The Development of a Management Model for Knee Osteoarthritis in a Community by Collaboration Between Nurse Practitioners and Village Health Volunteers
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Abstract
The aims of this research and development study were: 1) to study the situation of knee osteoarthritis
in a community; 2) to develop a management model for knee osteoarthritis in the community utilizing
collaboration between nurse practitioners and village health volunteers; and 3) to evaluate the developed
management model for knee osteoarthritis in the community.
The study methodology comprised three phases. Phase 1: An assessment of the situation regarding
knee osteoarthritis in the community at Nai Mueang Sub-district, Mueang District, Nakhon Si Thammarat
Province. The process used included: (1) a survey of the proportion and severity of knee osteoarthritis
in a sample of 420 persons who were over 50 years old and (2) a study of their problems and need for
care, resulting in a sample of 28 patients with knee osteoarthritis, along with their caregivers. Phase 2: The
development of a management model for knee osteoarthritis in the community using a sample of 17 nurse
practitioners and village health volunteers. And phases 3: An evaluation of the developed management
model for knee osteoarthritis in the community using a sample of 30 patients who had knee osteoarthritis.
These samples were selected by purposive sampling. The research tools comprised: 1) a severity assessment
form for knee osteoarthritis (Oxford Knee Score), 2) a focus group guideline for study problems and need
for care, 3) a focus group guideline for the model development, and 4) a questionnaire of self-management
behaviors. Content validity indexes of the first and fourth tools were 1.00 and .96, and reliabilities were .92
and .90, respectively. Quantitative data were analyzed by descriptive statistics and t-test. Qualitative data
were analyzed by content analysis.
The results revealed the following: 1) Over fifty seven percent (57.14%) of persons more than 50
years old had knee osteoarthritis, 24.76% were at the mild level, 19.52% were at the moderate level, and
12.86% were at the severe level. These persons had problems and needed help in terms of physical pain;
and in terms of mental, spiritual and social dimensions, as well as accessibility to health services. 2) The
management model comprised the following: village health volunteers screened knee osteoarthritis persons
in their respective geographic zones. Nurse practitioners provided training, monitoring, and data recording.
Both village health volunteers and nurse practitioners did collaborative visits to persons with severe knee
osteoarthritis. 3) After implementation of the developed model, self-management behaviors of persons with
knee osteoarthritis significantly improved from before implementation (p< .05).
Article Details
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