การพัฒนาแนวทางการให้บริการผู้ป่วยโรคเบาหวานที่มีภาวะแทรกซ้อนทางไตระยะที่ 1-2 ของหน่วยบริการระดับทุติยภูมิ จังหวัดนครราชสีมา The Development of guideline for caring Patients with Diabetic nephropathy At secondary care, Nakhonratchasima Province

Abstract

The purposes of this action research were to investigate the situation of existing diabetic nephropathy

Care service and develop the guideline of diabetic nephropathy healthcare system in secondary care Hospital. Participants were stakeholders, consisting of 14 patients with diabetic nephropathy stage 1-2, 14 primary caregivers, community leaders and 22 public health volunteers, 15 service personnel and 4 executives. The study process consists of 4 steps:

1) The study of the situation of diabetic patients with renal complications, stage 1-2 in the service unit 2) the design and planning activities by participation of the researcher 3) follow the plan and 4) evaluation and reflection. Analysis using descriptive statistics and content analysis.

From the study, it was found that the provision of services for diabetic patients with renal complications, stage 1-2 of the service unit, was not clear in the form of service procedures. The community did not receive the information. Causing the community to lack participation in caring for patients to slow the deterioration of the kidneys therefore all parties involved have designed and planned activities for service development. As follows: 1) Developing the potential of the staff and the development of the potential of public health volunteers  2)  Developing the self-management model of patients by case managers nurses And develop guidelines for visiting homes. 4) Developing communities to participate by visiting the house of public health volunteers’ collaboration with health officials.

The results of the service unit and the health outcomes of the patients after the implementation of the development plan showed that there was a clear service approach and effective service. Patients were able to control blood sugar levels better by 21.4 percent. Cumulative glucose levels improved 28.6 percent the glomerular filtration rate remained stable at 85.7 percent. Blood pressure improved 64.2 percent. Behavior was found to adjust the behavior in 50.0% better diet; primary caregivers reduce the use of condiments in cooking, 35.7%