Factors Affecting Self-Care Behaviors People in Rural Thai Community: An Experience from Lower Northern Thailand

Abstract

The Predictive Correlational Research aimed 1) to study the situation and problems related to the system for promoting, preventing, treatment and rehabilitation for health-related behaviors of people in rural communities in BanTak District, Tak Province; 2) to study the self-care behaviors of people in rural communities in BanTak District, Tak Province. And 3) to study the predictive factors of self-care behaviors of people in rural communities in Tak District, Tak Province. Based on Orem self-care theory and Green’s PRECEDE Framework were utilized for a conceptual framework. Mixed methodology was used combining quantitative method and qualitative method. A self-care behaviors questionnaire was developed with eating, exercising, medication adherence, and stress management. The qualitative sample consisted of 30 members of multidisciplinary teams working with non-communicable disease patients. Participants were selected using purposive sampling and interviewed in-depth. The quantitative sample consisted of 200 people aged 18 years and older, who were randomly selected. Data were collected using a self-care behavior questionnaire.

The qualitative findings revealed four main issues related to the system for promoting, preventing, treating, and rehabilitation health-related behaviors of people in rural communities in Tak District, Tak Province as follows; 1) Screening, identification, and management of at-risk and new patients, 2) Non-communicable disease prevention, treatment, and rehabilitation systems 3) Participation and capacity building of networks and 4) Use of digital health. The quantitative findings revealed that self-care behaviors, overall and in terms of diet, exercise, stress management, and medication-taking, were at a moderate level. The leading factors (knowledge and attitudes), enabling factors (access to health care), and reinforcing factors (social networks and support) were all significantly associated with self-care behaviors (p < .05). The factor that could best predict self-care behaviors related to chronic diseases was access to health care, followed by age, smoking behavior, and social networks (p < .05). The amount of variance explained was 35.19% (R2 = .3219, p < .05). The findings suggest that there should be a focus on promoting both knowledge and attitudes about self-care related to non-communicable diseases. This should be done through clear, targeted, and timely interprofessional work. The factors that were predictive of behavior in this study should be considered in conjunction with other variables, taking into account the context of both providers and recipients, in order to create effective support for self-care.