2.50
Hdl Handle:
http://hdl.handle.net/10755/158211
Type:
Presentation
Title:
Patterns of nausea in tube-fed adults
Abstract:
Patterns of nausea in tube-fed adults
Conference Sponsor:Western Institute of Nursing
Conference Year:1998
Author:Westfall, Una, PhD
P.I. Institution Name:Oregon Health & Science University
Title:Professor
Contact Address:School of Nursing, 3181 SW Sam Jackson Park Road, Portland, OR, 97201, USA
Contact Telephone:503.494.8311
Problem and Foundation: Nausea is a distressing sensation and has been reported by adults receiving tube feedings. To manage or minimize nausea there are multiple therapeutic strategies. However, such strategies are often used only after patient request, or are provided on a predetermined schedule, such as every 3 or 4 hours. Matching the time of therapy with a pattern of nausea could enhance care effectiveness for this adverse sensation. Yet little is known about how nausea in tube fed patients is perceived across consecutive hours. Thus, this study was designed to detect and characterize the sensation of nausea in adults receiving tube feedings as their only nutritional source.



Sample and Method: To describe daily patterns of nausea reported by adult oncology tube-fed patients, a single case study with replication, time series design was used with 19 adults (M=14; F=5), ages 44-84 years, on bolus feedings, and 5-7 days post-oropharyngeal surgery. Feedings were delivered 4 to 5 times/day via nasogastric tube. Data were collected hourly (when awake) over 24-48 continuous hours just prior to hospital discharge. There were 15-35 data points per subject. Subjects marked intensity (I) and unpleasantness (U) dimensions of nausea on 100mm visual analogue scales, a well accepted sensation measure. Scales ranged from 0 (none) to 100 (extreme). Pattern analysis focused on amount of nausea, proportion of time nausea was reported, intensity-unpleasantness links, and 24-hr rhythms via cosinor analysis.



Results: While 4 of 19 subjects (21%) consistently reported no or minimal nausea intensity and unpleasantness (<5mm), 6 (32%) reported nausea dimensions that spanned up to 30mm; 4 (21%), up to 50mm; and 5 (26%) a span of 53-92mm. Four subjects (21%) reported nausea intensity and unpleasantness at a level >40mm for at least 20% of the time. Of these 4 subjects, 3 experienced this severe level of nausea between 55-97% and 60-97% of the time for intensity and unpleasantness, respectively. Theses subjects reported nausea intensity </= unpleasantness (subject 1: I-55%, U-60%; subject 2: I-67%, U-87%; subject 3: I-97%, U-97%). Using cosinor analysis, 24-hour patterns for nausea intensity and unpleasantness were detected (p<.05) in these 3 subjects. The nausea dimensions peaked in the evening for 2 subjects, but in the early morning for the remaining subject.



Conclusions: These results indicate wide ranges and intra- and inter-individual nausea variability over 24-48 consecutive hours in the post-operative tube-fed adults. In the cases of nausea here, when data were gathered can affect the person's responses. A challenge is to not assume prior data reflect current status. Only 1/5 of the subjects experienced little or no nausea. The 3 subjects with the most severe ratings had detectable 24-hour patterns of nausea intensity and unpleasantness. If a tube-fed patient experiences predictable nausea fluctuations, caregivers may be better able to use such patterns to anticipate actions to control or minimize nausea more appropriately.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePatterns of nausea in tube-fed adultsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158211-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Patterns of nausea in tube-fed adults</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1998</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Westfall, Una, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Oregon Health &amp; Science University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">School of Nursing, 3181 SW Sam Jackson Park Road, Portland, OR, 97201, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">503.494.8311</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">westfall@ohsu.edu</td></tr><tr><td colspan="2" class="item-abstract">Problem and Foundation: Nausea is a distressing sensation and has been reported by adults receiving tube feedings. To manage or minimize nausea there are multiple therapeutic strategies. However, such strategies are often used only after patient request, or are provided on a predetermined schedule, such as every 3 or 4 hours. Matching the time of therapy with a pattern of nausea could enhance care effectiveness for this adverse sensation. Yet little is known about how nausea in tube fed patients is perceived across consecutive hours. Thus, this study was designed to detect and characterize the sensation of nausea in adults receiving tube feedings as their only nutritional source.<br/><br/><br/><br/>Sample and Method: To describe daily patterns of nausea reported by adult oncology tube-fed patients, a single case study with replication, time series design was used with 19 adults (M=14; F=5), ages 44-84 years, on bolus feedings, and 5-7 days post-oropharyngeal surgery. Feedings were delivered 4 to 5 times/day via nasogastric tube. Data were collected hourly (when awake) over 24-48 continuous hours just prior to hospital discharge. There were 15-35 data points per subject. Subjects marked intensity (I) and unpleasantness (U) dimensions of nausea on 100mm visual analogue scales, a well accepted sensation measure. Scales ranged from 0 (none) to 100 (extreme). Pattern analysis focused on amount of nausea, proportion of time nausea was reported, intensity-unpleasantness links, and 24-hr rhythms via cosinor analysis.<br/><br/><br/><br/>Results: While 4 of 19 subjects (21%) consistently reported no or minimal nausea intensity and unpleasantness (&lt;5mm), 6 (32%) reported nausea dimensions that spanned up to 30mm; 4 (21%), up to 50mm; and 5 (26%) a span of 53-92mm. Four subjects (21%) reported nausea intensity and unpleasantness at a level &gt;40mm for at least 20% of the time. Of these 4 subjects, 3 experienced this severe level of nausea between 55-97% and 60-97% of the time for intensity and unpleasantness, respectively. Theses subjects reported nausea intensity &lt;/= unpleasantness (subject 1: I-55%, U-60%; subject 2: I-67%, U-87%; subject 3: I-97%, U-97%). Using cosinor analysis, 24-hour patterns for nausea intensity and unpleasantness were detected (p&lt;.05) in these 3 subjects. The nausea dimensions peaked in the evening for 2 subjects, but in the early morning for the remaining subject.<br/><br/><br/><br/>Conclusions: These results indicate wide ranges and intra- and inter-individual nausea variability over 24-48 consecutive hours in the post-operative tube-fed adults. In the cases of nausea here, when data were gathered can affect the person's responses. A challenge is to not assume prior data reflect current status. Only 1/5 of the subjects experienced little or no nausea. The 3 subjects with the most severe ratings had detectable 24-hour patterns of nausea intensity and unpleasantness. If a tube-fed patient experiences predictable nausea fluctuations, caregivers may be better able to use such patterns to anticipate actions to control or minimize nausea more appropriately.</td></tr></table>en_GB
dc.date.available2011-10-26T20:37:15Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:37:15Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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