Development of a Tuberculosis Care Model in Tha Luang District, Lopburi Province: Action Research Approach

Abstract

Background: Tuberculosis (TB) is a significant public health issue worldwide and in Thailand. In 2023, Tha Luang Hospital in Lopburi province found that the registration rate for new and relapse TB patients was low, and the treatment success rate was also low due to patients missing their medication and dying. Therefore, a model for managing pulmonary TB patients in the community, where no standardized care system exists, should be developed.

Objectives: To develop a care model for TB patients in Tha Luang district, Lopburi province, and evaluate the outcomes of its implementation.

Methods: This action research study collected quantitative data from a target group of 22 pulmonary TB patients and their caregivers. Qualitative data was gathered from 34 healthcare personnel responsible for TB care and community health network members.

Results: Pulmonary TB patients demonstrated high knowledge of TB and transmission prevention, while caregivers had moderate knowledge. Both groups demonstrated good behavior in preventing the spread of TB. A care model for pulmonary TB patients in Tha Luang district, Lopburi province, was developed using the NTCRSE framework. Treatment results showed that all new pulmonary TB patients adhered to directly observed treatment, and no patients missed their medication during the first 3 months. The sputum conversion rate for new patients in the intensive phase was 81.82%. Satisfaction with the health network's care was moderate.

Conclusions: Managing pulmonary TB patients in Tha Luang district requires support from families, communities, and relevant agencies. Key factors for effective care include empowering families and communities through home visits, developing interagency collaboration, enhancing personnel capacity, appropriate budget allocation, and raising community awareness.