Development of palliative care model for patients at home of appropriate for social cultural context of community in Amnatcharoen Province.

Abstract

     This study was action research. Aim to develop and study of results to home-based palliative care model appropriate for social cultural context of community in Amnatcharoen Province. Sample group consisted qualitative group use doctors, pharmacists, professional nurses, nutritionists, physical therapists for focus group 11 person, Quantitative study group use 8 palliative patients, and 47 caregivers. Research tools used consisted of qualitative instruments, including open-ended questions, and focus groups. Quantitative instruments include general data collection forms, assessment of daily activities (ADL), assessment of patient self-help abilities (PPS), assessment of pain severity (ESASr), mental health assessment (2Q9Q), and knowledge assessment forms. The statistics used were percentages, standard deviations, and before-after comparisons using the Paired t test.

     The results of the study found that from the problem analysis, The 8 terminally ill patients, mostly female, 37.50 percent, primary education level 50.00 percent. The development of the model consists of 6 important models as follows: 1) Develop a patient assessment system 2) Develop a re-review system 3) Develop training to provide knowledge and skills to caregivers 4) Create an evaluation in a familiar, peaceful home atmosphere 5) Develop a coordination system with multidisciplinary professionals and all relevant parties 6) Promote the existence and use of nursing models for terminally ill patients in organizations and communities to be in the same format. The statistical difference test after the development found that knowledge, self-help skills (PPS), symptom distress (ESASr), and palliative care (PCOS) had a statistically significant improvement at p <.05.