การพัฒนารูปแบบการพยาบาลหญิงตั้งครรภ์ที่มีภาวะความดันโลหิตสูงโดยใช้การจัดการผู้ป่วยรายกรณีร่วมกับการสนับสนุนทางสังคม Development of a Nursing Care Model based on Case Management and Social Support on Pregnant Women with Pregnancy Induce Hypertension

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พรศิริ เสนธิริ สุดใจ ศรีสงค์ ศิริรัตน์ อินทรเกษม รัศมีแข พรหมประกาย ขวัญฤดี โกพลรัตน์

Abstract

This action research aimed to develop and investigate the developed of a nursing care model based on case management and social support on pregnant women with pregnancy induce hypertension at Antenatal Care Clinic (ANC), Nakhonphanom hospital. The subjects were 60 pregnant women with pregnancy induce hypertension, 60 family participants and 30 nurses. The development process had been performed from February 2016 to August 2017, it had been included three steps; 1) situation analysis to identify problem, 2) developing the nursing care model for pregnant women with pregnancy induce hypertension, and 3) evaluation. Quantitative data were analyzed by descriptive statistics (frequencies, percentages, means and standard deviation) and inferential statistic (paired t-test). Qualitative data were examined by content analysis.


             The results of this study showed that, the care model composed of 5 elements, 1) structure of multidisciplinary team and responsibilities, 2) clinical practice guideline, clinical nursing practice guideline and 3) case manager 4) social support 5) continuing care by telephone visit and home visit. After the nursing care model was implemented the result show that, the mean score of knowledge, self-efficacy were significantly higher than the score before development (t = 15.93, p < 0.001) and (t = 35.05, p < 0.001). Systolic blood pressure and diastolic blood pressure after 4 weeks and 8 weeks lower than before development (t = 8.98, p < 0.001; t = 6.01, p < 0.001) and  (t = 14.12, p < 0.001; t = 17.93, p < 0.001) respectively. The absence of appointment rate was 5 percent and the rate of visit was 100 percent.


               According to the findings, the nursing care model based on case management and social support on pregnant women with pregnancy induce hypertension is the effective care model to provide a quality of care.

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