Influencing Factors on Death Acceptance Among Thai Older Persons.

OBJECTIVES: This study aimed to investigate both the direct and indirect effects of various factors on the acceptance of death. METHODS: This cross-sectional study included 800 older Buddhist persons in Thailand, who were recruited through a multistage sampling method. Data were collected using six questionnaires and analyzed through path analysis using the MPlus program. RESULTS: Death anxiety was the main factor influencing death acceptance, with death anxiety exerting a negative direct effect on death acceptance. Buddhist beliefs about death demonstrated both a positive direct effect on death acceptance and a positive indirect effect on death acceptance through Buddhist practices. Furthermore, Buddhist practices exhibited a positive direct effect on death acceptance, while social support also showed a positive direct effect on death acceptance. CONCLUSIONS: This study highlights the significant direct and indirect effects on death acceptance among older Thai Buddhists. CLINICAL IMPLICATIONS: Buddhist-aligned interventions may be more effective and readily embraced by Thai older persons. For those who are receptive, nurses can foster death acceptance by developing interventions that reduce death anxiety and promote Buddhist beliefs about death, Buddhist practices, and social support.

Death Acceptance Process in Thai Buddhist Patients With Life-Limiting Cancer: A Grounded Theory.

Cancer patients with life-limiting illnesses have varied levels of death acceptance pervarious scales. Nevertheless, the process of developing death acceptance in patients with life-limiting cancer remains unclear. This study explores the death acceptance process among patients with life-limiting cancer. We used grounded theory methodology. Data were collected through in-depth interviews of 13 patients with cancer in a palliative care setting, and researchers completed field notes. Data were analyzed using constant and comparative methods. Thai Buddhist patients with cancer in palliative care process death acceptance through three dynamic phases: engaging suffering, being open-minded about death, and adhering to Buddhist practices for increasing death consciousness. The death acceptance process described in this study could serve as a guideline to support death acceptance in Thai Buddhist patients with cancer, and other patients with cancer in palliative care, to improve peaceful life and attain good death.

Describing Death Acceptance Among Thai Buddhists With Cancer.

INTRODUCTION: Death acceptance (DA) is perceived in culturally specific ways. The purposes of this study were to describe DA among Thai Buddhists with cancer and to compare DA differences in demographic data. METHODOLOGY: This research was a secondary data analysis. The participants were 363 Thai Buddhists with cancer, recruited using multistage sampling method. Data were collected using the Buddhist Death Acceptance Scale, reliability coefficient. .82. Data were analyzed using T-Tests and Two-Way ANOVA. RESULTS: The participants had high levels of DA. Age and stage of cancer had main effects on DA. DISCUSSION: This study highlighted the significant demographic differences with regard to DA levels among Thai Buddhists with cancer. Interventions include determining the patient's DA level, or offering patients and their families advance care plans. Nurses can then explore DA with patients, particularly those with life-limiting illnesses to ease their patients' lives and foster a good death.

Effect of an intervention based on basic Buddhist principles on the spiritual well-being of patients with terminal cancer.

PURPOSE: To evaluate the effect of an intervention based on basic Buddhist principles on the spiritual well-being of patients with terminal cancer. METHODS: This quasi-experimental research study had pre- and post-test control groups. The experimental group received conventional care and an intervention based on basic Buddhist principles for three consecutive days, including seven activities based on precept activities, concentration activities and wisdom activities. The control group received conventional care alone. RESULTS: Forty-eight patients participated in this study: 23 in the experimental group and 25 in the control group. Their mean age was 53 (standard deviation 10) years. The spiritual well-being of participants in the experimental group was significantly higher than that of participants in the control group at the second post-test (P < 0.05). CONCLUSIONS: An intervention based on basic Buddhist principles improved the spiritual well-being of patients with terminal cancer. This result supports the beneficial effects of implementing this type of intervention for patients with terminal cancer.

Efficacy of acupuncture in prevention of delayed chemotherapy induced nausea and vomiting in gynecologic cancer patients.

OBJECTIVE: To compare the efficacy between acupuncture and ondansetron in the prevention of delayed chemotherapy induced nausea and vomiting (CINV). METHODS: 70 patients were randomized to receive either 1) acupuncture at P6 point before chemotherapy infusion or 2) ondansetron 8 mg intravenously 30 min before chemotherapy infusion in their first cycle with cross-over of antiemetic regimen in the consecutive cycle. All patients received dexamethasone 5mg orally twice a day for 3 days. Patients were given additional does of ondansetron 4 mg orally every 12h if they experienced emesis. Emetic episode, severity of nausea score of 0-10 and adverse events were recorded. Complete response was defined as no nausea, no vomiting and no requirement of additional antiemetic drugs. FACT-G scale was used to evaluate quality of life (QOL) 7 days after each cycle of chemotherapy. RESULTS: The acupuncture group had a significantly higher rate of complete response in the prevention of delayed CINV (52.8% and 35.7%, P = 0.02). Compared to another group, the acupuncture group reported significantly lower delayed nausea (45.7% and 65.7%, P = 0.004), nausea score (P < 0.001) and fewer dosages of additional oral ondansetron (P = 0.002). Adverse effects were also significantly lower in the acupuncture group with less frequent constipation (P = 0.02) and insomnia (P = 0.01). Overall FACT-G scores were significantly higher in the acupuncture group. CONCLUSION: Acupuncture is effective in preventing delayed CINV and in promoting better QOL. With fewer adverse effects, it may be used as an alternative treatment option for CINV.

Situational analysis of palliative care education in thai medical schools.

OBJECTIVE: The Thai Medical School Palliative Care Network conducted this study to establish the current state of palliative care education in Thai medical schools. METHODS: A questionnaire survey was given to 2 groups that included final year medical students and instructors in 16 Thai medical schools. The questionnaire covered 4 areas related to palliative care education. RESULTS: An insufficient proportion of students (defined as fewer than 60%) learned nonpain symptoms control (50.0%), goal setting and care planning (39.0%), teamwork (38.7%), and pain management (32.7%). Both medical students and instructors reflected that palliative care education was important as it helps to improve quality of care and professional competence. The percentage of students confident to provide palliative care services under supervision of their senior, those able to provide services on their own, and those not confident to provide palliative care services were 57.3%, 33.3%, and 9.4%, respectively. CONCLUSIONS: The lack of knowledge in palliative care in students may lower their level of confidence to practice palliative care. In order to prepare students to achieve a basic level of competency in palliative care, each medical school has to carefully put palliative care content into the undergraduate curriculum.