A blueprint for an extended family nursing model to enhance family caregivers’ abilities to care for homebound and bedridden patients from hospital to community: A systematic innovation synthesis of sequential research data
Keywords:
capability development, systematic innovation, family caregivers, dependent patients, Khon Kaen University family health nursing model extensionAbstract
Significance: Caring for homebound and bedridden patients with chronic illnesses is a significant global health challenge. Effective care for these dependent patients following hospital discharge requires the preparation and empowerment of family caregivers. This article presents the findings of synthesis of the blueprint for the Khon Kaen Family Health Nursing Extended Model (KKU-FHN Extended Model), which focuses on enhancing the competencies of bedridden patients’ caregivers in providing continuous care, both in hospital and community settings.
Research Methods: Qualitative data were collected from patients, caregivers, health personnel, and community leaders from July to December 2023. Case studies of bedridden patients in the northeastern region of Thailand were gathered from July 2021 to December 2022.
Findings: The synthesized blueprint consists of three strategic pillars: 1) assessing patient and caregiver problems and needs, 2) selecting appropriate family caregivers based on their capacity and readiness, and 3) continuous patient care training and demonstration, along with user-friendly knowledge manuals to empower caregivers with the necessary skills. These strategies can be implemented in healthcare facilities to prepare family caregivers before referring patients back to their families in the community. The approach fosters collaboration among families, communities, and healthcare providers while leveraging social capital for more effective care.
Conclusion: This extended version of the KKU Family Health Nursing Model will help improve the care of bedridden patients by developing the capabilities of family caregivers and creating connections between hospitals, communities, and families. This model has the potential to be adapted and applied in various contexts to improve the quality of life for patients and their families on a broader scale.
References
Institute for Health Metrics and Evaluation (IHME). Global burden of disease 2021 (GBD 2021) results [Internet]. Seattle: University of Washington; 2021 [updated 2024; cited 2025 Feb 2]. Available from: https://vizhub.healthdata.org/gbd-results/
Wangler J, Jansky M. Prerequisites for providing effective support to family caregivers within the primary care setting-results of a study series in Germany. BMC Fam Pract 2021;22(1):252.
Ahmad Zubaidi ZS, Ariffin F, Teoh Cy Oun C, Katiman D. Caregiver burden among informal caregivers in the largest specialized palliative care unit in Malaysia: a cross-sectional study. BMC Palliat Care 2020;19:186.
Lobo EH, Frølich A, Abdelrazek M, Rasmussen LJ, Grundy J, Livingston PM, et al. Information, involvement, self-care and support-the needs of caregivers of people with stroke: a grounded theory approach. PLoS One 2023;18(1):e0281198.
Utaisang A, Cheumnok W, Pomsakha N, Sakongnakhon N, Junsevg K, Dumrongpakapakorn P. Bedridden patients care through family caregiving and community-based model in new normal. J Royal Thai Army Nurses [internet]. 2023 Dec 10 [cited 2025 Feb 19];24(3):415-23. Available from: https://he01.tci-thaijo.org/index.php/JRTAN/article/view/264504 (in Thai)
Peachpunpisal C, Intarakamhang U, Sombatwattana P. Environmental health literacy: applying to practice via caregivers for bedridden patients. Journal of Phrapokklao Nursing College, Chanthaburi 2021;32(1):291–302. (in Thai)
Wray CM, Jones CD. Bridging the know-do gap in hospital care transitions. JAMA Intern Med 2023;183(5):424-5.
Rusch SC. Continuity of care: from hospital unit into home. Nurs Manage 1986 Dec;17(12):38-41.
Yang X, Li X, Jiang S, Yu X. Effects of telemedicine on informal caregivers of patients in palliative care: systematic review and meta-analysis. JMIR Mhealth Uhealth 2024;12:e54244.
Bekdemir A, Ilhan N. Predictors of caregiver burden in caregivers of bedridden patients. J Nurs Res 2019;27(3):e24.
Burgdorf JG, Wolff JL, Chase JA, Arbaje AI. Barriers and facilitators to family caregiver training during home health care: a multisite qualitative analysis. J Am Geriatr Soc 2022;70(5):1325-35.
Kim Y, Carver CS, Ting A. Family caregivers' unmet needs in long-term cancer survivorship. Semin Oncol Nurs 2019;35(4):380-3.
Longo UG, Matarese M, Arcangeli V, Alciati V, Candela V, Facchinetti G, et al. Family caregiver strain and challenges when caring for orthopedic patients: a systematic review. J Clin Med 2020;9(5):1497.
Schulz R, Sherwood PR. Physical and mental health effects of family caregiving. Am J Nurs 2008;108(9 Suppl):23-7.
Fox A, Sharp J, Fruhauf C. Exploring the association between family dynamics and preraredness for family caregiving at the end of life. Innov Aging 2022;6(Suppl 1):101.
Kayaalp A, Page KJ, Rospenda KM. Caregiver burden, work-family conflict, family-work conflict, and mental health of caregivers: a mediational longitudinal study. Work Stress 2021;35(3):217-40.
Tasseron-Dries PEM, Smaling HJA, Nakanishi M, Achterberg WP, van der Steen JT. What are best practices for involving family caregivers in interventions aimed at responsive behaviour stemming from unmet needs of people with dementia in nursing homes: a scoping review. BMJ Open 2023;13(12):e071804.
Chen Q, Zhang H, Yuan S, Liu W, Lyu T. Perceived training needs of the informal caregivers of older adults: a cross-sectional study. Healthcare (Basel) 2024;12(23):2369.
Hu C, Kung S, Rummans TA, Clark MM, Lapid MI. Reducing caregiver stress with internet-based interventions: a systematic review of open-label and randomized controlled trials. J Am Med Inf Assoc 2015;22(e1):e194–209.
Jongudomkarn D, Macduff C. Development of a family nursing model for prevention of cancer and other noncommunicable diseases through an appreciative inquiry. Asian Pacific journal of cancer prevention 2014;15(23):10367-74.
Jongudomkarn D, Chantawong N, Ratchachai L, Thumkaew W, Buakhao W. Construct validity of the Khon Kaen university family health needs and problems assessment tool (KKU FHeNPAT): case studies of the informal sector families in Isan. Journal of Nursing Science and Health 2010;33(1):22-32. (in Thai)
Jongudomkarn D, Klangsang K, Prapannpong P, Kotchompoo N, Jamsaeng S, Srikongphan S, et al. Reducing alcohol consumption in the community: application of family health nursing concepts in participatory research. Journal of Nursing Science and Health 2010;33(4):38-41. (in Thai)
Jongudomkarn D, Poonthong S, Pongsiri K, Newalisant P, Singhawara P, Chanchom K, et al. The experiences of practice according to the KKU family health nursing model for reducing alcohol drinking problems in communities: a qualitative study of the family health leaders. Journal of Nursing Science and Health 2013;36(3):81-94. (in Thai)
Jongudomkarn D, Baokhamphai Y, Chumphain C, Diowtrakool A, Panamhom M, Pheangkes S. Results of knowledge translation into action: application of the Khon Kaen university family health nursing model toward knowledge, attitudes in practices for prevention, caring, and rehabilitation of stroke. Journal of Nursing Science and Health 2013;36(2):9-24. (in Thai)
Jongudomkarn D, Prungkhamma P, Kaewprom Y, Khomkham S, Kensila U. The construct validity of Khon Kaen university family quality of life scale: an exploratory factor analysis. Journal of Nursing Science and Health 2011;34(1):38-49. (in Thai)
Jongudomkarn D, Chantawong N, Ratchachai L, Thumkaew W, Buakhao W. Structural Chatjuntek R, et al. Development of village health volunteers’ knowledge and skills in caring for diabetes patient and their families at Koksung sub–district, Nongki district, Buriram. Journal of Sakon Nakhon Hospital 2018;21(1):65-72. (in Thai)
Suwarno, Jongudomkarn D. Effect of a training program on the Use of the Khon Kaen University family health assessment tool on nurses’ perception in primary health service units in Bantul, Yogyakarta, Indonesia. Journal of nursing and health care. 2016;34(3):104-9. (in Thai)
World Health Organization. Family health nursing: context, conceptual framework and competencies. Geneva: WHO;2000.
Mooljunda T, Jongudomkarn D. Competency development as to perception of healthcare personnel in sub-district health promotion hospital, amphur Pathum Ratchwongsa, Amnat Charoen province in using the Khon Kaen university family health assessment tool. Journal of Sakon Nakhon Hospital 2018;21(2):88-101. (in Thai)
Sombathom W, Jongudomkarn D. Development of the abilities of registered nurses to use the KKU family health assessment tool in a health care services: the inpatient department, Ban Khwao hospital, Ban Khwao district, Chaiyaphum province. Journal of Sakon Nakhon Hospital 2018;21(1):113-22. (in Thai)
Wongpatimaporn W, Jongudomkarn D. Development of nurse competency in using the Khonkaen university family health assessment in the emergency department: a case study of stroke patients and families, Khonsawan Hospital, Khonsawan District, Chaiyaphum Province. Journal of Sakon Nakhon Hospital 2017;20(3):207-20. (in Thai)
Theelak S, Jongudomkarn D. Development of health personnel capacity in using the khon kaen university family health assessment: a case study at sub-district health Promoting Hospital, Waeng Yai District Health Office, Khon Kaen Province.
Journal of Sakon Nakhon Hospital 2017;20(1):33-43. (in Thai)
Krachangchit Y, Jongudomkarn D. Development of knowledge and skills of village health volunteers in caring for hypertension patients and their families in the community, Donmon Sub-district, Satuek District, Buriram Province. Journal of Sakon Nakhon Hospital 2017;20(1):54-67. (in Thai)
Denzin NK, Lincoln YS. The SAGE handbook of qualitative research. 4th ed. Thousand Oaks, CA: Sage;2011.
Dewar B, Mackay R. Appreciating and developing compassionate care in an acute hospital setting caring for older people. Int J Older People Nurs 2010;5:299-308.
Umar U, Purwanto M, Al Firdaus M. Research and development: as the primary alternative to educational research design frameworks. Journal of English Language and Literature [Internet]. 2023 Mar 2 [cited 2024 Oct 7];8(01):73-2. Available from: https://journal.stibaiec-jakarta.ac.id/ojs/index.php/jell/article/view/172
Cho J, Trent A. Validity in qualitative research. Qualitative Research 2006;6:319-40.
Bryman A. Social research methods. Oxford: Oxford University Press;2001.
Raksuthi S. Phaya (Isan). Bangkok: Thanawatch Karnpim; 2010. (in Thai)
Panpanit L, Jongudomkarn D, Doungmungkorn A, Boontoch K. Neelasmith S, Manorat M, et al. Implementing a care model for bedridden stroke survivors: a qualitative
study in Northeastern Thailand. Patient Preference and Adherence 2025:19;345–58.
Mamom J, Daovisan H. Listening to caregivers’ voices: the informal family caregiver burden of caring for chronically ill bedridden elderly patients. Int J Environ Res Public Health 2022;19(1):567.
Haley WE, Roth DL, Hovater M, Clay OJ. Long-term impact of stroke on family caregiver well-being: a population-based case-control study. Neurol 2015;84(13):1323-9.
Katsarou A, Intas G, Pierrakos G. Investigating the needs of caregivers of patients suffering from chronic diseases: a mixed-method study. Indian J Palliat Care 2023;29(3):285-91.
Schulz R, Eden J. Families caring for an aging America. Washington, DC: National Academies Press; 2016.
Adelman RD, Tmanova LL, Delgado D, Dion S, Lachs MS. Caregiver burden: a clinical review. JAMA 2014;311(10):1052-9.
Huang HL, Liao YT, Kung PC, Shyu YIL, Hsu WC, Hsu JL. Caregiving management needs and predictors for family caregivers of persons with dementia: a cross-sectional study. BMC Geriatrics 2024;24(1):724.
Gasperini G, Renzi E, Longobucco Y, Cianciulli A, Rosso A, Marzuillo C, et al. State of the art on family and community health nursing international theories, Models and frameworks: a scoping review. Healthcare (Basel, Switzerland) 2023;11(18):2578.
Sasso L, Passarelli M, Manganello F, Alvino S, Dagnino FM, Mazzarino B, et al. Development of a European curriculum for family and community nurses. NY: SpringerLink; 2021.
National Health Security Office. Press release on the “warm community nursing clinic” establishing to serve as a primary healthcare service unit [Internet]. Nontaburi: National Health Security Office;2023 [updated 2023 May 28; cited 2024 Feb 15]. Available from: https://www.nhso.go.th/news/4022 (in Thai)
Thailand Nursing and Midwifery Council. Press release on the “warm community nursing clinic” in collaboration with NHSO establishing to serve as a primary healthcare unit [Internet]. Nontaburi: Thailand Nursing and Midwifery Council;2023 [updated 2023 May 28; cited 2024 Feb 16]. Available from: https://www.tnmc.or.th/news/407 (in Thai)
Lakanmaa RL, Suominen T, Perttilä J, Puukka P, Leino-Kilpi H. Competence requirements in intensive and critical care nursing-still in need of definition? A delphi study. Intensive & critical care nursing 2012;28(6):329-36.
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