Care Map Development for Control of Chronic Kidney Disease in Persons with Diabetes and Hypertension: A Case Study at a Health Promoting Hospital

Abstract

This research and development study aimed to develop a care map for control of chronic kidney disease in persons with diabetes and hypertension at a health promoting hospital, Employing an innovative care for chronic condition framework. The participants were 8 community members, 6 health care providers, 27 diabetic and hypertensive patients with CKD stage 3, and 27 of their caregivers. The study was conducted from June 2017 to May 2018. Four research processes included were 1) studying the situation of CKD care 2) developing a care map for control of CKD 3) applying the CKD care map to patients and caregivers and 4) evaluating the results of the care map. Data were collected using both qualitative and quantitative methods: interviews, questionnaires, focus groups, and participatory observation. Data analysis was performed by content analysis, descriptive statistics, paired t-tests, and Wilcoxon signed ranks tests. The care map developed from this study is called “PROMT” as it is composed of preparation, reeducation, ongoing, mindfulness and transition. After applying the “PROMT” care map, paired t-test analysis indicates that the “PROMT” care map significantly affected patients CKD control behaviors (t = 13.04, p<0.001), systolic blood pressure (t = -1.68 p = 0.05), and BMI (t = -0.39, p = 0.001). Using a Wilcoxon signed ranks test indicated that the care map did not significantly affect proteinuria (Z = -4.24, p>0.05).