Development of care models for HIV/AIDS patients in Ruamnamjai Clinic Phlabplachai Hospital Buriram

Abstract

Purposes: To examine the existing problems and contextual factors, to develop and refine service procedures and processes, and to evaluate the outcomes of care for people living with HIV and patients with AIDS at Ruam Namjai Clinic, Phlabplachai Hospital, Buriram Province.

Study design: Participatory Action Research : PAR.

Materials and Methods: This study was conducted among 175 individuals living with HIV and patients with AIDS who received care during the fiscal year 2024 at the Ruam Namjai Clinic, Phlabplachai Hospital, as well as 12 members of the Clinical Patient Care Quality Improvement Team at the same hospital. Data collection was carried out between May 30, 2025, and September 30, 2025.The research instruments consisted of a structured questionnaire and an in-depth interview guide. The questionnaire demonstrated high internal consistency reliability, with a Cronbach’s alpha coefficient of 0.96. Data were analyzed using both descriptive and inferential statistics, with the level of statistical significance set at .05.

Main findings: (1) Problem Situation and Context Related to the Care of People Living with HIV. The existing problems and contextual factors related to the care of people living with HIV include poor medication adherence, irregular follow-up visits for medication refills, limited and overcrowded physical facilities, and the absence of a standardized service delivery system. (2) Model of Care for People Living with HIV and AIDS at the Ruam Namjai Clinic. The model of care for people living with HIV and AIDS at the Ruam Namjai Clinic consists of three main steps: history taking, opportunistic infection (OI) assessment, physical examination, and ordering of chest X-ray (CXR) and basic laboratory investigations; consultation with physicians or nurses, provision of health education, and participation in group activities; and consultation with pharmacists, nurses, or peer leaders to provide counseling on medication adherence and self-care practices, followed by scheduling the next appointment. Following the development and improvement of this care model, several service procedures were updated and modernized. The results indicated that nurses demonstrated a high level of compliance with the nursing practices according to the developed model. Additionally, the clinical patient care quality improvement team reported a high level of satisfaction with the implementation of the model. When comparing satisfaction levels before and after the model development, both patients and members of the clinical care quality improvement team showed increased levels of satisfaction.

Conclusion and Recommendations:  The innovation developed from this research has been demonstrated to effectively enhance medication management efficiency, reduce redundant procedures, and concretely overcome limitations related to physical space. With a high level of adherence to the guidelines among healthcare personnel and an excellent level of satisfaction among service recipients, this model represents a valuable approach that should be expanded to other hospitals and integrated as a standard policy at the organizational level.