Development of an Islamic Integrated Nursing Model (MAYO Care Model) to Enhance Medication Adherence and Reduce Self-Stigma among People Living with HIV at Mayo Hospital, Pattani Province.

Abstract

      This study employed an action research design combined with a one-group pretest–posttest quasi-experimental design. The objectives were to examine the situation, nursing practice problems, and development needs; to develop and implement an Islamic Integrated Nursing Model (MAYO Care Model); to evaluate the effects of the model on medication adherence and self-stigma among people living with HIV; and to identify factors contributing to the success of the model at Mayo Hospital, Pattani Province. Data were collected from October 2025 to July 2026, a total of 8 months. The participants were 23 Muslim patients living with HIV who had been registered and receiving antiretroviral therapy for at least two weeks at the antiretroviral clinic of Mayo Hospital, selected by purposive sampling. The research instruments were the MAYO Care Model program; a personal information questionnaire (sex, age, marital status, education, occupation, income, health coverage scheme, and patient group); the medication adherence interview form of the Department of Disease Control, Ministry of Public Health; the self-stigma interview form for people living with HIV of the Department of Disease Control, Ministry of Public Health; and a focus group discussion guide. Qualitative data were analyzed using content analysis, and quantitative data were analyzed using frequency, percentage, mean, standard deviation, and paired t-test.

      The results showed that most patients were female (78.26%), and most were aged 40–49 years (47.83%) (Mean ± SD = 46.22 ± 10.23, Min = 13, Max = 62). Married patients accounted for 52.17%, 73.91% had primary education, and 65.22% were engaged in general labor. The model development comprised four approaches: 1) spiritual assessment and counseling based on Islamic principles to correct misconceptions about the disease and medication use; 2) education and adjustment of medication schedules to align with Islamic practices and daily routines, such as during the fasting period; 3) promotion of family Buddy and religious leader participation in providing encouragement; and 4) creation of a safe space in the clinic, maintenance of confidentiality, and continuous patient follow-up. After implementation, self-stigma decreased from 37.64% to 27.17% (t = 3.87, p = .001). The mean medication adherence score increased from 82.35 to 94.78 (t = 5.42, p < .001), and the proportion of patients with adherence of 95% or higher increased from 73.91% to 100%. All patients had HIV viral load levels not exceeding 1,000 copies/ml, and no drug-resistant regimens were used in 2025–2026.