HỖ TRỢ DINH DƯỠNG NHÂN TẠO TẠI NHÀ VÀ CÁC YẾU TỐ LIÊN QUAN CỦA BỆNH NHÂN UNG THƯ GIAI ĐOẠN CUỐI TẠI BỆNH VIỆN ĐẠI HỌC Y DƯỢC THÀNH PHỐ HỒ CHÍ MINH

Abstract

Background: Most end-stage cancer patients and their families started decision-making when confronted with decreased food intake. Home-based care is more comprehensive and supportive for patients and their families, alleviating the burden on the healthcare system and realizing the patient's wish to be cared for at home. The demand for and models of home-based care is increasing worldwide, but in Vietnam, there needs to be more research, leading to difficulties in implementation. Objectives: to identify the desire for home artificial nutrition (HAN) care and related factors among elderly adults with end-stage cancers in the Geriatrics and Palliative care departments at the University Medical Center in Ho Chi Minh city (UMC HCMC). Methods: A descriptive cross-sectional study was conducted on 160 older adults (aged 60 years and above) with end-stage cancers in the Geriatrics and Palliative care department at the UMC HCMC from December 2019 to May 2021. We collected data on demography, the desire for HAN and related factors. Results: Our preliminary study indicated that 42.5% of community-dwelling older people prefer HAN when they become unable to achieve sufficient nutrition orally; approximately 47.5% of patients want to receive parenteral nutrition support. Factors independently associated with HAN included comorbidities (odds ratio [OR]=2.72; 95% confidence interval [CI] 1.05-7.04, p = 0,031); life expectancy (OR=2.66; p=0.004; 95% CI 1.33-5,34); able to pay for medical expenses (OR=3.45; p=0.009; 95% CI 1.28-9.20); financial burden (OR=3.74; p=0.005; 95% CI 1.40-9.96), and feeding methods (OR=2.76; p=0.002; 95% CI 1.41-5.38). Conclusions: The demand for HAN is increasing, and it is necessary to consider the patient's characteristics, such as comorbidities, life expectancy, financial ability and feeding methods when establishing a care plan, supporting home-based care for patients.