Case study: Continuing End-stage cancer patients nursing care from hospital to home and community, In the context of palliative care center, Counseling Clinic of Nursing department, Klongtom hospital

Abstract

          Cancer is a disease caused by genetics and gene mutations in normal cells, transforming themselves into cancerous cells, spreading along the tissues. Their invasive growths make the organs lose their normal
functions. Finally the cancer turns itself into end - stage and causes the patient health. Mostly, the cancer will
spread after turn to end-staging for a while. So some patients may be suffered physically and mentally, moreover their quality of life may be also affected. The continuing nursing care of end-stage cancer patients from the hospital to home and community should provide patients and their families to manage the symptoms appropriately. These holistic cares result in their quality of life improvement and the deathy with full of human dignity.
          Case study : Two end-stage cancer patients, who refused to treat with chemotherapy and radiation therapy, reecived palliative care treatment. The first case was diagnosed with nasopharyngeal carcinoma and the other was diagnosed with hard palate carcinoma, both were admitted to Klongthom Hospital. Their symptoms were severe pain, the first one had nociceptive pain and the other had neuropathic pain, water and electrolyte imbalance and infection. When diagnosis was given, the continuing nursing care from the hospital to their home and community was done in all dimensions. Medical follow up was scheduled by the hospital advance appointment system.
          Results: Both patients were relieved from severe pain and other disturbances. About their illness, they accept the course of disease and live with encouragement in the rest of their life. Patients died at home. The satisfaction score for palliative care are 96.5% and 98%, respectively.
          Conclusion: For end-stage cancer patients nursing care, nurses should have knowledge about the disease and its pathology, treatment and symptom management. Continuing nursing care of end - stage
cancer patients from the hospital to home and community provides patients and families with holistic palliative care to improve quality of life and promote good death.