Development Of Care Model For Diabetic And Hypertensive Patients To Enter Remission Of Diabetes After The Transfer Of Sub-District Health Promotion Hospitals To Nakhon Pathom Provincial Administrative Organization.

Abstract

      This study aimed to: 1) investigate the situation, problems, related factors, and needs regarding the prevention and control of diabetes mellitus and hypertension following the transfer of Subdistrict Health Promoting Hospitals to the Nakhon Pathom Provincial Administrative Organization; 2) develop a model for the prevention and control of diabetes mellitus and hypertension following the transfer; 3) pilot test the developed model in selected areas under the Nakhon Pathom Provincial Administrative Organization; and 4) evaluate and validate the developed model in terms of appropriateness, feasibility, utility, and accuracy.     A mixed methods research design was employed. The quantitative component involved 392 participants selected through multistage sampling. Data were collected using a rating scale questionnaire with an overall reliability coefficient of 0.84. The data were analyzed using mean, standard deviation, Pearson’s product moment correlation coefficient, and multiple regression analysis. The qualitative component involved 28 key informants selected through purposive sampling. Data were collected through focus group discussions and in depth interviews using a semi structured interview guide. The qualitative data were analyzed using content analysis and verified through data triangulation.

      The findings revealed that: 1) the transfer of Subdistrict Health Promoting Hospitals to the Nakhon Pathom Provincial Administrative Organization was rated at a high level overall (= 4.31, S.D. = 0.24), while the overall effectiveness of the prevention and control model for diabetes mellitus and hypertension was also rated at a high level ( = 4.38, S.D. = 0.31); the transfer was positively and significantly correlated with the effectiveness of the model at the .01 level; and the five independent variables jointly predicted the effectiveness of the model at the .001 significance level. 2) The developed model was driven by a six step strategic management cycle and comprised five core components, namely PIRAB: Partnership, Investment, Regulation, Advocacy, and Building Capacity. 3) The overall results of the pilot implementation were rated at the high level ( = 4.38, S.D. = 0.38). 4) The evaluation of the model based on four standards, namely utility, feasibility, propriety, and accuracy, indicated that the overall evaluation was at the highest level (m = 4.51, s = 0.32).