Exploring Indications and Practices of Administering Artificial Hydration to Terminal Cancer Patients in Taiwan

NCT06329856 | Recruiting

• 1 other identifier: 202301218RIND
• Study Type: observational
• Target: 1,270
• Locations: 1 country
• Sites: 1

Brief Summary

Background: The issue of artificial hydration for terminal cancer patients is a classic ethical dilemma in palliative care. It is a common practice especially when patients are incapable of oral intake; however, there is a lack of research on indications and practices for the provision of artificial hydration to terminal cancer patients in Taiwan. The investigators aim to conduct a nationwide survey of palliative care physicians on their indications (general or specific), and practices of providing artificial hydration to terminal cancer patients. With that understanding of reasoning and clinical practice, the investigators would further establish an indigenous, evidence-based consensus guideline to serve as a reference for physicians in Taiwan. Methods: The study is comprised of two parts. The first part is to conduct a nationwide survey of palliative and oncology care specialists with a questionnaire designed from literature reviews and principles of clinical ethics. After validation of the questionnaire, the investigators will e-mail it to members of the Taiwan Academy of Hospice Palliative Medicine and the Taiwan Society of Cancer Palliative Medicine. The primary outcome measure of the study is the indication and clinical practice of artificial hydration, and the secondary outcome is factors associated with the administration or withdrawal of hydration. The second part is to establish a national consensus on clinical guidelines for administering artificial hydration, where the investigators will conduct a modified Delphi method for 6 rounds. Literature reviews will be first performed and 14 sessions of one-to-one interviews in Round 1 to develop a draft. Subsequent rounds comprise questionnaire surveys among all panelists, teleconferences and e-mail discussions among core members, and cancer patients/patients' family discussions. Statistical criteria include median and disagreement scores according to the Inter-Percentile Range Adjusted for Symmetry. Items voted for by 70% or more panelists will be selected and formalized into a consensus guideline. Expected results: The investigators hypothesize that the indication to administer artificial hydration to the terminal cancer patient is multi-factorial and culturally based. Conclusion: The establishment of a consensus guideline will help clinicians to make an appropriate decision from ethical, medical, cultural, and emotional factors and facilitate cancer patients to achieve a good quality of dying.

Conditions

Terminal Cancer; Hospice; Palliative Medicine

Keywords

Artificial hydration

Outcome Measures

Primary Outcomes (3)

• Likert scale on alteration of administer artificial hydration to the terminal cancer patient and principles of clinical ethics

  Multi-factorial and culturally based questionnaire in a nationwide survey of palliative and oncology care specialist, to explore the 5- to 9-point scale of opinion on indication and practices of administrating artificial hydration to terminal cancer patients

  Within 1 month

• Distributive statistics

  Statistical analyses of quality indicators from 14 sessions of one-to-one interviews and questionnaire surveys among panelists, to be formalized into a consensus guideline when over 70% of panelists voting for a questionnaire item

  At most 6 months

• Disagreement score according to the Interpercentile Range Adjusted for Symmetry (IPRAS) for survey results

  Higher scores indicating a worse outcome

  Within 6 months

Study Arms (2)

members of the Taiwan Academy of Hospice Palliative Medicine

members of the Taiwan Academy of Hospice Palliative Medicine

Behavioral: Administering of artificial hydration

members of the Taiwan Society of Cancer Palliative Medicine

members of the Taiwan Society of Cancer Palliative Medicine

Behavioral: Administering of artificial hydration

Interventions

Administering of artificial hydration BEHAVIORAL

Administering of artificial hydration to terminal cancer patients

members of the Taiwan Academy of Hospice Palliative Medicine; members of the Taiwan Society of Cancer Palliative Medicine

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

From the name list of the Taiwan Academy of Hospice Palliative Medicine and Taiwan Society of Cancer Palliative Medicine

You may qualify if:

• Taiwan Academy of Hospice Palliative Medicine
• Taiwan Society of Cancer Palliative Medicine
• At least a year in training to take care of terminally ill patients
• Have signed informed consent.

You may not qualify if:

• No clinical experience in palliative care
• Decline to sign informed consent

Sponsors & Collaborators

• National Taiwan University Hospital: lead

Study Sites (1)

Department of Family Medicine, National Taiwan University Hospital

Taipei, 100229, Taiwan

RECRUITING

Related Publications (26)

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Study Officials

• Shao-Yi Cheng

  Department of Family Medicine, College of Medicine and Hospital, National Taiwan University

  STUDY CHAIR

Central Study Contacts

Shao-Yi Cheng, MD,MSc,DrPH

CONTACT

+886-2312-3456; scheng2140@gmail.com

I Ann Hsiao, MD

CONTACT

+886-2312-3456; iamiannhsiao@gmail.com

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 11, 2024
• First Posted: March 26, 2024
• Study Start: August 15, 2024
• Primary Completion: December 10, 2024
• Study Completion (Estimated): July 1, 2026
• Last Updated: February 14, 2025

Record last verified: 2024-03

Data Sharing

• IPD Sharing: Will not share

Locations

TW (1)