Evaluating Illness Understanding and Preferences of End-of-Life Care Among Older Patients with Advanced Cancer in Vietnam

Abstract

Background/Purpose: Providing end-of-life (EOL) care inconsistent with patients’ preferences increases the physical distress and decreases the quality of life of patients. This study aimed to evaluate illness understanding and preferences of EOL care among older patients with advanced cancer in Vietnam. Methods: We performed a cross-sectional study at the Department of Geriatrics-Palliative Care at Ho Chi Minh City University Medical Center. Older people with stage IV cancer were enrolled in the study. Face-to-face interviews were conducted by palliative care specialists to explore patients’ illness understanding and EOL care preferences. Results: The study included 109 participants with a mean age of 70.9±3.5 years (44.1% female). Approximately 72% of the participants acknowledged their terminal illness, but 61.5% did not know their estimated life expectancy, and 89. 9% were not aware of advanced care pl anni ng (ACP). Most participants wished to die at home (76.1%) and not receive mechanical ventilation (62.4%) or resuscitation (64.2%). More than half of the participants preferred being around their family members during the last hours of life (51.4%). Conclusion: Most older patients with advanced cancer did not know their estimated life expectancy, and were relatively unfamiliar with advanced care planning. Hence, healthcare teams should identify patients’ values and preferences and facilitate ACP discussions to ensure that EOL care is consistent with their wishes. This will reduce physical distress and healthcare costs for older patients with advanced cancer.