Development Practice Guideline of Hypertension Patients for Chronic Kidney Disease Prevention

Abstract

This participatory action research aimed to develop a guideline for hypertension care approaches following the concept of expanded chronic care. The study was organized into three phases: 1) situational analysis to inform planning, 2) implementation of the plan with observation, and 3) reflection on the outcomes. The study sample consisted of 10 public health personnel and 218 patients with stage 2 and 3 chronic kidney disease-caused hypertension. Research tools included a health behavior questionnaire (index of item objective congruence: IOC ranged .63 - 1.00, Alpha coefficient = .87) and focus group interviews (IOC ranged .63 - 1.00). Data were analyzed using qualitative content analysis and quantitative methods, including the t-test and Repeated Measurement ANCOVA.

The findings revealed that the care approach improved kidney filtration rates by 43.60% in some patients, while 49.50% maintained their baseline levels. This approach incorporated three key elements: 1) community engagement, 2) integrated healthcare services with a patient-centered focus, and 3) monitoring treatment outcomes through a database tracking health behavior and kidney filtration rates. Effective patient care strategies should involve data integration to inform all stakeholders enabling individualized health management. Continuous monitoring and care by specialized healthcare teams are recommended to sustain patient health.