Developing and Feasibility testing of Practice Guideline for Surveillance of Stroke in community, Panomthuan district, Kanchanaburi province

Abstract

The morbidity and mortality rates of Stroke have consecutively risen worldwide, including Thailand. It is recognized that community engagement played a significant role for an effective Stroke surveillance. This mixed-method study aimed to develop and examine the feasibility of practice guidelines for the surveillance of Stroke in a community. This study consisted of 3 phases. First, the guideline was developed by the researcher, applying the model of community health engagement. The 8 steps of practice guideline were (1) ice-braking, (2) informing objectives, (3) reporting individual health-related data, (4) returning community risk assessment, (5) conducting a group discussion, (6) obtaining permission, (7) selecting a representative of Stroke, and (8) summarizing and making appointments. Second, a total of fifty-four subjects, who met the inclusion criteria were systematically randomized to engage in the practice guidelines for the surveillance of Stroke. Knowledge, attitude, behaviors related to Stroke, Thai CVD risk score, and satisfaction of engagement in the program were assessed by the researcher using questionnaires before and after implementation. Third, the feasibility of using the guideline was collected from 10 subjects who voluntarily joined a focus group discussion.

According to t-test analysis, knowledge, attitude, stroke risk behavior, and Thai CVD risk scores of those subjects after participation in the practice guidelines for the surveillance of Stroke were significantly improved than before participation (p<.001).  In addition, it showed that overall satisfaction of samples joining in the program was very good (mean=4.53, SD=0.54). The qualitative results showed that most subjects agreed that this guideline was feasible to help people monitor and surveillance Stroke. They also stated that all people in the community should be invited to participate in the program, and the engagement of community leaders played a significant role in the achievement of the program.

Overall, this practice guideline was feasible to improve knowledge, attitudes, and behaviors by monitoring and surveillance by the community.  However, some content and activities should be varied to tailor to the context of different communities before delivering to people effectively.

Key Words: Practice Guideline/ Surveillance/ Stroke/ Community