Hua Hin Medical Journal

The Systematic Reviews on Palliative Nursing Management in The Terminally Ill Cancer Patients from Hospital to Home

2023-04-11T14:12:27+07:00

Background: Patients with cancer who are in the terminal stage are at high risk of death. These patients must return home for palliative care until their last days. Therefore, there is a need for a patient treatment service system to manage and coordinate treatment between hospitals and homes for efficient and continuous nursing.

Objectives: This report is a literature review with the purpose to summarize the practice methods and results of palliative care at home.

Methods: The research method is studying the existing research results published between the years 2017 and 2022, from May 2022 to April 2023, using the electronic databases of Thai journals, namely TCIJO and Thai LIS Digital Collection, and following the PICOS Framework concept of Joanna Briggs Institute.

Materials: The quality analysis of the research study was conducted using the Review Manager software for a quasi-experimental study assessment, following the Checklist for Quasi-Experimental Studies: non-randomized experimental studies. Subsequently, the data was subjected to statistical analysis using Meta-analysis, and content analysis was performed to address the literature review questions.

Results: The search results from the keyword search yielded a total of 226 research reports. Among these, 219 were from the TCIJO database, and 7 were from the Thai LIS Digital Collection. Six studies met the criteria for literature review based on the PICOS framework: 3 quasi-experimental studies and 3 operational studies. The research quality levels were rated as TCI 1 and 2, with three studies falling into each category. However, the statistical results were insufficient for Meta-analysis, so content analysis was performed instead. The study focused on two models of patient care service systems for end-stage cancer patients transitioning from hospitals to home care. The first model was case management, and the second model involved network and family participation. The results indicated an improvement in the quality of care with the implementation of the Palliative Care Outcome Scale (POS). There was no significant difference in the measured physical performance (palliative performance scale: PPS) between the two models, but the group receiving care in the emergency department had fewer hospital admissions and shorter hospital stays compared to the control group. Additionally, the palliative care at home continuity led to an overall improvement in the patient's quality of life.

Conclusions: The patient care service system model of transitioning end-stage cancer patients from hospitals to home care, with the involvement of healthcare professionals and working as a network from hospital to home, promotes and supports patients and caregivers in self-care management, leading to an improved quality of life. This positively benefits the patients, their families, and the hospitals and aligns with the policies of the Ministry of Public Health.

The Effect of A Group Counseling Program on Promoting Social Intelligence in Adolescents with Depression

2023-10-16T09:36:26+07:00

Background: Depression is one of the major problems facing adolescents today. Resulting in the loss of years of health and being violent to the point of suicide. The group counseling program to develop social intelligence and adaptability may help reduce depression in adolescents.

Objective: To study the effects of a group counseling program on social intelligence and depression in adolescents.

Material/Method: This study utilized a quasi-experimental research design with a two-group pre-posttest design. The participants were depressed adolescents divided into two groups: a control group receiving standard nursing care and an experimental group receiving a group counseling program with a CVI of 0.95. The sample consisted of 20 individuals in each group, assigned through simple random sampling. Social intelligence and depression levels were assessed before and after the experiment, and the data were analyzed using descriptive statistics and t-tests.

Results: The initial levels of social intelligence and depression were not significantly different between the experimental and control groups (p >.05). However, after the experiment, both groups showed significant changes in social intelligence and depression (p <.001). Furthermore, there were significant differences in social intelligence and depression between the experimental and control groups after the experiment (p <.05).

Conclusion: Group counseling programs have been shown to increase social intelligence scores and reduce depression in adolescents.

Incidence and Factors Related with Improved Chest Radiographic Findings in Covid-19 Patients after Favipiravir Treatment at the second Hospital Field of Kasetsart University: Suphanburi

2023-09-15T13:29:14+07:00

Background: Coronavirus disease 2019 (COVID-19) is an emerging disease. Guidelines for medical practice advise patients with mild symptoms to consider favipiravir as soon as possible. But there are risk factors for severe diseases. For example, age > 6years, chronic obstructive pulmonary disease (COPD) combined chronic lung disease, stroke, uncontrolled diabetes, obesity (BMI ≥ 30 kg/m2), room air SpO2 ≤ 96% or found to have SpO2 while exertion decreases ≥ 3% of the first measured value (Exercise-induced hypoxia), which may require regular hospitalization or consider corticosteroid with favipiravir.

Objective: The purpose of this study was to investigate and analyze the factors associated with the improvement of chest radiographic findings in COVID-19 patients following favipiravir treatment at the second Hospital Field of Kasetsart University: Suphanburi.

Method: A retrospective cohort analytic study was performed by collecting data from the medical records or electronic health records of COVID-19 patients who enter to the second Hospital Field of Kasetsart University: Suphanburi. The medical data and chest radiographic reports were collected during July 11, 2021- September 30, 2021. By using the chi-square test, independent t-test, univariate, and multivariate logistic regression, data were analyzed to determine the percentage, mean statistic, and related factor between sex, age, underlying disease, body mass index, clinical level of C-reactive protein, and radiographic findings.

Results: The average age of the 151 patients enrolled in the study was 44.21 years, there were females 62.90% and 74.17% had no underlying disease. The C-reactive protein level levels greater than or equal to 15 mg/L had a statistically significant improvement in the change on chest radiographs (p = .009).

Conclusion: Level of C-reactive protein levels greater than or equal to 15 mg/L had a statistically significant improvement in the change on chest radiographs.

Factors Affecting Re-Hospitalization of Patients with Chronic Heart Failure in Hua Hin Hospital

2023-12-20T20:07:08+07:00

Background: Chronic heart failure is a serious health problem in all countries of the world. At present, the number of patients with heart failure is increasing. The diagnosis of the cause of heart failure is therefore important. So that the patient receives the correct and appropriate treatment.

Objective: To study factors affecting the re-hospitalization of patients with chronic heart failure at Hua Hin Hospital.

Method: This study was a retrospective analytical study. Data were collected from the medical records of patients diagnosed with chronic heart failure who were hospitalized in the cardiology intensive care unit and general ward in the internal medicine department, Hua Hin Hospital during the period from January 1, 2020, to December 31, 2022, for a period of 3 years. The instrument used in this research was the medical records of all patients admitted to the cardiology intensive care unit and general ward in the internal medicine department. The patients must be hospitalized with a diagnosis of chronic heart failure. The data were presented as the number, percentage, mean and standard deviation. Factors affecting the re-hospitalization of patients with chronic heart failure were analyzed by independent t-test and Chi-square test, including data analysis, univariate analysis and multivariate analysis with binary logistic regression statistical analysis.Results: A total of 405 patients, found that the re-hospitalization rate of patients with chronic heart failure was 24.2%. It was found that having ischemic heart disease, acute valvular regurgitation, insufficient control of water and salt, diet malnutrition (protein deficiency serum albumin) and SGLT2 inhibitor use had a statistically significant effect on re-hospitalization (p=0.041, p=0.039, p=0.034, p=0.026 and p=0.030, respectively). Gender, chronic diseases, smoking, alcohol consumption or the use of amphetamines, type of function of the heart muscle, cardiac arrhythmias, acute circulatory disorders, infectious diseases, anemia, chronic lung diseases, drugs and hormonal disorders had no effect on repeated hospitalization of patients with chronic heart failure.Conclusion: Many patients with heart failure have to be hospitalized again. From this study, it was found that there were many factors affecting. Therefore, physicians and relevant personnel should be aware of educating patients on self-care and provide comprehensive treatment to prevent re-admission to the hospital.

Prevalence and Associated Factors of Early Onset-to-Hospital Arrival Time of Acute Stroke Patients in Watphleng Hospital

2023-11-13T09:14:36+07:00

Background: Stroke is the second leading cause of death and the third leading cause of disability. This disease results from abnormalities in the gradually progressive nervous system, and timely treatment is crucial and highly beneficial. The effectiveness of treatment largely depends on the appropriate timing.

Objectives: To study the prevalence and associated factors of early Onset-to-Hospital arrival time of acute stroke Patients in Watphleng Hospital, Ratchaburi Province.

Methods: This research is a retrospective descriptive study. The sample size was determined by analyzing the power of the test and resulted in a sample size of 133 individuals. Data were collected from medical records between October 1, 2019, and April 31, 2023. A comparison was made between patients who received timely treatment within 3 hours and those who received treatment beyond 3 hours. General statistics were analyzed using descriptive statistics and log-binomial regression for correlation analysis.Results: It was found that 55.6% of acute stroke patients received timely treatment within 3 hours. Multivariate analysis revealed that living alone (adj. PR = 0.25, 95% CI: 0.11-0.57), lower severity of symptoms (adj. PR = 0.98, 95% CI: 0.97-0.99), and symptoms occurring at night (adj. PR = 0.63, 95% CI: 0.44-0.88) were factors preventing timely treatment for acute stroke patients.Conclusions: There should be public awareness campaigns, especially for individuals living alone and the general population. If symptoms occur at night, individuals should promptly go to the hospital without waiting. Creating community awareness about stroke symptoms and the importance of timely hospitalization can lead to quicker treatment and reduced disability in stroke patients.

The Effect of Clinical Supervision Model in Nursing Care Process for Nurse

2023-10-18T14:44:37+07:00

Background: Clinical supervision is an important process for nursing administrators to promote the quality of the nursing process. The goal is to ensure the quality of patient care, create a good working environment, and develop nursing skills.

Objectives: The objective of this study is to compare the level of knowledge and utilization of the nursing process, as well as satisfaction with supervision, among nurses who have undergone clinical supervision.

Methods: We used a quasi-experimental research design to measure the impact of clinical supervision on the knowledge and use of the nursing process by professional nurses. The study consisted of two phases: before and after the implementation of clinical supervision. Our sample population included 38 professional nurses with at least one year of work experience. We utilized the Proctor Clinical Supervision Model, which assesses knowledge and use of the nursing process, as well as satisfaction with clinical supervision. Data was analyzed using descriptive statistics and the Paired t-test to compare the results before and after the implementation of clinical supervision.

Results: The results showed that the knowledge of professional nurses regarding the nursing process significantly improved after clinical supervision. The mean score increased from a moderate level (13.63, SD=1.36) to a good level (15.79, SD=1.09). This improvement was statistically significant (p<.001). Furthermore, the mean score for the use of the nursing process also significantly increased after clinical supervision (from 109.13, SD=7.62 to 125.92, SD=6.87, p<.001). The supervisee's satisfaction with the clinical supervision was also at the highest level. Conclusion: The clinical supervision model has been shown to effectively support professional nurses in gaining knowledge and applying the nursing process to their practice. This not only aligns with professional standard, but also contributes to job satisfaction. Therefore, it is recommended that the nursing management team encourage first-level administrators to adopt this model for the further development of nursing work.