Journal of Preventive Medicine Association of Thailand

The Development of Head Injury Patient Care Model and Undergoing Cranial Surgery in Uthai Thani Hospital

Jariya Boonyalit, Jinda Pudpong, Maneerat Lueangwilai, Nissama Poochakhanit — Fri, 22 Mar 2024 00:00:00 +0700

Objectives: Developing of head injury patient care model and undergoing cranial surgery by applying a model to Enhanced Recovery After Surgery (ERAS) and study the results of head injury patient care model and undergoing cranial surgery. Methods: This research was research and development. The samples group in this study were 30 professional nurses with experience working and caring for head injury patients who had undergone cranial surgery and medical record of 30 patients who had undergone cranial surgery by selecting purposive sampling. This was consists of 3 phases as following: Phase 1: study the nursing situation for patients undergoing cranial surgery by tools include data recording form and semi-structured interview group discussion guide. Phase 2: develop of head injury patient care model and undergoing cranial surgery in Uthai Thani Hospital. The research tools consisted of (1) nursing model for head injury patient care and undergoing cranial surgery by applying a model to Enhanced Recovery After Surgery (ERAS). Phase 3: study the results before and after using the model. The research tools consisted of (1) a questionnaire regarding general information of professional nurses (2) a recording form for evaluation nursing practice for head injury patients who received cranial surgery, consisting of preoperative, intra-operative and postoperative nursing care and (3) patient outcome records collect information from medical records. The research instrument was checked for content validity with an item consistency index equal to 1.00 and Cronbach's alpha coefficient was used to find confidence equal to the appropriateness at 0.95 - 0.98. Qualitative data were analyzed in Phases 1 and 2 by content analysis and drawing conclusions. Quantitative data was analyzed in Phases 1 and 3. Quantitative data was analyzed using descriptive statistics. Comparative statistics: Paired t-test and Independent t-test were performed for data collection in June to December 2023. Results: Developing of head injury patient care model and undergoing cranial surgery consisting of preoperative, intra-operative and postoperative nursing care. The results was a higher adherence to the guidelines than before used, with a statistically significant difference (p < .05, p < .01, p< .001). The nursing outcomes for head injured patients that undergoing cranial surgery on the patient after using the model had better results than before using the model. Including postoperative death, Length of Stay (LOS) and re-operation are decreased. As for surgical wound infection, there was no significant difference. Conclusion: The development of head injury patient care model and undergoing cranial surgery by applying a model to Enhanced Recovery After Surgery (ERAS) could increase nursing care outcomes for head injury patients who undergoing cranial surgery and could be better result nursing care for head injury patient care model and undergoing cranial surgery.

Situation and Correlation Between Outcomes and Severity of Diabetic Ketoacidosis at Phra Nakhon Si Ayutthaya Hospital in 2022

Watcharanan Muenanan — Thu, 28 Mar 2024 00:00:00 +0700

Objective: Diabetic ketoacidosis is acute life-threatening complication of diabetes mellitus and also important health burden in Thailand, affected mortality and resource expenditure. The objective was to study situation, mortality rate and correlation between outcomes and severity of diabetic ketoacidosis at Phra Nakhon Si Ayutthaya hospital in 2022. Methods: A single center, retrospective cohort study was collected data from 5,193 hospitalized diabetes patients aged more than 15 years old, included by criteria according to American Diabetes Association at Phra Nakhon Si Ayutthaya hospital in 2022. Results: The rate of hospitalization for DKA was 2.5 per 100 persons with diabetes mellitus. 130 patients were enrolled with mean age 52.9 years (SD=19), mean height 159.6 centimeters (SD=11), mean body mass index 23.5 kilograms per square meter (SD=5). The female accounted more than male in all the groups. Patient with type 2 diabetes mellitus accounted mostly for 73.9% of all the patients. First diagnosed diabetes mellitus accounted for 10.8% presented with diabetic ketoacidosis. Hypertension is the most common underlying disease, second one is dyslipidemia. The mean duration of stay was 10.8 days (SD=12.3). The occurrence of acute kidney injury was 45.4%. The requirement of intensive care unit was 12.3% and needed invasive ventilation 36.2%. The mortality rate was higher in this study 24.6% compared with the previous study. Conclusion: The mortality rate, intensive care unit stay and requiring invasive ventilation was found correlated significantly with severity of diabetic ketoacidosis (p-value 0.021, 0.049, <0.001 respectively). From this study, the author concern about health burden of the patients and we should encourage and develop the care of patients with diabetic ketoacidosis in Phra Nakhon Si Ayutthaya hospital to decrease the life-threatening complication, mortality and promote the good quality of life.

Prevalence and Predictive Factors of Postpartum Depression in Chumphae Hospital, Khon Kaen

Pongsak Junngam — Wed, 03 Apr 2024 00:00:00 +0700

Objective: To study the prevalence of postpartum depression, and factors that can predict postpartum depression among postpartum mothers in Chumphae Hospital, Khon Kaen. Methods: This is cross-sectional analytical research. The samples were purposively selected to recruit 306 postpartum mothers within 48-72 hours after giving birth, who gave birth at Chumphae Hospital, Khon Kaen Province, between July and October 2023. The tools used were a general information questionnaire, Stress Test Questionnaire (ST5), and Edinburgh Postnatal Depression Scale (EPDS≥11), which are standard assessments of the Ministry of Public Health, used in maternal and infant health records. The Cronbach's alpha coefficient of ST5 in this study was .81, and EPDS was .75. The data were analyzed using descriptive statistics, and statistical analysis chi-square and binary logistic regression. Results: The prevalence of postpartum depression was found to be 8.5%. Factors that predict postpartum maternal depression, there are mental health problems (OR_adj=44.18, p<0.001), had postpartum complications (OR_adj=7.34, p=0.014), planned to breastfeed for less than 6 months (OR_adj=8.34, p<0.001), and had a birth weight less than 2,500 grams (OR_adj=10.08, p<0.001), and explained 33.9% of the variation in postpartum maternal depression (R²=0.339, p<0.001). Conclusions: This study found that the prevalence of depression in the 48-72 hours after birth was quite high. There are the factors of mental health problems, postpartum complications, plan for breastfeeding, and newborn baby weight, which can explain variations in postpartum depression. Therefore, every mother should be assessed for postpartum depression before discharge, to provide mothers with prompt care and assistance, and to prevent, and monitor the occurrence of postpartum depression.

Studying the Relationship Between Health Literacy and Health Behaviors 3E.2S. of the Elderly at Risk for Hypertension Ban Hua Den Subdistrict Health Promoting Hospital, Bang Khut Subdistrict, Sankhaburi District Chainat Province

Chonticha Aungkab, Ajcharapan Kayadee, Sasima Watthana, Saowalak Siengnan — Thu, 04 Apr 2024 00:00:00 +0700

Objectives: This research was to study the relationship between health literacy and the 3E.2S. healthcare behavior of the elderly at risk of Hypertension in Ban Hua Den Subdistrict Health Promoting Hospital. Methods: This study used Nutbeam's framework of health literacy as a guideline for the study. The sample group selected by simple random sampling of 176 elderly people at risk of hypertension aged 60 years and over. using a questionnaire regarding general characteristics, health literacy, knowledge about hypertension, and self-care behavior related to hypertension. Data were analyzed using descriptive statistics and Pearson correlation statistics. Results: Showed that the health literacy of sample had a low level and health behavior had a moderate level. The research results found that there is a relationship between health literacy and health behavior, according to the principles of 3E.2S. This study yielded statistically significant outcomes (p < .01) expect for decision making. Conclusion: Health literacy is important for self-care behavior. Health teams should find methods to develop health literacy among the elderly at risk Hypertension. To be able to use knowledge judiciously in selecting self-care behaviors so that high blood pressure can be properly controlled.

Studying the Situation of Abortion Following the Enforcement of the Amendment to the Criminal Code (No. 28) B.E. 2564 (2021)

Patchareewan Jensarikorn — Wed, 10 Apr 2024 00:00:00 +0700

Objective: To investigate the knowledge and attitudes towards Amendment (Act) No. 28 of the Criminal Code, as well as to explore the situation of policy execution and the operational aspects of abortion services following the enactment of this Amendment, B.E. 2564 (2021). Methods: This research was a descriptive study. The sample group included 29 executives and practitioners at the policy and local levels for qualitative data, and 521 individuals responsible for providing counseling and safe abortion services in public hospitals for quantitative data. Data were collected through interviews, questionnaires, and group discussions, and analyzed using content analysis for qualitative data and descriptive statistics for quantitative data. Results: The results revealed a deficiency in knowledge and understanding among practitioners regarding the substantive changes in the amended Act. A positive attitude towards the amendment facilitated a sense of comfort among practitioners in executing their duties lawfully and had a beneficial impact on service recipients, enabling access to legal abortion services for women with unplanned pregnancies. However, there were concerns about negative attitudes, fearing that the amendment might lead to decreased contraception use and promote premarital sexual activities. A qualitative analysis within an ecological framework highlighted several operational challenges in abortion services: 1) At the microsystems level, there was a lack of cooperation and personnel shortage among practitioners, as well as conflicts within families regarding the decision to abort; 2) At the mesosystems level, complexities in service procedures and inadequate service coverage across all locations were observed; 3) At the exosystems level, societal and community stigma towards abortion led to the concealment of such practices. These problems stemmed from personal beliefs viewing abortion as sinful; 4) At the macrosystems level, practitioners were found to be unaware of the guidelines for operating under the amended Act. Conclusion: There is a need to enhance knowledge and understanding of the Criminal Code Amendment (Act No. 28), B.E. 2564 among practitioners. Additionally, a change in societal mindset towards abortion, considering its socio-economic impacts, is crucial.

Biological Risk Factors of each Type of Developmental Delay among Children in Lampang Hospital

Pakawadi Vuttipittayamongkol, Kawinratt Srisutheenon, Prakasit Wannapaschaiyong — Thu, 11 Apr 2024 00:00:00 +0700

Objective: To identify risk factors affecting developmental delays in early childhood in Lampang Province to develop monitoring processes and promote age-appropriate development for children at risk of developmental delays. Methods: This retrospective case-control study collected data from the medical patient files of children with developmental delays whom developmental and behavioral pediatricians diagnosed and typically developing children born at the same time as children with developmental delays in Lampang Hospital, from 2 months to 5 years of age, from 1 January 2020 to 31 December 2021. Biological risk factors affecting developmental delay were identified by using multivariate risk difference regression analysis. Results: A total of 447 children were recruited for this study, divided into 149 children with developmental delays and 298 with typical development. Among children with delayed development, 57% have delayed language development. After risk difference regression analysis, the biological risk factors that were significantly associated with delayed development included males, history of birth asphyxia, microcephaly, more than five hospitalization days in the neonatal intensive care unit, hearing loss, malnutrition, twin pregnancy, maternal anemia, and maternal chorioamnionitis. Conclusion: Biological risk factors that affect developmental delays in children include maternal illness and malnutrition during pregnancy, perinatal complications, and children’s illness and nutritional status. Certain risk factors can be monitored and prevented to reduce developmental delays in early childhood. In addition, recognizing the risk factors for developmental delays can lead healthcare providers and parents to closely monitor developmental problems and promote the development of children with these risk factors from birth.

Development of a Nursing Service Model for Stroke Patients in Bueng Kan Hospital

Saowanee Deewala, Wallapha Changjeraja — Wed, 17 Apr 2024 00:00:00 +0700

Objectives: 1) To develop a nursing service model for stroke patients in Bueng Kan Hospital. 2) To evaluate the outcomes of the nursing service model for stroke patients in terms of: 1) service providers, 2) quality, and 3) service users. Methods: This was a research and development (R&D) study. Data were collected between July 20, 2023 and January 31, 2024. The samples were: 1) stroke patients admitted to Bueng Kan Hospital between November 1, 2023 and January 31, 2024, and 2) 74 professional nurses working in the care of stroke patients in the male medical ward (12 nurses), female medical ward (12 nurses), male surgical ward (12 nurses), female surgical ward (12 nurses), special ward (9 nurses), and intensive care unit (17 nurses). The research instruments were: 1) a questionnaire on the nursing service situation for stroke patients, 2) an evaluation form for the nursing service model for stroke patients in Bueng Kan Hospital, 3) the nursing model for stroke patients in Bueng Kan Hospital, 4) a knowledge assessment form for professional nurses on stroke nursing, 5) a satisfaction assessment form for professional nurses on the nursing model for stroke patients in Bueng Kan Hospital, 6) a record form for compliance with the nursing service model for stroke patients in Bueng Kan Hospital, 7) a data record form for stroke patients with ischemic stroke, 8) the Barthel Index (BI-ADL) for assessing the ability to perform daily activities, and 9) a satisfaction assessment form for patients/caregivers on the nursing practice guidelines for stroke patients in Bueng Kan Hospital. Descriptive statistics and Paired Samples t-test were used for data analysis. Results: The nursing service model for stroke patients in Bueng Kan Hospital consisted of 2 components: 1) Guidelines for the administration of nursing workforce for stroke patient care. 2) Nursing practice guidelines for stroke patients. The evaluation of the nursing service model for stroke patients showed that: 1) The knowledge of professional nurses about stroke nursing after using the nursing service model for stroke patients had a mean score increase and was statistically significant (p<.005). 2) The level of satisfaction with the nursing model for stroke patients in Bueng Kan Hospital was at a very satisfied level (60.8%), followed by the most satisfied level (35.1%). The overall mean score was 3.98. 3) Compliance with the nursing practice guidelines for stroke patients showed that all 7 activities of the nursing practice guidelines for stroke patients were highly practiced. The overall mean score was 13.5. 4) Compliance with the guidelines for the administration of nursing workforce for stroke patient care showed that all 7 activities of the guidelines for the administration of nursing workforce for stroke patient care were highly practiced. The overall mean score was 13.8. 5) No complications of increased intracranial pressure, pressure sores, and pneumonia were found after using the nursing model for stroke patients. The incidence of urinary tract infection was 1.70%. The average length of stay was 4.8 days. 6) The level of ability to perform daily activities (BI-ADL) before discharge was higher than that at admission. 7) The satisfaction of patients/caregivers with the nursing practice guidelines for stroke patients had an overall mean score of 3.93, which was at a very satisfied level (62.3%), followed by the most satisfied level (20.8%). Conclusion: The nursing service model for stroke patients in Bueng Kan Hospital, which was developed, resulted in high satisfaction of service users and a reduction in complications. Service providers had increased knowledge and high satisfaction.

A Study on the Concept of Field Hospitals for Pandemic Disaster Management in Thailand: A Case Study of the COVID-19 Outbreak

Isra Aksharanugraha, Pachanat Nunthaitaweekul, Thanapoom Rattananupong — Fri, 19 Apr 2024 00:00:00 +0700

Objective: To study the concept of the establishment of field hospital for disaster management in Thailand with the epidemic of COVID-19 as a case study for the situation of the COVID-19 outbreak. Methods: This research is descriptive research. Data was collected from interviews and questionnaires to administrators and employees in field hospitals in Thailand, by selecting a field hospital that represents the public health agency in the area and using the Delphi technique to gather the consistent opinion of the expert’s group. Results: There are 8 consistent opinions for model of the development in setting up of field hospital: 1) the meaning and role of a field hospital, 2) important features of a field hospital, 3) elements in setting up a field hospital, 4) method or process of operation, 5) Preparation for setting up a field hospital in the future, 6) Main problems in setting up and working in a field hospital, 7) The most important obstacles in operating a field hospital and the principles for solving problems in field hospitals, and 8) Solving problems in field hospitals. Conclusions: To Develop a model for setting up a field hospital, we need to consider the elements in setting up a field hospital and the model of operation as an important factor.

The Study of Cooking Recipes to Reduce Advanced Glycation End Products by Adding Antioxidants Herbs in Fried Pork Cuisine

Fri, 19 Apr 2024 00:00:00 +0700

Objective: To study the cooking recipes with antiglycation compounds in order to reduce advanced glycation end products (AGEs). Methods: This experimental study had been trailed a group of recipes by mixing antiglycation-antioxidant herbal vegetables, whether each selected mixing recipe could reduce AGEs in the group of fried pork recipes. The study was conducted in experimental research by analyzing AGEs from protein extract from the well-cooked samples during May-June 2023 via enzyme-linked immunosorbent assay (ELISA) equipment at Laboratory section in Bamras-naradura Institute. Results: The study found that AGEs in the samples: fried pieced pork (Fpp) found 114.45 ± 6.56 µg/ml, Fpp+Garlic 103.51 ± 10.50 µg/ml, Fpp+Curcumin 109.69 ± 7.80 µg/ml, Fpp+Krachai 109.65 ± 4.35 µg/ml, Fpp+Sesame seeds 108.65 ± 9.10 µg/ml, Fpp+lemonade squeeze 104.57 ± 9.45 µg/ml. The item of Fpp+Garlic showed a significance (p=0.032) in reducing AGEs. Fried minced pork (Fmp) found 105.25 ± 6.35 µg/ml, Fmp+Garlic 101.59 ± 8.27 μg/ml, Fmp+Curcumin 99.30 ± 6.46 µg/ml, Fmp+Krachai 96.93 ± 11.79 µg/ml, Fmp+Sesame seeds 105.83 ± 5.48µg/ml, Fmp+ Lemonade squeeze 111.10 ± 3.41 µg/ml, the item of Fmp was found less AGEs than Fpp with significance (p=0.037). Conclusion: This study found that Garlic extra-added in fried pieced pork could help reducing AGEs with statistical significance, also fried minced pork found less amount of AGEs than fried pieced pork.