Development of schizophrenic patients care model in the health services network of Lahansai District, Buriram Province

Abstract

Schizophrenic patients in Lahansai District, Buriram Province are the number one of the patients of psychotic disorders and are more likely to increase every year. However, it is also a lack of care model for the appropriate schizophrenia in context. This action research was applying the PAOR concept that proposed by Kemmis and McTaggart to develop a model for schizophrenia care in the health service network of Lahansai District and the assessment of the use of patient care model in clinical outcomes and quality of life. There are 2 groups of samples consist of  1) Multidisciplinary team involved in the care of schizophrenic patients in the health service network of Lahansai District amount 14 persons 2) 357 schizophrenic patients in the LahansaiDistrict to experiment with the patient care model developed. All of them were perform the workshop process during October 2016-September 2018.Data were collected from focus group discussion, questionnaire, a clinical outcome assessment and a quality of life assessment. Analyze data with descriptive statistics. To compare a clinical outcome changes and quality of life before and after the experiment of patient care model by using McNemar Chi-square test by defining a significant level at 0.05, the qualitative data section analyse data with content analysis method. The results found that the developed care model of schizophrenia in the health service network of Lahansai District composed of 5 stagesconsisted of; 1) improve public health personnel potential in the health care network 2) all of public health service units operate schizophrenia according to the care guidelines of user guide for schizophrenia. If the patient returns to the continuing treatment at home must coordinate the care of the Tambol health promoting hospital's officers. 3) The patient's absence of the appointment has a joint follow-up system by Lahansai hospital, all of Tambol health promoting hospitals, public health village’s volunteers and sub-district administrative organization focus on home visits and monitoring patients at least 1time a month 4) care plan and surveillance in the community consisted of surveillance system with a lack of medication, watch out for harsh aggressive events and monitor recurrent symptoms were performed by a relative or care giver and public health village’s volunteers and 5) controlling, monitoring and evaluation by medical supervision. After the trial of schizophrenia care model, it was found that patients with schizophrenia can be increased control over illness. The schizophrenia uncontrolled and relapsed cases were reduced. These three characteristics have a significant number of changes in statistical significance (P-value <0.05) and clinical results have changed statistically significant too (P-value <0.001). In addition, schizophrenic patients have a better quality of life, and the level of poor and moderate quality of life is reduced. The number of changes has been statistically significant (P-value <0.001). Therefore, the development of schizophrenic patient care model in health service network are enhance patient care, suitable model for the context in the area and continuing in the same direction in health service network of Lahansai District.