Development of an Intermediate Care Model with Community Participation, Ban Khok Muang Subdistrict Health Promoting Hospital, Prakon Chai District Public Health Office, Buriram Province.

Abstract

      This study aimed to develop a model for intermediate care of stroke patients through community participation. This study was action research divided into three phases. The preparatory phase, which includes (1) reviewing and analyzing existing problems in intermediate care for stroke patients; (2) establishing guidelines for new model development; and (3) formulating a framework for developing the intermediate care model for stroke patients. The implementation phase, which includes (1) clarifying the objectives of the intermediate care model development for healthcare staff and caregivers of stroke patients; (2) conducting assessments of Activities of Daily Living (ADL) levels, mobility, and essential equipment required for patients post-hospital discharge; (3) providing knowledge on physical rehabilitation and health promotion for relatives or community volunteers and conducting rehabilitation training for community volunteers; (4) conducting home follow-up visits; (5) developing a referral system via Line application or telephone for continuous follow-up and monitoring of symptoms. The evaluation Phase, the development of a new model and the measurement of changes in Activities of Daily Living (ADL) abilities. The data were analyzed using descriptive statistics, including percentages, and compared the pre- and post-test data using the Paired t-test.

      Results: The results of the community-based participation model for intermediate care in stroke patients showed that 97% of stroke patients discharged from the hospital were able to access post-hospital discharge services. The comparison results showed that the mean scores of Activities of Daily Living abilities of patients after the development of the intermediate care model for stroke patients increased significantly (P < 0.01). The evaluation of the level of knowledge and understanding in patient care found that caregivers had knowledge, understanding, and the ability to put it into practice at a mean score of 2.75 (S.D. = 0.23) and the level of satisfaction among relatives regarding intermediate care for stroke patients was at a very satisfactory level.