คุณภาพการดูแลแบบประคับประคองตามรูปแบบการจัดการรายกรณีในผู้ป่วยมะเร็ง

Pinta R; Soivong P; Phornphibul P

Authors

Pinta R Nursing Department, Faculty of Medicine, Chiang Mai University, Thailand
Soivong P Faculty of Nursing, Chiang Mai University, Thailand
Phornphibul P Faculty of Nursing, Chiang Mai University, Thailand

Keywords:

Palliative care, case management model, nurse case manager, cancer patients

Abstract

Objectives To describe palliative care of cancer patients based on the case management model.

Methods This descriptive research was guided by the Donabedian model for quality of care. Participants consisted of 60 cancer patients receiving palliative care at a provincial hospital, 60 family caregivers, seven palliative health care providers, and three hospital administrators. Data were analyzed using descriptive statistics and content analysis.

Results For palliative care processes, the nurse case manager’s roles include selecting patients for care, assessing and identifying problems, care planning, coordination and implementation of planned care, continued evaluation, and monitoring until termination of care. This model is feasible because this hospital had a policy on organizing an outpatient and inpatient service system, allocating human resources and budgets, provided adequate essential equipment, appropriate establishments/services, and the palliative care system also collaborates with the various levels of network service. Regarding outcomes, all patients received symptoms management and died at their preferred place, and 92.31 % received care consistent with their advance care planning. Patients and family caregivers highly satisfied with the overall quality of care. Moreover, implementing this model can enhance multidisciplinary teamwork in efficient palliative care.

Conclusion This study’s results can be applied as preliminary data supporting the development and improvement of palliative care based on the case management model among cancer patients in other hospitals. Further study should develop a competency development model of nurse case managers for palliative care and examine that model’s effects.

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