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

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

doi:10.1089/pmr.2022.0009

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

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

Authors

Akiko Abe^{1

2}, Koji Amano^{1

3}, Tatsuya Morita⁴, Tomofumi Miura⁵, Naoharu Mori³, Ryohei Tatara⁶, Takaomi Kessoku^{7

8}, Yoshinobu Matsuda⁹, Keita Tagami¹⁰, Hiroyuki Otani¹¹, Masanori Mori⁴, Tomohiko Taniyama¹², Nobuhisa Nakajima¹³, Erika Nakanishi^{14

15}, Jun Kako¹⁶, Daisuke Kiuchi¹, Hiroto Ishiki¹, Hiromichi Matsuoka¹⁷, Eriko Satomi¹, Mitsunori Miyashita¹⁴

Affiliations

¹ Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan.
² Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
³ Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute City, Japan.
⁴ Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu City, Shizuoka, Japan.
⁵ Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa City, Japan.
⁶ Department of Palliative Medicine, Osaka City General Hospital, Osaka City, Japan.
⁷ Department of Palliative Medicine, Yokohama City University Hospital, Yokohama City, Japan.
⁸ Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama City, Japan.
⁹ Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City, Japan.
¹⁰ Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai City, Japan.
¹¹ Department of Palliative Care Team, and Palliative and Supportive Care, St. Mary's Hospital, Kurume City, Japan.
¹² Department of Clinical Oncology and Palliative Medicine, Mitsubishi Kyoto Hospital, Kyoto City, Japan.
¹³ Division of Community Medicine and International Medicine, University of the Ryukyus Hospital, Nakagami-Gun, Japan.
¹⁴ Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai City, Japan.
¹⁵ Graduate School of Public Health, St. Luke's International University, OMURA Susumu and Mieko Memorial St. Luke's Center for Clinical Academia, Tokyo, Japan.
¹⁶ College of Nursing Art and Science, University of Hyogo, Akashi City, Japan.
¹⁷ Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan.

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 (n = 174) and cachexia group (n = 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), p = 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.

Keywords: advanced cancer; cachexia; nutritional support; palliative care; parenteral hydration; parenteral nutrition.