Authors (including presenting author) :
Chow KKY(1), Li MHL(1), Yau CWS(2), Tam SKF(2), Leung CWL(3), Poon MWY(1)
Affiliation :
(1) Physiotherapy Department, Hong Kong Buddhist Hospital
(2) Department of Medicine, Hong Kong Buddhist Hospital
(3) Department of Clinical Oncology, Queen Elizabeth Hospital
Introduction :
Palliative Care(PC) patients always prefer to be cared at home where they feel more comfortable and maintain a ‘normal family life’. However, distressing symptoms and functional dependency arise from diseases and related treatments always step-up caregivers’ stresses and burdens, especially during COVID-19 pandemic when face-to-face caregiver education and hand-on practices could hardly be provided in hospital. Therefore, Physiotherapy Department of HKBH has incorporated the use of telecare technology into Patients and Caregivers Empowerment Program at PC ward, aimed to equip participants competent skills on symptom management and manual handling, hence to support patients to be discharged and cared at home. Pre-discharge caregiver education and skills demonstration were provided through video-call with concerns from caregivers immediately addressed.
Objectives :
To evaluate the effectiveness of Enhanced Patients and Caregivers Empowerment Program in PC Unit on patient’s symptom burden, Quality of Life(QoL) and caregivers’ stress after using telecare technology.
Methodology :
A retrospective review was deployed. Patients and caregivers who had received empowerment program from January 2020 to December 2022 were included for analysis. Outcomes measures included (1)Edmonton Symptom Assessment System Chinese Version(ESAS-C) to measure symptom burden, (2)McQill Quality of Life Questionnaire Hong Kong Version(MQoL-HK) to measure patient’s QoL and (3)Modified Caregiver Strain Index Chinese Version(MCSI-C) to assess caregivers’ stress. Participants’ feedback was also explored through satisfaction survey.
Result & Outcome :
Forty-one PC patients suffered from stage III to IV cancer and their caregivers were reviewed. Upon program completion significant improvement was found in all outcome measures. Regarding symptom burden, there was significant decrease in pain sub-score from 4.27±2.91 to 3.22±1.64(p=0.002), fatigue sub-score from 5.85±2.92 to 4.63±1.98(p=0.011), anxiety sub-score from 2.27±3.37 to 1.63±2.20(p=0.007) and breathlessness sub-score from 2.90±2.89 to 1.98±2.10(p=0.002). Besides, caregivers' stress level was reduced from 16.56±4.03 to 14.66±3.24(p=0.001). Furthermore, patients’ overall QoL improved from 3.66±1.24 to 4.90±1.59(p<0.001). Significant improvement was found in sub-scores of MQoL-HK in physical, psychological and social support domain(p<0.001). Positive feedback was received with overall satisfaction score 8.73 out of 10.
Data supported that empowerment program with the use of telecare technology was effective in symptoms management, improving QoL and reducing caregivers’ stress, and it was welcomed by patients and caregivers. With this reformed delivery model of patient empowerment program, PC at home can be facilitated despite impact of COVID-19 pandemic.
