This research addresses the critical need to improve how older (= 65) adults self-manage side effects from cancer treatment such as chemotherapy induced nausea and vomiting (CINV). Older adults undergoing cancer treatment are at high risk for progressive severe effects resulting from nausea and vomiting. These effects include fluid and electrolyte imbalances, dehydration, muscle weakness, generalized fatigue, weight loss, dizziness, altered mental status, low blood pressure, changes in cardiac function, falls, and non-adherence with treatment plans. CINV is among the top five reasons why patients call their doctor while under treatment for cancer and has shown to lead to increased use of resources (e.g.,. unplanned emergency department (ED) and/or hospital admissions). Severe CINV related effects occur in up to 80% of older adults undergoing chemotherapy treatment resulting in high out-of-pocket costs. Additionally, quality of life (QOL) and daily functioning are greatly reduced with CINV. Guidelines exist for treating CINV; however, anti-nausea medications are often under-prescribed in the elderly and their use of self-management strategies at home is unknown. Research has shown that older people with cancer are able to identify cancer -related symptoms such as CINV, but they are often not able to recognize the consequences of symptoms. This affects their ability to self- manage the symptom. The goal of this project is to design, develop, and test an interactive game that will engage and prepare older adults to make self-care decisions related to CINV by allowing them to practice making self-care decisions for a character (avatar) in the game and visualizing the outcomes (positive or negative). The knowledge gained from playing the game will assist them in making better self-care decisions at home during or after chemotherapy treatment. This project will be conducted in two phases. Phase I will consist of designing and developing the game prototype to reflect real-life scenarios and experiences with CINV self-management. Older adults who have experienced CINV in the past, their caregivers, and oncology nurses will be included in the development team in order to create a game that is reflective of personal and professional experiences. Phase II will use a randomized clinical design to pilot test the game for feasibility and preliminary effectiveness in increasing self- managements behaviors, reducing CINV severity, and improving quality of life. Once shown to be effective, this novel educational strategy can be widely disseminated for use at the bedside and be adapted to educate older adults on self-management strategies for other cancer-related symptoms with negative outcomes.
The goal of this study is to increase the self-management behaviors for chemotherapy induced nausea and vomiting (CINV) and reduce treatment-related negative outcomes in older adults with cancer. CINV is a common reason for unplanned emergency department and/or hospital admissions in older adults with cancer. Early reinforcement of standard education and reframing preconceived beliefs about the potential serious consequences of CINV and the symptoms ability to be successfully managed will increase effective self- management behaviors and improve patient outcomes.
| Loerzel, Victoria; Clochesy, John; Geddie, Patricia (2018) Using a community advisory board to develop a serious game for older adults undergoing treatment for cancer. Appl Nurs Res 39:207-210 |
