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.

Descriptors of Insomnia among Patients with Heart Failure.

Objective: Explore the characteristics of insomnia in persons with heart failure and identify the predictive factors of insomnia in patients with heart failure. Marital and Method: A predictive correlational research design was used. Three hundred forty heart failure patients followed-up at heart clinics, outpatient departments of 10 tertiary hospitals from all regions in Thailand, were selected by multi-stage random sampling. Data were collected between July 2009 and January 2010. Research instrument included demographic questionnaire, state-trait anxiety inventory questionnaire, Center for Epidemiologic Studies Depression Scale, dyspnea questionnaire, Berlin Questionnaire, hygiene awareness and practice scale, and dysfunctional beliefs and attitudes about sleep and insomnia severity index. Data were analyzed by using descriptive statistic, Chi-square test, and logistic regression. Results: Thirty-two percent of heart failure patients had insomnia. Eighty-one patients had moderate insomnia (23.8%), and 28 patients had severe insomnia (8.2%). Most heart failure patients had insomnia of mixed types (73.40%), including difficulty falling asleep, difficulty staying asleep, and waking up too early. Correlated factors of insomnia included the predisposing factors, anxiety and depression, the precipitating factors, marital status, dyspnea, sleep disorder breathing, and the perpetuating factors, sleep hygiene and dysfunctional beliefs and attitudes about sleep. After using logistic regression analysis, the predictive factors of insomnia were anxiety, depression, marital status (separated, divorced, and widowed), dyspnea, and dysfunctional beliefs and attitudes about sleep with a 95% confidence level (α = 0.05). However, age, gender,sleep disorder breathing, and sleep hygiene were not significant predictors of insomnia. Conclusion: Insomnia is a significant problem in heart failures patients. Therefore, healthcare providers need to pay attention to this sensitive outcome. Several factors should be considered for further management.