การพัฒนารูปแบบการพยาบาลผู้ป่วยที่มีแผลเรื้อรังจากเส้นเลือดดำที่ขาบกพร่อง

Piraluk Laplai; Rungrat Trerape; Daranee Nongyow; Thippawan Naichap; Sasee  Srichote; Marasri Pinsuwa; Patompong Akkarapattanakool

Authors

Piraluk Laplai Pha Nakhon Si Ayutthaya Hospital
Rungrat Trerape Pha Nakhon Si Ayutthaya Hospital
Daranee Nongyow Pha Nakhon Si Ayutthaya Hospital
Thippawan Naichap Pha Nakhon Si Ayutthaya Hospital
Sasee Srichote Pha Nakhon Si Ayutthaya Hospital
Marasri Pinsuwa Pha Nakhon Si Ayutthaya Hospital
Patompong Akkarapattanakool Pha Nakhon Si Ayutthaya Hospital

Keywords:

development of nursing care medical, patient with chronic ulcer, Chronic venous leg ulcer

Abstract

Introduction: Quality of care for patients diagnosed with chronic venous leg ulcers (CVLUs) involves continuous quality improvement and reduced risk of organ loss.

Research objectives: To develop and examine the effectiveness of a nursing-care model for patients with CVLUs.

Research methodology: This research and development study was designed to develop a nursing care model for patients with CVLUs. Participants were recruited to assess problems with 10 healthcare providers and 47 CVLUs patients. This study was comprised of three phases. Phase 1 comprised situation analysis via document review and in-depth interviews. Phase 2 comprised the design and development of the model as well as the assessment of content validity by experts. Phase 3 included the implementation of the model and evaluation of its effectiveness.

Results: Phase I revealed that there were two issues. The first issue involves patient-related problems and the need to mention the healthcare delivery system. The second issue concerned retrospective data from medical records that compared patients receiving nursing care at ostomy
and wound care clinics. Regarding traditional care, it was found that the process for wound healing was improved with a reduction in wound volume index (cm²) (13.47 - 57.78 cm², p<.01) and reduced recovery time (.59 - 4.84 years, p<.01). Phase II established the development of the model and assessment of content validity by experts. Phase III comprised the results, which showed that, amongst 47 patients with CVLU and self-controlled interrupted time design, the process of wound healing was improved with a reduction in wound volume index (cm2) (32.33 - 127.78 cm², p< .01) and reduced recovery time (3.59 - 6.84 days, p< .01). The significance of the released pain was p< .05, and patients expressed satisfaction with the model.

Conclusions: Applying the nursing care model for patients with CVLUs can provide safe care and encourage patient satisfaction.

Implications: The nursing care model for patients with CVLUs should be disseminated or expanded through integration and different contexts.

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