The development of the community-based palliative care model in a district health system, Phitsanulok Province, Thailand

Kitreerawutiwong, Nithra; Mekrungrengwong, Sunsanee; Keeratisiroj, Orawan

doi:10.4103/ijpc.ijpc_34_18

Cited by 10 publications

(5 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…I am concerned about the drug abuse; therefore, this DHS does not prescribe Morphine to be used in the community/at home. We need to set a guideline first.” [PHAR1 (p343)] 40…”

Section: Prescribingmentioning

confidence: 99%

See 1 more Smart Citation

Perceptions and experiences of laws and regulations governing access to opioids in South, Southeast, East and Central Asia: A systematic review, critical interpretative synthesis and development of a conceptual framework

et al. 2020

View full text Add to dashboard Cite

Background: Opioids are essential medicines. Despite international and national laws permitting availability, opioid access remains inadequate, particularly in South, Southeast, East and Central Asia. Aim: To review evidence of perceptions and experiences of regulatory enablers and barriers to opioid access in South, Southeast, East and Central Asia. Design: Systematic review of post-2000 research according to PRISMA guidelines. Data were subjected to critical interpretive synthesis. International, national and sub-national barriers were organised developing a conceptual framework of opioid availability. Data sources: PsycINFO, Medline, Embase, The Cochrane Library. CINAHL, Complete and ASSIA from 2000 until 20th May 2019. Results: 21/14097 studies included: quantitative n = 15, qualitative n = 3 and mixed-methods n = 3. Four barrier/enabler themes were developed: Legal, regulatory, socio-political; lack of laws explicitly enabling opioid access, restrictive international controls and clinician prescribing concerns. Opioid availability; limited availability, poor policymaker and clinician education regarding opioid benefits, poor continuity of supply. Opioid Accessibility; medicine costs, distance to prescribing centres. Prescribing; extensive bureaucratic barriers, lack of human resources for prescribing. We present a novel framework of a self-perpetuating model of inadequate opioid provision. The Single Convention on Narcotics provides the context of restrictive laws and negative attitudes amongst policymakers. A consequent lack of prescribers and clinicians’ negative attitudes at sub-national levels, results in inadequate access to and use of opioids. Data of inadequate consumption informs annual requirement estimates used by the International Narcotics Control Board to determine future opioid availability. Conclusions: Regulatory and socio-political actions unintentionally limit opioid access. International and national laws explicitly enabling opioid access are required, to assuage concerns, promote training and appropriate prescribing.

show abstract

“…I am concerned about the drug abuse; therefore, this DHS does not prescribe Morphine to be used in the community/at home. We need to set a guideline first.” [PHAR1 (p343)] 40…”

Section: Prescribingmentioning

confidence: 99%

“…We need to set a guideline first." [PHAR1 (p343)] 40 Clinical guidelines for pain relief are reported within included studies as enablers of access to opioids. In the Philippines, a survey of clinicians found that 72% were aware of the WHO Ladder for Pain Control.…”

Section: Prescribingmentioning

confidence: 99%

Perceptions and experiences of laws and regulations governing access to opioids in South, Southeast, East and Central Asia: A systematic review, critical interpretative synthesis and development of a conceptual framework

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Palliative care is commonly situated within some type of health care institution—hospitals, clinics, nursing homes, outpatient, and in-home settings. Community-based palliative care delivery models can improve quality of care and positively affect caregivers and family lived experiences (Bhavsar et al, 2017; Kitreerawutiwong et al, 2018). Community-based palliative care models are designed to support patients, families, and caregivers across the continuum of advanced illness rather than focusing on the period just before death (Kamal et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Transforming Nurse Self-Care Through Integration of Spirituality: Lessons From an International Collaboration in Palliative Care

et al. 2022

View full text Add to dashboard Cite

Introduction: With growing evidence of compassion fatigue and burnout in health care, it is time for a deeper look at the vital practice of self-care among professionals providing palliative care. The purpose of this study was to provide insights into ways empowerment, caring for self, environment, and building relationships impact well-being among palliative care professionals. Methods: Interpretative descriptive methods framed focus group interviews, conducted during a conference on palliative care integrative health practices held in Thailand. An interprofessional research team used inductive reasoning processes to analyze the interviews. Results: Three themes emerged from the four focus groups ( N = 22): Buddhist Beliefs and Practices, Community-mindedness, and Empowerment. Aspects of spirituality were consistently woven into self-care practices. Discussion: Findings suggest that self-care can be reimagined to include highly personal and unique expressions of spirituality. Health care communities are called to integrate ritual in culturally congruent ways, thus supporting health care professionals to find new sources of meaning, enrichment, and empowerment.

show abstract

“…There have been continuing efforts to develop a protocol for palliative care provision in Thailand's context. In fact, many guidelines and quality of care measuring tools are available for wider use [9][10][11]; nevertheless, most Thai hospitals report following the guidelines developed in each facility [12]. In addition to the nationwide implementation of palliative care performance indicators related to some care process (e.g., opioid drug provision; advance care planning; home visit) [13][14], there is no clear protocol for the provision of facility-based palliative care in the country [12].…”

Section: Introductionmentioning

confidence: 99%

Structure and Process of Palliative Care Provision: A Nationwide Study of Public Hospitals in Thailand

Dokmai

Meemon

Paek

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The demand for palliative care in hospitals has rapidly increased in Thailand in recent years. Subsequently, the way in which palliative care systems should be arranged to facilitate the care process and patient preparation for their end stage of life (i.e., good death) is still an ongoing debate among policy makers and researchers. Although palliative care is provided in most facilities, there is no clear protocol for palliative care due to a lack of empirical evidence. Thus, this study attempts to analyse the situation and quality of palliative care provision in Thai public hospitals.Methods: A cross-sectional study was conducted in 2018. A questionnaire with measures reflecting hospital characteristics, structure of palliative care provision, and processes related to achieving a good death was developed. The questionnaire was sent to all 862 public hospitals across 76 provinces, and the response rate was 62.88%. A structural equation model was specified to operationalize Donabedian’s framework. To our knowledge, this is the first nationwide study to investigate facility-level palliative care provision in Thailand.Results: The study results confirmed the relationships between the structure and process of palliative care provision in hospitals. The sufficiency and competency of doctors and nurses and the variety of relaxation equipment were either directly or indirectly associated with all process components associated with response to the patient’s needs, effective communication, and respect to the patient’s dignity. In addition, the conduction of palliative care research in hospitals was associated with the response to the patient’s needs and effective communication, while the allocation of physical area was associated with effective communication.Conclusion: This model can be used to evaluate the overall situation of palliative care provision at the national level. It could also contribute to the development of standard measurements for evidence-based palliative care quality improvement in hospitals.

show abstract

The development of the community-based palliative care model in a district health system, Phitsanulok Province, Thailand

Cited by 10 publications

References 29 publications

Perceptions and experiences of laws and regulations governing access to opioids in South, Southeast, East and Central Asia: A systematic review, critical interpretative synthesis and development of a conceptual framework

Perceptions and experiences of laws and regulations governing access to opioids in South, Southeast, East and Central Asia: A systematic review, critical interpretative synthesis and development of a conceptual framework

Transforming Nurse Self-Care Through Integration of Spirituality: Lessons From an International Collaboration in Palliative Care

Structure and Process of Palliative Care Provision: A Nationwide Study of Public Hospitals in Thailand

Contact Info

Product

Resources

About