The Systematic Reviews on Palliative Nursing Management in The Terminally Ill Cancer Patients from Hospital to Home

Abstract

Background:  Patients with cancer who are in the terminal stage are at high risk of death. These patients must return home for palliative care until their last days. Therefore, there is a need for a patient treatment service system to manage and coordinate treatment between hospitals and homes for efficient and continuous nursing.

Objectives: This report is a literature review with the purpose to summarize the practice methods and results of palliative care at home.

Methods: The research method is studying the existing research results published between the years 2017 and 2022, from May 2022 to April 2023, using the electronic databases of Thai journals, namely TCIJO and Thai LIS Digital Collection, and following the PICOS Framework concept of Joanna Briggs Institute.

Materials: The quality analysis of the research study was conducted using the Review Manager software for a quasi-experimental study assessment, following the Checklist for Quasi-Experimental Studies: non-randomized experimental studies. Subsequently, the data was subjected to statistical analysis using Meta-analysis, and content analysis was performed to address the literature review questions.

Results: The search results from the keyword search yielded a total of 226 research reports. Among these, 219 were from the TCIJO database, and 7 were from the Thai LIS Digital Collection. Six studies met the criteria for literature review based on the PICOS framework: 3 quasi-experimental studies and 3 operational studies. The research quality levels were rated as TCI 1 and 2, with three studies falling into each category. However, the statistical results were insufficient for Meta-analysis, so content analysis was performed instead. The study focused on two models of patient care service systems for end-stage cancer patients transitioning from hospitals to home care. The first model was case management, and the second model involved network and family participation. The results indicated an improvement in the quality of care with the implementation of the Palliative Care Outcome Scale (POS). There was no significant difference in the measured physical performance (palliative performance scale: PPS) between the two models, but the group receiving care in the emergency department had fewer hospital admissions and shorter hospital stays compared to the control group. Additionally, the palliative care at home continuity led to an overall improvement in the patient's quality of life.

Conclusions: The patient care service system model of transitioning end-stage cancer patients from hospitals to home care, with the involvement of healthcare professionals and working as a network from hospital to home, promotes and supports patients and caregivers in self-care management, leading to an improved quality of life. This positively benefits the patients, their families, and the hospitals and aligns with the policies of the Ministry of Public Health.