Journal of Research and Health Innovative Development

Development of a Community-Based Participatory Approach for Drug Screening, Case Finding, and Patient Care: The “Roi-Et Model” in Phanom Phrai District, Roi Et Province

Wattanasak Suksai — 2025-09-03

Purposes: This study aimed to investigate the current situation and challenges of substance abuse; to develop, implement, and evaluate an operational guideline for community-participatory screening, identification, and care for individuals with substance use disorders; and subsequently to refine and disseminate the guideline.

Study Design: Research and Development (R&D).

Materials and Methods: The study, conducted from December 2023 to December 2024, employed a research and development (R&D) design. Three target groups were involved: 1) 260 individuals for a situational analysis survey; 2) 31,910 people aged 16-65, selected through purposive sampling for a screening program; and 3) 390 research collaborators comprising 13 sub-district operational teams (30 members each). Data were collected using a survey questionnaire with a Cronbach's alpha coefficient of 0.92, a focus group discussion guide, and record forms validated with an Item-Objective Congruence (IOC) index ranging from 0.80 to 1.00. Data were analyzed using descriptive statistics (frequency, percentage) and content analysis.

Main findings: The situational analysis revealed a severe methamphetamine abuse problem in Roi Et province, particularly in the Phanom Phrai district, prevalent among adolescents and the working-age population, leading to increased crime rates and social unrest. Fear and mistrust were identified as significant barriers to intervention despite the existence of reporting channels. The study led to the development of a six-step model: 1) Preparation; 2) Identification and Screening; 3) Summarizing screening results and providing community feedback; 4) A 9-session Community-Based Treatment (CBTx) program and evaluation; 5) Transitioning to sustainable follow-up; and 6) Monitoring and relapse prevention. The guideline's implementation showed that of the 31,910 individuals screened, 1,118 (3.5%) had positive urinalysis results. These individuals were classified as users (n=21, 1.88%), abusers (n=1,069, 95.62%), and addicts (n=28, 2.50%). Among the positive cases, 20 (1.79%) exhibited red-level aggression. Following the intervention, of the 1,064 'abusers' who completed the 9-session CBTx program, 177 (16.64%) subsequently tested positive for substance use, and 123 (11.56%) were identified as having relapsed.

Conclusion and recommendations: The implementation of the community-participatory guideline positively impacted the community. The CBTx model proved to be an effective approach for mitigating the adverse effects of drug abuse and supporting the sustainable recovery of individuals with substance use disorders.

Development of a Care Model for Psychiatric Patients with Substance Use Disorders In the Acute Phase: Inpatient Services at Thawatchaburi Hospital

Ratanapirn Upkaew — 2025-09-03

Purposes: This study aimed to assess the current situation and problems related to the care of patients with substance-induced psychiatric disorders in the acute phase, to develop an appropriate care model, implement it in practice, and evaluate and refine the model for use in inpatient settings.

Study Design: Research and Development (R&D).

Materials and Methods: A research and development design was employed. Data on 108 patients admitted with acute psychiatric complications related to substance abuse were collected from medical records. Focus group discussions were conducted with 19 key informants. The developed model was then implemented with 13 registered nurses and 43 purposively selected acute psychiatric patients. Data were collected through questionnaires and record forms and analyzed using frequency, percentage, mean, and standard deviation.

Main findings: Problems in acute care were identified at four levels: patients and their relatives, service providers, service systems, and medical equipment and supplies. The care model developed for acute substance-related psychiatric patients consisted of five steps: (1) preparation of personnel and readiness, (2) triage and admission, (3) area modification, (4) treatment process, and (5) admission to inpatient ward and discharge. Implementation of the model resulted in a reduced number of acute-phase hospitalization days (minimum = 3 days; maximum = 12 days), with 29 patients (44.18%) remaining in the acute phase for 7 days. A total of 32 patients (74.41%) successfully completed both the acute and IMC treatment phases. Overall, nurses’ satisfaction with the care model was at the highest level (Mean = 4.52, SD. = 0.44).

Conclusion and recommendations: The developed model effectively reduced the length of acute-phase hospital stay and enhanced treatment success, while yielding high satisfaction among service providers. Therefore, the model should be expanded to network hospitals and supported with adequate equipment and system resources. Continuous monitoring and evaluation are recommended to ensure suitability and sustainability in different contexts.

EFFECTS OF PLANNED GIVING INFORMATION PROGRAM BEFORE CARDIAC CATHETERIZATION ON ANXIETY AND READINESS IN PATIENTS WITH CORONARY ARTERY DISEASE AT ROI ET HOSPITAL

Sopha Suwannasri — 2025-09-08

Purposes : To compare anxiety scores and readiness scores regarding the effects of a planned giving information program prior to cardiac catheterization on anxiety and readiness among patients with coronary artery disease at Roi Et Hospital.

Study design : Quasi-experimental research.

Materials and Methods : The sample consisted of 44 patients with coronary artery disease undergoing cardiac catheterization, divided equally into a control group receiving routine nursing care (n = 22) and an experimental group receiving the planned giving information program (n = 22). The program was developed based on Bloom’s Taxonomy of Educational Objectives. Research instruments included a cardiac catheterization anxiety assessment scale and a readiness assessment scale, both validated by three experts (content validity index = 0.84 and 0.96; reliability = 0.89 and 0.87, respectively). Data were analyzed using descriptive statistics, Chi-square test, paired t-test, and independent t-test.

Main findings : Before the procedure, the experimental group had moderate anxiety (Mean = 3.41±0.82) and high readiness (Mean = 3.62±0.83), whereas the control group had high anxiety (Mean = 3.76±0.41) and moderate readiness (Mean = 3.30±0.66). After the procedure, the experimental group reported the lowest anxiety levels (Mean =1.33±0.36) and the highest readiness (Mean =4.97±0.05), while the control group had moderate anxiety (Mean =2.35±0.62) and moderate readiness (Mean =3.33±0.80). Between-group comparisons showed that the experimental group had significantly lower anxiety and higher readiness than the control group (p < .05).

Conclusion and recommendations : The planned giving information program prior to cardiac catheterization was effective in reducing anxiety and enhancing readiness among patients with coronary artery disease. It is therefore recommended that the program be applied in nursing practice to improve care effectiveness and enhance patient experience.

Development of a Comprehensive Psychiatric Care System (SMI-V) with Family and Community Involvement, at Mae Wadi Hospital, Roi Et Province

Saijai Singameueng — 2025-09-08

Purposes: This study aimed to investigate problems and needs, develop, implement, evaluate, improve, and disseminate a family- and community-based care system for patients with severe mental illness with complex needs (SMI-V).

Study design: A research and development design was employed

Materials and Methods :. Participants included 40 healthcare providers (physicians, nurses, pharmacists, and village health volunteers), 30 service users (patients with mental illness and their families), and 5 experts. The study was conducted between October 2024 and July 2025. Data were collected using standardized instruments: global functioning assessment, psychiatric symptom scale, quality of life questionnaire, knowledge test, and feasibility and appropriateness evaluation form. Data were analyzed using frequency, percentage, mean, standard deviation, and paired t-test.

Main findings : 1) Problems in SMI-V care were classified into four domains: service users and families, service providers, healthcare system, and medical equipment and supplies. 2) The developed SMI-V care system consisted of five components: (1) establishment of a multidisciplinary working group for continuous care, (2) creation of a Line application group for community communication and coordination, (3) case management, (4) monitoring and evaluation of high-risk aggressive behavior, and (5) psychosocial interventions (Matrix program) and community-based treatment and rehabilitation (CBTx). 3) After implementation, caregivers’ knowledge significantly increased (p<.001), with mean scores higher by 4.00 points (95% CI: 3.09–4.09). Patients showed significantly improved psychiatric symptoms, global functioning, and quality of life (p<.001 for all), with mean increases of 28.43, 15.46, and 33.43 points, respectively (95%CI: 22.82–34.03; 12.55–18.37; 29.20–37.65). Feasibility and appropriateness were rated at a high level (Mean=4.39, SD.=0.12).

Conclusion and recommendations: The developed family- and community-based SMI-V care system represents an innovative approach that fosters collaboration among patients, caregivers, and service providers, leading to positive outcomes at individual, family, and system levels. However, limitations related to generalizability and long-term sustainability highlight the need for further studies to validate and expand the model for broader application.

Analysis of Professional Competencies and Performance Outcomes in Financial and Accounting Operations among Health Service Network Personnel in Roi Et Province

Bunrueang Sae-ueng — 2025-09-13

Purposes : To analyze and examine the relationship between competencies and job performance outcomes in financial and accounting operations among health personnel within the health service network of Roi Et Province.

Study design : This study employed a cross-sectional design.

Materials and Methods : The sample consisted of 132 health personnel involved in financial and accounting tasks within health service networks and district public health offices in Roi Et Province. Participants were selected through stratified random sampling combined with simple random sampling using a lottery method. Data were collected using a structured questionnaire with a content validity index (CVI) ranging from 0.80 to 1.00, an Alpha coefficient of 0.93, and item discrimination power ranging from 0.42 to 0.78. Data were analyzed using frequency, percentage, mean, standard deviation, and multiple regression analysis.

Main findings : Overall, both competencies and job performance outcomes of financial and accounting personnel were rated at a high level (Mean±SD. = 4.12±0.51 and Mean±SD. = 4.20±0.78, respectively). Knowledge and personal characteristics were found to be significantly associated with job performance outcomes (p < .05). Together, these two factors explained 23.4% of the variance in job performance outcomes.

Conclusion and recommendations : The findings highlight that knowledge and personal characteristics of personnel are critical determinants of effective financial and accounting performance in public health organizations. Strengthening these factors may enhance organizational efficiency and service quality with in health networks.

A Comparative Study of Image Quality and Radiation Dose in Chest Radiography Using Different Tube Voltage Techniques : A Case Study at Bangplee Hospital

Yannawut Somsri — 2025-09-13

Purposes: This study aimed to compare the image quality and entrance surface air kerma (ESAK) in chest radiography using different tube potentials of 95, 105, and 120 kVp

Study design: Quasi-Experimental Designs.

Materials and Methods: This cross-sectional experimental study included 180 patients who underwent chest PA upright radiography, divided equally into three groups (95, 105, and 120 kVp, 60 patients each). Image quality was assessed by three radiologists using predefined criteria. The deviation index (DI) was recorded, and ESAK was measured for each group.

Main findings: The mean ESAK values for 95, 105, and 120 kVp were 0.40, 0.49, and 0.25 mGy, respectively. The 120 kVp technique produced the lowest radiation dose, which was 37.50% and 48.97% lower than those of 95 and 105 kVp, respectively, and significantly lower than the national diagnostic reference level of Thailand (0.4 mGy) (p < .001). Most DI values were within the acceptable range (±3). Radiologists’ satisfaction with image quality was high in all groups, with the 120 kVp group achieving the highest satisfaction (100% rated as excellent).

Conclusion and recommendations: Chest radiography performed at 120 kVp significantly reduces patient radiation dose without compromising diagnostic image quality. This technique is recommended for chest radiography in Bangplee Hospital and can be applied in other healthcare facilities.

Development of a Model for Prevention of Preterm Birth in the Hospital in Mahasarakham Province Network

Amporn Naksomboon — 2025-09-14

Purpose: To develop and evaluate the effectiveness of an operational model for preterm birth prevention within the hospital network of Mahasarakham Province.

Study Design: Action Research.

Materials and Methods: The target population included 1) 20 multidisciplinary team members (nurses in labor/antenatal care units and physicians) from 11 hospitals in Mahasarakham Province, and 2) 120 mothers who delivered preterm babies during the study period (December 1, 2023, to May 31, 2024). Quantitative data were collected using questionnaires and hospital databases, while qualitative data were gathered through in-depth interviews and focus group discussions.

Main Findings: The developed operational model consisted of four main components: 1) systematic screening and risk assessment, 2) health education and awareness for pregnant women, 3) multidisciplinary referral and care, and 4) continuous monitoring and evaluation. After the implementation of this model, the preterm birth rate among high-risk pregnant women showed a statistically significant decrease (p<.05). Additionally, healthcare professionals reported a high level of satisfaction with the operational model.

Conclusion and Recommendations: The developed operational model is effective in reducing the preterm birth rate in Mahasarakham Province. It can be adapted and utilized as a guideline for other hospital networks. Continuous scaling and further development are recommended to enhance its long-term effectiveness.

The Development of Care Guidelines for Patients with ST-Elevation Myocardial Infarction (STEMI) at Pathumrat Hospital

Duangjai Khumlae — 2025-09-14

Pupose: To study the problem, develop guidelines and evaluate the use of guidelines for the care of patients with ST-Elevation Myocardial Infarction (STEMI) at Pathumrat Hospital.

Study design: Research and development (R&D).

Materials and methods: The target group consisted of 7 nurses and medical personnel for 10 focus group discussions, 30 patients and relatives, and 30 patients for trial use of the guidelines.Including semi-structured interviews, needs questionnaires, suitability assessment forms, and satisfaction assessment forms. Qualitative data were analyzed using content analysis and quantitative data using descriptive statistics, One Sample t-test.

Main finding: The main problems in caring for STEMI patients were found to be incomplete assessment, delayed diagnosis and treatment due to lack of specialized personnel, and limitations in referrals. The highest priority (PNI) was the readiness of doctors and nurses to support patients 24 hours a day (PNI = 0.530). The developed guidelines consisted of 6 steps. 1) Screening of symptoms using the chest pain assessment form for acute myocardial infarction patients at Pathumrat Hospital. Increase screening in DM, HT, old MI patients who present with dizziness, dyspepsia. Perform EKG in every case and create a notification system in the HOSxP program. 2) Perform EKG and report results to the doctor within 10 minutes. 3) Consult cardio med at the main hospital, announce FT, give SK medication using the express channel for waiting to reduce the time for giving medication, workshop for officers on giving SK medication, record medication giving, specify the time of medication giving, the time the medication expired in order to receive medication in time effectively. 4). Coordinate the transfer to the main hospital, Roi Et Hospital, send information in the line to forward STEMI FT, deliver the patient by 2 nurses. 5) Follow up on treatment results, follow up on home visits for every case. And 6) Chronic disease clinic nurses and hospital staff provide health education to patients about AMI and the EMS system, so that patients and their relatives know about emergency symptoms that require hospital visits. The evaluation found that 27 people (90%) entered the Fast Track process, 15 people (50%) received EMS services, the average door-to-needle time was 27 minutes for 25 people (83.33%), the Onset to Needle Time (OTN) was 85 minutes for 21 people (70%), and the mortality rate was 0%.

Conclusion and Recommendations: This research demonstrates that the aforementioned approach reduces mortality rates and enhances the quality of care. It is therefore recommended to implement continuous staff training and development programs, establish a real-time ECG system, and promote the adoption and adaptation of this approach by other community hospitals.

The implementation of road accident prevention and resolution in Nadun District, Maha Sarakham Province

Samai Thongpool — 2025-09-14

Purposes: To study and analyze the patterns, development, and success factors in driving the prevention and resolution of road traffic accidents in Nadun District, Maha Sarakham Province.

Study Design: This study was conducted as action research.

Materials and Methods: The research was conducted from October 2021 to July 2024, focusing on the committees of the District Road Safety Operations Center and local authorities. It was carried out through four main phases: planning, action, observation, and reflection. Data were collected through situation and problem analysis, meetings, observation of operations, and knowledge exchange forums. Data analysis employed descriptive statistics and content analysis.

Main findings: 1) The operational model for preventing and addressing road traffic accidents in Nadun District utilized an integrated mechanism involving the District Road Safety Operations Center and local authorities. Workshops were held, committees were appointed, and safe driving campaigns were conducted across all areas and schools. This approach was developed into the NADUN Model (N = Network, A = Action, D = Development, U = Unity, N = No Accident), meaning “Development and action with full participation of all partners as one unit to achieve sustainable road safety” 2) The interventions enhanced traffic discipline among youth, promoted helmet use, and equipped them with “traffic vaccines” to survive road hazards. Both secondary schools signed MOUs with the District Road Safety Operations Center and relevant agencies under the slogan “Nadun residents are disciplined, drive safely, and wear helmets 100%.” This created model helmet-use areas in all sub-districts and nine alcohol-free model villages. Accident investigations for fatalities were completed fully, and risk data were managed across three dimensions: hazardous locations, high-risk groups, and risky behaviors. During festivals, main and secondary checkpoints were established covering roads leading to major routes, and 12 of 17 critical risk points (70.58%) were mitigated. Monthly reflection meetings-built staff morale, resulting in a reduction of accidents from 1,499 to 1,175 cases (21.6%), injuries from 1,798 to 1,506 cases (16.2%), and fatalities from 42 to 39 cases (7.1%). Risky behaviors, such as alcohol consumption and not wearing helmets, decreased during both normal periods and festivals. And 3) The key success factors included strong collaboration among the District Road Safety Operations Center committees, local authorities, department heads, health officers, village health volunteers, sub-district leaders, and the community. All parties worked together in an integrated manner from planning and implementation to monitoring and reflection resulting in effective and sustainable road safety outcomes.

Conclusion and recommendations: The road accident prevention mechanism in Nadun District was driven through full participation from all sectors, involving shared responsibility, joint planning, problem-solving, and action. Key success factors included clear appointment orders, systematic planning and implementation, strong support from administrators, staff motivation, and continuous positive supervision and monitoring. The entire process was summarized as the NADUN Model (N = Network, A = Action, D = Development, U = Unity, N = No Accident), meaning “Development and action with full participation of all partners as one unit to achieve sustainable road safety”.

Effects of an Intensive Behavioral Modification Program on Dietary Beaviors,Hemoglobin A1cand Body Mass Index in Patients with Remission Diabetes in Chiang Khwan Hospital, Roi Et Province

Ketkeaw Petchratsamee — 2025-09-22

Purposes: To compare dietary behaviors, Hemoglobin A1c and body mass index of patients with remission diabetes.

Study design: A quasi-experimental study using a one-group pretest-posttest design.

Materials and Methods: This study was conducted in 40 patients with type 2 diabetes who had a body mass index between 25.00 and 29.90 kg/m² and HbA1c levels between 7.00 and 7.50%, over a period of six months. Participants were purposively selected and then randomly assigned using simple random sampling with non-replacement. A pre-test and post-test design was used, with data collected from January to June 2025. Participants received an intervention program that combined a low-carbohydrate diet and intermittent fasting (8-hour eating window). The program included individualized activities lasting 20–30 minutes in months 1, 3, and 5. The intervention covered: 1) goal setting based on BMI and medication history, 2) dietary and nutritional behavior modification, 3) self-motivation and encouragement, 4) self-monitoring of blood glucose at home, and 5) BMI assessment combined with telemedicine follow-ups. Data were collected using a personal information questionnaire and a dietary behavior questionnaire. Descriptive statistics and inferential statistics were used to analyze the data. A paired t-test was applied to compare pre- and post-intervention outcomes.

Main findings: After participating in the behavioral modification program, the participants showed a significant improvement in mean dietary intake scores (p < .05), with an increase of 8.60 points (95%CI: -1.82 to -1.48). The mean HemoglobinA1c (HbA1c) level significantly decreased by 0.25 mg% (95%CI: 0.192–0.313, p<.0001). In addition, the mean body mass index (BMI) significantly decreased by 0.68 kg/m² (95% CI: 0.40–0.96, p<.0001).

Conclusion and recommendations: The results indicate that the intensive behavioral modification program led to improved dietary habits among patients, along with reductions in HemoglobinA1c levels and body mass index (BMI). These outcomes enhanced the patients’ confidence in self-care and empowered them to serve as role models for other individuals with diabetes in subsequent groups.

Development of a Surveillance System for Visual Impairments Among Grade 1 Primary School Students in Maha Sarakham Province

Sirirat Jakoonchon — 2025-09-22

Purposes : This study aimed to develop and evaluate a surveillance system for visual impairments among Grade 1 primary school students in Maha Sarakham Province, Thailand.

Study design : An action research approach.

Materials and Methods : An action research approach was employed and structured into three phases: (1) situation analysis, (2) system development, and (3) system evaluation. The research process was guided by the PAOR (Plan–Act–Observe–Reflect) framework in collaboration with local stakeholders. Research instruments included a vision screening guideline, in-depth interviews, and focus group discussions. Data collection tools comprised student health records, vision screening forms, and the Vision2020 program. Quantitative data were analyzed using descriptive statistics, while qualitative data were subjected to typological and thematic analysis.

Main finding : Phase 1: The situational analysis revealed that the previous practices lacked continuity, systematic coordination, and effective communication tools. Phase 2: The developed surveillance system consisted of four components: (1) management system, (2) personnel capacity building, (3) standardized screening and referral system, and (4) information and reporting system. Phase 3: The evaluation in the academic year 2024 demonstrated that 85.31% of Grade 1 students underwent vision screening, with 2.26% identified with visual impairments. Among these, 82.12% received appropriate corrective eyeglasses. Myopia was the most prevalent condition, followed by hyperopia and astigmatism. Furthermore, the developed system enhanced inter-agency collaboration and ensured continuity of services.

Conclusion and recommendations : The development of a surveillance system for visual impairments among primary school students improved screening coverage, facilitated early detection and referral, and fostered sustainable intersectoral collaboration. This model demonstrates scalability and applicability for provincial and national implementation.

Factors Associated with a Prolonged Hospital Stay Following Total Knee Arthroplasty in a Community Hospital: A Retrospective Cohort Study

Natthakan Barisri — 2025-09-22

Purposes: To investigate risk factors associated with prolonged hospital length of stay following total knee arthroplasty in a community hospital.

Study design: A Retrospective Cohort Study.

Materials and Methods: This retrospective cohort study reviewed medical records of 97 patients who underwent unilateral TKA performed by a single surgeon at Suwannaphum Hospital between January 2023 and December 2024. Patients were categorized into prolonged LOS (>3 days) and standard LOS (≤3 days). Variables with p < .20 in univariate chi-square analyses were included in a multiple logistic regression with backward elimination. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated, with significance defined at p < .05.

Main finding : Multivariable analysis identified three significant predictors of prolonged LOS: female (aOR = 6.25; 95% CI: 2.11, 8.87; p = 0.003), wound dehiscence (aOR = 13.86; 95% CI: 3.05, 62.96; p = .001), and spinal block anesthesia (aOR = 4.71; 95% CI: 1.79, 12.39; p = .002).

Conclusion and recommendations: Female, wound dehiscence, and spinal block anesthesia were independent risk factors for prolonged LOS after TKA in a community hospital. Proactive perioperative management particularly enhanced wound care and individualized anesthesia planning may shorten LOS and improve efficiency of care delivery.

Development of a nursing model for advance care planning in Palliative Care at Thawatburi Hospital Roi Et Province

Warunee Bootnai — 2025-09-22

Purposes: This study aimed to develop and evaluate an advance care planning (ACP) nursing model for terminally ill patients and to assess its effectiveness when implemented in the inpatient wards of Thawatchaburi Hospital.

Study design: A research and development design was employed.

Materials and Methods: Participants comprised 14 registered nurses, 35 end-of-life patients, and their primary caregivers who met the inclusion criteria and were admitted to the inpatient wards between January and August 2025. Data were collected using the WHOQOL-BREF, the Family Satisfaction Questionnaire, and the Model Appropriateness Assessment Tool. Descriptive statistics (frequency, percentage, mean, standard deviation) and paired t-tests were applied for data analysis.

Main finding: The developed ACP nursing model consisted of three steps: (1) assessment of patients’ and caregivers’ needs, (2) planning and implementing nursing care, and (3) documentation. After implementation, patients’ mean quality of life scores significantly improved compared to pre-intervention (p < .05). Caregivers reported a very high level of satisfaction, while the appropriateness of the model was rated as high.

Conclusion and recommendations: The ACP nursing model significantly enhanced patients’ quality of life, improved caregiver satisfaction, and promoted a dignified death at home while reducing unnecessary invasive interventions. These findings highlight the importance of structured ACP in palliative care nursing practice.

Factors Affecting Delays in Procurement Documentation by Supplies and Financial Accounting Personnel at Trakan Phuet Phon Hospital, Ubon Ratchathani Province

Phatchara Dechawat — 2025-09-28

Purposes : To investigate the documentation process and identify factors contributing to delays in the preparation of procurement documents by supplies, finance, and accounting officers at Trakan Phuet Phon Hospital, Ubon Ratchathani Province.

Study design : This study was a cross-sectional analytical research.

Materials and Methods : This study was a conducted from April to August 2025. The sample group consisted of 105 personnel involved in the procurement documentation process within the supplies, finance, and accounting departments of Trakan Phuet Phon Hospital. Data were collected using a questionnaire with a reliability coefficient (Cronbach's alpha) of 0.93. The data were analyzed using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (Multiple Regression Analysis).

Main finding : The overall level of the procurement documentation process and the contributing factors were found to be moderate, with mean scores (Mean ± SD) of 3.37 ± 0.82 and 3.06 ± 0.91, respectively. The factors that had a statistically significant effect on the delay in procurement document preparation were process-related factors and management and policy factors. Together, these two factors could explain 36.5% of the variance in the documentation delays (R² = 0.365).

Conclusion and Recommendations: The findings indicate that process-related factors and management and policy factors are significant predictors of delays in procurement documentation. This highlights the importance of reviewing and improving these areas to mitigate such delays and enhance operational efficiency.

Development of a System to Prevent Medication Errors in Diabetes Clinic With the Participation Process of the Patient Care Team at Kasetwisai Hospital Roi-et Province

Nipon Maha-ut — 2025-10-02

Purposes : To investigate medication error incidents, develop a preventive system, and evaluate its effectiveness in a diabetes clinic at Kaset Wisai Hospital, Roi Et Province, Thailand.

Study design : This action research study.

Materials and Methods: The study sample comprised prescription records of patients attending the diabetes clinic. Conducted between January and February 2025. A multidisciplinary team was engaged in developing and implementing standard operating procedures for medication error prevention. Data were collected using structured reporting forms and analyzed with descriptive statistics.

Main finding: The majority of medication errors occurred during the pre-dispensing stage, primarily due to incorrect drug quantities, and during the dispensing stage, mainly due to wrong-patient dispensing. A 14-component prevention system was developed, incorporating patient identification with ID cards or barcodes, patient record books, systematic verification of patient details, training on the HosXp system with learning-by-doing, establishment of medication error prevention protocols, pharmacist-led medication reconciliation, appointment scheduling via HosXp, color-coded drug registries, electronic prescribing with written confirmation, standardized labeling, arrangement of medications by storage codes, two-way microphone communication at dispensing points, early clinic services, and optional postal delivery of medicines. Following implementation, medication error rates per 1,000 prescriptions significantly decreased across all stages: prescribing errors decreased from 11.07 to 4.45 (−6.62), pre-dispensing errors from 9.22 to 7.79 (−1.43), and dispensing errors from 0.92 to 0.00 (−0.92) (p<.001). Staff satisfaction with the new system was high (85.71%).

Conclusion and Recommendations : The medication error prevention system effectively reduced errors and was well-accepted by healthcare personnel. The system is recommended for implementation across other chronic disease clinics with similar contexts.

Factors Associated with Product Development Needs and FDA Registration Requests Among Non-Factory Food Producers in Yasothon Province

Tinnakorn Sangsawat — 2025-10-02

Purposes: To examine factors associated with the demand for product development and the application for FDA registration among non-factory food producers in Yasothon Province.

Study design: Exploratory research design.

Materials and Methods: Key informants included 54 health food entrepreneurs operating outside factory criteria in Yasothon Province, during December 2024–March 2025. Data were collected through semi-structured interviews, interview guides, and questionnaires. Quantitative data were analyzed using descriptive statistics, Chi-square test while qualitative data were analyzed through content analysis.

Main finding : (1) Factors significantly associated with the demand for product development and FDA application included the creation of innovative products (p=.003), systematic production processes (p=.045), systematic financial accounting (p=.025), appropriate raw materials (p=.045), knowledge of product processing and development for FDA application (p=.006), and comprehensive, clear, and understandable consultation services (p=.003). (2) Entrepreneurs expressed a strong demand for support to upgrade production standards and enhance economic security and food safety at the community level. The main needs included small-scale machinery suitable for business types, standardized packaging design, and capacity building in digital marketing, especially online platforms. Sustainable development requires providing machinery, equipment, and financial support, along with detailed FDA application training and continuous guidance from support networks and agencies.

Conclusion and Recommendations: Non-factory food producers require product development, systematic production and financial management, and clear consultation to facilitate FDA application and improve production standards. Support in standardized machinery, packaging, digital marketing skills, and training with strong stakeholder networks is essential for sustainability.

Analysis of Antimicrobial Use and Mortality Factors in Patients with Drug-Resistant K. pneumoniae at Mukdahan Hospital

Prapassorn Nonjumjang — 2025-10-06

Purposes: To analyze the situation of carbapenem-resistant bacterial infections and to identify factors associated with mortality in patients infected with drug-resistant K. pneumoniae.

Study design: A retrospective cohort study.

Materials and Methods : The study included a total of 149 patients, of whom 42 had infections caused by drug-resistant K. pneumoniae. Data were retrospectively collected from medical records of patients with antimicrobial-resistant infections who had received approval for restricted antimicrobial use between January 1 and December 31, 2023. The research instrument was a data collection form, which was validated for content validity (IOC = 0.84). Data analysis employed descriptive statistics, including frequency, percentage, mean, and standard deviation, as well as inferential statistics using the Chi-square test and Independent t-test.

Main findings : Among 149 patients, 51 (34.28%) were infected with carbapenem-susceptible organisms, showing a mortality rate of only 5.88%, with appropriate drug selection in 92.16% and correct dosing in 88.24%. The mean hospital stay in this group was 17.0 ± 10.1 days. In contrast, 98 patients (65.77%) with carbapenem-resistant infections had a significantly higher mortality rate of 25.51%, appropriate drug selection in only 74.49%, and correct dosing in merely 24.49%, with a mean hospital stay of 37.7 ± 29.5 days. Statistical analysis revealed significant differences in both mortality (Chi-square test, p = .007) and length of hospital stay (Independent t-test, p < .001). The most common resistant pathogen was carbapenem-resistant Acinetobacter baumannii (CRAB) (51.01%), while the highest mortality was observed in carbapenem-resistant Klebsiella pneumoniae (CRKP) (35.71%). Mortality was significantly associated with the appropriateness of dosing and administration (p = .02). Patients receiving PK/PD-optimized regimens, such as meropenem high-dose prolonged infusion or appropriate colistin loading dose, had lower mortality. The most frequently prescribed regimen was colistin plus meropenem (65.31%) and colistin-related adverse events were observed in 22.78% of cases, mostly nephrotoxicity.

Conclusions and recommendation : Carbapenem-resistant infections are associated with high severity, significantly increased mortality, and prolonged hospital stay. Revision of the hospital CPG is warranted, with sulbactam recommended as first-line therapy for CRAB and ceftazidime-avibactam (restricted formulary, category J2) as first-line therapy for CRE where applicable. Updating the Drug Utilization Evaluation (DUE) process is essential to improve treatment outcomes, reduce mortality, and minimize long-term healthcare costs.

The Impact of Health Promotion Guidelines in Early Childhood Development Centers on Child Development in Sri Thep District, Phetchabun Province

Pathanee Dethammarong — 2025-10-06

Purposes: This study aimed to investigate the effects of the 4D (Diet, Development & Play, Dental, Disease) health promotion guideline on the health development of preschool children and to assess the satisfaction of stakeholders.

Study Design: A quasi-experimental, pretest-posttest two-group design was used.

Materials and Methods: The sample consisted of 42 preschool children from child development centers (experimental group n=21, control group n=21). The experimental group participated in activities based on the 4D guideline for 4 months, while the control group received standard care. Research instruments included the 4D guideline, the Department of Health’s Preschool Developmental Screening Program (DSPM), activity logbooks, behavioral observation forms, and satisfaction questionnaires.

Main Findings: After the intervention, the experimental group's average health development scores were significantly higher than the control group's in all dimensions (p<.05). The experimental group's scores also increased significantly from their pre-intervention scores. Regarding satisfaction, the multidisciplinary team reported the highest overall satisfaction (Mean=4.65, SD.=0.37). Parents and caregivers expressed high overall satisfaction (Mean=4.25, SD.=0.45 and Mean=4.10, SD.=0.36, respectively). All groups were most satisfied with the Diet and Development & Play dimensions. However, the lowest satisfaction ratings from teachers were for the Diet dimension, and from parents, for the Disease dimension.

Conclusion and Recommendations: The 4D guideline effectively promotes the health development of preschool children and received high acceptance from all stakeholders. These findings can serve as a practical guide for planning and implementing activities to enhance the quality of child care in child development centers.

Development of Medical Technical Service Systems in Diabetes and Hypertension Clinics through Application of Lean at Chaturaphak Phiman Hospital, Roi Et Province

Theerarat Jitprasertwong — 2025-10-13

Purposes: To investigate current service delivery challenges in the medical laboratory services for diabetes and hypertension clinic patients, develop an improved patient service system through Lean methodology implementation, and evaluate post-implementation service performance to reduce patient waiting times at Chaturapak Hospital.

Study Design: Research and Development (R&D) methodology.

Materials and Methods: The study included 200 patients receiving clinical services, selected through random sampling calculated using the Taro Yamane formula. The study was conducted in two phases: Phase 1 (pre-Lean implementation) from May 1-31, 2024, and Phase 2 (post-Lean implementation) from July 1-31, 2024. The development process comprised three stages: 1) Preparation phase - data collection on service delivery times and patient satisfaction; 2) Development phase - application of Lean tools to eliminate waste and redesign service systems; and 3) Implementation and evaluation phase - pilot testing and outcome assessment. Data collection utilized time recording forms and patient satisfaction questionnaires. Statistical analysis employed descriptive statistics (frequency, percentage, mean, standard deviation) and paired t-tests with 95% confidence intervals.

Main findings: (1) Current situation analysis revealed a continuous annual increase in diabetes and hypertension patient volumes, resulting in elevated demand for laboratory diagnostic services and increased laboratory workload. This led to service delays, extended patient waiting times beyond established standards, overcrowding in service areas, and decreased patient satisfaction. Additionally, these factors potentially impacted quality of care and continuity of chronic disease management. (2) The developed medical laboratory service system was structured into 5 main processes: registration point, blood collection point, blood centrifugation and urine preparation point, analysis point, and results reporting point, comprising 23 sub-processes according to established standards. Post-implementation results demonstrated: 1) reduction of sub-processes from 23 to 20 steps; 2) significant decrease in mean service time from 126.31 minutes to 76.10 minutes (p-value <0.001); and 3) substantial improvement in patient satisfaction scores, with a 29.15% increase reaching high satisfaction levels.

Conclusions and Recommendations: The analysis demonstrates that Lean system implementation significantly reduced waiting times, resulting in enhanced patient satisfaction. Therefore, this service system should be adopted to address overcrowding and prolonged waiting times across all hospital levels. The findings support the scalability of Lean healthcare methodologies in improving operational efficiency and patient experience in clinical settings.

The Development of a Support System for Herbal Medicine Prescription in Multidisciplinary Healthcare Teams, Roi Et Province

Paymika Yeethong — 2025-10-13

Purposes : This study aimed to investigate the current situation and problems, develop, and evaluate a support system for herbal medicine prescription in multidisciplinary healthcare teams in Roi Et Province.

Study design : Research and Development.

Materials and Methods : This research approach focuses on the study and development of a support system for herbal medicine prescriptions based on the HOSxP system for multidisciplinary healthcare teams in Roi Et Province. The System Development Life Cycle was used, dividing into 3 phases. Phase 1: Situational analysis and problem identification through interviews and focus group discussions with 10 medical personnel, analyzed by content analysis. Phase 2: System development, the original group of data was provided by conducting two rounds of testing and improvement. Each round used in-depth interviews and analyzed data using content analysis. Phase 3: System evaluation from 50 medical personnel by used questionnaire and descriptive statistical analysis.

Main findings : The developed support system effectively integrated comprehensive herbal medicine data with key decision support functions, including recommendations on indications, dosage, precautions, and alerts for drug interactions and adverse reactions. The system's performance was rated high (Mean = 4.18, SD. = 0.617), and overall user satisfaction was also high (Mean = 4.32, SD. = 0.493). Additionally, the utilization of herbal medicines increased significantly by 3.10%.

Conclusion and recommendations : The developed system effectively supports herbal medicine prescriptions among multidisciplinary healthcare teams. Expanding the implementation at the provincial level is therefore appropriate and practically feasible. As a result, the use of herbal medicines were increased, and the system received highly positive feedback from multidisciplinary teams.

Radiation Dose Optimization and Dose Deviation Index Analysis in Portable Chest X-ray Examinations for Newborns in Intensive Care Unit

Ausana Rangthong — 2025-10-17

Purposes: To study radiation doses received by newborns from portable chest X-ray examinations, analyze dose deviation indicators, and evaluate relationships between various factors affecting radiation dose.

Study design: Cross-sectional descriptive study

Materials and Methods: A comparative study was conducted before and after implementing improved portable chest X-ray techniques in 58 newborns in each group at the neonatal intensive care unit. The relationship between entrance surface air kerma (ESAK) and various parameters including tube current-time product (mAs), peak kilovoltage (kVp), chest thickness, radiation field size, and birth weight was analyzed.

Main findings: Before optimization, the mean ESAK was 1.36 ± 0.05 mGy, which significantly decreased to 0.06 ± 0.01 mGy after optimization (95.58% reduction, p < 0.001). mAs showed the strongest correlation with ESAK (r = 0.991), followed by kVp (r = 0.885) and chest thickness (r = 0.421), whereas beam size and weight showed no significant correlation. The proportion of images within the acceptable DI range (±3) increased from 55.17% to 94.83%, while overexposed images decreased from 44.83% to 5.17%. Post-optimization radiation dose levels complied with Thailand’s national reference levels (≤ 0.06 mGy).

Conclusion and recommendations: Optimized portable chest X-ray techniques significantly reduced radiation doses to newborns while maintaining diagnostic image quality within acceptable standards. mAs and kVp were the primary factors controlling radiation dose.

Clinical Characteristics, Precipitation causes and Therapy of Patients with Acute Heart Failure in A General Hospital

Thana Lueangpigultong — 2025-10-18

Purposes: To study the clinical characteristics, precipitating factors, treatment, mortality rate, and the rate of discharge or transfer for patients with acute heart failure treated at Phraputtabhat Hospital, and to utilize the data obtained from this study to develop a medical service system for heart disease care at the hospital.

Study design: A retrospective descriptive study.

Materials and Methods: The sample consisted of all patients aged 18 and over diagnosed with acute heart failure admitted to the inpatient ward at Phraputtabhat Hospital, Saraburi Province, from September 1, 2023, to October 31, 2024. Data were collected retrospectively from hospital medical records by extracting data from electronic databases. The data were analyzed and presented in percentage form of the total patients.

Main findings: A total of 328 patients with acute heart failure were included, with 174 females (53.05%) and 154 males (46.95%). The average age was 62.71 years. The majority had a history of heart failure (58.23%), with high prevalence of comorbidities such as hypertension (71.65%) and diabetes mellitus (45.12%). The primary presenting symptom was dyspnea (98.48%), with abnormal lung sounds (crepitation) in 86.89%. Chest X-ray often showed cardiomegaly (89.33%) and pulmonary congestion/cephalization (81.4%).The main triggering factors included fluid retention (salt water retention) at 62.5%, followed by bloodstream infections (sepsis) at 20.73%. Others included prior echocardiogram (11.28%), coronary bypass surgery (CABG) (1.83%), and coronary artery stenting (0%).The discharge rate was 86.89%, transfer rate was 1.21%, and mortality rate was 11.89%. The average hospital stay was 6.14 days, with a median of 3 days. The number of hospital days per year was 1.26 days, with a median of 1 day.

Conclusion and Recommendations: Patients with acute heart failure in this general hospital had an average age of 62.71 years, with nearly equal distribution between males and females. Most had chronic non-communicable comorbidities, and the presenting symptom was dyspnea. Few had prior imaging confirmation of cardiomegaly. The most common triggering factor was excess salt and water intake, followed by infections. The mortality rate was higher than the average reported in other studies, but the transfer rate was low. The researchers recommend improving care quality and establishing a dedicated heart failure clinic to enhance treatment efficacy.

“Competency in Elderly Healthcare of Health Personnel at Primary Care Units, Mae La Noi District, Mae Hong Son Province

Boonlert Sriaree — 2025-10-18

Purposes: This study aimed to examine the competencies in elderly health care, identify factors associated with such competencies, and explore approaches to enhancing the competencies of health personnel working at sub-district health-promoting hospitals in Mae La Noi District, Mae Hong Son Province.

Study Design: This study employed a mixed-methods research and development design.

Materials and Methods: The sample consisted of 40 health personnel who met the inclusion and exclusion criteria. Data were collected through structured questionnaires and interviews comprising 15 items. The instruments demonstrated good quality, with a content validity index ranging from 0.67 to 1.00 and an overall Cronbach’s alpha coefficient of 0.98. Quantitative data were analyzed using descriptive statistics, mean scale interpretation, Pearson’s correlation coefficient, and stepwise multiple regression with a 95% confidence interval at a significance level of .05. Qualitative data were analyzed through content analysis.

Main findings: The participants’ overall competency in elderly health care was at a moderate level (Mean = 52.50, SD. = 18.25). The service dimension scored the highest (Mean = 50.20, SD = 16.12), whereas the coordination dimension had the lowest mean score (Mean = 46.80, SD = 16.90). Pearson’s correlation revealed a statistically significant positive relationship between work experience and competency in elderly health care (r = 0.583, p < .001). Stepwise multiple regression indicated that work experience was the strongest predictor of competency (β = 0.56,
p < .001). Qualitative findings showed challenges in inter-agency and network coordination, time constraints, and heavy workloads that hindered capacity development, as well as geographical and linguistic barriers affecting communication.

Conclusion and Recommendation: The recommended competency development approach emphasizes modular, concise training sessions integrated into monthly meetings, supported by short and comprehensible digital learning materials. Experiential learning and a mentorship system tailored to operational levels and local communication contexts are proposed to enhance health personnel competency in elderly care effectively.

The development of a behavioral modification program for elderly care with a history of drug-resistant infections in the responsibility area of Nong Phok Hospital, Roi Et Province

Arpassara Thammasan — 2025-10-27

Purposes : To compare the mean difference scores of knowledge regarding the prevention of drug-resistant infections, perceived self-efficacy, social support, quality of life of older adults, and self-care behaviors for the prevention of drug-resistant infections, within and between the experimental group and the comparison group, before and after the experiment.

Study Design: A Quasi-Experimental Research, Two-Group Pretest-Posttest Design.

Materials and Methods: The sample consisted of older adults with a history of drug-resistant infections, aged 60-79 years, divided into an experimental group (Nongphok Hospital) of 35 people, receiving the behavioral modification program, and a comparison group (Phon Thong Hospital) of 35 people. The program consisted of 4 main activities: knowledge provision, exercise, environmental modification, and practice of self-care regularly. Data were analyzed using Paired t-test and Independent t-test statistics.

Main findings : By comparing the mean difference scores of knowledge regarding the prevention of drug-resistant infections, perceived self-efficacy in infection prevention, social support, quality of life of older adults, and self-care behaviors for the prevention of drug-resistant infections, within and between the experimental group and the comparison group before and after the experiment, it was found that after the experiment, the experimental group had mean difference scores for knowledge regarding the prevention of drug-resistant infections, perceived self-efficacy in infection prevention, social support, quality of life of older adults, and self-care behaviors for the prevention of drug-resistant infections higher than before the experiment and higher than the comparison group with a statistical significance level of .05 (p<.001).

Conclusion and Recommendation : The behavioral modification program for the care of older adults with a history of drug-resistant infections has high effectiveness in developing knowledge, self-efficacy, social support, quality of life, and self-care behaviors for the prevention of drug-resistant infections. This program should be expanded to promote health and reduce the spread of drug-resistant infections in the older adult population subsequently.

Development of Seamless Care Service Model for Stroke Patients: Implementation in Roi Et Province

Sasiwimon Vibulchai — 2025-10-27

Purposes : To analyze the trends and efficiency of stroke service systems using secondary data, Identify service gaps and challenges that need improvement, and propose a seamless stroke care model applicable in Roi Et province and Health Region 7, Thailand.

Study design : Descriptive study with quantitative analysis.

Materials and Methods : Secondary data were retrieved from health inspection reports, Stroke Tour records, and the Health Data Center (HDC) database during 2022–2024. Indicators included the proportion of ischemic stroke patients receiving intravenous rt-PA, mean Door-to-Needle Time (DTN), in-hospital mortality rate, and Tele-stroke coverage. Data were analyzed using descriptive and comparative statistics, and results were presented through tables and graphs.

Main findings : The rt-PA administration rate in Roi Et increased from 10.0% in 2022 to 13.9% in 2024, higher than Health Region 7 (10.5%) and the national average (9.0%). The mean DTN decreased from 74 minutes (2022) to 68 minutes (2024), shorter than the national average (78 minutes). In-hospital mortality in Roi Et decreased from 8.2% to 7.7%, compared with 8.3% nationally. Tele-stroke coverage in Health Region 7 expanded from 65% (18 Node hospitals) in 2022 to 92% (29 Node hospitals) in 2024.

Conclusion and recommendations : The seamless stroke care model in Roi Et and Health Region 7 significantly improved access to timely treatment, reduced DTN, and lowered in-hospital mortality. Investment in CT Scan and Endovascular Therapy (EVT) capacity at Node hospitals, expansion of Tele-stroke systems, workforce training for multidisciplinary stroke teams, and integration of rehabilitation services are recommended to ensure sustainability and nationwide scalability.

Service System Development and Quality of Life among Intermediate Care Stroke Patients Receiving Rehabilitation with Thai Traditional and Alternative Medicine

Wanwisa Phrommetta — 2025-10-30

Purposes : To develop a service system and evaluate the quality of life among intermediate care stroke patients receiving rehabilitation through Thai Traditional and Alternative Medicine.

Study design : Research and Development (R&D).

Materials and Methods : The study was conducted from December 2023 to September 2024 in three phases: (1) situation analysis of the existing service system and patient quality of life, (2) development of a TTCM-integrated service model, and (3) evaluation of service performance and patient outcomes. Participants included 20 health personnel responsible for TTCM services and 280 intermediate care stroke patients who received rehabilitation with Thai traditional and complementary medicine. Data were collected through interviews, service reports, and health databases (HDC, Nemo Care). Barthel Activities of Daily Living (ADL) Index was used to assess functional outcomes. Data were analyzed using descriptive statistics, paired t-test, and chi-square test.

Main findings : All 20 public hospitals in Roi Et Province (100%) provided integrated TTCM services for stroke rehabilitation. The proportion of intermediate care stroke patients receiving TTCM increased from 11.85% in 2023 to 30.13% in 2024 (2.54-fold rise). Among 280 patients, ADL scores improved in 65.56%, remained stable in 30%, and decreased in only 4.44%. Patients showed greater independence and reduced dependency on caregivers.

Conclusion and recommendations : Integrating Thai Traditional and Complementary Medicine into intermediate care rehabilitation enhances service accessibility, functional recovery, and quality of life among stroke patients. Establishing standardized Thai traditional medicine and alternative medicine service models with multidisciplinary collaboration can strengthen provincial health systems and provide a sustainable model for community-based stroke rehabilitation.

The Development of Evidence-Based Nursing Practice Guidelines for the Care of Patients with Intercostal Chest Drain in the Surgical Trauma Ward at Roi Et Hospital

Puangphaka Thammasombat — 2025-10-30

Purposes: The study aimed to investigate and analyze nursing problems in patients with chest tube drainage, to develop nursing practice guidelines for patients with chest tube drainage, and to evaluate the outcomes of implementing the nursing practice guidelines for these patients in the Trauma Surgery Ward of Roi Et Hospital.

Study design: This study was research and development.

Materials and Methods: The study was conducted from June to September 2025 and consisted of four phases: (1) situation analysis, (2) development of nursing practice guidelines, (3) implementation of the guidelines, and (4) evaluation. The participants were purposively selected and included 54 medical records of patients with chest tube drainage, 18 registered nurses, and 12 patients with chest tube drainage. The research instruments included a clinical data recording form, a guideline development record form, and a satisfaction evaluation form. Data were analyzed using descriptive statistics and content analysis.

Main findings: The study found that among 54 patients with chest tube drainage in the surgical trauma ward, most were male 90.7%with mean age 32 years. Adverse events occurred in 57.4% of patients, most commonly tube disconnection 45.2%, followed by pneumonia and lung atelectasis, each accounting for 16.1%. The mortality rate was 9.7%. Among nurses, it was found that they lacked sufficient knowledge and skills in monitoring complications, had inadequate equipment preparation, insufficient patient education and rehabilitation before discharge, and experienced communication gaps within the healthcare team. The developed nursing practice guideline for patients with chest tube drainage consisted of five phases: (1) patient admission, (2) patient preparation, (3) care during tube insertion, (4) lung re-expansion phase, and (5) tube removal and post-removal care. After implementing the guideline, patients showed a reduction in chest tube duration, hospital length of stay, and incidence of complications. Furthermore, nurses who applied the guideline reported a high level of satisfaction with its clarity, practicality, and effectiveness in improving patient outcomes.

Conclusion and recommendations: The developed nursing practice guideline for patients with chest tube drainage was effective in reducing post-procedure complications, shortening the duration of chest tube placement, and decreasing the length of hospital stay. It also enhanced staff satisfaction, reflecting outcomes consistent with evidence-based practices and demonstrating the potential for improving nursing service quality in the surgical trauma ward of Roi Et Hospital. For practical application, it is recommended that this guideline be formalized as a standard nursing manual for chest tube care and that regular workshops be organized for nurses in the surgical trauma ward to ensure consistent and effective implementation.

The Health literacy performance assessment model for Village Health Volunteers to Increase Their Work Potential with The Concept of VHV 4.0 and Smart VHV in Galayani Vadhana District, Chiang Mai Province

Ekachai Sombatrattanakorn — 2025-11-02

Purposes: To examine (1) the level of health literacy, (2) health behaviors, (3) performance based on the VHVs 4.0 and Smart VHVs concepts, and (4) the relationship between health literacy and performance among Village Health Volunteers (VHVs) in Kalayaniwattana District, Chiang Mai Province.

Study Design: Mixed Methods Research Design.

Materials and Methods: The study population comprised 229 village health volunteers (VHVs) working in Kalayaniwattana District, Chiang Mai Province, who were officially registered under the Ministry of Public Health regulations. Data collection was conducted from March 1 to August 31, 2025. The research instruments included a questionnaire, which demonstrated high reliability with a Cronbach’s alpha coefficient of 0.95, structured interviews, and a set of guiding questions for focus group discussions. Data were analyzed using descriptive statistics, correlation analysis, and content validity analysis.

Main findings : The overall level of health literacy among VHVs was high (70.77%). Health behavior in predisposing factors was also high (64.11%), while enabling factors (Mean = 3.50, SD. = 1.02) and reinforcing factors (Mean = 3.62, SD. = 1.01) were at a high level. Performance based on the VHVs 4.0 and Smart VHVs concepts was also high (Mean = 3.59, SD. = 0.89). Health literacy showed a low positive correlation with performance (r = 0.282, p < 0.01). The findings led to the development of the model titled “Performance Competency Assessment of Health Literacy among VHVs to Enhance Operational Efficiency under the VHVs 4.0 and Smart VHVs Concepts.”

Conclusion and Recommendation: The results can be applied to design health literacy promotion activities and capacity-building programs for health personnel and VHVs, enhancing their competency in implementing health literacy initiatives. This will contribute to sustainable community health development under the project “Kalayaniwattana VHVs: Empowering Health Literacy for the Well-being of the People.”

Results of volunteer program for diabetic patients on Promotive behavior to control bloodsugar levels and HbA1C of Diabetic patients in Phra That Subdistrict, Chiang Khwan District, Roi Et Province

Kannika Nacwan — 2025-11-05

Purposes: To compare blood sugar control behaviors and glycated hemoglobin (HbA1c) levels of diabetic patients before and after participation in the developed program.

Study design: A quasi-experimental study using a one-group pretest-posttest design.

Materials and Methods: This study was conducted among diabetic patients residing in Phra That Subdistrict, Chiang Khwan District, Roi Et Province. The sample consisted of 40 participants who were purposively selected and randomly assigned using simple random sampling by drawing lots without replacement. Data were collected before and after the intervention between October 2023 and May 2024. The participants received the Volunteer Program for Diabetic Patients to Promote Blood Glucose Control Behaviors, in which volunteer patients were paired with diabetic patients to jointly develop diabetes self-care through meetings, practical training, home visit observations, and telemedicine activities. Empowerment sessions were also conducted to review and strengthen patient self-care. The program was based on the Self-Management Concept, consisting of goal setting, self-regulation, self-evaluation, and self-reinforcement. To ensure shared understanding, the Blood Glucose Control Behavior Questionnaire was used as a guideline for home visits over a 16-week period (once a week). Data were collected using a personal information questionnaire and the Blood Glucose Control Behavior Questionnaire. The data were analyzed using descriptive statistics and inferential statistics to compare pre- and post-intervention results, employing the Paired t-test.

Main findings: After participating in the program, the participants showed a statistically significant increase in the overall mean score of blood glucose control behaviors. The mean glycated hemoglobin (HbA1c) level significantly decreased (p < .0001), with an average reduction of 0.60 mg% (95% CI: 0.431, 0.784) after the intervention.

Conclusion and recommendations: It was evident that the volunteer program enhanced the blood glucose control behaviors of diabetic patients after participating in the program compared to before participation. The program increased patients’ confidence in self-care and encouraged them to become role models for other diabetic patients in the community.

A Participatory Framework for Suicide Surveillance and Prevention: The Role of Family and Community in Moeiwadee Hospital, Roi Et Province

Supisa Boonpok — 2025-11-05

Purposes: This study aimed to investigate existing problems, develop, and evaluate a participatory surveillance and suicide prevention approach involving families and communities at Moeiwadi Hospital, Roi Et Province.

Study design: This study employed a mutual collaborative action research design.

Materials and Methods: The study involved three groups of key informants: (1) service recipients diagnosed with depression and identified as being at risk of suicide, along with their family members (n = 24), divided equally between the situational analysis and development phases; (2) six healthcare providers from Moeiwadi Hospital directly involved in mental health and suicide prevention services; and (3) eleven stakeholders responsible for the hospital’s suicide surveillance and prevention program. Data were collected using validated instruments assessing knowledge, attitudes, and behaviors related to suicide surveillance, prevention, and patient referral. The instruments demonstrated strong psychometric quality, with a content validity index (CVI) ranging from 0.67 to 1.00. The knowledge test showed satisfactory reliability (KR-20 = 0.84) and item difficulty indices between 0.43 and 0.76, while the attitude and behavior questionnaires showed high internal consistency (Cronbach’s alpha = 0.92 and 0.89, respectively). Data were analyzed using descriptive statistics, including frequency, percentage, mean, standard deviation, and percentage difference.

Main findings: The study was conducted through situation analysis, participatory planning, and implementation of a comprehensive suicide prevention program. Data were collected from service records and interviews covering four stages of care: pre-hospital, in-hospital, referral, and post-discharge follow-up. The developed model consisted of six key interventions: (1) training and resilience-building activities; (2) screening of target populations in schools, communities, and healthcare facilities; (3) referral of at-risk individuals according to the established system; (4) mental health care services by multidisciplinary teams; (5) discharge planning meetings involving patients, families, and community agencies; and (6) home visits for psychological assessment, family readiness evaluation, and ongoing counseling. After implementing the model, the proportion of individuals with mild depressive symptoms (scores 7–12) increased from 25.0% to 50.0% (percentage difference = 66.7), and those with moderate depression (scores 13–18) increased from 16.7% to 25.0% (percentage difference = 40.0). Conversely, severe depression (scores >19) markedly decreased from 58.3% to 25.0% (percentage difference = –80.0). Family knowledge regarding suicide surveillance and prevention increased by 38.31%, while attitudes and preventive behaviors improved by 39.35% and 39.88%, respectively.

Conclusion and Recommendations: The developed suicide surveillance and prevention model effectively reduced the proportion of individuals with severe depression and significantly enhanced family knowledge, attitudes, and behaviors toward suicide prevention. The findings support the integration of family and community participation in mental health surveillance systems as an effective strategy to strengthen suicide prevention in local contexts.

Development of Guideline for Community Participation Caring for Psychiatric Patients with Violent Behavior in Suwannaphum District, Roi Et Province

Niphakon Uengcharoenthanakit — 2025-11-24

Purposes: Psychiatric patients with violent behavior represent a significant mental health challenge affecting communities, particularly among those with substance abuse history. The absence of effective continuous care systems results in relapse and community violence incidents.

Study design: To develop a community participation approach for caring psychiatric patients with violent behavior in Suwannaphum District, Roi Et Province.

Materials and Methods: A participatory action research was conducted from October 2022 to March 2023. Co-researchers included 120 healthcare personnel, police officers, community leaders, village health volunteers, and caregivers. The research comprised three phases: preparation, development through PAOR cycle (Planning-Action-Observe-Reflex), and evaluation. Data were collected through questionnaires, in-depth interviews, focus group discussions, and participant observation. Quantitative data were analyzed using descriptive statistics while qualitative data underwent content analysis.

Main findings: The developed approach consisted of three main components: (1) Seamless Fast Track System covering pre-hospital, in-hospital, and post-hospital care; (2) Three-level patient classification system based on severity (red, yellow, green); and (3) Continuous follow-up mechanism through multi-sectoral network via Line Group system. After 20 months implementation, high-severity patients (red) decreased from 9 to 1 case (88.9% reduction), 28-day readmission rate decreased from 8.2% to 2.1%, and referral rate for severe symptoms decreased from 15.3% to 4.8%. No violent incidents recurred in the community.

Conclusion and recommendations: The community participation approach integrating multi-sectoral collaboration, seamless care system, and digital technology for coordination effectively reduced relapse rates and prevented community violence.

The Effectiveness of a Nursing Intervention Model for Preventing Preterm Birth on the Incidence of Preterm Delivery and Maternal Safety in Hua Chang Subdistrict, Chaturaphak Phiman District, Roi Et Province

Sasathon Chantakham — 2025-11-24

Purposes: To assess the local situation, develop, and evaluate a nursing model for preterm-birth prevention among pregnant women in Hua Chang Subdistrict, Chaturaphak Phiman District, Roi Et Province.

Study design: Action Research.

Materials and Methods: This action research, conducted from January to June 2025, engaged three groups of key informants: (1) pregnant women attending antenatal care (ANC) during the situation-analysis phase (n=5) and the model-development phase (n=22); (2) healthcare providers at Chaturaphak Phiman Hospital (n=14); and (3) core stakeholders involved in model development (n=6). Data were collected using a preterm-birth risk screening tool and semi-structured interviews. Quantitative data were analyzed using descriptive statistics and paired t-test, while qualitative data were analyzed using content analysis.

Main finding: Situation analysis revealed multilevel gaps spanning the pre-hospital, hospital, and post-hospital continuum of care. The developed nursing model comprised five components: (1) structured education and a prevention handbook; (2) assessment of understanding and individualized risk-reduction planning; (3) follow-up and reinforcement of preventive behaviors; (4) systematic risk screening and questionnaire assessment; and (5) continuous monitoring with village health volunteer participation. The most common preterm-birth risk factor was prior uterine surgery, including cesarean section (27.27%). After implementation, mean knowledge scores regarding preterm-birth surveillance and prevention significantly improved (mean difference = 2.98; 95% CI: 2.37–3.58; p < .001). No preterm births were observed during the post-implementation period (0.00%). Satisfaction among healthcare providers, volunteers, and pregnant women was rated at the highest level.

Conclusion and recommendations: The developed nursing model effectively strengthened preterm-birth surveillance and prevention in a community hospital context. Its structured, collaborative, and continuity-of-care approach demonstrates high potential for scale-up and integration into routine maternal health services across similar healthcare settings.

An Evaluation of Project Management of the Sakon Nakhon Provincial Public Health Office

Anuwat Wapagpat — 2025-11-29

Purposes: To evaluate the management of public health projects of the Sakon Nakhon Provincial Public Health Office and to study the problems, obstacles, and recommendations from the implementation.

Study design: Evaluation research.

Materials and Methods: The public health project management of the Sakon Nakhon Provincial Public Health Office was evaluated using the CIPP Model. The sample group consisted of 60 personnel responsible for health projects working at the Sakon Nakhon Provincial Public Health Office. The research instruments were quantitative and qualitative questionnaires. Quantitative data were analyzed using frequency, percentage, mean, and standard deviation, while qualitative data were analyzed using content analysis

Main findings: The evaluation of the public health projects of the Sakon Nakhon Provincial Public Health Office in terms of context, input, process, and product was found to be at a high level overall. Problems and obstacles in implementation were found in two main areas: (1) Input, where issues included delays in budget disbursement, insufficient budget, and excessive staff workload. and (2) Process, where the monitoring and evaluation system was found to be lacking in quality. Recommendations from the sample group were: (1) Personnel and work systems should be further developed. (2) The budget system should be improved to increase flexibility in its use. and (3) Staff should be given the opportunity to participate in expressing opinions and planning projects from the beginning.

Conclusion and recommendations: Current public health projects focus on product evaluation. Therefore, research should be conducted to evaluate the long-term impact of key projects on changes in people's health behaviors to determine the true effectiveness of the projects and use the findings to improve public health implementation strategies in the future.

Effects of maternal education program on newborn care behavior to prevent jaundice

Sajee Suwannasri — 2025-12-01

Purposes: To compare maternal behavior in caring for newborns to prevent hyperbilirubinemia between the group of mothers who received the educational program on newborn care for hyperbilirubinemia prevention and the group of mothers who received routine nursing care.

Study Design: Quasi-experimental research.

Materials and Methods: The participants were full-term mothers who delivered at Roi Et Hospital, special monk's ward, 3^rd floor, regardless of delivery method and without complications, and their full-term newborns, between May 1, 2025, and July 31, 2025. The study involved two groups, totaling 40 subjects, divided into a control group20 and an experimental group 20. Measurements were taken once after the experiment. Data were collected using questionnaires on maternal breastfeeding behavior and questionnaires on hyperbilirubinemia assessment behavior, which were validated by three experts. The Cronbach's alpha coefficients were 0.76 and 0.89. Data were analyzed using descriptive statistics, including mean, percentage, and standard deviation.

Main finding: The comparison of behavior scores between the group of mothers who received routine nursing care and the group of mothers who received the educational program for hyperbilirubinemia prevention showed that the experimental group had significantly better breastfeeding skills than the control group (p = .017), which was statistically significant (p < .05). The assessment of hyperbilirubinemia in both groups was not significantly different (p = .134), which was statistically greater than the determined significance level (p >.05). However, a consideration of the percentage data in the table revealed that the experimental group performed "always" higher than the control group for every item, indicating a tendency for the program to help mothers correctly assess hyperbilirubinemia.

Conclusion and recommendations: The application of the program in nursing services confirmed that the program for hyperbilirubinemia prevention was clearly effective in enhancing maternal breastfeeding skills. Therefore, this program should be applied to educate all postpartum mothers, especially those with risk factors for hyperbilirubinemia, to ensure their infants receive adequate and proper milk.

Research and Development of Pharmaceutical Inventory Management Using the First Expired, First Out (FEFO) System and Daily Inventory Accuracy Assessment Technique at Mukdahan Hospital

Wipada Chanthanabhordeesombat — 2025-12-02

Purposes: To develop and evaluate a pharmaceutical inventory management system applying the First Expired, First Out (FEFO) principle combined with the Daily Inventory Accuracy Assessment Form with FEFO System (DIAAF–FEFO Model) at Mukdahan Hospital.

Study Design: Action research.

Materials and Methods: The study included 1,053 pharmaceutical and material items stored in the main drug warehouse of Mukdahan Hospital, managed by the INVS inventory system. Inventory data were assessed daily using the DIAAF–FEFO form over a nine-month period (December 2024–August 2025), encompassing 24 inspection cycles. Data were analyzed using descriptive statistics-frequency, percentage, and 95% confidence intervals (95% CI).

Main findings: A total of 21,908 items were inspected across 24 cycles. The average inventory accuracy was 99.99% (95%CI = 99.97-99.99). The average accuracy of lot and expiration-date records was 99.68% (95%CI = 99.60-99.75). The accuracy of lot-identifying sticker placement averaged 98.33% (95%CI = 98.15-98.49), while FEFO arrangement accuracy averaged 99.75% (95%CI = 99.68-99.81). The total value of drugs returned or exchanged decreased from 1,377,678.66 THB in fiscal year 2024 to 956,585.64 THB in fiscal year 2025, representing a 30.60% reduction.

Conclusion and Recommendations: The implementation of the DIAAF–FEFO Model improved accuracy in all aspects of pharmaceutical inventory management, strengthened the quality and efficiency of internal control, and supported precise procurement planning. Continuous application is recommended to maintain data accuracy standards and ensure sustainable improvement in pharmaceutical warehouse quality.

Effectiveness of a Teacher Mentorship Development Program for Early Childhood Care Centers in Promoting Early Childhood Development through a Child-Centered

Nongnoot Kaewjit — 2025-12-02

Purposes: To evaluate the effectiveness of a capacity-building program for teacher assistants in implementing child-centered learning, focusing on teacher assistants’ knowledge and behavior, classroom environment quality, preschool children’s behavior, child development according to DSPM criteria, and executive function (EF) development.

Study design: This study employed a quasi-experimental research design using a one-group pretest-posttest design.

Materials and Methods: The sample consisted of 12 teacher assistants and 100 preschool children from child development centers in Lom Kao District, Phetchabun Province, selected through purposive sampling. The intervention program was implemented over a period of 12 weeks. Data were analyzed using descriptive statistics and the paired t-test, with statistical significance set at the .05 level.

Conclusion and recommendations: After participating in the program, caregivers demonstrated significantly higher knowledge scores (Mean = 17.25, SD. = 0.75) and learning management behavior scores (Mean = 28.67, SD. = 0.89) compared to pre-intervention levels (p < .001). Classroom environment quality scores increased (Mean = 29.25, SD. = 1.22), and early childhood behavior improved (Mean = 25.79, SD. = 3.04), with both changes being statistically significant (p < .001). For DSPM developmental outcomes, the overall mean score increased from Mean = 4.57 (SD. = 0.79) to Mean = 4.96 (SD. = 0.20), with gross motor, receptive language, and expressive language domains achieving a 100% pass rate. Furthermore, executive function scores increased from Mean = 72.82 (SD. = 22.38) to Mean = 100.29 (SD. = 18.91), demonstrating statistically significant improvement (p <.001).

Conclusion and recommendations: The capacity-building program for teacher assistants in child development centers using a child-centered learning approach proved to be highly effective in enhancing teacher competence and promoting preschool children’s development in both fundamental developmental domains (DSPM) and executive function (EF). Relevant agencies should consider scaling up this program and integrating EF-related content into teacher training curricula to establish a strong foundation for long-term child development.