Nursing and Continuing Care Management Work Plan for People Living with Coronavirus Disease 2019: A Case Study of Nakhon Pathom Province (Preprint)

BACKGROUND In Nakhon Pathom Province, residents who recovered from COVID-19 over the past 3-4 years have not been monitored for post-COVID-19 symptoms (Long COVID), resulting in a lack of necessary services. OBJECTIVE 1)To study the issues, needs, and systems of nursing and continuous care for people living with post-COVID-19 in Nakhon Pathom Province. 2)To design and develop a database system for continuous monitoring and care of individuals with post-COVID-19 in Nakhon Pathom Province. 3)To develop guidelines for the continuous care of patients recovering from post-COVID-19 in the community at Nakhon Pathom Province. 4)To evaluate the effectiveness of the database system for continuous monitoring and care of individuals with post-COVID-19 in Nakhon Pathom Province METHODS Participatory action research. RESULTS Post-COVID-19 symptoms persist for approximately six months, with common symptoms including persistent cough and easy fatigue. Patients with post-COVID symptoms have reduced access to services, relying on symptomatic treatment at local healthcare facilities and utilizing telehealth nursing systems. They expressed a need for continuous care from professional nurses and village health volunteers. Consequently, healthcare guidelines for post-COVID-19 recovery were developed, consisting of five approaches: 1) self-care through digital information retrieval, 2) care via telehealth nursing systems, 3) physical healthcare services post-recovery, 4) mental health services post-recovery, and 5) continuous care for referral in case of post-recovery incidents. These guidelines were used to design a database system for continuous monitoring and care, which was evaluated as highly effective. CONCLUSIONS This research highlights the critical need for a proactive and comprehensive approach to managing post-COVID-19 care in Nakhon Pathom Province. By developing and implementing a database system for continuous monitoring and care, along with clear guidelines, the study effectively addresses the ongoing needs of individuals recovering from COVID-19. The integration of technology, along with continuous care provided by professional nurses and village health volunteers, is highly effective in improving the quality of care. The findings suggest that adopting these strategies and implementing supportive policies on data management and communication systems focused on home visits will significantly enhance health service management and better prepare the region for future public health challenges.