การพัฒนาและประเมินผลแนวปฏิบัติในการประเมินสุขภาพผู้สูงอายุในแผนกผู้ป่วยนอก
Keywords:
การพัฒนาแนวปฏิบัติ, ผู้สูงอายุ, การประเมินสุขภาพ, การประเมินสุขภาพแบบองค์รวม, development guidelines, geriatric, health assessment, holistic health assessmentAbstract
Development and Evaluation of the Geriatric HealthAssessment Guideline For Outpatient Department
Objective: To develop and evaluate theutilization of aclinical practice guideline for assessing geriatric health inoutpatient department.
Design: Development research
Procedure: Twoprocesseswere conducted: 1) developing the clinical practice guideline, examining its content validity using a panel of 5 experts (CVI = 0.91) and inter-rater reliability (percentage of raters’ agreement = 95) and 2) implementing and evaluating the guideline by the 10 nurses and 30 elder patients.The users’ opinions on feasibility/ ease of the guideline, and satisfaction on adopting the guideline including its efficacy on making diagnosis for each elder’s health problems.Barriers and obstacles including suggestions on its utilization were analyzed using content analysis.
Results: The newly developed clinical practice guideline comprised 2 implementing steps: 1)health screening and 2) holistic health assessment. The feasibility/ ease of the guideline, and satisfaction on adopting the guideline were confirmed by all users. Only 2 nursesreported difficulty on social and spiritual assessment. The efficacy of using the guideline on making diagnosis was revealed that most elder participants (n=26) were diagnosed in all health dimensions (physical, psychological, social, and spiritual).
Recommendations: Theclinical practice guideline can be used for geriatric health assessment in outpatient department. However, a manual for making diagnosis on the elderly health should be provided in the guideline operation package. The further development of an information management system using digital technology is highly recommended for advancing the implementation of the clinical practice guideline.
References
1. United Nation. World population ageing [Internet].
2013 [cited 2012 Dec 20]. Available from: http://
www.un.org/en/development/desa/population/
publications/pdf/ageing/WorldPopulationAgeing
2013.pdf
2. National Statistical Offce. The elderly in Thailand
[Internet]. 2011 [cited 2012 Dec 20]. Available from:
http://service.nso.go.th/nso/nsopublish/themes/
fles/older_work.pdf
3. Tanmanuwat N. The elderly clinic, past, present and
future [Internet]. 2014 [cited 2014 Dec 17]. Available
from: http://slideplayer.in.th/slide/2215174
4. Prachuabmoh V. Situation of Thailand elder Thai.
1st ed. Bangkok: Phongpanitchareanphon;2011. p 1-96.
(In Thai).
5. Asssntachai P. Common health problems in the elderly
and prevention. 2nd ed. Bangkok: Union Creation;
2011. p. 1-12 (In Thai).
6. Thongcharoen V. Nursing science in the elderly.
1st ed. Bangkok: Faculty of Nursing Mahidol
University; 2011. p. 20-8 (In Thai).
7. Panyawong K, Pleuksuwan P. Learning document:
Holistic Health Care. Samut Songkhram: Learning
Institute for Everyone; 2012. p 6-7 (In Thai).
8. Jaroenjitkul CH. Spiritual: Caring [Internet]. 2006
[cited 2014 Oct 1]. Available from: http://www.
academic.hcu.ac.th/forum/board_posts.asp?FID=
33&UID
9. Sirapo-ngam Y. Assessing the health status of the
elderly in the research. Ramathibodi Nursing Journal
1996; 2(3): 58-63 (In Thai).
10. Danyutthasin CH. Principles of health assessment.
Phitsanulok: Naresuan University; 2009. (In Thai).
11. Thirawattananon Y, Kinkkaew P, Thantiwat S,
Kupitakkachron T. Check your health: Health Technology
Assessment and Policy Program. Nonthaburi:
Desamberry Press; 2014. p. 4-4 (In Thai).
12. Srithamma S. Screening and Assessing the Elderly.
Nonthaburi: WVO Offcer of printing mill; 2014.
(In Thai).
13. Elsawy B, Higgins EK. The geriatric assessment.
Am Fam Physician 2011; 83: 48-56.
14. Lilakunlasit S. Geriatric Services in Community Hospitals
Srisaket Province [Internet]. 2013 [cited 2016 Dec
18]. Available from: https://www.google.co.th
15. Kempen JA, Schers HJ, Jacobs A, et al. Development
of an instrument for the identifcation of frail older
people as a target population for integrated care. Br
J Gen Pract 2013; 63(608): 225-31.
16. Lambert S, Gardner L, Thomas V, Davies S. Assessing
older people with complex care needs using EASYCare, a pre-defned assessment tool. Research, Policy
and Planning 2007; 25(1): 43-56.Thai Journal of Nursing Council Vol. 32 No.3 July-September 2017 103
พัฒธมณฑ์ แก้วแสง และแสงอรุณ อิสระมาลัย
17. Vriesa JB, Staala CD, Ravensbergb JS, et al.
Outcomeinstruments to measure frailty: A systematic
review. Ageing Research Reviews 2011; 10:
104-14.
18. Spoorenberg S, Ronald JU, Berrie M, Berry PH, et al.
Embrace a model for integrated elderly care: study
protocol of a randomized controlled trial on the
effectiveness regarding patient outcomes, service use,
costs, and quality of care [Internet]. 2013 [cited 2015
Dec 18]. Available from: http://www.biomedcentral.com
19. National Health Security Offce. Long term care
[Internet]. 2016 [cited 2016 Jan 5]. Available
from: www.http.nhso.go.th
20. Department of Older Persons. The 2nd National Plan
on The Elderly [Internet]. 2002-2021 [cited 2014
Dec 18]. Available from: http://www.oppo.opp.
go.th /pages/law/law_15.html
21. National Health and Medical Research Council. A
guideline to the developmental Implementation and
evaluation of clinical practice guidelines [Internet].
1999 [cite 2015 July 27]. Available from: http://
www.nhmrc.gov.au
22. Rattanapathumwong P, Yooujaiyen M. Development
of clinical practice guidelines for pain management
among postoperative patients in the post – anesthesia
care unit in ranong hospital. Journal of Boromarajonani
College of Nursing 2014; 30(1): 86-99. (In Thai)
23. Department of Medical Services. Standard and Quality
Manual for the Elderly Clinic [Internet]. 2013 [cite
2013 Dec 15]. Available from: http://www.slideshare.
net/dmslibrary1/ss-32973208
24. Joanna Briggs Institute. JBI Levels of Evidence and
Grades of Recommendation 2014 [cite 2015 July 27].
Available from http://www.Joannabriggs.
25. Thongchai CH, Nantachaipan P. Survey on the use of
practice. Chaing Mai: Chaing Mai University; 2004.
(In Thai).
26. Weawwanjit D. The development and evaluation of
clinical nursing practice guideline for fever management
in patients with traumatic brain injury, Songklanakarind
Hospital, [Master of Nursing Science Thesis]. Songkhla:
Prince of Songkla University; 2011. (In Thai).
27. Atatanuchit S, Sae-Sia W, Songwathana P. Development
of Clinical Nursing Practice Guideline for Initial
Assessment among Multiple Injured Patients Admitted
in Trauma Units. Princess of Naradhiwas University
2010; 2(2): 16-28. (In Thai).
28. Thongchai CH. Clinical Practice Guidelines Development.
The Thai Journal of Nursing Council 2005; 20(2):
63-74. (In Thai).
29. Sanbudda T. Working experience of new graduated
nurses in a general hospital, [Master of Nursing Science
Thesis]. Bangkok: Chulalongkorn University; 2003.
(In Thai).
30. Pilaikiat R, Rittharomya J, Bootchan T. Spiritual Care
for Chronic Illness Patients: Experiences of Professional
Nurses. Thai Journal of Nursing Council 2009;
24(1): 62-76. (In Thai).
31. Sirisap P. Development and implementation of clinical
practice guidelines for fever management among
pediatric patients, [Master of Nursing Science Thesis].
Chaing Mai: Chaing Mai University; 2009. (In Thai).
32. Phomtong CH, Prechanond P, Pavavattananusorn S,
et al. Using an Evidence-Based Approach for Developing
Clinical Nursing Practice Guidelines for Breast
Cancer Patients Undergoing Surgery. Ramathibodi
Nursing Journal 2008; 14(1): 42-53. (In Thai).
33. Ketvatimart M, Phaonoi B, Peungtim P, Kittithan P.
Effectiveness of Pulmonary Rehabilitation Guidelines
Implementing for Patients with Chronic Obstructive
Pulmonary Disease in Saraburi Hospital. Nursing
Journal of the Ministry of Public Health 2012; 12:
49-62. (In Thai).
