Development of a Home Ward Care Model to Improve Health Literacy in Patients with Hypertension, Chaiyo Hospital.

Abstract

     This research was a Research and Development study aimed at investigating problems, developing, and evaluating a home ward care model for hypertensive patients' health literacy at Chaiyo Hospital, Ang Thong Province. The study was conducted from September 2025 to March 2026, spanning a total of 7 months. The sample consisted of 25 multidisciplinary team members and network partners who participated in model development, and 30 hypertensive patients in the Home Ward system. Research instruments included focus group guidelines, a general information questionnaire, health literacy assessment, self-care behavior assessment, a clinical indicator record form, expert appropriateness evaluation form, and satisfaction assessment. Data were analyzed using descriptive statistics and Paired t-test for pre-post comparisons.

     The results revealed that the developed model, named the "Chaiyo Home-CARE Model" (Home Ward Care for Adequate health literacy and self-care to Reduce blood pressure through Empowerment), comprised six main steps: health literacy and self-care behavior assessment; planning and educational material development; health literacy development using Teach-back technique and Line OA; home visits and community follow-up based on the Three Doctors concept every two weeks; interprofessional communication and network coordination; and outcome evaluation and monitoring following the PDCA cycle. Evaluation of model appropriateness by three experts indicated a high level of suitability across all domains (Mean = 4.49, S.D. = 0.38). Post-implementation evaluation revealed that overall health literacy scores increased from a low level to a moderate level (Mean = 97.57, S.D. = 8.01), overall self-care behavior scores increased to a moderate level (Mean = 84.97, S.D. = 3.69), both systolic and diastolic blood pressure decreased significantly, and the proportion of patients achieving blood pressure control increased to 56.67 percent. Patient satisfaction with the care model was at a high level (Mean = 3.87, S.D. = 0.10), and multidisciplinary team and network partner satisfaction was also at a high level (Mean = 4.06, S.D. = 0.13). Statistical testing demonstrated that health literacy scores, self-care behavior scores, and all clinical indicators showed statistically significant differences before and after model implementation at the .05 level.