Investigating The Effect of Palliative Care based on The Bow Tai Model on Increasing the Quality of Life of Patients with Chronic Diseases
Amir Mohammad Amini*
Patient Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran
*Corresponding Author: Amir Mohammad Amini, Patient Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran.
Published: February 14, 2023
Abstract
Currently, palliative care has become very important in terms of increasing the quality of life of patients , and palliative care based on the Bow Ttie model has become particularly important in recent years. The purpose is the investigate the impact of early palliative care based on the Bow-Tai model on the quality of life of chronic patients.
What is the palliative care meaning ?
According to the definition of the World Health Organization, it includes all active and complete measures to reduce suffering and pain and improve the quality of life in the patient. In the main case, this is a brief method for patients with a specific disease that does not respond to treatment and the direct result of the disease is death, and it is only related to calming down the patient and reducing the symptoms of the disease. In addition to the name of palliative care, we can refer to palliative drugs that include drugs to eliminate pain or reduce a symptom, for example, drug therapy to relieve nausea after chemotherapy or even to reduce symptoms in influenza.
Purpose of palliative care
The main goal in palliative care is to give meaning and meaning of life and dignity to the patient's life until its end, in the first step of self-relief of pain, help and support of the patient, but not only in the medical field, to understand this point to the patient, which has always been and will be important. It was until the end of life. This treatment method not only requires simple medical care instead of CCU rooms, but it can provide a peaceful and relaxing path through the life of the patient and the patient's family. For this reason, according to the unanimous opinion of international experts, the palliative care method is the best human answer to difficult and incurable diseases such as some cancers, as well as an answer to the proponents of euthanasia or mercy killing.
The goals of palliative care are as follows
Improving interventions for pain and symptoms.
Patient and family satisfaction, job satisfaction of nurses Reducing the occupancy of intensive care unit beds.
Reducing the length of hospitalization as well as reducing drug costs Specialization of care.
Types of palliative care methods
In the usual and old method, palliative care is used for patients who are in the last stages of the disease. These cares are used for cancer patients and other patients for whom there is no treatment, and the ultimate goal of these measures is to relieve the patient's pain and reduce the severity of the disease temporarily so that the patient finally has a peaceful death. These methods are used only in the difficult and final stages of the disease and the goal is to care for the patient to endure the hardships of the end of life.
A new method for palliative care has been invented, which unlike the old and usual method, palliative care starts from the time of diagnosis. This method develops with the progress of the disease and increases the distance between the onset of the disease and disability.
With the onset of the disease, palliative care begins, and the complications caused by the disease and the drugs used, which cause disability and exacerbation of the disease over time, disappear or become less effective at the very beginning of the disease diagnosis. For example, the use of chemotherapy drugs or blood pressure lowering drugs cause side effects such as anemia, which if treated at the beginning, causes the patient to reach the debilitating side effects of the disease in a longer period of time.
Palliative care based on the Butai model or early palliative care can, in addition to the use of painkillers to reduce the patient's pain, using methods such as music therapy, exercising as much as possible, reducing the side effects caused by the use of drugs, etc., can increase the quality of life of patients. During the diagnosis of the disease and the initiation of drug treatment, according to the type of disease, various complications arise, which will have a destructive effect on the patient's body and mind for a long time. For example, captopril after six months of use by heart patients causes symptoms such as itchy throat, dry and ineffective cough at night, and shortness of breath, which in case of not treating or changing the drug causes the patient to become disabled in the long term.
Or patients who use losartan may become resistant to the drug in the long term and the drug cannot control their blood pressure, causing brain and kidney complications due to the use of this drug.
The lack of knowledge of the composition of foods that contain ingredients such as sodium bicarbonate and written in their brochures, and their consumption by patients makes patients unable to control their blood pressure despite taking antihypertensive drugs. because despite the use of medication, the entry of sodium, which is the main cause of blood pressure, continues.
Bow tie based palliative care is recommended from the very beginning of the disease diagnosis to reduce the complications of the disease. This care is based on teaching the patient and helping the patient to better adapt to the existing problem and increase the quality of life of the patients, and when the patients have enough knowledge about their disease, they can tolerate the existing conditions better.
Most of those who suffer from chronic and debilitating diseases initially face a mental crisis, and if they are not well taken care of mentally, they may develop mental illnesses in the future, or accept treatment and care for them. It is impossible. For this reason, educating the patient completely and knowing the patient about the disease, medications, diet, and the amount of personal and social activities is the first step of early palliative care based on the Bow Tie model.
In the next stage, the priority is to educate the patient's family and the patient's health care provider so that they can recognize the symptoms and complications caused by the disease and drugs and help the patient to recover from them. Being aware of the patient's family can both help them in accepting the patient with new conditions and be effective for the patient mentally due to having a caregiver and those who pay reasonable and conscious attention to him.
In the continuation of palliative care based on the Bow tie model of controlling the diet of patients, it is important to encourage the patient to do sports and activities according to the doctor's orders and to avoid things that cause complications.
Based on this, all the care programs are to maintain the mental and physical abilities of the patient, so that the patients suffer from the complications of illness and disability later, and their quality of life increases or is maintained at a normal level during this period.
Implementation of palliative care for chronic patients can be the best form of care for them, which is possible with the efforts of nurses and doctors, and with the education and care of patients and their families, and can reduce the debilitating complications that cause the death of patients be used.