A Study of the Result from Palliative Care Program in Terminal Stage Patients, Bangpahan Hospital, Phra Nakhon Si Ayutthaya Province.

Abstract

     In this study, the results of palliative care program in terminal stage patients of Bangpahan Hospital were investigated by using descriptive retro-cohort design. The purposive sampling of 32 patients (20 males & 12 females) with terminal illness, whose Palliative Performance scale was ≤50%, was conducted from 2016, September 1st to 2018 February 28^th in the palliative care clinic. The studied population was followed up from patient’s registration until death. Based on the results, we found that the mean age of the sampled population was 64.5 13.7 years. The majority of the studied subjects were advanced stage cancer patients 87.5% (liver cancer 18.8%, lung cancer 12.5%, nasopharyngeal cancer 9.4%, cholangiocarcinoma 6.3%, pancreatic cancer 6.3%, esophageal cancer 6.3%, brain cancer 6.3%, breast cancer 6.3%, cervical cancer 3.1%, ovarian cancer 3.1%, colon cancer 3.1%, pyriform cancer 3.1% and Non-Hodgkin’s lymphoma 3.1%), while only 12.5% were found to be non-cancer patients. The initial symptoms that led to the treatment in palliative program were fatigue (Mdn=7.5, IQR=5-8), anorexia (Mdn=6.5, IQR=4-8), pain (Mdn=6, IQR=3-8.8), dyspnea (Mdn=5, IQR=1.3-7.8), drowsiness (Mdn=4, IQR=1-5), and nausea (Mdn=2, IQR=0-4), respectively. After receiving interventions from the palliative care program, the post-treatment follow-up revealed significantly decreased severity of symptoms, including fatigue, pain, anorexia, dyspnea, and nausea (p<0.05). Thirty-one patients (96.9%) died peacefully according to their advance care plans, while only one patient (3.1%) experienced unexpected death. Hopefully, this research might be useful for end-stage care because the treatment procedure could significantly alleviate sufferings from the aforementioned symptoms and allow patients to conceivably die based on the self-caring plan.