Development model of holistic palliative care system for patients with end-stage renal disease, Kuchinarai Crown Prince Hospital.

Abstract

     This study was participatory action research. The objectives are to study the characteristics and problems of end-stage renal disease patients and to study the development model of the holistic care system for end-stage renal disease patients at Somdech Phra Yuppharat Kuchinarai Hospital. The study period is between October 2023 and September 2024, a total of 12 months. The sample consists of 490 end-stage renal disease patients at Somdech Phra Yuppharat Kuchinarai Hospital. Data were collected from questionnaires and medical records. Data were analyzed using content analysis. Frequency, percentage, mean, and standard deviation.
     The results of the study found that a total of 490 patients received care according to the guidelines. It can be divided into groups of patients who received services under the treatment of family medicine specialists in cases where the symptoms of the disease were severe and near death, patients who received treatment from nephrology specialists in cases where the symptoms of the disease were stable and had individual medication adjustments. All patients with end-stage renal disease (stage 5) received information on renal replacement therapy (RRT). More than 90 percent of end-stage renal disease (stage 5) patients who did not receive dialysis and their families participated in the advance care planning process. Patients who entered the end-stage stage received appropriate symptom management, reduced crowding, and reduced waiting time for treatment in the hospital. It reduced unnecessary expenses in cases where patients entered the end-stage stage. The satisfaction of relatives of end-stage renal disease patients with palliative care at Somdech Phra Yuppharat Kuchinarai Hospital was found to be at the highest level overall and in each aspect.