Development of a model of Home-based Cancer Palliative Care Services in Mumbai - Analysis of Real-world Research Data over 5 Years.

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES
Indian Journal of Palliative Care Pub Date : 2022-10-01 Epub Date: 2021-10-28 DOI:10.25259/IJPC_28_2021
Sunil Rameshchandra Dhiliwal, Arunangshu Ghoshal, Manjiri Pushpak Dighe, Anuja Damani, Jayita Deodhar, Shalaka Chandorkar, Mary Ann Muckaden
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引用次数: 2

Abstract

Objectives: Patients needing palliative care prefer to be cared for in the comfort of their homes. Although private home health-care services are entering the health-care ecosystem in India, for the majority it is still institution-based. Here, we describe a model of home-based palliative care developed by the Tata Memorial Hospital, a government tertiary care cancer hospital.

Materials and methods: Data on patient demographics, services provided and outcomes were collected prospectively for patients for the year November 2013 - October 2019. In the 1st year, local general physicians were trained in palliative care principles, bereavement services and out of hours telephone support were provided. In the 2nd year, data from 1st year were analysed and discussed among the study investigators to introduce changes. In the 3rd year, the updated patient assessment forms were implemented in practice. In the 4th year, the symptom management protocol was implemented. In the 5th and 6th year, updated process of patient assessment data and symptom management protocol was implemented as a complete model of care.

Results: During the 6 years, 250 patients were recruited, all suffering from advanced cancer. Home care led to good symptom control, improvement of quality of life for patients and increased satisfaction of caregivers during the care process and into bereavement.

Conclusion: A home-based model of care spared patients from unnecessary hospital visits and was successful in providing client centred care. A multidisciplinary team composition allowed for holistic care and can serve as a model for building palliative care capacity in low- and middle-income countries.

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孟买以家庭为基础的癌症姑息治疗服务模式的发展——对过去5年真实世界研究数据的分析。
目的:需要姑息治疗的患者更愿意在舒适的家中接受治疗。尽管私人家庭保健服务正在进入印度的保健生态系统,但大多数仍然以机构为基础。在这里,我们描述了一个由塔塔纪念医院开发的以家庭为基础的姑息治疗模式,这是一家政府三级护理癌症医院。材料和方法:前瞻性地收集2013年11月至2019年10月患者的人口统计数据、提供的服务和结果。第一年,对当地全科医生进行了姑息治疗原则、丧亲服务和非工作时间电话支持方面的培训。在第二年,研究人员对第一年的数据进行分析和讨论,以引入变化。第三年,更新后的患者评估表格在实践中实施。第4年实施症状管理方案。在第5年和第6年,更新了患者评估数据和症状管理方案,作为一个完整的护理模式。结果:在6年的时间里,招募了250例患者,均为晚期癌症患者。居家照护能很好地控制症状,改善患者的生活品质,并提高照护者在照护过程及丧亲过程中的满意度。结论:以家庭为基础的护理模式使患者免于不必要的医院就诊,并成功地提供了以客户为中心的护理。多学科团队组成可实现全面护理,并可作为中低收入国家建设姑息治疗能力的典范。
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来源期刊
Indian Journal of Palliative Care
Indian Journal of Palliative Care HEALTH CARE SCIENCES & SERVICES-
CiteScore
2.30
自引率
0.00%
发文量
57
期刊介绍: Welcome to the website of the Indian Journal of Palliative Care. You have free full text access to recent issues of the journal. The links connect you to •guidelines and systematic reviews in palliative care and oncology •a directory of palliative care programmes in India and IAPC membership •Palliative Care Formulary, book reviews and other educational material •guidance on statistical tests and medical writing.
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