การพัฒนารูปแบบการดูแลต่อเนื่องทางการพยาบาลผู้ป่วยโรคหลอดเลือดสมองที่บ้าน โดยการมีส่วนร่วมของครอบครัว ในพื้นที่จังหวัดอุดรธานี

Darawan Torrapeesing; Kamonthip Tanglakmankhong

Authors

Darawan Torrapeesing Udonthani Public Health Provincial Office
Kamonthip Tanglakmankhong Boromarajonani College of Nursing Udonthani, Faculty of Nursing, Praboromarachanok Institute

Keywords:

continuous nursing care, stroke, family participation

Abstract

Introduction: Stroke is a leading cause of disability and dependency worldwide. Effective home-based continuous care is essential to prevent complications, enhance recovery, and improve quality of life for stroke survivors.

Research objectives: 1) To study the situation and problems of caring for stroke patients at home 2) To develop and evaluate the effectiveness of the continuous care model for stroke patients at home with family involvement in Udon Thani.

Research methodology: This action research was conducted in 3 phases: 1) assessing current conditions, 2) developing a continuous care model for stroke patients, and 3) monitoring and evaluating outcomes using the Health Belief Model (HBM) and family participation as a conceptual framework. Participants included 60 stroke patients, 60 primary caregivers, and 25 multidisciplinary personnel, purposively selected from five network hospitals. Research instruments comprised questionnaires on knowledge, beliefs, attitudes, and caregiving behaviors; an ADL assessment form; interview guidelines; and a satisfaction survey. Content validity was verified using the Index of Item Objective Congruence (0.67 - 1.00). The reliability was .79 (Cronbach's Alpha), and the knowledge test reliability was .80 (KR-20). Quantitative data were analyzed using descriptive statistics and paired t-tests, while qualitative data was analyzed using content analysis.

Results: The continuous nursing care model for stroke patients at home, implemented with family participation through activities that enhanced self-efficacy and reflection via a nursing care diary, significantly improved primary caregivers’ knowledge, understanding, health perceptions, and caregiving behaviors (p < .001).

Conclusions: The model strengthened caregiver capacity based on the Health Belief Model (HBM) and family participation concepts by enhancing perceived benefits and self-efficacy, while reducing perceived barriers to care. As a result, patients tended to achieve greater independence in performing daily activities.

Implications: The model should be expanded to other healthcare settings with contextual adaptations and supported by ongoing practical training for caregivers in the community.

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References

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