Palliative Care Needs and Responses Among Lung Cancer Patients: Insights from a Provincial Hospital in Vietnam.

Abstract

Background: Cancer remains a global health challenge, with rising incidence and mortality rates despite advancements in prevention and treatment. In 2022, cancer was the second leading cause of death worldwide, contributing to approximately 9.7 million deaths and 20 million new cases.

Objective: This study evaluates the palliative care needs and responses among lung cancer patients, aiming to inform healthcare policies and enhance palliative care delivery in Vietnam.

Methods: A cross-sectional descriptive study was conducted at a provincial hospital from February to October 2024. The study included 204 lung cancer patients aged ≥18 years, capable of providing informed consent and participating in interviews. Data were collected using a validated questionnaire grounded in national palliative care guidelines, assessing eight domains: physical, psychological, informational, daily activities, communication, spiritual care, self-management, and social welfare needs. The tool exhibited excellent reliability (Cronbach's alpha: 0.74-0.97).

Results: Among 204 participants, 75% were ≥60 years old, with a male predominance (72.5%) and rural residency (85.3%). Educational attainment was generally low (51% with lower secondary or below), and the majority were farmers (67.2%). Most patients were in advanced disease stages (Stage III: 38.2%; Stage IV: 32.4%). Physical needs, such as breathing difficulty relief (82.3%), and social interaction (86.8%) were predominant. Psychological needs, particularly anxiety reduction, were reported by 74.5%. Notably, 85.3% required clear medical explanations, and 90.2% sought better disease-related communication. While self-management (90.2%) and financial support (90.7%) were the most effectively addressed needs, spiritual care received the least attention, with 66.2% of patients reporting unmet needs and only 37.7% receiving adequate support.

Conclusion: The findings underscore critical gaps in palliative care, especially in spiritual, psychological, and financial support. A holistic, patient-centered approach integrating spiritual care, rehabilitation, and enhanced social support is essential. Improved access to specialized services through telemedicine and outreach programs is vital for rural patients. These results call for policy reform and strengthened healthcare infrastructure to meet the comprehensive needs of lung cancer patients. Future studies should evaluate the long-term outcomes of targeted palliative interventions.