Developing Guidelines for Providing Knowledge Using the Concept of Supporting Self-Management for Patients Receiving Warfarin at Warfarin Clinic, Kud Bak Hospital, Sakon Nakhon Province

Abstract

This research is a developmental study aimed at creating educational guidelines using the self-management support concept for patients receiving warfarin therapy and examining the effects of these educational guidelines on patients' knowledge about warfarin and their INR levels. The sample group consisted of 24 patients receiving warfarin treatment at a warfarin clinic. Data collection took place between January and April 2024, using purposive sampling methodology. Research instruments included educational guidelines based on the self-management support concept for warfarin patients, which were developed through three phases: 1) reviewing and analyzing research literature, 2) studying the situations and problems experienced by warfarin patients, and 3) synthesizing the findings to draft the guidelines. Data collection tools included a general information questionnaire and a knowledge assessment form regarding self-care using the self-management support concept for warfarin patients. Data analysis employed descriptive statistics and a paired t-test for comparing outcomes within the same sample group.

 Results: The educational guidelines using the self-management support concept for patients receiving warfarin therapy comprised five components: 1) assessment of general health information and measurement of INR levels, 2) education about medication administration, dietary considerations, adverse effect monitoring, and appropriate self-care practices, along with comprehension assessment, 3) collaborative development of healthcare plans between patients and the healthcare team, 4) implementation of the healthcare plans, and 5) evaluation of implementation outcomes. The study findings on the implementation of these guidelines revealed that the mean knowledge score before implementing the educational guidelines using the self-management support concept for warfarin patients (Mean= 16.29, S.D.= 1.989) and the mean knowledge score after implementation (Mean = 18.92, SD = 1.060) were significantly different at p< .001 (t = -9.797). Furthermore, the mean INR value before implementing the developed guidelines was 1.81 (S.D. = 0.95), while the mean INR value after implementation was 2.39 (S.D. = 0.44), showing a statistically significant difference at p< .001 (t = 3.673). These findings demonstrate that the self-management support concept should continue to be applied for patients receiving warfarin therapy in clinical settings.