The Development of a Management Model for Knee Osteoarthritis in a Community by Collaboration Between Nurse Practitioners and Village Health Volunteers

Main Article Content

Thuenjit Chuaychan
Sutteeporn Moolsart
Danai Heebthamai


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).


Download data is not yet available.

Article Details

How to Cite
Chuaychan, T., Moolsart, S., & Heebthamai, D. (2018). The Development of a Management Model for Knee Osteoarthritis in a Community by Collaboration Between Nurse Practitioners and Village Health Volunteers. Songklanagarind Journal of Nursing, 38(2), 43–59. Retrieved from
Original Articles


1. Woraratanarat P, Woraratanarat T, AngsanuntsukhC, et al. editor. Lifestyle with osteoarthritis.Bangkok: Charansanitwong Printing; 2015. Thai.

2. Health Data Center, Ministry of Public Health.Screening report for osteoarthritis in the elderly2016 [Internet]. Bangkok [cited 2017 Oct 30].Available from:

3. Wikipedia [Internet]. Nakhon Si ThammaratProvince. [cited 2018 Jan 7]. Available from:

4. Nimit-arnun N. The Epidemiological situationand risk assessment of knee osteoarthritis amongThai people. Journal of The Royal Thai ArmyNurses. 2014; 5(3): 185-94. Thai.

5. Aree-Ue S, Piyakhachornrot N. Outcomes of healtheducation and Home-Based exercise programs forpatients with knee osteoarthritis. Thai Journal ofNursing Council. 2008; 23 (3):72-84. Thai.

6. Boonpituk, K. Knee pain, osteoarthritis, medicalcare and prevention. Nonthaburi: Feel good;2013. Thai.

7. Suppasan S. Experiences on self care among thepatients with osteoarthritis of the knees. Journal of Nursing Science Naresuan University. 2007;1(1): 72-86. Thai.

8. Institute of Geriatric Medicine, Department ofMedical Services, Ministry of Public Health. Guidelines for the provision of health servicesto the elderly Healthcare. 2th ed. Chon Buri:Institute of Geriatric Medicine, Department of Medical Services, Ministry of Public Health; 2014.

9. Thanapiyawat N. Development of the elderly caremodel for osteoarthritis by community participation.The community participation on model developmentfor elderly with knee osteoarthritis. Conferenceand presentation of national research at: SecondAcademic Affairs 4.0 Research for CountryDevelopment for Prosperity, Wealth andSustainability; 2017 Jul 26-27; RatchathaniUniversity.

10. Pancharoen S. The development of a clinicalpractice guideline for weight control in order to increase the physical function of the inoverweight older adult with knee osteoarthritis.[Unpublished master’s thesis]. Bangkok: ThammasatUniversity; 2007.

11. Rungjang C. Development of a health promotionprogram for elderly with osteoarthritis of theknee in Koknamkliang village, Ubonrat district,Khon Kaen province. [An independent studyreport unpublished master’s thesis]. Khon Kaen:Khon Kaen University; 2011.

12. Pukdeesamai R, Panichacheewakul P. Improvingcare for elderly with knee pain at Ban Baktambol health promotion hospital, Changhan district,Roi Et province. Journal of Nursing Science &Health. 2011; 34(4): 46-55. Thai.

13. Narin R, Taunrat W, Booncheang W. Development of a community participation program for caringolder adults with knee osteoarthritis. Nursing Journal.2015; 42(3); 170-81. Thai.

14. Huber DL. Leadership and nursing care management.3rd ed. Philadelphia: Saunders; 2006.

15. Department of Health, Ministry of Public Health.Elderly health record. Bangkok: Chao ChomRestaurant Suan Sunandha Rajabhat University;2015. Thai.

16. McCaffery M, Pasero C. Pain clinical manual.2nd ed. St. Lousis: Mosby; 1999. doi:10.1046/j.1365-2702.2000.0374c.x

17. ThanachaiKhan N. Basic statistics for research.Bangkok: Withyaphat; 2010.

18. Triyamanirat K, editor. Osteoarthritis. Nonthaburi;[publisher unknown]; 2013.

19. Wongyara N. Health seeking process of the elderly with osteoarthritis of knee in Ratchaburi province.[master’s thesis]. [Chon Buri]: Burapa University;2004. 121 p.

20. Sinthuwongsri A. The fortune telling behavior of city life in Bangkok. Journal of Social Research.2017; 40(1):201-225. Thai.

21. Leeraphan B. Unit 6 health service.In: PotisupsukC, editor. Health policy and health system, leadership,concepts and theories in nursing and communitynurse practitioner,s roles. Nonthaburi: SukhothaiThammathirat Open University publisher; 2015.

22. Boonchan N. Join pain-Osteoarthritis and nursingprocess application. 2nd ed. Bangkok: NP Press;2009.

23. Thai Rheumatism Association. Guideline for thetreatment of Osteoarthritis of Knee. [Internet].[cited 2017 May 30]. Available from:

24. Chakarothai S. Effect of a self-management supporting program on disease severity amongelders with knee osteoarthritis. [Unpublished master’sthesis]. Chiang Mai: Chiang Mai University;2011.

25. Ontha R, Moolsart S, Pitchayapinyo P. The Development of a home visit model based onparticipation between professional nurses andvillage health volunteers for type II diabetes.Journal of Nursing and Health Care. 2016; 34(4): 19-27. Thai.

26. Tonueng B. Improving care for elderly with kneepain at Pak Kut Wai health promotion hospital,Mueng district, Ubon Ratchathani province. UBRUJournal for Public Health Research. 2017; 6(1):27-36. Thai.

27. Sangkrajang S. Effects of self-efficacy promotionprogram on health behaviors, body weight andhealth status in persons with knee osteoarthritis.[Unpublished master’s thesis]. Pathum Thani:Rangsit University; 2014.

28. Chumklang T, Duangsong R. The effects ofexercise promotion programs by the applying ofself-efficacy and social support for pain decreasingamong elderly with osteoarthritis knee in Wangnam-kheaw district, Nakornratchasama province. KKURes J (GS). 2012, 12(1): 46-56. Thai.