ประสิทธิผลของการใช้แนวปฏิบัติการส่งเสริมการวางแผนดูแล ล่วงหน้าสำหรับผู้ป่วยโรคมะเร็ง ศูนย์ศรีพัฒน์ คณะแพทยศาสตร์ มหาวิทยาลัยเชียงใหม่

Abstract

Advanced cancer is an incurable disease and life threatening, but it can often be managed. The treatment goal is to enable the patient to live longer, or to relieve their symptoms. Encouraging advance care planning is one of the most suitable approaches to enable cancer patients’ sense of control. This operation research aimed to study the effectiveness of implementing advance care planning promotion guidelines for cancer patients. Participants of this study were 37 advanced cancer patients attending the inpatient department at Sriphat Medical Center, Faculty of Medicine, Chiang Mai University. Twenty one of the participants were in the guidelines pre-implementation group and 16 in the guidelines post-implementation group. The instruments in the study included 1) the Advance Care Planning Promotion Guidelines for Cancer Patients, 2) the Sense of Control Interview Questionnaire and 3) the Advance Care Plan for Cancer Patient Assessment Form. The content validity and reliability were determined in all instruments. The framework of implementing evidence proposed by the National Health and Medical Research Council of Australia (National Health and Medical Research Council [NHMRC], 1999) was used. The proportion of participants who performed a good level sense of control and achieved advance care plans were used as the outcomes. Data were analyzed using descriptive statistics.

The study results revealed that: 1. The proportion of subjects among the guidelines pre-implementation group who reported a good level of control was 0.33, whereas in the post-implementation group was 0.38. 2. The proportion of subjects who achieved advance care planning in the guidelines pre-implementation group was 0.05, whereas in the post-implementation group was 0.56. The findings of this study can confirm the feasibility of advance care plan promotion guidelines among people with advanced cancer. This guideline should be used by nurse case managers in order to encourage the collaboration of multidisciplinary teams in promoting advance care plans. Further study should be done over a longer period to test the effectiveness of the developed advance care plan for each of the cancer patients.