Development of self-care model for patients with non-communicable diseases (NCDs) in primary care units of Narasingh Subdistrict, Pa Mok District, Angthong Province

Abstract

     This study was research and development study aimed to examine the situation and problems, develop a model, and compare pre-post outcomes of the self-care model for patients with non-communicable diseases (NCDs) in primary care units, Narasingh Sub-district, Pa Mok District, Ang Thong Province, conducted from January 2025 to August 2025, totaling 8 months. The qualitative sample included 20 health personnel and health network partners. The quantitative sample included 148 NCD patients in Narasingh Sub-district. Research instruments included focus group discussion guidelines, self-care health literacy test, self-care behavior assessment form, satisfaction assessment form, model appropriateness assessment form, and clinical outcomes assessment form. Data were analyzed using descriptive statistics and inferential statistics for pre-post testing using Paired t-test. Qualitative data were analyzed using content analysis.T

     he results showed that the self-care model development process consisted of 8 main processes: 1) Village assembly and participation building 2) Personnel and volunteer capacity development 3) Knowledge and education system development 4) Integrated care system development 5) Patient self-care system development 6) Social support system development 7) Technology and innovation system development 8) Continuous evaluation and improvement, using the 3A2S approach (Food, Exercise, Emotional control, No smoking, No alcohol) as the core framework. Experts evaluated the model appropriateness at a high level (= 4.43, S.D. = 0.52). The effectiveness of implementing the model showed that self-care health literacy increased from moderate to good level (from 5.69±1.96 to 7.61±1.81 points), self-care behavior increased from moderate to good level (from 49.35±8.45 to 58.05±7.23 points). All clinical outcomes improved significantly: HbA1c decreased from 8.45±1.23% to 7.12±0.98%, fasting blood sugar decreased from 156.78±23.45 mg/dl to 132.56±18.67 mg/dl, systolic blood pressure decreased from 145.67±15.23 mmHg to 135.78±12.45 mmHg, diastolic blood pressure decreased from 89.45±8.78 mmHg to 82.34±7.56 mmHg, body mass index decreased from 26.78±3.45 kg/m² to 25.23±2.98 kg/m², and waist circumference decreased from 92.45±8.67 cm to 87.89±7.23 cm, all statistically significant at .05 level (t = 9.43, 10.57, 11.21, 10.38, 6.39, 7.82, 4.51, 5.33 respectively). Patients showed high satisfaction with the model (4.45±0.61 points, 89.00%).