Developing a model for caring for multidrug-resistant tuberculosis patients in the community: A case study in Chumphonburi district, Surin province.

Abstract

     This action research was conducted according to the ideas of Kemmis and McTaggart in order to develop a care model for MDR-TB patients in the community. The target groups were; 1) the target group for collecting qualitative data and development of the model, totaling 15 people and 2) a sample group that will try out the model, purposefully selected from caregivers of 6 MDR-TB patients. Research was conducted in Chumphon Buri District, Surin Province between October 2023 – August 2024. Quantitative data were collected from questionnaires, interviews and medical records. Data were analyzed using descriptive statistics and content analysis for qualitative data.
     The results found that the model for caring for MDR-TB patients in the community has 5 steps: as follows: 1) developing the potential of public health officials and caregivers in terms of continuing patient care in the community and forwarding information both in the service facility and in the community 2) Directly observed therapy must be someone the patient trusts and has more than 1 person and use a reporting system through the LINE application. 3) Supporting patients and families, specially in cases where there are difficult and complex problems. It will be carried out using a case management model by multidisciplinary professionals and network partners in the community. 4) Managing the patient's household environment and in the community according to the context and 5) having a service appointment system; home visits using individual care plans and referring patients for treatment monitoring. Results from the model trial revealed that MDR-TB patients had good self-care behaviors. The treatment results after 6 months have passed with negative culture results 2 consecutive times. The overall caregiver’s behavior for MDR-TB patients care is at a good level (=13.66, SD =1.05).