The Development of the Health Behavior Care Model among HIV/AIDS Patients who received Anti-HIV Drug at Outpatient Department of Nakhon Phanom Hospital

Abstract

Objective : To develop the health behavior care model among HIV/AIDS patients who received anti-HIV drug at Outpatient department of Nakhon Phanom Hospital

Materials and methods : This action research applied the PCDA concept to study the development of the health behavior care model among 30 HIV/AIDS patients who received anti-HIV drug at outpatient department of Nakhon Phanom Hospital between December 2018 and March 2019. There were 4 steps including Step 1) Plan (P) by studying and collecting the information on the situation of HIV/AIDS patients who received anti-HIV drug at outpatient department, designed the health behavior care model using the “Group Dynamics” including group discussion, in-depth interview, participating observation, and social support. Moreover, the questionnaire on knowledge, practicing in self-healthcare and self-esteem measurement test were created. Step 2) Do (D) by developing the health behavior care model using the group dynamics and social support. There were many activities such as education, group exchanges, about AIDS, HIV treatment by anti-HIV drug, drug adherence, CD4 ,Viral Load, training on exercise skill, stress relief, individual and family counselling, self-help group of HIV infected patients, social support in both inside and outside the hospital during 2 months period. Step 3) Check (C) by measuring the outcome of the development of the health behavior care model and Step 4) Act (A), by evaluating the outputs of the implemented of new health behavior care model then adjusting and developing the model using all obstacles from the group dynamic concept. Besides, to do the pretest and posttest to compare the knowledge, practicing in self-healthcare, and self-esteem measurement before and after the development. Evaluated the anti-HIV drug adherences. The questionnaire’s content were analyzed by 3 experts, the validation of KR – 20 at 0.72 (Knowledge). For the questionnaire on the practice and self-esteem were Conbrach’s alpha coefficient at 0.71 and 0.70, respectively. Quantitative data were analyzed by frequency, mean, and percentage including the follow-up of anti-HIV drug adherence and comparison of mean of knowledge, practice and self-esteem before and after development using Paired t-test whereas qualitative date were analyzed using the content analysis from the group discussion, in-depth interview and participating observation

Results : Patients were mostly female, age ≥ 41 year old (70.67%), marriage status (73.33%), education in primary school (83.33%), agriculturist (56.67%), average income in 1,001-5,000 THB (80%), single family (66.67%). They were family member in 53.33%, while their couple were the family supporter (56.67%). They mostly living outside the municipality area (80%). From using the developed of the health behavior care model among HIV/AIDS patients found that the self-healthcare behaviors were appropriately improvement, avoiding the narcotics, tobacco, alcohol, safe sex, disciplined on anti-HIV drug consumption and taking anti-HIV drug adherence 100% and 96.67%, respectively. Patients had higher average score on knowledge, practice, and self-esteem statistically significant than prior study implementation (p < .05)

Conclusion : The health behavior care model of HIV/AIDS patients who received the anti-HIV by using the group dynamics and social support could induced the patients to have a good discipline on anti-HIV consumption, high anti-HIV drug adherence, and effectively of their self-healthcare.