Development of a Model to Delay Renal Impairment in Patients with Diabetes and Hypertension Using Case Management Process in Phusing Hospital, Sisaket Province

Abstract

The purpose of this study was to develop a model for slowing renal impairment in patients with diabetic and hypertension by the use of case management process. It was conducted in the period from January to March 2017. The samples were 44 patients with diabetes and hypertension who had impaired kidney function at stage 3b chronic kidney disease. The study process was divided into 3 stages: (I) preparation of the team and equipment, (2) situation analysis and model development, and (III) evalu­ation. Data were collected through group discussion and participatory observation with the use of PDCA framework. It was found that after the program implementation, the subjects had has appropriate self caring behavior which improved from 50.36% to 74.27%. After program GFR was better in 13 cases. The result was found that patients with diabetes and hypertension who had renal impairment stage 3b and got case management process, improved their self caring .Some subjects could control sugar blood test in good level that promoted reduction of renal impairment. The pattern that emphasis and empowerment patient to realize and modify their behavior was important for caring chronic disease patient. The sugges­tion is the researcher should bring case management process to using for quality of continuity of caring ,especially in another chronic disease. And before-after comparing result from case management process should be studied.