This is an eight-item five-point Li

This is an eight-item five-point Likert-type selfreport
pencil and paper instrument measuring the
patient’s perceived nausea, vomiting and retching
experience, occurrence and distress, reporting
high reliability.29 Subjects are instructed to
mark through or draw around the sentence in
each row what most clearly corresponds to their
experience. Subscale scores can be calculated for
nausea, vomiting and retching experience, occurrence
and distress separately as well as scores for
total experience, occurrence and distress. Scores
for individual items can range from 0 to 4 with
higher scores indicating more nausea, vomiting or
retching.
In addition to INVR, data was collected about the
patients’ age, marital status and education, history
of nausea and vomiting, body mass index, and personal
use of acupressure in the past. Clinical data
included the chemotherapy regime and antiemetics
used. Patients in the experimental group were
also given a daily log with the hours of the day on
it and were asked to tick the corresponding hour
every time they pressed the wristband’s stud.
Procedures
The researchers provided those patients randomised
to the experimental group with training
about what acupressure is, how to identify the
P6 acupoint and how to wear the wrist band.
Patients had the opportunity to practice with the
researchers several times. Following this, patients
were given a set of acupressure wristbands and
were instructed to wear them bilaterally throughout
the following 5 days taking them off only when
they were having a shower or a bath. Wristbands
could not easily move about the arm, as they have
a relatively tight fit. They were also instructed to
press the acupressure stud with light pressure for
2—3 min every 2 h, and note this in their daily log.
Patients in the control group received antiemetics
only, although they were told that they will
receive the acupressure instructions and be given
the wristbands to use from their next cycle of
chemotherapy onwards, thus serving as a waiting
list group. Although asking the patients in the control
group to wear the wristbands without pressing
the stud may seem a more appropriate technique to
decrease placebo effects than a waiting list control
group, this was not appropriate, as the wristband
studs are constantly pressing the P6 point as a result
of their tight fit. All patients completed the INVR
every evening after the chemotherapy administration
and for five consecutive evenings. Completed
questionnaires were returned either directly to the
researchers when coming for their second cycle
or using pre-paid envelopes. Sociodemographic and
clinical data were collected from the patients’
medical notes. The study was approved by the
Research and Ethics Committees of both participating
hospitals and patients had to sign a consent
form.
Data analysis
Data were coded and entered into SPSS (v.11)
for statistical analysis. Descriptive statistics were
calculated with all sociodemographic and clinical
data, and nausea, vomiting or retching subscale
scores. Repeated measures analysis of variance
(R-ANOVA) was used to assess the levels of nausea,
vomiting and retching between the two study
groups. Pearson’s correlation coefficients were calculated
between the demographic data and nausea
or vomiting variables. Chi-square tests were also
used to test any differences in sociodemographic
data between the two groups.
Results
Sample characteristics
Fifty-four patients were recruited and randomised
into the study, but 36 subjects completed the
study (attrition = 34%). Among those not returning
questionnaires, 6 were part of the control group
and 12 part of the experimental group. Among
the 36 patients who did return all study questionnaires,
19 were allocated in the control group
and 17 in the experimental group. Twenty-four
subjects were recruited from centre 1, and 12
from centre 2. Only 1 patient had used wristbands
before, but she was randomised to the control
group. The sample’s mean age was 49.5 years
(S.D. = 10.5, range = 32—76). Most (n = 28, 77.6%)
had received high school/secondary education,
while 8 (22.3%) had college or university education.
Most were also married (n = 30, 82.5%) with
only one being single (5.9%) and 5 being divorced or
separated (22.3%). The majority (61.1%) had experienced
nausea and/or vomiting (pregnancy, motion
sickness, etc.) before although only 8 (22.3%)
reported problems with managing nausea and vomiting
in the past. Subjects received Doxorubicin plus
Cyclophosphamide (n = 15, 41.7%), 5-FU, Epirubicin
and Cyclophosphamide (n = 15, 41.7%) or Epirubicin
with CMF (n = 6, 16.6%). There were no differences
(P > 0.05) in the sociodemographic and chemotherapy
variables between the experimental and control
groups (Table 1). Patients in the experimental
group pressed the studs from a median of 5—8 times
every day (range = 0—11 times).