ประสิทธิผลของแนวทาง D-METHOD F-P ต่อความพร้อมของญาติและอัตราการกลับมารักษาซ้ำภายใน 28 วันในผู้ป่วยโรคหลอดเลือดสมอง หอผู้ป่วยอายุรกรรมหญิงโรงพยาบาลสันป่าตอง

Suthathip Singkarad

Authors

Suthathip Singkarad Sapatong Hospital

Keywords:

การวางแผนจำหน่าย, ญาติผู้ดูแล, ผู้ป่วยโรคหลอดเลือดสมอง, แนวทาง D-METHOD F-P

Abstract

Introduction: Stroke is a major public health problem associated with high rates of disability and hospital readmission. After discharge, patients and caregivers often lack adequate preparedness for ongoing care. The D-METHOD F-P guideline is a structured discharge planning approach emphasizing participation and systematic preparation. This study aimed to examine the effects of this approach on caregivers’ knowledge, readiness, and 28-day readmission rates. Methods: A quasi-experimental two-group pretest–posttest design was conducted. The sample consisted of 40 stroke patients and 40 primary caregivers, equally assigned to control and experimental groups (20 pairs each). The experimental group received discharge planning based on the D-METHOD F-P guideline, while the control group received usual care. Data were analyzed using descriptive statistics, paired-samples t-test, independent-samples t-test, chi-square test, and Fisher’s exact test.

Results: Post-intervention, both groups demonstrated significant improvements in caregivers’ knowledge and readiness (p < .001). The experimental group had significantly higher posttest scores than the control group in both knowledge (p < .001, 95% CI 4.47–10.24) and readiness (p < .001, 95% CI 4.26–11.54). In the experimental group, 35.00% of caregivers achieved a high level of readiness, whereas none in the control group did. The 28-day readmission rate was lower in the experimental group than in the control group (5.00% vs. 20.00%); however, the difference was not statistically significant (p = .342). Caregivers in the experimental group reported high levels of satisfaction with the discharge planning process.

Conclusion: The D-METHOD F-P guideline improved caregivers’ knowledge and readiness and showed a trend toward reducing 28-day readmission rates. However, the study was limited by a small sample size and a single-center setting, which may restrict generalizability.

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