Relationships among Oral Care Behaviors, Quality Relationship of Family Caregivers, and Nutritional Status of Older Adults with Colorectal Cancer Undergoing Chemotherapy
DOI:
https://doi.org/10.60099/jtnmc.v40i02.271825Keywords:
oral care behaviors, quality relationship, family caregivers, nutritional status , older adults, colorectal cancer, chemotherapyAbstract
Introduction Older adults with colorectal cancer undergoing chemotherapy are at risk of malnutrition due to a combination of complex disease conditions, frequent and ongoing treatments, side effects of treatment, and the aging process, which collectively increase energy requirements. Maintaining good nutritional status plays a crucial role in enhancing recovery during treatment, ensuring treatment proceeds as planned, and reducing the incidence of severe complications. Additionally, oral care behavior is associated with the nutritional status of older adults, contributing to the alleviation and prevention of severe complications, as well as reducing barriers to food consumption. This positively affects overall quality of life. Furthermore, support and care from family caregivers, both in hospital settings and continuing care at home, are of paramount importance.
Objectives This study aimed to 1) describe the nutritional status of older adults with colorectal cancer undergoing chemotherapy, and 2) examine the relationship between oral care behaviors, the quality relationship of family caregivers, and the nutritional status of older adults with colorectal cancer undergoing chemotherapy.
Design This study employed a descriptive correlational design, utilizing literature reviews of factors associated with the nutritional status of older adults with colorectal cancer undergoing chemotherapy.
Methodology The sample consisted of 110 older adults aged 60 years and over and 110 family caregivers who met the inclusion criteria. The research instruments included screening tools, which were the Mini-Cog, with a Cronbach’s alpha coefficient of .810, and the Barthel Activities of Daily Living Index, with a Cronbach’s alpha coefficient of .723. The researchers conducted content validation test through expert review by three specialists and then analyzed reliability coefficients to ensure the quality of the instruments. Data were collected through structured interviews using 1) a demographic questionnaire for older adults, an oral care behaviors questionnaire yielded an Item-level content validity index (I-CVI) of .920 and Cronbach’s alpha coefficient of .890, and a mini nutritional assessment, a Cronbach’s alpha coefficient of .723; 2) a demographic questionnaire for family caregivers and the Thai quality relationship scale for family caregivers of patients with cancer, a Cronbach’s alpha coefficient of .890; and 3) The World Health Organization classification of oral mucositis, a Cronbach’s alpha coefficient of .706. Data were collected through structured interviews. Data were then analyzed using descriptive statistics, Pearson correlation coefficient, and Spearman’s correlation.
Results The sample had an average age of 66.43 years (SD = 5.67). The majority were married (75.45%), more than half were male (54.55%), and were at risk of malnutrition (57.27%). Approximately one-third were malnourished (33.64%). Most had good oral care behaviors (86.36%). The highest severity of oral mucositis was found at level 2. The quality relationship of the family caregivers, particularly in terms of affection, was the highest. Oral care behaviors were positively correlated with the quality relationship of the family caregivers (r = .240, p < .05). The quality relationship of the caregivers was positively correlated with the nutritional status of older patients undergoing chemotherapy from the 6th cycle onwards (r = .443, p < .001). However, oral care behaviors was not significantly correlated with nutritional status.
Recommendation The results of this study provide basic health information and are beneficial for older patients with colorectal cancer undergoing chemotherapy. Gerontological nurse practitioners can apply these findings in screening, assessment, and promoting the quality relationships of family caregivers to enhance oral care behaviors and improve the nutritional status of older adults with colorectal cancer undergoing chemotherapy.
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