Development of Palliative Care Model Using Thai Traditional Medicine for Treatment of End-stage Liver Cancer Patients in Thai Traditional Medicine Hospitals

Abstract

Current cancer modern medical treatment in mainly a treatment for inhibition of hepatocellular carcinoma proliferation in different stage, however, liver cancer is the still most diseases with high incidence and mortality rate. Moreover, modern medical treatment has several side effects. Thai traditional medicine is an alternative for the treatment of end-stage liver cancer patients.This research aimed to develop a palliative care model using Thai Traditional Medicine (TTM) for treatment of end-stage liver cancer patients in TTM Hospitals. Five TTM hospitals implemented the model comprised of 1) Thai Traditional and Integrated Medical hospital 2) Uthong hospital 3) Wattana Nakhon hospital 4)Khun Han hospital and 5)Sawang Daen Din Crown Prince Hospital. The methods were conducted in 3 phases including 1) the study of situations, problems, and obstacles in the care of end-stage liver cancer patients in TTM hospitals, 2) the development of the model of palliative care for end-stage liver cancer patients with TTM, and 3) the implementation and assessment of the possibility of using a palliative treatment model for liver cancer patients with TTM at TTM hospitals. The results showed that the palliative care model for end-stage liver cancer patients composed of 1) the roles of healthcare professional team 2) treatment of end-stage liver cancer patients guidelines 3) holistic care guidelines, and 4) guidelines for referral system and home visit. The model was applied to TTM hospitals with 3 different platforms, which were stand alone, paralleled and integrated services. After the implementation, the evaluations were conducted in 3 groups of participants; healthcare team, patients and caregivers. Data were analyzed by descriptive statistics such as frequency, percentage, mean, standard deviation and compare the evaluation score between before and after implementation with paired t-test statistics. Regarding possibility evaluation, all health care providers agreed that the palliative care model using TTM for treatment of end-stage liver cancer patients was possible at a high level for implementation. The satisfaction of health care team and the patients’ symptom were significantly changed after the implementation. Clinical outcomes in physical and mental aspects of patients were improved significantly (p<0.05). Patients and their caregivers’ satisfaction toward palliative care services were at highest level (M=4.38;SD=0.46) and (M=4.22;SD=0.38); respectively. In conclusion, the developed palliative care model using TTM for treatment of end-stage liver cancer patients can be implemented in the TTM Hospitals. The TTM model should be adjusted according to resources and policy of each hospital. However, outcome evaluation for testing the effectiveness of the model in the long term is highly recommended for further study.

-