Nursing Supports for Managing Nausea and Vomiting in Patients with Cancer Having a Prognosis of Months or Weeks: A Multisite Cross-Sectional Study of Palliative Care Nurses in Japan

Authors: Kobayashi Masamitsu, Kajiwara Kohei, Nakano Kimiko, Kanno Yusuke, Morikawa Miharu, Matsuda Yoshinobu, Kako JunJournal: Palliative medicine reportsPublished: January 1, 2025DOI: 10.1089/pmr.2024.0093

Q1 JournalSJR: 1.5h-index: 112SCImago

Limited EvidenceCross Sectionaln=539 participants

Nausea Cancer Pain Management

In Plain Language: nausea, explained

This study aimed to clarify the types of nursing support provided by palliative care unit (PCU) nurses in Japan to manage nausea and vomiting in patients with cancer who have a prognosis of months or weeks. This multisite cross-sectional study surveyed registered nurses from all 389 PCUs across Japan. Eligible participants were nurses providing direct care to patients. Data were collected via online surveys from October 2023 to March 2024. The frequency of 13 types of nursing supports for nausea and vomiting was evaluated using a five-point Likert scale, stratified by patient prognosis (months or weeks). Of the 389 PCUs invited, 162 (41.6%) consented to participate. A total of 2448 nurses were invited, of which 539 (22.3%) responded. The most frequently implemented nursing supports were "avoiding unpleasant odors," "providing shaved ice or ice chips," "providing fresh air," and "gargling with cold water." These were consistently practiced by many nurses, regardless of patient prognosis. Conversely, specialized supports such as "reiki," "acupressure," "guided relaxation exercises," "therapeutic touch," and "foot reflexology" were rarely or seldom used. Noninvasive, simple nursing supports that do not require specialized knowledge or skills were frequently provided to patients with cancer who were experiencing nausea and vomiting, irrespective of their prognosis. However, nursing supports that require specialized knowledge and skills were rarely used. Further research is needed to evaluate the effectiveness of these nursing supports.

Key Findings: what this cross-sectional study found about nausea

✓The most frequently implemented nursing supports for managing nausea and vomiting in palliative cancer patients were avoiding unpleasant odors, providing shaved ice or ice chips, providing fresh air, and gargling with cold water.
✓Palliative care nurses in Japan reported consistent use of these nursing interventions regardless of whether patients had a prognosis of months or weeks.
✓The response rate from Japanese palliative care units was 41.6% (162 of 389 units), with 22.3% of invited nurses (539 of 2448) completing the survey.

What This Means for You

This study shows that reflexology is uncommonly used in Japanese palliative care settings for nausea management, with simple comfort measures being the standard approach; more research is needed to determine reflexology's effectiveness for this symptom.

What This Means for Practitioners

Reflexology remains underutilized in formal palliative care settings in Japan, suggesting potential barriers to integration or lack of evidence-based protocols in clinical practice.

Study Design: how this cross-sectional study was run

Sample Size

539 participants

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Nausea: common questions

What does this study say about nausea?

What did this study find?

The most frequently implemented nursing supports for managing nausea and vomiting in palliative cancer patients were avoiding unpleasant odors, providing shaved ice or ice chips, providing fresh air, and gargling with cold water. Palliative care nurses in Japan reported consistent use of these nursing interventions regardless of whether patients had a prognosis of months or weeks. The response rate from Japanese palliative care units was 41.6% (162 of 389 units), with 22.3% of invited nurses (539 of 2448) completing the survey.

How strong is this evidence?

This is a cross-sectional study and we rate its evidence limited. It covers 539 participants. It was published in Palliative medicine reports, a Q1 journal. This study is indexed here for context; it did not test reflexology itself.