Factors Affecting Appointment Adherence Behavior among Patients with Chronic Non-Communicable Diseases at Bang Phriang Subdistrict Health Promoting Hospital, Bang Bo District, Samut Prakan Province

Abstract

This study aims to examine the levels of personal, health service system, family and social, environmental factors, appointment adherence behavior, and Factors Affecting Appointment Adherence Behavior among Patients with Chronic Non-Communicable Diseases at Bang Phriang Subdistrict Health Promoting Hospital, Bang Bo District, Samut Prakan Province. A cross-sectional survey design was employed. The sample consisted of 283 patients with chronic non-communicable diseases selected by stratified sampling. Data were collected using a questionnaire covering personal factors, health service system, family and
social factors, environmental factors, and appointment adherence behavior. The questionnaire demonstrated content validity with an index of item-objective congruence (IOC) of 1.00, and reliability coefficients for each subscale of 0.79, 0.73, 0.85, 0.87, and 0.80, respectively. Data were analyzed using descriptive statistics, Pearson’s correlation, and multiple regression analysis with the Enter method. The results showed that the participants had a mean age of 61 years, were predominantly female, older than 60 years, married, had primary education, worked in trading/own business or as general laborers, had an average monthly income of 5,000-14,999 Baht, and lived 1-4 kilometers from the health promoting hospital. Most had hypertension for 4–6 years and occasionally postponed their appointments. The related factors were all at the highest level, including environmental factors (Mean = 4.84, S.D. = 0.33), family and social factors (Mean = 4.77, S.D. = 0.34), health service system factors (Mean = 4.66, S.D. = 0.34), and personal factors (Mean = 4.56, S.D. = 0.34). Appointment adherence behavior was also at the highest level (Mean = 4.57, S.D. = 0.30). Health service system factors had the strongest positive influence on appointment adherence behavior (β = 0.57, P-value < .001). Family and social factors had a significantly negative influence (β = −0.24, P-value < .001), while environmental factors (β = 0.17, P-value < .05) and personal factors (β = 0.10, P-value < .05) had weaker positive influences. All variables together explained 41%
of the variance in appointment adherence behavior (R² = 0.41, F = 48.28, P-value < .001). These findings indicate that the health service system, particularly appointment scheduling and proactive patient follow-up, should be strengthened alongside promoting the roles of families and social networks in appropriately supporting appointment adherence, in order to enhance the long-term care of patients with chronic non-communicable diseases.