การพัฒนารูปแบบการดูแลผู้ป่วยมะเร็งระยะท้ายจากโรงพยาบาลสู่บ้าน โรงพยาบาลอุบลรัตน์ จังหวัดขอนแก่น Development of Care Model for Patients with End Stage of Cancer: from Hospital to Home Ubonrat Hospita, Khon-Kaen Province

Abstract

This action research aimed to development of caring patients with end stage of cancer from hospital to home using the principle concept system theory and to take the Deming cycle. This study comprises four steps: 1) problem analysis and plan 2) operation 3) evaluation and 4) the continuous improvement. The purposive samplings are 30 patients with end stage of cancer, 30 caregivers, 15 multidisciplinary team, 15 community networks and total 90 persons. An operation starts from year 2016 to 2017. Tool gathering data is a questionnaire consists of evaluation form caring patients with end stage of cancer and a care referring form between multidisciplinary team. These tools are already verified from experts and tested reliability by the Cronbach’s alpha coefficient method with 0.95 and 0.87. A quantitative analysis uses a percentage and a qualitative analysis uses the content analysis.

                Results are found that 1) problems and situations are no obvious patterns, lose self-confidence, and lack of forwarding information, 2) the development of caring patients with end stage of cancer as follows: 2.1) brainstorming to find out patterns 2.2) training to teams 2.3) appointment a committee to works and 2.4) the referring into community by visiting home. Results after developing patterns of caring: the patients are taken good care with 100 %, refer to home with 90.00 %, died in a hospital with 10 %, died at home with 62.96 %, living at home with 37.03%.

The result of the care model was found to be practical with 93.33, satisfaction of patients and caregivers are in a high level (x̅ = 2.91, SD= 0.61) and satisfaction of staffs are in a high level (x̅ = 2.86, SD= 1.75). These results are indicated that teams have model of caring patients with end stage of cancer to seamless, the care model should be expanded in health promoting hospital and general hospital to create a more effective care system.