Development of Nursing Model for Non-Adherent Tuberculosis Patients through Empowerment and Case Management in Suwannaphum Hospital.

Abstract

     This action research aimed to study the context of caring for tuberculosis patients who missed appointments, develop an empowerment and case management model, and evaluate the outcomes of this model. The study was conducted in three cycles following Kemmis and McTaggart's approach. The purposively selected sample consisted of 20 tuberculosis patients who missed appointments and 15 healthcare professionals. Research instruments included demographic questionnaires, assessment forms for factors affecting missed appointments, and in-depth interview guides. All instruments were validated for content validity and reliability. Data were analyzed using descriptive statistics, and pre-post comparisons were performed using the Paired t-test.

     Findings revealed that in the first cycle, problems of disconnected information and discontinuous care were identified. In the second cycle, a communication system was developed through a "TB Alert" Line group, and guidelines for patient follow-up were established. In the third cycle, community volunteers' capabilities were enhanced, and collaboration with community leaders was strengthened. Following the implementation of the model, the rate of treatment continuation increased to 95.00 percent, while the missed appointment rate decreased from 17.40 percent to 5.00 percent. Patient and family satisfaction significantly improved (p<0.01).