skip to main content

The Effect of Hypnotherapy on Anticipatory Nausea in Head and Neck Cancer Patients Undergoing Chemotherapy

*Dadi Hamdani orcid  -  STIKes Muhammadiyah Ciamis, Indonesia
Awal Prasetyo orcid scopus  -  Universitas Diponegoro, Indonesia
Anggorowati Anggorowati orcid scopus  -  Universitas Diponegoro, Indonesia
Open Access Copyright (c) 2020 Nurse Media Journal of Nursing
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Citation Format:

Background: One of the chemotherapy side effects on head and neck cancer patients is anticipatory nausea. However, the anticipatory nausea problem has not been properly resolved. Nausea might be psychologically reduced by hypnotherapy. There only have been very few studies conducted to examine the effects of hypnotherapy in alleviating anticipatory nausea.

Purpose: This study aimed to determine the effect of hypnotherapy using Hanung induction technique on anticipatory nausea in head and neck cancer patients undergoing chemotherapy.

Methods: This research employed a pre-post test of quasi-experiment with control group design. Consecutive sampling technique was used to obtain 64 subjects who met inclusion and exclusion criteria and were equally divided into the intervention and control groups. Hypnotherapy as the intervention was carried out in two sessions, each of which lasted for 20 minutes, with a week distance between sessions. The data were collected using a visual analog scale (VAS), which was used twice to measure anticipatory nausea and analyzed using the paired and independent-sample t-test.

Result: The results showed that the mean score of anticipatory nausea in the intervention group reduced from 7.6±1.4 to 2.3 ±1.2 after hypnotherapy, while the mean in the control group increased from 6.4±1.6 to 6.7±1.4. There was a significant difference in the score of anticipatory nausea after the implementation of hypnotherapy between the intervention and the control group (p<0.001).

Conclusion: The study concluded that hypnotherapy is effective in reducing the intensity of anticipatory nausea in head and neck cancer patients undergoing chemotherapy. Therefore, hypnotherapy can be applied by oncology nurses as an intervention in treating anticipatory nausea.

Fulltext View|Download
Keywords: Anticipatory nausea; chemotherapy; head and neck cancer; hypnotherapy

Article Metrics:

  1. Assen, A. (2016). Hypnotherapy Explained. United States: CRC Press
  2. Azam, F., Latif, M., Farooq, A., Tirmazy, S., Alshahrani, S., Bashir, S., & Bukhari, N. (2019). Performance status assessment by using ECOG (Eastern Cooperative Oncology Group) score for cancer patients by oncology healthcare professionals. Case Report in Oncology, 12, 728-736. doi: 10.1159/000503095
  3. Barber, T. X., & Wilson, S. C. (2011). The barber suggestibility scale and the creative imagination scale. American Journal of Clinical Hypnosis, 21(2-3), 84–108. doi: 10.1080/00029157.1978.10403966
  4. Billhult, A., Bergbom, I., & Stener-Victorin, E. (2007). Massage relieves nausea in women with breast cancer undergoing chemotherapy. Journal of Alternative and Complementary Medicine, 13(1), 53–57. doi: 10.1089/ACM.2006.6049
  5. Booth, S. (2020). Hypnosis in a specialist palliative care setting - enhancing personalized care for difficult symptoms and situations. Palliative Care Social Practice, 14, 2632352420953436. doi: 10.1177/2632352420953436
  6. Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R. L., Torre, L. A., & Jemal, A. (2018). Global cancer statistics 2018: Globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 68(6), 394-424. doi: 10.1056/NEJMra1715715
  7. Carlson, L. E., Toivonen, K., Flynn, M., Deleemans, J., Piedalue, K. A., Tolsdorf, E., & Subnis, U. (2018). The role of hypnosis in cancer care. Current Oncology Reports, 20(12), 93. doi: 10.1007/s11912-018-0739-1
  8. D'Souza, G., Gross, N. D., Pai, S. I., Haddad, R., Anderson, K.S., Rajan, S., … Posner, M.R. (2014). Oral human papillomavirus (HPV) infection in HPV-positive patients with oropharyngeal cancer and their partners. Journal of Clinical Oncology, 32(23), 2408-2415. doi: 10.1200/JCO.2014.55.1341
  9. Figueroa-Moseley, C., Jean-Pierre, P., Roscoe, J. A., Ryan, J. L., Kohli, S., Palesh, O. G., …, Morrow, G. R. (2012). Behavioral interventions in treating anticipatory nausea and vomiting. Journal of the National Comprehensive Cancer Network: JNCCN, 5(1), 44–50. doi: 10.6004/jnccn.2007.0006
  10. Garba., M. H., & Mamman., M. (2019). Hypnosis and hypnotherapy: The role of traditional versus alternative approach. London: IntechOpen. doi: 10.5772/intechopen.91619
  11. Grealish, L., Lomasney, A., & Whiteman, B. (2000). Foot massage. A nursing intervention to modify the distressing symptoms of pain and nausea in patients hospitalized with cancer. Cancer Nursing, 23(3), 237–243. doi: 10.1097/00002820-200006000-00012
  12. Hakim, A. (2009). Dahsyatnya hipnosis [The power of hypnosis]. Jakarta: Visimedia
  13. Hamdani, D., Prasetyo, A., & Anggorowati. (2019). Intervensi untuk mengatasi mual antisipatori pada pasien kanker yang menjalani kemoterapi: review literatur [Interventions to treat anticipatory nausea in cancer patients undergoing chemotherapy: A literature review]. Jurnal Smart Keperawatan, 6(1), 65-72. doi: 10.34310/jskp.v6i1.239
  14. Janie, B., Karen, L. (2015). Philosophies and theories for advanced nursing practice. 2nd ed. Burlington, Massachusetts: Jones & Bartlett Learning
  15. Jung, H., Tae, C., Moon, C., Kim, S., & Shim, K. (2019). Chronic unexplained nausea in adults: Prevalence, impact on the quality of life, and underlying organic diseases in a cohort of 5096 subjects comprehensively investigated. Plos One, 14(12), e0225364. doi: 10.1371/journal.pone.0225364
  16. Kamen, C., Tejani, M. A., Chandwani, K., Janelsins, M., Peoples, A. R., & Roscoe, J. A. (2014). Anticipatory nausea and vomiting due to chemotherapy. European Journal of Pharmacology, 722(1), 172–9. doi: 10.1016/j.ejphar.2013.09.071
  17. Kendrick, A. H. (2012). Exhaled carbon monoxide devices in smoking cessation: physiology, controversies and equipment. In: The buyers guide to respiratory care products. Bristol: Department of Respiratory Medicine-Bristol Royal Infirmary. and vomiting. Journal of the Advanced Practitioner in Oncology, 6(3), 225–229. doi: 10.6004/jadpro.2015.6.3.4
  18. Lee, K, & Kieckhefer, G. (2011) Measuring human responses using visual analog scales. Western Journal of Nursing Research, 11, 128-132. doi: 10.1177/019394598901100111
  19. Meek, R., Kelly, A. M., & Hu, X. F. (2009). Use of the visual analog scale to rate and monitor the severity of nausea in the emergency department. Academic emergency medicine, 16(12), 1304-1310. doi: 10.1111/j.1553-2712.2009.00581.x
  20. Ministry of Health Republic of Indonesia (MoHRI). (2018a). Laporan hasil riset kesehatan dasar (Riskesdas) Indonesia [Indonesian basic health research report]. Retrieved from
  21. Ministry of the Health Republic of Indonesia (MoHRI). (2018b). Laporan hasil riset kesehatan dasar Provinsi Jawa Tengah [Report on Basic Health Research Results in Central Java]. Retrieved from
  22. Molassiotis, A., Lee, P. H., Burke, T.A., Dicato, M., Gascon, P., Roila, F., & Aapro, M. (2016). Anticipatory nausea, risk factors, and its impact on chemotherapy-induced nausea and vomiting: Results from the Pan European emesis registry study. Journal of Pain and Symptom Management, 51(6), 987-93. doi: 10.1016/j.jpainsymman.2015.12.317
  23. Mosa, A., Hossain, A. M., Lavoie, B. J., & Yoo, I. (2020). Patient-related risk factors for chemotherapy-induced nausea and vomiting: A systematic review. Frontiers in pharmacology, 11, 329. doi: 10.3389/fphar.2020.00329
  24. Mustian, K., Devine, K., Ryan, J., Janelsins, M., Sprod, L., Peppone, L., …, & Morrow, G. (2011). Treatment of nausea and vomiting during chemotherapy. US Oncology & Hematology, 7, 91-97. doi: 10.17925/OHR.2011.07.2.91
  25. Navari, R. M. (2016). Management of chemotherapy-induced nausea and vomiting. Switzerland: ADIS. doi: 10.1007/978-3-319-27016-6
  26. Prapti, N., Petpichetchian, W., & Chongchareon, W. (2012). Nausea, vomiting, and retching of patients with cervical cancer undergoing chemotherapy in Bali, Indonesia. Nurse Media Journal of Nursing, 2(2), 467-481. doi: 10.14710/nmjn.v2i2.3983
  27. Prasetya, H. (2017). Intervensi medikal hipnosis sebagai upaya pemberdayaan pasien tuberkulosis untuk meningatkan kepatuhan pengobatan [Hypnosis medical intervention as an effort to empower tuberculosis patients to improve medication adherence]. Retrieved from
  28. Prasetya, H., Murti, B., Anantanyu, S. (2018). The effect of hypnosis on adherence to antituberculosis drugs using the health belief model. International Journal of Clinical Hypnosis, 66(2), 211–27. doi: 10.1080/00207144.2018.1421361
  29. Rao, K. V., & Faso, A. (2012). Chemotherapy-induced nausea and vomiting: optimizing prevention and management. American health & drug benefits, 5(4), 232–240
  30. Richardson, J., Smith, J. E., McCall, G., Richardson, A., Pilkington, K., & Kirsch, I. (2007). Hypnosis for nausea and vomiting in cancer chemotherapy. European journal of cancer care, 16(5), 402–412. doi: 10.1111/j.1365-2354.2006.00736.x
  31. Robert, M. S., Kenneth, L. K., & Paul, A. (2011). Nausea mechanisms and management. New York: Oxford University Press
  32. Roscoe, J. A., Morrow, G. R., Aapro, M. S., Molassiotis, A., & Olver, I. (2011). Anticipatory nausea and vomiting. Support Care Cancer, 19(10), 1533-1538. doi: 10.1007/s00520-010-0980-0
  33. Roy, H. (2010). The art of hypnosis: Mastering basic techniques. United Kingdom: Crown house Publishing
  34. Stitch, MA, Rock, E. M., Limebeer, C. L., & Parker, L. A. (2014). Endocannabinoid mechanisms influencing nausea. International Review of Biology, 125, 127-162. doi: 10.1016/bs.irn.2015.09.001
  35. Umami, A., Sudalhar, S., Pratama, T. W. Y., Fitri, I., & Firmansyah, A. (2020). Knowledge, barriers, and motivation related to breast and cervical cancer screening among women in Bojonegoro, East Java: A qualitative study. Journal of Health Promotion and Behaviour, 5(1), 1-10. doi: 10.26911/thejhpb.2020.05.01.01
  36. Van den Bosch, J. E., Moons, K. G., Bonsel, G. J., & Kalkman, C. J. (2010). Does Measurement of Preoperative Anxiety Have Added Value for Predicting Postoperative Nausea and Vomiting?. Anesthesia & Analgesia, 100(5), 1525-1532 doi: 10.1213/01.ANE.0000149325.20542.D4
  37. Yildiz, C. N., Suren, M., Demir, O., & Okan, I. (2019). Karnofsky performance scale validity and reliability of Turkish palliative cancer patients. Turkish Journal of Medical Sciences, 49(3), 894–898. doi: 10.3906/sag-1810-44

Last update:

  1. Non-pharmacological treatments for anticipatory nausea and vomiting during chemotherapy: a systematic review and meta-analysis of the Clinical Practice Guidelines for Antiemesis 2023

    Masamitsu Kobayashi, Jun Kako, Arisa Iba, Ayako Okuyama, Keiko Ozawa, Masakazu Abe, Makoto Wada, Tatsuo Akechi, Hirotoshi Iihara, Chiyo K. Imamura, Yong-Il Kim, Hidenori Sasaki, Eriko Satomi, Masayuki Takeda, Ryuhei Tanaka, Takako Eguchi Nakajima, Naoki Nakamura, Junichi Nishimura, Mayumi Noda, Kazumi Hayashi, Takahiro Higashi, Narikazu Boku, Koji Matsumoto, Yoko Matsumoto, Kenji Okita, Nobuyuki Yamamoto, Kenjiro Aogi, Keiko Iino. International Journal of Clinical Oncology, 29 (7), 2024. doi: 10.1007/s10147-024-02536-w

Last update: 2024-07-11 22:58:43

No citation recorded.