THE DEVELOPMENT OF CARE MANAGEMENT FOR HYPERTENSION PATIENTS WITH CHRONIC KIDNEY DISEASE IN A COMMUNITY

Abstract

The purposes of this research and development were to: 1) examine problems and needs of care in hypertension patients with chronic kidney disease in community; 2) develop a model of care management for hypertension patients with chronic kidney disease in community; and 3) evaluate the feasibility of activities and community readiness to implement the care management model among hypertension patients with chronic kidney disease in community.

         A sample was classified according to the study phases as the following. The first phase aimed to investigate problems and needs of care among hypertension patients. Sample consisted of 24 hypertension patients and caregivers in Ao Luek Nuea subdistrict, Ao Luek district, Krabi province.

The second phase aimed to develop the model, the sample in this phase composed of 12 health personnel in a developed team and community representatives. The last phase aimed to evaluate the feasibility of activities and community readiness to implement the model. Sample included 30 health personnel and community representatives. Sample was recruited using a purposive sampling. The research instruments included: 1) a focus group guideline to investigate study problems and needs of care; 2) a focus group guideline for model development. The content validity of the unstructured questionnaires was tested using 5 experts. The content validity index ranging from .80 to 1.00 were reported; and 3) a set of questionnaires to evaluate the feasibility of activities and community readiness. Descriptive statistics were used to analyze quantitative data and content analysis was used to analyze qualitative data.

         The findings were as follows: 1) the problems and needs of care for hypertension patients with chronic kidney disease included physical, mental, spiritual, and social aspects and accessibility to healthcare system; 2) the care management model comprised timely publishing information, health assessment and care planning in the level of communities and families, implementing the care plan, monitoring, and evaluation; and 3) the health personnel and community representatives perceived that the activities of the developed model was feasibility and the community was ready to implement the model at the highest level.