American Journal of Advances in Nursing Research

NEEDS, CONCERNS AND LEVEL OF DISTRESS AMONG PATIENTS UNDERGOING PALLIATIVE CARE IN A SELECTED RURAL AREA, PATHANAMTHITTA DISTRICT, KERALA

Beena Mathew Bhasan, Remya Varghese*, Riya Rachel George, Sunu P Abraham

remyaavu@gmail.com

Needs, Concerns, Level of distress, Palliative care patients.

Palliative care is an approach that improves the quality of life of patients and their families who are facing the problem associated with life threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems. Assessment of needs, concerns and distress of palliative care patients is important as it affects their overall health. During our Community Health Nursing posting we identified that many patients who are receiving palliative care in their homes are suffering from physiological as well as psychological discomfort and in most of the houses, family members are considering the terminally ill as a burden. From this experience, we identified that it is essential to assess the needs, concerns and level of distress among patients undergoing palliative care. A quantitative non experimental research study was conducted to assess the needs, concerns and level of distress among patients undergoing palliative care in a selected rural area, Pathanamthitta district. This study is based on General systems theory by Von Ludwig Bertalanffy (1968). A total of 60 palliative care patients were selected as participants using purposive sampling technique. The tools used were baseline variable proforma, NEST interview schedule, and concern checklist and distress thermometer. The validity and reliability of the tools were established by using split half method and was further computed using Spearman‟s Brown Prophecy formula and was found to be reliable. The „r‟ value for NEST interview was 0.78, Concerns checklist was 0.83 and Distress thermometer was 0.9 respectively. The results revealed that majority of palliative care patients, [190(79%)] had negative experience on need, 45(75%) of them had moderate level of concerns and 49(81.66%) had highest level of distress. There was a significant association between need scores of palliative care patients and selected baseline variable i.e., diagnosis (2=8.19,p<0.05). There was a significant positive correlation existing between needs and level of distress of palliative care patients ( r =0.4) and concerns and level of distress of palliative care patients (r=0.6) at p<0.05 level of significance. It was concluded that the level of distress of palliative care patients increase as their needs and concerns increase. Hence the palliative care patients of Ayroor Panchayat, Pathanamthitta district need various interventional strategies to maintain their quality of life. This will encourage strict adherence to proper implementation of palliative care especially in rural area.