Hua Hin Medical Journal

Factors Associated with the Time for Undergoing Forensic Examination of Sexual Assault Victims in Samutsakhon Hospital

Apisara Kulwongthanaroj — 2025-08-26

Background: The examination and care of sexual assault victims are crucial within 72 hours due to the limitations of evidence stability and the response to preventing unwanted pregnancies and sexually transmitted infections.

Objective: To study the factors associated with the time for undergoing forensic examination and medical treatment in the hospital of sexual assault victims.

Methods: This is a retrospective cohort study of victims of sexual assault who were examined at Samutsakhon hospital between January 1, 2022, and December 31, 2024, from the medical records of children, women and victims of violence. The study examines the victims' demographic characteristics, those who assisted in sending them, details of the assault, and other factors associated with the time for undergoing forensic examination, either within or more than 72 hours of the incident. Analysis was conducted using descriptive statistics and univariable and multivariable logistic regression to identify associated factors.

Results: Among the 133 sexual assault victims, 54 (40.6%) underwent forensic examination within 72 hours, while 79 (59.4%) underwent examination after 72 hours. In this group, factors associated with the time of undergoing forensic examination of sexual assault victims were first-time event and ability to recall details of the event.

Conclusion: First-time event and ability to recall details of the event are factors associated with the time of undergoing examination (within 72 hours after the incident) in sexually assaulted victims.

Factors Affecting Eye Drops Non-adherence in Patients with Glaucoma in Hua-Hin hospital

Nualnang Guysorn — 2025-08-26

Background: Glaucoma is a progressive optic neuropathy and the leading cause of irreversible blindness worldwide. Effective medical treatment can prevent visual loss.

Objective: To study the factors affecting eye drop non-adherence and the characteristics of non-adherence in glaucoma patients at Hua Hin Hospital.

Methods: This study is a cross-sectional analytical study involving 172 glaucoma patients. Data were collected using a personal information and glaucoma medication usage questionnaire, along with a record of visual acuity and visual field data. Descriptive statistics were used to analyze general information, while multivariable logistic regression was employed to analyze factors affecting eye drop non-adherence.

Results: The sample consisted of 51.2% male patients with an average age of 66.97 years. About 50.58% had been using glaucoma eye drops for 1-3 years, and 78.49% used two or more drops per eye per day. Regarding glaucoma staging, 61.05% were classified as having severe glaucoma, and visual acuity, 72.67% had normal to mild visual loss. The analysis of factors affecting eye drop non-adherence revealed that patients with blindness had 2.58 times higher odds of non-adherence (OR_adj =2.58, 95%CI: 1.05-5.53) compared to those with better visual acuity. Additionally, patients under 60 years of age had 2.42 times higher odds of forgetting to use their eye drops (OR_adj =2.42, 95%CI: 1.06-1.27) compared to those aged 60 and above. As for the characteristics of non-adherence, 61.2% of patients forgot to take their medication, 16.3% ran out of medication before their next scheduled refill, and only 1% of patients discontinued the medication on their own.

Conclusion: Patients with blindness were more likely to be non-adherent to eye drop medication compared to those with better visual acuity. Additionally, patients under 60 years of age had a higher chance to forget to use their eye drops. Forgetting to use the eye drops was a common reason for non-adherence among glaucoma patients.

Outcomes of Intermediate Care Rehabilitation and Factors Associated with Functional Improvement of Post-Stroke Patient in Mueang Lopburi District, Lopburi Province

Pornpun Angyureekul — 2025-08-26

Background: Cerebrovascular disease is a significant public health problem worldwide, including in Thailand. After surviving the critical phase, post-stroke patients require intermediate care (IMC) to enhance their ability to perform daily activities independently, reduce disability, and reintegrate into society.

Objective: This study aimed to (1) study the outcomes of intermediate care rehabilitation for post-stroke patients in Mueang Lopburi district, and (2) study factors associated with functional improvement.

Methods: A retrospective study collected data from King Narai Hospital’s medical records and the IMC coordination center of King Narai Hospital’s database. The study included post-stroke patients in Mueang Lopburi District, Lopburi Province, from October 1, 2022, to July 31, 2024. The demographic data and clinical data were collected. Functional changes were calculated from Barthel index at admission and at discharge the IMC rehabilitation and analyzed using the paired t-test. Functional gain and rehabilitation effectiveness was calculated. Factors associated with functional improvement were analyzed using Chi-square test, unpaired t-test, Mann-Whitney U test, and logistic regression analysis.

Result: The study included 251 patients, 60.6% were males, 69.7% were ischemic stroke and mean age was 64.18 (SD 13.88) years. The mean Barthel Index score significantly improved from 6.44 (SD 4.90) at admission to 16.20 (SD 5.78) at discharge (p<0.001). Mean functional gain and rehabilitation effectiveness was 9.76 (SD 5.95) and 74.86 (SD 36.82), respectively. Multivariate logistic regression analysis revealed that patient who had no complication after stroke was significantly associated with functional improvement (adjusted OR=2.92, 95%CI=1.07-8.00, p=0.037).

Conclusion: Following intermediate care rehabilitation, post-stroke patients in Mueang Lopburi district improved in functional outcome. Patient who had no complication after stroke revealed significant association with functional improvement.

Effects of Transitional Physical Therapy Program for Stroke Patients and Caregivers on activity of daily living and movement from hospital to home

Pimchanok Parnthong — 2025-08-26

Background: It is important to recognize that stroke is a disease that has widespread impact. Many patients face mobility challenges, some encounter physical disabilities, and some face a combination of disability and mortality due to limited knowledge, practical skills, and physical rehabilitation.

Objective: The purpose of this study is to investigate the effects of a physical therapy program for stroke patients and their caregivers during the transition period from hospital to home on the caregivers' knowledge and skills, the patients' mobility and ability to perform activities of daily living.

Method: This study is an experimental research design (Randomized Controlled Trials; RCT) with two groups: an experimental group and a control group, each consisting of 46 participants. Each group includes 23 stroke patients and 23 caregivers. The experimental group receives a physical therapy program for both stroke patients and their caregivers during the hospital-to-home transition, while the control group receives traditional physical therapy. Data is collected by comparing the caregivers' knowledge and skills, as well as evaluating patients' mobility tested by the STREAM information scale and ability to perform activities of daily living tested by Barthel Index scale. The data is then analyzed using independent t-tests.

Results: It was found that the caregivers’ skills, activities of daily living (Barthel Index) and patients' mobility (STREAM) between the control and experimental groups increased and were significantly different at the 0.05 statistical level. The difference in scores was 11.6 (5.7, 17.5), 13.3 (7.1, 19.4), and 11.3 (6.0, 16.7) respectively. However, the caregivers' knowledge scores did not differ significantly between the two groups.

Conclusion: The physical therapy program for stroke patients and their caregivers during the hospital-to-home transition can enhance caregivers' skills, as well as improve patients' ability to perform daily activities and their mobility.

Knowledge, Attitude and Selfcare Behavior of The Monks With Hypertension in Bangkruay District, Nonthaburi Province. A Phenomenological Study

Chamlong Chuto — 2025-08-26

Background: From a survey on the health of monks in Thailand, it was found that 45.23% of monks suffer from hypertension due to limitations in knowledge, monastic practices, physical activity, and dietary patterns.

Objectives: To investigate knowledge about hypertension, attitudes towards the disease and its treatment, and self-care behaviors among monks with hypertension.

Method: This qualitative research employed a hermeneutic phenomenological approach using structured in-depth interviews conducted by the researcher. The sample comprised 12 monks with hypertension from seven temples in Bangkruay District, Nonthaburi Province, selected through purposive sampling. Data were analyzed using inductive analysis and verified through triangulation methods.

Results: Regarding knowledge, monks understood they should limit salty foods but were unaware of specific sodium quantities. Concerning treatment, they recognized the importance of continuous medical follow-up and strict medication adherence. For exercise, they merely understood regular physical activity was necessary. Regarding self-care practices, monks had limited food choices, strictly followed prescribed medications and medical appointments, and engaged in physical activity through daily routines and alms rounds. Concerning attitudes, monks believed hypertension was incurable and could easily lead to complications, but they did not consider it frightening.

Conclusion: This research highlights opportunities to support monks with hypertension by providing education on appropriate dietary practices, recommending exercises compatible with monastic disciplines, and educating laypeople about offering suitable food to monks.

Functional Recovery in Elderly with Hip Fracture Treated with Home Skin Traction: A Retrospective Study

Worrawan Kantapokai — 2025-08-26

Background: Hip fractures are a complex problem requiring a multidisciplinary approach with close collaboration from all disciplines, especially in treating elderly hip fractures requiring skin traction to prevent potential complications and promote quality of care for the best possible outcome.

Objective: To study the ability to perform daily activities of older adults with hip fractures on skin traction at home at different times.

Method: This study was a retrospective descriptive study. The sample consisted of 56 older adults with hip fractures who had limitations for hip surgery and received skin traction between 2021 and 2023. The research instruments included 1) a personal data record form, 2) Barthel Activities of Daily Living Index: ADL on the day of discharge from the hospital (T1), 1 month after discharge (T2), and 3 months after discharge (T3), 3) a complication record form, and 4) a data record form for mortality and cause of death. The data were analyzed using descriptive statistics, and the data were compared using One-Way ANOVA.

Results: The mean scores of activities daily living at T1, T2, and T3 were 7.90 (SD=2.69), 11.30 (SD=3.12), and 13.27 (SD=3.16), respectively, and the mean scores of activities daily living during T2 and T3 were significantly higher than T1 (F=59.989; p= .000). Complications were pressure sores (5.36%) and mortality rates within 30 days after hip fracture (1.79%) and within 1 year (8.93%).

Conclusion: Effective home care for older patients with hip fractures using skin traction requires a multidisciplinary team that emphasizes communication and coordination between the hospital and community to address each patient's complex needs. Improving interdisciplinary work processes is crucial for enhancing the quality of patient care.

Predictive Factors of Blood Glucose Control among Pregnant Women with Gestational Diabetes Mellitus

Pornnipa Wongmak — 2025-08-26

Background: Gestational diabetes mellitus (GDM) is a complication that affects both the pregnant woman and the fetus. Many factors affect blood sugar control. The main goal of pregnancy care should be to control blood sugar levels within normal range to prevent complications.

Objective: To examine the risk factors maternal age, pre-pregnancy body mass index (BMI), gestational weight gain, health literacy, and social support that contribute to elevated blood glucose levels among women with GDM.

Method: This is a cross-sectional analytic study. Data were collected from 104 pregnant women diagnosed with GDM who attended antenatal care at Saraburi Hospital. Participants were categorized based on whether their blood glucose levels were within or above the recommended range. Data collection tools included a personal information questionnaire, a health literacy assessment, and a multidimensional perceived social support scale. Descriptive statistics and multivariable logistic regression were used for data analysis.

Results: Women with gestational diabetes aged 30 years or older were 6.63 times more likely to have elevated blood glucose levels compared to those under 20 years (95% CI: 1.17–37.54, p=0.031). Additionally, those who experienced excessive gestational weight gain had a 3.18 times higher risk of elevated blood glucose compared to those with weight gain below the recommended level (95% CI: 1.19-8.48, p=0.021).

Conclusion: Pregnant women with diabetes who are over 30 years old and gain an average of more than the standard weight per week during pregnancy are factors that affect blood sugar levels in pregnant women exceeding the standard. Therefore, nurses should give advice on changing their health care behavior to prevent complications.