Development of a Nursing Care Model for Patients with Chronic Kidney Disease Stage 3 - 4 at Nopparat Rajathanee Hospital
Keywords:
Nursing care model, Chronic kidney disease stages 3 - 4, Health literacyAbstract
This research and development study aimed to develop and evaluate outcomes of a nursing care model for patients with chronic kidney disease (CKD) stages 3 - 4. The study was conducted in four phases: 1) situational analysis, 2) nursing care model development, 3) pilot study, and 4) implementation and outcome evaluation. Participants comprised 303 registered nurses and 106 patients with CKD stages 3 - 4. Research instruments consisted of the “STOP-CKD Model”, questionnaires, and assessment tools, totaling seven sets. Content validity indices ranged from .83 to 1.00, and reliability coefficients ranged from .78 to .88. Data were analysed using descriptive statistics, the chi-square test, t-test, Wilcoxon signed-rank test, Fisher’s exact test, and repeated measures ANOVA.
The research findings revealed that the developed STOP-CKD Model was theoretically appropriate and practically implementable. Following implementation of the nursing care model, registered nurses showed a significantly increased knowledge (Z = -14.252, p-value < .001). There was a significant difference in eGFR changes over time between the two groups (F = 14.812, p-value < .001). The experimental group had higher eGFR values than the control group, particularly at the 2-month follow-up (MD = 11.694, 95%CI [6.020, 17.368], p-value < .001) and 3-month follow-up (MD = 18.983, 95%CI [12.917, 25.048], p-value < .001). The findings demonstrate that the developed nursing care model can serve as a guideline for nurses in caring for patients with CKD stages 3 - 4 to preserve kidney function and improve clinical outcomes.
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