Region 11 Medical Journal <p>บทความวิชาการทางการแพทย์และวิทยาศาสตร์สาธารณสุข</p> <p><label class="sub_label" for="printIssn-5be50696b9220">ISSN&nbsp;</label>0857-5975</p> <p>ISSN 2730-3365 (Online)&nbsp;</p> โรงพยาบาลสุราษฎร์ธานี en-US Region 11 Medical Journal 0857-5975 Factors Influencing Stress Coping among Pregnant Women during the COVID-19 Pandemic <p><strong>Background:</strong> Coping with stress is a crucial mechanism for pregnant women, particularly in the context of the COVID-19 pandemic. Despite the challenges posed by the outbreak, limited research exists on the factors influencing stress coping among pregnant women.</p> <p><strong>Objectives:</strong> To investigate the factors influencing stress coping among pregnant women during the COVID-19 pandemic.</p> <p><strong>Method:</strong> The sample comprised 120 pregnant women attending the antenatal care department at Maha Sarakham Hospital, selected based on specific criteria between October 2021 and December 2022. Research instruments included a personal data record form, a revised version of the Pregnancy Coping Scale, Hardiness Scale for Women with Gestational Diabetes, and Uncertainty in Illness Scale. Predictive relationships were analyzed using multiple regression analysis, and personal information was examined using descriptive statistics. </p> <p><strong>Results:</strong> The sample group had an average age of 27.93 ± 5.85 years. The majority of the participants (58.33%) had received information about the 2019 coronavirus infection. Multiple regression analysis indicated that uncertainty (Beta=-156; p&lt;.05), and hardiness (Beta= .320; p&lt;.05) collectively significantly predict stress coping through planning and preparation. Additionally, family income (Beta=-.224; p&lt;.05) cans predict stress coping using a positive spirit style with statistical significance. Moreover, age (Beta=.239; p&lt;.05), uncertainty (Beta=.214; p&lt;.05), and hardiness (Beta=.285; p&lt;.05) together predict non-productive coping with statistical significance. Nurses should leverage the insights from this study to design programs that promote appropriate stress coping. Additionally, assessing hardiness and uncertainty is crucial for planning nursing activities, providing essential information for promoting effective stress management among pregnant women.</p> Parichat Wunchooserm Auksaranut Sutthiprapa Anucha Thaiwong Copyright (c) 2024 Region11Medical Journal 2024-05-17 2024-05-17 38 2 Sensitivity and specificity of focused CT for the diagnosis of acute appendicitis <p><strong>Background:</strong> Contrast-enhanced CT abdomen and pelvis plays the key role in the workup of acute appendicitis. With increasing rates of CT scans, concerns about the risks from radiation exposure are also increased. Focused CT is one of alternative protocols that has been suggested considering to radiation dosage. Therefore, accuracy of focused CT for the diagnosis of acute appendicitis was studied.</p> <p><strong>Objective:</strong> To determine accuracy of focused CT for the diagnosis of acute appendicitis</p> <p><strong>Method:</strong> Retrospective review of 270 patients with CT scans for evaluation of suspected appendicitis in Krabi hospital from April 2023 to September 2023 were included in this study. From those CTs, we reconstructed images with limited scan range from superior border of L3 to superior border of pubic symphysis which served as the focused CT. These focused CTs were reviewed, assessing for appendix visualization and diagnosis of acute appendicitis or other diseases. The reference standard was obtained from medical records, intra-operative findings, and/or histopathology.</p> <p><strong>Results:</strong> The appendix was completely covered by focused CT in 269 cases and partially covered in 1 case. 94 cases (34.81%) showed acute appendicitis, 73 cases (27.04%) showed other diseases, whereas 103 cases (38.15%) showed no relevant findings. The sensitivity, specificity, positive predictive value, and negative predictive value of focused CT were 92.86%, 98.26%, 96.81%, and 96.02%, respectively.</p> <p><strong>Conclusion:</strong> For the diagnosis of acute appendicitis, CT scan range can be limited to cover from superior border of L3 to superior border of pubic symphysis.</p> Theerarat Manmanee Copyright (c) 2024 Region11Medical Journal 2024-05-28 2024-05-28 38 2 Outcomes of Thungsong sepsis treatment protocol in sepsis management, Thungsong Hospital Nakornsrithammarath Province <p><strong>Introduction</strong>: Sepsis is condition with high mortality rate and current public health problem. The treatment process includes administration of fluids, rapid and empirical antibiotics, proper administration of inotropic drugs and eliminates the source infection.</p> <p><strong>Objective</strong>: To compare mortality rates and results of the treatment process before and after using the treatment guideline.</p> <p><strong>Methods</strong>: A quasi-experimental retrospective study. Collect all patient data from inpatient medical records who diagnosed sepsis and septic shock, pretreatment group from Jan 1 to June 3 2022 and post treatment group between July 1 and Dec 31 2022</p> <p><strong>Results</strong>: This study enrolled 169 patients before guideline implementation and 277 patients after the guideline. The outcomes showed an increase in ICU admission that went from 12.4% to 23.8% (P=0.04). Doctors that used the guidelines increased from 53.3% to 63.3% (P=0.01) and assessed early warning signs that rosed from 42.6 to 52.8% (P=0.02). By using the guideline, the duration of blood draw process for culture and initial antibiotics were increased from 30 minutes to 20 minutes (P&lt;0.001). Treatment by the administering was more than 30cc/kg/hour of fluid in patients with low blood pressure (septic shock). It was found that after using the guidelines, fluid administration increased from 55.1% to 71.7% (P=0.042). The result of mortality rate after deducting palliative care decreased from 11.8% to 9%(P=0.339)<strong> </strong></p> <p><strong>Conclusion</strong>: The results of the treatment process after using the guidelines were found that the treatment process improved. Meanwhile the results of mortality rate were not signifincantly decreased.</p> Piamsook Sarikprueck Copyright (c) 2024 Region11Medical Journal 2024-06-05 2024-06-05 38 2 Comparison of the Quality of Bowel Preparation for Colonoscopy in Inpatients Versus One-Day Surgery Patients <p><strong>Background:</strong> Currently Most of Thungsong Hospital colonoscopy patients are inpatients. One-day surgery system reduces congestion in hospitals, reduces the length of hospital stay, reduces the risk of infection, and saves costs for patients and hospitals</p> <p><strong>Objectives:</strong> To study and compare bowel preparation results for colonoscopy between inpatients and One-day surgery patients.</p> <p><strong>Method: </strong>Retrospective observational study. By collecting data on colonoscopy patients Between 1 April 2023 and 30 June 2023, there were 186 patients, divided into 126 inpatients and 60 outpatients. By comparing 2 parts of information: Part 1 includes gender, age, BMI, and underlying diseases, and part 2 is an assessment of results of bowel preparation, Length of colonoscopy, and colonoscopy results</p> <p><strong>Results:</strong> One-day surgery and inpatient were female 60% and 57.9% (p-value = 0.789), Average age was 53.7 ± 8.65 years and 60.25 ± 10.81 years (p-value &lt;0.001), No underlying diseases were found 81.7 and 53.2(p-value &lt; 0.001), respectively. One-day surgery patients had bowel preparation results of Good/Excellent 1.05 times (Unadjusted RR = 1.05, 95%CI: 0.75, 1.48) with no statistical significance (p-value = 0.780) and length of colonoscope of both groups that no Statistically significant difference (p-value = 0.073).</p> <p><strong>Conclusion:</strong> The comparison of bowel preparation in the colonoscope between inpatients and one-day surgery patients found no difference.</p> Jukkapong Jaturawanit Copyright (c) 2024 2024-06-04 2024-06-04 38 2 Effects of the self-efficacy promotion program on self-management behavior of patients with chronic kidney disease state 3 in primary care service of the Surat Thani hospital <p><strong>Backgrounds: </strong>Chronic Kidney Disease is a global public health problem, that every country is facing and is having an increasing trend around the world. It is a disease that cannot be completely cured. Continuous treatment is required and treatment costs are high.</p> <p><strong>Objective: </strong>To study the Effects of the self-efficacy promotion program on self-management behavior of patients with chronic kidney disease state 3 in primary care service of the Surat Thani hospital.</p> <p><strong>Methods: </strong>The sample group was patients with chronic disease, stage 3, in primary care centers in the Surat Thani hospital network. A glomerular filtration rate test result of 45 - 60% in the 6 months before joining the research project. The sample was randomly selected using the label picking method. The sample size from calculating the influence value (Effect size) to be equal to .70. The statistical significance level at .05, test power value at .80. Open Cohen's table, a sample size of at least 25 people per group. Analysis data were compared using independent t-test.</p> <p><strong>Results: </strong>Self-management behavior, knowledge of self-management, glomerular filtration rate (GFR) and creatinine (Cr), after receiving the program, it was found that self-management behavior and knowledge of self-management of the experimental group had a higher mean score than the control group. Creatinine of the experimental group was lower than of the control group. The glomerular filtration rate was significantly higher than the control group, p&lt;.05.</p> <p><strong>Conclusions: </strong>The program promotes self-efficacy in self-management behavior of patients with stage 3 chronic kidney disease. It can improve knowledge and change self-management behavior and can lead to kidney function in patients with stage 3 kidney disease.</p> Plearnta Raungsung sadakan eamchunprathip Copyright (c) 2024 Region11Medical Journal 2024-06-19 2024-06-19 38 2