Situational Analysis of Barriers to Continuity of End-of-Life Care in Urban Areas, Bangkok.

This qualitative study was designed to describe the continuity of end-of-life care and identify barriers to continuity in urban Bangkok. Continuity of care is considered an essential part of palliative care to promote the quality of life of patients at the end of life. The majority of studies have been conducted exploring continuity of care in rural communities. However, few studies have focused on urban areas, particularly in big cities. Twelve healthcare providers were the participants, including nurses in inpatient units, and in the Health Community and Continuity of Care Unit, a palliative care physician, and social workers. The data collection consisted of individual interviews, field notes, and observations. Content analysis was used to analyze data and identify barriers. The continuity of end-of-life care in a selected setting was fragmented. Three main barriers to the continuity of end-of-life care consisted of misunderstandings about patients who required palliative care, staff workloads, and incomplete patient information. The development of a comprehensive patient information sheet for communication among a multidisciplinary team could promote continuity of end-of-life care from hospital to home. An interprofessional training course on continuity of end-of-life care is also recommended. Finally, the staff workload should be monitored and managed.

Health practice among Muslim homebound older adults living in the Southern Thai community: An ethnographic study.

Background: Age-friendly environment helps promote older people's health practices and healthy aging. However, little is known about health practices among those living at home in a Thai Muslim community. Objective: This study aimed to explore the health practices of Thai Muslim Homebound Older Adults (HOAs) in relation to their beliefs and experiences to maintain their holistic health. Methods: An ethnographic study design was used. Purposive and snowball sampling methods were used to select 15 HOAs as key informants, among whom nine were living in an urban area, and six were living in a rural area. Data were collected using in-depth interviews, participant observation, and field notes. Data were analyzed using thematic analysis. Results: Muslim HOAs performed their health practices culturally under the central theme of "Life and health are designated by God (Allah) for living with nature and comfort at their age." The health practices consisted of four patterns: 1) Maintaining day-to-day functioning to stay independent, 2) Having a simple and comfortable life with support, 3) Performing religious activities as a priority of life for well-being, and 4) Managing symptoms to gain a balance and restore health. Conclusions: Understanding health practice patterns among HOAs would help nurses, especially primary care professionals, to promote healthy aging and independent living. In addition, culturally sensitive nursing care may be required to maintain the healthy living of Muslim older adults in the long term.

Complementary Therapies Used by Indonesians With Myocardial Infarction.

This descriptive, cross-sectional study was conducted to identify types, frequency, methods, duration, and purpose of complementary therapies used by Indonesians with myocardial infarction. The majority of the respondents used biologically based therapies, with the most common subtype being herbs. The purpose of using biologically based therapies was for health promotion.

Cardiovascular self-management support program for preventing cardiovascular complication behaviors and clinical outcomes in the elderly with poorly controlled type 2 diabetes mellitus in Indonesia: A pilot study.

AIM: The aim of the study was to determine the feasibility, and to evaluate the effect of, a cardiovascular self-management support program by applying the 5A's self-management support program on preventing cardiovascular complication behaviors and to assess the clinical outcomes in the elderly with poorly controlled type 2 diabetes mellitus (DM). METHODS: This pilot study used a quasi-experimental study design. Twelve elderly persons with poorly controlled type 2 DM were assigned into either a control or experimental group, with six participants in each group. The Preventing Cardiovascular Complication Behaviors (PCCB) was measured by the Preventing Cardiovascular Complication Behaviors Questionnaire, while the clinical outcomes were measured by clinical devices that were provided. These measurements were conducted and compared at baseline and 6 weeks after the completion of the program. The self-management support program was a 6 week program with several implementation methods, based on the 5A's self-management support program. RESULTS: The participants who received the cardiovascular self-management support program reported a significant improvement in their PCCB and clinical outcomes, compared to those receiving the usual care. CONCLUSION: This study revealed that a cardiovascular self-management support program that applies the 5A's self-management support program is feasible for implementation.