The Development of Guidelines on Home - Visiting Pulmonary Tuberculosis Patients With Short Course Treatment in Mueang District, Samut Prakan Province

Abstract

The purpose of participatory action research was to develop a home visit guideline of pulmonary tuberculosis (TB.) patients with short course treatment in Mueang district, Samut Prakan province. The concepts of case management and King’s nursing theory were applied. The research was divided into three stages ; stage 1 evaluating caring situations, stage 2 developing guidelines for home visits, stage 3 comparing the perception of TB patients before and after developing a home visit guideline. The samples were 22 TB patients. The participants included family members, the multidisciplinary teams, health volunteers and the community leaders. Research tools included questionnaire, indepth interviews, and group discussions guidelines. Data collection tool has been reviewed for content validity by 3 experts, reliability was 0.89 and the exact content of 0.80. Data were analyze by paired t- test and content analysis. The results showed that most patients were males (77.30%), aged between 56-65 years (31.80%), married (77.30%), graduated secondary (school)1-6 (40.90%), had an income less than 5,000 baht (38.10%), had a spouse as a caregiver (50.00%), had physical inactivity (50.00%), and BMI less than 20 (59.10%). (4.50%) Patients forgot to take medications and had adverse drug reactions. The developed guideline about brought 1) a home visit guideline which determined roles of the involvements in the 1-8 weeks. 2) a home visit plan which specifies the weekly objective and steps of a home visit. 3) a home visit record book. After the developed home visit guideline was employed, patients percived higher treatments higher (¯x before use = 4.11, ¯x after use = 4.75), percived lower stress (¯x before use = 2.14, ¯x after use = 1.34), and percived treatments the family members, health personnel, community leaders higher than using the guideline significantly (¯x before use = 2.94, ¯x after use = 3.75). The analysis of the role of health personnel practice during an intensive phase (2 months) were monitoring TB patients at home every week and once a month for 4 months later. Also, finding family members to be DOTS’ watcher and distributing leaflets were done. But the coordination with community leaders in caring TB patients was absent.