Development of a care model for diabetic and hypertensive patients with chronic kidney disease of participation of primary care networks in Renu Nakhon District, Nakhon Phanom Province.

Abstract

      This action research aimed to study the patterns and outcomes of care for diabetic and hypertensive patients with chronic kidney disease through the participation of the Network of Primary care Unit, Renunakhon District, Nakhon Phanom Province. The sample consisted of 50 diabetic and hypertensive patients with chronic kidney disease, selected using simple random sampling, who met the specified criteria. Research instruments included assessments of dietary control behavior, physical activity, stress, treatment and medication use. Clinical outcomes included Blood pressure, A1C, and eGFR. Data were analyzed using percentages, means, and standard deviations. Health behaviors and clinical outcomes before and after participation were compared using a paired t-test.

      The study results showed that before and after participating in the activity, the sample group's dietary control behaviors increased from an average score of 3.20 (SD=.60) to 3.49 (SD=.42), indicating a moderate level; physical activity behaviors increased from an average score of 1.44 (SD=.57), the lowest level, to 2.40 (SD=.36), indicating a low level; stress levels decreased from 1.40 (SD=.52) to 1.26 (SD=.33), the lowest level; and treatment and medication use scores increased from an average score of 3.47 (SD=.38), the moderate level, to 4.30 (SD=.52), indicating a high level, after participation in the activity. These differences were statistically significant at the .05 level. These were the overall health outcomes. The study found that systolic blood pressure (SBP) decreased from 142.6 (SD=16.16) to 129.58 (SD=7.81) in terms of mean, and A1C decreased from 8.6 (SD=3.68) to 7.7 (SD=2.37) in terms of mean, both showing statistically significant differences at the .05 level. Diastolic blood pressure (DBP) decreased from 76.26 (SD=11.09) to 74.12 (SD=8.32), glomerular filtration rate (eGFR) increased from 40.15 (SD=8.64) to 41.76 (SD=12.25) in terms of mean, with no differences.