Development of a Self-Care Manual for Patients with Hyperthyroidism in the Thyroid Clinic, Sadao Hospital

Abstract

This research and development study aimed to examine the current situation, problems, and needs, as well as to develop and evaluate the effectiveness of a self-care manual for patients with hyperthyroidism in the Thyroid Clinic at Sadao Hospital. The study was conducted in three phases. Phase 1 involved assessing the situation, problems, and needs of patients using secondary data review and qualitative methods. Phase 2 focused on developing the manual based on the principles of design thinking, which included understanding the problem, clearly defining the problem, brainstorming, creating selected prototypes, and conducting testing. The manual underwent expert validation by three specialists. Phase 3 examined the effectiveness of the manual using a one-group pretest–posttest quasi-experimental design. The sample consisted of 27 patients with hyperthyroidism. The research instruments included the newly developed self-care manual for patients with hyperthyroidism. The content validity index for the self-care behavior and satisfaction measures was 0.86. Cronbach’s alpha reliability coefficients were .77 and .71, respectively. Data were analyzed using frequency, percentage, mean, standard deviation, dependent t-test, Wilcoxon Signed Rank test, and One-sample Wilcoxon Signed Rank test. The results of the study revealed that

1. In 2024, there were 251 patients with hyperthyroidism. The majority were female (72.11%). Among them, 7.57% had undergone thyroid surgery, 13.94% received radioactive iodine therapy, and 3.59% refused referral for radioactive iodine and chose lifelong antithyroid medication instead. A total of 0.40% were allergic to Methimazole, 17.93% had Graves’ disease, and 16.73% had comorbidities. Recurrent hyperthyroidism occurred in 4% of patients, and 1.20% were diagnosed with thyroid crisis. The main problems identified included irregular medication adherence, self-discontinuation of medication, drug side effects, self-adjustment of medication doses, and failure to attend scheduled follow-up appointments.

2. The self-care manual for patients with hyperthyroidism was developed to be easy to understand and included illustrated visual content.

3. After using the manual, patients demonstrated improved self-care behaviors. FT3 and FT4 levels significantly decreased at the .001 level. TSH levels showed no significant difference before and after manual use. Overall, satisfaction with the manual was at the highest level (Mean = 4.60, SD = 0.35).

Based on the study findings, it can be concluded that the self-care manual for patients with hyperthyroidism is beneficial for individuals receiving antithyroid medication therapy.