Development of a service model for patients with chronic kidney disease stage at Bueng Nam Rak sub-district health promoting hospital

Abstract

Chronic kidney disease is a global public health problem. Bueng Nam Rak sub-district health promoting hospital actively promoted health of patients with chronic kidney disease. However, there is a continuous increase in the number of stage 3A chronic kidney disease patients. The objective of this study was to develop a service model and system for stage 3A chronic kidney disease patients in the chronic disease clinic with the participation of a network to meet patient needs. This study was an action research using Kemmis & McTaggart's research framework. The study included 35 patients with stage 3A chronic kidney disease treated at the Bueng Nam Rak sub-district health promoting hospital. Data collection included knowledge tests, interviews, observations, and laboratory results. Data were analyzed using descriptive statistics and comparisons of the average scores of knowledge and behaviors related to dietary intake before and after implementing the new service model.          

The research findings indicated that after implementing the new service model, patients showed improved average scores in knowledge about chronic kidney disease and self-care behaviors. Patients also experienced 100% improvement in the glomerular filtration rate (eGFR). This improvement resulted from separating the chronic kidney disease clinic from other non-communicable disease clinics, providing more specific information about the disease. The use of supportive educational media that stimulated easy and clear understanding was also noted. However, the study identified limitations and obstacles in lifestyle adjustments, leading to the planning and setting of common goals for behavior modification. The follow-up team should receive increased training to enhance their knowledge, clarity in answering questions, and the ability to monitor patient behaviors. Clear behavior monitoring tools should be developed for easy summarizing and analysis during home visits.