Anticipatory Gastrointestinal Symptoms In Patients Receiving Intravenous Adriamycin

Objectives:To explore the relationship between prevalence of anticipatory gastrointestinal symptoms in patients receiving intravenous adriamycin and individual psychological reaction,other risk factors,in order to provide the basis for the implementation of effective interventions to improve chemotherapy tolerance,and promote treatment in cancer patients.Methods:1.12malignant bone tumor patients with anticipatory gastrointestinal symptoms were enrolled in the study.An explorative study using individual semi-structured,in-depth interviews was conducted to learn emotion variables during diagnosis and treatment,and coping strategies to adverse reactions resulting from antineoplastic drugs.Data was analysised with Colaizzi’s procedures.2.32patients were asked to record9different symptoms on a time-scheduled diary-type form for9days in consecutive3cycles. The feeling of nausea was evaluates with Nausea Profile designed by Muth after the third session:3.Cardiac electrical activity was collected from32patients,undergoing intravenous adriamycin with12-lead Holter in successive2cycles.To determine the activities of the antonomic nervous system, time-domain parameters of heart rate variability,HRV were analyzed with Cardio Trak analysis system.Results:1. Patients with anticipatory gastrointestinal symptoms had serious post-treatment adverse reaction,and greate rpsychological burden.Pre-chemotherapy anxiety, depression and expectations to nausea and vomiting contributed to the development of anticipatory gastrointestinal symptoms. 2.There were gender differences in the development of anticipatory gastrointestinal symptoms.Women reported a greater incidence.Anticipatory gastrointestinal symptoms occurrence beyond the contribution of the duration and severity of post-treatment nausea and vomiting were not correlative(γ=0.258, γ=0.331),P>0.05,and was positively correlated with prevalence of symptoms(y=0.612),and prevalence of heartbeat is greater.Howere,severity of vomiting was statistically signification,p<0.05.3.For patients with anticipatory gastrointestinal symptoms,sympathetic activity increased intensely in the duration of and post-adriamycin infusion.Compared with pre-infusion, SDANN increased in post-infusion,p<0.05. Compared with non-anticipatory gastrointestinal symptoms, RMSSD decreased significantly in the duration of infusion,P<0.01.4.As the number of chemotherapy increasing,magnitude of parasympathetic(vagus) reaction was larger in the second session,P<0.05. Compared with the first session, PNN50increased in the during and post-infusion,p<0.05.Conclusions:1.Anticipatory gastrointestinal symptoms and post-treatment gastrointestinal reaction may be bidirectional.Classical conditioning is physiological basis of development of Anticipatory gastrointestinal symptoms.2.There were gender differences in the development of anticipatory gastrointestinal symptoms.Women reported a greater incidence.3.Anticipatory gastrointestinal symptoms occurrence is positively correlated with prevalence of symptoms;association with cardiotoxicity of adriamycin, and not correlated with the duration and severity of post-treatment nausea and vomiting.4.Indicators of sympathetic tone are the predictors of anticipatory gastrointestinal symptoms.Patients with non-anticipatory gastrointestinal symptoms are relatively stable psychological conditions.