Asian Pacific journal of cancer prevention : APJCP · 2025
Health Outcomes and Symptom Intensity Over Time among Cancer Patients Receiving Palliative Care in Vietnam: A Prospective Cohort Study.
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Mai Thuy Thi Thanh, Trinh Oanh Th, Do Dung Van, Cheng-Pei Lin, Harding Richard
Аннотация
BACKGROUND: In Vietnam, research on palliative care, particularly for cancer patients, remains limited. This gap reduces the practical relevance of research findings in shaping policies and strategies for palliative care tailored to Vietnam's healthcare system. This study aimed to assess health outcomes in cancer patients receiving palliative care over a one-year period using the APCA African Palliative Outcome Scale (IPOS).
METHODS: The prospective cohort study was conducted over one year, with monthly interviews using IPOS scale to measure patient health outcomes. A multilevel linear mixed model was used to analyze changes in IPOS scores over time, and a Bonferroni-adjusted pairwise comparisons test was applied to compare mean IPOS scores of patients before death.
RESULTS: Among the 134 patients included, mean IPOS scores along with physical, emotional, and communication symptoms decreased over time. The total IPOS score declined from 32.2 (95% CI: 30.3-34.1) to 11.4 (95% CI: 9.6-13.3) after one year, with the greatest reduction observed in physical symptoms. Patients in the 0-2 months before death group had significantly higher scores than those in the 3-5 months and 6 months before death groups. Physical symptoms, including pain, dyspnea, and weakness, worsened the most, while communication issues remained stable, peaking at 2 months and reaching their lowest point at 6 months before death.
CONCLUSION: This study provides evidence of the benefits of palliative care in improving the health of cancer patients. Quality of life declines most in the final months, highlighting the need for early symptom management. This study also paves the way for further research into symptom progression before death.
METHODS: The prospective cohort study was conducted over one year, with monthly interviews using IPOS scale to measure patient health outcomes. A multilevel linear mixed model was used to analyze changes in IPOS scores over time, and a Bonferroni-adjusted pairwise comparisons test was applied to compare mean IPOS scores of patients before death.
RESULTS: Among the 134 patients included, mean IPOS scores along with physical, emotional, and communication symptoms decreased over time. The total IPOS score declined from 32.2 (95% CI: 30.3-34.1) to 11.4 (95% CI: 9.6-13.3) after one year, with the greatest reduction observed in physical symptoms. Patients in the 0-2 months before death group had significantly higher scores than those in the 3-5 months and 6 months before death groups. Physical symptoms, including pain, dyspnea, and weakness, worsened the most, while communication issues remained stable, peaking at 2 months and reaching their lowest point at 6 months before death.
CONCLUSION: This study provides evidence of the benefits of palliative care in improving the health of cancer patients. Quality of life declines most in the final months, highlighting the need for early symptom management. This study also paves the way for further research into symptom progression before death.