The Development of Management Model in Community at Tha Hat Yao Sub-District Phon Sai District Roi-Et Province
Keywords:model, disease management, chronic obstructive pulmonary disease, community
Introduction: Chronic obstructive pulmonary disease (COPD) management is important for exploring the problems and needs of COPD patients, risk group prevention, and care for effective exacerbation control of COPD patients.
Research objectives: The purposes of this research and development (R&D) were: (a) to investigate problems and needs of care among patients with COPD in the community; (b) to develop a COPD management model in the community; and (c) to evaluate the developed COPD management model in the community.
Research methodology: Participants were classified according to the study phases. Phase I: to investigate problems and needs of care, participants included 15 COPD patients and caregivers at Tha Had Yao Sub-district, Phon Sai District, Roi-Et Province. Phase II: for model development, 15 healthcare providers, village health leaders, and sand dredging entrepreneurs were included. Phase III: for the evaluation of model effectiveness, participants were: (a) 243 people aged 40 years and over selected by using stratified random sampling method; and (b) 30 COPD risk persons and 15 COPD patients selected by using simple random sampling method. Instruments included focus group guideline, brainstorming guideline, COPD prevention behavior questionnaire, and self-management behavior questionnaire. Content validity indexes of the questionnaires were .83, and .97; and Cronbach alpha coefficients were .81, and .88, respectively. Quantitative data were analyzed using descriptive statistics, t-test, and Wilcoxon signed rank test. Content analysis was used to analyze qualitative data.
Results: Findings are as follows. The problems of COPD patients were cough, dyspnea, stress, and sensitivity over family members misunderstanding the illness. The needs were inhaled medicines, caregivers, emergency vehicles, and environmental problem-solving. The COPD management model comprised of: (1) people aged over 40 years who should be screened, knowledge improvement, and modified risk behavior; (2) COPD high-risk group should be enrolled in workshops; and (3) COPD patients should be enrolled in workshops and having home visits by multidisciplinary teams. The COPD management model could improve knowledge, COPD preventive behaviors, self-management behaviors, and lung function in the participants (p=.05).
Conclusions: COPD management model in the community leads to chronic disease management in the community in 3 groups: people aged 40 years and over, people at risk for COPD, and COPD patients. The COPD management model was proved and revealed successful and good outcomes for participants.
Implications: COPD management model in the community could be implemented for developing the COPD management model in similar context areas. It also could be a guide to develop COPD prevention and control programs in the studied area.
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