Developing and assessing a vomiting-free ward workflow for gynecological patients receiving chemotherapy.

Abstract

Background: Chemotherapy-induced nausea and vomiting (CINV) significantly diminishes the quality of life (QoL) for patients undergoing early and late-stage cancer treatments. Despite preventive antiemetic measures, CINV remains a challenge, with limited response rates. CINV adversely affects not only patients' physical health but also their psychological well-being, social interactions, and treatment adherence.

Objective: This study aimed to evaluate the impact of a vomiting-free ward initiative on managing CINV and its effects on the psychological well-being and QoL of gynecological cancer patients receiving chemotherapy.

Method: In this study, 960 gynecological oncology patients receiving inpatient chemotherapy at a premier obstetrics and gynecology hospital in Sichuan Province were enrolled from January to December 2023. They were evenly divided into intervention and control groups based on their admission dates. Both groups underwent standard care, and the intervention group followed a vomiting-free ward protocol. The effectiveness of this specialized ward was evaluated using the Multinational Association of Supportive Care in Cancer (MASCC) Antiemesis Tool, the Functional Living Index-Emesis (FLIE), and the Hospital Anxiety and Depression Scale (HADS).

Results: The intervention group showed significant improvements in the frequency and severity of both acute and delayed CINV compared to the control group. Furthermore, there was a 9.7% and 7.2% decrease in the impact of severe nausea and vomiting on leisure activities and a 6.9% and 8.6% reduction in how moderate to severe nausea and vomiting affected daily living, respectively. The introduction of the vomiting-free ward significantly reduced levels of patient anxiety (t = - 3.148, P < 0.001) and depression (t = - 3.223, P < 0.001) compared to standard care.

Conclusion: The implementation of a vomiting-free ward effectively mitigates nausea and vomiting, enhances QoL, and decreases anxiety and depression among gynecological oncology patients. This innovative approach can be integrated into clinical practice, providing valuable insights and guidelines for healthcare professionals.