ความชุกของผู้ป่วยที่ได้รับการดูแลแบบประคับประคองต่อผู้ป่วยที่เข้าเกณฑ์ในการดูแลแบบประคับประคองในหอผู้ป่วยระยะวิกฤติ และหอผู้ป่วยกึ่งวิกฤติ ของแผนกอายุรกรรม โรงพยาบาลอุดรธานี

supannee sudsa

Authors

supannee sudsa -

Keywords:

palliative care , internal medicine , advance care planning

Abstract

Palliative care is a holistic approach that aims to relieve suffering from both disease and non-beneficial medical interventions. It can be initiated early in the disease trajectory alongside curative treatment and continued until the end of life and facilitating a peaceful death. Previous studies have shown that critically ill patients have limited access to palliative care compared with their actual needs. This study aimed to determine the prevalence of palliative care among patients meeting the Supportive and Palliative Care Indicators Tool (SPICT) Criteria 2022 and to examine the association between palliative care and invasive interventions in intensive and intermediate care units. This study is a cross-sectional study was conducted among patients admitted on the first day to intensive care and intermediate care units in the Department of Internal Medicine, Udon Thani Hospital, between January 1, 2024 and June 30, 2024. A total of 350 patients who met the SPICT criteria were included. Data were collected from electronic medical records. Descriptive statistics were used to summarize baseline characteristics. Inferential analyses included Chi-square test, Fisher’s exact test, Independent t-test, or Mann–Whitney U test, as appropriate. Multivariable logistic regression analysis was performed to identify factors associated with receiving palliative care. Results were reported as odds ratios (ORs) with 95% confidence intervals (CIs). Statistical significance was set at p < 0.05.

The results showed that, among 350 patients who met the criteria for palliative care, 63.4% received palliative care. Receipt of palliative care was significantly associated with a lower likelihood of invasive interventions, including endotracheal intubation (adjusted OR = 0.15, 95% CI: 0.06–0.39, p < 0.001), inotropic support (adjusted OR = 0.52, 95% CI: 0.32–0.83, p = 0.004), cardiopulmonary resuscitation (Adjusted OR = 0.26, 95% CI: 0.12–0.56, p < 0.001), and renal replacement therapy (adjusted OR = 0.46, 95% CI: 0.23–0.91, p = 0.025). In contrast, patients receiving palliative care were significantly more likely to receive analgesics (adjusted OR = 6.95, 95% CI: 2.47–19.53, p < 0.001).

In conclusion, A relatively high prevalence of palliative care was observed among patients meeting palliative care criteria in intensive and intermediate care units. Palliative care was associated with reduced use of invasive interventions and increased symptom management. These findings support the integration of palliative care into standard clinical practice for patients with advanced illness

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