end-stage renal disease, needs assessment, Thailand palliative care, uncertainty in illness



  1. Artsanthia, Jintana MS, NP
  2. Mawn, Barbara E. PhD, RN
  3. Chaiphibalsarisdi, Puangtip PhD, RN
  4. Nityasuddhi, Dechavudh PhD
  5. Triamchaisri, Somporn K. PhD, RN


This article describes the results of a pilot study that was undertaken as a needs assessment for the development of a home-based palliative care model for people living with end-stage renal disease (ESRD) in Thailand. Using the theory of uncertainty in illness as a guide, this mixed-methods study explored the palliative care needs of individuals with ESRD in Bangkok, Thailand. The study included 30 participants with ESRD, 39 family members, four community leaders, and four healthcare providers. The participants completed the revised Edmonton Symptom Assessment Scale, which provided descriptive data on nine symptoms commonly experienced among palliative care patients. In addition, focus group and in-person interviews were conducted with study participants. Four major themes emerged from the qualitative interviews that were congruent with the uncertainty in illness constructs: tremendous suffering, economic consequences, inadequate community support, and concern for the future. The participants suggested improvements in palliative home care from their unique cultural and spiritual perspectives. These findings will facilitate the development of a future intervention study that will examine the impact of a palliative care program for Thai persons living with ESRD.