Telemedicine-Based Home Visiting Services for Dependent Elderly Groups.

Abstract

     This action research aimed to investigate the needs and develop a home-visit service model for dependent older adults using telemedicine. The study was conducted from October 2023 to August 2024 and consisted of three phases. Phase 1 involved the first action research cycle, focusing on the assessment of the community context and the needs for home-visit services among dependent older adults through telemedicine. Phase 2 involved the development and implementation of a home-visit service model using telemedicine, with LINE Video Call as the communication platform to facilitate continuous care between healthcare providers, older adults, and caregivers. Phase 3 involved the evaluation of the outcomes of the developed service model.

     The participants were older adults aged 60 years and over residing in Nong Sim Subdistrict who were purposively selected and had Barthel Activities of Daily Living (ADL) scores ranging from 0 to 11 points. The research instruments consisted of the Barthel Activities of Daily Living Index, the World Health Organization Quality of Life-BREF-Thai (WHOQOL-BREF-THAI), a self-management support manual, and a self-management plan. Data were analyzed using descriptive statistics, including frequency, percentage, mean, and standard deviation, and inferential statistics using the paired-samples t-test.

     Results: The developed community-based self-management support model for dependent older adults yielded two key outputs: 1) guidelines for home visiting services via tele-nursing, and 2) 100% individual care plans categorized into 5 health condition groups: pressure injury prevention (resulting in a 20% wound healing rate); rehabilitation for joint contractures and muscle atrophy (enabling 3 new disabled persons to register for state benefits); urinary tract infection prevention; chronic disease self-management for diabetes/hypertension integrated with community health stations; and common elderly health care. Six months post-development, the results showed a statistically significant increase in the mean ADL scores (= 8.34). Furthermore, the quality of life among the dependent older adults was rated at a high level ( = 3.67).