Development of Palliative Care Model for End-of-Life Cancer Patients with Community Participation, Mueang District, Nong Bua Lamphu Province.

Abstract

     This study was Quasi-Experimental research with Retro-Prospective data collection. The objective is to develop a palliative care model for end-of-stage cancer patients with community participation in Mueang District, Nong Bua Lamphu Province. The study was conducted on all types of end-stage cancer patients who received services at Sukchiwa Clinic, Nong Bua Lamphu Hospital. The data were collected retrospectively from October 2022 to June 2023, totaling 103 patients using the original model, and prospectively from July 2023 to March 2024, totaling 103 patients using the newly developed model. The main outcome was analyzed by comparing the number of advance care plans using Multivariable risk difference regression analysis and measuring knowledge before and after training community health volunteers using paired t test.
     The research results found that 206 terminal cancer patients receiving palliative care who were treated at Nong Bua Lamphu Hospital, 103 people in the pre-development group and 103 people in the post-development group. The comparative results of the development of the palliative care model for terminal cancer patients with community participation, when analyzed using multivariable risk difference regression and multivariable mean difference regression after adjusting for the influence of variables, found that the development of the palliative care model for terminal cancer patients with community participation could increase the number of advance care plans by 47% (95%CI: 0.34, 0.60) (p<0.001), increase the living will by 12% (95%CI: 0.04, 0.19) (p=0.002), increase the family meeting by 34% (95%CI: 0.21, 0.45) (p<0.001), and the Edmonton Symptom Assessment System (ESAS) assessment could reduce various disturbing symptoms, but no statistically significant differences were found. The results of knowledge of volunteers in caring for terminally ill patients by the knowledge score after training increased from 11.54(±2.54) to 14.45(±3.03) (p<0.001) compared to before training.