Krabi Medical Journal

Nursing care of a premature newborn who is jaundiced with hemolysis and has yellow substance stuck to the brain tissue together with acute respiratory failure: a case study

2023-11-23T14:17:58+07:00

A case study of two premature newborns with jaundice. The objective is to provide guidelines for nursing care of premature newborns with jaundice who have hemolysis and yellow substance clinging to the brain tissue together with acute respiratory failure He was treated with phototherapy and blood transfusions. Pediatric department Krabi Hospital Between February 2022 - September 2022 collect data with information from patient medical records, observations, and interviews with mothers Analyze data by comparison The study found that the 2 patients were different in their characteristics and causes. Pathology of the disease Doctors' treatment approaches and nursing practices are therefore specific to the patient's condition. Guidelines for nursing of jaundiced infants receiving phototherapy and blood transfusions have been implemented. which requires nursing skills in preparation Complications from blood transfusions and from positive pressure ventilation are monitored. Symptoms are closely monitored and comprehensive nursing care provided. To ensure that premature babies survive safely without complications in both cases.

Statistics for Medical Practice and Research 101

2023-12-06T15:45:15+07:00

Statistics and epidemiological principles, measure, and tests are important tools that can used to facilitate clinical decision-making and are key in implementing and evaluating clinical research. This review provides an overview of basic knowledge to understand the purpose, advantages, and limitation of various study designs. To apply these concepts to clinical research and practice.

Caring Model Development for Serious Mental Illness High Risk to Violence (SMI-V) with Community Participation: A Case Study of One District, Thailand

2023-10-02T14:13:30+07:00

This participatory action research aimed to develop the caring model for Serious Mental Illness High Risk to Violence (SMI-V) with community participation and to study the clinical outcome of SMI-V in a district of south Thailand. The model was developed from April to July 2023 in 4 steps: 1) joint planning, 2) joint execution, 3) joint observation, and 4) joint reflection. 54 informants consisted of 17 SMI-V, 10 patients' relatives, 18 drug-addicted mental health workers, 9 community leaders. Qualitative data were analyzed by content and narrative analysis, while descriptive statistics and t-tests were used to analyze quantitative data.

The results revealed that the caring model for SMI-V with community participation can be divided into 3 levels. The first level was pre-hospital care, which comprised 8 components: 1) Establishing an area working group and searching the key leaders or local leaders, 2) Arranging an incident action plan training, 3) Screening and assessing aggression, 4) Arranging an individual registration and grouping, 5) Following home visits, 6) Mapping patients, 7) Setting the channel for report incidents and community checkpoints, and 8) Setting the community measures and agreements. The second level was hospital caring, which comprised 5 components: 1) Preparing the medical personnel, 2) Preparing the inpatient safety system, 3) Assessing the patient symptoms and problems, 4) Following the referral guidelines, and 5) Preparing the families and communities before discharging patients. The third level was post-hospital caring, which comprised 5 components: 1) Establishing an area working team, 2) Establishing a community communication group, 3) Case managing, 4) Patient behavior monitoring and assessment, and 5) Patients healing by psychotherapy and rehabilitating with community participation. After the SMI-V caring model implementation, the average score of SMI-V in psychiatric symptoms statistically decreased significantly (t = 7.84, p-value < 0.05), while the overall ability of SMI-V in mental, social, and professional statistically improved significantly (t = -12.64, p-value < 0.05).

The Effects of Health Promotion Programs For Elderly with Uncontrolled Hypertension

2023-09-26T14:01:49+07:00

This Quasi-Experimental Research was conducted to evaluate the effects of a health Promotion Program for elderly with uncontrolled Hypertension. The sample groups for the study consisted of 60 elderly with hypertension aged 60-79 years old, 30 were randomly assigned to the experimental group and 30 to the comparison group. Data were collected through questionnaire before and after the experiment. Statistical analysis was done with percentage, arithmetic mean, standard deviation, Paired Sample t-test and Independent t-test.

The results showed that the mean score of perceived self-efficacy, outcome expectations, and self-care behaviors of the experimental group after the experiment were significantly higher than before the experiment and comparison group at .05 level (p<.001). The average systolic and diastolic blood pressure of the experimental group after the experiment were significantly lower than before the experiment and comparison group at .05 level (p<.001).

The findings suggest that the health promotion program from this research is practical for application as a guideline for arranging the health promotion activities for the elderly who have similar conditions. The relevant health personnel should also continually conduct follow-up and health condition assessments.

The Comparative of Expectation of Patient towards Nursing Care in Minor Operating Room at Sadao Hospital in Songkhla Province

2023-09-01T13:47:51+07:00

This descriptive research aimed to compare between expected nursing care and actual nursing care as perceived by clients in minor operating room, Sadao hospital. Sample were 100 recruited using simple random sampling. Instruments were questionnaires of expected nursing care and actual nursing care which were validated for content validity by a panel of 3 nursing experts. Item-objective congruence (IOC) index ranged from .67 to 1.00 and Cronbach alpha coefficient were .842 and .937 respectively. Data were analyzed using descriptive statistics and dependent t-test. Research result revealed as follows;

Expected nursing care and actual nursing care as perceived by clients in minor operating room, Sadao hospital in each item, each aspect and overall were significantly different (p=.05). Only 5 items were not different namely 1) illness history taking such as drug allergies, underlying diseases, past surgeries, 2) fall prevention such as restrain, 3) sufficient light in operating room, 4) proper wound dressing, 5) surgery document distribution.

From findings, all clients undergoing both minor and general surgery should be prepared for reducing anxiety of clients and family members as well as implementing procedures consistent with routine surgery.

Self – Care Behavior of Diabetes Mellitus Patients in Ban Khlong Khanan Tambon Health Promotion Hospital.

2023-10-16T11:02:57+07:00

The Objective of this cross – section Research were to self – care behavior of Diabetes Mellituspatients in Ban Khlong Khanan Tambon Health Promotion Hospital.The sample consisted of 105 uncontrolled Diabetes Mellitus patients ; having HbA1C value more than 6.5 mg%, Be between 50 -69 years old, live In moo 1-5 Ban Khlong Khanan Sub-district which is obtained from the calculation of the sample group size of Krejci and Morgan.⁽⁵⁾Tools used in the research implementation were: a

questionnaire about opinions self – care behavior of uncontrolled Diabetes Mellitus patients. Data

were collected using self – care questionaires of uncontrolled Diabetes Mellitus patients. Reliability of

the tools was tested using Cronbach’s alpha coefficient yielding values of .91, respectively. Data were

analyzed using descriptive, frequency statistics, percentage, mean and standard deviation.

The results of this study revealed as follows.The self – care behavior of uncontrolled Diabetes Mellitus patients. In all aspects when analysing income, it was found that self – care behavior were Follow-up and prevention of complications is at a high level. The self – care behavior moderate level were : Eating, Exercise, Emotional and stress management. There is a herbal medicine to treat Diabetes Mellitus, smoking and drinking alcohol were low level. When considering each item, it was found that The highest level of behavior is going to see the doctor according to every appointment ( =3.96,SD =2.997), Second is when there are abnormal symptoms. go see a doctor immediately, even if it's not the day of your appointment. And see a doctor to follow up on symptoms and take care of yourself according to the doctor's advice regularly ( =3.65, SD = .554). The behavior at the lowest level is smoking ( =0.857 SD = .395), followed by taking medicine immediately when you remember you forgot to take medicine

( =0.9 SD = .343).

Therefore ; changing the self - care behavior of uncontrolled Diabetes Mellitus patients it necessary to develop the self – care behavior of taking medicine, smoke and alcohol drinking. In another to develop of knowledge, follow – up behavior of eating, exercising, emotional and reduces stress for patients can controlled Diabetes Mellitus. In addition, changing your self-care behavior will be effective. Staff in the subdistrict health promotion hospital must set a format. or guidelines for continuously monitoring and evaluating performance so that diabetic patients can control their blood sugar levels.

Risk factors of systemic inflammatory response syndrome following retrograde intrarenal surgery for renal and upper ureteric stones in Trang hospital , Thailand

2023-10-09T11:40:54+07:00

Objective :Retrograde intrarenal surgery (RIRS ) has many complications . This study aimed to evaluate the risk factors of systemic inflammatory response syndrome (SIRS) following retrograde intrarenal surgery.

Method :This study retrospectively analyzed 48 patients who underwent RIRS between January 2020 to July 2023 at Trang hospital. All RIRS were conducted with patients under general anesthesia in the low lithotomy position and performed by 1 urologist. Preoperative and intraoperative risk factors that potentially contribute to SIRS were compared in patients who developed postoperative SIRS and those who did not. Univariable ( two way analysis of variance ) and multivariable analysis ( one way multivariate analysis of variance ) was done. The level of significance was set at p-value <0.05.

Results :The incidence of SIRS following RIRS was 47.9% . In univariate test analysis, significant between SIRS and three factors was noted : BMI ≥25 kg/m² , longer operative time ≥ 90 minutes and preoperative positive urine culture were likely to have SIRS (p=0.002 , p=0.021 , p=0.000 respectively ). In multivariate analysis confirmed that BMI ≥25 kg/m² , longer operative time ≥ 90 minutes and preoperative positive urine culture results (p=0.044,p=0.040,p=0.001 respectively ) were significant risk factors of SIRS following RIRS procedure .

Conclusion :The patients with BMI ≥25 kg/m² , operative time ≥ 90 minutes or preoperative positive urine culture resuts should be concerned about SIRS following RIRS procedure.

Comparison of Intraocular Pressure between Non-Contact Air-Puff Tonometer and Goldmann Applanation Tonometer in Glaucoma Patients at Krabi Hospital

2023-10-02T15:27:27+07:00

Background: Glaucoma is a leading cause of irreversible blindness worldwide. Intraocular Pressure (IOP) is an important factor for glaucoma patients’ evaluation, diagnostic and management .The standard IOP measurement is Goldmann Applanation Tonometry (GAT). However, there are some limitations in some patients who need of skilled examiner, children, uncooperative patient and patients who are allergic to anesthetic eye drops or fluorescein staining. Non-contact air-puff tonometer (NCT) has been developed for IOP measurement to solve these problems. So the accuracy of NCT compare to standard GAT was studied.

Objectives: To compare intraocular pressure (IOP) measured by non-contact air-puff tonometer and Goldmann applanation tonometer in patients with glaucoma.

Methods: An observational cross-sectional comparative study was done from 1 October to 31 December 2021 in Krabi hospital. There are 92 patients, 174 eyes from both glaucoma and glaucoma suspect groups. The IOP were measured by NCT and GAT in glaucoma outpatient clinic. The differences in IOP readings between the two techniques were evaluated.

Results: The mean IOP values of overall participants measured by NCT and GAT were 17.17 ± 5.17 and 18.72 ± 6.39 mmHg (p-value = 0.000) respectively. In the group with IOP less than 21 mmHg, the mean IOP values measured by NCT and GAT were 14.80 ± 3.13 and 15.89 ± 2.87 mmHg (p-value <0.001) and in the group with IOP greater than or equal to 21, the mean IOP values were 22.79 ± 4.72 and 25.43 ± 7.39 mmHg (p-value = 0.000) respectively

Conclusion: The mean IOP values measured by NCT was significantly lower than IOP measured by GAT in both IOP less than 21 mmHg group and IOP greater than or equal to 21 mmHg group. The examiner should consider additional IOP measurements by GAT for more accurate and reliable clinical decision-making

The Model of Community Participation for Coronavirus 2019 Surveillance and Control in Ban NaNueaSubdistrict, AoLuek District, Krabi Province

2023-10-25T14:21:53+07:00

This Participatory Action Research aimed to develop a Model of Community Participation for Coronavirus 2019 Surveillance and Control in Ban NaNueaSubdistrict, AoLuek District, Krabi Province. Four steps of model development comprised 1) Planning, 2) Implementation, 3) Observation, and 4) Reflection. Data were collected from 50 key informants during April - July 2023, including two professional nurses in Ao Luek Hospital and a health-promoting hospital, two public health technical officers, thirty village health volunteers, and fifteen community service recipients. Then, data were analyzed by content analysis and narrative analysis.

The participatory model of surveillance prevention and infection control of Coronavirus Disease 2019 comprised five components: 1) Internal-Safety Administration (I1) 2) Internal-Active Risk Finding (I2) 3) Community Active Risk Finding (C1) 4) Coordination and information management for risk communication, and 5) Community measures implementation and Law enforcement (C3) or the 2I3C model. This model was developed after the coronavirus disease 2019 outbreak with the reduction of government measures in surveillance prevention and infection control. However, in preparing for various epidemic situations, the management processes in surveillance and control of infectious disease should be continuously developed together with the preparation of community readiness and health service units regulated by service standards.

เรื่องควรรู้สำหรับการวิ่งมาราธอน

2023-12-06T15:55:20+07:00