The Effects of Care Model for Patients with Chronic Obstructive Pulmonary Disease in Khon Rak Pod Clinic, Chawang Crown Prince Hospital, Nakhon Si Thammarat Province - ผลของรูปแบบการดูแลผู้ป่วยโรคปอดอุดกั้นเรื้อรังใน คลินิกคนรักษ์ปอด โรงพยาบาลสมเด็จพระยุพราชฉวาง จังหวัดนครศรีธรรมราช

บทคัดย่อ

Guidelines for management of chronic obstructive pulmonary disease in general focus on smoking cessation,
medications, pulmonary rehabilitation, long-term oxygen therapy and management risk factors of chronic obstructive
pulmonary disease (COPD). This study added social network, social support and the patient’s self care; and the effectiveness
was evaluated by comparing the readmission rates within 28 days of the admission before and after the implementation
among fourteen COPD patients admitted to the Khon Rak Pod clinic of Chawang Crown Prince Hospital, Nakhon Si
Thammarat Province from January to March 2012. The intervention consisted of hospital service provision by an interdisciplinary
health care team, self management at home, monthly home visits by a mobile clinic, social networking and social
support. Data were analyzed by percentage and the Wilcoxon signed-rank test. The results revealed a significant reduction
of readmission rate (p<0.05) which indicated that a program which integrated self management support, social networking,
and family and social support was an effective strategy for COPD care.
Key words: development model, chronic obstructive pulmonary disease, Khon Rak Pod Clinic