Development of palliative care services for end of life patients connected to the community in Na Chueak District, Maha Sarakham Province.

Abstract

     This action research aimed to develop palliative care services for end of life patients connected to the community in Na Chueak District, Maha Sarakham Province. The research based on the concept of Kemmis & McTaggart's, using a community-based palliative care model and a family meeting process. Sample size were 48 end of life patients in Na Chueak District, 2) 48 caregivers, and 3) 19 public health personnel. The study was conducted between July 2022 and June 2023. The study is tools include 1) End of life patients data recording form. 2) Palliative Performance Scale for adult Suandok version 2 form (PPS v2) 3) Edmonton Symptom Assessment System form (ESAS) 4) Thai standards for advance care planning form 5) End of life patients family satisfaction assessment form Data were analyzed using descriptive statistics and content analysis.
     The results revealed that situation analysis phase 1) Increasing demand for palliative care services. 2) Public health personnel faced skill gaps in assessing and planning comprehensive care. 3) Issues with discharge planning and continuity of care. 4) Lack of clear nursing guidelines.5) Advance care planning did not cover all disease groups. 6) adequate tools and medications for symptom relief various disturbing symptoms. Development phase: 2 development cycles were carried out by 1) There were nursing practices for end of life patients in the hospital to the community using the nursing process for effective care and discharge planning. 2) Established communication channels for 24-hour patient and family support. 3)Strengthened public health personnel skills. 4) built a community network for ongoing home-based care. The results revealed that evaluation phase 1) End of life patients receive palliative care 98 % 2) End of life patients received advance care planning 80.46 % 3) End of life patients had access to Opioids to relieve pain and shortness of breath 57.57 % 4) End of life patients received home visits 98% 5) The family satisfaction of palliative care patients with palliative care nursing services 96%.