The Thailand health policy aim to develop the patient care system in a community level, especially, the home rehabilitation program for stroke patients. Currently, stroke patients have long term disabilities and recurrent stroke leading to the serious life-threatening and death. The study investigated the problems and needs of caregivers for taking care stroke patients after hospital discharge and caring at home. A qualitative study was conducted in 80 key informants that comprised of 25 post stroke patients, 25 caregivers, 10 local health care officers at the community, 10 community leader, and 10 health volunteers. An in-depth interviews and focus group discussions were designed to collect the data. Caregivers were not confident about ability and skill to care stokes patients at home. Additionally, they were not understood the policy and health care service system. Health volunteers lacked of experience for supporting stroke patients in the community. The community leader and local health care officer needed more knowledge and skills including budgets, equipment, and facilities for caring the stroke patients. Ability, knowledge, skill and experience for caring stoke patients of the health care team should be addressed. Moreover, resources, facilities, equipment and budgets must be properly supported.<br /><br />

Background: Stroke patients and their caregivers face huge challenges from patients’ health problems when they leave the hospital to rehabilitate at home. Objective: To develop a model for coordinating the participation of family and community care teams to support stroke patients at home. Methods: We conducted a qualitative study applying the Appreciation Influence Control technique. Purposive sampling was employed to select 120 key informants comprised of 50 family medicine members, 10 community leaders, 30 stroke patients, and 30 patient caregivers. Data collection consisted of interviews and focus group discussions. Patients and caregivers were followed up at 1, 3, and 6 months after discharge from the hospital. Data were analyzed by content analysis. Results: The coordinating model of the health care team provided standard guidelines for home care of stroke patients, improved the referral system from hospital to home, trained public health volunteers and caregivers about caring stroke patients at home, and organized community leaders to support patient equipment and rehabilitation facilities. The collaboration between the health care team and community leaders, as well as with patients and caregivers, improved the quality of life for stroke survivors.

This research aimed to study the effectiveness of the Public Health Volunteer Participation Program in the home care of stroke patients. Methods: This was quasi-experimental research; the samples consisted of 30 public health volunteers in each comparison and experimental group by simple sampling. The experimental group participated the Public Health Volunteer Engagement Program that consisted of 1) improving the environment at home and supporting the physiotherapy by increasing movement to improve the body balance, 2) Stress management and social support of stroke patients at home, 3) Taking care the nutritional status among stroke patients at home, 4) Following on a daily within 12 weeks by nurse and public health volunteer. Data were collected by using the knowledge interview form on stroke and care of stroke patients. Data were analyzed by using frequency, percentage, mean, standard deviation, pair-sample t-test, and independent-sample t-test. Results: The results found that the knowledge average score and the home care practice score of the health volunteers were significantly higher than the comparison group (p < 0.001). When comparing the results before and after program implementation, the cerebrovascular disease care in public health volunteers were significantly higher than before program implementation. (P < 0.001). Conclusion: The Public Health Volunteer Engagement Program in Home Care for Stroke Patients was effective. This program was suitable for promoting the public health team to care stroke patients at the community level.

The objective of this documentary research was to analyze the empowerment approach of third year Thammasat University medical student health promotion projects in the academic years from 2003 to 2005. The data were extracted from six student group reports and a research report entitled "The Promise of Empowerment". The approach began with knowledge/ideas of sharing and transparency in decision making. The community underwent the empowerment process by active participation. Provision of a local resource person is suggested for on-going activities for problem solving and the learning process to continue when the students and instructor leave the community. This model is the Strengthening of Community Action and the Developing of Personal Skills, following the Ottawa Charter strategy, whereby students themselves acquire community experience in the actual context