DEVELOPMENT OF THE HIV/AIDS PATIENT CENTERED CARE IN COMMUNITY HOSPITALS IN NAKHON RATCHASIMA PROVINCE
DOI:
https://doi.org/10.14456/taj.2022.4Keywords:
HIV/AIDS, HIV/AIDS patients centered care, Nakhon Ratchasima provinceAbstract
Shifting the task of HIV care to community hospital service is an important strategy to sustain expanding access to antiretroviral therapy (ART) in high HIV burden countries like Nakhon Ratchasima Province in Thailand. This action research aimed to develop the health service system for HIV / AIDS patients in hospitals. HIV/AIDS patient centered care in community hospital service is an important strategy to sustain
expanding access to antiretroviral therapy (ART) in high HIV burden area such as in Nakhon Ratchasima province in Thailand. This action research aimed to develop the health service system for HIV/AIDS patients
in hospitals.
The research was conducted in 7 community hospitals in Nakhon Ratchasima province during October 2018 to September 2020. Participants were 10 health executives, 20 health personnel and 40 people living with HIV/AIDS. The research instruments consisted of quantitative and qualitative data collection tools using questionnaires for primary data collection, extractions of data from NAP database, and collecting qualitative data from the multidisciplinary team with in-depth interviews, focus group discussions and non-participatory observation without identification including data retrained from lesson learned activities. Data were analysised using classification techniques, interpretation and conclusion.
The findings of research were as follows. The differentiated care and task sharing for HIV/ AIDS patients process for appropriateness and continuity of the HIV/AIDS patients included: 1) problem solving study and development of a HIV/AIDS patient centered service project, 2) development of capability of the coach team at the provincial level to assist in the consultancy operations which include training to increase the potential of the multi-disciplinary team in maintenance and counseling services, 3) target service unit operated to improve service quality according to the situation each area context (Quality Improvement: QI) by improving the system to use NAP-Program data and evaluation, 4) taking off the operating lessons and
coaching results. Outcome of service system development were as follow patient medication adherence to
ARV was improved to 94% and HIV viral suppression to <1,000 copies/ml was 96% and viral load test was performed 85% of the patients.
QI approach, using learning networks to exchange data-driven methods for improving and addressing
HIV/AIDS patient centered system could assist districts to quickly reach coverage targets. It is recommended
to further develop service system structure, as well as operation and standard in HIV/AIDS patient centered care to cover every aspect service such as economical, social, physical and mental aspect while patients were receiving-care in the hospital.
Downloads
References
HIV INFO HUB. Response [Internet]. Nonthaburi: Division of AIDS and STIs, Department of Disease Control; 2019. [cited 2019 Aug 1]. Available form: https://hivhub.ddc.moph.go.th/response.php. (in Thai)
UNAIDS. UNAIDS DATA 2018. [Internet] 2018 [cited 2020 June 13]. Available form: https://www.unaids.org/sites/default/files/media_asset/unaids-data-2018_en.pdf.
Stephen Kemmis, Robin Mc Taggarto. The action research planner. 3rd edition. Victoria: Deakin University press; 1990.
Yothin Sawangdee, Pimonpan Isarabhakdi, Malee Sanpuwan. Problems and sufferings Experienced by Patients Obtaining Services at Health Care Facility. Nakhon Pathom: Institute for Population and Social Research, Mahidol University; 2000. (in Thai)
Suchada Taweesit, Sureeporn Punpueng. Understanding and accessing the worldview of sexuality of people with HIV with a gender perspective. In: Krittaya Archavanitkul, Kanchana Tangcholathip, Editors. Population and Society 2008: Gender Dimensions in Population and Society. Nakhon Pathom: Population and Society Publishing House. 2008. p.180-193. (in Thai)
Nareelux Suwanobol, Srikiat Anansawat, Ratchadapon Jai-ai. Success Factors and Barriers to Develop the Caring System for People Living with HIV and AIDS. Journal of The Royal Thai Army Nurses. 2016; 17(1): 70-78. (in Thai)
Thidaporn Jirawattanapisal. Antiretroviral Treatment Service Delivery and Roles of Human Resource for Health in Different Levels of Care. Thai AIDS Journal. 2017; 29(1): 1-9. (in Thai)
Srisak Tangjittham, Boonma Soontrawirat. Mutual assistance of HIV/AIDS patients through group process Thali Hospital. Journal of the Office of Disease Prevention and Control No. 6th, Khon Kaen. 2007; 15(2): 124-30. (in Thai)