis of the data collected via the structured interview revealed that most of the CVC sample did not respond to catheter insertion as a sign of a worsening of their illness.