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晚期癌症患者对肠外营养和水合作用的信念与认知

Beliefs and Perceptions About Parenteral Nutrition and Hydration by Advanced Cancer Patients.

作者信息

Abe Akiko, Amano Koji, Morita Tatsuya, Miura Tomofumi, Mori Naoharu, Tatara Ryohei, Kessoku Takaomi, Matsuda Yoshinobu, Tagami Keita, Otani Hiroyuki, Mori Masanori, Taniyama Tomohiko, Nakajima Nobuhisa, Nakanishi Erika, Kako Jun, Kiuchi Daisuke, Ishiki Hiroto, Matsuoka Hiromichi, Satomi Eriko, Miyashita Mitsunori

机构信息

Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan.

Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.

出版信息

Palliat Med Rep. 2022 Aug 8;3(1):132-139. doi: 10.1089/pmr.2022.0009. eCollection 2022.

Abstract

BACKGROUND

The beliefs and perceptions of parenteral nutrition and hydration (PNH) by advanced cancer patients have not been elucidated.

OBJECTIVES

To clarify their beliefs and perceptions and to explore the relationships between their beliefs and perceptions and cachexia stages.

DESIGN/SETTING/SUBJECTS: A questionnaire survey of advanced cancer patients receiving palliative care across Japan.

MEASUREMENTS

We asked patients to answer 15 items regarding their beliefs and perceptions of PNH. Frequencies were calculated for the patient characteristics and survey parameters. Comparisons were performed using the Mann-Whitney U test. We conducted a factor analysis and a multiple logistic regression analysis to identify the independent factors affecting cancer cachexia stages.

RESULTS

Among 495 patients, 378 responded. Due to missing data, 357 remained in the frequency distribution analysis, and 344 were classified into the noncachexia group ( = 174) and cachexia group ( = 170). Approximately 60% thought that PNH were beneficial. Approximately 70% considered PNH a standard medical practice. Approximately 70% did not feel that they received a sufficient explanation. There were no significant differences in any items between the two groups. We extracted four conceptual groups. The concept of "Belief that PNH are harmful" was identified as an independent factor [odds ratio 2.57 (95% confidence intervals 1.10-6.01),  = 0.030].

CONCLUSION

More than half of the patients thought that PNH were beneficial and standard medical practices with or without cancer cachexia. The negative perception of PNH decreased in patients with cancer cachexia.

摘要

背景

晚期癌症患者对肠外营养与水化(PNH)的信念和认知尚未阐明。

目的

阐明他们的信念和认知,并探讨其信念和认知与恶病质阶段之间的关系。

设计/地点/研究对象:对日本各地接受姑息治疗的晚期癌症患者进行问卷调查。

测量方法

我们让患者回答15项关于他们对PNH的信念和认知的问题。计算患者特征和调查参数的频率。使用曼-惠特尼U检验进行比较。我们进行了因子分析和多元逻辑回归分析,以确定影响癌症恶病质阶段的独立因素。

结果

495名患者中,378人做出了回应。由于数据缺失,357人纳入频率分布分析,344人被分为非恶病质组(=174)和恶病质组(=170)。约60%的人认为PNH有益。约70%的人认为PNH是标准医疗行为。约70%的人觉得没有得到充分解释。两组在任何项目上均无显著差异。我们提取了四个概念组。“认为PNH有害”这一概念被确定为独立因素[比值比2.57(95%置信区间1.10 - 6.01),=0.030]。

结论

超过一半的患者认为PNH有益且是标准医疗行为,无论是否患有癌症恶病质。癌症恶病质患者对PNH的负面认知有所下降。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c91a/9438434/ef5bbbe44697/pmr.2022.0009_figure1.jpg

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