ประสิทธิผลของการพัฒนาแนวทางการเข้าถึงบริการในคลินิกโรคหืดและปอดอุดกั้นเรื้อรังโดย ใช้กระบวนการเสริมพลังในเครือข่ายหน่วยบริการปฐมภูมิ

Abstract

This is a participatory action research combined with the implementation of Gibson
(Gibson, 1995) empowerment process. The objectives are 1) to create asthma and COPD
networks in primary care units 2) to develop guidelines for accessing services in the clinic
using the empowerment process 3) to compare the results before and after implementing
the guidelines. The studied group consisted of 120 healthcare network members and 100
patients with asthma and COPD.
Research showed that the network consisted of health workers, community leaders,
village health volunteers, and patients with asthma and COPD. The guideline is that the
network plays the role in locating patients, providing knowledge about diseases and
treatments, monitoring medication/appointments, public relations for clinic, accompanying
patients in examinations, and creating a linked patient database by integrating with other
chronic diseases care in the area.
There are 4 aspects regarding the development of hospital guidelines 1) Public
relations 2) Service system 3) Participation in associate network 4) Personnel / equipment /
locations. Subsequent to the research, it appeared that the number of patients treated at
the clinic increased by 49.14% and clinic appointments increased 45.93%.
When comparing with Paired t-test statistics, it was found that the average number of ER-Visit
patients and missed appointments were decreased; Patients had better lung capacity and
more accurate medication usage; and the hospital incurred significantly less expenses for
emergency room treatments which is statically reduced at .05 This shows that building and strengthening the primary care unit network promote
cooperation within community and asthma and COPD patients so a practical and sustainable
guideline can be formulated with positive outcome by integrating the work with other
chronic disease care in the area. This research can also be a model for solving the problem
of patients missing their appointments or not attending clinics for other diseases both inside
and outside the hospital.