1 Community Participation in the Care of Chronic Schizophrenia Patients

Angkana Wangthong, et al.

Journal of the Association of Researchers. Vol 19 No.2 May – August 2014.

Community participation in the care of chronic schizophrenia patients. NongChik District, Pattani Province.

Background and significance of the problem.

Schizophrenia is the most prevalent disease. It is estimated that around 1-1.5% of the world population. And the incidence of the disease is about 2.5-5: 1000 people per year (American Psychiatric Association [APA], 1995, cited in Kankook Sirisathien, 2007). The number of outpatients receiving services from mental health services increased from 1,022,504 in 2009 to 1,055,548 and 1,0912,646 in FY 2010 and 2011, respectively. (Department of Mental Health, 2011). It can be seen that the rate of mental illness is likely to increase. And still a major public health problem. The loss of the economy and resources of the country, while the number of personnel involved, such as psychiatrists, psychiatric nurses and other personnel. There are insufficient resources to drive care for schizophrenic patients at home (Suchitra Nampai, 2005).

Schizophrenia is a disorder characterized by emotional, behavioral and perceptual symptoms. The two groups are characterized by positive and negative symptoms. The disease progresses chronically and severely. There are 3 stages. Prodominal phase, active phase, and residual phase (Mannos, Laytrakul, and Pramote Suksanit, 2005). The schizophrenia often not cured. Patients will have chronic disease. Most of the time there is a relapse. They need to be hospitalized periodically. As a result, the family life efficiency of caregivers (caregivers) was

significantly declined becayse it takes a long time in caring. Also,it’s related to policy of caring

schizophrenia pateints which focus on psychiatric patients to maintain a continuum at home. If the need to be hospitalized, they for a very short time.( Boonthawatchai, 2002).

Mental Health Recovery Center NongChik District, Pattani Province There are about 338 psychiatric patients in the community who are classified as schizophrenic. (67.7%), depression (22.1%), and anxiety disorder (GAD) 10.2%. Most of them return to the community. Patients or relatives do not see significant therapeutic succession. Think about it. The lack of drug treatment resulted in patients with mental health crisis. And back to the original disease. (Mental Health Remedies Center, 2011)

Family and community influence on schizophrenia care. Community and organizations takes big role to participate in the care of schizophrenic patients. It must be based on cooperation and effective implementation which effectively reduce the number of patients with schizophrenia who return to hospital. The cost of the hospital and the state is another way. (Tasanee Anantapanpong, 1997)

Therefore, the research team was interested to studyabout community participation in caring for schizophrenic patients in Amphoe Nong Chik, Changwat Pattani. We want to encourage patients to receive treatment. And continue to take medicine. Also, we have to find ways to give service and solve problems in the community between patients, families and communities to prevent recurrence, reduce the problem of patients in crisis, and assist family

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members in caring for patients. This will affect the quality of life and dignity in society (Jaruwanpada, 2002).

Research Objectives

To study community participation in care chronic complications of schizophrenia.

Research scope

This study is a study of community participation in caring for chronic schizophrenic patients in Nong Chik District, Pattani Province. from June 2011 to April 2012.

Literary review and concept

A study of community participation in caring for patients with chronic schizophrenia in
Nong Chik district, Pattani province. The research team adapted some of the activities from the participatory community participation model of Saranrom Hospital (Nattaya Kongwatmai,2006) The following activities are defined:
1.1 Friends meet friends, aiming to build community relationships, be praised warmth, have a positive feeling. and be a part of the community.
1.2 Understand different perspective, among to learn to how live happily together Look at each other's good things to understand. The defect occurred to the person. Learn to pick good things. Accept the good of other person's admiration. Encourage Bug fixes Bring harmony to yourself and your community.
1.3 Love and commitment, aiming to explore the problem. Recognize the potential of self and others, and build self-esteem.
1.4 Our Perception of Psychiatric Patients The purpose of this study was to investigate the problem of schizophrenia. The effects of family and community caregivers. Feeling the power of sympathy Provide understanding to caregivers. Families push for energy, help and support. More knowledge of the bugs to make a give encouragement to disease to the sick and the symptoms of the person. I’ll give you a positive idea. Intentional intent or intent. The direction of care.
1.5 Our expectations for psychiatric patients are intended to explore the need for patients.
It is a mutual hope.
1.6 Finding a way to help people with mental illness can help them find a way to think critically and physically.
1.7 Our task is to share a plan to share our hopeful behavior. Has a duty assignment determine activities.
It can be seen that community participation in the care for chronic schizophrenia patients in Nong Chik District, Pattani which is the leading factor and source of benefits to individuals. The community has been involved in the care of patients with chronic schizophrenia. Comprehensive care for chronic schizophrenia patients. The community is using the resources in the community. To live together happily. Happiness is a benefit. Together, everyone takes into consideration. (Wassana,2003)

Terminology

Community involvement means that the community is actively involved in the operation.
And sincerely by mutual consent. Consider the solution sharing responsibility in the social cothinking, decision-making to achieve happiness. Satisfaction (Nattaya Kongwatmai,2006)

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Care for chronic schizophrenia patients at home refers to the treatment of schizophrenia patients with symptoms. It is enough to stay at home in his old society by having a relative, families, community and medical personnel visit. Home to follow up, rehabilitate and promote health, mental health and prevent recurrence as well. Community family to help.(Jalee Jalornsup and group 2005)

Method

This research is a qualitative research. The research and data collection are as follows.
The sample size is from a community of chronic schizophrenic patients in the area. Nong Chik District, Pattani Province Group SizeSample of 50 people by sampling method. (Simple Random Sampling) using the contact list.There is a mental health rehabilitation center in Nong Chik District.Pattani
Research tools Quantitative data is Personal Information Inquiries Is the answer as. Builtin tool And community participation activities. In the care of patients with chronic schizophrenia complex Nong Chik.Pattani Province The research team has adapted some sub-activities. From the community participation model 7Activities of Saranrom Hospital (Nattaya Kongwatmai, 2006) and Quality control by 3 experts.
Steps to collect information Quantitative Research Team 50 questionnaires were used.
Asking volunteers to do interviews and observation sessions took 30 - 60 minutes. Five groups of 10 people after the group. Interviews The research team removes all the tapes and checks. Information obtained when the information is incomplete. We had a phone call. Ask for more information from the sample. Information with data collection, the saturation data. Then discontinued the data.
Data analysis Knowledge gained from answering the questionnaire analyzed by frequency. Percentage and mean The data obtained from the interviews were analyzed using multiple reading methods. Moderate issues Classified Compared to the data provided by other data providers. Adjust the categories to be clearer. Reduce duplication And more cover up repeatedly. Until a new category is found.
Reliability of data The research team summarizes the issues after every interview with the informants to confirm the accuracy of the researcher's thoughts and feelings. (investigator triangulation)

Research result

Part 1: Quantitative data found that 36.00% of the sample was between 25-34 years old.
64.00% were female. 88.00% were Muslims, 77% were married, 60.00% high school graduate, 52.00 percent were employee, 48.00 percent of the sample had a social status as a public health volunteer, and 56.00% had a relationship with the patient, a public health officer, and an administrative officer. Secondly, 14.00% had a father relationship.

Part 2 Qualitative information consists of community participation. 7 activities can be summarized into 3 cycles as follows.

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1st Cycle Link

Creating a participation in this circuit. Each sample performs from a subjective attitude.
Sense of thought for patients with chronic schizophrenia.

As words
I have to take care of villagers in the area. I know that many people in the area are sick. I do not want to get sick. Fear will come, but I sympathize with him "(G2)

The acquisition of sample participation in the care of patients with chronic schizophrenia is complex. Engagement activities:

1. Friends Activity Create a relationship. Start by greeting Purpose of this study is to create a relationship. The research team was familiar and had good relationships with the sample and had worked together before. And the samples themselves have volunteered to care for patients. It is willing to provide information in order to summarize the knowledge to others to continue. Samples were dared to ask questions from the research team. The research team has built trust. By the familiarity that has worked together before. The sample learned. Make a selfreport on how the team is trustworthy. From the words or attitude expressed, the trust of the research team. During the activity, the research team paid attention and listened. Try to understand what the samples say without dispute.

2. Activities look at different angles. In order for the samples to know and understand themselves, their good points and defects lead to self-improvement. At the same time, the person has to know and understand the difference of the person. Learn to live together happily. Look at each other's good. Understand the shortcomings that occur with individuals. Learn to choose good things, accept good things of others, appreciate the encouragement of debugging. Accept other people and adapt to others. Bring harmony to yourself and your community. As the saying goes, "When you see a good psychiatric patient. It will be appreciated as a supportive spirit "(G1)". Make yourself known and understand the difference of people. Look at each other's good. Adjust to live together happily. Under the circumstances, "(G4)

2nd cycle together.

This step after getting to know. Create a relationship of participation of the sample. Each person practicing exchanges. Conducted the experience of participating in the care of patients with chronic schizophrenia complex in the community as summarized below.

1. Activity with love and commitment. In order for the sample to explore the problem, the self-esteem and other potential And proud. The pride is the feeling that each person has for themselves. Awareness of self-image or self-image as a valuable person. This awareness will bring a sense of stability and happiness. Everyone has good things in themselves, not more or less. Which is considered a self-esteem. People who are proud of themselves will be able to give

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love to other people. People without self-esteem Even in a family with economic readiness. It may be difficult to adapt to others. Self-esteem is a strong person with self-confidence. It is depend on others and daring to ask for help from others as well. By adding activities to create compassion and appreciation, such as

- Give caregivers of schizophrenic patients who are maternal / paternal. People who love children speak, express your feelings towards children, and deal with having a chronic illness. With mental illness Desire to wish for the symptoms of the child. As the saying goes, "Poor children. "G1)" is a disease that does not disappear. I have to take medicine. Sometimes bored But as a child, it must be tolerated. "(G4)

- Encourage and empower the sample to express sympathy to patients with schizophrenia and caregivers. Want to help Want to light As the saying goes, "There is coordination and networking in the community to help and support each other." (G1, G3) "The children are treated and those around them understand the importance of their children. I have a good mental health, accept the truth and care for sick children as well. "(G2)

- Disease information. Preliminary treatment Resolve problems that help patients with schizophrenia improve. With community care,The word "religious" is used in conjunction with the drug. "G2." The SAO came to help with his career. The patient or caregiver is employed. Increase your self-esteem (G2)

2. Our perception activity for psychiatric patients was to investigate the condition of mental illness patients and their families. Recognize the effects of family and community caregivers. Understanding family caregivers push for help. And it is common knowledge that mental illness. Not the only problem of the family. It has an impact on the community. As the saying goes, "The day before, Kagah watched the TV news that the mother killed two children. See the news already acclaimed. Kagah thinks that everyone thinks and feels like her. It has all the consequences. We must help each other "(G3)

3. Our Expectations for Psychiatric Patients For the sample to explore their aspirations.
A study of psychiatric patients in the community. And the community has been educated. The hope of other people. A study of psychiatric patients in the community. The sample was shared. The common hope is true. Want to help outpatients in the community? This is because the opportunity for the sample to build on their aspirations to help patients with psychosis in the community. Helps the sample feel self-important in helping. The problem of psychiatric patients in the community is as follows: "I want religious leaders to gain mental knowledge. In order to use that knowledge. Tell the Muslims to pray at the mosque. Or the Buddhists who make merit at the temple "(G2)". Divide responsibility for mental health care in the community "(G1).

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The 3rd Circuit

The third cycle is bound to require this step is to find a model of community participation in the care of chronic schizophrenic patients in Nong Chik district, Pattani. Join the plan and push to share ownership, to show the work behavior to achieve common goals.

Summary
1. Co-operative Activity For the sample to learn how to think. Logically and formally To make that goal mutual success. The result of co-thinking and defining solutions. Join the community by sharing the community. Good results from the co-help people in the community. Enough said. Is the result of the mind is to cause happiness or good health. Because of the feeling of warmth. Feeling safe, meaningful, valuable and healthy. The words "help each other. It has the mental effect to make the job easier. It's a good result overall. "(G3)" Helping patients and families. We are happy. Have a good friendship And happy to see his smile and family again. "(G2) The material effect is a group of people or communities that share a common activity. Have a generous Share the object like food, utensils Pride and stability in life. As the saying goes, "SAO came to help with careers. The patient or caregiver is employed. Increase your self-esteem. "(G2) The social effect is that when the co-operation is done, it is a social energy that can lead to solutions to problems and mental illness in people. social As the saying goes, "The common solution to each problem is small. Will cause harmony Community Empowerment Make the community happy "(G4)

2. Our Activities To provide the sample with a step-by-step implementation plan. It is the responsibility of the system to focus on participation. It will be clear and easy to contact. Promote to share the work behavior to achieve hope. As the saying goes, "We share best practices and functions. Will make us happy People around them are happy "(G1). Thus, community involvement in the care of chronic schizophrenia patients can be said. Community involvement activities. The factors and resources that community individuals have to take part in the care of chronic schizophrenia patients due to the care of patients with chronic schizophrenia complex by the community. The use of resources in the community. Happiness is the mutual benefit that everyone takes into account. (Vasana Chandawan, 2003), resulting from the creation of people in their own communities to gain knowledge. Have a good attitude Understand the role. And a leader in change. To organize the care, follow up and evaluation (New York Times, 2006), and to build and expand the network. Synchronization Forward with The quality and continuity of staff (Nongkhai Kasetphong, 2007)

Discussion of results

Qualitative research found that Community participation in the care of chronic schizophrenia patients. The patient care in the community continuously to provide good quality of life, can accept and adapt to the society happily. Relative knowledge is skill in patient care. Relatives and communities. A good attitude towards schizophrenic patients is essential.(Montree Jantra,Sumatthana Klangkan and Julalat Hawhan ,2011) Contingent attitudes, feelings, thoughts,

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and community behaviors on behavioral needs of patients with chronic schizophrenia which can be discussed as follows.
1. Attitudes toward feelings and thoughts toward patients with chronic schizophrenia. 2. Community behavior towards chronic schizophrenia patients. Patterns of attitudes toward chronic schizophrenic patients from the community at home care services:

Sensory perception of patients with chronic schizophrenia.

1. Friends Activity Create a relationship. The feeling of being a single sample of the fun, and preparation of the sample to participate in the activity by encouraging the sample to find the good of others. It creates a good feelingthat leads to a good relationships, and maybe promote collaboration. Creating relationships or relationships is very important to human beings. To promote readiness. This is an important strategy that has been discovered in social coexistence. To have good relationships with others, I trust to prevent problems. Let the health care provider listen. In this study, It is a very important method of mental healing. Nurses need to use their own tools to build relationships. The disclosure of information or feelings in both behavior, thoughts or feeling by targeting together. It will be ready to take care. This is consistent with the study by Raneeanakorn Kongchok (2010). The psychiatric nurse's perspective on family membership of schizophrenic patients. The study indicated that Promoting care availability is an important step in the relationship between psychiatric nurses and family members of schizophrenic patients, in order to help family members maintain and support schizophrenic patients. Live with family and community.
2. Activities look at different perpectives for the sample to know and understand themselves. Seeing good points and their own shortcomings leads to self-improvement. At the same time, the person has to know and understand the difference of the person. Learn to live together happily. Look at each other's good. Understand the shortcomings that occur with individuals. Learn to pick good things, accept good things. The other person's admiration. Encourage debugging. Accept other people and adapt to others. Bring harmony to yourself and your community. Maybe because The people will live together happily. It must be started by having good relationships with each other. People should know and understand themselves and others. Promote good attitude or attitude. Consistency of the study Luck (2010). Psychiatric nursing perspective on family members of schizophrenic patients. The study found that promoting the positive attitudes of family members of schizophrenic patients is one way to promote family members' ability to care for and support schizophrenic patients. Encourage participation in care. And is part of the health team. Understand more patients. The study of Kanchana Manarat, Wipawee Tribal Khon Kaen and Surachada Kuntanan (2012) on the Development of Nursing Network. To care for schizophrenic patients at home. The study indicated that Community leaders understand more patients and families. Birth Network Health is proud of happiness. And the community is very cooperative with ith help compassion of the people in the community. There will be more harmony and affectionate This will lead to help the schizophrenic patients to live happily with the family in the community. This will make him proud and creat self-esteem . This will bring harmony to the society.

Opinion on chronic schizophrenia patients.

1. Activity with love and commitment. In order for the sample to be able to explore the problems of the sample,values of themselves and others. The pride is the feeling that each

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person has for themselves. Awareness of the value of the self. Or the image of self as a valuable person. This awareness will bring a sense of stability and happiness. Everyone has good things in themselves, not more or less. Which is considered a self-esteem. People who feel self-esteem will be able to give love to other people who have no self-esteem. Even in a family with economic readiness. It may be difficult to adapt to others. Self-esteem is a strong person, selfreliant, self-reliant. And dare to ask for help from others as well. By adding activities to create compassion and appreciation. The study of Aree Supavong (2006) found that family members with schizophrenia were embarrassing. And do not want others to have bugs family members. Caregivers are embarrassed to care for patients. Neighbors and people in society will be disgusted and aggravated by critically ill patients and caregivers. Especially the family in the countryside. The nature of the rural people will be interested in my story. In the village there is a vowel story. If any family has mental illness patients with severe exacerbation or disability Do not participate in social activities. Attitude of neighbors In this study,
2. Our perception activities for psychiatric patients, in order to allow the sample to explore the morbidity of the patients and their families. Recognize the effects of family and community caregivers. Understanding family caregivers push for help. And more knowledge of the bugs. To make a good feeling for the sick person. And the symptoms of the patient. Positive thoughts The intention or direction to help. It helps the sample to look at the problem more broadly. More detail And it is common knowledge that mental illness. Not the only problem of the family. It has an impact on the community.
An analysis of the chronic schizophrenia problem in Nong Chik district using the participatory community participation model. By the involvement of the caregiver. And village health volunteers. Common problems in chronic schizophrenia patients. 1) lack of knowledge about mental illness; 2) discontinuation of medication; Due to the lack of knowledge in the observation and management of side effects of the drug, the patient thought it was gone, the side effects of the drug. Cause of suffering, time to take medication for a long time. Cause boredom in the drug. Also, cannot tell the exact time to stop taking the drug when the complexity of treatment. Hardship The complexity of Arya Research Supawadee (2006). On taking medication. Most patients do not take continuous medications. May be due to side effects of the drug. Or is it good? No need to eat again. 3) The society has a bad attitude towards schizophrenic patients. Specifically, the effects of schizophrenia patients are lacking. Family let alone Not care as it should be. The result of the activity. It was found that the patients had panic attacks. Because of the aggressive behavior to destroy the relatives and those nearby.
3. Our Expectations for Psychiatric Patients For the sample to explore their aspirations. A study of psychiatric patients in the community. And the community has knowledge of psychosis in the community. Let the participants share a common hope. This may be due to the opportunity for the sample to build on their aspirations for helping the schizophrenic in the community, enabling them to feel self-critical. To help Recognize that they are part of the society, cooperate to solve problems in schizophrenic patients in the community. Correlation of factors related to the ability of caregivers of schizophrenic patients in the community. The study indicated that Perception of caring for each other is closely related, making the person feel secure. Recognize and expect to be a part of society. Opportunity to help others. Cause self-esteem. Suwadee Wongphan, Jaretip Pinijit and Hathairat Nopmitt (2011), on the effect of using the psychiatric and family care skills development program for public health volunteers, is an important force. It is important to work together to provide patients with a normal lifestyle. The results showed that the family and community were satisfied with participation by home visits of health volunteers at