Lanna Journal of Health Promotion and Environmental Health

Development of a Clinical Nursing Practice Guidelines to Prevention Postpartum hemorrhage in the first 2 hours after birth Rongkwang Hospital, Phrae Province

Jinna Rodkhem — 2025-10-10

Postpartum hemorrhage is the most common obstetric emergency and a major cause of maternal mortality worldwide, especially during the first 2 hours after birth. This research and development study aimed to Development of a Clinical Nursing Practice Guidelines to Prevention Postpartum hemorrhage in the first 2 hours after Birth at Rongkwang Hospital, Phrae Province, and evaluating the outcomes of the developed guidelines. The study was conducted in 3 phases: 1) Involved reviewing evidence-based practice development using the IOWA Model's 4 step process. The quality of the developed guidelines was assessed by 5 experts using the AGREE II instrument, achieving scores of over 80% in all domains and a CVI of 0.96 Furthermore, a questionnaire assessing registered nurses' opinions on the developed guideline for preventing early postpartum hemorrhage at Rongkwang Hospital achieved a CVI of 1.00. 2) Implemented the developed guidelines with two sample groups: (1) seven registered nurses in obstetric care, and (2) women who delivered vaginally at Rongkwang Hospital between October 2024 and March 2025. The sample size was determined to be 30 participants, divided into a control group and an experimental group (15 each). 3)Evaluate of the implementation. Data were analyzed using frequency, percentage, and the independent t-test to compare postpartum blood loss between the experimental and control groups. The results showed that the experimental group experienced significantly less blood loss than the control group during both the first 2 and 24 hours postpartum. No cases of PPH were found in the experimental group, while the control group had an incidence of 6.7%. Registered nurses expressed the highest level of agreement with the use of the guidelines. This study demonstrates that the developed nursing practice guidelines effectively prevent postpartum hemorrhage in the first 2 hours after birth and can be utilized as a standard nursing protocol.

Factors Influencing Self-Care Behaviors in Hypertension Patient, Wiang Sa Hospital, Nan Province.

Nantika Pribwai — 2025-07-14

Hypertension is a chronic condition that has a major impact on the health and quality of life of patients. If left uncontrolled, it can lead to severe complications such as cardiovascular diseases and stroke. This cross-sectional analytic study aimed to examine (1) the level of self-care behaviors and (2) the factors influencing self-care behaviors among patients with hypertension at Wiang Sa Hospital, Nan Province. The sample consisted of 300 hypertensive patients receiving services at Wiang Sa Hospital, selected through systematic sampling. Data was collected using questionnaires with a reliability coefficient ranging from 0.73 to 0.97. Data analysis was performed using descriptive statistics and stepwise multiple regression analysis.

The results showed that the participants demonstrated a high level of self-care behavior The results showed that the participants had a high level of self-care behaviors (𝑥̅ = 3.43, SD = 0.56). Statistically significant factors influencing self-care behaviors at the 0.05 level included family support (β = 0.608,
p-value < 0.001), perceived behavioral control (β = 0.182, p-value < 0.001), health literacy (β = 0.142, p-value = 0.001), and perception of hypertension (β = 0.083, p-value = 0.031), respectively. The predictive equation, based on raw scores, was: Self-care behaviors of hypertensive patients = 4.519 + 0.657 (Family Support) + 0.140 (Perceived Behavioral Control) + 0.110 (Health Literacy) + 0.153 (Perception of Hypertension). The findings suggest developing family engagement programs and further research on local cultural factors

Development of a model for the infectious waste management system of the Subdistrict Health Promoting Hospital. that transferred its mission to the Provincial Administrative Organization in Heath region 1

Ithawara Samdangsuk — 2025-07-31

The management of infectious waste is a critical issue in both health and environmental dimensions, It is necessary to have a management system based on academic and legal requirements. This study aimed to examine the current situation and management systems in subdistrict health-promoting hospitals (SHPHs) whose responsibilities have been transferred to Provincial Administrative Organizations (PAOs) in Health Region 1. The research employed a mixed-methods approach. The quantitative component surveyed 232 SHPHs using structured questionnaires to assess the situation. The qualitative component involved in-depth interviews with 32 purposively selected executives and staff responsible, with data analyzed through content analysis. Findings indicated that compliance with legal standards remained partial-particularly in human resource qualifications, where most responsible personnel did not meet legal education requirements, and only 54.3% had received related training. Collection, transportation, and disposal processes largely followed traditional models and were constrained by personnel shortages, limited budgets, and insufficient resources. These challenges hindered effective implementation in some areas. The study proposed four models: (1) establishment of infectious waste disposal center with standardized systems; (2) development of centralized storage facilities with private sector engagement; (3) direct contracting of private companies for collection and disposal; and (4) collaborative disposal with Mid-Level Referral Hospital, with costs covered by the PAO. The selection of an appropriate model should align with local contexts. Recommendations include tailored management strategies, systematic oversight, adequate budgeting, capacity building, and procedural improvements in line with academic and legal standards to enhance efficiency, protect public health, and mitigate long-term environmental risks.

Effect of Plyometric Training on Sand and Grass on the High Jumping Performance of Secondary School Volleyball Players.

์Nattawat Yimsawat — 2025-08-04

Developing jumping ability is important for volleyball performance, especially for young athletes who have limited physical size, which puts them at a disadvantage in competition.This research aimed to compare the effectiveness of plyometric training on sand versus grass surfaces on vertical jump performance in secondary school volleyball players.The study employed an experimental design with a sample of 20 male volleyball players aged 12-15 years from schools under the Lampang Primary Educational Service Area Office 3, Wang Nuea District, Lampang Province. Participants were simple randomly sampling by lottery into two equal groups of 10 players each: a sand-surface plyometric training group and a grass-surface plyometric training group. Both groups followed identical plyometric training programs comprising Multiple Box to Box Jump, Depth Jump, Jump and Reach, and Split Squat Jump exercises. The training program was divided into two phases: Phase 1 (1^st -4^th weeks) with 3 sets of 10 repetitions per exercise, and Phase 2 (5^th -8^th weeks) with 3 sets of 15 repetitions per exercise, with 2-minute rest periods between sets and 3-minute rest periods between exercises. Training sessions were conducted three times per week for 8 weeks. Vertical jump ability was measured by the Counter Movement Jump technique using a Vertec™ Vertical Jump Tester before and after the 8-week training program. Data were analyzed using Mann-Whitney U Test and Wilcoxon Signed Rank Test. Results showed no statistically significant differences between the two groups in baseline characteristics including age, weight, height, body mass index, and volleyball experience (p > 0.05). Pre-training vertical jump heights for the sand and grass training groups were not statistically different (37.90±11.37 and 42.50±6.55 centimeters, respectively, p > 0.05). After 8 weeks of training, both groups showed improvements in jump height, but there was no statistically significant difference between the groups (39.00±13.61 and 42.10±7.85 centimeters, respectively, p > 0.05). The changes in vertical jump ability following training did not differ significantly between the sand and grass training groups (1.10±3.11 and 0.04±2.67 centimeters, respectively, p = 0.280). The study concludes that 8 weeks of plyometric training on either sand or grass surfaces can improve vertical jump performance in volleyball players, with no significant difference between the two training surfaces. Therefore, coaches can select the training surface based on availability and contextual suitability without compromising the development of vertical jump ability in secondary school volleyball players.

Factors Associated with Stroke Prevention Behaviors Among Hypertensive Patients in Maharaj District, Phra Nakhon Si Ayutthaya Province

wanyarat kunapan — 2025-08-15

Stroke is a major global public health concern and a leading cause of mortality, particularly among older adults. It significantly affects quality of life and imposes economic burdens. Hypertension is the primary risk factor contributing to stroke incidence. This cross-sectional descriptive study aimed to examine personal factors, knowledge, perception, social support, and stroke preventive behaviors among patients with hypertension. It also explored factors associated with these preventive behaviors in hypertensive patients residing in Maha Rat District, Phra Nakhon Si Ayutthaya Province. A total of 380 hypertensive patients aged 35 years and above were selected using multi-stage sampling. The research instrument consisted of five-part questionnaires covering: personal factors, stroke knowledge, perception, social support, and preventive behaviors. The reliability of the instruments ranged from 0.73 to 0.76. Data were analyzed using descriptive statistics and Pearson’s correlation coefficient.

The study found that participants had a high level of stroke knowledge (Mean = 9.82, SD = 0.72), overall perceived information (Mean = 3.75, SD = 0.36), and social support (Mean = 3.82, SD = 0.47), while stroke prevention behaviors were at a moderate level (Mean = 3.27, SD = 0.70). At the 0.05 significance level, knowledge, perception, and social support were significantly correlated with prevention behaviors among patients with hypertension. Correlations in descending order were: perceived benefits (r = 0.491, p-value < 0.001), cues to action (r = 0.407, p-value < 0.001), information from media (r = 0.371, p-value < 0.001), perceived barriers (r = 0.346, p-value < 0.001), information from family (r = 0.238, p-value < 0.001), perceived severity (r = 0.216, p-value < 0.001), perceived susceptibility (r = 0.212, p-value < 0.001), and information from healthcare personnel (r = 0.138, p-value < 0.001). Stroke knowledge showed a significant negative correlation with prevention behaviors (r = −0.109, p-value = 0.035).

Effectiveness of Promoting the Clinical Nursing Guidelines for Prevention of Ventilator-Associated Pneumonia (VAP) in Medical Intensive Care Unit 3, Lamphun Hospital

Kittikarn Panyawattano — 2025-08-20

Ventilator-associated pneumonia (VAP) is the leading problem of infections in hospitals and patients on mechanical ventilation. This quasi - experimental research aims to evaluate the knowledge and skills of nurses in nursing practice before and after the promotion of the promoting of the Guidelines and compare the incidence of VAP in patients with internal medicine critical care before and after the promoting of the Guidelines. The sample group was 16 nurses. Patients admitted to the medical intensive care unit 3 of Lamphun Hospital between February 1 to March 31, 2025 were divided into 2 groups. 40 cases per group.The tools for conducting the research include clinical nursing guidelines for prevention of VAP. The data collection tools include the patient personal data record form, the nurse personal data record form, the Incidence record form for VAP and the nurse knowledge and practice assessment form. The data were analyzed with descriptive statistics, including frequency, percentage, mean and standard deviations and inferential statistics include: Fisher’s exact probability test, Independent Samples Test and Paired Samples t-test

The results of the study showed that after promoting the use of the Guidelines, Nurses had an increase in average knowledge score from 12.62 (SD=3.22) to 17.62 (SD=2.18). (Score out of 20) statistically significant. (p<0.05). The overall correct nursing skills for the prevention of VAP increased from 85.0% to 97.0% statistically significant (P< 0.05). The mean number of days intubated decreased from 5.32 to 3.02 statistically significant (P< 0.05). There was no rate of VAP. In conclusion, the promotion of the use of the guidelines helps to improve the knowledge and skills of nurses, reduce the incidence of VAP and shorten the duration of use the mechanical ventilation.

The effect of Discharge Planning Program on Total Knee ArthroplastyPatient Rehabitation, Lamphun Hospital

Ankana Khumfoo — 2025-09-05

The discharge planning for total knee arthroplasty patient is an important nursing care process for promoting safety, helps to restore postoperative conditions and improve the quality of life for patients. The purpose of this quasi-experimental research was to compare the knowledge scores, postoperative rehabitation and complications of patients after knee arthroplasty between the group that received the discharge planning program and the group that received regular care. The sample group is patient osteoarthritis of knee underwent knee arthroplasty at Lamphun Hospital the participants were divided into a control group of 25 people and an experimental group. 25 people. The tools used in conducting the trial include a discharge planning program of total knee arthroplasty patient. The tools used to collect data include personal data and health records, self-care knowledge assessments, and post-knee arthroplasty behavior assessments, pain score record form, knee mobility record form, 10-meter flat walking ability record form, and postoperative complications recording form. Data analysis statistics were used, including frequency, percentage, mean, standard deviation, and inferential statistics, including: fisher exact probability test and independent t-test.

The results of the study showed that the experimental group that received the discharge planning had higher scores on self-care knowledge and post-knee arthroplasty behavior than the control group with was statistically significant (p<0.001) Pain score was statistically significantly lower than that of the control group (p<0.001). It was statistically significant that both knee and flat ground movements were restored at a distance of 10 meters better than the control group, which was statistically significant (p<0.001).No postoperative complications. The experimental group also had a statistically significant decrease in the length of hospital stay less than the control group (p<0.001)

Conclusion, the discharge planning program helps patients rehabilitate themselves, improves their knowledge of self-care and post-operative behavior after total knee arthroplasty and effectively prevents post-operative complications.

Health Literacy and Health Promoting Behaviors Regarding Stroke Prevention among People in A Semi-Urban Community, Chiang Mai

Aunyapat Wiwatkamonchai — 2025-09-17

Stroke is a severe and life-threatening disease that can be prevented, if people have sufficient health literacy and consistently adopt health-promoting behaviors regarding stroke prevention. The chance of stroke occurrence can be minimized. This cross-sectional descriptive research aimed to explore the health literacy and health promoting behaviors regarding stroke prevention among people who attended services at Ban Pa Khoi Nuea Tambon Health Promotion Hospital, Sanphisua Subdistrict, Mueang, Chiang Mai from July to October, 2024. The sample was purposively selected and consisted of 405 subjects. Research instruments, the demographic data record form, the Stroke Health Literacy Questionnaire, and the Health Promoting Behaviors Among Persons at Risk of Stroke’s Questionnaire, were reviewed and approved by five experts for content validity and tested for reliability prior to data collection. Data analysis using descriptive statistics.

The study results indicate that most participants were middle-aged and older adults (aged over 45 years). Overall, their stroke health literacy and health-promoting behaviors for stroke prevention were found to be at a moderate level, at 69.14% and 68.89%, respectively. The six health literacy skills related to stroke are also at a moderate level, including cognitive skill (72.35%), access to health information and services skill (55.80%), communication skill (61.23%), self-management skill (61.98%), media literacy (76.79%), and decision skill (50.12%). Similarly, health-promoting behaviors for stroke prevention in all six subscales are also at a moderate level: health responsibility (53.58%), physical activity (52.10%), nutrition (83.70%), spiritual growth (53.33%), interpersonal relationships (55.31%), and stress management (60.99%).

This research findings demonstrate that the majority of the participants have a moderate level of health literacy and health-promoting behaviors for stroke prevention which is considered insufficient for adopting or maintaining appropriate behaviors to effectively prevent stroke. Therefore, this people group should be supported in enhancing their stroke health literacy for enabling them to engage in proper and appropriate health-promoting behaviors for stroke prevention.

Factors related to the perception and participation in age-friendly community operations in Health Region 1

patcharee ramphai — 2025-09-18

This cross-sectional study aimed to examine older adults’ perception and participation levels, and factors associated with age-friendly community initiatives in Health Area 1. The sample included 424 older adults from eight provinces in Chiang Mai, Lamphun, Lampang, Phrae, Nan, Phayao, Chiang Rai, and Mae Hong Son, selected via convenience sampling. A questionnaire covering (1) demographic data, (2) perception level, and (3) participation in age-friendly community development was employed. The tool verified content validity and reliability of Cronbach’s alpha = 0.97. Data were collected from January to July 2024 and analyzed using chi-square tests with statistical significance at p < 0.05.

Results found that most participants had moderate levels of perception (58.3%) and participation (44.1%). Factors significantly associated with perception included gender
(p = 0.001), age (p = 0.016), province of residence (p = 0.050), monthly household income
(p = 0.040), community role (p = 0.001), and local Administrative Organization model (p = 0.023). Participation levels were linked to education (p < 0.001), membership in senior clubs/schools (p = 0.016), community role (p < 0.001), and committees’ membership in age and disability -friendly community (p = 0.002). In addition, the high perception levels correlated with greater participation (p < 0.001), with 64.6% of highly perceptive individuals actively engaged.

Conclusion: Enhancing perception through accessible channels (e.g., media, educational activities) and fostering roles in senior clubs or community committees can effectively boost participation. Furthermore, policies and infrastructure supporting age-friendly communities should be strengthened for sustainable outcomes.

Keywords: Age - friendly communities, Health Region 1, Elderly, Perception, Participation

Relationship between Temperature/Rainfall and Number of Patients with Hand-foot-mouth disease, Mushroom poisoning, Melioidosis and Leptospirosis in Phetchabun Province

Vadhana Jayathavaj — 2025-10-10

This observational study in ecological time-series analysis aimed to examine the correlations and Incidence Rate Ratio (IRR) of the number of patients related to temperature and rainfall factors in Phetchabun province, using the monthly time series data with the sample size of 44 months from 2021 to August 2024. The minimum and maximum daily average temperatures and monthly and average daily rainfall volumes were collected from the Meteorological Information Division, Northern Meteorological Center. The number of monthly patients with hand-foot-mouth disease (HFMD), mushroom poisoning, melioidosis, and leptospirosis were collected from the Disease Surveillance Reporting System 506, Bureau of Epidemiology, Department of Disease Control. The data were analyzed using Pearson’s correlation and the generalized linear model, processed with the jamovi statistical analysis program, GLAMj module. The results showed that 1) the number of monthly patients with HFMD was a Quasi-Poisson regression model, the total rainfall was the independent variable, the Pearson’s correlation coefficient equaled 0.35, the coefficient of determination was 0.22, and the IRR when the rainfall increased by 1 millimeter was 1.01 times from average. 2) The number of monthly patients with mushroom poisoning was a Quasi-Poisson regression model, the average minimum temperature as the independent variable. The Pearson’s correlation coefficient equaled 0.43, the coefficient of determination was 0.40, and the IRR when the average minimum temperature increased by 1 degree Celsius was 1.95 times from the average. 3) the number of monthly patients with melioidosis did not have a statistically significant model. And 4) leptospirosis had only 17 cases over a 44-month period, so no suitable model was considered. Advance rainfall and minimum temperature forecast data can be used as a leading factor to estimate the number of patients from HFMD and mushroom poisoning, which can be used by local public health agencies to determine appropriate surveillance measures.

The Effects of Self-Regulation Program on Anxiety, Pain and Postoperative Self-Practice of Patients with Abdominal Hysterectomy, Nursing Work Group for Obstetrics and Gynecology patients Lamphun Hospital

Tunwarut Intarajak — 2025-10-07

Hysterectomy affects women physically, mentally, and sexually. Therefore, to accept the situation, a woman must adapt and find ways to meet her and society’s needs for a better quality of life. This quasi-experimental research aimed to compare mean anxiety scores, mean pain scores, and mean self-management scores between an experimental group receiving a self-regulation program and a control group receiving standard nursing care. The sample is patients who have been diagnosed with an abnormal pathology of the uterus and need to be treated by abdominal hysterectomy, Nursing Work Group for Obstetrics and Gynecology patients Lamphun Hospital. Between January 1 and April 30, 2025, 60 subjects were simple random sampling and divided into an experimental group of 30 subjects and a control group of 30 subjects. The research tools used were:
1) self-regulation program 2) personal data recording and treatment forms 3) anxiety assessments 4) pain assessments and 5) postoperative behavior assessments. The data were analyzed using descriptive statistics such as frequency, percentage, mean, standard deviation, and inferential statistics, including Fisher’s exact probability test and independent t-test.

The results showed that after receiving the self-regulation program, the experimental group had statistically significantly lower mean anxiety scores than the control group at the level of p<0.001 Mean postoperative pain score showed that at 24 hours, there was no difference in mean postoperative pain score between the experimental group and the control group. However, at 48 hours and 72 hours, the experimental group had a statistically significantly lower mean pain score than the control group at a level of 0 p<0.001. Postoperative behavior was found to be statistically significantly better than the control group at a level of p<0.001. In summary, this self-adjustment program effectively reduces anxiety, pain, and strengthens good postoperative behavior for patients undergoing abdominal hysterectomy.

Anemia and Malnutrition

Yuttana Mundee — 2025-07-31

Anemia and malnutrition are the related public health problems. Anemia caused by malnutrition, which results in a deficiency of nutrients necessary for red blood cell production, such as iron, vitamin B12, and folate, leads to low red blood cell production and abnormal red blood cells, reducing oxygen transport and causing fatigue and dizziness. Meanwhile, malnutrition impacts various systems in the body, including the blood producing system. The main cause of anemia from malnutrition is iron deficiency anemia (IDA), which is often found in children and pregnant women. In addition, vitamin B12 and folate deficiency can lead to megaloblastic anemia (MA). Furthermore, protein and energy deficiencies, as well as diseases that affect nutrient absorption, such as gastrointestinal inflammation and infection, can also cause anemia. Preventive and corrective measures for these conditions include supplementing essential nutrients for red blood cell production, improving eating behavior, and providing nutrition education to the public. These approaches will help decrease the incidence of anemia caused by malnutrition and promote sustainable population health.