Journal of Preventive Medicine Association of Thailand

การเตรียมการด้านสาธารณสุขในสภาวะสงคราม

Surachai Chokkhanchidchai — 2026-04-30

จากการเกิดเหตุความไม่สงบในพื้นที่ภูมิภาคตะวันออกกลาง ระหว่างสหรัฐอเมริกาและอิหร่านนั้น ส่งผลกระทบกับวิกฤติพลังงานของโลกทำให้ราคาน้ำมันพุ่งสูงขึ้นและมีความเสี่ยงต่อ การขนส่ง การผลิต วัสดุอุปกรณ์ต่าง ๆ ซึ่งจะมีผลต่อุตสาหกรรมยาและเครื่องมือแพทย์ ในอนาคตอันใกล้ โดยเฉพาะถ้าสถานการณ์ รุนแรงขึ้น ขยายพื้นที่สู้รบไปมากขึ้น ก็จะส่งผลกระทบต่อ โรงพยาบาลในพื้นที่สงครามได้ ดังนั้น ในสถานบริการสาธารณสุขต่าง ๆ ควรมีการเตรียมความพร้อมด้านสาธารณสุขในภาวะสงคราม / ฉุกเฉิน ดังต่อไปนี้

@ โครงสร้างการบัญชาการโรงพยาบาลควรเตรียมการจัดตั้งศูนย์ปฏิบัติการภาวะฉุกเฉินด้านการแพทย์และสาธารณสุข ( PHEOC ) เพื่อวางแผนและสั่งการแบบเบ็ดเสร็จ การสำรองเวชภัณฑ์และทรัพยากร โรงพยาบาลควรสำรองน้ำเกลือ ยาฆ่าเชื้อ เลือด อุปกรณ์พื้นฐานให้เพียงพอต่อสถานการณ์ การเตรียมระบบคัดแยกผู้ป่วย ( Triage ) โดยการแบ่งผู้ป่วยคัดแยกตามสี ได้แก่ สีแดง สีเหลือง สีเขียว เพื่อช่วยเหลือชีวิตผู้บาดเจ็บจำนวนมาก ได้อย่างทันท่วงที การจัดเตรียมบุคลากรโดยการจัดเตรียมแพทย์ พยาบาล สำหรับการทำงานและเตรียมการเรื่อง การจัดตั้งโรงพยาบาลสนามและหน่วยแพทย์เคลื่อนที่เมื่อสถานการณ์จำเป็น การบริหารจัดการสิ่งแวดล้อม ดูแลเรื่องความสะอาด น้ำดื่ม อาหาร การจัดการขยะเพื่อป้องกันโรคระบาด การแบ่งทีมทำงานที่ครบวงจรนั้น จะทำให้มีการติดตามสถานการณ์ อย่างใกล้ชิดและประเมินสถานการณ์ได้อย่างรอบคอบ โดยการทำงานประสานกันทั้งในภาพการสั่งการ จากภาครัฐและการประสานในพื้นที่ เพื่อให้การทำงาน ดูแลสถานการณ์ด้านสาธารณสุข อย่างมีประสิทธิภาพต่อไป

Malignant Pleural Mesothelioma with Concurrent Pleural Plaques Following Occupational Asbestos Exposure: A Case Report

Chayuth Tangwiwat — 2026-04-30

Malignant pleural mesothelioma (MPM) is an aggressive neoplasm primarily associated with occupational asbestos exposure and typically manifests decades after initial contact. We report the case of a 73-year-old Thai male presented with non-productive cough, progressive dyspnea and left-sided pleuritic chest pain for 3 months. He underwent medical thoracoscopy with pleural biopsy and was diagnosed with malignant pleural mesothelioma with pulmonary metastases. The patient had a 39-year occupational history as an asbestos processing operator in a roof-tile factory and had ceased asbestos exposure for over 10 years before developing symptoms. Imaging demonstrated a pleural mass, loculated effusion, and multiple calcified pleural plaques, while histopathology and immunohistochemistry confirmed MPM. Despite chemotherapy, his condition deteriorated, leading to palliative care.
This case emphasizes the aggressive course of malignant pleural mesothelioma, the prolonged latency of asbestos-related disease, and illustrates that clinical manifestations can occur long after cessation of exposure. It highlights the urgent need for preventive policies, strict regulation of asbestos, and comprehensive occupational health strategies. Importantly, periodic health examinations and long-term surveillance of asbestos-exposed workers remain essential even after exposure cessation or retirement, to support early detection and strengthen preventive strategies.

Methanol Poisoning Outbreak in Thailand, 2024: in the Aspect of the Return to Work of Patients Affected by Counterfeit Alcohol

Nuttapong Sahakijpijarn — 2026-04-30

Objective: To explore the factors influencing the return-to-work ability of patients diagnosed with methanol poisoning who received treatment at Nopparat Rajathanee Hospital. Methods: This study included patients diagnosed with methanol poisoning, focusing on health conditions, occupational characteristics, long-term complications, and return-to-work status after treatment. Data was collected through medical record reviews and patient interviews conducted within 6months after hospital discharge and were analyzed using descriptive methods. Results: Most patients were employed in skilled labor and service occupations, with education levels no higher than high school. Those with neurological or visual complications were unable to return to work without job modification, while patients with both complications had the lowest likelihood of returning to work. Key supportive factors included assistance from employers and colleagues, whereas barriers included a lack of alternative work skills and low motivation, particularly among older individuals. Conclusion: This study highlights the importance of developing structured work capacity assessment systems for patients diagnosed with methanol poisoning. It also underscores the critical role of employer-supported job modifications and access to labor-related benefits in facilitating successful return to work and rehabilitation.

The Effectiveness of a Digital Break Reminder Based on the 20-20-20 Rule on Computer Vision Syndrome among Hospital Support Staff

Ekke Kunphol — 2026-04-30

Objectives: Hospital support staff are at high risk of Computer Vision Syndrome (CVS) due to prolonged computer use. While the 20-20-20 rule is a standard recommendation for eye rest, adherence is often poor without active reminders. This study aimed to evaluate the effectiveness of a digital break reminder software , based on the 20-20-20 rule, in reducing CVS severity among hospital support staff. Methods: A quasi-experimental study was conducted with 43 support staff members working at a hospital in Bangkok, who used computers for more than 4 hours daily. The EyeLeo software was installed on participants' computers to provide automatic break reminders every 20 minutes for a duration of 3 weeks. CVS severity was assessed using the Thai version of the Computer Vision Syndrome Questionnaire (CVS-Q) at baseline, week 2, and week 3. Data were analyzed using Repeated Measures ANOVA. Results: The study found that the mean CVS severity score significantly decreased after the intervention (p < 0.001). The prevalence of CVS dropped from 100% at baseline to 97.7% at week 2, and significantly further to 41.9% at week 3. These findings suggest that consistent use of the reminder software over time leads to better symptom relief. Conclusion: The application of the 20-20-20 rule via digital reminder software is effective in reducing both the severity and prevalence of CVS. It is a practical and low-cost intervention recommended for occupational health promotion in hospital settings.

Work-Related and Other Factors Associated with Medication Adherence among Working-Age Patients with Hypertension without Complications at a Tertiary Hospital in Bangkok

Palita Rachmanee — 2026-04-30

Objective: To investigate work-related and other factors associated with medication adherence and to examine the level of adherence among working-age patients with hypertension without complications at a Tertiary Hospital in Bangkok. Methods: This cross-sectional analytic study sampled 402 uncomplicated hypertensive patients at a Bangkok tertiary hospital from May to June 2025 using systematic sampling. Questionnaires assessed personal, medication-related, and work-related factors, including the Medication Adherence Questionnaire-20, which yielded a Cronbach’s alpha coefficient of 0.657. Statistical analysis used multiple logistic regression to report Adjusted Odds Ratios (aOR) and 95% Confidence Intervals (CI). Results: The medication adherence rate was 89.80%. Multivariate analysis identified four key factors significantly and inversely associated with adherence: a longer hypertension duration of 6–10 years (aOR=0.04, 95% CI 0.00–0.39), smoking (aOR=0.08, 95% CI 0.01–0.69), salt-reduction food selection (aOR=0.001, 95% CI 0.00–0.31), and irregular workday meal times (aOR=0.08, 95% CI 0.01–0.46). These key findings indicate that prolonged illness, smoking, dietary behaviors, and irregular routines negatively influence adherence levels among working-age patients. Conclusion: This study recommends developing tailored programs focusing on proactive counseling and integrated smoking cessation efforts. Healthcare providers should prioritize education on hidden sodium and implement flexible medication schedules for patients with irregular daily routines. Such management plans are vital for improving medication adherence and enhancing health outcomes. However, the results regarding food selection methods and disease duration should be interpreted with caution due to the wide confidence intervals, which likely resulted from small sample sizes in these subgroups.

The Associations Between Nutritional Status, Physical Activity, and Sleep Quality among Older Adults Living in Urban Areas of Nonthaburi Province, Thailand

Suparat Siripan — 2026-04-30

Objective: This study aimed to examine the associations between nutritional status, physical activity, and sleep quality, as well as their combined effects, among older adults living in an urban area, Thailand. Methods: An analytical cross-sectional study was conducted among 445 adults aged 60 years and older residing in Nonthaburi Province, Thailand. Nutritional status, physical activity, and sleep quality were assessed using the MNA-SF, RAPA, and GSQ-6 questionnaires. Binary and multiple logistic regression analyses were performed to identify factors associated with poor sleep quality, adjusting for demographic covariates. Results: The prevalence of poor sleep quality was 21.3%. In bivariate analyses, being at risk of malnutrition (OR = 1.667, 95% CI: 1.040–2.671) and inactive aerobic physical activity (OR = 2.136, 95% CI: 1.246–3.662) were significantly associated with poor sleep quality. After adjustment, only inactive aerobic physical activity remained significant (AOR = 1.796, 95% CI: 1.018–3.168). Conclusion: Aerobic physical activity demonstrated a stronger association with sleep quality than nutritional status among urban-dwelling older adults. These findings highlight the importance of prioritizing aerobic physical activity promotion, alongside nutritional care, to improve sleep quality and overall health in aging urban populations.

External Validation of a Prognostic Model for Predicting 24-Hour Mortality in Patients with Severe Septic Shock Presenting to the Emergency Department of Phra Nakhon Si Ayutthaya Hospital

Sorasit Punyavirocha — 2026-04-30

Objective: To validate the accuracy of a 10-variable prediction model for 24-hour mortality in patients diagnosed with septic shock presenting to the ED of Phra Nakhon Si Ayutthaya Hospital. Methods: This was a prognostic prediction study in the external validation phase, utilizing a retrospective cohort design. Medical records from 2023–2024 were reviewed for patients aged over 18 years who were diagnosed with septic shock (ICD-10: R57.2) upon presentation to the ED. Inclusion required clinical documentation indicating shock due to suspected or confirmed infection in any organ system. Patient outcomes were compared between those who died within 24 hours and those who survived beyond 24 hours. Data were analyzed in two cohorts: derivation data (2018–2022, n=602) and validation data (2023–2024, n=216). Group comparisons were conducted using exact probability tests and Wilcoxon rank-sum tests for categorical and continuous variables, respectively. Model discrimination was evaluated using the c-statistic in both datasets. Mortality risk was stratified based on total scores into three categories: low (0–27.5 points), moderate (28.0–31.0 points), and high (31.5–37.5 points) according to the original model. The 24-hour mortality rate in each risk group was assessed in both datasets. Results: C-statistics were 0.79 for the derivation cohort and 0.69 for the validation cohort. Four of the ten model variables showed statistically significant differences between the two datasets: diastolic blood pressure, pH, phosphorus, and albumin. The observed 24-hour mortality rates by risk category were as follows: https://shorturl.asia/YfM4C Conclusion: The model demonstrated reduced predictive performance in the 2023–2024 validation dataset (c-statistic < 0.7). These findings suggest the need for periodic recalibration or revision of the model coefficients and/or risk threshold scores to maintain accuracy in predicting 24-hour mortality among septic shock patients. Finally, if the model can no longer maintain adequate predictive performance, it should be recalibrated or redeveloped by re-evaluating and incorporating the relevant input variables.

Factors Associated with Shift Work Tolerance of Registered Nurses, Practical Nurses and Nursing Assistants in Det Udom Crown Prince Hospital

Pantat Plikomol — 2026-04-30

Objective: This study aimed to investigate shift work tolerance and associated factors among registered nurses, practical nurses and nursing assistants at Det Udom Crown Prince Hospital. Methods: This study is a cross-sectional descriptive study. Data were collected between April and May 2025, involving 302 participants. The data collection instruments included a set of self-report questionnaires: potential associated factors, the Thai version of Athens Insomnia Scale, the Thai version of Hospital Anxiety and Depression Scale, the Thai version of Piper fatigue scales-revised and the Thai version of EQ-5D-5L. Data analysis included descriptive and inferential statistics. Bivariate analysis and multivariable logistic regression were performed. Results: This shift work tolerance study was assessed using composite Z-score method, calculated by summing Z-score from each questionnaire measuring problems and abnormalities related to shift work tolerance. The findings revealed that 53.0% of the participants had high shift work tolerance. The factors significantly associated with high shift work tolerance included: not having children (AOR = 1.68; 95% CI: 1.02-2.79), financially stable status (AOR = 3.96; 95% CI: 2.16-7.27), financially surplus status (AOR = 3.00; 95% CI: 1.38-6.54), never or rarely taking naps during shifts (AOR = 2.09; 95% CI: 1.26-3.47), never or rarely using sleep-affecting medication (AOR = 2.71; 95% CI: 1.37-5.34), and not having conflicts with colleagues (AOR = 4.92; 95% CI: 1.62-14.96). Conclusion: This study identified the factors significantly associated with shift work tolerance, included: having children, financial status, taking naps during shifts, a history of using sleep-affecting medications, and conflicts with colleagues. The findings may be applied to promote health, manage human resources and prevent the health impact of shift work in the future.

Prevalence and Associated Factors of Depression among Upper Primary School Students in Mueang District, Nakhon Si Thammarat Province

Thatawat Pilukpakawat — 2026-04-30

Objective: To study the prevalence and associated factors of depression among upper primary school students in Mueang District, Nakhon Si Thammarat Province. Method: This was a descriptive cross-sectional study. The study population consisted of 458 primary school students in grades 4-6. A multi-stage sampling technique was used to select participants from seven schools, categorized by their affiliations, located within the Mueang District of Nakhon Si Thammarat Province by using self-reported questionnaires. Measurement used 1) the Thai version of Children’s Depression Inventory (CDI-Thai) using cutoff point at 21 2) demographic, family and psychosocial data record form, and 3) the Thai version of Rosenberg Self-Esteem Scale (RSES-revised) using cutoff point at 15. Statistical analysis use percentage, Chi-Square and Logistic Regression. Results: The study population was predominately male (51%). The mean age of subjects was 10.97 years old and the prevalence of depression was 27.5%. The associated factors of depression were female gender, the latest semester's GPA is not more than 3.00, poor parental relationship, poor relationship with parents, poor relationship with siblings, poor peer relationship, insufficient family income, dissatisfaction with school grades, a history of physical and/or psychological abuse, and low self - esteem (p < 0.05). Conclusion: Depression is prevalent in 27.5% of upper primary school students, making it a significant mental health issue. Therefore, strengthening the family institution, promoting self-esteem, and developing social skills are factors that should be considered to prevent and reduce the severity of depression in children and adolescents.

Results of Home Visits for Schizophrenic Patients by a Preventive Medicine Team, Community Mental Health Branch, Erawan District, Loei Province: a Randomized Controlled Trial

Netiluck Silaudomkit — 2026-04-30

Objectives: Schizophrenia is a significant public health problem that impacts patients, families, and society. The lack of continuous treatment is a crucial factor leading to relapse. This study aims to examine the outcomes of home visits for schizophrenia patients conducted by community mental health preventive medicine teams. Methods: This was a Randomized Controlled Trial involving 152 schizophrenia patients at Erawan Hospital, Loei Province, between January-July 2025. Participants were randomly assigned to either the study group (receiving 3 home visits with motivational counseling) of 76 patients, or the control group (receiving standard care) of 76 patients. Outcomes were followed for 6 months and assessed using the Brief Psychiatric Rating Scale (BPRS), 9Q Depression Assessment Scale, 8Q Suicide Assessment Scale, EQ-5D-5L, and Visual Analog Scale. Results: Complete follow-up was achieved for 145 participants (loss to follow-up rate of 4.6%). The study group showed a mean reduction in BPRS scores of 5.1 points compared to the control group (p < 0.001, Cohen's d = 1.06). EQ-5D-5L quality of life scores increased by 0.11 points (p < 0.001), and VAS scores increased by 9.7 points (p < 0.001). The relapse rate decreased from 34.2% to 19.4% (p = 0.032, NNT = 7). Appointment adherence increased from 52.1% to 72.2% (p < 0.001), and medication compliance improved from 56.2% to 80.6% (p < 0.001). Conclusion: Home visits for schizophrenia patients by multidisciplinary teams combined with motivational interviewing techniques are effective in improving psychiatric symptoms, reducing relapse rates, enhancing quality of life, and increasing treatment adherence. This represents a promising approach for community-based care of schizophrenia patients.

The Effects of Self-Management Program among Uncontrolled Hypertensive Patients Effects of Self-Management Program among Uncontrolled Hypertensive Patients

Saowalak Siengnan — 2026-04-30

Objective: This study aimed to evaluate the effects of a self-management program on health behaviors and blood pressure levels among patients with uncontrolled hypertension who were receiving healthcare services at a Subdistrict Health Promoting Hospital in Chai Nat Province, Thailand. Methods: This quasi-experimental study was conducted using Kanfer and Gaelick-Buys' self-management conceptual framework to develop a comprehensive self-management program. The sample was selected using simple random sampling, and participants were assigned into an experimental group and a control group, with 28 participants in each group. The intervention group received an 8 week self-management program focusing on health behaviors and blood pressure control, while the control group received routine nursing care in accordance with the standard practice of Subdistrict Health Promoting Hospitals. Data were collected using a validated health behavior questionnaire for patients with uncontrolled hypertension (Cronbach's alpha = 0.86). Statistical analyses included descriptive statistics, chi-square tests, and t-tests for mean comparisons. Results: The intervention group demonstrated significantly higher mean health behavior scores compared to the control group post-intervention (p < 0.01). Both systolic and diastolic blood pressure levels showed significant improvements in the intervention group compared to the control group after the program implementation (p < 0.01). Conclusion: The self-management program effectively improved health behaviors and blood pressure control among patients with uncontrolled hypertension. This intervention demonstrates potential for implementation in primary healthcare settings to enhance hypertension management outcomes.

Effectiveness of Ergonomic Program for Preventing Musculoskeletal Diseases among Patient Transport Staff in Health Region 4 Hospital

Pitchayaporn Pathaweesrisutha — 2026-04-30

Objective: Musculoskeletal disorders (MSDs) are common health problems among occupational workers, particularly low back pain. Low back pain is a major cause that directly affects work performance and quality of life, especially among working-age people. Patient transfer work, especially sideways patient transfers or transfers between wheelchairs and beds, is a task that carries a high risk of back pain due to the lifting, pushing, and pulling involved. Lifting and moving patients is therefore a major ergonomic issue. This quasi-experimental research aimed to evaluate the effectiveness of an ergonomics program for preventing of musculoskeletal diseases. Promote awareness of ergonomic health issues, ergonomic knowledge (correct patient lifting and transfer and wheelchair handling) stretching exercises to reduce back and leg muscle pain. Methods: The program participants, 94 Patient Transport Staff among Health Region 4 Hospital, received an 8-week ergonomics program to prevent musculoskeletal diseases. Nordic Standard Questionnaire (NMQ), content validity 0.80, reliability 0.90, and questionnaire on awareness of ergonomic health problems and ergonomic knowledge. Data were collected between July and September 2025. Data were analyzed using descriptive statistics and t-test. Results: The research results found that the program participants had significantly higher scores of awareness of ergonomic health problems (Mean Change= 2.57, 95% CI: 1.96 – 3.19, p<0.001) and ergonomic knowledge scores (Mean Change= 7.47, 95% CI: 6.63-8.31, p<0.001) after the experiment than before the experiment. Pain levels of the lower back muscles and feet were significantly reduced. Conclusion: This program is effective in promoting ergonomic health and can be used as an effective guideline for preventing musculoskeletal diseases among Patient Transport Staff who are at risk from the nature of patient lifting and transport work.

Factors Predicting Blood Sugar Control in Type 2 Diabetes Patients Receiving Health Services at the Subdistrict Health Promoting Hospital, Muang Udon Thani District, Udon Thani Province

Soiy Anusornteerakul — 2026-04-30

Objective: To study the factors predicting uncontrolled blood sugar level in type 2 diabetic patients receiving health services at Subdistrict Health Promoting Hospitals in Mueang Udon Thani District, Udon Thani Province. Methods: This was a predictive descriptive research study using an analytic cross-sectional study. The sample consisted of 150 diabetic patients receiving healthcare services at Na Dee and Sok Nam Khao Sub-District Health Promotion Hospitals in Mueang Udon Thani District, Udon Thani Province. The study group comprised 50 patients with uncontrolled blood sugar levels, and a control group of 100 patients with controlled blood sugar levels. The research instruments included questionnaires on general information, knowledge of diabetes, attitudes towards diabetes, and health-promoting behaviors among diabetic patients. The reliability coefficients for the knowledge, attitude, and health-promoting behavior questionnaires were 0.82, 0.73, and 0.89, respectively. Descriptive statistics, Chi-square, and binary logistic regression statistics were used to analyze the data. Results: Three factors could predict uncontrolled blood glucose levels in patients with type 2 diabetes were patients with BMI ≥ 23 kg/m² had a 0.36 times higher risk of uncontrolled blood glucose (OR_adj 0.36, 95% CI=0.16-0.82), patients with comorbidities had a 5.95 times higher risk of uncontrolled blood glucose (OR_adj 5.95, 95% CI=2.28-15.52), and patients with complications from diabetes had a 3.36 times higher risk of uncontrolled blood glucose. (OR_adj 3.36, 95% CI=1.54-7.32). These factors could explain 26.7% of the variance in blood glucose levels among diabetic patients (Nagelkerke R² =0.267, p<0.001). Conclusions: Body mass index, comorbidities, and complications can explain variations in blood sugar control. Therefore, promoting weight management, managing comorbidities, and preventing complications can help patients better control their blood sugar levels.

The Prevalence and Factor Associated with Workplace Violence in Healthcare Workers in a Tertiary Care Hospital in Bangkok

Tewat Hansrivijit — 2026-04-30

Objective: To determine the prevalence and factor associated with workplace violence in healthcare workers in a tertiary care hospital in Bangkok. Methods: This study was conducted an analytical cross-sectional study using anonymous online questionnaires with study sample of 326 healthcare workers who voluntarily participated between March 25, 2025, and June 30, 2025. Data was analyzed in descriptive statistic, using chi-square test (or Fisher’s exact test), and multiple logistic regression to calculate factors associated with workplace violence. Results: Most participants were female with average age in middle working years. The 12-month prevalence of workplace violence is 33.16%, with verbal violence (31.6%), physical violence (2.76%), and sexual violence (2.45%). Significant risk factors included working as medical technicians (AOR: 10.55, 95%CI: 1.55-71.65), pharmacists (AOR: 5.93, 95%CI: 1.07-32.99), interpersonal work (AOR: 8.89, 95%CI: 2.93-27.03) , male gender (AOR: 3.29, 95%CI: 1.34-8.08), and shift work (AOR: 1.97, 95%CI: 1.23-3.15), while being married (AOR: 0.44, 95%CI: 0.25-0.78) and perceiving adequate staff attendance (AOR: 0.24, 95%CI: 0.13-0.44) were protective factors. Conclusion: One-third of healthcare workers experience workplace violence annually. Workplace violence in this hospital relates to both individual (gender, marital status) and work environmental factors (shift work, interpersonal work, staffing adequacy perception). Verbal abuse is still the most common type of violence in the workplace, which is consistent with international studies. Interestingly this study shows medical technicians and pharmacists have the highest risk of experiencing workplace violence in this hospital, up 10-fold higher than doctors, whereas doctors or nurses are usually the highest-risk group. These finding emphasize the necessity for prevention programs targeting all healthcare occupations.

Cardiovascular Risk and Associated Factors among Personnel of Bangkok Metropolitan Administration

Veranuch Chawakitchareon — 2026-04-30

Objective: To determine the risk of cardiovascular disease and its associated factors among personnel of the Bangkok Metropolitan Administration from annual health examination in 2025. Methods: This study design was a retrospective descriptive study analyzed data from the annual health examination program conducted by BMA General Hospital, between February 1 to May 2, 2025. The study sample of 8,331 personnel were included. Descriptive statistics were used to determine the prevalence of high cardiovascular risk using the Thai CV risk score. The prevalence of CV risk was analyzed by proportion test and the associated factors were analyzed by multiple logistic regression. Results: The prevalence of high cardiovascular risk among BMA personnel was 25.47% (95% CI: 24.54 - 26.42). In addition to the variables included in the Thai CV risk score, factors significantly associated with high cardiovascular risk were overweight and obesity class I and II (OR 1.28; 95% CI: 1.02 - 1.60, OR 1.72; 95% CI: 1.40 - 2.11, and OR 2.38; 95% CI: 1.86 - 3.04), non-postgraduate level; primary school, secondary school, vocational education, bachelor’s degree, and others (OR 2.72; 95% CI: 1.85 - 3.98, OR 2.40; 95% CI: 1.65 - 3.51, OR 2.13; 95% CI: 1.43 - 3.16, OR 1.53; 95% CI: 1.03 - 2.26 and OR 2.09; 95% CI: 1.18 - 3.68), alcohol consumption (OR 1.57; 95% CI: 1.32 - 1.87), Blood sugar in prediabetes and diabetes level (OR 2.09; 95% CI: 1.76 - 2.47 and OR 4.92; 95% CI: 3.92 - 6.18), and non-health department personnel (OR 1.68; 95% CI: 1.22 - 2.31). Conclusion: Cardiovascular disease risk is a major health concern among workforce. Health promotion programs should emphasize weight control, lifestyle modification, and continuous surveillance of non-communicable diseases to enhance good health and work efficiency among personnel.

Developing Tools and Protocols for On-Site Patient Triage for Emergency Medical Responder in Yala Municipality

Yaninee Dueathaisong — 2026-04-30

Objective: The study aimed to (1) to develop tools and practices for patient triage at the scene; and (2) to study the effectiveness of these tools and practices among Emergency Medical Responders (EMR) in the Yala Municipality. Methods: This research employed a research and development (R&D) design conducted between August 2022 to August 2024, comprising four phases: (1) a situation analysis of patient triage effectiveness using EMS statistics from the ITEMS 4.0 system; (2) the design and development of triage tools and guidelines, validated by experts with an IOC of 0.95 and a Cronbach’s Alpha Coefficient of 0.954; (3) the implementation and testing of the developed tools with a purposive sample of 46 Emergency Medical Responders (EMRs) over a 3-month period to observe practical application; and (4) a comprehensive evaluation of tool accuracy, consistency in triage decisions, and the effectiveness in minimizing over-triage and under-triage rates. Results: The study results showed that: 1) The level of appropriateness and practical applicability of the tools was at the highest level (4.72 ± 0.62 out of 5.00); (2)The level of knowledge among EMRs was at a high level (13.78 ± 2.32 out of 20.00); (3) Regarding specific criteria, the highest effectiveness was found in identifying signs of shock (98%), followed by assessing blood oxygen levels (96%). The overall efficiency of the tool in triaging patients at the scene was high, at 90.0%. Conclusion: The developed triage tool and protocols significantly enhance the competency and accuracy of Emergency Medical Responders (EMR) in the Yala Municipality. By providing a reliable framework based on international standards, these tools effectively reduce triage inaccuracies, such as over-triage and under-triage. This advancement contributes to more efficient resource management and improved patient safety within the emergency medical services system.

Mortality and Associated Factors among Royal Thai Army Personnel with Non-Communicable Diseases

Pitchaya Pattamapornpong — 2026-04-30

Objective: To determine the mortality rate and factors associated with mortality among Royal Thai Army personnel with non-communicable diseases. Methods: A retrospective cohort study was conducted using data from 8,172 Royal Thai Army personnel who underwent annual health examinations between January 2021 and December 2023. The collected data included demographic factors, including sex, age, anthropometric measures (body mass index and waist circumference), underlying diseases, military position, health-related behaviors, and laboratory parameters, including fasting blood sugar (FBS), renal function tests (blood urea nitrogen [BUN] and creatinine), lipid profiles (triglycerides and total cholesterol), serum uric acid, and liver enzymes (AST and ALT). Descriptive statistics and multivariable logistic regression were used to identify factors associated with mortality. Results: The mortality rate was 1.1% among Royal Thai Army personnel with non-communicable diseases. Factors significantly associated with mortality included age ≥55 years (OR = 1.81, p = 0.024), non-commissioned officer rank (OR = 2.50, p = 0.001), diabetes mellitus defined as FBS ≥126 mg/dL (OR = 2.53, p = 0.001), and impaired renal function defined as creatinine ≥1.3 mg/dL (OR = 1.26, p = 0.033). Overweight status (BMI 25–29.9 kg/m²) was associated with a lower risk of death (OR = 0.53, p = 0.017). Conclusion: Among Royal Thai Army personnel with non-communicable diseases, mortality was associated with non-commissioned officer rank, diabetes mellitus, impaired renal function, and age ≥55 years, whereas overweight status was associated with a lower risk of death. These findings may serve as useful baseline information for targeted screening, health monitoring, and surveillance in high-risk personnel, and may support more appropriate health care for Royal Thai Army personnel with non-communicable diseases.

Factors Associated with Mental Health among Staff at Pranangklao Hospital

Sureeporn Tingsabhat — 2026-04-30

Objective: This study aims to investigate the prevalence and associated factors of mental health issues among personnel at Pranangklao Hospital. The findings serve as evidence-based support for policy development to establish preventive measures and mitigate mental health impacts, ultimately enhancing staff well-being and clinical care efficiency. Methods: A cross-sectional descriptive study was conducted using secondary data analysis from the "Mental Health Check-in" database and the 2025 annual health examination records of Pranangklao Hospital staff. The prevalence and analysis of associated factors were analyzed in 637 participants with complete data. Multiple Logistic Regression was employed to identify significant associations, with results reported as Adjusted Odds Ratios (AOR). Results: The highest prevalence of mental health issues was high-level stress at 12.59%, followed by burnout at 8.48%. The prevalence of moderate-to-severe depression and suicide risk were 3.45% and 1.57%, respectively. After adjusting for confounding variables, the presence of underlying diseases was identified as a significant risk factor for high-level stress (AOR = 2.41, 95% CI: 1.38-4.19) and suicide risk (AOR = 7.37, 95% CI: 1.75-38.84). Conversely, increasing age acted as a protective factor against stress, burnout, and depression. Furthermore, obesity (AOR = 2.71, 95% CI: 1.10-7.11) and direct patient contact (AOR = 4.16, 95% CI: 1.37-14.48) were identified as significant risk factors for depression. Interestingly, shift work was found to be a protective factor against the risk of depression (AOR = 0.27, 95% CI: 0.10-0.73). Conclusion: The study demonstrates significant correlations between personal factors (age, underlying diseases, obesity) and occupational factors (shift work, direct patient contact) mental health outcomes.