Results of Palliative Care at Nang Rong Hospital Buri Ram Province

Abstract

Background: End of life and Palliative care were aims to symptoms management and improved quality of life for good death, human dignity and the family have been good memory and moved on.
Objective: 1. The objective was to study results of end-of-life and palliative care.
                    2. To compare clinical symptom outcomes at admission and before discharge in the palliative care of patients with end stage cancer and end stage chronic illnesses.
Methods: This research was a retrospective cross-sectional study. The data collection periods were 50 palliative care patients’ medical records from December 2023 to May 2024. The statistics used were descriptive and inferential statistics analysis (chi-square and a t-test).
Results: Based on a sample of 50 participants, it was found that 36% had end-stage cancer and 64% had end-stage chronic illnesses. Among patients with end-stage cancer, 22% were under 60 years of age, while the majorities (54%) were over 61 years old. The age distribution between the groups was significantly different (p = 0.003). Regarding body mass index (BMI), 14% of end-stage cancer patients were underweight, whereas 22% of end-stage chronic illness patients were classified as overweight to obese class II. This difference between the groups was statistically significant (p = 0.005). In terms of clinical symptoms, the first Palliative Performance Scale (PPS) scores showed that 22% of end-stage cancer patients had low PPS levels of 10–30%, while 24% of end-stage chronic illness patients had higher PPS levels of 40–60%. This difference was statistically significant (p = 0.004). Regarding pain at admission, 22% of end-stage cancer patients reported pain, whereas 58% of end-stage chronic illness patients reported no pain. The difference between the groups was significant (p = 0.004). Considering medical interventions, the use of feeding tubes differed significantly between the groups (p = 0.004). Comorbidities also showed a significant difference between the groups (p = 0.001).The length of hospital stay was significantly different between the groups (p = 0.006), as was the type of discharge (p = 0.005). When comparing clinical outcomes at admission and prior to discharge in terms of the Palliative Performance Scale, level of consciousness, pain level, and dyspnea level, no significant differences were found between the groups.
Conclusions: Palliative care outcomes for patients at the end of life, including those with terminal cancer and advanced chronic illnesses, indicate that an interdisciplinary team should provide care tailored to differences in age and physical condition. This includes effective management of suffering, nutritional support, advance care planning, and continuous assessment of the Palliative Performance Scale (PPS), level of consciousness, pain, and dyspnea. Such comprehensive and timely adjustments to the care plan ensure that the patients’ needs are adequately addressed throughout the end-of-life trajectory.