THE DEVELOPMENT OF PALLIATIVE CARE INDICATORS FOR PATIENTS WITH COVID-19 IN THAILAND UTILIZING DELPHI TECHNIQUE
DOI:
https://doi.org/10.37268/mjphm/vol.24/no.2/art.2543Keywords:
Palliative care, COVID-19, Delphi study, Advance care planningAbstract
Coronavirus disease 2019 (COVID-19) is marked by rapid disease progression and presents signs and symptoms when severe progression occurs. Frailty and the risk of dependence and death require palliative care. Thus, this study aimed to identify the palliative care indicators for patients with COVID-19 in Thailand. The Delphi technique served as the methodology for this descriptive study, with 19 experts enlisted to participate. Throughout the study, three rounds of the Delphi method were conducted to gather expert input and refine the identified indicators. Data analysis and development of a questionnaire for palliative care indicators for patients with COVID-19 and the final medians and interquartile ranges were calculated. The study involved predominantly female participants (78.95%) with a mean age of 46.65 years (SD = 6.54) and a mean work experience of 17.85 years (SD = 7.73). All 19 subject matter experts responded to the final questionnaire. Nine palliative care components with 71 indicators for patients with COVID-19 were identified: advance care planning, physical health care, psychological and mental care, spiritual care, effective communication with the patients and their families, caring for the patients after their treatment and for their families after the patient's death, controlling and preventing the spread of infection, professional healthcare teams, and system of care. The results of this study, which were drawn from appropriate sources, can be used by health facilities as preliminary data for developing a care assessment questionnaire and a guideline for healthcare professionals’ provision of effective and comprehensive palliative care for COVID-19 patients.
References
Wu YC, Chen CS, Chan YJ. The outbreak of COVID-19: An overview. J Chin Med Assoc. 2020;83(3):217-220.
Centers for Disease Control and Prevention. COVID Data Tracker. Atlanta, GA: US Department of Health and Human Services, CDC. https://covid.cdc.gov/covid-data-tracker. Published 2022. Accessed September 12, 2022.
Koontalay A, Suksatan W, Prabsangob K, Sadang JM. Healthcare Workers' Burdens During the COVID-19 Pandemic: A Qualitative Systematic Review. J Multidiscip Healthc. 2021;14:3015-3025.
Yodmai K, Pechrapa K, Kittipichai W, Charupoonpol P, Suksatan W. Factors Associated with Good COVID-19 Preventive Behaviors Among Older Adults in Urban Communities in Thailand. Journal of Primary Care & Community Health. 2021;12:21501327211036251.
Widjaja G, Turki Jalil A, Sulaiman Rahman H, et al. Humoral immune mechanisms involved in protective and pathological immunity during COVID-19. Human Immunology. 2021;82(10):733-745.
Choompunuch B, Suksatan W, Sonsroem J, Kutawan S, In-udom A. Stress, adversity quotient, and health behaviors of undergraduate students in a Thai university during COVID-19 outbreak. Belitung Nursing Journal. 2021;7(1):1-7.
Kutsuna S. Coronavirus disease 2019 (COVID-19): Research progress and clinical practice. Global Health & Medicine. 2020;2(2):78-88.
Posai V, Suksatan W, Choompunuch B, Koontalay A, Ounprasertsuk J, Sadang JM. Assessment of the Health-Promoting Behaviors of Hospitalized Patients with Non-Communicable Diseases During the Second Wave of COVID-19. J Multidiscip Healthc. 2021;14:2185-2194.
Navas-Blanco JR, Dudaryk R. Management of Respiratory Distress Syndrome due to COVID-19 infection. BMC Anesthesiology. 2020;20(1):177.
Wilkinson DJC. Frailty Triage: Is Rationing Intensive Medical Treatment on the Grounds of Frailty Ethical? The American Journal of Bioethics. 2021;21(11):48-63.
Damani A, Ghoshal A, Rao K, et al. Palliative Care in Coronavirus Disease 2019 Pandemic: Position Statement of the Indian Association of Palliative Care. Indian J Palliat Care. 2020;26(Suppl 1):S3-s7.
Esmaeili VA, Rafiei H, Mohammdi M. Palliative care in advanced coronavirus disease in intensive care units. BMJ Supportive & Palliative Care. 2020;10(3):340.
World Health Organization. Definition of Palliative Care. http://www.who.int/cancer/palliative/definition/en/. Published 2021. Accessed September 12, 2022.
Phengjard J. Nurse’s role in palliative care. Journal of Boromarajonani College of Nursing, Bangkok. 2014;30(1):100-109.
Nuekwe P, Hanprasitkam K, Junda T. Nurses’ perceptions and practice on palliative care. Thai Journal of Cardio-Thoracic Nursing. 2016;27(1):128-141.
Hexem KR, Mollen CJ, Carroll K, Lanctot DA, Feudtner C. How parents of children receiving pediatric palliative care use religion, spirituality, or life philosophy in tough times. J Palliat Med. 2011;14(1):39-44.
Zeru T, Gerensea H, Berihu H, Zeru M, Wubayehu T. Nurses practice towards palliative care in Shire Endasilasie health facilities, Northern Ethiopia: a cross-sectional study. Pan African Medical Journal. 2020;35(1):110.
Pai RR, Nayak MG, Serrao AJ, Salins N. Integrating palliative care into primary health care: Indian perspectives. Progress in Palliative Care. 2023;31(5):282-286.
Rainsford S, MacLeod RD, Glasgow NJ, Phillips CB, Wiles RB, Wilson DM. Rural end-of-life care from the experiences and perspectives of patients and family caregivers: A systematic literature review. Palliat Med. 2017;31(10):895-912.
Nilmanat K. Palliative care in Thailand: Development and challenges. Can Oncol Nurs J. 2016;26(3):262-264.
Doorenbos AZ, Juntasopeepun P, Eaton LH, Rue T, Hong E, Coenen A. Palliative Care Nursing Interventions in Thailand. Journal of Transcultural Nursing. 2013;24(4):332-339.
Thiamwong L, Pungchompoo W. Embedding Palliative Care Into Healthy Aging: A Narrative Case Study From Thailand. Journal of Hospice & Palliative Nursing. 2018;20(4):416-420.
Posai V, Jitpanya C. A Delphi Study on Palliative Care in Stroke Patient. North-Eastern Thai Journal of Neuroscience. 2019;14(4):8-26.
Posai V, Jitpanya C. A Factor Analysis of Palliative Care for Stroke Patient. J Med Health Sci. 2020(2):63-76.
Thangaratinam S, Redman CWE. The Delphi technique. The Obstetrician & Gynaecologist. 2005;7(2):120-125.
Harvey N, Holmes CA. Nominal group technique: An effective method for obtaining group consensus. International Journal of Nursing Practice. 2012;18(2):188-194.
Hasson F, Keeney S, McKenna H. Research guidelines for the Delphi survey technique. Journal of Advanced Nursing. 2000;32(4):1008-1015.
Mukherjee N, Hugé J, Sutherland WJ, et al. The Delphi technique in ecology and biological conservation: applications and guidelines. Methods in Ecology and Evolution. 2015;6(9):1097-1109.
Burnard P. A method of analysing interview transcripts in qualitative research. Nurse Education Today. 1991;11(6):461-466.
Punpataracheevin J. Delphi technique research in tospornsirisomphum. Bangkok: Chulalongkorn University Press; 2008.
Artsanthia J, Srisa-art R, Sumet S. Palliative nursing care for Coronavirus Infection 2019. J Pub Health Nurse 2019;35(1):141-156.
Janssen DJA, Ekström M, Currow DC, et al. COVID-19: guidance on palliative care from a European Respiratory Society international task force. European Respiratory Journal. 2020;56(3):2002583.
National Institutes of Health. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. https://www.covid19treatmentguidelines.nih.gov/. Published 2020. Accessed September 12, 2022.
Bajwah S, Wilcock A, Towers R, et al. Managing the supportive care needs of those affected by COVID-19. European Respiratory Journal. 2020;55(4):2000815.
Chidiac C, Feuer D, Naismith J, Flatley M, Preston N. Emergency Palliative Care Planning and Support in a COVID-19 Pandemic. Journal of Palliative Medicine. 2020;23(6):752-753.
Sese D, Makhoul A, Hoeksema L, Shoemaker L. The role of palliative care in COVID-19. Cleve Clin J Med. 2020:1-4.
Earnest M. On Becoming a Plague Doctor. New England Journal of Medicine. 2020;383(10):e64.
Sutherland AE, Stickland J, Wee B. Can video consultations replace face-to-face interviews? Palliative medicine and the Covid-19 pandemic: rapid review. BMJ Supportive & Palliative Care. 2020;10(3):271.
Ritchey KC, Foy A, McArdel E, Gruenewald DA. Reinventing Palliative Care Delivery in the Era of COVID-19: How Telemedicine Can Support End of Life Care. American Journal of Hospice and Palliative Medicine®. 2020;37(11):992-997.
Morris SE, Moment A, Thomas Jd. Caring for Bereaved Family Members During the COVID-19 Pandemic: Before and After the Death of a Patient. Journal of Pain and Symptom Management. 2020;60(2):e70-e74.
Fox M, McIlveen J, Murphy E. Death, dying and bereavement care during COVID-19: Creativity in hospital social work practice. Qualitative Social Work. 2021;20(1-2):131-137.
World Health Organization. WHO guidelines on hand hygiene in health care: first global patient safety challenge clean care is safer care. World Health Organization, Geneva, Switzerland. http://apps.who.int/iris/bitstream/handle/10665/44102/9789241597906_eng.pdf?sequence=1. Published 2009. Accessed September 12, 2022.
Tomczyk S, Aghdassi S, Storr J, et al. Testing of the WHO Infection Prevention and Control Assessment Framework at acute healthcare facility level. Journal of Hospital Infection. 2020;105(1):83-90.
