The effect of discharge education based on the Roy Adaptation Model on quality of life and adaptation of palliative care patients and caregivers

Introduction: In palliative care patients, the educational role of nurses is important in developing methods for coping with the feeding process with percutaneous endoscopic gastrostomy (PEG), improving quality of life, and ensuring psychosocial adaptation. Objective: The study was conducted to determine the effect of discharge education based on the Roy Adaptation Model (RAM) provided to palliative care patients with malnutrition and fed via PEG and their caregivers on their quality of life and adaptation processes. Method: The study was conducted using a pre-test-post-test randomised controlled experimental design. The population consisted of 176 patients who were hospitalised in the palliative care clinic of a state hospital between November 2023 and October 2024, and the sample consisted of 66 patients and caregivers who met the inclusion criteria and volunteered to participate in the study. In the study, individuals in the experimental group received RAM-based discharge education from the researcher, while individuals in the control group received discharge education administered at the clinic. Data were collected using the following instruments: Individual Characteristics Form, Nutritional Risk Screening Test-2002, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), Assessment Scale for Adjustment Difficulties in the Elderly (ASADE), Nutritional Follow-up Form, Telephone Counselling Follow-up Form, Coping and Adaptation Process Introduction: In palliative care patients, the educational role of nurses is important in developing methods for coping with the feeding process with percutaneous endoscopic gastrostomy (PEG), improving quality of life, and ensuring psychosocial adaptation. Objective: The study was conducted to determine the effect of discharge education based on the Roy Adaptation Model (RAM) provided to palliative care patients with malnutrition and fed via PEG and their caregivers on their quality of life and adaptation processes. Method: The study was conducted using a pre-test-post-test randomised controlled experimental design. The population consisted of 176 patients who were hospitalised in the palliative care clinic of a state hospital between November 2023 and October 2024, and the sample consisted of 66 patients and caregivers who met the inclusion criteria and volunteered to participate in the study. In the study, individuals in the experimental group received RAM-based discharge education from the researcher, while individuals in the control group received discharge education administered at the clinic. Data were collected using the following instruments: Individual Characteristics Form, Nutritional Risk Screening Test-2002, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), Assessment Scale for Adjustment Difficulties in the Elderly (ASADE), Nutritional Follow-up Form, Telephone Counselling Follow-up Form, Coping and Adaptation Process Scale (CAPS), World Health Organisation Quality of Life Scale-Short Form-Turkey (WHOQOL-BREF-TR), and PEG-Related Knowledge, Attitudes, and Behaviour Form. During the study period, individuals were assessed three times: upon hospital admission, prior to discharge, and three months after discharge. Results: 53% of the patients were male, and the mean age was 79,58±7,62 years. It was determined that discharge education increased the mean EORTC-QLQ-C30 scores in the functional difficulties dimension and decreased the mean scores in the symptoms subdimension in the experimental group over time, and decreased the ASADE total mean scores (p<0,01). 66,7% of caregivers were female, and the average age was 55,48±13,67 years. Caregivers in the experimental group had higher mean scores than those in the control group in terms of WHOQOL-BREF-TR total scores, CAPS total/subscale scores, and PEG-related knowledge, attitude, and behaviour scores (p<0,05). Conclusion: It was determined that RAM-based discharge education had a positive effect on the quality of life and adaptation to the process of patients and caregivers. It may be recommended to evaluate the sustainability of the effects of discharge education with longer-term follow-ups.