Model of Integrated Primary Care System Management Based on People-Centered Approach
Keywords:
Primary Care System, People-Centered Approach, Patients with Chronic Diseases, Primary Care ClusterAbstract
This mixed method research objective was to propose the appropriate integrated primary health care system management model based on a people-centered approach. The research sample consisted of 212 patients with chronic disease in the primary care cluster. The data was collected through questionnaires and group discussions of 61 personnel in the primary care cluster. Descriptive and inferential statistics were analyzed in quantitative data to analyze the structural equation modeling with Smart PLS Graph 4.0. Qualitative data was analyzed by systematic content analysis.
The results found that 1) The level of opinions among chronic disease patients in family medicine clinics regarding health factors and treatment goals is high (x= 3.95, SD = .80, x= 3.73, SD = .97). In contrast, factors related to treatment plans, self-care behaviors, and treatment outcomes are moderate (x= 3.40, SD = 1.18, x = 3.04, SD x= .80, x= 3.03, SD = .95). 2) The integrated primary healthcare system, which focuses on the population as the central point, is characterized by patient self-care behaviors as a mediating variable for treatment outcomes. Health factors and treatment goals are significant starting factors that influence treatment outcomes. Therefore, the personnel in family medicine clinics should organize service systems that prioritize patient needs, promote patient involvement in planning their healthcare, and set goals with family participation to ensure continuity and effectiveness of care to support appropriate self-care.
References
Alberta Health Service. (2012). Workforce Model Transformation Project, Workforce Model Transformation (WMT) Leading Practices, Definitions, and References, September
Buraphunt R., Muangsom N. (2013). Factors Affecting Uncontrolled Type 2 Diabetes Mellitus of Patients in Sangkhom Hospital, Udonthani Province. KKU Journal for Public Health Research. 6(3): 102-109. (in Thai)
Chobthamasakul S. (2021). Causal Factors Affecting Health Promoting Behaviors of Ramkhamhaeng University Personnel. Journal of The Royal Thai Army Nurses. Vol. 22 No.1 January - April 2021: 422-431. (in Thai)
Chunrum K., Chaichana B., Chaosuansreechroen K. (2016). Self-care of Patients with Type 2 Diabetes Mellitus: Development of Model Integration with AIC Technique (Sukhirin Hospital). The Southern College Network Journal of Nursing and Public Health. 3(3): 179-193. (in Thai)
Comrey, A. L., & Lee, H. B. (1992). A First Course in Factor Analysis (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum.
Department of Disease Control, Ministry of Public Health. (2021). Chronic Non-Communicable Diseases (NCD). (in Thai). Nonthaburi: Ministry of Public Health. (in Thai)
Department of Disease Control, Ministry of Public Health. (2022). Chronic Non-Communicable Diseases (NCD). (in Thai). Nonthaburi: Ministry of Public Health. (in Thai)
Ekman I, Swedberg K, Taft C, Lindseth A, Norberg A, Brink E, Carlsson J, Dahlin-Ivanoff S, Johansson IL, Kjellgren K, Lidén E. (2011). Person-centered care-ready for prime time. European journal of cardiovascular nursing. 10(4):248-51.
Horapleard S., Toontom N., Siwina S. (2019). Application of Self-care Behavior Promotion Program and Social Support For Diabetic Patients at Ban Khaotakhong Health Promoting Hospital, Kasetwisai District, Roi Et Province, Thailand. Academic Journal of Community Public Health. 5(2): 52-67. (in Thai)
Husserl, E. (1965). Philosophy as a rigorous science. In Phenomenology and the crisis of philosophy. New York: Harper and Row.
Kanfer, F. (1988). Self-management methods. In. Kanfer & A.P. Goldstein. (Eds.). Helping People Change: A Textbook of Methods. (3rdedition) (pp. 283-338). New York:
Pergamon.Kaewtem Y., Panchakhan N., Wannalai U., Foochuen Y., (2020). The Causal Model Affecting
Caring of the elderly with disabilities in Phichai Sub-district, Mueang, Lampang Province Research and Development Health System Journal. 13(3):42-51.
Kaewtem Y., Panchakhan N., Suntep W., Wongthida K., Nirattisai P. (2022). The Key Successand Failure Factors in Health Literacy to Reduce Salty Consumption Ban Pa HiangCommunity, Mueang District, Lampang Province. Academic Journal of Community PublicHealth. 13(3):28-44.
Kerdmongkol P., Amnatsatsue K., Rattanasoungthum P. (2017). Effect of a Case Management Program for Older People with Diabetic Retinopathy. Journal of Public Health Nursing 31(2): 1-10. (in Thai)
Khumkaew J. (2023). Self-Assessment of Primary Healthcare Service Delivery System at Family Medicine Clinics for Managing Non-Communicable Chronic Diseases in Municipal Districts. Regional Health Promotion Center 9 Journal, 17(3): 894-907. (in Thai)
Kogan, H.N., & Betrus, P.A. (1984). Self-management: a nursing mode of Therapeutic influence. Advance in Nursing Science, (7), 55-73.
Kosonjit R., Noimuenwa P. (2017). Effectiveness of Case Management in Patients with Diabetic Mellitus at Pak Phli Hospital, Nakhon Nayok Province. Nursing Journal. 44(1): 26-38. (in Thai)
Leutz WN. (1999). Five Laws for Integrating Medical and Social Services: Lessons from the United States and the United Kingdom. Milbank Q.
Likert, R. (1967). The method of constructing an attitude scale. In M. Fishbein (Ed.), Readings in attitude theory and measurement (pp. 90-95). New York: Wiley & Son.
Ministry of Public Health. (2016). Primary Care Cluster Guideline for Health Care Units. Ministry of Public Health. (in Thai)
Office of the Constitutional Court. (2017). Constitution of the Kingdom of Thailand B.E.2560 (2017). P. Press. Co. Ltd. s 258. (in Thai)
Paesuea S. (2015). Factors related to self-care behavior of patients with type 2 diabetes in urban community Bangkok. Master of Public Health Thesis Graduate School Mahidol University. (in Thai)
Paimoolpiam P., et al. (2023). Model Development to Improve Accessibility of Diabetes and Hypertension Patients with Participation of Community Network, Maesakorn Health Promoting Hospital, Wiang Sa District, Nan Province. Journal of Health Science. 25(3): 394-400. (in Thai)
Polit, D. F., & Beck, C. T. (2018). Essentials of Nursing Research: Appraising Evidence for Nursing Practice (9th ed.). Philadelphia: Lippincott, Williams & Wilkins.
Promdee A., Chaitrong T. (2020). Effectiveness of Case Management among Patients with Diabetes Mellitus in Primary Care Cluster at Mukdahan Hospital. Research and Development Health System Journal. 13(1): 292-299. (in Thai)
Promsuwan K. (2017). Factors related to health promotion behaviors of Nongmaikaen elderly club members, Chachoengsao Province. Dissertation, Chachoengsao: Rajabhat Rajanagarindra University. (in Thai)
Royal Thai Government Gazette. (2019). Primary Health System Act 2019. Retrieved 30 April 2019 from https://shorturl.at/DQU01. (in Thai)
Saengsinsorn P. (2021). A Study of Factors Related to Health Behavior of People at Risk of Diabetes and ypertension in Phichit Province. Phichit Public Health Research And Academic Journal. 2(2): 43-54. (in Thai)
Saraphi Provincial Health Office. (2020). Inspection and supervision of the Ministry of Public Health, Health Region 1. Chiang Mai. (in Thai)
Sattayasomboon T. & Sattayasomboon Y. (2020). Hypertension and type 2 Diabetes Mellitus Patients: A Systematic Review on the Chronic Care Model (CCM) and Self- Management Support (SMS). The Southern College Network Journal of Nursing and Public Health. 7(2), 232-243. (in Thai)
Srithamrongsawat S, Suriyawongpaisan P, Sornsriwichai W, Labbenjakul S, and Sriyakul D. (2020). Research project to develop an integrated and people-centered primary service system. Nonthaburi: Health Systems Research Institute (HSRI) (in Thai).
Starfield B. (2011). Is Patient-Centered Care the Same as Person-Focused care. Perm J.15(2):63–9.
Sukkawaspong S. (2019). Evaluation of the operation of Mueang Pak Chong primary care cluster. Reg 11 Med J, 33(1):73-89. (in Thai)
Taengsakha K., Maneesriwongul W., Putawatana P. (2019). Factors Related to Adherence to Treatment in Essential Hypertensive Patients with Early Renal Insufficiency. Rama Nurs J. 25(1): 87-101. (in Thai)
WannaKul, S. (2023). The Study of Age-Friendly Primary Health Care: Case Study of Primary Care Cluster, Ban Si Muat Klao Sub District Health Promoting Hospital, Mueang District, Lampang Province. Journal of Health Sciences Scholarship. 6(2), 43-65.
Wasi P. (2017). Thai Health System in the Decade. Nonthaburi: Office of the National Health Commission (NHO). (in Thai).
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