Development and Evaluation of a Care Model for New Smear-Positive Pulmonary Tuberculosis Patients by Village Health Volunteers in Sisaket Province

Abstract

This research investigated factors associated with the care behavior and supervision of medication intake for new smear-positive pulmonary tuberculosis patients. Additionally, a care model was developed and evaluated for new smear-positive pulmonary tuberculosis patients by village health volunteers in Sisaket Province. The research consisted of three phases: Phase 1, an analytical cross-sectional study aimed to identify factors associated with the care behavior and supervision of medication intake for new smear-positive pulmonary tuberculosis patients; Phase 2, action research aimed to develop a care model for new smear-positive pulmonary tuberculosis patients based on the PDCA model; and Phase 3, a quasi-experimental study aimed to assess the effect of the developed model from Phase 2. The data were analyzed using multivariable linear regression, content analysis, and independent t-test statistics. The results indicated three predicted factors associated with the care behavior and supervision of medication intake for new smear-positive pulmonary tuberculosis patients, including a family income of more than 5,000 baht per month (Mean diff = 2.95, 95% CI = 0.38-5.52), a good level of attitude (Mean diff = 5.72, 95% CI = 2.95-8.49), and a good level of health perception (Mean diff = 4.17, 95% CI = 1.40-6.93). A care model for new smear-positive pulmonary tuberculosis patients by Village Health Volunteers consists of five components, including knowledge and skills, stuff and systems, quality for home visits, coacher and coaching, and follow-up. After the experiment, the scores for knowledge, attitude, health perception, and the behavior of care and supervision of medication intake for new smear-positive pulmonary tuberculosis patients in the experimental group were significantly higher than those in the comparison group. Therefore, health administrators should implement models or activities to supervise the medication intake of tuberculosis patients, aiming to increase the success rate of tuberculosis treatment and reduce the spread of the disease in the area.