Cancer is a leading cause of death in Thailand. Thai cancer patients often seek medical treatment while in advanced stages of the disease. This longitudinal qualitative study aimed to describe the suffering that patients with terminal advanced cancer experience in their everyday life. A series of interviews were conducted and patient observation performed with 15 patients with terminal advanced cancer. Thematic analysis was applied and the overriding theme of the end-of-life experiences was living with suffering. Five inter-related sub-themes regarding the experience of suffering were identified in the informants' accounts, including physical symptom distress, feeling of alienation, sense of worthlessness, sense of burden to others, and desire for hastened death. The findings of this study can be of value for health professionals in cancer care in Thailand. Comprehensive end-of-life care programmes are needed to alleviate suffering in this group of patients.

Nurses need to be sensitive toward the religious faiths of their patients and provide culturally appropriate care for them. Nursing interventions to maintain hope and connectedness should be promoted by respecting the patients' expressions of hope and supporting the involvement of family members in end-of-life care.

This study examined the prevalence of and risk factors predicting cognitive impairment among elders in southern Thailand. Four-hundred Thai elders were administered five interview-based questionnaires that assessed demographic characteristics, cognitive function, depression, independent activities of daily living, and social connections. Although most of the elders had normal cognitive function, approximately 15% experienced cognitive impairment. Though nine of the 10 risk factors examined were identified as being associated with cognitive impairment, only a lack of formal education, female gender, depression, and physical inactivity were found to be significant predictors of cognitive impairment. The results suggested that elders with risk factors should be assessed for cognitive impairment. Depression, and deficits in activities of daily living and educational activities should be addressed and corrected to improve elders' cognitive abilities.

Aims Effective symptom management is important part of end of life care. It is aimed at improving the quality of dying. The findings presented in this conference are taken from a larger project, the aim of which was to explore the experience of patients living with terminal cancer in southern, Thailand. This presentation reports on one of the main themes under this study's investigation; symptom management and its barriers. Method A longitudinal qualitative study was conducted. Fifteen patients who had been diagnosed with terminal cancer and 20 caregivers were recruited. Series interviews and observations were employed. Content analysis was applied. Findings The common symptoms perceived by patients as most burdensome and distressful were lack of energy, anorexia, pain and dry mouth. Family played a key role in managing symptoms for the dying patients. Symptom management strategies used by family caregivers focused not only on searching for cure by using complementary therapy, but also on managing everyday symptoms based on their beliefs and experiences. The barriers to manage symptoms consisted of attitude and concern about medication and its side effects, lack of knowledge about symptoms and symptom management, patients' wills to live, limited access due to the services system, and communication gaps among persons involved in care (doctor-care giver, care giver-care giver, patient-care giver). Conclusion The finding from this research will provide a picture of experiences of patients with terminal advanced cancer. Awareness of effects of perceived barriers to symptom management will guide healthcare providers to develop effective interventions to improve quality of life among these patients.