Abstract
The purpose of this research was to study the prototype development of palliative
care services for end-of-life patients through community participation in Selaphum district,
Roi Et Province, between January and September 2008. The aim was to explore and
develop continuity of palliative care from the hospital to the community by using three
steps in a participatory process, i.e. preparation, planning and implementation phases.
Data were collected by using questionnaires and interviews. The results revealed that the
participation processes were used throughout the study by consulting and by group discussion.
The policy was developed; the palliative care unit was established and team was
formed, including hospital staff, health-care workers, volunteers, and patients’ relatives.
A total of 99 patients were enrolled in the study. The most common group, which included 35 patients, comprised those with cancer. The most common services provided
were demonstration and skill training for patients’ relatives to enable them to take care of
the patients at home. There were 18 funeral cere-monies which staff could join. Development
of the services had followed the “4S” principles: start early, stakeholders, sincerity
and suitability. Situation analysis found the strength of the service was sound policy and
good communication between stakeholders, but the weaknesses were budget schemes
which did not support the service set up. Opportunities in the participatory process were
assigned by the Constitution and the Ministry of Public Health’s policy, but there were
also threats about staff confusion concerning decentralization to the local government
level.
