Development of Diabetic Care Service Model of Primary Care Unit during COVID-19 Pandemic, Chan Lan Subdistrict, Phana District, Amnat Charoen Province

Abstract

           The action research aimed to develop a diabetic care service model of primary care unit during the COVID-19 pandemic in Chan Lan subdistrict, Phana district, Amnat Charoen province. The research methodology was divided into three stages: 1) Research preparation phase, which involved understanding local issues and developing a mobile application, assessing risks and health behaviors of patients; 2) Research implementation phase, which included conducting practical experiments and improving the model; and 3) Evaluation phase, which involved purposively selecting a sample comprising 47 people, including diabetes clinic staff, Phana Hospital staff, Chan Lan subdistrict municipality health promoting hospital, representatives of the community health volunteers, diabetic patients, officials from Phana district public health office, president of subdistrict administrative organization, subdistrict headmen and village headmen. The tools used were in-depth interview, semi-structured interview, patient health behavior assessment, satisfaction assessment, and a mobile application to verify the content validity and improve the tools according to expert recommendations.

   The research findings indicated that during the COVID-19 pandemic, subdistrict municipality health promoting hospital staff adjusted measures to reduce the grouping of patients. Screening and monitoring of patients were carried out by the community health volunteers who then sent the information to the hospital via Line group, sending the patient notebook to the sub district municipality health promoting hospital, delivering medication to homes, which put the volunteers at risk of contracting COVID-19 and spreading it to the community. The novel community-based diabetes care service model by the community health volunteers using a mobile application is a tool for assessing the risk and the risk behavior of each individual. The program would process and immediately display results along with providing proper advice to patients. Subdistrict municipality health promoting hospital could obtain real-time data and the community health volunteers could also organize peer assist activities in the community, resulting in sample’s satisfaction with the use of the mobile application. The satisfaction with the newly developed model was at the high level. After implementing the model, the mean health behavior scores of all diabetes patients were significantly higher than before with a statistical significance level of .05. Finally, good control of blood sugar levels tended to increase.