Meeting the challenges of chronic illness: A nurse-led collaborative community care program in Thailand

Abstract

Background: Chronic illness is of concern to health care systems globally. Although a significant evidence base supports the concept of nurse-led interventions, less data is available to address unique features of health care systems in the developing world. Aim: The purpose of this study aimed to undertake preliminary testing of an intervention of nurse-led community care program, the Network Collaborative Action Plan (N-CAP), to assess the impact on disease severity and patient satisfaction. Method: A quasi-experimental study, using historical controls, evaluated a collaborative nurse-led intervention to promote coordination and continuity of care for patients with chronic illness. Results: Participants, diagnosed with chronic obstructive lung disease (COPD), coronary heart disease (CHD) and chronic heart failure (CHF) were recruited. Prospective consecutive patient meeting the study criteria (n= 47) were assigned into the control group and following development and implementation of the intervention eligible consenting patients were enrolled in the experimental group (n= 44). Participants in the experimental group had significantly lower scores on severity of disease measurements during the third week (F= 4.61, p= 0.035) and the eighth week hospital (F= 4.30, p= .041) following hospital discharge than those in the control group. Participants in the experimental group expressed significantly higher scores on satisfaction with community care than those in the control group. Conclusions: A nurse-led, collaboratively developed program has potential to improve satisfaction and decrease symptom development in people with chronic illnesses in Thailand. © 2010 Royal College of Nursing, Australia.