Participatory Development of a Community-Based Intermediate Care Model at Borabue Hospital, Maha Sarakham Province.

Abstract

      This research was action research study aiming to develop a participatory community-based model for ongoing intermediate care for patients. It consists of three phases: Phase 1: Studying healthcare service needs; Phase 2: Developing a participatory community-based model for ongoing intermediate care using self-management concepts; and Phase 3: Evaluating outcomes. The developed model for ongoing community-based intermediate care applies self-management support concepts and home visits using tele-nursing and telemedicine. The study was conducted from October 2023 to October 2024, with a purposive sampling method based on inclusion criteria. The population consisted of 28 intermediate care patients who received services at Borabue Hospital between November 1, 2023, and April 31, 2024, residing in Borabue and Nong Sim subdistricts, Borabue District, Maha Sarakham Province. The research instruments included interview questionnaires, satisfaction surveys, Activity-Based Living (ADL) assessments, a self-management support manual and individual self-management plans, and a quality of life assessment. Data were analyzed using descriptive and inferential statistics, including the paired samples t-test.

      Results The developed model consisted of:A care flow chart;A discharge planning model;A structured care plan model. After six months of implementation, the mean ADL score significantly increased from 9.60 (S.D. = 0.71) to 13.50 (S.D. = 0.75). All patients demonstrated improved ADL scores, and no complications were reported.The mean quality of life score improved from a low level (mean = 1.77, S.D. = 0.23) before implementation to a moderate level (mean = 2.89, S.D. = 0.18) after implementation. Overall satisfaction among service providers and recipients was at a high level (mean = 4.32, S.D. = 0.81).