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影响癌症活跃老年人群姑息治疗意愿的因素:缅甸曼德勒的案例研究。

Factors Influencing the Willingness of Palliative Care Utilization among the Older Population with Active Cancers: A Case Study in Mandalay, Myanmar.

机构信息

ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand.

Institute of Nutrition, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand.

出版信息

Int J Environ Res Public Health. 2021 Jul 26;18(15):7887. doi: 10.3390/ijerph18157887.

Abstract

Palliative care is an effective, multidisciplinary healthcare service to alleviate severe illness patients from physical, psychological, and spiritual pain. However, global palliative care has been underutilized, especially in developing countries. This cross-sectional survey aimed to examine the factors associated with older cancer patients' willingness to utilize palliative care services in Myanmar. The final sample was composed of 141 older adults, 50-years of age and above who suffered from cancers at any stage. Simple random sampling was applied to choose the participants by purposively selecting three oncology clinics with daycare chemotherapy centers in Mandalay. We collected data using structured questionnaires composed of five sections. The sections include the participant's socio-economic information, disease status, knowledge of palliative care, psychosocial and spiritual need, practical need, and willingness to utilize palliative care services. The study found that approximately 85% of older cancer patients are willing to receive palliative care services. The significant predictors of willingness to utilize palliative care services include place of living, better palliative care knowledge, more need for spiritual and psychosocial support, and practical support. This study can guide health policymakers in increasing the rate of palliative care utilization. The suggested policies include developing community-level palliative care services in Myanmar, especially in rural areas, promoting palliative care knowledge, applying appropriate religious and spiritual traditions at palliative treatment, and developing suitable medicines for the critically ill.

摘要

姑息治疗是一种有效的多学科医疗服务,可减轻重病患者的身体、心理和精神痛苦。然而,全球姑息治疗的利用率一直较低,尤其是在发展中国家。本横断面调查旨在探讨与缅甸老年癌症患者使用姑息治疗意愿相关的因素。最终样本由 141 名年龄在 50 岁及以上、患有任何阶段癌症的老年人组成。采用简单随机抽样,通过有目的地选择曼德勒的三家日间化疗中心的肿瘤科诊所选择参与者。我们使用由五个部分组成的结构化问卷收集数据。这些部分包括参与者的社会经济信息、疾病状况、姑息治疗知识、心理社会和精神需求、实际需求以及使用姑息治疗服务的意愿。研究发现,约 85%的老年癌症患者愿意接受姑息治疗服务。愿意使用姑息治疗服务的显著预测因素包括居住地点、更好的姑息治疗知识、更多的精神和心理社会支持需求以及实际支持。本研究可以为卫生政策制定者提供指导,以提高姑息治疗的利用率。建议的政策包括在缅甸,特别是在农村地区发展社区级姑息治疗服务,推广姑息治疗知识,在姑息治疗中应用适当的宗教和精神传统,以及为重病患者开发合适的药物。

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