Development of a home ward nursing service model for self-management of Patients with uncontrolled high pressure Mahasarakham Hospital Mahasarakham Province

Abstract

Objective : To develop a home ward nursing service model for self- managing the health of patients with uncontrolled high pressure at Mahasarakham Hospital Mahasarakham Province

Methods : This study employed an action research design, divided into three phases:
1) Preparation and situational analysis, 2) Development of the home ward care model, and
3) Assessment of studies between July 2023 – September 2024. The participants included  30 patients with uncontrolled hypertension residing in Mueang Mahasarakham District  and who provide inpatient care at home (Home ward) Mahasarakham Hospital, 20 people. Select a purposive sample group based on specified properties. The tools used was the model home ward nursing service developed by the researcher, data recording forms, knowledge tests, and questionnaires. Data were analyzed using descriptive statistics (frequency, percentage, mean, standard deviation) and inferential statistics (Paired Sample t-test).

Result : The developed home ward nursing service model for self - managing uncontrolled hypertension at Mahasarakham Hospital consisted of scheduled follow-ups via the Line application, provision of health education, assessment of self-care behaviors, medication administration, and self-care guidance. If blood pressure remained uncontrolled, home visits were conducted by the home ward nursing team to identify underlying causes, promote family involvement in care, and adjust medications as necessary. After the implementation, patients demonstrated significantly increased knowledge about hypertension (t = 27.81, p < 0.001) and significantly improved self-care behaviors (t = 27.97, p < 0.001). Furthermore, both systolic and diastolic blood pressure levels significantly decreased (t = 10.09, p < 0.001 and t = 5.37,
p < 0.001, respectively). Patients also reported a high level of satisfaction with the home ward nursing service model (Mean = 3.93, SD = 0.12).

Conclusion : The home ward nursing service model is an effective approach for managing patients with uncontrolled hypertension. It enhances patient knowledge, promotes self-care behaviors, supports better blood pressure control, and achieves high patient satisfaction.