Effect of education on preference of parenteral nutrition for patients in palliative care unit: quantitative and qualitative study with an anthropological approach
Background: Patients and their family have resistance in withholding parenteral nutrition (PN) when patient become unable to intake food in the We aimed to investigate whether the preference for PN is changed after receiving an individual education about the risk and benefit of PN. Additionally, we...
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| Veröffentlicht in: | Annals of palliative medicine 2020-09, Vol.9 (5), p.2793-2799 |
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| container_title | Annals of palliative medicine |
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| creator | Jung, Ki-Sun Oh, So Yeon Jun, Hyun Jung Song, Byung-Ki Park, Kwonoh Oh, Sangbo Kim, Jae-Joon Park, Eun-Ju |
| description | Background: Patients and their family have resistance in withholding parenteral nutrition (PN) when patient become unable to intake food in the We aimed to investigate whether the preference for PN is changed after receiving an individual education about the risk and benefit of PN. Additionally, we focused on the preferences of patients and their.family and why they prefer it about the nutritional support in the end of life.
Methods: This is prospective study. Patients are eligible if they cannot tolerate oral intake and enteral feeding and have Palliative Performance Scale (PPS) 50% clue to progressive cancer. After informed consent, investigators educated patients and family for an hour using the handouts. Then, patients decided if they will receive PN. Quality of life (QOL) was checked by European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C15-PAL) weekly during 3 weeks. Symptoms related to fluid overloading or dehydration was surveyed weekly also. A social anthropologist participated as an observer or interviewer during whole process of this study.
Results: After education, 12 patients (80%) chose to keep receiving PN and 3 patients (20%) changed their decision from PN to minimal hydration among the 15 patients. More calories were administered to patients who chosen PN (median 1,042.2 vs. 324.3 Kcal/day, P |
| doi_str_mv | 10.21037/apm-20-269 |
| format | Article |
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Methods: This is prospective study. Patients are eligible if they cannot tolerate oral intake and enteral feeding and have Palliative Performance Scale (PPS) 50% clue to progressive cancer. After informed consent, investigators educated patients and family for an hour using the handouts. Then, patients decided if they will receive PN. Quality of life (QOL) was checked by European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C15-PAL) weekly during 3 weeks. Symptoms related to fluid overloading or dehydration was surveyed weekly also. A social anthropologist participated as an observer or interviewer during whole process of this study.
Results: After education, 12 patients (80%) chose to keep receiving PN and 3 patients (20%) changed their decision from PN to minimal hydration among the 15 patients. More calories were administered to patients who chosen PN (median 1,042.2 vs. 324.3 Kcal/day, P<0.001) for initial 7 days. Overall survival, scores of QLQ-C15-PAL, and symptoms were not different with or without PN. According to the anthropologist, medical staffs regard PN as complex medical treatments, while patients and family recognize it as meal rather than medicine.
Conclusions: Most patients and family prefer to receive PN despite its potential harm and marginal benefit. An in-depth discussion about prognosis and aim of care must be preceded before a decision whether to receive PN can be made.</description><identifier>ISSN: 2224-5820</identifier><identifier>EISSN: 2224-5839</identifier><identifier>DOI: 10.21037/apm-20-269</identifier><identifier>PMID: 32921086</identifier><language>eng</language><publisher>SHATIN: AME PUBLISHING COMPANY</publisher><subject>Health Care Sciences & Services ; Humans ; Life Sciences & Biomedicine ; Palliative Care ; Parenteral Nutrition ; Prospective Studies ; Quality of Life ; Science & Technology ; Surveys and Questionnaires</subject><ispartof>Annals of palliative medicine, 2020-09, Vol.9 (5), p.2793-2799</ispartof><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>2</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000576670500043</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c396t-b8850c30a74f690d2e38a2bd2f580cb941072e736a5606102fb96e8a2acfefae3</citedby><cites>FETCH-LOGICAL-c396t-b8850c30a74f690d2e38a2bd2f580cb941072e736a5606102fb96e8a2acfefae3</cites><orcidid>0000-0002-2562-9257 ; 0000-0002-7667-9588</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27929,27930,28253</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32921086$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jung, Ki-Sun</creatorcontrib><creatorcontrib>Oh, So Yeon</creatorcontrib><creatorcontrib>Jun, Hyun Jung</creatorcontrib><creatorcontrib>Song, Byung-Ki</creatorcontrib><creatorcontrib>Park, Kwonoh</creatorcontrib><creatorcontrib>Oh, Sangbo</creatorcontrib><creatorcontrib>Kim, Jae-Joon</creatorcontrib><creatorcontrib>Park, Eun-Ju</creatorcontrib><title>Effect of education on preference of parenteral nutrition for patients in palliative care unit: quantitative and qualitative study with an anthropological approach</title><title>Annals of palliative medicine</title><addtitle>ANN PALLIAT MED</addtitle><addtitle>Ann Palliat Med</addtitle><description>Background: Patients and their family have resistance in withholding parenteral nutrition (PN) when patient become unable to intake food in the We aimed to investigate whether the preference for PN is changed after receiving an individual education about the risk and benefit of PN. Additionally, we focused on the preferences of patients and their.family and why they prefer it about the nutritional support in the end of life.
Methods: This is prospective study. Patients are eligible if they cannot tolerate oral intake and enteral feeding and have Palliative Performance Scale (PPS) 50% clue to progressive cancer. After informed consent, investigators educated patients and family for an hour using the handouts. Then, patients decided if they will receive PN. Quality of life (QOL) was checked by European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C15-PAL) weekly during 3 weeks. Symptoms related to fluid overloading or dehydration was surveyed weekly also. A social anthropologist participated as an observer or interviewer during whole process of this study.
Results: After education, 12 patients (80%) chose to keep receiving PN and 3 patients (20%) changed their decision from PN to minimal hydration among the 15 patients. More calories were administered to patients who chosen PN (median 1,042.2 vs. 324.3 Kcal/day, P<0.001) for initial 7 days. Overall survival, scores of QLQ-C15-PAL, and symptoms were not different with or without PN. According to the anthropologist, medical staffs regard PN as complex medical treatments, while patients and family recognize it as meal rather than medicine.
Conclusions: Most patients and family prefer to receive PN despite its potential harm and marginal benefit. An in-depth discussion about prognosis and aim of care must be preceded before a decision whether to receive PN can be made.</description><subject>Health Care Sciences & Services</subject><subject>Humans</subject><subject>Life Sciences & Biomedicine</subject><subject>Palliative Care</subject><subject>Parenteral Nutrition</subject><subject>Prospective Studies</subject><subject>Quality of Life</subject><subject>Science & Technology</subject><subject>Surveys and Questionnaires</subject><issn>2224-5820</issn><issn>2224-5839</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>EIF</sourceid><recordid>eNqNkU1PwzAMhiMEYtPYiTvKHRXSpE0TbmgaH9IkLnCu0jRhQV1T0pRpv4c_irexcUWyFNvvY1t6g9BlSm5oSlhxq7pVQklCuTxBY0ppluSCydNjTskITfv-gxCSUiYySc_RiFEJ04KP0ffcWqMj9habetAqOt9iiC4Ya4JptdlKnYI0mqAa3A4xuB1lfQAhOlB67GBENY2D-stgDTweWhfv8Oeg2ujivq_aettoDnUfh3qD1y4uQYKIy-A73_h3p-GU6rrglV5eoDOrmt5Mf98JenuYv86eksXL4_PsfpFoJnlMKiFyohlRRWa5JDU1TCha1dTmguhKZikpqCkYVzknPCXUVpIbQJS2xirDJuh6v1cH3_dgQNkFt1JhU6ak3LldgtslhYJLoK_2dDdUK1Mf2YO3f-vWpvK2127r5hGD_8gLzguSQ5YxoMX_6dnOQN_O_NBG9gOzlKBr</recordid><startdate>20200901</startdate><enddate>20200901</enddate><creator>Jung, Ki-Sun</creator><creator>Oh, So Yeon</creator><creator>Jun, Hyun Jung</creator><creator>Song, Byung-Ki</creator><creator>Park, Kwonoh</creator><creator>Oh, Sangbo</creator><creator>Kim, Jae-Joon</creator><creator>Park, Eun-Ju</creator><general>AME PUBLISHING COMPANY</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><orcidid>https://orcid.org/0000-0002-2562-9257</orcidid><orcidid>https://orcid.org/0000-0002-7667-9588</orcidid></search><sort><creationdate>20200901</creationdate><title>Effect of education on preference of parenteral nutrition for patients in palliative care unit: quantitative and qualitative study with an anthropological approach</title><author>Jung, Ki-Sun ; Oh, So Yeon ; Jun, Hyun Jung ; Song, Byung-Ki ; Park, Kwonoh ; Oh, Sangbo ; Kim, Jae-Joon ; Park, Eun-Ju</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c396t-b8850c30a74f690d2e38a2bd2f580cb941072e736a5606102fb96e8a2acfefae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Health Care Sciences & Services</topic><topic>Humans</topic><topic>Life Sciences & Biomedicine</topic><topic>Palliative Care</topic><topic>Parenteral Nutrition</topic><topic>Prospective Studies</topic><topic>Quality of Life</topic><topic>Science & Technology</topic><topic>Surveys and Questionnaires</topic><toplevel>online_resources</toplevel><creatorcontrib>Jung, Ki-Sun</creatorcontrib><creatorcontrib>Oh, So Yeon</creatorcontrib><creatorcontrib>Jun, Hyun Jung</creatorcontrib><creatorcontrib>Song, Byung-Ki</creatorcontrib><creatorcontrib>Park, Kwonoh</creatorcontrib><creatorcontrib>Oh, Sangbo</creatorcontrib><creatorcontrib>Kim, Jae-Joon</creatorcontrib><creatorcontrib>Park, Eun-Ju</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Annals of palliative medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jung, Ki-Sun</au><au>Oh, So Yeon</au><au>Jun, Hyun Jung</au><au>Song, Byung-Ki</au><au>Park, Kwonoh</au><au>Oh, Sangbo</au><au>Kim, Jae-Joon</au><au>Park, Eun-Ju</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of education on preference of parenteral nutrition for patients in palliative care unit: quantitative and qualitative study with an anthropological approach</atitle><jtitle>Annals of palliative medicine</jtitle><stitle>ANN PALLIAT MED</stitle><addtitle>Ann Palliat Med</addtitle><date>2020-09-01</date><risdate>2020</risdate><volume>9</volume><issue>5</issue><spage>2793</spage><epage>2799</epage><pages>2793-2799</pages><issn>2224-5820</issn><eissn>2224-5839</eissn><abstract>Background: Patients and their family have resistance in withholding parenteral nutrition (PN) when patient become unable to intake food in the We aimed to investigate whether the preference for PN is changed after receiving an individual education about the risk and benefit of PN. Additionally, we focused on the preferences of patients and their.family and why they prefer it about the nutritional support in the end of life.
Methods: This is prospective study. Patients are eligible if they cannot tolerate oral intake and enteral feeding and have Palliative Performance Scale (PPS) 50% clue to progressive cancer. After informed consent, investigators educated patients and family for an hour using the handouts. Then, patients decided if they will receive PN. Quality of life (QOL) was checked by European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C15-PAL) weekly during 3 weeks. Symptoms related to fluid overloading or dehydration was surveyed weekly also. A social anthropologist participated as an observer or interviewer during whole process of this study.
Results: After education, 12 patients (80%) chose to keep receiving PN and 3 patients (20%) changed their decision from PN to minimal hydration among the 15 patients. More calories were administered to patients who chosen PN (median 1,042.2 vs. 324.3 Kcal/day, P<0.001) for initial 7 days. Overall survival, scores of QLQ-C15-PAL, and symptoms were not different with or without PN. According to the anthropologist, medical staffs regard PN as complex medical treatments, while patients and family recognize it as meal rather than medicine.
Conclusions: Most patients and family prefer to receive PN despite its potential harm and marginal benefit. An in-depth discussion about prognosis and aim of care must be preceded before a decision whether to receive PN can be made.</abstract><cop>SHATIN</cop><pub>AME PUBLISHING COMPANY</pub><pmid>32921086</pmid><doi>10.21037/apm-20-269</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-2562-9257</orcidid><orcidid>https://orcid.org/0000-0002-7667-9588</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Health Care Sciences & Services Humans Life Sciences & Biomedicine Palliative Care Parenteral Nutrition Prospective Studies Quality of Life Science & Technology Surveys and Questionnaires |
| title | Effect of education on preference of parenteral nutrition for patients in palliative care unit: quantitative and qualitative study with an anthropological approach |
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