Development of a continuing care model for older adults with stroke in can tho city, viet nam

DEVELOPMENT OF A CONTINUING CARE MODEL FOR OLDER ADULTS WITH STROKE IN CAN THO CITY, VIET NAM TRAN THI HANH A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PUBLIC HEALTH FACULTY OF GRADUATE STUDIES MAHIDOL UNIVERSITY 2017 COPYRIGHT OF MAHIDOL UNIVERSITY iii ACKNOWLEDGEMENTS I would not reach the meaningful achievement in my professional life without supporting from teachers, colleagues and the other supporting First of all, my deepest heartfelt appreciation goes to my beloved advisors, Assistant Professor Dr Kwanjai Amnatsatsue and Assistant Professor Dr Patcharaporn Kerdmongkol for their supports and raising my professional life up by giving invaluable lessons, bringing about extraordinarily tolerant heart and holding my hands when I almost fall down I would like to express my gratitude to Assoc Prof Dr Somporn Kantharadussadee Triamchaisri, who had provided me an opportunity to be in the program I would like to express the deepest appreciation to Associate Professor Dr Punyarat Lapvongwatana for her valuable lessons, insightful comments and suggestions with hearted concerns on her students I am deeply grateful to Associate Professor Dr Nitaya Vajanapoom, Associate Professor Nawarat Suwannapong, Associate Professor Dr Ratchneewan Ross and Lecturer Dr Cua Ngoc Le, my dissertation exam committee, for their encouragement, suggestions and comments on my dissertation were invaluable Special thanks go to Professor Dr Pimpan Silapasuwan, Associate Professor Dr Sunee Lagampan and other faculties, for their constructive comments and warm encouragement; to Dr.Surat Boonyakarnkul and Ms Puangpaka Panyo for their kindness and conscientiousness during my developing intervention tools; to our staffs in Dr.PH program and Public Health Nursing Department for their supportings I would also like to thank Can Tho City People Committee and Can Tho Medical College, who created advantages for my participating in the program; and thanks my coordinators, my colleagues, my families and my friends, especially my husband during my intensive learning experience Lastly, it is greatly happy to dedicate my achievement to my late parents' soul, whose morality and lives had oriented my direction of better care for the disabled people Last but not least, special thanks and appreciation for my stroke patients and their families for their great contribution in my research Tran Thi Hanh, Fac of Grad Studies, Mahidol Univ Thesis /iv DEVELOPMENT OF A CONTINUING CARE MODEL FOR OLDER ADULTS WITH STROKE IN CAN THO CITY, VIET NAM TRAN THI HANH 5437497 PHPH/D Dr.P.H THESIS ADVISORY COMMITTEE: KWANJAI AMNATSATSUE, PhD., PATCHARAPORN KERDMONGKOL, PhD., RATCHNEEWAN ROSS, PhD., CUA NGOC LE, Dr.PH ABSTRACT Stroke management has become a public health challenge worldwide because of its severity and impacts, in particular among older adults This mixed method research was conducted to determine the components of the continuing care model (CCM) and to evaluate its effects on older adults with stroke in Can Tho City, Vietnam Based on data from the situation analysis and brainstorming with key stakeholders, the CCM model has seven components, including continuing care management, family caregiver’s training, family caregiver’s support, resource allocation, monitoring for stroke patient care, activities of daily living (ADLs) and rehabilitation care, and family reintegration Among 31 older adults with stroke received a 12-week intervention whereas a comparison group (n=46) received usual care The effects of the model were measured among 55 subjects in terms of older adults with stroke’s self-care agency, functional outcome, quality of life and complications using standard questionnaires According to Mann-Whitney Test, selfcare agency, quality of life, functional outcome, and dysphagia among the intervention group have been siginicantly improved comparing with the comparison group (p