Development and Evaluation of Disease Control Behavior Model among Chronic Kidney Disease Patients in Ongphrapathomchedee Health Community Center Networking of Nakhonpathom Hospital’s Contracted Unit of Primary Care

Abstract

The purposes of this research development study were to develop and evaluate a disease control behavior model for chronic kidney disease in Ongphrapathomchedee Health Community Center networking of Nakhonpathom Hospital’s Contracted Unit of Primary Care. The research procedure consisted of 3 phases including: 1) analysis of behavior in 35 chronic kidney disease patients by using questionnaires and in-depth interviews;  2) development of the model based upon the outcomes of phase 1 using self-efficacy theory; and 3) testing and evaluating the model for 34 patients in the experimental group. The instruments used in this study were questionnaires and in-depth interviews. The data were analyzed by descriptive statistics and paired sample t-test.

          The results showed that; 1) most of the participants had the middle level of perceived self-efficacy of disease control behavior, outcome expectations of disease control behavior and disease control behavior; 2) the development of disease control behavior model among chronic kidney disease patients included 3 stages: firstly, development of perceived self-efficacy and outcome expectations of food and drug intake; secondly, development of perceived self-efficacy and outcome expectations of exercise and holding bladder or urinary continence; and finally, development of maintenance of disease control behavior; and 3) the results of the model implementation revealed that the average scores of perceived self-efficacy of disease control behavior, outcome expectations of disease control behavior, and disease control behavior were significantly higher than before model implementation (p-value<0.001). In addition, eGFR had significantly higher rate than before intervention (p-value<0.05), while Cr had significantly lower rate than before intervention (p-value<0.05).

          The findings of this study demonstrated that the disease control behavior model can improve perceived self-efficacy, outcome expectations and disease control behavior among chronic kidney disease patients. Therefore, this model should be continued and expanded in other communities.