Development of community health network to prevent cerebrovascular disease in the high-risk group, Pak Thong Chai District, Nakhon Ratchasima Province

Abstract

The prevention of cerebrovascular disease in a high-risk group in Pak Thong Chai District, Nakhon Ratchasima Province had been operated without cooperation of health network.  Consequently, we addressed the weakness through a “participatory action research.”  The samples consisted of 20 individuals from the community health network known as “Pak Thong Chai Model” and 257 high-risk subjects (i.e. patients diagnosed with diabetes, hypertension, and hyperlipidemia, and were receiving treatment at Pak Thong Chai Hospital).  The study implementation was divided into three phases: preliminary data study, development process, and the outcomes from health network collaboration.  The data were collected using questionnaires and recording forms. Data analysis was performed using descriptive statistics (frequency, percentage, mean, and standard deviation), analytical statistics (paired t-test), and content analysis. The results showed: 1) The health network including doctors, nurses, public health officers, village health volunteers (VHVs), and academicians were responsible for 1.1) Organizing health care activities based on the principle of “Eight Healthy Habits”, 1.2) Evaluating results, 1.3) Implementing lessons learned, and 1.4) Adjusting drug use; 2) the program implementation outcomes included: 2.1) Capacity building program for health network, 2.2) Working systems and mechanisms for the health network, 2.3) Guidelines for rational drug use, and 2.4) Increased scores for knowledge and skills of the health network after the program development and implementation (p<0.05); 3) The outcomes from health network collaboration indicated that the high-risk group exhibited a higher behavioral level than before the program development and implementation (p<0.05).  Moreover, patients with prolonged illness lasting three to over 10 years were successful in controlling the diseases. There were 60.14%, 64.14%, and 98.11% of the subjects who were able to reduce or stop using medications for the treatment of diabetes, hypertension, and hyperlipidemia, respectively.  More importantly, new findings and outcomes were discovered: 1) Patients were the first doctor to care for themselves, 2) There was a novel health station that has made the local communities more self-reliant when it comes to health care, 3) Criteria for dose reduction and permanent discontinuation of medications which includes: 3.1) Unusual symptoms occurring after regular administration of medication, low blood sugar or blood pressure or lipid profile, 3.2) Weekly measurement and recording of blood sugar level and/or blood pressure, and 3.3) The risk group had to regularly practice the Eight Healthy Habits. Suggestion: For those at risk, incorporating lifestyle changes alongside adjusting or discontinuing medication, according to guidelines, is key to preventing cerebrovascular disease.