Journal of Medical and Public Health Region 4

The causal relationship model of factors influencing fall prevention behaviors of the elderly in Lopburi Province

Siriwun wisetkaew, Prapapen Suwan — Tue, 11 Jun 2024 00:00:00 +0700

The purposes of this quantitative research were to study the level of fall prevention behaviors of the elderly,
to develop a causal relationship structural equation model of factors influencing the fall prevention behaviors of the elderly, and to examine the pathways of influence of causal factors on fall prevention behaviors. The sample consisted of 520 elderly people living in Lopburi Province and were selected by multi-stage sampling method. Data were collected using a 5-rating scale questionnaire with a content validity index between 0.60 - 1.00 and questionnaire reliability index of 0.92. The statistics used for data analysis were percentage, mean, standard deviation, influence path analysis by using a computer program.
The results showed that the developed model was consistent with the empirical data (Chi-square = 259.96, df = 133, c²/df = 1.95, Index GFI = 0.91, AGFI = 0.86, RMSEA = 0.042). The direct coefficients of self-efficacy and attitude towards fall prevention in elderly fall prevention behavior were 0.86 and 0.44, respectively and the fall prevention behaviors of the elderly were indirectly influenced by health belief model and social support through self-efficacy and attitude towards fall prevention with the influence coefficients of 0.84 and 0.24, respectively. All variables could explain 65% of the variance in fall prevention behavioral variables. In summary, fall prevention among the elderly should promote self-efficacy awareness and have a positive attitude to prevent falls.

Nurses’ palliative care behaviors among patients with heart failure in the 4th Public Health Region

Tue, 11 Jun 2024 00:00:00 +0700

This descriptive research design aimed to investigate nurses' palliative care behaviors for heart failure patients. Participants included 203 registered nurses among the five hospitals in Health Region 4, Thailand. The inclusion criteria were 1) nurses who had been working for at least one year and 2) nurses who had experience caring for heart failure patients with New York Heart Association Functional Classification class III - IV at least three patients. Data was gathered by 1) demographic form and 2) nurses’ behavior palliative care for heart failure patient’s questionnaire (NBPC-HF) with Cronbach's alpha of 0.94. Data were analyzed by using descriptive statistics. The findings indicated that nurses' palliative care behaviors among patients with heart failure were moderate level ( = 88.08, S.D. = 19.89). When considered each aspect,it was observed that some aspects were found to be at a low level: 1) the assessment of disease progression ( = 5.24,
S.D. = 1.86), with the lowest score for the Palliative Performance Scale (PPS) ( = 1.94, S.D. = 0.66); and 2) advance care planning ( = 9.24, S.D. = 2.75), with the lowest score for seeking the last wishes and the needs of the patients and their families ( = 1.95, S.D. = 0.57). The findings can be used to enhance the quality of palliative care nursing services for heart failure patients. Especially in the assessment of disease progression and advance care planning for efficient care that fulfills the needs of patients and their families.

Ventricular arrhythmia after aortic declamping during heart valve surgery: Comparison between Custodiol cardioplegia and cold blood cardioplegia

Tue, 11 Jun 2024 00:00:00 +0700

The purpose of this retrospective study was to investigate the incidence of ventricular arrhythmias after aortic declamping and the outcomes of custodial cardioplegia compared with blood CPG in patients undergoing single heart valve surgery, double heart valve surgery and triple heart valve surgery. Method: data were collected from the medical record database of heart valve surgery patients at Naresuan University Hospital in Phitsanulok province from 2015 - 2021. The participants were patients undergoing heart valve surgery, received custodiol cardioplegia or blood cardioplegia, aged between 20 - 70 years and selective random sampling according to the inclusion and exclusion criteria. The research instruments were a general information and a surgical information form. The results showed that the total number of heart valve surgery was 105 patients, 59 single heart valve surgery, 33 double heart valve surgery and 13 triple heart valve surgery. The rate of ventricular arrhythmias in single heart valve surgery who received custodial cardioplegia was significantly higher than those received cold blood cardioplegia (6 (25.00):1(2.90); p = 0.010). The propensity for ventricular arrhythmias was in the same direction as patients undergoing double and triple heart valve surgery. The outcome of using both cardioplegia solution in patients undergoing single, double and triple heart valve surgery including Intra-aortic balloon pump, ICU stay, and hospital length of stay was found to be no different.

Using the theory of planned behavior to predict condom use among men who have sex with men in upper Northern Thailand

Montiwa Sunanta, Sineenart Chautrakarn, Parichat Ong-artborirak — Tue, 11 Jun 2024 00:00:00 +0700

This study was Cross-sectional analytic study which has objective to study the between Theory of Planed Behavior (TPB) to predicted Condom use behavior among Men who have sex with men (MSM) in Northern Thailand. Sample were 342 cases who recruited by convenience sampling and Snow ball sampling techniques. Data were collected by questionnaires, which developed from TPB, there was Index of item objective congruence (OIC) 0.6 - 1 point and was reliability tested by Cronbach's alpha coefficient = 0.82. Using descriptive statistics to explained sampling’s characteristics, the TPB correlation with Condom use was analyzed by Spearman’s rank correlation coefficiency and was predicted condom use possibility by Logistic regression model. This research results were following: Sample were 27.9 and consistently using a condom 49.7%. The result was related with TPB model, Condom use intention was significant correlation with Condom use intention (r = 0.6, p-value < 0.001). The TPB was 36% predicted intention of condom use (R² = 0.36) and was 21% predicted condom use behavior (R² = 0.21). The people who are involved Condom use promotion/policy should develop behavior modification program which heading to reinforce condom use behavior intention than condom use knowledge.

Assessment of hemodialysis adequacy and associated factors related to hemodialysis adequacy in end - stage renal disease patients

Yingluk Watcharananan — Tue, 11 Jun 2024 00:00:00 +0700

Patients with end stage renal disease receiving hemodialysis have increased risk of morbidity and mortality from inadequate hemodialysis. This study aims to access the adequacy of hemodialysis and to study factors related to hemodialysis adequacy in patients with end stage renal disease. This study was performed as a retrospective cohort study in end stage renal disease patients undergoing hemodialysis at 2 hemodialysis centers in Langsuan between 1 July and 30 September 2022. Data were analyzed to access adequacy and associated factors related to hemodialysis adequacy using multivariate logistic regression analysis. One hundred and eighty patients were enrolled in the study. Patients achieved hemodialysis adequacy for 76% of Kt/V and 77% of URR, mean Kt/V 1.73 ± 0.53 and mean URR 73.28 ± 12.36.There were four factors significantly related to adequacy of hemodialysis: female adjust OR = 4.41, 95% CI 1.89 – 10.28, p = 0.001, dialyzer surface area of 2.1m² adjust OR = 3.32, 95% CI 1.28 - 8.59, p = 0.013, blood flow rate 350 ml/min adjust OR = 4.39, 95% CI 1.79 - 10.76, p = 0.001, dialysis frequency 3 times per week adjust OR = 4.32, 95% CI 1.71 - 10.93, p = 0.002. There were four factors significantly related to hemodialysis adequacy including female, dialyzer surface area of 2.1m², blood flow rate 350 ml/min, dialysis frequency 3 times per week

Wisdom and predictive factors of indigenous vegetables consumption for elderly health promotion in Salung - Keelek Community, Mae Rim District, Chiang Mai Province

Samart Jaitae — Tue, 11 Jun 2024 00:00:00 +0700

The objectives of mixed methods were to investigate the health promotion of the elderly based on indigenous vegetable wisdom and factors predicting elderly consumption of indigenous vegetables. They were selected by a multi-stage random sampling of 300 people and 12 stakeholders living in Saluang - Keelek community, Mae Rim district, Chiang Mai province. The data were collected through questionnaires, non–structured interviews, and focus group discussions. The data were analyzed using descriptive statistics, regression analysis, and content analysis. Results showed that indigenous vegetable wisdom consisted of increasing indigenous vegetable areas, utilization, and conservation. The consumption of indigenous vegetables was moderate (mean = 2.77). It was found that the factors significantly influencing of the indigenous vegetable consumption were age (β = -.149, p = 0.006), number of members in the household (β = .133, p = 0.011), and perception toward indigenous vegetables utilization (β = .046, p = 0.000). In conclusion, stakeholders suggested that promoting the consumption of local vegetables may require the development of a system through community networks to ensure equitable access to safe local vegetables based on Lanna consumption culture. Scientific information may help prevent this wisdom from being lost to modern consumerism.

Effect of Kegel and Urinary bladder training exercise program on Severity of Urinary Incontinence among Older adults living alone

Tue, 11 Jun 2024 00:00:00 +0700

A condition in which urine leaks uncontrollably, it is a geriatric syndrome and causing health problems affecting
the quality of life of the elderly. Which such symptoms can be the cure, but most people ignore it. The single group pre and post–test designs were employed. The purpose of this study was to examine the effectiveness of the Kegel and Urinary bladder exercise training program on the severity level of urinary Incontinence for older people living alone. The study sample recruited 30 elderly who were living alone, using purposive sampling. The Kegel and Urinary bladder exercise training program was carried out for 13 weeks. Tools used for screening sample groups, include: Chula mental test [CMT]) and assessment to screen for urinary incontinence in the elderly. The tools used to collect data include a general information questionnaire and a form to assess the severity of urinary incontinence Kegel and Urinary bladder training exercise program consisting of a practice manual for those with urinary incontinence, pelvic floor muscle training equipment, form to record time and number of pelvic floor exercises, daily urination record form incontinence of urine screening form in the elderly, urinary incontinence severity assessment form Data analysis using descriptive statistic and paired t–test. Results of the study reveal that after completing in the training program, the study sample had significantly reduced severity level of urinary incontinence (t = 14.14, p < .05). This study suggested that the Kegel and Urinary bladder exercise training program could help an elderly woman manage their stress incontinence, urge incontinence, and mixed incontinence, effectively.

Work ability and related factors among registered nurse in inpatient departments in a university hospital, Thailand

Tue, 11 Jun 2024 00:00:00 +0700

Registered nurses working in inpatient departments are responsible for caring for patients receiving overnight treatment in the hospital. This role demands professional skills and the ability to cope with uncertain working hours and conditions. Therefore, assessing and maintaining the work ability of nurses in inpatient departments is crucial. The objective of this study was to evaluate the level of work ability and assess the factors associated with it among nurses working in the inpatient departments of a university hospital in Thailand. The study was a cross-sectional study. Information on nurses was collected through a questionnaire survey. Exposure factors, including heat, light, and noise, were measured using standard methods. Cluster random sampling was employed to select the study population. Descriptive statistics and ordinal logistic regression analyses were conducted. A total of 374 registered nurses working in the inpatient departments participated in the study. The average work ability index was 32.8 points out of 49 points, and 78.8% of participants were categorized as having a moderate level of work ability. The factors associated with better work ability were age 45 years old and older (OR_adj = 3.73, 95%CI = 1.31 - 10.86), an average monthly income of more than 50,000 baht (OR_adj= 5.31, 95%CI = 1.72 - 16.87), and working beyond one's self-capacity (OR_adj = 0.38, 95%CI = 0.20 - 0.71). To maintain the work ability of registered nurses, the hospital administrative team should consider and adjust the workforce of registered nurses to ensure the proper distribution of the workload. Additionally, policymakers should pay more attention to newly registered nurses in order to maintain and promote their work ability, enabling them to continue working effectively and happily.

The development of a clinical nursing practice guideline for prevention catheter associated urinary tract Infection in female orthopedic ward, Udonthani hospital

Tue, 11 Jun 2024 00:00:00 +0700

This research and development study aims to develop a nursing practice guideline for the prevention of urinary tract infections associated with urinary catheterization. Female orthopedic ward Udonthani hospital and to study the satisfaction of professional nurses who use the guideline. The sample consisted of nurses working in the female orthopedic ward. Udonthani hospital, 10 people were used for trial and data collection. Fifteen patients undergoing urinary catheterization using the AGREE II clinical quality assessment questionnaire. The results showed that all the subjects were female and graduated with a bachelor's degree. The average age was 35 years, with 23-30 years of age (44.4 %). The period of operation was between 5-9 years (44.4%) of each category found that the highest score on stakeholder participation ( = 6.1, S.D. = 1.0) was assessed. Possible in applying CNPG, it was found that the CNPG development group consisted of personnel from all relevant professional groups has the highest ( = 6.2, S.D. = 0.9). Satisfaction is at a high level with value ( = 4.1, S.D. = 0.8). the research results, it can lead to the development of nursing practice guidelines in the organization's work.

A comparison of Normal Saline and Ringer’s lactate solution for fluid resuscitation and mortality rate in adult patients with sepsis and septic shock in Nakhon Nayok Hospital

Wiratchanee Wongwilai — Tue, 11 Jun 2024 00:00:00 +0700

Sepsis and Septic Shock are critical conditions in hospitals. It is a common condition found in hospitals. It is also a significant problem in the public health system because it has a high mortality rate and is the primary cause of death worldwide, even in Nakhon Nayok Hospital, where the researcher works. Practice that is popular and accepted all over the world is the Surviving Sepsis Campaign, which found that giving fluids to maintain a standard circulatory system is the main factor and essential factor in reducing the mortality rate of Sepsis patients. However, there is still a debate about the most suitable fluid for resuscitation in Sepsis patients. The researcher collected medical records from patients diagnosed with sepsis/severe sepsis/septic shock and admitted to Nakhon Nayok Hospital. In the period from Jan. 2021 - May 2023. Recorded type of fluid for resuscitation NSS or RLS, the fluid volume in 1 hour after diagnosis. Comparison of mortality rate, the incidence of renal failure at the end of treatment and 30 days after treatment, and length of stay in the Hospital between two groups of patients who received NSS or RLS. The mortality and acute renal failure rates after treatment between the NSS and RLS groups in Sepsis/Septic shock in Nakhon Nayok Hospital differed. However, the length of stay at Nakhon Nayok Hospital was different. The RLS group had a more extended hospital stay than the NSS group.

Personal characteristics and administrative factors affecting the performance of prevention and control in Dengue hemorrhagic fever of village health volunteers at Nongwoaso district in Udonthani province

Tue, 11 Jun 2024 00:00:00 +0700

This cross-sectional descriptive research aimed to study personal characteristics and administrative factors affecting the performance of prevention and control in dengue hemorrhagic fever of village health volunteers in Nongwoaso district, UdonThani province, 167 personnel were randomly selected as samples by stratified random sampling techniques from 1,255 populations who were village health volunteers in Nongwaoso district, UdonThani province. Data was collected by questionnaires for quantitative data and used in-depth interview guidelines for qualitative data gathering from 13 key informants. The questionnaire was examined and verified by three experts for content validity with items objective congruence (IOC), all items were more than 0.50, and reliability with Cronbach’s alpha coefficient was 0.93. Data was collected between 13^th to 31^st January 2023. Data analysis was performed by descriptive and inferential statistics at a significant level of 0.05. The results showed that the overall administrative factors and the performance of dengue hemorrhagic fever prevention and control were at a high level with averages of 2.46 (S.D. = 0.37) and 2.55 (S.D. = 0.25) respectively. Duration of being a village health volunteer of personal characteristics had a low relationship with the performance of dengue hemorrhagic fever prevention and control of village health volunteers (r = 0.161, p-value = 0.038), and the overall administrative factors had a moderate relationship with the performance of dengue hemorrhagic fever prevention and control of village health volunteers (r=0.609, p-value<0.001). The results found that three variables of administrative factors; management, technology, and money affected and could jointly predict the performance of dengue hemorrhagic fever prevention and control of village health volunteers in Nongwoaso district, UdonThani province at 37.0 (R²adj = 0.370, p-value < 0.001).

Factors influencing intention to practice for the prevention of Syphilis among junior high school students in Nakhon Ratchasima Province

Tue, 11 Jun 2024 00:00:00 +0700

This descriptive correlational research was conducted to examine factors influencing the intention to practice to prevent syphilis among junior high school students in Mueang District, Nakhon Ratchasima Province. A multi-stage sampling was utilized to select 413 participants, and data were collected through questionnaires with a Cronbach's alpha coefficient greater than 0.70. Descriptive statistics and stepwise multiple regression were used to analyze the data with a statistical significance level of 0.05. Results showed that 60.0% of participants demonstrated a moderate level of intention to practice disease prevention. Factors influenced the intention to practice disease prevention were female (β = .271), not alcohol consumption (β = .196), perceived benefits of disease prevention (β = .233), perceived barriers to disease prevention practices (β = -.133), not viewing pornography (β = .102) and grade point average (β = .108), which significantly predicted 29.2% of intentions to practice syphilis prevention. Therefore, public health professionals should promote practices to prevent syphilis by taking into account differences in factors such as gender, exposure to pornography, drinking alcohol. Additionally, knowledge should be given to prevent disease, increase awareness of the benefits of disease prevention, etc., in order to promote teenagers’ knowledge and have an appropriate attitude towards further prevention of syphilis infection.

The data management study of blood glucose control of diabetic patients in Hospital Region 4 : Ayutthaya province

Kamolwan Kumwong, Thanyaporn Ewers, Decha Buathed — Tue, 11 Jun 2024 00:00:00 +0700

Patients with good blood sugar control (target 40%) had 27.10% with the least control in fiscal year 2019 in the 4^th health region for Phra Nakhon Si Ayutthaya Province. This study aims to study the process, coverage, completeness, problems, obstacles, and solutions for registering diabetic patients who can control their blood sugar levels. The qualitative mixed-methods study format is to collect data by discussing group processes. A semi-structured interview was used. Personnel working in chronic non-communicable disease clinics of the Tharuea Hospital Health Service Network Quantitative data were collected using a diabetic patient record form. The results of the study found that when diagnosed as a diabetic patient, they would follow up with a blood test to check the blood sugar level with FBS. If the blood sugar level with FBS was 145 mg/dl, they would follow up next time if FBS was 145 mg/dl three or more times in a row. underwent treatment with behavior modification. And monitor blood sugar levels every 3 months. The doctor will send for an HbA1c test if it doesn't improve. Registration coverage was found to be 39.28 percent, with 88.60 percent completeness. Patients who received follow-up checks were able to control their blood sugar levels. 7.84% Data problems found that medical personnel responsible for entering ICD-10 codes did not know the codes for tracking. Therefore, it is necessary to decide to code as a diabetic patient. As a result, the data contains more diabetic patients than exists. and the diagnosis cannot be removed. Therefore, information system management should review goals and put them to good use using a participatory development process, namely policy formulation. Develop personnel potential. Provide opportunities for personnel to participate and promote the use of technology in recording diabetic patient information.

Infection of encysted trematode metacercariae in Cyprinoid fish from the middle Mun-upper Chi River basin of Thailand, with micromorphological and molecular approach using

Tue, 11 Jun 2024 00:00:00 +0700

The Cyprinoid fish play a crucial role in the distribution and proliferation of trematode metacercariae in the ecosystem. They also serve as significant intermediate hosts transmitting liver fluke diseases to humans. However, there is a lack of epidemiological surveillance data on the second intermediate host in the river basins of the at-risk areas of Nakhon Ratchasima, Buriram, Surin and Chaiyaphum provinces. Therefore, information on infection in disease reservoir hosts is essential. This study focuses on the infection of trematode metacercariae and aims to develop sentinel surveillance methods using micromorphological and molecular techniques. The study area encompasses 11 sub-districts in the middle Mun-upper Chi River basin of Thailand. A total of 813 fresh fish samples, representing four species of Cyprinoid fish, were collected. The samples underwent pepsin HCL digestion and were subsequently confirmed via PCR, revealing the presence of Haplorchoides sp. metacercariae in 5 sub-districts in Buriram province during the winter season, Opisthorchis viverrini (Ov) metacercariae in 2 sub-districts in Chaiyaphum province during the rainy season, and unknown metacercariae in 4 sub-districts in Nakhon Ratchasima, Chaiyaphum, and Surin provinces during the rainy season. Ov metacercariae were also found in 1 sub-district in Nakhon Ratchasima province during the rainy season. Micromorphological examination of Haplorchoides sp. metacercariae was performed, and illustrations were created as supporting references. This study emphasizes that Cyprinoid fish act as second intermediate hosts for many species of trematodes, and in the upper Chi River basin, there continues to be contamination with Ov metacercariae. The collaboration of local networks is crucial for monitoring the epidemic spread of intermediate hosts transmitting diseases to humans in the areas of regional health 9.