Effects of Nurse Case Management Program for Patients with Terminal Stage Hepatocellular Carcinoma on Perception of Symptom Induced Suffering and Palliative Care Outcome
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Abstract
Patients with terminal stage hepatocellular carcinoma suffers both physically and mentally. Nurse case management can help alleviate the suffering of terminal stage patients. This quasi-experimental research with one - group pretest-posttest design aimed to determine the effects of a nurse case management program on perception of symptom induced suffering and palliative care outcomes among patients with terminal stage hepatocellular carcinoma. The sample was 36 patients with terminal stage hepatocellular carcinoma who were admitted to a medical ward of a tertiary hospital. The 5-day program composed of 5 stages: (1) identifying and selecting the target patients; (2) assessing and examining the problems; (3) planning case-based care; (4) implementing the care plan; and (5) evaluating the outcomes. Research instruments consisted of: 1) the Thai version of the Edmonton Symptom Assessment; and 2) the Thai version of the Palliative Care Outcome Scale. The Cronbach, s alpha reliability of the instruments were 0.78 and 0.75, respectively. The data were analyzed using paired t-test. Results revealed that after the program: (1) the mean score of the perception of symptom-induced suffering after receiving the program statistically significant lower than before receiving the program (t = 10.49, p < 0.001); and (2) the mean score of the perception of palliative care outcomes after receiving the program statistically significant lower than before receiving the program (t =17.90, p < 0.001). The nurse case management program could help improve the perception of symptom-induced suffering of the patients with terminal stage hepatocellular carcinoma. Further study should be done in a larger sample and with longer period.
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