The feasibility of integrating a home telehealth model for older persons living with hemodialysis.

BACKGROUND: In Thailand, there is a rapidly increasing population of older persons living with hemodialysis (OPLWH) for whom quality of life and clinical outcomes are their main focus. This study aims to assess the feasibility of an integrated home telehealth model on quality of life and laboratory parameters of OPLWH. METHODS: In this study, the second phase of a mixed methods exploratory sequential design was conducted using a repeated measures experimental design. Participants met the inclusion criteria, which included being an OPLWH at a single hemodialysis center of one hospital in Chiang Mai province, Thailand, during the experimental period between 1 April and 30 September 2018, and willing to participate in the study. The 54 participants were purposively selected and randomly assigned to receive either an intervention (n = 24) consisting of health education and health monitoring using a telehealth device (an iPad) and a web application, or usual care (n = 30). The instruments included a demographic data form, which was analyzed using the chi-square test. The health-related quality of life questionnaire (the 9-item Thai Health Status Assessment questionnaire) and blood chemistry (BUN, Cr, Hb, Hct, Alb, K, Kt/V, and nPCR) were compared and measured at baseline, and at 3 and 6 months after enrolment using independent t-test and one-way repeated measures ANOVA. RESULTS: The comparison of quality of life between the two groups at the two points of repeated measurement (after 3 months) showed a statistically significant difference in mental health scores at P < 0.05. Six months after the intervention, mean scores for health outcomes and patients' quality of life improved; however, this change did not reach statistical significance. CONCLUSIONS: An integrated home telehealth model implemented by a hemodialysis nurse is a feasible holistic care approach for OPLWH. However, the absence of statistical significance may partly be associated with the clinical characteristics of frailty and risk factors such as increased age, hypertension, diabetes, heart disease, longer dialysis time, and inadequacy of Kt/V. Large-scale multi-centre trials are warranted to fully examine the acceptability of the model. The duration and long-term effects of the telehealth model are also recommended for further investigation. PATIENT OR PUBLIC CONTRIBUTION: The development of a home telehealth model was a collaborative process between patients, caregivers, healthcare professionals from the hemodialysis unit, and the research team.

The Effectiveness of an Information-Motivation Behavioral Skill Health Promotion Video on Health Status Among Chiang Mai University Personnel During the COVID-19 Pandemic.

PURPOSE: The purpose of this research was to study the effectiveness of the IMB Educational Health Promotion (IMBEHP) video for improving quality of life, health risk awareness, and health promotion among Chiang Mai University (CMU) personnel. METHODS: This research was a quasi-experimental study with a 1-group pre-posttest design. The sample group included 528 CMU personnel who worked at the university between June 2020 and December 2021. Data collection was conducted before and after participants watched the IMB health promotion video. RESULTS: After watching the video, the participants' quality of life scores were at a medium level. Moreover, physical health, mental health, social relations, and total quality of life score measures showed statistically significant differences between before and after viewing, at P < .05. The mean total for quality of life increased from the prior intervention implementation. Understanding of health risks also increased after watching the video, and the levels of health risk increased as follows: low level of health risk increased to 343 (64.96%), followed by medium and high health risk, at 21.78% (n = 115) and 10.04% (n = 53), respectively. Lastly, awareness about nutrition was statistically significant at .05. CONCLUSIONS: The results of this study demonstrate the efficacy of video in educating, motivating, and developing health-promoting skills among this population. After watching the video, CMU personnel increased their awareness of chronic disease risk factors, health promotion practice, illnesses prevention, healthy behaviors, and improvement of quality of life.

Situational analysis on the recovery of patients who have undergone major abdominal surgery.

Aim: To analyse the recovery situation of patients who underwent abdominal surgery. Design: A descriptive study. Method: This study was conducted among 50 participants: 15 postoperative patients, 16 caregivers, 2 surgeons and 17 nurses in a tertiary hospital in Thailand. The state of patients' recovery after undergoing major abdominal surgery was analysed using Donabedian's approach. Results: The findings showed that hospitals and some organizations do not have a clear policy about clinical care to help patients recover after undergoing major surgery or to prevent the risk of complications following major abdominal surgery. In addition, there were no clinical practice guidelines in use in each ward. Each ward should have a set of guidelines and procedures for assisting with patient recovery. The procedures should be based on nursing care. It is necessary to have a coordinated multidisciplinary care guideline to use with other health professionals to promote the recovery of patients.