The Development of Continuing Nursing Model in Pemphigus Patients at the Institute of Dermatology

Authors

  • Somjai Chantavoraluk, B.N.S., M.Sc. สถาบันโรคผิวหนัง
  • Inglada Sripoka, B.N.S. สถาบันโรคผิวหนัง
  • Pantip Yimwadsana, B.N.S. สถาบันโรคผิวหนัง
  • Chintana Pakeenet, B.N.S. สถาบันโรคผิวหนัง
  • Chinmanat Lekhavat, M.D. สถาบันโรคผิวหนัง

Keywords:

Continuity care, Nursing care, Pemphigus patient, Model development

Abstract

Background : Pemphigus is a chronic autoimmune blistering skin disease. The severity degree of the disease can be varied, affecting the quality of life and even death from its complications such as infections, and the use of immunosuppressants. Patients need to receive continued care from hospital to home to avoid possible complications.

Objective : To develop and study the results of a continuing nursing model in pemphigus patients.

Methods : This was a research and development study. The data were collected on 17 professional nurses and 68 patients (8 patients with moderate disease severity or worse and 60 patients with mild diseases severity) at the Institute of Dermatology. We analyzed the problems and developed a nursing model for continuing care in pemphigus patients. The data were analyzed through content analysis. Wilcoxon signed-rank test and Paired t-test were used to compare the differences between pre and post processing of the continuing nursing model.

Results : The nursing model for continuing care of pemphigus diseases was developed to address 1) Nursing practice guideline 2) Discharge planning program 3) Health education plan 4) Pemphigus Patient’s identification book 5) Assigning nurses to monitor patients at home by phone 6) Exchanging information about patient problems between the inpatient ward and the vesiculobullous clinic. The professional nurses had a statistically higher knowledge than before implementing the model (p<0.05). Mean nurses’ operation following the nurse care model was 86.42%, and nurse satisfaction was at the highest level. The patients with all disease severity levels had significantly higher mean score of self-care knowledge (p<0.05). Patients with mild disease severity had a significantly higher mean score in care behavior (p<0.05) although there was no statistically significant difference between before and after model in patients with moderate and more disease severity (p>0.05). Patient satisfaction was at the highest level in all severity group after the model was used. The re-visit rates reduced from 5.96% to 1.67% in the mild disease severity group, while the readmission rates reduced from 4.33% to 0% in the moderate and more disease severity group.

Conclusion : The development of continuity nursing model in pemphigus could support the professional nurses’ practice in continuing care. Educated patients were able to take care of themselves, resulting in a significant reduction in complications and the revisit and readmission rates.

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References

Payne AS, Stanley JR, Pemphigus. In: Goldsmith LA, Katz SI,Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors.Fitzpatrick’s dermatology in general medicine. 8th ed. New York: McGraw-hill Medical; 2012.

Sanjir Grover. Scoring system in pemphigus. Indian J Dermatol2011; 56: 145-9.

Phisarnbutr P. Vesiculobullous Disease. In: Kunlavanich P,Phisarnbutr P, editors Dermatology 2010.1st ed.Bangkok: Holistic Publishing Company Limited; 2548.

Sung JY, Roh MR, Kim Sc. Quality of life assessment in Korean patients with pemphigus. Ann Dermatol 2015;27:492-8.

Krain RL, Kushner CJ, Tarazi M, Gaffney RG, Yeguez AC, Zamalin DE, et al. Assessing the correlation between disease severity indices and quality of life measurement tools in pemphigus.Front Immunol2019; 10:2571.

Medical records and statistics, Institute of dermatology Patient Statistics Summary 2016-2018.

Quality Development Division Institute of dermatology Quality Indicators 2016-2018.

Department of Financial and accounting Institute of Dermatology Pemphigus Patients Cost 2015-2016.

Kullavanijaya P, National Dermatology Committee of Thailand,March 26, 2018; Queen sirikit national institute of child health.Bangkok Thailand; 2019.

Tresukosol P, Indicator of institute of dermatology. Supervision of department of medical services, Queen sirikit national institute of child health. Bangkok Thailand; September 3; 2019.

Nasongkhla P, Kwangsukstid O. A Comparition of prednisolone plus oral azathioprine or oral cyclophosphamide versus prednisolone for the treatment of mild pemphigus. Thai J Dermatal2011; 4: 273-83.

Piamphongsant T. Treatment of pemphigus with corticosteroids and cyclophosphamide. J Dermatol1979 ;6:359-63.

Haggerty JL, Roberqe D, Freeman GK, Beaulieu C, Breton M.Validation of a generic measure of continuity of care: when patients encounter several clinicians. Ann Fam Med 2012; 10:443–51.

Teeranut A. Sangsom D. Metakarnjanasak N. Rouysungnon W.Development of a holistic continuing care model for elderly with chronic illnesses: a case study in a tertiary care hospital.Journal of nurses’ Association of Thailand North-eastern Division 2009; 27: 65-77.

Nillake K, Chantra R. The Effects of Discharge program for Burn Patients on Self-care ability and Quality of life in Surgical 4 Department Suratthani Hospital. Medica Journal 2019; 33:143-56.

Thongchai C. Clinical Practice Guidelines Development. The Thai Journal of Nursing Council 2005; 20: 63-74.

Souza-Junior VD, Mendes IA, Mazzo A, Godoy S. Application of telenursing in nursing practice: an integrative literature review.Appl Nurs Res2016;29:254-60.

Kawaguchi T, Azuma M, Ohta K. Development of a telenursing system for patients with chronic conditions. J Telemed Telecare 2004;10:239-44.

Ratintorn A. Continuity of care: the core of quality improvement in midwifery practice. 1st ed. Bangkok:Wattanaprinting; 2016.

Sakcharoen P. Adult learning theory and Self-directed learning concept: process for promoting lifelong learning. Journal of the Royal Thai Army Nurses 2015; 16: 8-13.

Arpaichiraratana C, Attharos T. Effect of small group discussion on critical thinking, self-directed learning,satisfaction on the learning of nursing students of The Thai Red Cross College of Nursing. Thai Red Cross Nursing Journal 2012 ; 5 : 21-31.

Sikkabandit S. Education Technology. 11th ed. Bangkok : King Mongkut’s Institute of Technology North Bangkok Printing Press; 2528.

Published

18-06-2021

How to Cite

1.
Chantavoraluk ส, Sripoka อ, Yimwadsana พ, Pakeenet จ, Lekhavat ช. The Development of Continuing Nursing Model in Pemphigus Patients at the Institute of Dermatology. j dept med ser [Internet]. 2021 Jun. 18 [cited 2022 Aug. 14];46(1):228-36. Available from: https://he02.tci-thaijo.org/index.php/JDMS/article/view/251891

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Original Article