Patterns of care at the end of life patients in the palliative care community in Bangkok

Abstract

The purposes of qualitative study were to study the problems and needs among end of life patientsand caregivers including the quality of life and patterns of the palliative care in the community. Thestudy subjects were 9 palliative patients, 7 care givers, 7 health care staffs, 9 community leaders, TambonAdministrator organization(TAO) and village health volunteers (VHVs) and the monks. The data werecollected from observation, in-depth interview, evaluated the perceived quality of life of patients and focusgroups. Qualitative data were analyzed and synthesized of the specific issues.The results of this study revealed that: The problems of end of life patients are as pain, dyspnea, fatigue,loss of appetite, dejection, sadness, despair, anxiety about severity of diseases and concerned cost of medicalcare and medication follow up. The quality of life was at moderate level (X = 5, SD = 2.179). Patients aresuffering from pain, fatigue, loss of appetite, insomnia, frustrated with illness , grieving, no value of lifeand burden. However the patients were satisfaction with care provided by relatives ,village health volunteers,neighbors and health care teams. The problems and needs of caregivers mainly are daily fatigue, weakness,anorexia, anxiety about the change in symptoms of end of life patients and patterns of caring. Some of thecaregivers had hypertension or diabetes and the most of the caregivers had required the attention of a healthcare providers. The palliative care model is to care for individual patients . The relatives have a significantrole in caring by helping improve quality of life. Community nurses, village health volunteers play a rolein counseling and providing the necessary any equipments as need.The research findings demonstrated that the patterns of palliative care of patients in the community, therelatives have a significant role in caring .Health providers and health volunteers have a role by assistingand making the decisions based on the circumstance of each patient. The