Development of a nursing model for advance care planning in Palliative Care at Thawatburi Hospital Roi Et Province
Keywords:
Terminally ill patients, Advance care planning, Unnecessary medical interventionAbstract
Purposes: This study aimed to develop and evaluate an advance care planning (ACP) nursing model for terminally ill patients and to assess its effectiveness when implemented in the inpatient wards of Thawatchaburi Hospital.
Study design: A research and development design was employed.
Materials and Methods: Participants comprised 14 registered nurses, 35 end-of-life patients, and their primary caregivers who met the inclusion criteria and were admitted to the inpatient wards between January and August 2025. Data were collected using the WHOQOL-BREF, the Family Satisfaction Questionnaire, and the Model Appropriateness Assessment Tool. Descriptive statistics (frequency, percentage, mean, standard deviation) and paired t-tests were applied for data analysis.
Main finding: The developed ACP nursing model consisted of three steps: (1) assessment of patients’ and caregivers’ needs, (2) planning and implementing nursing care, and (3) documentation. After implementation, patients’ mean quality of life scores significantly improved compared to pre-intervention (p < .05). Caregivers reported a very high level of satisfaction, while the appropriateness of the model was rated as high.
Conclusion and recommendations: The ACP nursing model significantly enhanced patients’ quality of life, improved caregiver satisfaction, and promoted a dignified death at home while reducing unnecessary invasive interventions. These findings highlight the importance of structured ACP in palliative care nursing practice.
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