การเสริมพลังอำนาจผู้ป่วยเรื้อรังในการสร้างบ้านปลอดบุหรี่เพื่อป้องกันภาวะฉุกเฉิน Empowering People with Chronic Illness to Create Smoke-Free Homes for Emergency Condition Prevention

Abstract

Emergency condition, stroke and myocardial infarction may be occurred among people with non communicable disease who smoke. This Participatory Action Research (PAR) aimed to empower people with non-communicable disease (NCD) to motivate family member to set up Smoke – Free Homes for emergency condition prevention. The purposive study setting included 11 communities of Ban Phue Health Promoting Hospital, Moung district, Khon Kaen. There were 295 participants included 100 people with NCD from 100 families, 90 care givers from difference family, 56 health volunteers, 44 community leaders, and 5 health personals. Research process was divided into 2 cycles and 4 phases in each cycle during 1 year (October, 2017- September 2018): 1) assessing smoking and quit smoking situation by in-depth interviews and focus group discussion; 2) brain storming for setting up strategic plans; 3) implementing through family participation in controlling smoking; and 4) evaluating and concluding for further development.  

         The results revealed that: There were 34% of NCD people have Smoke-Free Home. Smokers were husband, son in law, son, and also people with NCD (28 male, 4 female). All of family members accepted smoking is normal life of their culture even they received the information from health personal about stop and avoid smoking. Moreover, all of patients didn’t know the relationship of emergency conditions and smoking among people with NCD even they had experiences about caring for NCD with stroke and STEMI. After brain storming; the participants were interested to join this project, moreover, every community had 2-3 ex-smokers who need to join as the idol to motivate stop smoke. The participants also initiated 4 strategies; 1) asking for hand book about regimen to stop smoking from communities’ experiences and how to prevent emergency condition among NCD, 2) training stop smoking volunteers to motivate family members to create Free Smoke Home, 3) NCD home visit by stop smoking volunteers to initiate appropriated method for each family to stop smoking, 4) continuing evaluation by brain storming through community experiences. After 1 years running this project, there were increased Smoke-Free Home to 62 families, still had 12 male NCD smokers, moreover, health personals and health volunteers committed to include these strategies to routine work of health promoting hospital and community need to train more volunteers in order to expand the project through the entire population of community. The Smoke-Free Home would keep as sustainable project, and stop smoking volunteers were key person in each community who could continue counseling for those smokers at all times if stopped smoking needed.