Development of Transitional Care Program for Older Adults Person with Pulmonary Tuberculosis from Hospital to Home Care

Abstract

Purpose : To development of transitional care program of pulmonary tuberculosis older adults during transition period from hospital to home care.

Study Design : Action Research

Materials and Methods : The Implementation in Three phases, Planning and Preparatory phase, situation analysis by reviewing medical records of pulmonary tuberculosis patients registered at Maha Sarakham Hospital from January 2018 to December 2020. 1,162 of cases established a research team to develop the transitional care program with evidence based and improvement use. Implementation phase, Implementing and put the transitional care program into practice. Evaluation phase, Evaluation by using in-depth interview, group discussion, health status record form, and quantitative data were analyzed by descriptive statistics, percentage, qualitative data were analyzed by content analysis.

Main finding : 1) From situation analysis found that should be encourage TB persons have more self-esteem and focus on importance of treatment to the accomplishments and provide caregivers evident care guidelines supported. The team needs a clear approach to supervision. And develop a care program to improve. (1) The assessment of pulmonary tuberculosis older adult’s self-care. (2) The self-care preparation of pulmonary tuberculosis older adult and their caregivers. (3) Using ancillary roles to support continuing care after discharged from hospital. 2) Implementation phase, applying the program to pulmonary tuberculosis older adults. 3) The evaluation phase, found that from sample group who participated the transitional care program, 16 cases were males(50.00%) equals to females average age of 71 years (SD=6.58). In 8 cases mostly were unemployed (50.00%), 13 cases(81.25%) were fully recovered, 3 cases(18.75%) with a tendency to improve and continued treatment.(due to the change in the drug regimen, the treatment period must be extended) The Comparison of QOL level scores after joining the transitional care program Mdn(IQR)=3.15(0.17) higher than before Mdn(IQR)=3.03(0.12)

Conclusion and recommendations :  As a result, shown that the target group has a treatment achievement increasing. Therefore, All of the relevant organizations should bring the transitional care program be used to further develop advanced nursing outcomes.