Royal Thai Navy Medical Journal

Curriculum of Emergency Medical Operations for Disaster

2024-04-01T11:01:41+07:00

None

Opportunities and Challenges on the Integration between Thai Traditional Herbal Sauna and Medical Nutrition Therapy for People with Dyslipidemia

2024-03-08T09:21:30+07:00

Dyslipidemia, an abnormal blood lipid level, is reported to have a high prevalence in Thai people that can lead to complications such as cardiovascular disease, ischemic heart disease, and atherosclerosis. It is well known that long-term excessive fat comsumption and an unhealthy diet are major causes of dyslipidemia. Medical nutritional therapy (MNT) can help patients in modifying their dietary habits which can improve their blood lipid profiles. In addition, a previous study in Europe showed the effectiveness and mechanism of steam and dry sauna in lowering some blood lipid profiles. The herbal sauna is one of the care processes used in Thai traditional medicine which is comparable to steam and dry sauna of other countries. Although, the Thai traditional herbal sauna may tend to be beneficial to blood lipids based on the mechanism reported by previous studies, there was no evidence that existed to support the effectiveness of the Thai traditional herbal sauna on blood lipid profile improvement. This review article aimed to present the updated scientific evidence on the effectiveness of MNT based on the therapeutic lifestyle (TLC) diet on dyslipidemia, as well as the benefits of steam and dry sauna on people with blood lipid abnormalities. The information could be a potential opportunity and a challenge for integrating MNT and Thai traditional herbal sauna interventions to be more effective in health care processes for patients with dyslipidemia

Non-suicidal Self-injury among Adolescents: Characteristics and Assessment Instruments

2024-03-18T10:38:04+07:00

Non-Suicidal Self-Injury (NSSI) is a prevalent mental health threat among adolescents. It's found that NSSI rates steadily increase within this demographic. Additionally, adolescents engaging in NSSI behavior are more likely to exhibit suicidal behavior in adulthood. Since adolescence is a vulnerable period characterized by difficulties in emotion and behavior regulation, coupled with insufficient problem-solving, communication, and coping skills compared to adults, ineffective emotional management through self-injury behavior often ensues. NSSI also refers to the act of managing negative emotions through behavior that causes physical harm to the body, without any intention of causing death. This mental health condition has gained recognition in recent years. However, it shares similarities with borderline personality disorder, making diagnosis complex and incomplete. Typically, it's diagnosed alongside self-harm, depression, or suicide attempts. Interviews and history-taking often reveal that self-injury serves as a coping mechanism for anger or dissatisfaction without suicidal intent. In other countries, the Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition (DSM-5) is used for diagnosing with clear criteria, which differs from Thailand where the International Statistical Classification of Diseases and Related Health Problems, 10^th Revision (ICD-10) is used, along with no clear assessment instrument suitable for the prevalent Thai adolescent context. Therefore, understanding NSSI among adolescents and emphasizing the importance of assessment and screening are essential for all units involved with adolescents including families, communities, schools, and hospitals. Choosing appropriate instrument for assessing NSSI in adolescents is crucial because accurate and rapid assessments can help screen such behaviors, reduce risk factors, enhance protective factors, monitoring to prevent violence or loss resulting from self-injury can also help intervene with at-risk adolescents promptly and reduce the likelihood of suicidal behavior in adulthood.

Diseases and Injuries among Seafarers and Fishermen based on Consultation from Ships to Telemedical Maritime Assistance Service in Thailand

2024-03-07T10:14:43+07:00

Seafarers and fishermen have a different working environment and routine life compared to the onshore workers. They have to work far from the coast for a long time, making it difficult to access proper medical care. This research aimed to study the characteristic of diseases or injuries among seafarers and fishermen based on consultation from ships to Telemedical Maritime Assistance Service in Thailand. The research’s study design was a descriptive study. The data was collected from Telemedical Maritime Assistance Service in Thailand case report, which composed of the Royal Thai Navy Area Command 1, 2, and 3 and Thai Marine Enforcement Command Center Command 1, 2 and 3 between 1 January 2015 to 30 June 2022. There were 316 consultations and 578 patients were reported in total. The majority were fishermen (92.91%). 91.52% had an injury and 8.48% acquired diseases. The most common injury was falling overboard or drowning which was a result of a bad weather and the most common diagnostic group of disease was central nervous system (34.69%). The majority of patients were evacuated and 69.55% were alive. Area command 1 had the most number of consultations. This research shows the important role of TMAS in saving seafarers and fishermen who get illnesses or injuries at sea. Most causes of injuries can be prevented. The majority of patients were fishermen who were informal workers, so the policy should focus on increasing working skills, safety, and first aid on ship for fishermen. Moreover, the data and database should be developed to improve TMAS in the future.

Development of Innovative Aedes Larvae Control Technology for Dengue Hemorrhagic Fever Prevention

2024-03-08T08:15:30+07:00

Dengue hemorrhagic fever is transmitted by Aedes mosquitoes. This disease has been continuously spreading, resulting in health impacts, and incurring substantial costs for prevention, control, and patient care in Thailand. The main purposes of this study were to develop an innovation for mosquito larvae control with ultrasonic wave and to test the efficacy of mosquito larvae elimination for the prevention of dengue hemorrhagic fever.
The research findings revealed that the innovation in controlling mosquito larvae using developed ultrasonic waves featured an elongated tube with a tapered end. The size was 146 x 908 cm, controlled by piezoelectric system and 12-volt battery. The ultrasonic wave detected the frequency range of 35.71 kHz.
The results of the mosquito larvae control efficiency test was conducted on a sample group of 420 mosquito larvae, divided into groups of 60 each, placed in 3,000 milliliters of water. There were a total of 7 groups. Following that, each group was further subdivided into 3 sets, with 20 mosquito larvae placed in containers containing 1,000 milliliters of water. The test involved releasing ultrasonic waves at intervals of 5, 10, 15, 20, 25, and 30 seconds, which were repeated three times. A 100% mortality rate of mosquito larvae was observed within a 30 second timeframe. The morphology of Aedes larvae was damaged through the destruction of their head, thorax, anal segment, and siphon. This study offers an eco-friendly alternative to reduce chemical use in limiting breeding grounds, which can serve as a vector for future disease outbreaks.

The Influence of Personal Factors, Social Support, and Self-efficacy on Health Information-seeking Behavior in Pregnant Women with Gestational Diabetes Mellitus

2024-03-08T08:26:49+07:00

The objective of this descriptive research was to study the influence of age, education level, family income, social support, and self-efficacy on the health information-seeking behavior of pregnant women with gestational diabetes mellitus. The conceptual framework of information-seeking behavior evolved by Wilson was used. The sample consisted of 125 women with gestational diabetes mellitus who met the inclusion criteria at the antenatal care unit at Siriraj Hospital. Data were collected using the general information questionnaire, the health information-seeking behavior questionnaire, the social support questionnaire, and the self-efficacy questionnaire. The descriptive statistical methods of frequency distributions, percentage, mean and standard deviation, and multiple regression statistics were used to analyze the data.
According to the findings, factors influencing health information-seeking behavior statistically significant were social support (β = 0.211, p = .036) and self-efficacy (β = 0.277, p = .007), which could explain the variation in health information-seeking behavior, 22.90% (R² = 0.229, F = 5.826, p < .05). It was also found that the topics used for seeking information were about eating which was the number one, followed by gestational diabetes mellitus and symptoms of the disease. It was also discovered that the most used sources for information-seeking were general search websites (Google, Yahoo, etc.), followed by physicians and nurses or certificated diabetes mellitus education nurses.
For recommendations, the health care team should promote their self-efficacy and social support for pregnant women with gestational diabetes mellitus in order to have health information-seeking behavior in self-care. In addition, there should be knowledge sharing activities regarding gestational diabetes mellitus that involves disseminating information on the internet.

The Study of Sensitivity and Specificity of Whispered Voice Test in Assessing Hearing among Public Drivers of a Regular Transportation Company in Samut Prakarn Province

2024-03-08T08:41:22+07:00

This cross-sectional analytic study aimed to identify the sensitivity and specificity of whispered voice test (WVT) in comparison with pure tone audiometry (PTA) for screening hearing loss in public drivers. This study also aimed to determine the prevalence of hearing loss and its potential contributing factors. The data collection was performed by using self-questionnaire and WVT as well as PTA for hearing test which were conducted among 170 public drivers of a regular transportation company in Samut Prakarn province. The hearing loss was diagnosed by using the WHO grades of hearing impairment (1991) and WHO grades of hearing loss (2020). The data were analyzed by descriptive and analytical statistics including multiple logistic regression. According to the WHO (1991) and WHO (2020) criteria, the results showed that the sensitivity (95% CI) of WVT in screening mild hearing loss were 77.66% (73.23 - 82.09) and 85.86% (82.15 - 89.56), while the sensitivity of WVT in screening moderate hearing loss were 70.10% (65.23 - 74.96) and 73.85% (69.18 - 78.52). The specificity (95% CI) of WVT in screening mild hearing loss were 51.97% (46.66 - 57.28) and 44.40% (39.12 - 49.68), while the specificity of WVT in screening moderate hearing loss were 96.55% (94.61 - 98.49) and 82.46% (78.41 - 86.50). The prevalence of hearing loss in public drivers of a regular transportation company were 34.71% (95% CI, 27.58 - 42.37) and 65.29% (95% CI, 57.63 - 72.42) respectively. Moreover, there were factors associated with this prevalence which consisted of age and gender. In conclusion, WVT with appropriate sensitivity and specificity can be used as a screening test for moderate hearing loss among public drivers.

Effects of Clinical Nursing Practice Guidelines for Preventing Persistent Pulmonary Hypertension of the Newborn (PPHN) in High-risk Newborns at the Neonatal Intensive Care Unit of Sakon Nakhon Hospital

2024-03-08T09:11:25+07:00

This quasi-experimental research aimed to study the effects of clinical nursing practice guidelines for preventing persistent pulmonary hypertension of the newborn (PPHN) in high-risk newborns including: 1) comparing the incidence of persistent pulmonary hypertension in high-risk newborns between the experimental and control groups, 2) comparing the day spent at the neonatal intensive care unit of high-risk newborns between the experimental and the control groups, 3) examining compliance of the professional nurses to the nursing practice guidelines, and 4) examining the satisfaction of professional nurses after using nursing practice guidelines. The sample was a total of 40 newborns at the neonatal intensive care unit. They were divided into a control group who received nursing care according to the original model, while the experimental group received nursing care according to nursing practices guidelines. There were 20 in each group, and 16 professional nurses working in the neonatal intensive care unit. The research instrument was a clinical nursing practice guidelines for preventing persistent pulmonary hypertension of the newborn in high-risk newborns. The tools used for collecting data consisted of a general information of high-risk newborns and professional nurses, as well as the nurses’ compliance and satisfaction assessment after using the guidelines. The data were analyzed by 1) analyzing personal data of both groups and the researchers analyzed data on compliance with professional nursing guidelines by distributing frequencies, percentages and comparing differences in personal data of the experimental and control groups using the Chi-square test, 2) comparing the incidence rate of persistent pulmonary hypertension and days spent in the neonatal intensive care unit between the experimental and the control groups using the Chi-square test and independent t-test, and 3) analyzing the satisfaction of professional nurses after using the developed guidelines of clinical nurses by using percentages, mean, and standard deviation.
The results were as follows: 1) Infants in the experimental group had a lower incidence of persistent pulmonary hypertension (30%) than those in the control group (45%) with statistical significance at the .05 level. 2) Infants in the experimental group had a lower number of days spent in the neonatal intensive care unit (Mean = 9.05, SD = 3.50) than those in the control group (Mean = 15.10, SD = 7.17) with statistical significance at the .05 level. 3) Clinical nursing guidelines for preventing persistent pulmonary hypertension in high-risk newborns were developed in 3 phases. Professional nurses who took care for high-risk newborns followed these guidelines. Overall, the level of the clinical nursing practice guidelines was at a high level (88.63%). For phase 1, monitoring to prevent newborns in the high-risk group from developing persistent pulmonary hypertension was (81%), except for the early warning sign activity performed at a moderate level (75%). For phase 2, the score for caring for newborns with persistent pulmonary hypertension was (97.50%), and phase 3 caring for newborns with persistent pulmonary hypertension to prevent the development of complications was (86.22%). Lastly, 4) after using the developed clinical nursing guidelines, professional nurses were satisfied in all aspects at the highest level (Mean = 4.64, SD = 0.43).

Prevalence and Associated Factors of Computer Vision Syndrome among Radiologists, Thailand

2024-03-18T10:19:11+07:00

A cross-sectional study conducted among Thai radiologists aimed to investigate the prevalence and factors associated with Computer Vision Syndrome (CVS). The prevalence of CVS was assessed using an online CVS-Questionnaire in Thai version, showing an Index of Item Objective Congruence (IOC) ranging from 0.67 to 1. The Chronbach's alpha coefficient was 0.88. A total of 285 individuals, including radiologists and radiology residents, actively participated in the study. The collected data were analyzed using descriptive statistics, bivariate analysis, and logistic regression analysis. The results showed a high prevalence of CVS at 82.81%. Factors associated with CVS included subspecialties (aOR = 0.19, 95% Cl: 0.06 - 0.60) pre-existing eyeconditions (aOR = 4.97, 95% Cl: 1.74 - 14.14), taking eye breaks while working (aOR = 0.20, 95% Cl: 0.08 - 0.49). In conclusion, Thai radiologists showed a high CVS prevalence. Taking regular breaks at work may help to prevent and reduce this syndrome.

Factors Influencing Activities of Daily Living in Patients with Acute Ischemic Stroke: A Retrospective Study

2024-03-18T10:27:02+07:00

This research was a retrospective study to determine the predictive relationship of factors for recurrent stroke. The factors were aphasia, neglect, initial blood glucose, Body Mass Index (BMI), and nutritional status on Activities of Daily Living in acute ischemic stroke patients. The subjects were 310 acute ischemic stroke patients, both males and females, aged 18 years and older, admitted to the acute stroke unit. The researcher collected personal information, laboratory results and treatment, the Thai version of the National Institute of Health Stroke Scale for assessing stroke severity, and the total Barthel's Index (BI) score for assessing Activities of Daily Living from the patient's medical records. The researcher analyzed the data using descriptive statistics, Spearman rank correlation coefficient, and logistic regression analysis.
The results showed that 61.9% of the patients had impaired ability to perform daily activities, with a mean BI score of 50.7 (SD = 35.6) on the first day of admission, and 26.8% of them, with a mean BI score of 80 (SD = 27) on the discharge day. Factors that were statistically significant for predicting impaired ability to perform daily activities in acute ischemic stroke patients (p < .05) were aphasia (OR = 1.88, 95% CI = 1.06 - 3.33, p = .031), neglect (OR = 3.97, 95% CI = 1.69 - 9.29, p = .002), BMI (OR = 1.06, 95% CI = 1.01 -1.12, p = .045) and nutritional status (OR = .48, 95% CI = .26 - .88, p = .019). The analysis revealed that the prediction was 73.9% correct. On the other hand, the recurrent stroke and initial blood glucose did not correlate to predict the patient's Activities of Daily Living.
Based on the study results, the healthcare team should screen aphasia, neglect, BMI, and nutritional status in all acute ischemic stroke patients on admission and help them improve their conditions at the beginning of the disease to reduce the impaired ability to perform daily activities. Moreover, the healthcare team should prepare the caregivers to cooperate with these conditions before discharge, which would be able to reduce impairments of ADL at home.

Factors Associated with Exercise Behaviors among Working-aged People Using Naval Medical Department Sport Field

2024-04-01T10:38:45+07:00

Non-communicable diseases are currently important problems in Thai public health system. Exercise behaviors can help prevent non-communicable diseases, promote good health, and prohibit disease in working-aged group. The PRECEDE-PROCEED model was applied in this cross-sectional study which aimed to study predisposing, reinforcing, and enabling factors related to exercise behaviors in working-aged group. During October - November 2023, two hundred thirty-two samples were collected through administered questionnaire which was divided into three parts, as followed: 1) personal and work factors; 2) predisposing, reinforcing, and enabling factors which showed content validity of 1 and reliability value between 0.86 - 0.94; and 3) exercise behaviors which showed content validity of 0.66 and reliability value equal to 0.89. The Pearson’s coefficient and Chi-square were used for analysis.
The result revealed that 17.24% of early working-aged people, 8.19% of late working-aged people, and 6.03% of middle working-aged people had high exercise behaviors. Predisposing factors such as education level, occupation, and work pattern were related to exercise behaviors with statistical significance at .05 (² = 15.174, 32.093, and 20.821, respectively). Enabling factor including accessibility to sport field service (r = .217) was very low related to exercise behaviors among working-aged people using the Naval Medical Department sport field with statistical significance at .05.

The Development of Nursing Staffing in the Medical Ward Using Smartphone Application, Somdech Phra Pinklao Hospital

2024-04-01T10:52:37+07:00

            The aim of this participatory action research was to develop and assess the effectiveness of employing nursing staffing in medical wards through a smartphone application at Somdech Phra Pinklao Hospital. The participants composed of 18 professional nurses working in the medical ward. The research was conducted using framework of Kemmis, et al (2014)'s action research cycle (PAOR), commencing with an analysis of the nursing staffing situation in the medical ward. This process included development planning (Plan), the creation of a smartphone application for manpower management (Act), implementation of this application (Observe), and evaluation of practice results (Reflect). The goal was to achieve nursing staffing through a smartphone application that suits the ward's context and helps mitigate current limitations. Qualitative data underwent content analysis, while quantitative data underwent descriptive statistics. The research findings were as follows:
            1. The developed smartphone application for staffing included 5 features: patient admission and discharge, patient classification based on nursing needs, power calculation, and work shift scheduling.
            2. The research participants expressed satisfaction with the jointly developed smartphone nursing staffing application. They felt they were a part of the research's success due to their involvement at every stage of the development process. The developed smartphone application for manpower management met user needs and was viable for implementation to address existing limitations in manpower management. This demonstrates its feasibility and potential to influence ongoing developments in manpower management in the future.

Factors Influencing Stroke Preventive Behaviors among the Risk Group of Royal Thai Navy Personnel

2024-04-05T09:14:51+07:00

The objectives of this predictive research were to study stroke preventive behaviors and identify the influencing factors in risk group. The sample consisted of 142 Royal Thai Navy personnel who were at risk of stroke. They were diagnosed with hypertension, diabetes mellitus or dyslipidemia at outpatient department in tertiary hospitals of the Naval Medical Department. The instruments used in this study were demographic data form, perceived stroke vulnerability questionnaire, expectation to stroke preventive behavior questionnaire, perceived self-efficacy questionnaire, social support questionnaire and stroke preventive behaviors questionnaire. The content validity index of the questionnaires were 1, 1, 1, and 0.92 respectively. The Cronbach’s alpha coefficients were 0.89, 0.93, 0.91, 0.86 and 0.73, respectively. Descriptive statistics and multiple regression analysis were used to analyze the data.
Findings in the present study showed that the average score of stroke preventive behaviors was 69.51 (SD = 6.25). Perceived stroke vulnerability, expectation to stroke preventive behaviors, perceived self-efficacy and social support could explain 20% of the variance of stroke preventive behaviors in the risk group of Royal Thai Navy personnel (Adjusted R² = .20, p < .001). Perceived self-efficacy was the most important predictable variable for stroke preventive behaviors (β = .315, p < .05) followed by social support (β = .195, p < .05). However, perceived stroke vulnerability and expectation to stroke preventive behaviors were not statistically significantly influenced by the stroke preventive behaviors.

The Study of Burnout Syndrome among Registered Nurses in one Hospital during COVID-19 Pandemic

2024-04-05T09:23:29+07:00

The purposes of this descriptive research were to study the registered nurses’ burnout syndrome, associated factors of burnout syndrome and compare the differences of burnout syndrome. They were classified according to registered nurses’ responsibility in COVID-19 pandemic between two groups of nurses including frontline (exposure group) and other nurses working in usual wards (non-exposure group). The sample group consisted of 260 registered nurses working in one hospital and they were recruited using a proportional stratified random sampling technique. The instruments were 1) general data form, 2) Suanprung Stress Test-20 (SPST-20), 3) The Maslach burnout inventory (MBI)-Thai version. All questionnaires were tested for content validity by five experts. Their reliability coefficients of SPST-20 and MBI-Thai version were 0.88, and 0.84, respectively. Data were analyzed using descriptive statistics, Chi-square test, and t-test.
The findings were as follows:
1. The burnout syndrome among registered nurses who had worked during Covid-19 pandemic was found at a high level of exhaustion (Mean = 27.02, SD = 14.40), medium level of inefficiency (Mean = 35.96, SD = 8.95) and low level of cynicism (Mean = 5.46, SD = 6.03).
2. The factors related to burnout syndrome with a statistical significance included economic status (p < .05), stress (p < .01) and registered nurses’ responsibility in COVID-19 pandemic (p < .01)
3. There was a difference between the dimensions of burnout syndrome (exhaustion and cynicism) between groups of frontline (exposure group) and other nurses working in usual wards (non-exposure group) in COVID-19 pandemic with statistical significance at the .01 level.
The burnout syndrome among registered nurses has been observed in all dimension and requires closer monitoring. The burnout intervention for registered nurses should be seriously considered and developed.

Factors Influencing the Preparedness of Family Caregivers among First-time Ischemic Stroke Patients

2024-04-05T09:33:28+07:00

This predictive research aimed to study factors influencing the preparedness of family caregiver among first-time ischemic stroke patients. The influencing factors included uncertainty, experience, educational level, social support, anxiety and resilience. The sample was consisted of caregivers who cared first-time ischemic stroke patients at the inpatient department of 4 hospitals in Chonburi. The sample composed of 161 patients collected through purposive sampling technique. The research tools consisted of personal information of family caregivers’ questionnaire, personal information of patients with first-time ischemic stroke questionnaire, caregiver preparedness scale (CPS), Mishel Uncertainty in Illness Scale for Family Members (MUIS-FM), Social support, The five-item short forms of STAI (STAIS-5) and Connor-Davidson Resilience Scale (CD-RISC10). Data were analyzed using descriptive statistics and stepwise multiple regression.
The research results found that most of the participants had a mean preparedness score of 16.70 (SD = 4.20), with most of them receiving a moderate level of preparation. Uncertainty, anxiety, and resilience were able to predict the preparedness of caregivers among first-time ischemic stroke patients, together explaining 41% variance of preparedness (R² = .41, p < .001). The uncertainty factor was the most influential predictive variable (β = -.30, p < .001), followed by anxiety (β = -.28, p < .001), and resilience (β = .27, p < .001).
The results of this research shown that nurses should assist caregivers who prepare to care for patients to deal with uncertainty, anxiety, and resilience that occurs during the transition process.

The Effects of Cartoon Animation Folktale and Medical Equipment Play on Fear of Preschool Children Administering Aerosol Jet Nebulizer in Somdech Phra Pinklao Hospital

2024-04-05T09:41:47+07:00

The aerosol jet nebulizer is a necessary procedure and raises numerous fears in preschool children. Proper play can reduce fear and increase the effectiveness of providing aerosol therapy. This research was a quasi-experimental study aimed at comparing fear scores of administering aerosol jet nebulizer between using cartoon animation folktales with medical equipment play methods and traditional nursing methods in preschool ages. The purposive sample were 34 patients aged 3 - 6 years who were admitted at the pediatric ward of Somdech Phra Pinklao hospital between 1 July to 31 August 2023, diagnosed with respiratory disease and treated with a bronchodilator aerosol jet nebulizer. They were selected by simple random sampling and divided into 2 groups consisted of 17 patients each. The experimental group used cartoon animation folktale and medical equipment play, while the control group used individual demonstrations and received brochures. Meanwhile, the research instrument used a behavioral observation model for fear of administering aerosol jet nebulizer. Three experts in pediatric medicine and pediatric nursing confirmed the content validity of research equipment. The content validity was 0.96 and the interrater reliability of the research equipment was 0.98. The data was analyzed with Chi-square statistics to test the equality of the personal information of the sample and found that there were no significant differences (p > .05). Mann-Whitney U test statistics were used to compare the fear scores of administering aerosol jet nebulizer with both sample groups. The result showed that the experimental group had a fear score lower than the control group with statistical significance at the .05 level (Mean = 12.71, SD = 0.67 and Mean = 22.29, SD = 2.73, respectively). It was concluded that the cartoon animation folktale and medical equipment play should be applied to preschool children to reduce their fear when treatment procedure is administered.

Editorial

2024-04-18T07:39:09+07:00

none