Abstract
This action research aimed to develop the community-based cardiac rehabilitation (CR) model for patients with post myocardial infarction, Muang Roi-Et district, Roi-Et province. Participants consisted of post myocardial infarction patients, caregivers, community leaders, stakeholders, and multidisciplinary teams. The study processes followed three phases: 1) situational analysis 2) development and 3) evaluation. Research instruments included in-depth interview questions, questions for a focused group discussion, field note record, after action review record form, readmission record form, six-minute walk test record form, questionnaires of Duke Activity Status Index, questionnaires of Thai Depression Inventory, and questionnaires of The Revised Illness Perception. The data were analyzed using percentage, mean, standard deviation, logistic regression analysis, one way repeated measure ANOVA, inductive content analysis and deductive content analysis. Results: 1) Readmission rate was found at 35.8%. Needs for the development were identified in five dimensions: community participation in the CR, promoting the self-efficacy of patients in the CR, enhancing the capacity of a caregiver network in the community, continuing care, and care coordination between hospital and community 2) the development process consisted of four steps: building awareness and the development needs, building up caring and managing team, a pilot study for the development in a health-promoting hospital model, and expanding networks for the CR in community to other health-promoting hospitals 3) outcomes of the development were as follows. The care network in community, environments and facilities, guidelines, and innovations that contributed to the CR were improved. Health outcome of the patients were improved including (a) the readmission rate in four months decreased from 35.8% to 10% (b) After hospital discharge in 1 week, 1 months, and 4 months, the six-minute walk test and the illness perception scores were significantly differences (F=51.458, p<.001; F=27.092, p<.001, respectively). 100% of patients had an improvement in functional status outcomes, and no patients had depression. The results indicate that the developed model contributes to improving the CR resulting in patients’ better health
