A Study on the Prevention and Management Model for Chronic Kidney Disease in Mae Sariang District, Mae Hong Son Province

Abstract

Chronic Kidney Disease (CKD) is a significant public health concern. This quasi-experimental study employed a one-group pretest-posttest design to examine the effects of a CKD prevention and health promotion program in Mae Sariang District, Mae Hong Son Province, Thailand. The findings aim to contribute to the development of a model and policy recommendations. The study included 26 purposively selected patients diagnosed with CKD stages 2–4. The intervention program was based on Lewin’s Change Management Model, which consists of three stages: Unfreezing (behavioral awareness), Transition (behavioral modification), and Refreezing (behavioral maintenance). The research instruments consisted of 1) the CKD prevention and health promotion program and 2) a self-monitoring health record book for CKD patients. Data were analyzed using descriptive statistics and paired t-tests, and the study was conducted from August 2024 to January 2025. The results demonstrated a statistically significant improvement in estimated glomerular filtration rate (eGFR) (p < 0.05) after participation in the program. Furthermore, there was a decreasing trend in mean body weight, body mass index (BMI), stress levels, and laboratory parameters, including fasting blood sugar (FBS), glycated hemoglobin (HbA1C), total cholesterol, low-density lipoprotein (LDL), blood urea nitrogen (BUN), creatinine, urine protein, urine creatinine, and urine protein-to-creatinine index (UPCI), although these changes were not statistically significant. However, an increase in waist circumference, systolic blood pressure, diastolic blood pressure, high-density lipoprotein (HDL), and triglyceride (TG) levels was observed, but these changes were also not statistically significant. The findings support the effectiveness of behavioral modification strategies based on Lewin’s Change Management Model, which facilitated systematic improvements in dietary habits, nutritional control, and physical activity among CKD patients. The program enhanced motivation, knowledge, and self-care management, reducing the risk of complications and improving long-term quality of life