A Research Of The Model Of Health Education For Terminal Cancer Patients In Home-based Palliative Care

Objectives:To investigate the effect a systematical model of health education on terminal cancer patients’quality of life and to assess such a model of health education.Methods:The subject patients were confirmed cases of cancer in the second level of hospitals or above, for whom doctors suggest palliative care. The KPS (Karnofsky Performance Status Scale) scores of these patients were above40. Subjects were taken at random from the terminal cancer patients who made their application to the Hospice of Hunan Provincial Tumor Hospital between February2010and February2011. The resulting200subjects were assigned randomly into two groups:one intervention group (90) and one control group (110) for research. Each subject was inquired for his or her general condition. The intervention group was given systematical health education while the control group was not. All the patients will receive a Quality of Life questionnaire (QOL) before and after the health education was conducted.Results:1. Female subjects account for52%and males48%; The average age is58.07±13.18, with the subject over65years of age constituting44%;73%patients are supported by family;97%patients live with relatives; Patients come from both urban and rural areas,52%and48%respectively; 50%patients fully understand their won diagnosis and prognosis,33%patients are aware of their own state of illness but not their prognosis, and17%have no idea of their own state of illness. The comparison of the general situation between these two groups has no statistical significance, but still comparable.2. The difference in QOL scores between the intervention group after the health education and the control group has statistical significance:the QOL scores of the intervention group is apparently higher than those of the control group. The difference of QOL scores for the intervention group before and after the health education has statistical significance. There is a clear improvement in the scores of the intervention group after the health education.3. A comparison of Quality of Life Questionnaire dimensions:(1) Prior to the health education, there is no statistical significance in the difference in QOL scores between the intervention group and the control group; After the health education, the intervention group’s scores in appetite, sleep, pain, family understanding and support, and facial expressions, are higher than those of the control group, which is a difference of statistical significance.(2) The comparison of the QOL scores of the control group before and after the research session:no changes are detected in the scores for appetite, knowledge of the illness, attitude towards the treatment, and side effects of the treatment; Scores decline in vigor, tiredness, daily life and facial expressions; Scores are improved in sleep, pain, family understanding and support, workmates’understanding and cooperation.(3) The comparison of the QOL scores of the intervention group before and after the health education:no changes are detected in the scores for vigor, tiredness, workmates’understanding and cooperation, knowledge of the illness, attitude towards the treatment,, daily life and side effects of the treatment; Scores are improved in appetite, sleep, pain, family understanding and support, and facial expressions. Both groups experience changes in sleep, pain, and family understanding and support, but the difference is bigger with the health education.4. The analysis of the influential factors of health education The effect of health education is influenced by the four variables of age grouping, financial support, household per capita income, and the source of income.Conclusions:The difference in QOL scores between the intervention group after the health education and the control group has statistical significance:The QOL scores of the intervention group after the health education are apparently higher than those of the control group; Health education helps terminal patients in palliative care in the eight aspects of appetite, vigor, sleep, pain, tiredness, family understanding and support, daily life and facial expressions. The effect of health education is influenced by the four variables, age grouping, financial support, household per capita income, and the source of income. The model of health eduction in use is proved to be effective and feasible.