Development of a Palliative Care Model for End-stage Patients by the Participation of Network Partners in the Community, Phan Don Subdistric, Kumphawapi District, Udon Thani Province

Abstract

Community partnerships play key roles in palliative care for people at the end of life. The research and development study aims to: 1) study the situation of problems and needs in late-stage palliative care; 2) develop a model for palliative care in the late stages; and 3) study the effectiveness of the developed palliative care model.he study was divided into three stages. Phase I examined the situation, and the samples were families of 10 patients who died before 2021, 10 multidisciplinary teams, and 10 network partners. The study tool consisted of semi-structured questions for in-depth interviews and focus group discussions. Phase II: development of a late-stage palliative care model with the participation of network partners in the community. The sample consisted of six terminally ill patients, 10 multidisciplinary teams, and 10 network partners. The tool was a set of semi-structured questions for focus group discussion. Phase III: evaluate the effectiveness of the model; the sample was the same as in Phase II. The tools were composed of two parts: 1) a good death assessment form, comprising 35 items with a content validity of.98; and 2) a satisfaction assessment form for patients, multidisciplinary teams, and network partners. The qualitative data were analyzed by content analysis, and the quantitative data were analyzed using descriptive statistics. The results of this research revealed that 1) the end-of-life patients had physical,mental, social, and economic problems requiring psychological care, managing physical disturbances, support for medical  supplies, and religious  activities;  2) guidelines  for  the  implementation  of end-stage  palliative  care emphasized holistic care, physical, mental, social, and spiritual, using the WHO 2002 concept of six topics; and 3) after intervention, all patients received care according to the guidelines of the "Phan Don Model" and had a good death. In addition, it was also found that the patients and their families had the highest level of satisfaction, and the satisfaction scores of multidisciplinary teams and network partners were significantly higher than before using the model. Therefore, this model could be used as a guideline with partnership network participation for caring for end-of-life patients in the community.