An analysis of the antiemetic protection of metoclopramide plus dexamethasone in Chinese patients receiving moderately high emetogenic chemotherapy.

This descriptive study aimed to evaluate the antiemetic protection of metoclopramide plus dexamethasone in a sample of 33 Chinese breast cancer patients who were receiving doxorubicin and cyclophosphamide. The antiemetic protection effect was not satisfactory. The results showed that the worst nausea and vomiting was experienced on the third day, with 87.9% of patients reporting nausea and 63.6% experiencing vomiting on that day. In almost one-third of the sample antiemetic medication failed to protect against either acute vomiting or delayed vomiting (i.e. patients continued to experience more than five emetic episodes). Complete protection from acute vomiting was seen in 36.4% of patients, whereas complete protection from delayed vomiting was seen in only one-third of the patients. There was an association between acute nausea/vomiting and delayed nausea/vomiting. Different types of antiemetics need to be offered to Chinese patients receiving chemotherapy (i.e. 5-HT3 receptor antagonists or a combination of antiemetics), but more research should be directed to this area.

Pretreatment factors predicting the development of postchemotherapy nausea and vomiting in Chinese breast cancer patients.

A prospective longitudinal study was designed to assess the role of pretreatment proneness to nausea and vomiting (NV) in the development of postchemotherapy NV in a group of Chinese breast cancer patients receiving moderately highly emetogenic chemotherapy. Seventy-one chemotherapy-naive subjects participated in the study. Patients were assessed the day before chemotherapy with measurements of their anxiety level, depression, fatigue and proneness to NV, motion sickness, NV experienced in past pregnancies, history of labyrinthitis, expectation of developing NV and expectation of developing pain. Patients also completed daily assessments of frequency, duration and intensity of NV for the 7 days after chemotherapy. Regression analyses revealed that nonpharmacological factors explained part of the variance of NV, the most common predictors being a history of labyrinthitis, expectation of developing NV after chemotherapy, younger age, stage of disease, and state anxiety. The explanatory power of the models ranged from 6% to 23% of the variance of the independent variable. There were different explanatory models for acute and delayed NV. Results indicate that consideration of the role of nonpharmacological factors in the development of NV could lead to more effective management of NV induced by chemotherapy.

Traveling through the cancer trajectory: social support perceived by women with gynecologic cancer in Hong Kong.

A qualitative research design was selected to gather data on the experiences of social support for Chinese women with gynecologic cancer. Eighteen women were recruited and interviewed at an oncology unit of a teaching hospital in Hong Kong. Content analysis of the interview data showed Chinese women with gynecologic cancer placed enormous emphasis on their human relationships. Family members were especially significant to them although not all identified their family relations as satisfactory or helpful. Their social network comprised 4 major sources, including family and friends, work and colleagues, health professionals, and religion and spiritual beliefs. Each network offered significant reciprocal relations, authoritative relations, or entrusting relations. The positive appraisal of the support function was linked to the Chinese value of food, work ethics, the Confucian and religious philosophy, whereas negative aspects of support, such as the stress of maintaining relationships and inadequate information, conjoined with the Chinese suppression of emotion and the busyness of health professionals. Future studies, including social relations as a determinant, should ensure a broad and multifunctional view of social support and acknowledge the cultural influences on the perspective of support.

Quality of life in Chinese women with gynaecological cancers.

Sixty-two Hong Kong Chinese women with gynaecological cancers participated in this cross-sectional study to assess their quality of life (QOL). Chinese versions of the World Health Organisation Quality of Life Measure--abbreviated version, the Profile of Mood States, and the Sexual Relationships subscale of the Psychosocial Adjustment to Illness Scale were used. Qualitative data were collected about the meaning of QOL and the areas of life most affected by the cancer and its treatments. The overall QOL was found to be moderate (mean 92.4, SD 16.34), with the domains of psychological health and social relationships most affected. The distressed facets of life were related to pain, dependency, finances, sexuality, psychological health and spirituality. Mobility, accepting one's outlook, social support and "eating" were areas considered by these women to contribute to a better QOL. The meaning of QOL was described in terms of happiness and material resources. The overall mood score was found to be impaired (mean 43.84, SD 32.31), with relatively high scores for depression, anger and tension. Depression could explain 45% of the variance in the QOL. Despite some missing data, sexual relationships among the respondents were moderately affected, with reduced sexual desire and activity. However, the patients' relationships with their husbands were minimally affected, suggesting the men's understanding and support in the cancer trajectory of their wives. Areas of life that may need further support, such as sexual functioning and psychosocial adjustment, could be improved by the use of sex therapy or group support interventions. Limitations of the present study and suggestions for future research are discussed.