Psychological interventions for nausea and emesis and the sequelae of Hyperemesis Gravidarum

Jacobi, Emma 2024. Psychological interventions for nausea and emesis and the sequelae of Hyperemesis Gravidarum. ClinPsy Thesis, Cardiff University. Item availability restricted.

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Abstract

Paper one of this thesis is a systematic review of the evidence base exploring the effectiveness of psychological interventions for persistent symptoms of nausea and vomiting, related to a physical health condition and/or its treatment. Symptoms of nausea and vomiting are typically treated with antiemetic medication; however, reports indicate that many people continue to experience distressing symptoms and this has a negative impact on their lives. The aim of the current study was to explore non-pharmacological treatment alternatives, specifically psychological interventions that may be effective at reducing symptoms of nausea and vomiting. The literature search identified psychological interventions for nausea and vomiting for four different groups of participants, including cancer patients undergoing chemotherapy treatment, HIV patients receiving antiretroviral therapy, pregnant people and people with a condition called hyperemesis gravidarum (HG) that causes extreme levels of nausea and/or vomiting in pregnancy. Psychological interventions for nausea and vomiting included cognitive behaviour therapy (CBT), mindfulness-based cognitive therapy (MBCT), CBT-informed counselling, progressive muscle relaxation training (PMRT) and hypnotherapy. Findings indicate that psychological interventions, when combined with antiemetic medication, can relieve symptoms of nausea and vomiting more effectively than taking antiemetic medication alone. However, studies in this area need to be of higher quality and the acceptability of psychological interventions for people who experience persistent nausea and vomiting needs to be assessed more consistently. Chapter two presents an empirical study that investigated the occurrence of emetophobia, a specific fear of vomiting, following hyperemesis gravidarum (HG) in pregnancy and its impact on parenting. HG is a pregnancy-related condition characterised by extreme levels of nausea and/or vomiting and difficulties eating and drinking that significantly impacts activities of daily living. If left untreated the symptoms have the potential to be life-threatening for both mother and baby. The lived experience of HG is often reported by women and birthing people as traumatic, and they may consequentially develop a fear of vomiting (emetophobia). Emetophobia is typically characterised by an overwhelming fear of being or witnessing someone else being sick, and an avoidance of nausea-inducing or vomit-related stimuli. Currently the evidence base into the prevalence of emetophobia following HG pregnancy and its impact on parenting is very limited. The specific aims of the current study were: (1) to determine the rates of emetophobia in a postnatal sample of perinatal women who had experienced HG during pregnancy; (2) to examine the impact of HG and emetophobia on parental sense of competence and parenting stress; and (3) to examine whether symptoms of emetophobia mediated the relationship between HG and parental adjustment outcomes. To address the research questions a cross-sectional survey was conducted with a sample of 212 postnatal women (up to 24 months postnatal) who had experienced HG in their most recent pregnancy. Participants completed questionnaires online to collect information on their socio-demographic background and obstetric history, HG severity, fear of vomiting (emetophobia), parenting stress, and parental sense of competence. The findings indicated elevated levels of emetophobia amongst women who have had HG in pregnancy, highlighting the need for routine screening for this condition amongst women affected by HG. Further, elevated levels of emetophobia following HG predicted increased parenting stress and decreased sense of competence in the parenting role. These findings need to be replicated in studies that use longitudinal design to examine whether the impact of emetophobia on parenting outcomes has any consequences for child development. The current findings have important clinical implications for women who experienced HG during pregnancy, including a need for routine screening of emetophobia, and the development of interventions to address the symptoms of emetophobia as well as its impact on parental adjustment during the postnatal period.

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of First Compliant Deposit:	29 August 2024
Last Modified:	30 Aug 2024 09:52
URI:	https://orca.cardiff.ac.uk/id/eprint/171638

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