Development of a Community-Participatory Healthcare Model for Homebound Elderly at Namphut Subdistrict, Mueang Trang District, Trang Province

Abstract

Objectives: 1) To study the challenges of healthcare for homebound elderly in Nam Phut Subdistrict, Mueang Trang District, Trang Province; 2) To develop a healthcare model with community participation for the homebound elderly in the area; and 3) To evaluate the effects of the implementation of the developed Model. Methods: This action research consisted of three phases. First phase involved the analysis of problem using data collected from 38 homebound elderlies including their general health, knowledge and self-care behaviors. The researchers also conducted group meeting among 15 stakeholders to collect the information on challenges for healthcare in this group of elderly based on the concept of the Six Building Block Plus One. The second phase was group meeting among 15 stakeholders to gather their opinions on the Model development and action plans for its implementation. The third phase was the evaluation after a 12-week implementation of the Model based on blood sugar, blood pressure, knowledge and self-care behaviors among elderly. A meeting was then held with 15 community stakeholders to receive their feedback and perspectives regarding the appropriateness of the developed Model and suggestion for further improvement. Results: Key health issues among homebound elderly included chronic diseases (n=35), depression (n=19), and lack of continuity in care (n=19). Data of the elderly were fragmented with no integration across agencies. There was limited participation in elderly care from families and communities. The developed Model was “NAMPHUT Model” consisting of seven components including Non-communicable disease (NCD), Active aging, Monitoring system, Participation, Holistic care, Unity, and Trang care. After implementation of the Model, all clinical outcomes in homebound elderly were significantly improved (P<0.001). Blood glucose significantly decreased from 133.45±15.44 to 127.29±18.16 mg/dL. Systolic blood pressure decreased from 139.79±5.40 to 135.79±5.51 mmHg. Diastolic blood pressure decreased from 82.26±4.15 to 80.39±4.58 mmHg. Knowledge on self-care among elderly increased from 7.29±1.25 to 11.00±1.19 from the full score of 14 (P<0.001). The scores on self-care behavior improved from 1.79±0.39 to 2.33±0.14 from the full score of 3 (P<0.001). Conclusion: The NAMPHUT Model is a comprehensive care model integrating prevention, treatment, and health promotion. It emphasizes community participation, intersectoral collaboration, and holistic care, resulting in improved health outcomes and a more structured care system for the homebound elderly. Key success factors included multi-sectoral collaboration, clear operational structure, use of supportive technology, caregiver capacity building, and quality of life promotion activities.