THE DEVELOPMENT OF END OF-LIFE CARE PRACTICE SYSTEM FOR CONTINUING CARE AT HOME OF THE PATIENTS IN THE OUTPATIENT DEPARTMENT

Abstract

The purpose of this research is to develop the end-of-life care practice system for continuing care at home of the patients in the outpatient department. This research and development was done using Deming cycle which consists of 4 steps: Analyze, Plan, Do, and Evaluate. The process consists of 3 Deming cycles where the purposive sampling technique was used where 3 registered nurses, 2 multidisciplinary, and at 177 end-of-life patients or the patients’ relatives were included. Three research tools were used including 1) the palliative care practice system for continuing care at home Manual which was developed by the author in collaboration with multidisciplinary team. 2) Semi-structured Interview. 3) Case Record form. The results were analyzed using descriptive statistics, frequencies, and percentages. The results from each Deming cycle are compared using Chi-square and t-test. The analysis of the end-of-life care practice system for continuing care at home of the patients in the outpatient department, which developed by multidisciplinary team, includes the care manual and patient’s data transfer system from the hospital to the community hospital in its network. The result shows that there is an improvement in the assessment score compared with the score during pre-development period and the statistical significance is 0.05. The percentage of disturbing symptom indicators from the clinical follow-up results has also improved with a statistical significance of 0.05. The satisfaction survey from the patients’ relatives has a positive incremental with a statistical significance of 0.05. To conclude, this development in the end-of-life care practice system for continuing care at home of the patients in the outpatient department provides benefits to the patients and relatives. Therefore, this system should be applied to other hospitals further.