Mitigation of Chemotherapy-Induced Nausea Using Adjunct Music Listening: A Pilot Study.

The persistence of chemotherapy-induced nausea (CIN) underscores the need to consider nonpharmacologic treatments such as music listening as adjunct interventions. This pilot study investigated the feasibility and overall effects of a 30-minute adjunct music listening intervention in 12 patients experiencing CIN. Music listening was started at the time participants took their as-needed antiemetic medication, and it was repeated as needed during the 5 days after chemotherapy. Data for 66 music listening engagements were collected. A significant reduction of nausea severity (t = 10.97, p < .001) and distress (t = 9.86, p < .001) was noted overall, as well as significant reductions when examining the acute and delayed phases of nausea individually. Qualitative data on study feasibility demonstrated the intervention was well received by participants and held minimal operational difficulty. Investigator feasibility data suggested good understanding of data collection tools. Improvements to the study design have been collected and will form the basis of the future randomized controlled trial.

Barriers to Implementation of Music Listening Interventions for Cancer-Related Phenomena: A Mapping Review.

Introduction: Despite music listening interventions (MLIs) being recommended in multiple clinical practice guidelines, implementation into oncology clinical practice sites has been slow. This mapping review aimed to critique and identify barriers to MLI clinical implementation, as well as offer practical solutions for both clinicians and researchers. Methods: A PRISMA-based mapping review of MLI literature was performed using CINAHL, PubMed, PsycINFO, and Web of Science databases. Eligibility criteria included studies with MLIs as independent variables and cancer-related phenomena as outcome variables. Search was performed in October 2021, and no date limit was set. Results: Thirty-eight studies met the eligibility criteria for inclusion. Several aspects of MLI studies suggested potential barrier status to clinician or patient adoption. These findings included choice of music, music delivery hardware, dose of MLI, and timing of MLI specific to outcomes of interest (e.g., pain, anxiety, mood). Few investigators addressed the concurrent effects of pharmaceuticals (e.g., analgesics, anxiolytics), and controlling for the effects of competing auditory stimuli was minimal. Discussion: This review has identified several barriers that may obstruct clinician and patient adoption of MLIs, despite level of evidence for MLIs that presently exists in the literature. The review makes practical suggestions for clinicians, researchers, and patients to overcome the present barriers and ease MLIs into common practice in clinics and homes.

Incorporating Music-Listening Interventions into Clinical Nursing Practice.

A call to expand the study and use of this effective adjunct therapy.

Chemotherapy-Induced Nausea and Vomiting Mitigation With Music Interventions
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PROBLEM IDENTIFICATION: Despite three decades of studies examining music interventions as a mitigant of chemotherapy-induced nausea and vomiting (CINV), to date, no systematic review of this literature exists.
. LITERATURE SEARCH: PubMed, Scopus, PsycInfo®, CINAHL®, Cochrane Library, and Google Scholar were searched. Keywords for all databases were music, chemotherapy, and nausea.
. DATA EVALUATION: All studies were appraised for methodology and results.
. SYNTHESIS: 10 studies met inclusion criteria for review. Sample sizes were generally small and nonrandomized. Locus of control for music selection was more often with the investigator rather than the participant. Few studies controlled for the emetogenicity of the chemotherapy administered, nor for known patient-specific risk factors for CINV.
. IMPLICATIONS FOR RESEARCH: The existing data have been largely generated by nurse scientists, and implications for nursing practice are many, because music interventions are low-cost, easily accessible, and without known adverse effects. However, this specific body of knowledge requires additional substantive inquiry to generate clinically relevant data.

Trajectory of Dyspnea and Respiratory Distress among Patients in the Last Month of Life.

BACKGROUND: The trajectory of dyspnea has been reported among patients approaching the end of life. However, patients near death have been dropped from longitudinal studies or excluded altogether because of an inability to self-report; proxy estimates have been reported. It is not known whether dyspnea or respiratory distress remains stable, escalates, or abates as patients reach last days. OBJECTIVE: Determine trajectory of dyspnea (self-reported) and respiratory distress (observed) among patients who were approaching death. DESIGN: A prospective, repeated-measures study of dyspnea/respiratory distress among a sample of hospice patients was done. Measures were collected at each patient encounter from hospice enrollment until patient death. MEASUREMENTS: Dyspnea was measured in response to "Are you short of breath?" and using the numeric rating scale anchored at 0 and 10. Nurses measured respiratory distress with the Respiratory Distress Observation Scale (RDOS). Patient consciousness (Reaction Level Scale), nearness to death (Palliative Performance Scale), diagnoses, and demographics were recorded. Data for the 30-day interval before death were analyzed. RESULTS: The sample was 91 patients who were female (58%) and Caucasian (83%) with dementia (32%), heart failure (26%), and cancer (13%). RDOS increased significantly from mild distress 30 days before death to moderate/severe distress on the day of death (F = 10.8, p < 0.0001). Distress was strongly correlated with nearness to death (r = -0.97, p < 0.0001) and consciousness (r = 0.97, p < 0.0001). CONCLUSIONS: Respiratory distress escalated in the last days. Inability to self-report raises care concerns about under-recognition and under-treatment of respiratory distress.

Genetic Influence on Chemotherapy-Induced Nausea and Vomiting: A Narrative Review.

Chemotherapy-induced nausea and vomiting (CINV) is a phenomenon common to patients being treated for a solid or hematologic malignancy. This adverse effect to cancer treatment persists in about half of all patients receiving highly emetogenic treatment, despite prophylaxis with serotonin (5-hydroxytryptamine-3 [5-HT3]) antagonists, steroids, and additional agents. Two broad categories increase risk for CINV: the emetogenic potential of chemotherapeutic drugs and patient-specific risk factors, such as younger age, female gender, low or no alcohol intake, and history of motion sickness or pregnancy-induced nausea. Despite these predictors for CINV, guidelines for prophylaxis continue to be based solely on the emetogenicity of agents administered. New strategies for CINV are unlikely until additional data emerge.
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Cancer as a Platform for Genetics Education in the Undergraduate Nursing Curriculum.

BACKGROUND: Nursing leaders and governing agencies have long requested more genetic content in the undergraduate nursing curriculum. Despite this, evidence in the literature detailing how to meet this objective is scarce. METHOD: Using a familiar health condition such as cancer, undergraduate nursing students are introduced to the multiple genetic abnormalities that underlie the cellular dysregulation leading to carcinogenesis. RESULTS: Nursing students complete the course with a knowledge of cancer and its genetic underpinnings. CONCLUSION: This approach facilitated integration of genetic content in a disease-focused nursing course.