Publication: Tratamiento psicológico de la emesis anticipatoria
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2018-03-12
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Universidad Complutense de Madrid
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Abstract
La emesis por quimioterapia sigue siendo uno de los principales problemas que presentan los pacientes oncológicos y que puede afectar significativamente a su calidad de vida. La emesis anticipatoria es una respuesta aprendida a la quimioterapia que, según los estudios de Morrow, Roscoe, Kirshner, Hynes, y Rosenbluth en 1998, ocurre en un 25 % de los pacientes sobre el cuarto ciclo de tratamiento. Es una respuesta condicionada que aparece en pacientes que han desarrollado náuseas y vómitos importantes durante los ciclos previos de quimioterapia. Roscoe, Morrow, Aapro, Molassiotis y Olver en 2011 señalaban que este tipo de emesis es difícil de controlar mediante fármacos. Existen dos factores que influyen en su aparición: clínicos o farmacológicos, potencial emético, método de administración, número y duración de las sesiones) y psicológicos (nivel de ansiedad previo a la quimioterapia o posibilidad de distracción durante la misma). La Guia NCCN Antiemesis 2015 resalta la importancia de la prevención en cada ciclo de tratamiento. Si aparece emesis anticipatoria el tratamiento se basaría en relajación, desensibilización sistemática, hipnosis e imaginación guiada junto con la musicoterapia, acupuntura y como tratamiento farmacológico se podrían usar benzodiacepinas que añadidas al tratamiento antiemético y al apoyo psicológico, parecen mejorar los vómitos anticipatorios (Razavi et al., 1993; Malik et al., 1995)...
Emesis by chemotherapy (QT) is one of the main problems presented by cancer patients and it can significantly affect their quality of life. Anticipatory emesis is a learned response to chemotherapy that, according to some studies such as Morrow’s, Roscoe’s, Kirshner’s, Hynes’ and Rosenbluth’s in 1998, occurs in 25% of patients on the fourth cycle of treatment. It is a conditioned response that happens in patients who have developed major nausea and vomits during the previous cycles of chemotherapy. Roscoe, Morrow, Aapro, Molassiotis and Olver in 2011 indicated that this type of emesis was difficult to control by drugs. There are two factors influencing in its appearance: clinical or pharmacological (emetic potential, method of administration, number and duration of sessions) and psychological (the level of anxiety before to the chemotherapy or the possibility of distraction during the session). The NCCN Antiemesis 2015 Guide highlights the importance of prevention in each treatment cycle. If anticipatory emesis appears, then the treatment would be based on relaxation, systematic desensitization, hypnosis and guided imagery together with music therapy and acupuncture. As a pharmacological treatment, benzodiazepines could be used, and added to antiemetic treatment and psychological support, seem to reduce the anticipatory vomit. (Razavi et al. Al., 1993; Malik et al., 1995)...
Emesis by chemotherapy (QT) is one of the main problems presented by cancer patients and it can significantly affect their quality of life. Anticipatory emesis is a learned response to chemotherapy that, according to some studies such as Morrow’s, Roscoe’s, Kirshner’s, Hynes’ and Rosenbluth’s in 1998, occurs in 25% of patients on the fourth cycle of treatment. It is a conditioned response that happens in patients who have developed major nausea and vomits during the previous cycles of chemotherapy. Roscoe, Morrow, Aapro, Molassiotis and Olver in 2011 indicated that this type of emesis was difficult to control by drugs. There are two factors influencing in its appearance: clinical or pharmacological (emetic potential, method of administration, number and duration of sessions) and psychological (the level of anxiety before to the chemotherapy or the possibility of distraction during the session). The NCCN Antiemesis 2015 Guide highlights the importance of prevention in each treatment cycle. If anticipatory emesis appears, then the treatment would be based on relaxation, systematic desensitization, hypnosis and guided imagery together with music therapy and acupuncture. As a pharmacological treatment, benzodiazepines could be used, and added to antiemetic treatment and psychological support, seem to reduce the anticipatory vomit. (Razavi et al. Al., 1993; Malik et al., 1995)...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Psicología, leída el 21-06-2017