The Development of a Care Model according to Food Consumption Culture for Patients with Chronic Kidney Disease in a Community at Kalasin Province

Abstract

   This research and development study aimed to: 1) examine food consumption culture and factors associated with food consumption culture among patients with chronic kidney disease (CKD) in a community; 2) develop a care model relevant to food consumption culture for patients with CKD, and 3) to study the effectiveness of the developed care model of food consumption culture for patients with CKD. Participants were divided according to the study phases. Phase 1 aimed to examine the food consumption culture and factors associated with the food consumption culture, and the participants consisted of 27 patients with CKD and caregivers in Phu din Sub-district, Muang Kalasin district, Kalasin province. Phase 2 aimed to develop care model of food consumption culture, and the participants were 12 members of a development team. Phase 3 aimed to investigate the effectiveness of the developed care model of food consumption culture, and the participants consisted of 15 patients with CKD and 80 community residents. Research instruments were: 1) a focus group guideline for patients with CKD and caregivers; 2) a brainstorming guideline for developing the model; and 3) a food consumption behavior questionnaire for patients with CKD which showing content valid of .80-1.00 and reliable Cronbach’s alpha of .92; and 4) a satisfaction questionnaire for community residents. Quantitative data were analyzed using descriptive statistics, and Wilcoxon Signed Match-paired Rank test. Qualitative data were analyzed using content analysis.

Research results are the following. First, the main food consumption patterns among patients with CKD were eating sticky rice and freshwater fish without limiting their consumption. The seasoning was pickled fish, salt, and monosodium glutamate. Factors related to the pattern were radio advertisements which convincing patients to consume food and herb, patients’ belief. Such belief was that alcohol drinking could wash and clean their kidneys, and they should drink in the Buddhist Lent festival. In the traditional festival, strong-flavored food with seasoning was served. Residents used state welfare card to buy seasoning easily. Second, care model relevant to food consumption culture were the following. Patients were encouraged to preserve the culture of self-cooking and eating rice, fish, and vegetable. This could be done by home visits to enhance vegetable and fruit cultivation, and developed a role model village for renal preservation. Negotiation was done for limiting food consumption and seasoning using education, food wheel innovation, sticky rice box for patients with CKD and friend bonding for renal preservation. A new pattern was organized by stopping alcohol drinking. This was done using home visits with community residents. After using the developed care model, food consumption behavior of patients with CKD was significantly better than before using the developed model (p<.05). Community residents were satisfied with the developed care model at a high level.