Authors (including presenting author) :
Chow KKY, Cheng JWY, Lam CYP, Lui RTY, Poon MWY
Affiliation :
Physiotherapy Department, Hong Kong Buddhist Hospital
Introduction :
Palliative care patients usually experience distressing symptoms that arise from diseases and their related treatments. Studies showed that patients always wishes to be cared at home and stay in community where they feel more comfortable. However, symptoms and functional dependency always step up their stresses/burdens in home care when pre-discharge face-to-face carer education cannot be conducted, which is more significant during the period of COVID-19 pandemic. Thus, palliative patient and caregiver empowerment program was enhanced in Physiotherapy Department of Hong Kong Buddhist Hospital, aimed to ensure competent skills on symptom management and patient handling, hence to facilitate patient to be cared at home. In addition to pre-discharge caregiver education and skill demonstration via telecare, post-discharge community physiotherapy service was provided to ensure their skill competency.
Objectives :
To evaluate the effectiveness of Enhanced Palliative Care Patient and Caregivers Empowerment Program on symptoms management, Quality of Life(QoL) and caregivers’ stress level
Methodology :
A retrospective review was employed. Patients and their caregivers who had received the empowerment program within the period of January 2020 to December 2020 were included for analysis. Outcomes measures included (1)Edmonton Symptom Assessment System Chinese Version(ESAS-C) to measure the symptoms, (2)McQill Quality of Life Questionnaire Hong Kong Version(MQoL-HK) to measure quality of life level and (3)Modified Caregiver Strain Index Chinese Version(MCSI-C) to assess caregivers’ stress level. Comparison was performed before and upon program completion. Participants’ feedback was also collected via satisfaction survey.
Result & Outcome :
Sixteen patients and caregivers were reviewed in which all patients were suffering from cancer with multiple metastasis. Upon program completion, improvements were shown for all outcome measures. For symptom management, there was significant decrease in pain sub-score from 4.62±3.24 to 3.13±2.25(p=0.007), fatigue sub-score from 6.94±2.57 to 5.06±1.91(p=0.004) and anxiety sub-score from 2.94±3.96 to 1.94±2.67(p=0.023). Besides, caregivers stress level was also reduced from 16.63±4.65 to 14.06±2.54(p=0.003). Meanwhile, patients’ overall QoL improved from 3.44±0.89 to 5.87±1.2(p=0.003). Sub-scores in physical domain, psychological domain and support domain of MQoL-HK also improved (all p≤0.001). All participants were satisfied with the program which scored 8.4 out of 10.
Data supported that enhanced program was welcomed by palliative care patients and caregivers and was effective in relieving symptoms burden on patient, improving QoL and reducing caregivers’ stress after discharge.
