Congress Abstracts 2003

36

MEASURING NAUSEA, VOMITING, AND RETCHING: THE MODIFIED RHODES INDEX OF NAUSEA AND VOMITING SHORT VERSION FOR RESEARCH AND CLINICAL USE. Ellen Saltzman, RN, BSN, Jane C. Shivnan, RN, MScN, Annemarie Tolman-Jager, RN, MS, Richard Mallik, RN, BSN, Mary Melvin, RN, and Jill Roman, RN, BSN, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Medical Center, Baltimore, MD.

Nausea and vomiting (N/V) remain common and distressing side effects of preparative chemotherapy regimens for blood and marrow transplantation (BMT) and other intensive chemotherapy. Planning appropriate treatment interventions is dependent upon accurate assessment and documentation of patients’ perceptions of these symptoms. The purpose of this clinical project was to identify a valid, reliable, and clinically useful instrument to assess N/V and retching in BMT patients. We compared the validity of the 8-item Modified Rhodes Index of Nausea and Vomiting Scale (RINV) with our shortened version of the scale, the Modified Rhodes Index of N/V-Short Version (RINV-SV). The RINV provides information about nausea, vomiting, and retching, and patients’ perceived distress regarding these symptoms (Rhodes, Watson, & Johnson, 1983). It has been widely used in studies of cancer-related N/V and has been shown to have an internal reliability of .90 and .98, respectively, using a split half procedure and Cronbach’s Alpha (Rhodes, Watson, & Johnson, 1983; Rhodes, Watson, & Johnson, 1987). The shortened version consists of 4 items taken from the original instrument and measures each of the sub-scales of N/V and retching. Content validity was confirmed by clinical experts. We compared the RINV with the RINV-SV as part of a randomized placebo-controlled clinical trial investigating the effectiveness of acupressure as adjunct to pharmacological control of emesis during the preparative regimen of BMT. Our instrument showed an internal consistency reliability of .92. The mean score of the RINV was 3.38 (range of 0–32), and the mean score of the RINV-SR was 1.83 (range of 0–16). The RINV-SV is reliable for BMT patients and has been incorporated into daily clinical assessment. In addition, the modified instrument is now the standard at our NCI-designated comprehensive cancer center and is used daily on each patient to assess and manage the symptoms of N/V and retching.