Non-Communicable Diseases (NCDs) are the significant public health problem in Thailand and worldwide. NCDs are major causes of morbidity and mortality. The major causes of NCDs deaths included stroke, ischemic heart disease (IHD), hypertension (HT), and type2 diabetes (DM). The consequences are impacts on health status and socioeconomic status. Patients with NCDs who do not receive care properly result in complications, leading to disability, premature death, and increased healthcare cost including personal income losses, family income losses and medical expenditure at the national level. Primary care systems are therefore significant for prevention and management of NCDs. Healthcare accreditation institution began to accredit primary care at district level in order to improve quality of the primary care systems with an emphasis on holistic care. Thus, nursing is important for health services in primary care. This study aimed to describe needs of nursing for prevention and management of NCDs as perceived by health care providers and patients with NCDs.
Methods: This study used a descriptive design that combined quantitative and qualitative methods. The conceptual framework of this study was guided by the Donabedian Quality of Care framework in assessing prevention and management of NCDs in primary care. This framework has three components: 1) Structure, 2) Process of Care and 3) Health Outcome. The participants were 30 healthcare providers and 384 patients with NCDs from five Thai Health Promotion Hospitals (THPHs) in Thailand. The data were collected using questionnaires on demographic data, needs of nursing, and satisfaction and medical records including patient health status. The quantitative data were analyzed using descriptive statistics including, frequency, percentage, mean and standard deviation and qualitative data were analyzed using content analysis.
Results:
The preliminary finding showed that the needs of nursing as perceived by health care providers include nurses’ health prevention and management activities, clinically competent nurses, interprofessional collaboration, nurse-patient relationship, adequate nurse staffing, information and technologies on nursing care, and community engagement. The strategies to increase follow-up health outcomes and educate early warning signs of NCDs complications are essential needs of nursing for prevention and management of NCDs. In addition, the needs of nursing as perceived by patients with NCDs include accessibility, comprehensiveness, and continuing of nursing care. Moreover, promoting effective communication between patients and nurses is important strategy to enhance quality of nursing care. On the other hand, there are several obstacles to increase quality of nursing care such as inadequate nurse staffing and equipment, limited time of nursing care activities, communicating with patients, and lack of interprofessional collaboration and competence with respect personal characteristics and culture.
Conclusion:
Needs of nursing are described in three major components including structure, process, and outcomes. Improving quality of nursing care and primary care services leads to reduce morbidity, mortality and complications of NCDs. Thus, implementation of the policies or strategies to support nurses’ roles are required in order to achieve patient well-being with sustainability.