Development of a Model for Prevention and Resolution of Chronic Kidney Disease in Banthi District, Lamphun Province, Thailand

Abstract

Chronic kidney disease is an important problem and tends to increase. This research was conducted as a participatory action research using the chronic care model to develop a model for preventing and resolving of chronic kidney disease in Banthi District, Lamphun Province between January 2015 – January 2017. The samples groups were 35 multidisciplinary teams, sub-district administrators, community leaders, public health officers, village volunteers selected by purposive sampling, including 72 patients with chronic kidney disease and caregivers selected by simple random sampling. Data were collected using focus group discussion, personal interview, observation and health assessment. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed using content analysis. The results revealed that a model for preventing and resolving of chronic kidney disease development process comprised of 3 phases: (1) situation analysis which was found that the caring of chronic kidney patients did not have any specific model; (2) planning and implementing based on the chronic care model (CCM) of which both passive and proactive model were adjusted; and (3) evaluation phase which showed that the service system had clear policies and specific healthcare team, supporting for self-management according to the stage of the disease, having a decision supporting system using CPG, service systems design both proactive and passive, the whole network management for clinical information system, and community participation in preventing and resolving of chronic kidney disease. There were changes in 3 aspects: (1) the multidisciplinary team had clinical practice guidelines; (2) many patients were able to receive kidney screening and could delay renal degeneration; and (3) community participation was promoted to have role in chronic patient care. The results of this research showed that the participation of relevant parties could create a model for preventing and resolving of chronic kidney disease that wuld be appropriated in accordance with the community context. Therefore, this approach should be applied to the prevention and management of other chronic diseases.