THE DEVELOPMENT OF A CASE MANGEMENT MODEL FOR CARE COLLABORATION FROM A HOSPITAL TO A COMMUNITY FOR HYPERTENSION PATIENTS WITH CORONARY ARTERY DISEASE

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เพชรรัตน์ ทัดเทียม สุทธีพร มูลศาสตร์ กฤษณาพร ทิพย์กาญจนเรขา

Abstract

The purposes of this research and development were to: 1) study problems and needs of care for hypertension patients with coronary artery disease, 2) develop a case management model for care collaboration from hospital to community for hypertension patients with coronary artery disease, and 3) evaluate the developed case management model for care collaboration from hospital to community for hypertension patients with coronary artery disease.


The sample was justified according to the study phases. 1) Phase I: Study on problems and needs of care, the sample consisted of 22 hypertension patients with coronary artery disease and caregivers at Yang Chum Noi district, Sisaket province. 2) Phase II: Model development, 12 physicians and nurses were recruited. 3) Phase III: Evaluation on the effectiveness of model, 5 hypertension patients with coronary artery disease were recruited. The sample was selected using purposive sampling method. The research instruments comprised of: 1) a focus group guideline for investigating problems and needs of care, 2) a focus group guideline for model development, and 3) a self-management questionnaire that content validity indexes were .94 and Cronbach’s alpha coefficient was .82. Quantitative data was analyzed using descriptive statistics and Wilcoxon singed rank test. Content analysis was used to analyze qualitative data.


The findings were as follows. 1) Hypertension patients with coronary artery disease reported problems and needs of care in terms of physical, mental, spiritual, social aspects, and access to a healthcare service system. 2) The model comprised of the following issues. Hypertension patients with coronary artery disease were target group for case management. Professional nurses reported patients’ sign and symptoms of chest pain and/or uncontrolled blood pressure, non-adherence medication, living alone, or illiteracy to nursing managers. Nursing managers assessed the priority for needs of care for these patients before coordinating with a multidisciplinary team as well as community nurses, as a result, nurses could plan, conduct home visits, and evaluate. 3) After implementing case management model, self-management behavior scores of hypertension patients with coronary artery disease were significantly better than those scores before implementation (p <.05). The mean score of the arterial pressure was at the average level, and there was no significant difference between before and after implementation (p >.05).

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How to Cite
ทัดเทียมเ., มูลศาสตร์ส., & ทิพย์กาญจนเรขาก. (2018). THE DEVELOPMENT OF A CASE MANGEMENT MODEL FOR CARE COLLABORATION FROM A HOSPITAL TO A COMMUNITY FOR HYPERTENSION PATIENTS WITH CORONARY ARTERY DISEASE. Journal of Boromarajonani College of Nursing, Bangkok, 34(2), 1-12. Retrieved from https://www.tci-thaijo.org/index.php/bcnbangkok/article/view/150884
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บทความวิจัย