The Development of a Care Model for Patients with Depression in Chronic Disease Chonburi Hospital

Abstract

The aim of this research and development study were to develop a care model for patients with depression in chronic disease in Chonburi hospital and to investigate the outcomes of the care model.  Three phases of research were conducted, including 1) situation analysis by reviewing medical records, nurse focus group discussions, and patient interviews, 2) development of the care model for patients with depression in chronic disease based on the Donabedian framework, and 3) outcome evaluation of the care model with the sample of 70 chronic disease patients and 110 professional nurses. The research instruments used were a depression assessment form, patient satisfaction assessment form, knowledge assessment form, compliance assessment form and the professional nurse satisfaction assessment form. The results showed that the care model for patients with depression in chronic disease, Chonburi hospital, consisted of 3 components: 1) structure: personnel, care guidelines, communication system, and outcome indicators, 2) process: announcement of a policy and deployment into practice, training on care guidelines, implementation of the care guidelines, communicating and monitoring  outcomes, 3) outcomes: depression, satisfaction with the care model and safety from suicide attempts by patients, knowledge, guideline compliance, and satisfaction with the care model of nurses. After implementing the model, it was found that depression among chronic disease patients was significantly reduced at the .05 level. The patients had no thoughts of self-harm, no incidence of suicide and patients were satisfied with the care model at the highest level. The nurses had a statistically significant increase in knowledge at the .05 level, followed practice guidelines, and were more satisfied with the model than the target of 80% at a statistically significant level of .05.