Model of Self-Management Support for Intermediate Care and caregiver in the community Yangsisurat District, Mahasarakham Province

Abstract

The purpose of this research was to develop and evaluate a self-management support for Intermediate Care and caregiver in the community. Study period research October 2021 - September 2022.It consists of 3 steps: Step 1 Study the problem, Step 2 Development of self-management support model, and Step 3 Evaluation of the use of the model using the concept Self - management. Research tools are: 1) Instrument used in the experiment; Consists of a self-management support model manual, a professional nurse's self-management support plan, and a self-management health plan the content validity was verified with a CVI of 0.86. 2)The tools used to collect information; Interview/conversation group, ADL, INHOME-SSS, 2Q and 9Q, self-management behavior, self-management skills, self-management skills. Quantitative data were analyzed by descriptive statistics. Qualitative data were analyzed by content analysis.

The results of research is the Intermediate Care patient self-management support model in the community will be a follow-up visit to the patient 4 times within 1 month. Thereafter, a follow-up visit was once a month for 6 months. The activities are as follows: Activity 1 Assess symptoms and look for risks or health problems, Activity 2 Solve problems and support self-management of health, Activity 3 Monitor and evaluate the results of self-health management. Results found; after development Community nurses had a high level of knowledge, Have a high level of attitude, Patients and relatives had a high level of self-management skills ( = 4.21, SD = 0.43).No complications were found in Intermediate Care patients such as urinary tract infections, pressure sores, depression, and no Readmit patients. From follow-up assessment of ADL at the end of 6 months, it was found that all patients had an increase in ADL scores, with ADL score =16-20 (94.29%) and ADL score =11-15 (5.71%).