Development of a Disease Management Model for Colorectal Cancer in the Community in Photak District, Nong Khai Provice
Keywords:model, disease management, need of care, Colorectal cancer
Introduction: Colorectal cancer disease management is important for exploring the problems and needs of colorectal cancer patients, risk group prevention, and effective care for colorectal cancer patients. Research objectives: The purposes of the research and development were 1) to study problems and needs of care of colorectal cancer patients; 2) to develop a disease management model for colorectal cancer in the community; and 3) to evaluate the appropriateness of activities and community readiness to implement the disease management model for colorectal cancer in the community in Photak District Nong Khai Province. Research methodology: The sample was classified according to the study phases. Phase I: for the study on problems and needs of care for patients with colorectal cancer, the sample was 16 colorectal cancer patients and caregivers. Phase II: for the development of a disease management model for colorectal cancer in the community, 15 care providers and community representatives were included. Phase III: for the evaluation of the appropriateness of activities and community readiness to implement the model, the samples were 30 care providers and community representatives. The research tools were focus group questions, brainstorming guidelines, and a questionnaire assessing the appropriateness of activities and community readiness for implementation of the colorectal cancer management model in the community. The quantitative data were analyzed by descriptive statistics. Content analysis was used to analyze qualitative data. Results: The findings revealed as follows. 1) The problems of colorectal cancer patients were fatigue, abdominal pain, weariness, anxiety, discouragement with the disease, fear of death, and fear of being repulsive and burdensome. The needs of care were food appetite, sleep, encouragement from family, friends, and caregivers, peaceful dying at home, and funding from the cancer patient foundation. 2) The colorectal cancer management model was (1) people over 50 years old to be screened by expert village health volunteers, and awareness improvement to prevent risk behaviors by having public health scholars manage campaigns at significant festivals. (2) The high-risk group is to be screened by screening form, fecal immunochemical test (FIT), and colonoscopy, including enrolling in a work-shop managed by professional nurses. (3) Patients will receive continuing care at home by a multidisciplinary team. (4) The end-stage patients will receive palliative care at home by a multidisciplinary team. 3) The care providers and community representatives perceived that the model activities were appropriate, and the care providers and community were ready to implement the model at the highest level. Conclusion: The developed model helps to understand patient problems and foster an understanding of colorectal cancer care and a community-based colorectal cancer management model. Implications: Colorectal cancer disease management model in the community could be applied for developing the colorectal cancer disease management model in similar context areas. It also could be guided to develop colorectal cancer disease prevention and control programs in the studied area.
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