Date of Award

9-4-1992

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

Abstract

Individuals diagnosed as having cancer are confronted with challenging life and death issues. Medical interventions aimed at retarding or eradicating malignant growths have fortunately met with increasing success over recent years, thus offering patients optimism in the form of either prolonging life or attaining a permanent cure. However, such optimism is not met without risks of suffering distressing treated related side-effects. Perhaps the most unpleasant side-effects facing patients are nausea and vomiting which can be associated with undergoing either chemotherapy or radiotherapy.Over the past decade, research with chemotherapy patients has aided in identifying treatment related and psychological or emotional factors contributing to patients' experiences of nausea and vomiting. This has resulted in interventions which have achieved success in reducing the frequency and severity of nausea and vomiting episodes which patients endure. In contrast, relatively little research of a similar nature has been focused on radiotherapy related nausea and vomiting.The present study followed 46 cancer patients throughout their entire course of radiotherapy. Frequency and severity ratings for nausea and vomiting were obtained for both post-treatment and anticipatory periods. Prior radiotherapy studies have not examined nausea and vomiting along this dimension, although it has been found to be an important undertaking in research with chemotherapy. Patients' ratings of symptoms were viewed in relationship to a number of treatment and clinical status variables, as well as in relationship to depression and state anxiety.Discriminant analyses of post-treatment nausea, post-treatment vomiting, and anticipatory nausea revealed that group membership (symptomatic/asymptomatic) could be predicted with relatively high accuracy using combinations of treatment, clinical, and emotional variables. Emotional factors have previously been hypothesized to influence patients' experiences of radiotherapy related nausea and vomiting, although the present study appears to be the first to empirically examine this relationship. In general, patients experiencing either post-treatment or anticipatory symptoms experienced relatively greater depression than did asymptomatic patients. Greater state anxiety also appeared to be associated with the expression of anticipatory symptoms. The possible roles of emotional factors are discussed and suggestions for future research offered.

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