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Developing an Integrated Care Model for Diabetic Patients of Borabue CUP in Mahasarakham Province

สุรพงษ์ ชาวงษ์; Suraphong Chawong; สงัด เชื้อลิ้นฟ้า; Sangud Chualinfa; ระเบียบ วัฒนดตรีภพ; Rabeab Wattanatripob; จริยา แวงวรรณ; Jareeya Wangwan; สุภาพ บุญสา; Supap Bunsa; ทิพวรรณ มุ่งหมาย; Tipavan Mungmay;
Date: 2550
Abstract
Diabetes is a lifelong chronic illness. Effective diabetes treatment has to adjust patients’ behaviors by integrating the care techniques of the health team and service science. This study is aimed at developing an integrated care model for diabetes patients and developing diabetes patients’ potential. The study population consisted of 204 diabetes patients of all kinds, selected by using the purposive sampling technique, in the two tambon service area of the primary care unit of Borabue Hospital. The study was a research and development model. Before developing it, data were collected for assessing problem conditions as a supplement to planning. Development was divided into two rounds of six months each. Round 1 assessed the period before development, and then the model was improved so that it would be appropriate for operating in the next round. Round 2 assessed operations based on the developed and improved model from Round 1, compared the operational outcomes with Round 1, and further developed the model for more appropriateness. Then the study results were concluded. The instruments used for collecting data were: 1) patient records, 2) a patient data-recording form comprising personal data, body mass index, complications (diseases), and values of sugar in the blood, HbA1c, 3) an interview form on knowledge, attitude, and self-behavior to control diabetes, and a questionnaire on patient stress using the GHQ-28 questionnaire; and 4) a guideline for an in-depth interview. Data were comparatively analyzed using paired t-test, independent t-test, 95% confidence interval, and content analysis. For development outcomes in Round 1, the following were found. The developed integrated care model for diabetic patients covered the dimension of service provision at the hospital and at family/community levels, the dimension of the interdisciplinary team of service provision practitioners at the hospital and at the family/community levels, and the dimension of the services provided using the science of modern medicine and the science of alternative medicine in these five aspects: physical, mental and emotional, intellectual, social, and environmental. The assessment outcomes after development in Round 1 were as follows. The diabetic patients had statistically significant higher knowledge of diabetes, attitudes toward diabetes, and diabetes control behaviors (p < 0.05); the mean of stress decreased statistically and significantly (p = 0.002); sugar in the blood of both the female and male diabetic patients statistically and significantly decreased (p < 0.05); and the HbA1c mean after development in Round 1 was 7.84 per cent (SD=1.49). From in-depth interviews with patients in a group with well-controllable diabetes and in a group with not-well-controlled diabetes, it was found that their beliefs were different with regard to correct healing and self-adjustment so that they would still have joy despite their diabetic ailment. Development in the next round had to create confidence in healing and self-care of the patients. The interdisciplinary team, in providing services at the clinic and at the family/community levels, had to foster correct behaviors according to the normal way of life, together with increasing the potential for caring for diabetic patients by the interdisciplinary team.
Copyright ผลงานวิชาการเหล่านี้เป็นลิขสิทธิ์ของสถาบันวิจัยระบบสาธารณสุข หากมีการนำไปใช้อ้างอิง โปรดอ้างถึงสถาบันวิจัยระบบสาธารณสุข ในฐานะเจ้าของลิขสิทธิ์ตามพระราชบัญญัติสงวนลิขสิทธิ์สำหรับการนำงานวิจัยไปใช้ประโยชน์ในเชิงพาณิชย์
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