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Experiences and health care needs of older people with End Stage Renal Disease managed without dialysis in Thailand during the last year of life

Experiences and health care needs of older people with End Stage Renal Disease managed without dialysis in Thailand during the last year of life
Experiences and health care needs of older people with End Stage Renal Disease managed without dialysis in Thailand during the last year of life
There is a growing population of elderly patients with End Stage Renal Disease (ESRD) managed without dialysis in Thailand, and as yet services have not been developed to specifically respond to the needs of this group. As a consequence this population are likely to have unmet needs with respect to health care, and suffer from symptoms that could be better managed. In order to develop palliative care aimed at improving the quality of life of this group in Thailand research is required about patients? experiences, symptom burden and health care needs as the end of life approaches.
Objectives: Phase 1) to explore experiences and health care needs during the last year of life among older people with ESRD managed without dialysis from the perspective of bereaved carers; Phase 2) to develop/adapt the VOICES (View of Informal Carers – Evaluation of Service) questionnaire for use in Thailand; and Phase 3) to conduct a pilot survey to test and refine the VOICES questionnaire. A mixed-method exploratory design underpinned the approach to this study.
Phase 1: Retrospective, exploratory semi-structured interviews and purposive sampling were used to collect data from 12 bereaved relatives of patients who had attended two hospitals in one region in Thailand. Interviews were digitally recorded, transcribed and analysed using framework analysis, and results used to develop the VOICES Thai prototype. The experiences and health care needs of older people with ESRD managed without dialysis were explored under four main themes, including: 1) symptom experiences; 2) impacts; 3) symptom management; and 4) health care needs and utilisation. Findings confirmed patients? needs were not being met, and the need to develop approaches to symptom management (pain and breathlessness) at home, health education, and psychological and spiritual support at the end of life.
Phase 2: A cognitive interviewing technique was implemented, using two cycles of data collection with a sample of 10 bereaved carers and a prototype of the Thai VOICES questionnaire. These data were analysed using content analysis. A culturally specific questionnaire was generated during this second phase and issues with questionnaire design rectified.
Phase 3: A small-scale pilot survey of an interviewer-administered Thai-VOICES questionnaire with a sample of 20 bereaved carers was conducted. Two main factors affected response rate: method of recruitment and interview method. The telephone interview was considered to be the best choice for conducting a national survey in the Thai context. The resulting VOICES-ESRD questionnaire can now be used to generate evidence about the needs of patients with ESRD in Thailand and inform future policy and practice.
Pungchompoo, Wanicha
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Pungchompoo, Wanicha
c55ba0e0-4854-4eb0-8aa1-b27bf848cc24
Richardson, Alison
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Brindle, Lucy
17158264-2a99-4786-afc0-30990240436c

(2013) Experiences and health care needs of older people with End Stage Renal Disease managed without dialysis in Thailand during the last year of life. University of Southampton, Faculty of Health Sciences, Doctoral Thesis, 431pp.

Record type: Thesis (Doctoral)

Abstract

There is a growing population of elderly patients with End Stage Renal Disease (ESRD) managed without dialysis in Thailand, and as yet services have not been developed to specifically respond to the needs of this group. As a consequence this population are likely to have unmet needs with respect to health care, and suffer from symptoms that could be better managed. In order to develop palliative care aimed at improving the quality of life of this group in Thailand research is required about patients? experiences, symptom burden and health care needs as the end of life approaches.
Objectives: Phase 1) to explore experiences and health care needs during the last year of life among older people with ESRD managed without dialysis from the perspective of bereaved carers; Phase 2) to develop/adapt the VOICES (View of Informal Carers – Evaluation of Service) questionnaire for use in Thailand; and Phase 3) to conduct a pilot survey to test and refine the VOICES questionnaire. A mixed-method exploratory design underpinned the approach to this study.
Phase 1: Retrospective, exploratory semi-structured interviews and purposive sampling were used to collect data from 12 bereaved relatives of patients who had attended two hospitals in one region in Thailand. Interviews were digitally recorded, transcribed and analysed using framework analysis, and results used to develop the VOICES Thai prototype. The experiences and health care needs of older people with ESRD managed without dialysis were explored under four main themes, including: 1) symptom experiences; 2) impacts; 3) symptom management; and 4) health care needs and utilisation. Findings confirmed patients? needs were not being met, and the need to develop approaches to symptom management (pain and breathlessness) at home, health education, and psychological and spiritual support at the end of life.
Phase 2: A cognitive interviewing technique was implemented, using two cycles of data collection with a sample of 10 bereaved carers and a prototype of the Thai VOICES questionnaire. These data were analysed using content analysis. A culturally specific questionnaire was generated during this second phase and issues with questionnaire design rectified.
Phase 3: A small-scale pilot survey of an interviewer-administered Thai-VOICES questionnaire with a sample of 20 bereaved carers was conducted. Two main factors affected response rate: method of recruitment and interview method. The telephone interview was considered to be the best choice for conducting a national survey in the Thai context. The resulting VOICES-ESRD questionnaire can now be used to generate evidence about the needs of patients with ESRD in Thailand and inform future policy and practice.

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Final Thesis of Wanicha Pungchompoo.pdf - Other
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Final-APPENDIX R The refined VOICES-ESRDThai questionnaire -English version-.pdf - Other
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Final-APPENDIX S The refined VOICES-ESRDThai questionnaire.pdf - Other
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More information

Published date: September 2013
Organisations: University of Southampton, Faculty of Health Sciences

Identifiers

Local EPrints ID: 362833
URI: http://eprints.soton.ac.uk/id/eprint/362833
PURE UUID: 7addae05-92c8-4238-9ee6-f8787ce1e239
ORCID for Alison Richardson: ORCID iD orcid.org/0000-0003-3127-5755
ORCID for Lucy Brindle: ORCID iD orcid.org/0000-0002-8933-3754

Catalogue record

Date deposited: 17 Mar 2014 14:40
Last modified: 06 Jun 2018 12:41

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Contributors

Author: Wanicha Pungchompoo
Thesis advisor: Alison Richardson ORCID iD
Thesis advisor: Lucy Brindle ORCID iD

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