Royal Thai Navy Medical Journal

Editorial

Wannaporn Thongsangchan — 2024-08-28

None

Effects of Sleep Hygiene Promotion Program and Sleep Acupressure on the Quality of Sleep and Severity of Insomnia in the Elderly with Chronic Kidney Disease Stages 4-5 before Receiving Kidney Replacement Therapy

Russamee Sirisawat — 2024-08-28

This quasi-experimental research aimed to study the effects of a sleep hygiene promotion program and sleep acupressure on sleep quality and severity of insomnia in elderly with chronic kidney disease stages 4-5 before receiving kidney replacement therapy. The sample consisted of 64 elderly with stage 4-5 chronic kidney disease before kidney replacement therapy and separated into a control group and an experimental group with 32 people each. The sample group was selected using purposive sampling according to specific characteristics. The experimental group received a program to promote sleep hygiene and sleep acupressure while the control group received normal nursing care. The research tools were a sleep hygiene promotion and sleep acupressure program which were developed by the researchers. The validity index of research tools was 0.97 and Cronbach's alpha coefficient was 0.88. The validity of severity of insomnia symptoms questionnaire was 0.97 and Cronbach's alpha coefficient was 0.80. The data were analyzed by using independent and paired t-test.
The results showed that the experimental group had a significantly lower mean sleep quality score (The Pittsburgh Sleep Quality Index: PSQI) (Mean = 8.20, SD = 3.36) than the control group (Mean = 11.67, SD = 2.61) with statistical significance at the .05 level (p < .001) and the experimental group had a lower mean score on insomnia severity index (ISI) (Mean = 10.68, SD = 2.36) than the control group (Mean = 13.87, SD = 3.73) with statistical significance at the .05 level (p < .001). According to the results of this study, the program promotes sleep hygiene, and sleep acupressure was effective to promote sleep and reduce severity of insomnia. Professional nurses should be supported and educated in leading a program to promote sleep hygiene and sleep acupressure among elderly who have sleep problems as well as in similar population to help promote sleep and reduce the usage of medicine and minimize side effects of sleeping pills.

The Effectiveness of Sodium Reductional Tube in Patients with Hypertension

Chanida Mattavangkul — 2024-08-28

This quasi-experimental research with two groups and a pre and post-test design, aimed to compare sodium consumption behavior and levels of blood pressure before and after the experiment. The samples were patients who were diagnosed with high blood pressure according to specified criteria, aged 20 years and over, with living in Bangkok and surrounding areas. They were divided into an experimental group and a control group with 54 people each. The experimental group received a knowledge program combined with innovation. Research instruments included 1) a sodium measuring tube with a scale indicating the amount of sodium obtained from fish sauce, light soy sauce and salt at standard levels; 2) a daily sodium intake and blood pressure recording form; and 3) a questionnaire on behavior related to consuming foods containing sodium that had been checked for content validity with CVI = 1 and reliability with Cronbach’s alpha = 0.95. Data were analyzed by descriptive statistics, including frequency distribution, percentage, mean and standard deviation, and inferential statistics including paired t-test and independent t-test.
The research results found that the mean score of sodium consumption behavior in the experimental group in the post-experiment was lower than the pre-experiment and lower than the control group (p < .001). The average level of blood pressure in the post-experiment was lower than the pre-experiment in the experimental group and lower than the control group (p < .001).

A Model of Health Literacy Skills Development for Preventing Preterm Birth of Pregnant Women in the Parental Schools under Health Region 4

Sawaiwan Paiprasert — 2024-08-28

Preterm birth in pregnant women is a crucial problem in maternal and child health work. It has direct effects towards physical conditions of baby and mother. Psychologically, it also causes stress and anxiety, including economic impact on the costs of consecutive care over a long period of time. This research and development aimed to develop and evaluate health literacy skills for preventing preterm birth in pregnant women for the Parental Schools under Health District No. 4. This research and development consisted of 2 phases: 1) Construct health literacy skills development model for preventing preterm birth for pregnant women; and 2) Operationalize and evaluate the health literacy skills development model for pregnant women. The samples were 60 pregnant women under prenatal care service at 7 hospitals. The data collection employed document analysis and questionnaire. The qualitative data was analyzed by content analysis, while the quantitative data was analyzed using descriptive statistics and the paired t-test.
The study found that 1. The constructed model consisted of 11 processes including: 1) Communicate/invite and select pregnant women to participate in developing health literacy skills; 2) Persuade or motivate the target group to set goals for achieving full-term delivery; 3) Train information management skills in searching, filtering, and verifying the data; 4) Search the data for the topic “Problems of Preterm Birth”; 5) Search the data for the topic “How to Prevent Preterm Birth;” 6) Train inquiry skills; 7) Train decision-making skills; 8) Train decision-making with new problems; 9) Train application skills; 10) Review the trained skills. 11) Share good practices in preventing preterm birth without limitation of stories or examples. 2. After operationalizing the model, it was found that pregnant women showed higher literacy level than that of the pre-operationalizing of the model (p < .01) regarding preterm birth literacy, health literacy in preventing preterm birth, and preventive behaviors for preterm birth.

Factors Influencing Legal Substance Use Behaviors among Vocational Students in Eastern Region, Thailand

Pornpan Srisopa — 2024-08-28

This cross-sectional research aimed to examine factors influencing legal substance use behaviors among vocational students in the Eastern Region, Thailand. The samples were students randomly recruited from vocational schools in the Eastern Region, Thailand using multistage cluster sampling. Self-reported questionnaires were used for data collection including 1) personal data record form 2) Substance Abuse Behavior Scale 3) Difficulties in Emotion Regulation Scale 4) Substance Use Risk Profile Scale, and 5) Depression Anxiety Stress Scale: DASS-21. The CVI values were in the range of 0.89 - 1. The reliability of the third to fifth questionnaires was tested using Cronbach’s alpha coefficient, yielding values of 0.81, 0.75 and 0.86 respectively. Data were analyzed using descriptive statistics and multivariate logistic regression. The results showed that 45.48% of the sample used legal substances in the past 3 months with 48.8%, 41.6%, and 3.4% of all legal substances coming from alcohol, cigarettes, and cannabis respectively. The majority of those utilizing legal substances (80.9%) were men. The multivariate logistic analysis found that the average academic performance level (GPA) was within the range of 3.01 - 4.00 (OR_Adj = 0.26, 95% CI: 0.12 - 0.58), insufficient income (OR_Adj = 1.60, 95% CI: 1.14 - 2.26), having part-time work (OR_Adj = 1.64, 95% CI: 1.20 - 2.23), having a friend who used drugs in the past (OR_Adj = 3.59, 95% CI: 2.39 - 5.39) and having a friend currently using substance (OR_Adj = 5.14, 95% CI: 3.64 - 7.27) had statistical significant influence with current legal substance use behaviors in the past 3 months. Therefore, enhancing life skills related to choosing friends. As well as other skills such as life skills and refusal skills. And provide resources to support students who are in financial need.

A Comparative Study of Selected Factors among School-aged Children and Parents between Normal Nutritional Children and At-risk of Metabolic Syndrome Children in Chainat Province

Kanjanaphorn Theekhaphorn — 2024-08-28

This descriptive comparative study aimed to compare the knowledge of metabolic syndrome in school-aged children and their parents, children’s food consumption behavior, exercise and activity behavior and parental support between children with normal nutritional status and children at-risk of metabolic syndrome. The samples were students aged 10 - 12 years studying in grades 4 - 6 and their parents in Chainat province, divided into normal nutritional group (N = 124) and at-risk group (N = 62). Research instruments included 1) personal information questionnaire, 2) knowledge of metabolic syndrome questionnaire, 3) food consumption behavior questionnaire, and 4) exercise and activity behavior questionnaires for children. The content validity index was 1 and the intraclass correlation coefficient was 0.99, Cronbach’s alpha coefficient were 0.81 and 0.83, respectively. The knowledge of metabolic syndrome questionnaire and parental support questionnaire were used for parents with content validity index of 1 and Cronbach's alpha coefficients of 0.90 and 0.96, respectively. Data were analyzed using descriptive statistics, independent t-test and Mann-Whitney U test. The results indicated that there were no significant differences of knowledge of metabolic syndrome of children and their parents, food consumption behavior and parental support between children with normal nutritional status and children at-risk of metabolic syndrome (z = - 0.400, p > .05, z = - 0.218, p > .05, z = - 0.026, p > .05, t = 0.369, p > .05 respectively). They had significant differences in exercise behavior and physical activities (t = 2.860, p < .05). At-risk children had lower average scores of exercise behaviors and physical activities than children with normal nutritional status. This study therefore suggests that parents, teachers and school administrators should support children to have appropriate exercise and physical activities in order to reduce the risk of metabolic syndrome in school-aged children.

Factors Predicting COVID-19 Infection Surveillance Operations of Bangkok Public Health Volunteers

Kannalin Suksombote — 2024-08-28

The purpose of this descriptive cross-sectional research was to identify the predictors of COVID-19 surveillance operations of Bangkok Public Health Volunteers (PHVs) by applying the conceptual framework of PRECEDE-PROCEED Model. Three hundred seventy-three Bangkok PHVs, aged 18 and over, were randomly selected using multistage random sampling. A rating scale was used for collecting data from 9-part self-administered questionnaires. The content validity index ranged from 0.93 to 1. The reliability of the questionnaires ranged between 0.72 and 0.92. Data were analyzed using Statistical Package for the Social Sciences including descriptive statistics, Pearson's product-moment correlation coefficient and stepwise multiple regression analysis, with the level of significance equal to .05.
The findings showed that 80.16% of COVID-19 surveillance operations of Bangkok PHVs were at a moderate level. The predicting factors of the COVID-19 surveillance operations of Bangkok PHVs included perceived self-efficacy, occupation, social support, materials and equipment accessibility, prevention policies, age, education, perceived susceptibility, and marital status. These predictors together explained 81.9% of the variance in COVID-19 surveillance operations. Recommendation from this study is that, public health volunteers who work in Bangkok should be periodically prepared in terms of knowledge and skills to enhance their self-confidence in infectious disease surveillance practices in case of future outbreaks. The awareness of policy, materials and equipment support, social support, and perceived self-efficacy should be increased for further effective surveillance operations among people with communicable diseases.

Effectiveness of the 20-20-20 Rule in Reducing Digital Eye Strain among Staff at a Social Security Center in a Hospital, Chonburi Province

Ravipas Akkachotikul — 2024-08-28

This quasi-experimental study was conducted to investigate the effectiveness of the 20-20-20 rule in reducing digital eye strain caused by digital device usage among personnel at a social security center in a hospital in Chonburi Province. Simple random sampling method was employed, targeting personnel who spent a minimum of 4 hours per day working with computers, totaling 27 individuals. Data were collected in January 2024 using questionnaires including personal information and the Digital Eye Strain and Risk Level (DESRIL-27) -Thai version. Statistical analysis was performed using Wilcoxon signed rank test to compare the mean ranks of DESRIL-27 scores before and after participating in the program during each week. Additionally, the correlation between the frequency of training sessions and DESRIL-27 scores were analyzed using Spearman's correlation coefficient, with a statistical significance level set at .05.
The majority of the sample group were females (96.3%) with a mean age of 36.22 years. All participants spent at least 4 hours per day working with computers. Analysis revealed a noteworthy decrease in digital eye strain among participants after training sessions in weeks 1, 2, and 3, reaching statistical significance at the 0.05 level. Additionally, a significant correlation emerged between the frequency of training sessions and DESRIL-27 scores during the 2^nd and 3^rd weeks, also at the 0.05 level. This study demonstrates the effectiveness of the 20-20-20 rule in reducing digital eye strain and highlights the importance of increased training frequency in mitigating digital eye strain.

Factors Related to Caring Behaviors of Naval Nursing Students in New Normal Era

Tippawan Chaiyakul — 2024-08-28

The purposes of this descriptive correlational research were to study the naval nursing students’ level of caring behaviors and examine factors related to caring behaviors with classified by learning at different year levels, GPAX and quality of life. The sample consisted of 152 naval nursing students, from first to fourth year in academic year 2023, who were recruited by using a proportional stratified random sampling. The research instruments were questionnaires on caring behaviors and quality of life. The data were analyzed using frequency, percentage, mean, standard deviation, Chi-square and Pearson correlation. The findings were as follows:
1. The overall level of caring behavior among naval nursing students accounted for high level (Mean = 4.29, SD = 0.75), calculated as 84.20%. The quality of life was at a good level (Mean = 3.67, SD = 0.98), calculated as 78.20%.
2. The relationship between the quality of life and caring behaviors of naval nursing students was positive at a medium level, with a statistical significance of .01 (r = .637, p < .01).
3. Educational levels and GPAX showed no correlation with caring behaviors.

Knowledge, Attitudes and Practices of Heat-related Illnesses among Thai Merchant Seafarers

Nuttawinee Horadee — 2024-08-28

This cross-sectional descriptive study aimed at determining the knowledge, attitudes, and practices of heat-related illnesses and factors related to practices among 246 Thai merchant seafarers. Data were collected from a self-administered questionnaire comprising personnel, occupational factors, knowledge, attitudes, and practices of heat-related illnesses. Cronbach's alpha coefficient were 0.41, 0.71, and 0.71, respectively. Correlation was analyzed using Chi-square statistics and Pearson's Correlation Coefficient. The results found that positive attitude relates to practices more than knowledge. 34.6% had low level in knowledge, 37.3% had moderate level in attitudes, and 36.6% had low level in practices. The factors related to the level of practice included the level of education, merchant job positions, type of ship, working hours, knowledge, attitudes and work exposure to other heat sources and it was found that increased exposure time to other heat sources while working was associated with lower practice scores (r = -.146). Therefore, knowledge and attitudes enhancement should be provided inorder to achieve proper preventive practices and there should be measures to prevent heat-related illnesses among Thai merchant seafarers in conditions of climate change.

The Effects of Health Promotion Program on Health Promoting Behaviors in Older Persons after Percutaneous Coronary Intervention

Onuma Khamwipat — 2024-09-11

This quasi-experimental research aimed to study the effect of health promotion program on health promoting behaviors among older persons after percutaneous coronary intervention by applying Pender's health promotion framework. The sample group was elderly people aged 60 years and over, who had coronary artery disease (CAD) after percutaneous coronary intervention (PCI) and stent placement for the first time at Queen Sirikit Heart Center of the Northeast, Faculty of Medicine, Khon Kaen University. Forty-eight samples were selected according to the inclusion criteria. They were equally divided into the experimental group and the control group: 24 people per group. The experimental group received a health promotion program while the control group received regular nursing care for 4 weeks. The data collection tools included a general information interview form, a health behavior assessment form, a health assessment form and a health promoting behavior assessment form. The data were analyzed using descriptive and t-test analysis.
The result revealed that the mean score of health promoting behaviors of the experimental group in the post-experimental period was higher than the pre-experimental period and significantly higher than the control group (p < .05). Therefore, the findings have shown that the health promotion program has an effect on health promoting behaviors in older persons after PCI. Nurses can use this program to care for and promote healthy behaviors in older persons after PCI to reduce the risk of stent restenosis in coronary artery disease patients.

Medical Corps Officer Course

Suwapak Vesamavibool — 2024-08-28

None

The Roles of Lifeguards in Mitigating Drowning Incidents in Thailand

Chanin Pokabarl — 2024-08-28

Drowning is a major cause of unintentional death globally, posing significant public health implications that greatly impact economies and societies. According to the World Health Organization (2014), an estimated 91% of drowning incidents occur in countries with low to middle incomes levels. In Thailand, data shows that children under 15 years old have a mortality rate from drowning ranging from 5 to 8.6 per 100,000 population.
The International Life Saving Federation has identified several noteworthy risk factors, which includes the following: lack of knowledge, understanding, and negligence towards potential threats, as well as insufficient information and unrestricted access to hazardous areas, lack of survival skills when facing emergency situations, lack of supervision and vigilance, and other risk factors that may occur simultaneously.
Therefore, in areas with high risk of drowning incidents, it is crucial to have the presence of skilled personnel who can promptly assess risks and provide assistance. Additionally, drowning statistics in the area should be collected to utilize the data for planning prevention measures and reducing potential risks in the future.

Work-related Illnesses and Injuries among Urban Informal Workers in Thailand

Chathaya Wongrathanandha — 2024-08-28

Informal workers lack labour law protection and struggle to control occupational hazards due to various constraints. This article reviews literature related to occupational health problems of Thai urban informal workers to explore the burden and provide recommendations. In 2022, there are 7 million urban informal workers, including taxi drivers, motorcycle taxi drivers, platform delivery riders, and others. Common hazards are occupational accidents, awkward postures, air pollution, stress and long working hours causing injuries, muscle pain, respiratory symptoms and cardiovascular disease. To prevent and address these issues effectively, it is crucial to establish an informal worker database system, maintain vigilant monitoring for early issue detection, and implement targeted measures for different occupational groups. For instance, the Ministry of Labour is registering self-employed, while the Department of Land Transport is enhancing service opportunities during health checks for driver's license renewals.

Thailand's 50-Year Journey in Underwater Medicine

Thanasawat Chaiyakul — 2024-08-28

Underwater medicine in Thailand formally originated with the establishment of the Underwater Medicine Section, Academic Affairs Division, Naval Medical Department, on 29^th May 1973 as approved by the Ministry of Defence. While practices in underwater medicine had been developing for some time and have continued to the present day, academic advancements played a pivotal role in the rapid development of this field. The Royal Thai Navy has developed knowledge and organized training and through this, it was later equipped with hyperbaric chambers, and the discipline has expanded to support civilian activities, both in terms of underwater operations or activities and medical services addressing diving-related ailments. The development of hyperbaric medicine, a related field, has furthered the efficiency of using hyperbaric chambers, making underwater medicine widely accessible and beneficial throughout the nation.

The Role of Underwater Medicine in Thai Cave Rescue Mission

Natthasak Woracharoensri — 2024-08-28

The Tham Luang cave rescue in 2018 is considered a memorable event with numerous lessons to learn from. Over the years, there have been presentations of articles and narratives that reveal what actions were taken to aid the affected individuals and how they were carried out. However, regardless of these presentations, there remains a scarcity of in-depth information concerning the principles, concepts, and decision-making processes. This article, therefore, compiles intriguing aspects related to ethical medical decision-making in disaster relief situations and the management of potential ethical conflicts that may arise. These aspects have contributed to the formulation of operational strategies, including specific details regarding the application of underwater medical knowledge.

Hyperbaric Oxygen Therapy for Treatment of Malayan Pit Viper Bite Patients at Somdej Pranangchaosirikit Hospital

Pichayen Silpsrikul — 2024-08-28

Malayan pit viper is a snake that can be found in every region of Thailand. Its venom affects the blood coagulation system and local complication at the bite site. Although the chance of death is found to be low, most of the patients often show local complication. The main complication are compartment syndrome and tissue necrosis. In cases that the patient has severe symptoms, surgical treatment is required and many patients become disabled. Somdej Pranangchaosirikit hospital has used hyperbaric oxygen therapy to prevent and treat local complication in patients bitten by Malayan pit viper to reduce disability from local complication. From the data collection in 33 patients from May 2013 - May 2018, it was found that HBO₂T could reduce compartment syndrome and extensive tissue necrosis, as well as reduce the incidence of fasciotomy and debridement, thereby contributing to a reduction in the incidence of Malayan pit viper bite morbidity. There should be clear indications for selecting patients for HBO₂T. However, further randomized control trial study is still needed.