การพัฒนารูปแบบการป้องกันโรคไตเรื้อรังในผู้ป่วยความดันโลหิตสูง ที่มีภาวะเสี่ยงในชุมชนชนบท ตำบลเดิมบาง อำเภอเดิมบางนางบวช  จังหวัดสุพรรณบุรี

Orawan Yusuwan; Napaphen Jantacumma; Mukda                                                           Nuysri

Authors

Orawan Yusuwan School of Nursing, Sukhothai Thammathirat Open University
Napaphen Jantacumma School of Nursing, Sukhothai Thammathirat Open University
Mukda Nuysri School of Nursing, Sukhothai Thammathirat Open University

Keywords:

prevention model, chronic kidney disease, Hypertensive patients, chronic care

Abstract

Introduction: Patients, multidisciplinary teams, and community networkers should take part in the prevention of chronic kidney disease (CKD).

Research Objectives: This research and development (R & D) study aimed to: 1) investigate the situation and problems of CKD prevention among at risk hypertensive patients in rural communities; 2) develop a model for CKD prevention in at risk hypertensive patients; and 3) examine the effects of CKD prevention model for at risk hypertensive patients in the rural communities of Doem Bang subdistrict, Doem Bang Nang Buat district, Suphanburi province.

Research methodology: This R & D study consisted of 3 phases as follows: 1) situation investigation, 2) model development, and 3) examination of model effectiveness. Research instruments were a self-care behavior questionnaire, and satisfaction assessment of both patients and healthcare providers. Qualitative data were analyzed using content analysis. Quantitative data were analyzed using descriptive statistics, t-test, and Wilcoxon-test.

Results: Findings revealed that 1) at the beginning of the study, there were no activities and plans regarding CKD prevention in the community. The roles of stakeholders were unclear; data was not linked; and there were lack of guidelines and manuals, and participation among community networks. 2) subsequently, a CKD prevention model was developed. A comprehensive treatment information system was implemented. Guidelines for giving feedback to patients, a clinical practice guideline, a manual to prevent CKD, and home visit guidelines were developed. Within this model, community networks took part in patient care. 3) at follow up, mean score of health behavior in patients was significantly higher than at base line (p<.05).

Conclusions: Stakeholder involvements, patients, multidisciplinary teams, and community networks, can prevent CKD.

Implications: The model can be used as a guideline for the development of a prophylactic model for end-stage renal disease in patients with at-risk diabetes mellitus and hypertension in rural communities.

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