Effects of a Case-Based Management Nursing Programme for Terminally Ill Patients on Their Perception of Symptom-Induced Suffering and Terminal Care Quality
Keywords:symptom-induced suffering, care quality, case-based managemen, terminally ill patients, nurses
Objective: To compare terminally ill patients’ perception of symptom-induced suffering
and terminal care quality before and after participating in a case-based management nursing
programme for terminal patients.
Design: One-group experimental research with a pre-test and a post-test.
Procedure: This study was conducted between August and November 2017 in a tertiary
hospital in Songkhla province. Through purposive sampling, 30 patients were recruited based
on the following qualifcations: 1) being adult patients diagnosed with terminal illnesses and
referred by their physicians to the palliative care centre; 2) being informed by their physicians of
their terminal illnesses and advised to receive palliative care; and 3) being of completely sound
mind. The patients participated in the 5-day case-based management nursing programme for
terminally ill patients. This programme was implemented in 5 stages: 1) identifying and selecting
patients; 2) assessing and examining their problems; 3) planning necessary case-based care methods
based on the problems identifed; 4) implementing the programme according to plan; and 5)
evaluating the outcomes of the programme.
Data were collected through 1) the patient’s general records; 2) the Thai version of
the Edmonton Symptom Assessment System; and 3) the Thai version of the Palliative Care
Outcome Assessment Scale developed by the Nursing Division, Maharaj Nakhon Chiang Mai
Hospital. The Edmonton Symptom Assessment System and the Palliative Care Outcome Assessment
Scale were subjected to a validity test using Cronbach’s alpha coeffcients, and scored .76 and
.73 (n = 20), respectively. The general data were analysed using descriptive statistics, whilst
the comparison between the perception of symptom-induced suffering and that of the palliative
care outcomes was measured using paired t-tests.
Results: After participating in the programme, the patients displayed a signifcantly
lower average score on symptom-induced suffering (t = 5.89, p < .001) and a signifcantly
higher average score on the perception of palliative care quality (t = 3.72, p < .001).
Recommendations: It is suggested that this case-based programme be used in palliative
care centres as a means of alleviating symptom-induced suffering in terminally ill patients
and improving palliative care quality.
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