This study explored the quality of life (QOL) of advanced cancer patients before and after receiving hospital-based palliative shared care; also compared their quality of life with those of terminal ill patients in palliative care units. Sixty-eight cancer patients in a southern Taiwan hospital were selected, purposive sampling, as our study samples. Among these 68 patients in our study were under three care models; 20 patients were under general care, 17 patients were under hospital-based palliative shared care, and 31 patients were under palliative care. One week after their admission into care units, we evaluated their QOL using MQOL ¡VTaiwan version. The QOL data of these three groups of advanced cancer patients ,then grouped and compared as in general care unit, hospital-based palliative shared care unit, and palliative care unit. All data collected were analyzed using SPSS for Word 10.0 statistic software. Furthermore, we have in-depth interviewed with four chiefs of general care units, five patient caretakers, and one professional of hospital-based palliative share care. Contents of the in-depth interviews focused on in what aspects hospital-based palliative shared care provided help to terminally ill patients in terms of quality of life or life difficulty. Contents of the discussion were then analyzed and interpreted.
Results of our analysis, measured by MQOL ¡V Taiwan version, showed there is no significant difference in QOL of advanced cancer patients between hospital-based palliative shared care and general care. But results of our in-depth interview with caretakers and caregives showed interesting aspects: 1. Physical symptoms of advanced cancer patients was brought under control. 2. Psychological symptoms of advanced cancer patients or their family was taken care of. 3. Advanced cancer patients or their family are all benefited from continued advice and instructions. 4. Provide cancer patients and their family with guidance and instructions as to preparing for death. 5. Support the emotional needs of family of advanced cancer patients. 6. Hospital-based palliative shared care offered palliative consultation, supporting patient caretakers and providing improvement QOL for cancer patients. 7. Mindset change to doctors: inform cancer patients or their family of developing cancer symptom so that early intervention can be ensued. 8. Caretakers of general care unit and hospital-based palliative shared care unit formed a joint team, enabling cancer patients and their family feel secured in treatment. In conclusion, hospital-based palliative shared care benefits patients and their family. Comparing with hospital-based palliative shared care, palliative care showed significant improvement in physical symptom domain, psychological domain, and the mean of four domains. In all palliative interventions, palliative care has better effect in improving QOL of cancer patients than hospital-based palliative shared care.
By this study, we examined and evaluated the effectiveness of ¡§Hospital-based Palliative Shared Care Program¡¨ promoted by Bureau of Health Promotion, Department of Health, R.O.C. With the in-depth information revealed, we can improve this promotion program and ensure that patient¡¦s needs have been taken care of. We would also recommend any promotion program must focus on patients, and a model of combined effort of palliative shared care should be on top of all.
| Identifer | oai:union.ndltd.org:NSYSU/oai:NSYSU:etd-0105107-193709 |
| Date | 05 January 2007 |
| Creators | Lee, Mei-ying |
| Contributors | none, Chung-fu Lan, none |
| Publisher | NSYSU |
| Source Sets | NSYSU Electronic Thesis and Dissertation Archive |
| Language | Cholon |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.lib.nsysu.edu.tw/ETD-db/ETD-search/view_etd?URN=etd-0105107-193709 |
| Rights | not_available, Copyright information available at source archive |
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