Mahasarakham Hospital Journal

Development of a social care model for people with disabilities to support the primary health care system, Maha Sarakham hospital

sudajan chaiphar — 2024-06-27

Objectives : To investigate problem situation and context of society preferential care for disabled develop society care model for disabled group and evaluate the effective of developed society care model for disabled group in primary health care service system, Maha Sarakham hospital.

Methods : This action research was carried out during April 2022 – January 2023. Target group were 100 people with mobility, mental or behavioral disabilities. Key informants were 30 representative of party network cooperations. Both quantitative and qualitative data were collected. Content analysis method was manipulated for qualitative data. Number, percentage, mean, standard deviation, minimum and maximum were used as quantitative statistics.

Results : Disabled care problems were geriatric people, having congenital disease, needing attended care, unemployed, having no income, lacking of coordinating with relevant agencies, information and services were paper recordand not covered of organizing help care system. A society care model for disabled was developed by these following activities, conferencing of team work and party network cooperations for role setting, remote online communications were used for information sharing and disabled servicing of party network cooperations, returning data to stakeholder for activities designing until holding an appropriated disabled care model according to context of communities and provider organization. The effectiveness of a disabled care model development illustrated that 100 percentage of disabled people were cared from society via a remote online communication. Five party network cooperations had worked together and 100 percentage of disabled people were cared continuously with a quality service.

Conclusion : A development society care model for disabled group in primary health care service system by sharing information forproviding plan of party network cooperations resulted in holistic care coverage.

Organizational Climate And Administrative Factors Affecting The Performance Of Surveillance And Rapid Response Of Public Health Personnel At Sub-District Health Promoting Hospitals In Udon Thani Province

Sukanya Pilatan — 2024-06-27

Objective : To Study the organizational Atmosphere and administrative factors influencing the efficiency of Rapid Surveillance and Response Teams (SRRT) among public health officer in subdistrict health promotion hospitals within Udon Thani Province.

Methods : This cross-sectional descriptive study involved a sample of 146 public health officer employed at sub-district health promotion hospitals in Udon Thani Province, drawn from a population of 208. The research utilized a questionnaire, validated by three experts for content validity, with each question exhibiting a consistency index greater than 0.05. The reliability of the questionnaire was assessed using Cronbach's alpha coefficient, yielding a high value of 0.975. Additionally, in-depth interview guidelines were utilized to collect qualitative data from 12 individuals.

Results : The study revealed that administrative factors including budget management, materials, equipment, and technology, along with organizational climate dimensions as unity, influenced the performance of Rapid Surveillance and Investigation (SRRT) among public health officer in subdistrict health promotion hospitals in Udon Thani Province, accounting for 76.2 percent (R²=0.762, p-value< 0.001).

Conclusions : The budget management, materials, equipment, technology, and unity have been identified as key factors influencing the performance of Rapid Surveillance and Investigation (SRRT). Therefore, it is imperative for public health officer to prioritize and enhance these aspects to promote the effectiveness of SRRT operations and achieving operational goals can be attained, thus ensuring the sustainability of SRRT endeavors.

Motivation and Soft Skills for Leadership Affecting the Opisthorchiasis and Cholangiocarcinoma Prevention and Control Among Health Personnel at Sub-District Health Promoting Hospitals in Nongkhai Province

kanchana phanna — 2024-06-27

Objective : To investigate the motivation and aesthetics of leadership skills that affect the prevention and control of liver fluke disease and bile duct cancer among healthcare professionals in sub-district health promotion hospitals in Nong Khai Province.

Methods : This action research was cross-sectional descriptive research.Population-based study of the among health personal in the sub-district health promoting hospital, Nong Khai Province. In this study, out of the entire population of 384, questionnaires were completed by 140 respondents who were working in Nong Khai province. Data were collected by the questionnaire that was examined and verified by the three experts for content validity items objective congruence (IOC) all items were more than 0.50 and and reliability Cronbach’s alpha coefficient was 0.97, and in-depth interview guidelines for collecting qualitative data for 12 people.

Results : The study's results identified five variables, including interpersonal relationships, planning and organizational skills, advancement in position, responsibility, acceptance, and respect, which have an effect and can predict the performance of preventing and controlling liver fluke disease and bile duct cancer among healthcare personnel in the sub-district health promotion hospitals of Nong Khai Province. These factors collectively account for 72.6 percent (R²=0.726, p-value<0.001).

Conclusions : In operations aimed at preventing and controlling liver fluke disease and bile duct cancer, attention should be given to various factors. These include the relationship between individuals, planning and organizational skills,advancement in position, responsibility, acceptance, and respect. These factors significantly impact the success of the operation in achieving its goals and ensuring long-term sustainability.

Penile Calciphylaxis of the Penis in a Patient of End-Stage Renal Disease: A Case Report

Kuntinun Kanchana — 2024-06-27

Objective : Penile calciphylaxis is a very rare disease that presents in patients with end-stage renal disease. The prognosis is poor with high mortality rate. We would like to present a rare case of penile calciphylaxis, risk factors and pathologic findings.

Methods : A case report, data was collected from medical records of Roi-Et hospital

Result : A 69-year-old man with end-stage renal disease, who underwent continuous ambulatory peritoneal dialysis (CAPD). He presented with chronic wound at glans penis for 2 months. Physical examination revealed necrosis of glans penis. The penectomy was done and the pathologic findings reveal penile calciphylaxis.

Conclusion : Prompt management of the disease is required; penectomy would acts as an infectious source control, improve the prognosis and reduce the mortality rate.

Efficacy and safety of adjunctive midazolam with propofol-based TCI for sedated colonoscopy

Jaramporn Pattanapichakorn — 2024-06-27

Objective : To study the efficacy and safety of Midazolam in reducing the dose of Propofol used for anesthesia during colonoscopy to mitigate intraoperative hypotension.

Methods : This study was a randomized controlled trial (RCT). All patients received Propofol target-controlled infusion (TCI) for anesthesia during treatment. They were randomly divided into two groups: the M Group received Midazolam 0.03 milligrams/kilogram + Fentanyl 1 microgram/kilogram followed by Propofol TCI : Ce starting at 1.5 micrograms/milliliter and increasing Ce by 0.5 micrograms/milliliter until Modified Observer's Assessment of Alertness/Sedation (MOAA/S) score ≤ 2, and the P Group received Fentanyl 1 microgram/kilogram + Propofol TCI : Ce starting at 1.5 micrograms/milliliter and increasing Ce 0.5 micrograms/milliliter at a time until MOAA/S score ≤ 2.

Results : When comparing between Groups, it was found that the mean total Propofol (milligrams) in Group M was 150.4±73.3 and in Group P was 198.2±97.5, and this difference was statistically significant (p=<0.01), indicating that Midazolam helped reduce the dose of Propofol used for anesthesia during colonoscopy. However, when comparing hypotension resulting from Propofol, Group M had 27 cases (58.7%), and Group P had 26 cases (57.8%). There was no statistically significant difference (p=0.92). Additionally, when comparing the results of side effects from drug use, it was found that Group M had 12 airway maneuvers (26.1%), and group P had 9 cases (20.0%). There was no statistically significant difference (p=0.49). Discharge from the recovery room was not delayed for any patient from either Group.

Conclusion : Midazolam has demonstrated efficacy in reducing the dose of Propofol during colonoscopy. Moreover, our findings indicate no significant difference between the Groups in intraoperative hypotension and other complications.

Sleep quality and related factors of patients with type 2 diabetes in the area of responsibility of Ban Bueng Hospital Chonburi Province

Nutsinee Nalinthutsanai — 2024-06-27

Objective : This study is to assess the prevalence of poor sleep quality and explore related factors in patients diagnosed with type 2 diabetes within the area of responsibility of Ban Bueng Hospital, Chonburi Province.

Methods : The research employed a cross-sectional study design, focusing on patients with type 2 diabetes in the Ban Bueng Hospital's juriS.D.iction in Chonburi Province. The sample size, determined using the proportion estimation formula, was 148 subjects. Data collection involved a comprehensive questionnaire covering general information, diabetes-related details, sleep quality assessed through the PSQI, depression set through the 9Q, and quality of life assessment. The collected data were subjected to descriptive and inferential statistical analyses, including simple and multiple logistic regression, with a 95% confidence interval.

Results : In a study involving 148 diabetic patients, 68 individuals were identified with poor sleep quality, accounting for 45.9% of the participants. Factors influencing poor sleep quality in patients with type 2 diabetes were examined, revealing two statistically significantb associations at the 0.05 level. These factors include divorced/separated/

widowed status (Adj. OR = 13.24; 95%CI = 1.77 – 98.68), latest HbA1c (Adj. OR = 1.34; 95%C I= 1.02 - 1.82), and moderate depression (Adj. OR = 13.36; 95%C I= 1.34 – 132.25)

Conclusion : The study concludes that 45.9% of diabetic patients exhibited poor sleep quality. The factors significantly associated with poor sleep quality in patients with type 2 diabetes include divorced/separated/widowed status, HbA1c levels, and the presence of moderate depression.

Factors Associated with the Health Literacy for Disease Prevention and Control of Village Health Volunteers in Kanchanaburi Municipality Area, Kanchanaburi Province

Chanatip Chailek — 2024-06-27

Objective : To study factors associated with health literacy for disease prevention and control among Village health volunteers (VHVs) in Kanchanaburi Municipality, Kanchanaburi Province.

Methods : This analytical cross-sectional study was conducted among VHVs working in 27 communities in 2023. The sample was randomly selected by one-stage cluster sampling in 17 communities, totaling 198 people. Data were collected using a health literacy assessment form for disease prevention and control for public health personnel stipulated by the Bureau of Risk Communication and Health Behavior Development, Department of Disease Control of which a reliability was 0.93. Data were analyzed using descriptive statistics and ordinal logistic regression analysis.

Results : The mean health literacy for disease prevention and control of all skills was at the problematic level (58.3±9.4 points). For each skill, understanding and applying skills were sufficient. Access, questioning, and decision-making skills were problematic. A factor associated with health literacy was education. Controlled for gender, a diploma degree or higher had higher health literacy than primary school (adjusted OR=2.54, 95% CI: 1.22-5.29).

Conclusion : Strategies to enhance health literacy for disease prevention and control among VHVs in Kanchanaburi Municipality, the hospital should emphasize access, questioning, and decision-making skills and take educational factors into account when designing activities.

A comparative study of the results of controlling the Non-communicable diseases by Bansadej Network Primary Care Unit in Bansadej Subdistrict Health Promoting Hospital Nikom 16 Subdistrict Health Promoting Hospital and Saithong Subdistrict Health Promoting Hospital, Amphoe Mueang Lampang Province

PONTHEP MANEEWAN — 2024-06-27

Objective : To study and compare the outcomes of Non-communicable disease control in Diabetic and Hypertensive patients of Bansadej Subdistric Health Promoting Hospital, Nikom16 Subdistric Health Promoting Hospital, and Saithong Subdistric Health Promoting Hospital under the responsibility of the Family care team of Bansadej Network Primary Care Unit.

Methods : This research is a cross-sectional analytical study design by collecting data from diabetic and hypertensive patients in the 3 SHPH who underwent annual check up from October 2023 to January 2024, totaling 944 patients. General informations and treatment outcomes data, including Fasting Blood Sugar , HbA1c, Blood Pressure and colors of Vichai’s 7 Colors Ball Model were analyzed by descriptive statistics.The differences in treatment outcomes among the 3 SHPH were analyzed by using One-way ANOVA and Bonferroni test.

Results : The diabetes control showed mean fasting blood sugar (FBS) values ranging between 91 (33.32) to 96 (25.83), which is considered well-controlled. However, the mean glycated hemoglobin (HbA1c) values were found to be above 7 % but not exceeding 8 % in all 3 SHPH, which is acceptable for elderly patients. Regarding to the hypertension control using the Vichai’s 7 Colors Ball Modes , it was found that the majority were green color, indicating well-controlled. Upon the inferential statistical analysis, it was found that Bansadej SHPH had better diabetes control than Saithong SHPH with statistical significance (p=0.002). When testing the mean systolic blood pressure (SBP) values, it was found that Bansadej SHPH had better control than Nikom16, and Saithong SHPH had better control than Nikom16 SHPH with statistical significance (p=0.001) and (p=0.019) respectively. However, there were no statistically significant differences of the mean fasting blood sugar (FBS) and diastolic blood pressure (DBP) values among all 3 SHPH.

Conclusion : The results of diabetes and hypertension control in all 3 SHPH showed good and acceptable level. However, differences were found in-depth with inferential statistical analysis. Despite receiving treatment from the same Family Care Team (FCT), there should be efforts to develop and improve new service models in the future to ensure efficiency and equity in the Network Primary Care Unit (NPCU) system.

Development of Long-Term Care Service System for Community Older Adults in the Community: The Secondary Hospital Context

Anut Purisung — 2024-06-27

Objective : To develop a long-term care service system for community older adults in the community

Method : This mutual collaborative action research comprised 3 phases: 1) The situational analysis of long-term care services of community older adults, 2) The development of a long-term care service system for community older adults, 3) The evaluation of the developed long-term care service system for community older adults.The sample group comprises 75 dependent elders, 34 public health officials, and related network partners. The research tools used are questionnaires, In-depth interviews, and group discussion guidelines. Quantitative data were analyzed using descriptive statistics, and qualitative data used content analysis and the summary.

Results : The situation of the older adults in the study area found that: 1) Physically, most of the elderly have a moderate health condition, must use assistive equipment, have movement problems, and have loss of memory and vision 2) Mental health have mild to moderate depression and have a risk of dementia 3) Economic and social aspects even though they received financial support from their children government and community but there are also financial concerns Developing a long-term care service system for the elderly in the community consists of 1) creating participation, 2) creating awareness, 3) creating a center for integrating work between three partner organizations, and 4) managing integrated services and long-term care between three partner organizations. Results from development found that long-term care services (LTCS) are provided for the elderly in the community. Moreover, there is unity among people in the community and related organizations working together for the elderly who are dependent. There are three networking: the hospital, the sub-district administrative organization, and the public sector organization, and service providers are satisfied working together. The conditional factors related to the development of a long-term care service system for the elderly in the community are the vision of the leader, the potential of the local working team, and the social capital of the community. These are considered factors for success in developing a long-term care service system for the elderly in the community.

Conclusion : Development of a long-term care service system for the elderly in the community. It was born from the cooperation of three parties: the hospital, the sub-district administrative organization and public sector organizations, resulting in the 4Cs Model

Effect of developing a computerized drug-drug interaction monitoring program at Mahasarakham Hospital

์Narumon Kuncharoenrut — 2024-06-27

Objective : To evaluate the effectiveness of a program developed to prevent adverse events from drug interactions.

Methods : This retrospective study involved gathering data through data collection methods and processing prescription information from the hospital database. The study was divided into two phases: the preprogram development phase, spanning from October 1, 2017, to September 30, 2020, and the postprogram development phase, covering October 1, 2020, to September 30, 2023. Data analysis was conducted using descriptive statistics, including frequency, percentage, and fisher's exact test analysis.

Results : Program and database adjustments resulted in a significant increase in the detection of drug - drug interactions by more than 2-fold. Prior to the adjustments, adverse events from drug interactions with severity level E, such as instances of bleeding, occurred twice, necessitating intervention for adverse reactions. Additionally, patients with elevated INR levels were observed 13 times. After the program and database adjustments, no patients with bleeding events were identified, but there was an increase in patients with elevated INR levels, specifically 17 patients with bleeding events. Regarding errors in drug prescribing and dispensing, statistically significant reductions were observed (p=0.033 and p=0.028, respectively). Before the adjustments, severe errors in drug prescribing at levels B and above occurred 248 times and 80 times, respectively. After the adjustments, the number of prescribing errors decreased significantly, with 142 times at level B and only 4 times at level C and above.

Conclusion : The development of a computer program and database aimed at preventing drug interactions has enhanced the ability to detect and alert healthcare professionals to potential drug interactions. This approach can assists physicians and pharmacists in minimizing medication errors and preventing adverse drug events. The system has been effective in reducing prescribing and administration errors, contributing to a safer and more efficient patient care environment. To further improve treatment efficiency and patient safety, it is advisable to implement computerized medication ordering systems throughout the hospital.

Formulation of Barium Sulfate Suspension (2% w/v) for Use as a Fecal Tagging Agent in Computed Tomography Colonography"

วิศิษฏ์ โสดาวิชิต — 2024-06-27

Objective : This research aimed to develop and evaluate barium sulfate suspension (2% w/v) for use as a fecal tagging agent in computed tomography colonography. The study focused on the formulation's physical, chemical, and biological stability, as well as its efficacy.

Methods : The study was conducted in three phases. Phase 1 involved compounding and formulating the vehicle of barium sulfate suspension (2% w/v) with varying concentrations of Carboxymethylcellulose sodium (0.2%, 0.3%, 0.4%, 0.5% w/v CMC sodium). Phase 2 assessed the physical, chemical, and biological stability of the formulations. Phase 3 evaluated the efficacy of the formulations as fecal tagging agents in computed tomography colonography.

Result : In Phase 1, the formulations containing 0.2% (A2-L) and 0.3% (A3-L) NaCMC received the highest overall satisfaction scores for taste, smell, viscosity, and composition, with scores of 71.17% and 62.33%, respectively. In Phase 2, the BaSO4-A2-L and BaSO4-A3-L formulations showed no changes in physical, chemical, or biological characteristics. The sedimentation volume (F=0.913-0.99) remained stable under all storage conditions, with pH values ranging from 4.31 to 4.47. No growth of E. coli, Salmonella, S. aureus, or P. aeruginosa was detected during the six-month storage period. In Phase 3, the efficacy of both formulations as fecal tagging agents was not significantly different (p-value 0.311) at the 0.05 significance level.

Conclusion : Mahasarakham hospital has selected the barium sulfate suspension (2% w/v) prepared with 0.2% CMC sodium for use under refrigerated storage conditions. The designated storage duration is six months after the preparation for clinical use.

Factors associated with acceptance for organ donation in donation center Mahasarakham Hospital

Suchanya Dejsiri — 2024-06-27

Objectives : To study the factors related to the acceptance of organ donation, the Mahasarakham Hospital Organ Donation Center.

Methods : The sample group was brain-dead patients selected according to the inclusion criteria for the study at Mahasarakham Hospital. Between 1 October 2011 - 30 June 2023, 213 cases. Data were collected from medical records using a data recording form. Data analysis consists of 1) situational data and sample characteristics using descriptive statistics. 2) factors related to the acceptance of organ donation using logistic regression statistics.

Results : The study results found that 51 samples agreed to donate organs from the total samples. The factors related to the acceptance of organ donation include an average family income of 15,000 - 25,000 baht per month (OR _Adj2.51; 95%CI = 1.14, 5.49; p = 0.022), having the intention to request organ donation in advance ((OR _Adj1.97; 95%CI = 1.24, 3.27; p < 0.001), caregivers have knowledge and understanding about organ donation from various media (OR _Adj6.79; 95%CI = 1.45, 9.28; p < 0.001), caregivers have knowledge and understanding about brain death (OR _Adj1.46; 95%CI = 1.13, 5.65; p < 0.001), and caregivers have knowledge and understanding about organ removal surgery for transplantation (OR _Adj2.49; 95%CI = 1.21, 4.06; p < 0.001)

Conclusion : The factors related to the acceptance of organ donation include an average family income of 15,000 - 25,000 baht per month, having the intention to request organ donation in advance, have knowledge and understanding about organ donation from various media, have knowledge and understanding about brain death, and have knowledge and understanding about organ removal surgery for transplantation

Nursing Care in Tuberculosis among Hospital Staffs: 2 Case Studies

ลัดดาวัลย์ บูรณวรศิลป์ — 2024-06-27

Objective : 2 case studies to compare patients nursing care in Tuberculosis among Hospital Staffs.

Methods : A comparative 2 case studies with purposive sampling selected from Hospital staffs of Mahasarakham Hospital who were infected with tuberculosis and received treatment with tuberculosis drugs. Collecting information from patient’s relatives and hospital medical, taking patients history and relatives. Take data analyzed and compared with pathology, signs&symptoms and treatment. Using the 11 Gordon Health Patterns for assessment to determine nursing diagnosis and patient discharge planning. Study during between 25 May 2023 – 20 December 2023.

Results : Case 1 is a 27-year-old Thai woman who is a professional nurse in the obstetric ward. Operate in a causal manner annual health check-up 2023 radiographic results showed reticulonodular infiltration at left upper lobe. Sputum test results showed TB on day 3, confirming Pulmonary TB. Have a history of bilateral surgery Lt. Oophorectomy 2 weeks before the annual health check-up. Hct and Hb were found to be lower than normal, so they were at greater risk of activity tolerance than in the second case. SGOT and SGPT were found to be higher than normal. No jaundice, yellow eyes, normal eating. The second patient is a 45-year-old Thai woman who is a life nurse on HIV clinic in Mahasarakham Hospital. Annual health check-up results 2023 radiographs showed increased focal opacity lesion at lateral aspect of left upper hemi thorax with lumps on 2 breast masses. Sputum test results did not detect TB. Health perceptions that there was an abnormal CXR result. It is a chronic focal pleural thickeny since 2021. The sputum test results did not detect TB, but confirmed the diagnosis of TB from CT results throughout treatment. Joint pain and noise are found in the joints when moving. After 2 weeks of co-care at physical therapy, general symptoms improved. Eating little, losing appetite, losing 1 kg in 6 weeks, no signs and symptoms of drug allergy.

Conclusion : Studies suggest that rapid screening and treatment of patients with tuberculosis reduces the spread of infection, severity and complications that are life-threatening. Therefore, nurses need to have knowledge, attitude and practical skills in working with a multidisciplinary team will be help keep patients safe and have a better quality of life.

Development of Nursing Services Model to Prevent Drug-resistant Organisms Infections Mahasarakham Hospital and network

นุชจรี พันธุ์โยศรี — 2024-06-27

Objective : To study the development of nursing service models to prevent Drug-resistant Organisms Infections Mahasarakham Hospital and network.

Methods : This is action research with the concept of preventing the spread of antimicrobial resistance as the content concrpt. on the concepts.The studying in 13 wards.The co-researchers are: The development team analyzed the situation and valuated the results, consisting of 30 people and 150 nurse. The tools used in the research consisted of General information, questionnaire, infection surveillance record form, satisfaction questionnaire, knowledge test about the meaning and methods of spreading infection. Prevention and compliance with SHIP measures ,semi-structured interviews on the issues situation of antimicrobial resistant infections nursing service organization model problems and obstacles in nursing supervision plan,SHIP bundle compliance observation form, training plan.

Results : From studying the situation of antimicrobial resistant infections in Maha Sarakham Hospital and service network. Most commonly found in the critical care group and internal medicine group, host issues were found, which were more common in people over 70 years of age, 37.60 percent, and 64 percent of those who came with severe symptoms and were intubated from community hospitals. Pathogen (Agent) The most common pathogen is Acinetobacter baumannii CRAB MDR Environment (Environment) found that compliance with measures is not yet comprehensive. and 7.6 percent of patients with drug-resistant infections were sent for treatment to the service network. These things result in the possibility of the spread of drug-resistant germs Development of a nursing service model developed with 8 activities to prevent the spread of antimicrobial resistance at Maha Sarakham Hospital and service network. The results showed a decrease in the rate of antimicrobial resistant infections. The development model is most appropriate to the hospital context. Nursing personnel were satisfied with the development model at the highest level.

Conclusion : This development model Learning occurs Personnel participate in giving opinions and are motivated to create innovations in development. There is an exchange of knowledge between departments. There is teamwork. Standard nursing quality Reduce the rate of antimicrobial resistant infections, benefiting both patients and personnel.

A Study on Factors Affecting Promoting Relatives or Caregivers in Making Decisions for Palliative Care Patients to Good Death: Nursing Group Prakhon Chai Hospital, Buriram Province.

thanyarat sriworananthanrong — 2024-06-27

Objective : To study factors that encourage relatives or caregivers in making decisions for palliative care patients to enter the good death.

ethods : This study is a descriptive research. 1. A sample group of 30 patients diagnosed as palliative care patients was selected. There were 30 relatives or caregivers of patients who have decision-making authority on behalf of patients. Divided into 3 steps: preparation phase 1. Clarifying the objectives and procedures. 2. Create nursing care guidelines for palliative care patients. Research period 1. Assess the patient's symptom level with the PPS assessment and ESAS assessment. 2. Nursing treatment. 3. Providing knowledge to relatives or caregivers. Evaluation period. Changes in patient symptom levels using the PPS and ESAS assessments. Statistics were analyzed by paired t-test. The data were analyzed using paired t-test and the level of satisfaction of patient care services using descriptive statistics, percentage and the standard deviation.

Results : The results of comparing the patient levels according to the PPS and ESAS assessments before and after were found to be statistically significantly different (P< 0.001) and the level of satisfaction of relatives or caregivers in palliative care services is at a very satisfied level.

Conclusion : Factors affecting patients and relatives in palliative care that includes a care process that covers physical, mental, and social aspects, resulting in palliative care patients entering the good death.

Management of Medication Adherence in Patients with Chronic Diseases At Sub-district Health Promoting Hospital, Mueang District, Maha Sarakham Province

Supinya Phoomwanitchakit — 2024-06-27

Objective : To develop a Medication adherences monitoring model and analyze the management of medication adherence problems among patients with chronic diseases across three sub-district health promoting hospitals, Mueang district, Maha Sarakham province.

Method : This study used a descriptive approach, examining patients with chronic diseases who sought medication within the study settings between October 1, 2020 and September 30, 2022. Drug-related problems, their underlying causes, and management strategies were analyzed using measures such as frequency, mean, and standard deviation.

Result : The Medication adherences monitoring model for medication use at the individual and family level was developed. When evaluating patients who received services froms pharmacists 1,272 times. Medication non-adherences were found 46 patients, with a total of 55 problems found mostly associated with intermittent drug usage, self-discontinuation, intentional non-use, incorrect dosages, and adverse drug reactions. Primary causes of these problems included adverse drug reactions, patient memory problems, and the utilization of alternative medicines or herbal remedies for self-care. Solutions for drug-related problems included providing verbal instructions to patients, implementing the adverse drug reaction monitoring system, and engaging in consultations with physicians to adjust treatment plans. It was found that most of the identified drug-related problems were successfully resolved.

Conclusion : The study showed the significance of establishing recommendations and guidance for classifying drug-related problems, identifying their root causes, implementing management, and monitoring outcomes. Such measures could be used to evaluate and classify drug-related problems involving medication adherence among patients with complex chronic diseases and lead to solving problems of an individual patient. It was expected that the recommendation and guidance of this study could be expanded across the network of sub-district health promoting hospitals affiliated with Maha Sarakham hospital.

Development of a model for modifying ergonomic behavior to prevent injuries from work of personnel in hospital

Pranomporn Tumon — 2024-06-27

Objective : This study aimed to Development of a model for modifying ergonomic behavior to prevent injuries from work of personnel at the Central Sterile Supply Department in Maha Sarakham Hospital

Methods : This research and development study were divided into 4 steps: 1) The current symptoms caused by incorrect ergonomics, 2) The development of guidelines for modification of self-efficacy and result expectancy in health behaviors, 3) The results of applying the guidelines for self-efficacy obtained by using the questionnaires to evaluate the knowledge, result expectancy and health behaviors, and 4) Assessment of these guidelines. The 37 participants were purposively selected from the staff in central payment center with more than 1-year working experience and no history in accident-related musculoskeletal injuries. This study was performed during June 2023 to March 2024 and the results were analyzed for percentage, mean, standard deviation, and compared by paired sample t-test.

Result : 1) The symptoms caused by incorrect ergonomics were pains in the shoulder, lower back, and neck, the fatigue after work was found occasionally, the most frequently reported symptoms were work-related stiffness, and most of the participants relieved their pain by self-massage; 2.The results after applying the guidelines showed that some participants still had pain in the shoulder (29.72%) and lower back (24.32%), they relieved the pain by self-massage (45.90%), and their latest painful episodes were at moderate level (score=3-5, 24.32%) and minimal level (score=1–2, 9.72%); 3. Application of the guidelines could increase the participants’ knowledge in ergonomics, health behaviors, and self-efficacy. Also, the participants were found to have significant lower risk in ergonomics and higher result expectancy at 0.01; 4) These guidelines received the highest level of satisfaction from the participants.
Conclusion : After applying the self-efficacy theory for behavior modification in working ergonomics, the participants Application of the guidelines could increase the participants’ knowledge in ergonomics, health behaviors, and self-efficacy. Also, the participants were found to have significant lower risk in ergonomics and higher result expectancy at 0.01; 4) These guidelines received the highest level of satisfaction from the participants.