Development of a preparation model to enter the renal replacement therapy for patients with chronic kidney disease stage 4 and their families, Phayakkhaphumiphisai Hospital, Mahasarakham Province.

Abstract

     This action research aimed to develop and study the results of a preparation model for renal replacement therapy among stage 4 chronic kidney disease (CKD) patients and their families in Phayakkhaphumphisai District, Mahasarakham Province. The research participants consisted of 7 multidisciplinary healthcare professionals working with CKD patients and 123 stage 4 CKD patients, chosen via purposive sampling based on inclusion criteria. Research instruments included in-depth interview guidelines and focus group discussions, a practice manual for CKD clinic service providers, stage 4 CKD patient service records, satisfaction questionnaires, knowledge assessment forms, and self-care ability measurement forms. Data were analyzed using descriptive statistics, paired t-tests, and content analysis. The research and development were conducted between October 2022 and September 2023.
     The results showed that a clear, concrete preparation model for renal replacement therapy among stage 4 CKD patients and their families that aligned with the organizational context. The model consisted of 5 components: laboratory screening and monitoring, treatment monitoring and reporting system, specialist referral system, specialized nurse follow-up care, and holistic continuous care, collectively called the P-Y-K-P-S model. Implementation of the model showed approving outcomes in patient care and stakeholder satisfaction. Patients demonstrated significantly increased knowledge about chronic kidney disease and renal replacement therapy and improved self-care behavior scores compared to pre-implementation (p<0.001).