The Development of a Self-care Model of Hypertensive Patients to Prevent Chronic Kidney Disease by Using Community Participation in Pasao Subdistrict, Muang Uttaradit
Keywords:model, self-care, hypertension, chronic kidney disease, community participation
Introduction Hypertension is a chronic disease which mainly caused by inappropriate behaviors and lifestyle. Self-care to prevent complications of the disease, particularly, chronic kidney disease (CKD) is important. Research objective: The purpose of this study was to develop a self-care model for hypertensive patients to prevent CKD using community participation in Pasao Subdistrict, Muang District, Uttaradit Province. Research methodology: The research and development (R & D) design was undertaken throughout the study. According to R & D , there were four steps including: 1) situation analysis; 2) development of the self-care model to prevent CKD among hypertensive patients using brainstorming with those who involved in the community; 3) implementation of the self-care model; and 4) evaluation of the self-care model. Sample consisted of 29 hypertensive patients who registered and received medication at Pasao Health Promoting Hospital. Data were collected using a self-administered questionnaire about knowledge, self-care behavior, patients' perceptions of CKD prevention from hypertension, an estimated Glomerular Filtration Rate (eGFR), and a Creatinine (Cr.) value. Data were analyzed using descriptive statistics (frequency, percentage, mean, and standard deviation), and Paired t-test. Results: Results of this study showed that there were four components of the self-care model in preventing the complications of CKD among hypertensive patients. Four components were the following. First, input component: there were four levels in this component including Individual level (patients themselves), family level (family members or caregivers), community level (municipality, and village leader, and sub-district leader), and health-care sector level (health care providers, and village health volunteers). Second, process component consisted of knowledge development and self-care skills for CKD prevention attributed to hypertension, reminding, a follow-up system using continuous home visiting, a monitor of patient’s health behaviors, a supportive environment creation, and a setup of coordinating system. Third, output component consisted of knowledge regarding CKD prevention attributed to hypertension, self-care behaviors, and patients' perceptions to prevent CKD attributed to hypertension. And fourth, outcome component included low rate of CKD attributed to hypertension. Also, at follow up, mean scores of knowledge, self-care behavior, and patients' perceptions in the prevention of CKD attributed to hypertension were significantly higher than those at baseline (p= .05, .01, and .05, respectively). At follow up, eGFR was higher than those at baseline, Cr values were lower than those at baseline (p=.01). Patients were satisfied with the self-care model at the highest level. Conclusion: This self-care model might be used to enhance knowledge, self-care behavior, and patients' perceptions in the prevention of CKD attributed to hypertension. The eGFR, and kidney function are better. Implications: Healthcare sectors may implement this model to prevent CKD among hypertensive patients using cooperation and participation from stakeholders in the community for the better care among patients with CKD attributed to hypertension.
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