背景:登革热已成为泰国南部的重要健康问题。然而,这个地区只有一个监视预防系统,对于从家庭到初级保健单位(PCU)和地区医院的患者,没有关于登革热治疗的分步指南。因此,这项研究是为了制定和使用登革热患者护理指南(DPCG),评估知识,态度,登革热患者护理实践(KAP)。
方法:26名医疗保健提供者(13名护士,和13名公共卫生官员)来自八个PCU和地区医院开发了DPCG。研究设计基于社区参与行动研究,该研究整合了爱荷华州模型,涉及以下步骤:准备,指导方针发展,使用和监测,评价和结论,和引用技术。我们评估了使用DPCG前后参与者在患者护理和设备准备方面的改善情况。McNamara检验用于比较使用DPCG前后的变化结果。定性数据收集是在两次会议讨论中进行的,有六个开放式项目。使用主题分析技术,我们提取了结论并提出了解决方案。
结果:该指南包括在家庭中提供患者护理的四个步骤,PCU,门诊部,急诊室,和住院部。在39例登革热患者中使用DPCG后,其中30例住院1,两名患者转诊至三级护理医院,无死亡。总体参与者的知识和态度,病人护理的六个方面中的两个,八种设备管理中的三种得到了显着改善(p<0.05)。评估了与定量数据相关的11个主题。
结论:DPCG指导登革热患者从家庭到PCU和地区医院的医疗保健提供者的护理。所有参与者都提高了KAP,和设备管理。需要逐步使用DPCG,并需要所有利益相关者的参与。
BACKGROUND: Dengue has been an important health issue in southern Thailand. However, this area has only a surveillance-prevention system, without step-by-step
guidelines on dengue treatment for patients admitted from households to primary care units (PCUs) and district hospitals. Therefore, this study were to develop and use a dengue patient care
guideline (DPCG), and to evaluate knowledge, attitude, practice (
KAP) of dengue patient care.
METHODS: 26 health care providers (13 nurses, and 13 public health officials) from eight PCUs and the district hospital developed the DPCG. The study design was based on the community participatory action research that integrated the Iowa model involving the following steps: preparation, guideline development, use and monitoring, evaluation and conclusion, and referring technology. We assessed the improvement between before and after using the DPCG regarding the participants\'
KAP on patient care and preparedness of equipment. McNamara\'s test was used to compare the changing results before and after using the DPCG. Qualitative data collection was performed in two meeting discussions with six open-end items. Using a thematic analysis technique, we extracted conclusions and suggested solutions.
RESULTS: The guideline included four steps for patients\' care provision at households, PCUs, outpatient departments, emergency rooms, and inpatient departments. After using the DPCG in 39 dengue patients of which 30 patients were admitted to the inpatient department1 and two patients were referred to the tertiary care hospital without mortality. The overall participants\' knowledge and attitude, two of six aspects of patients\' care, and three of eight types of equipment management were significantly improved (p < 0.05). Eleven themes were evaluated which were associated with the quantitative data.
CONCLUSIONS: The DPCG instructed dengue patient\'s care for health care providers from households to the PCUs and district hospital. All participants improved
KAP, and equipment management. Step-by-step of DPCG use and participation of all stakeholders are needed.