Effects of a learning enhancement program on knowledge, self-care behavior, blood coagulation levels, and abnormal bleeding among patients receiving warfarin at Mae Lao hospital, Chiang Rai province
Keywords:
Learning enhancement program, warfarin, self-care behavior, blood coagulation, abnormal bleedingAbstract
Warfarin is a high-risk anticoagulant. Patients receiving warfarin need to be controlled keep blood coagulation levels within the target range to prevent complications from receiving medicine. The research was a quasi-experiment design, two groups measured before and after the experiment. The objective was to examine the effects of the learning enhancement program on knowledge, self-care behaviors, blood coagulation levels, and abnormal bleeding in patients receiving warfarin. The sample consisted of 52 patients aged 18 years and over receiving treatment at Mae Lao Hospital. They were divided into an experimental group of 26 and a control group of 26. Simple random sampling with math pair was conducted to ensure similarity between the two groups. The control group received standard care, while the experimental group underwent a six-week learning enhancement program. Data were collected using a knowledge assessment form, self-care behavior assessment in warfarin use, and an abnormal bleeding questionnaire. The reliability coefficients for knowledge and behavior assessment instruments were 1.00 and 0.67-1.00, respectively, with Cronbach's alpha coefficients of 0.80 and 0.78, respectively. The study revealed that after participating in the program, the experimental group significantly increased mean scores in knowledge, self-care behaviors regarding warfarin use, and blood coagulation levels within the target range (p< 0.001, p<0.000, p=0.000, respectively), and higher than the control group (p=0.038, p<0.001, p=0.026, respectively). There was no significant difference in abnormal bleeding between the experimental and control groups. These findings demonstrate that the learning program enhances knowledge and self-care behaviors among patients receiving warfarin. Therefore, it should be continously used.
References
Patel S, Singh R, Preuss CV, Patel N. Warfarin. In: StatPearls [Internet] 2023 [cited 6 August 2023]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470313/
Thaichana T, Phrommintikul A, Ruengorn C, Niwatananun K. Factors affecting major bleeding in Thai patients receiving warfarin. Thai Journal of Pharmacy Practice. 2019;12(4):954-968.
Yomsrikun P, Thanyawan T, Mungkornkaew R, Chommueang R, Tungtragool K, Suebsing S, et al. Factors affecting INR control and bleeding of warfarin-treated patient, Warinchamrab hospital. Isan Journal of Pharmaceutical Sciences. 2017;13 (Supplement):301-310.
Thai Hematology Association. Guideline for management of bleeding in patients taking direct oral anticoagulants [Internet] 2022 [cited 6 August 2023]. Retrieved from https://www.tsh.or.th/Activity/Detail/ 304.
Laopaiboonkul S, Chuaychai A, Banluephuet S, Matmoontri S, Kongthep W. The problem of outpatient patients receiving warfarin medication with out-of-range INR values during home visits in Tha Sala district, Nakhon Si Thammarat province. Walailak Procedia. 2019;4:HS.144.
Wangnirattisai N, Muangman U, Kalaphakdee PO. Clinical outcomes of implementation of the network for taking care of patients receiving warfarin among Sawanpracharak hospital and community hospitals. Thai Journal of Pharmacy Practice. 2021;13(4):1029-1036.
Interdisciplinary Team. Clinical Practice Guidelines for Patient Care on Warfarin Therapy. Chiang Rai: Mae Lao Hospital; 2021.
Outpatient Team, Mae Lao Hospital. Annual Report 2023. Chiang Rai: Mae Lao Hospital; 2023.
Chawarat S, Ubahad C. Factors affecting INR values in warfarin users, Benchalak Chaloem Phrakiat 80th Pansa hospital. Journal of Environmental and Community Health. 2023;7(1):137-146.
Boonruen U. Effect of brief counseling on self-care behavior of patients taking warfarin warfarin clinic outpatient work Dong Luang Hospital Mukdahan Province. Journal of Environmental and Community Health. 2024;8(1):229-238.
Dsouza JP, Chakrabarty J, Ramachandran P, Guddattu V, Nayak BS, George A. Effectiveness of a nursing intervention module on adherence, knowledge, quality of life, and complications among patients receiving anticoagulation therapy—A randomized controlled trial protocol. Patient Prefer Adherence. 2022;1723-1731.
Souza-Silva MVR, Domingues MLDP, Chagas VS, Pereira DN, de Sá LC, Almeida MSS, et al. Implementation of a text messaging intervention to patients on warfarin therapy in Brazilian primary care units: A quasi-experimental study. BMC Primary Care. 2022;23(1):1-13.
Mansin A, Somnarin O, Khamsombat N. Effects of applied education program for self-directed learning via internet on knowledge and self-care ability in patients undergoing coronary artery bypass grafting. Nursing Journal of the Ministry of Public Health. 2022; 32(1):88-100.
Buntanapisan N, Naewbood S. Effects of a self-management program using LINE application on health behaviors and A1C levels among uncontrolled diabetes patients. [Master's Thesis]. Phitsanulok: Naresuan University; 2021.
Bloom BS, Engelhart MD, Furst EJ, Hill WH, Krathwohl DR. Taxonomy of educational: The classification of educational goals: Handbook I: Cognitive domain. New York: David McKay Company. 1956.
Burns N, Grove SK. The Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence. 6thed. St Louis: Saunders Elsevier; 2009.
Sombhopcharoen M. Health communication for health literacy. Bangkok: Charoendee Man Kong Printing; 2022.
Rojanapithayakorn W. Health Literacy - How to achieve Effective Learning. Journal of Health Science of Thailand. 2021;30(2):195-196.
Tangkiatkumjai M. Reasonable use of herbal Medicine. Thai Journal of Parenteral and Enteral Nutrition. 2021;29(1):34-47.
Tan CSS, & Lee SWH. Warfarin and food, herbal or dietary supplement interactions: A systematic review. British Journal of Clinical Pharmacology. 2021;87(2): 352-374.
Wanna S, Samseemoung K, Bouttongcome T, Charoenpiboonlab N. Effects of a caregivers participation program in taking medication chronically to control the behaviors of taking medication chronically among older adults in Phetchabun province. Journal of Disease Prevention and Control: DPC. 2 Phitsanulok. 2020;7(2):40-53.
Lo FM, Wong EM, Hong FK. The effects of educational programs on knowledge, international normalized ratio, warfarin adherence, and warfarin-related complications in patients receiving warfarin therapy: an integrative review. Journal of Cardiovascular Nursing. 2022;37(3):E32-46.
Rattana C, Phusirit T. Developing a self-direct learning video media for chronic kidney patient in Nongkai hospital. Journal of Educational Technology and Communications Faculty of Education Mahasarakham University. 2020;3(9):54-61.
Pettongkhao S, Sukban U, Sungrod T, Choomek T. Effects of a self-care promotion program on knowledge, perceptions, and self-care behaviors among type 2 diabetic patients with uncontrolled blood sugar. Lanna Public Health Journal. 2023;19(2):88-101.
Changtong K, Narin R, Aungwattana S. Effects of the learning enhancement program on knowledge and caring for lung in groups at risk for chronic obstructive pulmonary disease. Christian University Journal. 2023;29(2);28-44.
Pamungkas RA, Chamroonsawasdi K. Self-management based coaching program to improve diabetes mellitus self-management practice and metabolic markers among uncontrolled type 2 diabetes mellitus in Indonesia: A quasi-experimental study. International Journal of Diabetes & Metabolic Syndrome. 2020;14(1):53-61.
Jirapattrathamrong S. Use of oral anticoagulant for prevention of embolic stroke and systemic embolism in atrial fibrillation. Vajira Medical Journal: Journal of Urban Medicine. 2018;62 (Supplement):S64-74.
Pandey AK, Xu K, Zhang L, Gupta S, Eikelboom J, Cook O, McIntyre WF, Lopes RD, Crowther M, Belley-Côté EP, Whitlock RP. Lower versus standard INR targets in atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials. Thrombosis and Haemostasis. 2020;120(03):484-94.
Wanaprom S. Factors related to adverse events and treatment outcomes of warfarin patients in Nonghan hospital (node) and Pibulak hospital (sub - node), Udon Thani province. Nakhonphanom Hospital Journal. 2021;8(2):15-27.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Journal of Medicine and Health Sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.