การพัฒนาการบริการสุขภาพอย่างต่อเนื่องโดยการมีส่วนร่วมของชุมชน สำหรับผู้ป่วยโรคหลอดเลือดสมอง ในพื้นที่ตำบลบรบือ อำเภอบรบือ จังหวัดมหาสารคาม The Development of Continuous Intermediate Care Services by Participation of Community for Patients with Stroke in Borabue Sub-district, Borabue District, Mahasarakham Province

บทคัดย่อ

Abstract

           Stroke is a major public health problem. The intermediate care services have been produced that is attempting to focus on patients after acute ischemic or hemorrhagic stroke for rehabilitation and complication prevention. This action research aimed to develop the continuous intermediate care services by participation of community for patients with stroke in Borabue Sub-district, Borabue District, Mahasarakham Province. The participants consisted of 2 groups: 1) a group 8  patients with stroke; 2) a group 50 stakeholders including community leaders, health volunteers, caregivers, staffs formBorabue Subdistrict Administrative Organization, and health care provider from Borabue Community Hospital. The development process was composed of four steps; plan, acting, observe, and reflecting. Data were analyzed by descriptive statistics and content analysis.

           The findings revealed that the development of continuous intermediate care services by participation of community for patients with stroke consisted of 9 steps: 1) identifying problems and solutions by participation of community
2) integrated action plan for problem solving 3) establishing the members committee at sub-district level for monitoring and solving problem
4) strengthening the knowledge and skills of caregivers and health volunteers
5) health volunteers coordination when any stroke patents presenting
6) proactive home visiting by community nurses 7) supportive intermediate care services by community leaders 8) supervision by preceptors 9) knowledge management on intermediate care services, conclusion, and giving back data to community.  After the period of development, the participants’ satisfaction was at good level. The patients’ functional status in the activity daily level improved; 5 cases among 8 cases. The key success factors of the development included
1) the strengthening of members committee at sub-district level 2) supportive intermediate care services by community leaders 3) the mutual cooperation of multidisciplinary teamwork and 4) the dedication of care of health volunteers

Keywords : Intermediate care, Participation, Community, Stroke