การพัฒนาแนวทางสนับสนุนการดูแลผู้สูงอายุในภาวะพึ่งพิงด้วยกลไกสามภาคี  ตำบลท่าพญา อำเภอปะเหลียน จังหวัดตรัง

Thanyalak Nakban

Authors

Thanyalak Nakban Tha Phaya Subdistrict Health Promoting Hospital, Palian District, Trang Province

Keywords:

Dependent Older Adults, Tripartite Collaboration, Primary Health Care

Abstract

This research and development study aimed to (1) examine the situation and problems of community-based care for dependent older adults, (2) develop a supportive care guideline for dependent older adults through a tripartite mechanism, and (3) evaluate the outcomes and appropriateness of the developed guideline. The study was conducted in Tha Phaya Subdistrict, Palian District, Trang Province. The research was implemented in three phases. Phase 1 explored the situation and problems of care for dependent older adults using in-depth interviews and focus group discussions with 27 participants. Phase 2 involved the development of the supportive care guideline through a workshop meeting of the tripartite mechanism with 15 participants. Phase 3 consisted of pilot implementation and evaluation of the developed approach with 30 pairs of dependent older adults and their caregivers, along with 10 stakeholders. Outcomes were assessed using the Barthel ADL Index, and quality of life was assessed using the EQ-5D-5L. Data were analyzed using descriptive statistics, paired t-tests, and Wilcoxon signed-rank tests, and content analysis.

The findings from Phase 1 showed a continuous increase of dependent older adults in the area by experiencing systemic issues, caregiver burden, resource constraints, and a lack of integrated operations. Phase 2, a supportive care guideline for dependent older adults consisted of a tripartite working structure, a four-dimensional integrated care, and a monitoring and evaluation system. Phase 3 found that after implementing the guideline, with increased ADL scores and decreased EQ-5D-5L scores, indicating better quality of life. The developed approach showed high levels of appropriateness and feasibility.

The supportive care guideline for dependent older adults effectively improved both individual outcomes and the community-level care system and can serve as a practical model for scaling up in other areas with similar contexts.

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