The Effects of a Nurse-Led PEACE Program on Perceived Peaceful End-of-Life and Quality of Life Among Head and Neck Cancer Patients Undergoing Concurrent Chemoradiation

Background: Evidence indicates that peaceful end-of-life care programs benefit terminally ill patients, with nurses playing a central role in program delivery. However, no structured end-of-life care programs currently exist for patients with head and neck cancer (HNC), who often experience profound physical and psychological distress. A nurse-led Peaceful End-of-Life Care (PEACE) program was therefore developed. This study aimed to evaluate the effects of the PEACE program on perceived peaceful end-of-life (PEOL) and quality of life (QoL) among HNC patients undergoing concurrent chemoradiotherapy (CCRT). Methods: A quasi-experimental, two-group time-series design was conducted with 64 HNC patients recruited from oncology wards at a Thai cancer center. Participants were assigned to either the intervention group (n = 32), which received the nurse-led PEACE program, or the control group (n = 32), which received usual care. The program addressed pain relief, comfort, dignity, inner peace, and closeness to significant others. PEOL and QoL were measured at baseline, immediately post-intervention, and at 4- and 8-week follow-ups using the Peaceful end-of-life care scale: PEOLCS (CVI = 1.00, α = .96) and FACT-H&N (α = .97). Data were analyzed using mixed-model ANOVA. Results: The intervention group reported significantly higher PEOL and QoL scores than the control group across all post-intervention time points (p < .05). Conclusion: The nurse-led PEACE program effectively enhanced peacefulness and quality of life in HNC patients undergoing CCRT. Keywords: Head and neck cancer, Nurse-led PEACE program, Peaceful end-of-life, Quality of life