ประสบการณ์การใช้เครื่องพยุงชีพที่บ้านในผู้ป่วยระยะท้าย: การวิจัยเชิงคุณภาพ

Ratima  Ongarjitthichai; Penchan  Pradubmook Sherer; Pimpawun Boonmongkon

Authors

Ratima Ongarjitthichai Policy Research and Development Institute Foundation (PRI)
Penchan Pradubmook Sherer Faculty of Social Sciences and Humanities, Mahidol University
Pimpawun Boonmongkon Faculty of Social Sciences and Humanities, Mahidol University

Keywords:

Life support machine, end-of-life patients, Illness experience

Abstract

Introduction: Life support machine plays a crucial role in improving patients’ quality of life and has positive and negative effects on the patient life experience and their caregivers.

Research objectives: This research aimed to explore the experiences of the end-of-life patients who use life support machine with focusing on the interaction between technology, patients, and the society.

Research methodology: A qualitative study using case study approach was applied. A purposive sampling method was used to recruit the informants, including 18 end-of-life patients and their caregivers from 12 families, and 5 healthcare providers. Data collection methods were narrative interview with patients and caregivers, in-depth interviews with healthcare providers, and observation while using the machine at home. Data were analyzed using thematic analysis.

Results: The experiences of using life support machines in end-of-life patients were identified in 3 dimensions: 1) life support machine and the end-stage illness: life support machine means a lot to prolong life and achieve the ultimate quality of life without suffering; 2) life support machine and the patient's life world: life support machine has been compared as an indispensable organ. It is a part of life contributing to patients' psycho-physio-social encounters. This reflects patients’ dependency, being fear, and uncertainty; 3) In medical context, life support machine is a symbol of medical knowledge and has been monitored and surveilled through medical guidelines. Caregivers and patients can negotiate medical practices, both direct and indirect way.

Conclusion: Life support machine interplays with the illness but seems to be meaningful and interrelate to patients’ illness experiences, patients’ life, caregivers, and healthcare service.

Suggestions: Healthcare providers should provide continuity of care using holistic approach to empower patients and caregivers to attain a good life while using life support machine at home. Caring while using life support machine to achieve patients’ and caregivers’ need should be promoted.

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