การพัฒนาระบบการดูแลผู้ป่วยจิตเวชฉุกเฉินในหน่วยบริการสาธารณสุข อำเภอปราสาท จังหวัดสุรินทร์

Sukanya Saisaengjan; Prueksachat Thobpae; Monrudee Yuenyaw; Sujitta Ritmontree

Authors

Sukanya Saisaengjan Prasat Hospital
Prueksachat Thobpae Prasat Hospital
Monrudee Yuenyaw Prasat Hospital
Sujitta Ritmontree Faculty of Nursing, RoiEt Rajabhat University

Keywords:

system development, psychiatric emergency care, healthcare system

Abstract

Introduction: The number of psychiatric emergency cases is rising, primarily due to medication nonadherence and substance use, which is negatively impacting on health services.

Research objectives: 1) To assess the current situation and identify existing problems in psychiatric emergency care; 2) To design and implement a tailored care system to address these issues; and 3) To evaluate the effectiveness of the implemented care system.

Research methodology: This research and development study was conducted from January to November 2025 across public health service units in Prasat District, Surin Province, Thailand. The study comprised four phases: situational analysis, system development, system piloting, and effectiveness evaluation. The sample consisted of 30 psychiatric emergency medical records, 30 registered nurses, and 30 psychiatric emergency patients. Research instruments included a data record form, an interview guide, a knowledge test, the Global Assessment of Functioning (GAF), and the Thai version of the World Health Organization Quality of Life (WHOQOL-BREF) assessment. Data were analyzed using descriptive statistics, paired t-tests, and content analysis.

Results: Most patients experienced recurrent psychiatric emergencies, primarily due to medication nonadherence and substance use. The developed system consisted of three phases: prehospital care, hospital-based care, and continuous care in the community. Following implementation, registered nurses demonstrated significantly higher knowledge scores regarding psychiatric emergency care (p< .001). Patients also showed significant improvements in both GAF scores and quality-of-life scores after a 3-month follow-up (p < .05).

Conclusions: Implementation of the integrated three-phase psychiatric emergency care system significantly improved nurses’ knowledge and enhanced both patient functioning and quality of life.

Implications: The system should be expanded to similar healthcare settings in conjunction with strengthened community follow-up to prevent the recurrence of psychiatric emergencies.

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