A situational analysis: A care for patients with chronic diseases and renal complications in the Urban community

Abstract

This action research study is part of the development of a care system for patients with chronic diseases and kidney disease in the primary care unit of Khon Kaen Municipality using action research approach. This article was in the planning stage of its study. Fifty- seven informants were selected by using purposive sampling. Semi-structured in-depth interviews were conducted in 1) chronically ill patients with complications of stage 3 chronic kidney disease; 2) family members, who were primary caregivers; 3) multidisciplinary teams; and 4) health care unit administrators. focus groups were carried out with public health volunteers, community leaders, and health insurance fund administrators. Research instruments were verified and obtained content validity index at 0.85, 0.85, 0.83, 0.83, and 0.85, respectively. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed using content analysis.

The study findings revealed that main issues were: 1) ineffective self-management knowledge and skills; 2) inefficient service system and health service models; 3) inadequate decision support; 4) lack of systematic use of information; 5) not cover health promoting community public policies; 6) inadequate health-friendly environment; 7) unsuccessful community empowerment.

Proper care of patients with chronic disease and renal complications in urban areas, therefore, required 1) policy support at all levels; 2) work systems, operational guidelines and defined responsibilities of care participants; as well as 3) physical and social health environment that supports caring and learning. Thus, community nurses should use the information in planning of care and treatment for chronic ill patients with renal complication in order to improve their quality of life.