The efficacy of honey or olive oil on the severity of oral mucositis and pain compared to placebo (standard care) in children with leukemia receiving intensive chemotherapy: A randomized controlled trial (RCT).

BACKGROUND: Oral mucositis (OM) is a significant complication occurring in approximately 40 to 80% of patients receiving chemotherapy regimens. Although a wide variety of agents have been tested to prevent OM or reduce its severity, none have provided conclusive evidence. OBJECTIVES: To determine the efficacy of honey or olive oil on the severity and OM pain in children with leukemia and suffering from OM compared to placebo (standard care) and, to assess which of the two interventions is more beneficial. METHODS: A single blind randomized controlled study (RCT) was used to evaluate the effect of Manuka honey or olive oil, in the treatment of chemotherapy-related OM in 42 children with leukemia. The primary outcome was the severity of mucositis, using the World Health Organization (WHO) scale and the secondary outcome was the pain assessed using the Visual analogue scale (VAS). RESULTS: Children who received the honey had less severe OM (assessed on the (WHO) scale), p = 0.00 and less pain (assessed on the VAS scale), p = 0.00, compared to the control group. Children who received the olive oil had less pain than the control group, p = 0.00), although not lower than the honey group. CONCLUSION: Manuka honey or olive oil can be used as alternative therapies by nurses to children with leukemia and suffering from OM, especially in low and middle-income countries where more expensive therapies may not be available or economical. PRACTICE IMPLICATIONS: Pediatric nurses may recommend Manuka honey to treat OM in children with leukemia as it is safe and inexpensive compared to other treatment modalities.

Effects of Exercise on Physiologic and Psychologic Outcomes in Patients with End Stage Kidney Disease on Hemodialysis: A Quasi-Experimental Study.

End stage kidney disease (ESKD), a public health concern, has overwhelming effects on individuals' holistic wellbeing. Hemodialysis, albeit a life-saving treatment for patients with ESKD, can lead to muscle atrophy, weakness, and decreased quality of life mostly due to an inactive lifestyle. This quasi-experimental, pre-post design was used to study the effects of exercise on physiologic and psychologic outcomes of patients with ESKD at a hemodialysis unit in Lebanon. Patients acted as their own controls and were assessed before and after introducing the exercise program. Data were collected on quality of life of patients as well as their dialysis adequacy. Results showed that while there was a significant improvement in the dialysis adequacy post-exercise intervention, quality of life was not affected.

A Nonrandomized Pretest Posttest Study on the Impact of an Educational Pain Management Program on Nurses' Knowledge and Attitudes Regarding Pain in a Middle Eastern Country.

BACKGROUND: Although nurse's knowledge and attitudes regarding pain management has been sufficiently studied worldwide, the impact of an educational intervention program in improving such attitudes and knowledge has not been likewise researched, especially in Middle Eastern countries. AIMS: To examine nurses' knowledge and attitudes regarding pain at a university hospital in Lebanon before and after the introduction of a pain management educational program. And to assess the relationship between the characteristic of nurses and their pain knowledge. METHODS: Design; A nonrandomized pretest posttest study design was used. Setting; A university hospital in Lebanon. Participants; Included 183 nurses using the Nurses' Knowledge and Attitudes Survey Regarding Pain questionnaire. The pain educational intervention was based on the principles of Ajzen's theory of planned behavior. RESULTS: A significant difference between the pre and post test scores was noted (p = .016). Questions answered correctly by 80% of participants were related to questions about pain, pain assessment and management, and questions related to medications, such as correct dosages and opioid side effects were not answered correctly by the majority of nurses. There were significant associations between test scores and the nurses' educational level, their age, and their years of experience. Nurses who worked in critical care units, the emergency department and oncology had higher scores than nurses who worked on general units. CONCLUSIONS: Despite the intensive pain education provided at our institution, the pain knowledge of nurses remains below that recommended level which indicates a dire need for more intensive and continuous education in order to provide a pain free environment.

The Impact of Therapeutic Exercises on the Quality of Life and Shoulder Range of Motion in Women After a Mastectomy, an RCT.

Breast cancer ranks highest in incidence and mortality among females and second among both genders. Lebanon has the second highest rate of breast cancer worldwide for those 35-39 years old and the highest for those 40-49. Mastectomy often results in deceased shoulder and arm mobility and decreased quality of life. The objective of this study was to assess the effect of an educational program of therapeutic exercises on the quality of life and functional ability in women after a mastectomy. Sixty women undergoing a mastectomy were randomly assigned to either an intervention or control group. The intervention group received extensive pre-surgery education as well as training on therapeutic exercises. Follow-up phone calls to the intervention group were made to ensure that the exercises were being done. Both groups were visited at home at two and four weeks to obtain the outcome variables. The Breast Cancer Patient Version was used to assess quality of life, and the "Goniometer" was used to assess the range of motion of the affected shoulder. At two and four weeks after surgery, women in the intervention group had significant improvements in their shoulder range of motion: flexion, extension, and abduction were significantly different between the control and intervention group at p = 0.04-0.00. For quality of life, physical, psychological, psychological, social, and spiritual well-being were significantly higher for the intervention group at both two and four weeks after surgery, p < 0.001. In a middle-income country, one-to-one education provided by a nurse, which included demonstrations, back demonstrations, and weekly phone calls had a positive impact on women's shoulder range of motion and quality of life. NCT04184102.

Health-promoting behaviors among American and Lebanese nursing students.

BACKGROUND: Although there are well-known benefits of maintaining a healthy lifestyle, few nursing students practice health-promoting behaviors (HPBs). AIMS: The aim of this study was to compare the HPBs of undergraduate nursing students from two different cultures-the United States of America (U.S.), a high-income country, and Lebanon, a low-income country. METHODS: A cross-sectional, descriptive study included 320 undergraduate nursing students, of which 200 were from the U.S. and 120 were from Lebanon. RESULTS: The results indicated significant differences between the groups in their HPBs, as measured by the total Health-Promoting Lifestyle Profile-II score of t(318) = 6.66, p = .001, and its subscales of health responsibility, t(318) = 5.06, p = .001; physical activity, t(318) = 6.29, p = .001; interpersonal relations, t(318) = 4.24, p = .001; nutrition, t(318) = 3.54, p = .001; spiritual growth, t (318) = 3.05, p = .002; and stress management, t(318) = 3, p = .003. LINKING EVIDENCE TO ACTION: The significant differences in HPBs of nursing students from two different countries indicated that cultural factors may influence students' healthy lifestyle. Therefore, nursing education should consider exploring strategies that promote student participation in health-promoting activities.

Translation, Cross-Cultural Adaptation, and Validation of the Adolescent Pediatric Pain Tool (APPT) for Multidimensional Measurement of Pain in Children and Adolescents.

BACKGROUND: Pain is subjective and multidimensional in nature. Its assessment is very challenging especially in the pediatric population. Adequate assessment of pain in children is the keystone for effective management. Accurate and comprehensive evaluation of the child's pain experience requires the use of multidimensional pain assessment tools such as the Adolescent Pediatric Pain Tool (APPT) which measures the intensity, location and quality of pain. AIMS: The aim of this study was to translate and culturally validate the APPT for use in Lebanese children and adolescents with cancer. METHODS: The instrument was translated and culturally adapted following the WHO four steps; 1) forward translation and back-translation, 2) expert panel, 3) pre-testing and 4) cognitive interviewing. The semantic validation of the pain quality descriptors was performed by healthy children and children with cancer aged 8-17 years, using the Q-sort method. RESULTS: A final Arabic version with 31 pain descriptors equivalent to the original tool was produced based on the results from the pilot study and the children's interviews. Children were able to differentiate between the different words they use to describe their pain. CONCLUSION: Our results showed that the Lebanese version of the APPT is a culturally sensitive tool to assess the location, intensity and quality of pain in Lebanese children with cancer. Health professionals are encouraged to use this tool to assess the pain characteristics in Lebanese children with cancer, hence leading to effective pain management.

Predictors of Pressure Injuries in a Critical Care Unit in Lebanon: Prevalence, Characteristics, and Associated Factors.

PURPOSE: The purpose of this study was to identify factors associated with pressure injury in a medical-surgical intensive care unit (MSICU). DESIGN: Retrospective review of medical records. SUBJECTS AND SETTING: We reviewed the medical records of 145 patients who developed a new pressure injury in the MSICU of a 420-bed university medical center in Lebanon. METHODS: Medical records of all patients cared for in the MSICU from December 2014 to June 2017 were reviewed by a research assistant using a standardized form. We extracted potential risk factors for pressure injury including sex, age, weight upon admission, weight at discharge, length of MSICU stay, episodes of hypotension, administration of inotropes/vasopressors, admitting diagnosis, comorbid conditions, and cumulative scores on the Braden Scale for Pressure Sore Risk. The outcome variable was development of any new pressure injury during their stay in our intensive care unit. RESULTS: Forty-nine patents (33.7%) developed a new pressure injury. Bivariate analysis found statistically significant associations between pressure injury occurrences and administration of vasopressors (odds ratio [OR] = 0.42; 95% confidence interval = 0.29-0.87; P = .02), the administration of dopamine (OR = 0.20; 95% confidence interval = 0.04-0.94; P = .04), and hospital-acquired pressure injury. Among the continuous variables, analysis revealed significant relationships between weight at discharge (t = 2.31, P = .02), MSICU length of stay (t = 5.30; P = .000), cumulative Braden Scale score (t = 3.06; P = .002), hypotension (t =-2.74; P = .007), and development a new pressure injury. Multivariate analysis indicated that length of stay (ß= -.110; P = .002), administration of vasopressors (ß=-.266; P = .029), and total hours of hypotension (ß=-.53; P = .041) were significant predictors of pressure injury. CONCLUSIONS: Vasopressor use, hypotension, and length of stay were associated with an increased likelihood of pressure injury in adults managed in an MSICU. None of these factors is specifically evaluated during completion of the Braden Scale for Pressure Sore Risk. Based on these findings we recommend development of a pressure injury scale specific to critically ill adults.

Evidence on Nurse Staffing Ratios and Patient Outcomes in a Low-Income Country: Implications for Future Research and Practice.

BACKGROUND: Conclusive evidence on the effect of nurse staffing ratios on nurse-sensitive outcomes (NSOs) has not yet been achieved worldwide. AIMS: To describe the relationship between nurse staffing and NSOs at a Magnet designated, university hospital a low-income country. METHODS: A 48-month prospective study assessed the relationship between nurse staffing and six patient outcomes or NSOs in medical-surgical units and critical care units (CCUs). Nurse staffing was measured by nursing hours per patient day (NHPPD) and skill mix, whereas NSOs were total falls and injury falls per 1,000 patient days, percent of surveyed patients with hospital-acquired pressure injuries (HAPI), catheter-associated urinary tract infections, ventilator-associated pneumonia, and central line-associated bloodstream infections (CLABSI) per 1,000 central line days. RESULTS: The odds for total falls, injury falls, HAPI, and CLABSI in the medical-surgical units were higher with lower NHPPD ratios, OR = 4.67, p = .000; OR = 4.33, p = .001; OR = 3.77, p = .004 and OR = 2.61, p = .006, respectively. For the CCUs, lower rates of NHPPD increased the odds for total falls, OR = 6.25, p = .0007, HAPIs OR = 3.91, p = .001 and CLABSI, OR = 4.78, p = .000. Skill mix was associated with total falls, OR = 2.40, p = .005 and HAPIs OR = 2.07, p = .03 in the medical-surgical units but had no effect in any NSOs in the CCUs. LINKING EVIDENCE TO ACTION: Higher rates of nurses per patient were effective in improving some NSOs but not others. Skill mix had no effect on any of the six NSOs in the CCUs. As such, the results remain inconclusive as the benefits of the higher nurse to patient ratios in this low-income country warranting further multisite studies in different settings and countries.

Body positioning for spontaneously breathing preterm infants with apnoea.

BACKGROUND: It has been proposed that body positioning in preterm infants, as compared with other, more invasive measures, may be an effective method of reducing clinically significant apnoea. OBJECTIVES: To determine effects of body positioning on cardiorespiratory parameters in spontaneously breathing preterm infants with clinically significant apnoea.Subgroup analyses examined effects of body positioning of spontaneously breathing preterm infants with apnoea from the following subgroups.• Gestational age < 28 weeks or birth weight less than 1000 grams.• Apnoea managed with methylxanthines.• Frequent apnoea (> 10 events/d).• Type of apnoea measured (central vs mixed vs obstructive) SEARCH METHODS: We used the standard search strategy of the Cochrane Neonatal Review Group (CNRG) to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 10), MEDLINE via PubMed (1966 to 14 November 2016), Embase (1980 to 14 November 2016) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982 to 2016 November 14). We also searched clinical trials databases and conference proceedings for randomised controlled trials and quasi-randomised trials. SELECTION CRITERIA: Randomised and quasi-randomised controlled clinical trials with parallel, factorial or cross-over design comparing the impact of different body positions on apnoea in spontaneously breathing preterm infants were eligible for our review. DATA COLLECTION AND ANALYSIS: We assessed trial quality, data extraction and synthesis of data using standard methods of the CNRG. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess the quality of evidence. MAIN RESULTS: The search conducted in November 2016 identified no new studies. Five studies (N = 114) were eligible for inclusion. None of the individual studies nor meta-analyses showed a reduction in apnoea, bradycardia, oxygen desaturation or oxygen saturation with body positioning (supine vs prone; prone vs right lateral; prone vs left lateral; right lateral vs left lateral; prone horizontal vs prone head elevated; right lateral horizontal vs right lateral head elevated, left lateral horizontal vs left lateral head elevated). AUTHORS' CONCLUSIONS: We found insufficient evidence to determine effects of body positioning on apnoea, bradycardia and oxygen saturation in preterm infants. No new studies have been conducted since the original review was published. Large, multi-centre studies are warranted to provide conclusive evidence, but it may be plausible to conclude that positioning of spontaneously breathing preterm infants has no effect on their cardiorespiratory parameters.

Preterm infants exhibited less pain during a heel stick when they were played the same music their mothers listened to during pregnancy.

AIM: Playing music during painful procedures has shown inconsistent benefits for preterm infants. This study observed preterm infants during a heel stick procedure to assess whether listening to the music their mothers listened to during pregnancy had any impact on their pain and physiological and behavioural parameters. METHODS: We randomly exposed 42 preterm infants, with a mean gestational age of 31.8 ± 2.79 weeks, to the music their mothers listened to during pregnancy, recorded lullabies and no music, before, during and after a heel stick. Pain responses were measured using the Neonatal Pain, Agitation and Sedation Scale (N-PASS), and physiological and behavioural responses were recorded by a nurse blinded to the intervention. RESULTS: N-PASS pain scores were lowest during mothers' music, with a mean of 1.40 (±1.28), compared to 2.33 (±1.64) for no music and 1.62 (±2.27) for the lullabies [F(3/121) = 4.86, p = 0.009]. Physiological parameters were not significantly different between the conditions. During the mothers' music, infants spent more time in a quiet alert state, with a significant decrease in their respiratory rates. CONCLUSION: The music mothers listened to during pregnancy was more beneficial for preterm infants, as it decreased pain and improved behavioural states during a heel stick.

The satisfaction of families in the care of their loved ones in CCUs in Lebanon.

BACKGROUND: The needs of family members vary among cultures and hospitals. Often, these needs remain unmet increasing their stress and anxiety and decreasing their satisfaction with care, which may negatively impact the quality of patient care. AIMS: To assess the satisfaction of families with the care of their loved ones in critical care units (CCUs) in a large university medical centre in Lebanon and to assess the predictors of satisfaction. METHODS: A cross-sectional descriptive design was conducted using the Critical Care Family Satisfaction Survey (CCFSS). The participants were 123 adult relatives or significant others of patients cared for in both adult and paediatric intensive care units for at least 3 days. RESULTS: The CCFSS showed acceptable internal reliability and construct validity in a Lebanese population. In general, families were satisfied with the care their loved ones received in the CCUs, and the least satisfaction was in the area of 'comfort' and the highest was in 'assurance'. Younger family members with more education were less satisfied with care and Christian families expressed less satisfaction with informational needs compared with Muslim families. Families of children in the paediatric CCU expressed least satisfaction with care. Gender, residency, relationship to patient, unit, prior experience in a CCU and diagnosis had no effect on satisfaction scores. CONCLUSIONS: Assessment of family satisfaction in different cultures is important as each culture has specific needs that are essential to decipher. IMPLICATIONS FOR PRACTICE: Patient satisfaction leads to improved quality of care; thus, it behoves nurses to meet the needs of families from different cultures to help them cope and increase their satisfaction, which leads to improve patient outcomes.

Distraction Using the BUZZY for Children During an IV Insertion.

UNLABELLED: Needle pricks are rated by children as their most feared medical event resulting in acute pain, anxiety and distress, which negatively affects both the child and his/her parents. OBJECTIVES: To investigate the effects of external cold and vibration via the "BUZZY" on pain ratings of children, their parents and nurses during peripheral IV insertion, to measure the time to a successful IV insertion and to assess the factors that are associated with pain perception of children. METHODS: In this randomized control trial (RCT), children between the ages of 4 to 12years were assigned to either an intervention or a control group. The intervention group (n=25) had the "BUZZY" applied during IV insertion while the control group (n=23) did not have the "BUZZY". Children were asked to rate their pain along with their parents and nurses on the Wong-Baker FACES Pain Rating Scale. Time to successful IV insertion and background characteristic of children were assessed and compared. RESULTS: Pain scores were significantly lower in the "BUZZY" group for children and the nurses. Time to a successful IV insertion did not differ between groups. Gender, age, previous hospitalization, diagnoses and analgesics were all factors associated with the children's pain scores. However, a multiple regression analysis found that only the "BUZZY" remained a significant predictor of pain scores in children. CLINICAL IMPLICATIONS: The "BUZZY" may be an easily accessed, inexpensive ($39.95 each at $0.09 per 3 minute stick), and effective technique to control or reduce pain in young children undergoing IV insertion.

NeoSeal to Prevent Nasal Injury in Preterm Infants Receiving Oxygen Therapy.

PURPOSE: To determine if a foam septum protector prevents nasal injury in preterm infants receiving nasal heated humidified oxygen. DESIGN: A retrospective before and after comparative design was used. SAMPLE: Medical records of 101 preterm infants receiving either nasal continuous positive airway pressure (NCPAP) or nasal intermittent positive pressure ventilation (NIPPV) were reviewed; 50 were in the control group and 51 were in the intervention group that had the NeoSeal septum protector applied. The groups were not different in terms of gender, birth weight, gestational age, days intubated, or on days on NCPAP/NIPPV. Skin condition of nares was scored daily using the Neonatal Skin Risk Assessment Scale (NSRAS). RESULTS: Infants who had the NeoSeal applied had significantly less nasal injuries, OR = 4.08; 95% confidence interval (CI), 1.22-9.59; p = .01. The best predictors of nasal injury were gestational age and whether the NeoSeal was applied or not.

Does administrative support negate the consequences of nurse abuse?

AIM: To assess the relationship between disruptive/abusive situations and the 'intention to leave' nursing. BACKGROUND: While every nurse deserves to feel safe in his or her working environment, nurse abuse remains a common occurrence worldwide. Only when hospitals are safe, is retention enhanced and patient care improved. METHOD: A cross-sectional survey was conducted with 1053 nurses. RESULTS: Almost 70% of nurses experienced stressful disruptive/abusive situations that were mainly caused by patients/families. The majority felt skilled in dealing with these situations, yet around 40% considered leaving nursing because of disruption/abuse. Stress from disruption/abuse, the skill in dealing with abuse and the administrations' support were the best predictors for the 'intention to leave'. CONCLUSIONS: It may not be the amount of abuse per se that affects the nurses' intention to leave, but rather how the abuse is perceived, the skill in dealing with it and the support received from administration. IMPLICATIONS FOR NURSING MANAGEMENT: The support received from nursing administration may negate the effect of stress and the 'intention to leave' because of disruptive/abusive situations. This should behove nurse managers and administrators to have a system in place to provide support for nurses, which in turn could improve job satisfaction and retention.

The effectiveness of a pressure ulcer intervention program on the prevalence of hospital acquired pressure ulcers: controlled before and after study.

BACKGROUND: Pressure Ulcers (PUs) are associated with high mortality, morbidity, and health care costs. In addition to being costly, PrUs cause pain, suffering, infection, a lower quality of life, extended hospital stay and even death. Although several nursing interventions have been advocated in the literature, there is a paucity of research on what constitutes the most effective nursing intervention. OBJECTIVES: To determine the efficacy of multidisciplinary intervention and to assess which component of the intervention was most predictive of decreasing the prevalence of Hospital acquired pressure ulcers (HAPU) in a tertiary setting in Lebanon. DESIGN: An evaluation prospective research design was utilized with data before and after the intervention. The sample consisted of 468 patients admitted to the hospital from January 2012 to April 2013. RESULTS: The prevalence of HAPU was significantly reduced from 6.63% in 2012 to 2.47. Sensitivity of the Braden scale in predicting a HAPU was 92.30% and specificity was 60.04%. A logistic multiple regression equation found that two factors significantly predicted the development of a HAPU; skin care and Braden scores. CONCLUSION: The multidisciplinary approach was effective in decreasing the prevalence of HAPUs. Skin care management which was a significant predictor of PUs should alert nurses to the cost effectiveness of this intervention. Lower Braden scores also were predictive of HAPUs.

Substance abuse In Middle Eastern adolescents living in two different countries: spiritual, cultural, family and personal factors.

It is estimated that the percentage of students using illicit substances by sixth grade has tripled over the last decade not only in developed countries but in developing countries as well probably due to the transition to a more Western society. Although much has been done to understand the mechanisms underlying substance abuse, few studies have been conducted with minority ethnic and religious groups such as Middle Eastern Youth. The primary goal of this study was to determine whether there are differences in factors contributing to substance abuse in adolescents from Lebanon versus the U.S.A. and to decipher the role of spirituality, religion, and culture among other factors that may influence substance abuse. A correlational cross-sectional design was used with adolescents living in two different countries: Los Angeles, California and Beirut, Lebanon. Muslim adolescents had significantly less rates of alcohol and substance use than Christians in both Lebanon and Los Angeles. More years lived in the U.S.A. increases the likelihood of abuse for both Muslims and Christians. Attachment to God and family was negatively associated with substance abuse. These results among others facilitate a better understanding of the influence of culture, religion, family and personal factors on substance abuse. Culturally sensitive interventions could benefit from the findings of this pilot study.

Implementing a Rapid Response Team: A Quality Improvement Project in a Low- to Middle-Income Country.

BACKGROUND: The benefits of rapid response teams (RRTs) have been controversial with few studies conducted in low- to middle-income countries. OBJECTIVE: The aim of this study was to investigate the effectiveness of implementing an RRT on 4 patient outcomes. METHODS: We conducted a quality improvement pre-and-post design using the Plan-Do-Study-Act model in a tertiary hospital in a low- to middle-income country. We collected data before and after implementing the RRT in 4 phases and over 4 years. RESULTS: Survival to discharge after cardiac arrest was 25.0% per 1000 discharges in 2016 and increased to 50% in 2019, a 50% increase. The rate of activations per 1000 discharges was 20.45% for the code team in 2016 and 33.6% for the RRT team in 2019. Thirty-one patients who arrested were transferred to a critical care unit before implementing the RRT, and 33% of such patients were transferred after. The time it took the code team to arrive at the bedside was 3.1 minutes in 2016 and decreased to 1.7 minutes for the RRT team to arrive in 2019, a 46% decrease. DISCUSSION AND CLINICAL IMPLICATIONS: Implementing an RTT led by nurses in a low- to middle-income country increased the survival rate of patients who had a cardiac arrest by 50%. The role of nurses in improving patient outcomes and saving lives is substantial and empowers nurses to call for assistance to save patient lives who show early signs of a cardiac arrest. Hospital administrators should continue to use strategies to improve nurses' timely response to the clinical deterioration of patients and to continue to collect data to assess the effect of the RRT over time.

Chemotherapy-induced nausea and vomiting in Asian women with breast cancer receiving anthracycline-based adjuvant chemotherapy.

BACKGROUND: Chemotherapy-induced nausea and vomiting (CINV) remain among the most frequently reported distressing side effects associated with anthracycline-based chemotherapy despite significant advances in antiemetic management. The main risk factor for severity of CINV is the emetogenic potential of the chemotherapeutic agents. However, patient-related risk factors have been identified, including genetic makeup. Although studies have noted that ethnicity influences nausea and vomiting in other contexts, there is a paucity of research regarding the impact of ethnicity on CINV. This study was undertaken to evaluate whether Asian women receiving anthracycline-based chemotherapy experience more CINV than non-Asians. METHODS: A retrospective, comparative, correlational chart review was performed to abstract the relevant variables. RESULTS: Data from a convenience sample of 358 women with breast cancer who received chemotherapy with doxorubicin between 2004 and 2008 at City of Hope in Duarte, California, were evaluated. The sample consisted of Caucasians (45%), Hispanics (27.7%), Asians (19.8%), and African Americans (7.5%). The results indicate that Asian women with breast cancer undergoing anthracycline-based chemotherapy experienced statistically significantly more clinically important CINV than their non-Asian counterparts. LIMITATIONS: The data were collected retrospectively, with a certain population distribution at a specific time. CONCLUSION: This study provides interesting preliminary evidence that Asian ethnicity plays a role in the development of severe CINV. When managing chemotherapy toxicities in women with breast cancer, health-care providers should tailor therapy to individual risk profiles. Specifically, consideration of antiemetic therapy should accommodate patient characteristics, such as Asian descent.