Development of a community-based care model for patients with pulmonary tuberculosis through a healthcare network of Khlongthom District, Krabi Province

Abstract

This action research aimed to develop a community-based care model for patients with pulmonary tuberculosis through the Khlong Thom District Health Network, Krabi Province. The target group consists of 80 participants, including 13 patients newly diagnosed with pulmonary tuberculosis, 13 caregivers, 30 community health network members, and 24 individuals responsible for tuberculosis-related work at all levels. Data collection included both quantitative and qualitative approaches using tests, questionnaires, interviews, observations, and activity record forms. The data were analyzed using descriptive statistics. Pre- and post-development comparisons were conducted using a paired t-test at a statistical significance level of .05. Qualitative data were analyzed using content analysis. The study was conducted during October 2024 and July 2025.

The study found that most patients with pulmonary tuberculosis experienced difficulties in self-care, particularly missing appointments for medication and taking medications inconsistently. Health service units did not provide comprehensive home visits to patients and lacked supervision of patients’ medication adherence. The development of a community-based care model for patients with pulmonary tuberculosis by the health network in Khlong Thom District, Krabi Province, consisted of four stages: (1) Preparation phase, analyzing problems related to tuberculosis patient care in the community; (2) Implementation phase, which included (2.1) planning, (2.2) implementing the plan, (2.3) observation, and (2.4) reflection; and (3) Evaluation phase. The findings revealed that the community-based tuberculosis care model developed in Khlong Thom District consisted of service provision, coordination of information referral, and continuous follow-up care by mentors supervising medication adherence and home visits. The outcomes demonstrated that patients’ knowledge and self-care behaviors significantly improved after the implementation of the model (p-value<.05). Regarding clinical outcomes, the treatment success rate was 100%, and the rate of mentors supervising medication adherence was achieved at 100%.