Effectiveness of Palliative Home Care in Patients with Advanced Liver Cancer
Abstract
A good death at home is preferred by most terminally ill patients. Helping terminally ill patients to spend their lives in the place they prefer is an important part of palliative care because of its positive effects on patients' quality of life. This quasi-experimental study investigated the effects of a palliative homecare protocol among advanced liver cancer patients for their deaths at home and hospital utilization. The samples were 267 advanced liver-cancer patients at Phrae Hospital. The sample was divided in 2 groups--131 patients in the experimental group, and 136 in the control group. The experimental group received normal hospital care and underwent the program protocol for 12 months. The palliative homecare protocol comprised two parts; symptom management and family support. The control group received normal hospital care. After the experiment, data were collected from medical records and analyzed. The results showed that the home death rate among the experimental group was significantly higher than the comparison group (P<0.001). In addition, in the last three months of life, the experimental group had fewer emergency department visits, fewer unexpected hospital admissions, and fewer hospital days (P<0.001). It was concluded that the palliative homecare protocol can promote home deaths and reduce hospital utilization among advanced liver-cancer patients. Therefore, a palliative homecare program should be implemented among primary healthcare services
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