Palliative Care in Disaster Situation among Thai Elderly Emergency Department Patient; A Survey of Patient Perspective
Keywords:
disaster, elderly, palliative careAbstract
Introduction: Recently, disasters occur frequently. In disaster situations, the elderly patients are particularly considered in the vulnerable population group. They have chronic diseases as usual. Some of them should receive appropriate palliative care. But the researches on the perspectives of elderly patients about the palliative care during any disaster situations are limited.
Objective: To know the perspectives of Thai elderly patients sent to the emergency room for palliative care during disaster situations. Methods This study was a cross-sectional survey among elderly patients (aged at least 60 years old) visiting emergency department of the Faculty of Medicine Vajira Hospital from August 1 to September 30, 2016.
Results: We surveyed 243 patients. Most of them were female 154 (63.4%). The median age was 72 (IQR 66-81) and the most common underlying diseases were hypertension (148, 60.9%) and diabetes mellitus (108,44.4%). The majority of patients reported that they had much knowledge on both the disaster response (162,66.7%) and high palliative care (147, 60.5%). The first objective of the palliative care was to feel no pain (190,78.0%) while the first medical aid in the palliative treatment assistance was to receive symptomatic treatment whether they are in the normal (208, 86.0%) or disaster situations (209,86.0%) (P=1.00). Most elderly patients asked for some palliative care assistance from hospitals, 223 (92.0%) in normal and 230 (95.0%) disaster situations (P=.065). The end-stage patients wanted to be admitted in hospitals, 126 (52.0%) both in normal and171 (70.0%) and disaster (P=<0.001) situations.
Conclusion: The elderly thought that they had much knowledge on the disaster response and palliative care. The first objective of the palliative care was to feel no pain but the highest need in the palliative treatment assistance was to receive symptomatic treatment. The trend was the same whether they are in normal or disaster situations.
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