Guideline of Care for Stroke Patients through Family and Community Participation in the North Region
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Abstract
This research and development study aimed to: 1) examine and analyze the current situation, problems, and needs in stroke patient care in the northern region of Thailand;
2) develop a stroke care guideline with the participation of families and communities in
the northern region; and 3) implement and evaluate the effectiveness of the developed stroke care guideline involving family and community participation. The study involved stroke patients, caregivers, healthcare personnel, and community leaders. The research instruments included: 1) focus group discussion and interview guides; 2) a stroke care guideline; 3) a stroke handbook; 4) a health promotion handbook based on the 3Es-2Ss principle; 5) an Activities of Daily Living (ADL) assessment form; 6) a stroke knowledge and care assessment form; 7) a stroke prevention behavior assessment form; and 8) a satisfaction survey. Qualitative data were analyzed using triangulation, while quantitative data were analyzed using descriptive statistics and the Wilcoxon Signed-Rank Test.
Research found that phase 1, the study found that home visit follow-ups were inconsistent, healthcare personnel lacked confidence in patient care, and community leaders were unaware of the situation, problems, and needs. There was no established coordination framework for data transfer or participation promotion. Phase 2, the developed stroke patient care approach consisted of patient admission, home visit follow-ups,healthcare service system and evaluation. Phase 3, after implementing the approach that patients showed a statistically significant improvement in their Activities of Daily Living (ADL) scores (p-value < .05). Caregivers demonstrated significantly higher knowledge of stroke and improved stroke prevention behaviors (p-value < .05). Healthcare personnel and community leaders had significantly increased knowledge of stroke (p-value < .05). Caregivers reported significantly higher satisfaction with the approach (p-value < .05).
Primary healthcare units should promote family and community involvement in patient care, enhance the knowledge and caregiving skills of healthcare personnel and community leaders and collaboratively assess the success of patient care.
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