Thammasat University Hospital Journal Online

Community Nurses’ Role in Promoting the Wellness among the Community-Dwelling Older Adults under the Self-Determination Theory Concept

2025-06-10T08:36:27+07:00

Currently, the world is facing an aging society, with Thailand being no exception. Preparing individuals for the challenges associated with aging has become an urgent and complex issue within public health systems. Older adults are considered a vulnerable population, often facing multiple life crises such as declining health, financial instability, social isolation, bereavement, and unemployment. Therefore, the ability to adapt and cope with these life transitions is essential for maintaining overall well-being. This article explores the application of Self-Determination Theory (SDT) as a framework for community nurses to promote wellness among community-dwelling older adults. In the context of a rapidly evolving digital era, community nurses play a pivotal role in supporting older individuals to engage in health-promoting behaviors through various health activities that enhance intrinsic motivation. By fostering a sense of competence (feeling capable and confident), autonomy (the ability to make independent health-related decisions), and relatedness (establishing meaningful social connections), community nurses can empower older adults to take ownership of their health. The expected outcome is that older individuals will adopt sustainable health behaviors, improve their capacity for self-care, reduce dependence on others, and ultimately experience an enhanced and enduring quality of life.

Oral Mucositis Care in Pediatric Oncology Patients

2025-05-19T13:40:58+07:00

Oral Mucositis (OM) is a common side effect in pediatric patients undergoing chemotherapy and radiotherapy, particularly in the head and neck region. This condition leads to inflammatory ulcerations in the oral cavity and oropharynx, resulting in pain, discomfort, and impaired eating and sleeping. These symptoms significantly reduce patients’ quality of life and cause considerable anxiety for both patients and caregivers. A literature review indicates that current management of OM primarily focuses on promoting oral health alongside other methods, aiming to prevent and alleviate symptoms. Many studies support the efficacy of cryotherapy, low-level laser therapy, palifermin, and honey in reducing the severity of OM. In contrast, other interventions such as glutamine, benzydamine, vitamin E, zinc, propolis, and olive oil require further research, especially in pediatric patients. The use of chlorhexidine and sucralfate is not recommended for the prevention of OM.

Therefore, appropriate management and prevention strategies, particularly for high-risk patients, along with patient and caregiver education, oral health promotion, nutritional support, and psychological support, are crucial for reducing the incidence and severity of OM during treatment and improving the quality of life in pediatric patients.

The Effectiveness of Rosella on Blood Pressure in Individuals with Hypertension: A Systematic Review

2025-04-23T15:21:44+07:00

Background: Hypertension is a major cause of stroke and heart disease, leading to death. Currently, many individuals with hypertension seek alternative treatments to help lower blood pressure, with the use of Thai herbs being one such option. Roselle (Hibiscus sabdariffa L.) is a Thai herb listed in the National Essential Medicines List and is known for its potential to lower blood pressure.

Objective: To review, analyze, synthesize, and summarize studies on the effects of roselle on blood pressure in patients with hypertension.

Materials and methods: The Joanna Briggs Institute methodology included research published between 2013 and 2023. Randomized controlled trials (RCTs) and quasi-experimental studies were selected and examined for the effects of roselle on blood pressure in hypertensive patients, with a total of 7 studies meeting the inclusion criteria.

Results: The findings of this systematic review revealed that roselle can lower systolic blood pressure in hypertension patients, although its effect on diastolic blood pressure was inconclusive, it may or may not reduce diastolic pressure. When compared to standard hypertension management, the combination of roselle supplementation with lifestyle changes was found to be more effective at lowering blood pressure than lifestyle changes alone. However, it could not be conclusively stated that roselle is more effective than conventional antihypertensive medications.

Conclusion: Roselle influences blood pressure in patients with hypertension, leading to a decrease in blood pressure among those who consume it.

The Effectiveness of a Value and Belief Promotion Program on Professional Values and Beliefs Regarding Organ Donation Among Professional Nurses Working in Intensive Care Units at Sakon Nakhon Hospital

2025-05-07T10:45:35+07:00

Background: Enhancing the competency of professional nurses in delivering accurate values and beliefs to family caregivers remains a challenging yet crucial factor influencing decisions regarding organ donation in brain-dead patients. This issue has not been extensively studied in Thailand.

Objective: To examine the effectiveness of a Values and Beliefs Program on the competency of professional nurses regarding values and beliefs about organ donation, specifically among those working in intensive care units (ICUs) at Sakon Nakhon Hospital.

Material and methods: This quasi-experimental study employed a post-test-only design. The participants comprised 60 professional nurses working in the ICUs of Sakon Nakhon Hospital, equally assigned to either the experimental group (n = 30) or the control group (n = 30). The experimental group received the Values and Beliefs Program on organ donation in addition to routine ICU nursing practices. In contrast, the control group received only standard ICU care. Data collection instruments included a demographic information form and a competency assessment questionnaire focusing on values and beliefs related to organ donation. Data were analyzed using descriptive statistics (frequency and percentage) and inferential statistics (independent t-test).

Result: The mean competency score related to values and beliefs about organ donation was significantly higher in the experimental group than in the control group (p < .001).

Conclusion: The Values and Beliefs Program on organ donation effectively enhanced the competency of professional nurses in promoting appropriate values and beliefs. This improvement may support family caregivers in making informed decisions about organ donation.

Causal Model of Factors Affecting the Performance of Medical Record in Hospitals under the Office of the Permanent Secretary, Ministry of Public Health

2025-05-22T10:51:29+07:00

Background: The medical records department is an important unit within healthcare facilities. Its primary role is to manage and supply essential medical and public health data for various purposes, including planning, disease diagnosis, and medical research. Therefore, the efficiency of this department is paramount and must be a top priority for every hospital.

Objective: This study aimed to develop a causal model of factors influencing the performance of medical records departments in hospitals under the Office of the Permanent Secretary, Ministry of Public Health. It also sought to examine the consistency of this causal model with empirical data.

Material and methods: This is a descriptive cross-sectional study conducted in March 2025. Data were collected from 200 hospitals under the Office of the Permanent Secretary, Ministry of Public Health. The sample size was set at 10 units per observable variable, and participants were selected using proportional stratified random sampling. The research instrument was a questionnaire validated by three experts, showing IOC from 0.67 to 1.00 and a reliability coefficient of 0.98. Data analysis was performed using descriptive statistics and structural equation modeling.

Results: Correlation analysis revealed that all observed variables had a positive and statistically significant relationship at the 0.05 level. The model fit assessment with empirical data showed that the organization had the greatest direct effect on the use of information systems, followed by the environment and technology, respectively. Furthermore, the use of information systems directly influenced the performance of medical records. It was also found that the organization had the greatest indirect effect on the performance of medical records, again followed by the environment and technology.

Conclusion: The factors affecting the performance of medical records in hospitals under the Office of the Permanent Secretary, Ministry of Public Health, consist of four factors in the following order: 1) information system usage, 2) organizational factors, 3) environmental factors, and 4) technological factors.

A Survey on Indoor Radon Concentration in Thammasat University Rangsit Campus: A pilot study

2025-05-22T10:49:30+07:00

Background: Radon is a natural gas that results from uranium decay. Radon is mostly found at high levels near uranium mining areas, geological formations such as granite, and hot springs, where water from underground aquifers rises to the surface. These areas are considered open spaces. Closed areas, such as residential buildings, often accumulate radon gas in the soil, rock, and sand used in construction. Prolonged exposure to high levels of radon gas can affect health by increasing the risk of lung cancer.

Objective: To measure and compare the concentration of radon gas in each building located within Thammasat University, Rangsit Center, Pathum Thani Province.

Materials and methods: CR-39 plastic film-type radon measurement plates were installed on the first floor of 22 buildings within Thammasat University. The plates were installed for 40 days, after which the radon concentration was analyzed using the nuclear track etching method.

Result: The buildings with the highest and lowest radon gas concentrations were the area of the pillars in front of the Social Science Building 2 (SC2) and the fire escape, 1st floor of the Ratchasuda Building, with values of 873.35 ± 9.35 Bq/m³ and 6.35 ± 0.67 Bq/m³, respectively. In the dormitory zone, the average radon gas concentrations in Dormitories A, B, C, and F ranged from 39.38 ± 49.73 to 82.47 ± 114.28 Bq/m³.
In the classroom zone, the Piyachart1 Building, Piyachart2 Building, Rajchuda Building, and Social Sciences Building 1-3 had an average value ranging from 16.41 ± 12.01 to 351.46 ± 455.00 Bq/m³.

Conclusion: Areas with radon gas concentrations exceeding 148 Bq/m³ were found in the dormitory zone, which has relatively low air circulation and inadequate ventilation. In Social Science Buildings 2 and 3, some areas showed high radon gas concentration levels, particularly in enclosed spaces, and some areas had abnormally high values that should be re-measured.

The multidisciplinary team approach experience in the single institute of breast cancer patients: impact on disease-free survival

2025-09-10T11:48:45+07:00

Background: Breast cancer is a significant health concern in Thailand, and the multidisciplinary team (MDT) approach is widely regarded as a strategy to improve cancer care outcomes. This study aims to evaluate the impact of MDT care on disease-free survival (DFS) in patients treated at a single institution.

Methods: This retrospective review analyzed 677 breast cancer cases treated at Thammasat Hospital from 2012 to 2021. The study compared disease-free survival (DFS) between patients managed with a multidisciplinary team (MDT) approach (n=394) and those managed without MDT involvement (n=283). Survival outcomes were assessed using Kaplan-Meier methods and Cox regression analysis.

Results: The mean disease-free survival (DFS) was 10.14 years in the MDT group, compared to 10.09 years in the non-MDT group, with no statistically significant difference observed across the 0–11.5 years follow-up period (HR: 1.061, 95% CI: 0.653–1.726, p = 0.810). However, when follow-up extended beyond 5 years, the MDT group demonstrated superior DFS compared to the non-MDT group. Significant predisposing factors influencing DFS in the MDT group included ECOG performance status, cancer staging, receipt of radiotherapy, and hormonal therapy.

Conclusion: Although MDT care does not statistically improve DFS (Disease-Free Survival), there is an observed trend suggesting a survival benefit. Furthermore, significant factors affecting DFS in the MDT group included patients' ECOG performance status, cancer staging, receipt of radiotherapy, and hormonal therapy.

Recognition of medical treatment rights in Thammasat University Hospital of students of Thammasat University

2023-07-17T16:16:59+07:00

Background: Thammasat University has implemented a health insurance program for students in collaboration with Thammasat University Hospital to provide medical services and publicize information on the rights of medical treatment. Some students were unaware of their medical rights, procedures, and documentarys to receive medical services according to their medical treatment rights. Consequently, problems with receiving medical services arise.

Objective: To study the perception of information on medical rights of Thammasat University students receiving services at Thammasat University Hospital.

Materials and methods: This was an exploratory and descriptive study. Data were collected from 262 students from 17 faculties at Thammasat University, Rangsit Campus. Data were collected using a questionnaire on the perceptions of the right to receive medical treatment among students at Thammasat University Hospital. All data were analyzed using descriptive statistics, including frequencies and percentages.

Results: 52.7% of students were aware of their rights to medical treatment, and 47.3% were unaware. Of the respondents, 66.3% were aware of all rights regarding medical treatment, while 34.3% were unaware. A total of 56.9% were aware of the procedures for exercising their rights. However, 43.1% were unaware of the procedures. 47.3%, 46.6 %, and 40.5 % of the students were aware of the documents/evidence to use for medical treatment at the hospital in case of sickness rights, accident rights, and universal health insurance patentability (gold card), respectively, while 59.5%, 53.4%52.0%, respectively, were unaware. In the case of publicizing the process of using medical treatment, 64.3% of the students received information about their rights to medical treatment from their peers, and 57% received information about their rights to medical treatment from Thammasat University's website. A total of 64% of students wanted to increase public relations channels on the Thammasat University website.

Conclusion: Not more than 60.0% of the Thammasat University students on the Rangsit campus recognize their rights to medical treatment, procedures for exercising their rights, documents, and evidence for all medical treatment rights. They would like to receive information and treatment channels from the Thammasat University website.

Development and effectiveness of an automatic response system for disease code search for medical code providers, Thammasat University Hospital

2025-07-08T06:11:05+07:00

Background: In fiscal year 2023, there was a problem of failure to submit medical service fee reimbursement, which was partly due to the incorrect disease code at 53.31%. Therefore, the researcher is interested in developing an automatic response system for searching for disease codes (Line Chatbot) to meet user needs for the correct ICD-10 codes and reduce the time spent searching for the criteria for providing ICD-10 codes.

Objective: To develop and study the effectiveness of the automatic response system according to the ICD-10 coding criteria, including coding duration, coding accuracy, and satisfaction with using the Line Chatbot.

Material and methods: This research was a developmental study. Phase 1 studied the content of the Line Chatbot and the criteria for ICD-10 coding. Phase 2 created a Line Chatbot. Phase 3 tested it with 11 medical coders and administered a test and satisfaction assessment. Phase 4 evaluated the results, comparing the time and accuracy obtained from the test before and after using the Line Chatbot using Wilcoxon statistics. Satisfaction with using Line Chatbot was analyzed using the mean () and standard deviation (SD).

Result: After using Line Chatbot, the sample group had a statistically significantly higher mean score of ICD 10 coding accuracy (p < 0.003). The mean score before using Line Chatbot was 17.09 (SD = 3.208) and increased to 19.00 (SD = 1.732). The time taken to give ICD-10 coding decreased statistically significantly (p < 0.003). The mean score before using Line Chatbot was 39.09 (SD = 15.391) and decreased to 21.82 (SD = 8.340). The overall satisfaction assessment of Line Chatbot was at the highest level ( = 4.77, SD = 0.447).

Conclusion: The developed Line Chatbot can increase the accuracy and speed of ICD-10 coding, which is a collection of criteria and techniques for coding diseases, easy to search, useful for submitting medical service fees, and leading to the development of other medical coding in all levels of hospitals.

The Effects of Dental Health Education Program Applying The Social Support Theory on Knowledge Behavior in Oral Health Care and Dental Plaque of High School Students Southern School for The Blind, Surat Thani Province

2025-05-14T11:11:36+07:00

Background: Oral health is a crucial component of overall health that significantly impacts quality of life. Especially in children with visual impairments, they often face challenges in learning and self-care from an early age, leading to more severe oral health problems compared to the general population. Promoting oral health through support from family, teachers, and peers, along with the provision of appropriate information and teaching materials, is therefore essential to foster improved oral health behaviors.

Objective: To compare the mean scores of knowledge, behavior in oral health care, and dental plaque before and after participating in the dental health education program.

Material and Methods: This quasi-experimental one-group design was a pretest-posttest design. The population consisted of 18 students in Grades 10 to 12 at the Southern School for the Blind, Khun Thale Subdistrict, Mueang Surat Thani District, Surat Thani Province. The research instruments included a dental health education program by applying the Social Support Theory, a questionnaire, and a dental plaque recording form. The intervention was conducted over a five-week period. Data were analyzed using descriptive statistics, Paired samples t-test, and Wilcoxon signed rank test.

Results: After participating in the program, the students had significantly higher mean scores in oral health knowledge and behavior compared to before participating in the program (p-value < 0.001), and they had a significantly lower amount of dental plaque compared to before participating in the program (p-value < 0.001).

Conclusion: The dental health education program applying the Social Support Theory, combined with appropriate and engaging teaching materials for children with visual impairments, enhanced their access to and understanding of information, leading to positive changes in oral health care behavior.

Analysis of factors Associated with Injuries and Deaths from Road Accidents in Health Region 4, 2023-2024

2025-04-23T15:36:49+07:00

Background: Injuries and fatalities from roads are a major public health problem that affects the health service system, especially in Health Region 4, which covers several provinces in the central region with heavy traffic. This study leads to effective policy planning and management.
Objective: To study the factors associated with injuries and deaths from road accidents in Health Region 4 during 2023-2024.
Materials and Methods: This retrospective descriptive study used secondary data from the medical record system of hospitals in Health Region 4 during 2023-2024 and was analyzed using binary logistic regression statistics.
Results: Most fatalities were male, aged < 20 years, and outpatients. The cause of the fatality was the motorcycle driver. The injuries and deaths were caused by not wearing a helmet, and the accident time was 4:00 p.m.-6:00 p.m. The analysis found that males were 1.54 more likely to die than females (AOR: 1.54, 95%CI=1.42-1.81). Those aged over 60 were 2.06 more likely to die than those aged under 20 (AOR: 2.06, 95% CI=1.89 -2.03). Inpatients were 1.13 more likely than outpatients (AOR: 1.13, 95%CI=1.10-1.53). Motorcycles were 1.26 more likely than other types of vehicles (AOR: 1.26, 95% CI= 1.21-1.32). The cause of death was not wearing a helmet or fastening a seatbelt. The chance of death is 1.62 times higher among those who wear a helmet/seat belt (AOR: 1.62, 95% CI= 1.52-1.73). Drinking alcohol has a chance of death 2.26 than those who do not drink alcohol (AOR: 2.26, 95% CI= 2.18 -2.43). And the period 16.01-18.00 has a chance of death 1.09 of other periods (AOR: 1.09, 95% CI= .41-1.52). The factors that were not related to injury and death were the nature of the accident and driving. When analyzed with the ROC Curve, it was found that the area under the graph was more than 0.750, which indicates good sensitivity in prediction.
Conclusion: Factors related to injuries and deaths from road accidents in Health Region 4 include gender, age, type of service recipient, type of vehicle, safety equipment, alcohol consumption, and time period. The ROC Curve value is greater than 0.750. This analysis can be used as an effective guideline and preventative measure for hospitals in Health Region 4.

Prevalence of sarcopenia and fear of falling among patients who submitted total knee arthroplasty at Thammasat University Hospital: A preliminary cross-sectional study

2025-06-05T16:00:12+07:00

Background: Sarcopenia is a progressive disorder of the muscles and body, leading to adverse outcomes. It results in various complications, including falls, fractures, disabilities, and mortality. Osteoarthritis is a disease caused by the degeneration of the musculoskeletal system, with knee osteoarthritis being the most prevalent. This often leads to total knee arthroplasty which It helps relieve pain, enhance physical performance, restore mobility, and improve patients' quality of life. There is a noted prevalence of falls in patients both before and after surgery.

Objective: To examine the prevalence of sarcopenia and compare the groups of sarcopenia and fear of falling in patients with knee osteoarthritis awaiting total knee arthroplasty.

Methods: This was a cross-sectional study in patients with knee osteoarthritis who were scheduled to undergo total knee arthroplasty at Thammasat University Hospital, aged 50 years or older. All participants were screened for sarcopenia according to the Asian Working Group for Sarcopenia 2019 Consensus. Bioelectrical impedance analysis, handgrip strength, and the short physical performance battery test were used to assess muscle mass, muscle strength, and physical performance, respectively. In addition, participants were asked to complete the Falls Efficacy Scale International (FES-I) Thai version.

Results: In over 100 participants, the all prevalence of sarcopenia was 32%, categorized to sarcopenia was 9%, severe sarcopenia was 23%, and possible sarcopenia was found 66%. In addition, the difference between sarcopenia groups was found to have statistically significant differences in fear of falling (p=0.014) compared to the group without sarcopenia.

Conclusion: The prevalence of sarcopenia in patients with knee osteoarthritis awaiting total knee arthroplasty in this study was relatively high, with the severe sarcopenia group having a high level of fear of falling.

Factors Associated with Stress Management Behaviors among Ambulance Drivers in Trang Province

2025-06-18T10:22:04+07:00

Background: Ambulance drivers are under high-pressure work, placing drivers at increased risk of both accidents and psychological stress. Maintaining good physical and mental health among ambulance drivers is essential to mitigating these risks.
Objective: To study stress management behaviors and identify factors associated with stress management among ambulance drivers in Trang Province.
Material and methods: A descriptive cross-sectional design. Data were collected from January to February 2025. The sample consisted of a total of 187 ambulance drivers in Trang Province. A structured questionnaire was used as the research instrument. The reliability of the tool was verified using Cronbach’s alpha, yielding coefficients of .750 for work-related factors, .789 for environmental factors, and .908 for stress management behaviors. Data were analyzed using descriptive statistics and inferential statistics, including the Chi-square test, Fisher’s exact test, and Pearson correlation coefficient, with a significance level set at 0.05.
Results: Out of 187 participants, 157 completed the questionnaire, accounting for 83.94% of the sample. All respondents were male, with a mean age of 42.0 years and an average of 8.3 years of emergency driving experience. On average, they drove 90.7 kilometers per day and responded to two critical patients daily. Approximately 50.3% had completed emergency driving training. Most participants demonstrated moderate levels of stress management behaviors (81.5%). Factors significantly associated with stress management behaviors (p-value < 0.05) included chronic diseases, energy drink consumption, completion of emergency driving training, occupational health risks, work-related peer pressure, and musculoskeletal pain.
Conclusion: Enhancing physical and mental health support systems for ambulance drivers in Trang Province alongside stress management training, team relationship building, and the development of positive communication skills, especially among high-risk groups will contribute to improve mental well-being, reduce stress, enhance decision-making efficiency, fewer accidents, and overall improvement in the safety and quality of emergency services.

The Effects of a Health Literacy and Social Support Promotion Program on Health Behaviors and Blood Pressure Levels among Hypertensive Patients in Chon Buri Province

2025-06-18T11:45:18+07:00

Background: Hypertension is a major public health problem worldwide and in Thailand, leading to severe complications such as cardiovascular and cerebrovascular diseases, disability, and mortality. Programs integrating health literacy enhancement with social support are essential for effective hypertension management.

Objective: This study aimed to evaluate the effects of a health literacy and social support promotion program on health behaviors and blood pressure levels among hypertensive patients in Chon Buri Province, by comparing mean scores of health behaviors, health literacy, social support from village health volunteers (VHVs), and systolic and diastolic blood pressure between groups.

Material and Methods: A quasi-experimental design with a two-group pretest–posttest was employed. The sample comprised 64 hypertensive patients (32 in the intervention group from Ban Khao Cha-ang Health Promoting Hospital and 32 in the control group from Ban Pak Mun Health Promoting Hospital). The intervention program was implemented over eight weeks (January–March 2025). Research instruments included: (1) the health literacy and health behavior modification program, and (2) questionnaires, VHV home-visit records, and a blood pressure monitor. Data were analyzed using descriptive statistics, chi-square test, paired t-test, and independent t-test.

Results: After the intervention, the experimental group showed significantly higher mean scores in health behaviors, health literacy, and social support from VHVs, along with significantly lower systolic and diastolic blood pressure compared with both baseline and the control group
(p < 0.001).

Conclusion: The program effectively improved health literacy, social support, and health behaviors while reducing blood pressure among hypertensive patients. Its components and activities have potential for adaptation to other chronic disease populations with similar characteristics, provided that community context, disease nature, and long-term follow-up are considered.

Physical Activity and Sedentary Behavior of Thammasat University Hospital Staff

2025-09-15T14:34:16+07:00

Background: Insufficient physical activity and sedentary behaviors, such as prolonged sitting, are important risk factors for non-communicable diseases (NCDs), particularly abdominal obesity, diabetes, and cardiovascular diseases. Hospital personnel, as healthcare providers, are expected to serve as role models for healthy behaviors to enhance institutional credibility and encourage the public to prioritize health promotion.
Objectives: To study and compare physical activity and sedentary behaviors among personnel at Thammasat University Hospital, classified by sex, age, and marital status.
Methodology: This cross-sectional survey included 364 participants selected through simple random sampling. Data were collected using the Global Physical Activity Questionnaire (GPAQ). Descriptive statistics, including the mean, standard deviation, and percentage, were applied. Inferential statistics consisted of t-test, one-way ANOVA, and Scheffe’s post hoc test, with a significance level set at 0.05.
Results: The majority of personnel had a low overall level of physical activity (82.42%). Work-related physical activity was at a moderate level (51.92%), while travel-related and recreational activities were at low levels (60.99% and 69.23%, respectively). Regarding sedentary behavior, 42.86% of the participants reported sitting continuously for more than two hours on some days. No statistically significant differences were found in physical activity and sedentary behavior according to sex and marital status. However, age was significantly associated with work-related physical activity, with differences observed between personnel aged 20–30 years and 30–40 years, and between 30–40 years and 40–50 years (p < 0.05, Scheffe’s test).
Conclusion: Most hospital personnel had low levels of physical activity, particularly in the travel-related and recreational domains, and engaged in sedentary behaviors, such as prolonged sitting. Health promotion strategies should focus on encouraging physical activity during work hours and implementing workplace health programs to strengthen the role of healthcare workers as models of healthy living.

Nursing Workforce Analysis and comparison in the Non-Invasive Cardiac Diagnostic Units: Calculation Using Full Time Equivalents (FTEs)

2025-07-29T10:51:06+07:00

Background: Non-invasive cardiac diagnostic services require specialized nursing expertise. Appropriate nursing staffing levels are crucial for efficient and high-quality care delivery, especially for complex procedures. Inadequate staffing or improper workforce allocation may negatively impact patient care quality.

Objectives: 1) To analyze nurse staffing based on workload in the non-invasive cardiac diagnostic unit at Songklanagarind Hospital; 2) To compare required staffing based on the Full Time Equivalents (FTEs) with current staffing levels.

Methods: A descriptive study was conducted from February to July 2024, involving 23,209 patients, 3 registered nurses (RNs), and 12 other assistants (OAs, rotating 4 daily). Data was collected using a time-recording tool for procedures (CVI=0.86, ICC=0.845) and clinic statistics. FTEs were calculated from a total workload of 8,010.6 hours/year and compared with the Nursing Council’s standards (RN:PN ratio 70:30).

Results: The average workload was 34.83 hours/day, with 100.91 patients/day. The unit required 5.72 FTEs (4 RNs, 2 PNs) or 6 RNs without PNs. Currently, it has 3 RNs and 4 OAs. The most time-intensive procedures were Dobutamine Stress Echocardiogram (3:36:30 hours/case) and Echocardiography (2,451:39:00 hours/year).

Conclusion: The absence of practical nurses (PNs) results in excessive RN workload, potentially compromising care quality. Recommendations include increasing RNs/PNs per the 70:30 ratio, training OAs for basic tasks, and developing comprehensive workload analysis tools to enhance healthcare system sustainability.

Factors Related to Attitude of caregiver for home-bound and bedridden Patients toward Home Health Care among Multidisciplinary Teams, Khlong Luang Hospital, Pathum thani Province

2025-06-30T11:31:55+07:00

Background: Home health care is a primary care service that supports the universal health coverage policy by emphasizing integrated healthcare services provided by multidisciplinary teams to people of all age groups.

Objective: To study the attitude of caregivers for home-bound and bed-bound patients and factors associated with these caregivers' attitude toward home health care among multidisciplinary teams, Khlong Luang Hospital, Pathum Thani Province

Materials and methods: This paper is a cross-sectional study. Data were collected using questionnaires from 477 caregivers. The questionnaires included caregivers’ demographic data, patients’ demographic data, and caregivers' attitudes. Data were analyzed using frequency, percentage, mean, standard deviation, and multiple logistic regression.

Results: The attitudes of caregivers toward home health care among multidisciplinary teams were at a moderate level. Factors significantly associated with caregivers' attitudes toward home visits by the multidisciplinary team (p-value < 0.05) were caregiver's age (adjusted odds ratio = 1.54: 95% CI; 1.34 -1.84), caregiver's monthly income (adjusted odds ratio = 1.34: 95% CI; 1.33 - 3.74), and caregiver's underlying diseases (adjusted odds ratio = 1.72: 95% CI; 1.42 – 2.38).

Conclusion: The development of home health care should consider the diversity of caregivers, particularly focusing on younger caregivers, those with lower income, and those with underlying diseases, who tend to have lower attitudes. Additionally, caregiver health care should be integrated into the home visit system to sustainably improve the quality of care for home-bound and bed-bound patients.

Evaluation of User satisfaction toward Sitting Postures Detection System Using a Webcam

2025-08-19T10:44:33+07:00

Background: Prolonged sitting in an awkward posture in computer work may lead to musculoskeletal disorders (MSDs), especially in the neck, shoulders, back, and arms.

Objective: To evaluate computer users’ satisfaction with a motion posture detection system based on a webcam.

Materials and methods: A cross-sectional descriptive study using a questionnaire was completed by 60 computer users. The questionnaire data included demographic data and user satisfaction. Data were analyzed using frequency, percentage, mean, and standard deviation.

Results: The results revealed that most computer users were women (75.00%), with an average age of 36.57 years (SD = 17.07). The overall user satisfaction with the posture detection system was high, with an average rating of 3.80 (SD = 0.30). The five-part evaluation of user satisfaction, which included an easy-to-use interface, clarity of instructions, accuracy and correction, non-interference while working, and simplicity, showed high levels of satisfaction with means of 3.88, 3.92, 3.68, 3.90, and 3.92 and standard deviations of 0.32, 0.28, 0.62, 0.30, and 0.28, respectively.

Conclusion: Computer user satisfaction with the posture detection system was high, especially for items of clarity of instructions and easy-to-use interface. However, there should be testing of the effectiveness and validation of a motion posture detection system.

The effect of community participation-based behavioral modification on blood pressure levels and the risk of stroke and heart disease in the elderly with hypertension in Huai Sai Subdistrict, Mae Rim District, Chiang Mai Province

2025-08-14T15:43:41+07:00

Background: Thailand is currently transitioning into an aging society, resulting in an increased number of elderly individuals at risk for chronic diseases, particularly cerebrovascular and cardiovascular diseases, which are predominantly caused by hypertension. These conditions can be prevented through health behavior modification and community participation. Therefore, it is essential to develop appropriate and effective health promotion approaches for the elderly population.

Objective: To study the effects of a behavior modification model through community participation on blood pressure levels and the risk of cerebrovascular and cardiovascular diseases among elderly residents in Huai Sai Subdistrict, Mae Rim District, Chiang Mai Province.

Methodology: This study employed a quasi-experimental design with a single-group pretest-posttest approach. The participants comprised 34 elderly individuals with hypertension. The elderly participants received activities following a behavior modification protocol with community participation, based on the transtheoretical model of behavior change and community participation concepts, over a 12-week period. Data were collected using personal information questionnaires, blood pressure recording forms, and cardiovascular risk assessment tools, which demonstrated content validity of 1.0 and reliability coefficient of .88. Data analysis was conducted using descriptive statistics and paired t-tests.

Results: Following the intervention, elderly participants with hypertension showed statistically significant reductions in mean differences of systolic blood pressure, diastolic blood pressure, and risk of cerebrovascular and cardiovascular diseases compared to pre-intervention levels (p < .001).

Conclusion: The behavior modification model through community participation can effectively reduce blood pressure levels and the risk of cerebrovascular and cardiovascular diseases among elderly individuals with hypertension.

Factors Predicting Postpartum Depression Among Mothers with Preterm Birth

2025-09-17T10:14:26+07:00

Background: Mothers with preterm birth have to face situations that affect their mental health and increase their risk of postpartum depression. However, data on factors predicting postpartum depression in this population remain limited.

Objective: This study aimed to examine postpartum depression and the factors predicting it among mothers with preterm births. These factors include the length of the infant’s hospital stay, self-esteem, resilience, and social support.

Materials and methods: This study employed a predictive correlational research design. The participants were mothers who had preterm births between 24 and 36⁺⁶ weeks of gestation and attended a 6-week postpartum check-up at Thammasat University Hospital, Pathum Thani Hospital, Phra Nakhon Si Ayutthaya Hospital, and Saraburi Hospital. A total of 103 participants were included. The research instruments included the Personal Information Questionnaire, the Rosenberg Self-Esteem Scale, the Mental Health Power Scale, the Social Support Assessment Scale, and the Edinburgh Postnatal Depression Scale (EPDS). Descriptive statistics and binary logistic regression were used to analyze the data.

Results: A total of 45.63% of the participants experienced postpartum depression, with a mean score of 9.17 (SD = 5.40). Self-esteem and social support are statistically significant predictors of postpartum depression. Participants with higher levels of self-esteem had a significantly lower likelihood of experiencing postpartum depression (aOR = 0.13, 95% CI: 0.03–0.50, p < .001). Similarly, higher levels of social support were significantly associated with lower odds of postpartum depression (aOR = 0.34, 95% CI: 0.13–0.90, p < .001). These two factors explained 33.5% of the variance in postpartum depression among mothers with preterm birth (Nagelkerke R² = 0.335, p < .001). However, the length of the infant’s hospital stay and resilience were unable to predict postpartum depression in this group.

Conclusion: Nurse-midwives can use this information as a foundation for developing programs to promote self-esteem and social support to prevent and reduce postpartum depression among mothers with preterm birth.

Development of an Exercise Program to Reduce – Severity and Improve Quality of life in Chemotherapy-Induced Peripheral Neuropathy

2025-07-31T16:02:21+07:00

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect that significantly affects the daily functioning and quality of life of cancer patients. Exercise has been suggested as a non-pharmacological strategy to alleviate CIPN symptoms. This study systematically reviewed related literature and developed an exercise program specifically for colorectal cancer patients receiving oxaliplatin-based chemotherapy.
Objective: To synthesize evidence on the characteristics and clinical outcomes of exercise programs for CIPN, and to develop and preliminarily evaluate the effectiveness of an exercise program on symptom severity and quality of life in patients with oxaliplatin-induced peripheral neuropathy receiving oxaliplatin.
Methods: A systematic literature search was conducted using the PICO framework across Thai and international databases. The findings were synthesized and used to design an evidence-based exercise program. The program was implemented with 30 purposively selected participants and evaluated at baseline, week 4, and week 6 using validated assessment tools.
Results: Among the reviewed studies, three showed statistically significant improvements in the intervention group compared to controls, and two reported enhanced quality of life. The preliminary trial found that participants had improved motor-related quality of life at weeks 4 and 6 compared to baseline, although sensory and autonomic symptoms did not significantly improve.
Conclusion: The developed exercise program shows potential for enhancing quality of life, alleviating motor symptoms associated with CIPN in patients undergoing oxaliplatin chemotherapy, and reducing suffering in cancer patients undergoing chemotherapy.

Development of a Prototype Smart External Ventricular Drainage System

2025-09-26T09:14:31+07:00

Background: Traditional cerebrospinal fluid (CSF) drainage systems lack precise control and continuous monitoring of drainage volume, increasing the risk of complications from overdrainage or underdrainage. Furthermore, the lack of an automatic alert system for abnormalities forces medical personnel to rely on manual observation and assessment, resulting in limited accuracy and continuity.

Objective: The goal is to develop a prototype of a smart external ventricular drainage system.

Material and methods: This study entailed the creation of a prototype smart external ventricular drainage (Smart EVD) system to evaluate its viability for clinical implementation. The research instruments consisted of (1) materials and components used in the development of the Smart EVD and (2) a feasibility assessment form for evaluating its potential use. Data analysis included a descriptive presentation of the prototype development process and an analysis of the feasibility assessment results using descriptive statistics, namely the mean and standard deviation.

Result: The study successfully created a prototype smart external ventricular drainage system with four main parts: (1) measuring the angle of the head, (2) keeping track of the volume of cerebrospinal fluid, (3) setting a reference point, and (4) an alert system for abnormalities. Five experts evaluated the Smart EVD and found that it was very likely to work in real life (overall mean = 45.80, SD = 4.87).

Conclusion: The developed prototype smart cerebrospinal fluid drainage system demonstrates potential for assisting in the management of patients with hydrocephalus by reducing drainage errors and enhancing patient safety. However, further studies are required to evaluate the system’s accuracy and reliability in laboratory settings before proceeding to clinical testing in accordance with medical device evaluation standards.

Analysis of Bacterial pathogens and Multidrug-Resistant and Extensively Drug-resistant patterns from Blood Cultures in Results in Emergency Department Patients at Samutsakhon Hospital

2025-07-31T11:32:17+07:00

Background: Sepsis is a critical medical emergency with increasing incidence and severity, particularly due to the growing prevalence of antimicrobial-resistant pathogens. Accurate data on causative microorganisms and resistance patterns are essential to guide appropriate early treatment decisions.

Objective: To analyze the types of bacterial pathogens and patterns of multidrug-resistant (MDR) and extensively drug-resistant (XDR) organisms from blood cultures in patients admitted to the emergency department of a provincial hospital.

Methods: This descriptive study included patients aged over 18 years who were admitted to the emergency department of a provincial hospital between September 1, 2023, and August 31, 2024. A total of 426 cases were reviewed. Data were collected on age, sex, bacterial species identified, and 324 cases for analysis of antimicrobial resistance profiles.

Results: The mean age of patients was 67 ± 15.9 years, with 50.70% being male. The most common bacterial pathogens identified were Gram-negative bacilli/coccobacilli (50.70%). The most frequently isolated organism was E. coli (27.00%), followed by S. hominis (10.80%) and K. pneumoniae (9.86%). ESKAPE pathogens detected included K. pneumoniae, S. aureus, A. baumannii, P. aeruginosa, and E. faecium. Among 324 cases with complete antimicrobial data, the prevalence of MDR/XDR organisms was 31.48%, most notably E. coli, K. pneumoniae, A. baumannii, and P. aeruginosa.

Conclusion: Sepsis cases in the Emergency Department showed a high rate of drug-resistant infections, particularly among Gram-negative ESKAPE pathogens. These findings highlight the urgent need for an appropriate antibiotic stewardship strategy to reduce the severity of antimicrobial-resistant pathogens and transmission of antimicrobial-resistant pathogens.

Intraoperative Hemodynamic Parameters Related to Acute Kidney Injury in Non-ruptured Infrarenal Abdominal Aortic Aneurysm

2025-09-19T10:29:30+07:00

Background: Postoperative acute kidney injury (AKI) affects up to 30% of patients after infrarenal abdominal aortic aneurysm (AAA) repair, increasing mortality, extending hospitalization, and causing long-term renal dysfunction. The specific intraoperative hemodynamic factors that influence perioperative AKI risk remain unclear. Clarifying these modifiable factors is key to developing targeted interventions to improve outcomes and reduce costs.

Objective: To determine the association between intraoperative hemodynamic parameters and perioperative acute kidney injury (AKI) in patients with non-ruptured infrarenal AAA repair.

Material and Methods: Patients underwent non-ruptured infrarenal AAA repair by open aneurysmorrhaphy and endovascular aneurysm repair (EVAR) at Thammasat University Hospital between January 2016 and October 2021. Intraoperative hemodynamic parameters and AKI by raising of creatinine (Cr) correlation were analysed by Spearman’s rank correlation test. The multivariate regression analysis determined the perioperative risk factors of AKI.

Results: 32 patients were included, with 14 patients (43.75%) in open aneurysmorrhaphy and 18 patients (56.25%) in EVAR. Peri-operative urine output < 0.5 ml/kg/min was associated with AKI in patients with non-ruptured infrarenal AAA repair (RR 11.5, 95%CI 1.49-88.27; p-value = 0.019). Immediate de-clamping or deployment of diastolic blood pressure (DBP) and mean arterial pressure (MAP) were significantly related with Cr raising by moderated correlation (DBP: ρ = 0.434, P = 0.013; MAP: ρ = 0.414, P = 0.018, respectively). De-clamping hypotension by SBP, DBP, and MAP was significantly related with Cr raising by moderated correlation (SBP: ρ = 0.471, P = 0.006; DBP: ρ = 0.609, p < 0.001; MAP: ρ = 0.612, 95%, p < 0.001), respectively).

Conclusion: Peri-operative urine output < 0.5 ml/kg/min was a risk factor of perioperative AKI. Immediate de-clamping/deployment DBP, MAP, and de-clamping hypotension were significantly correlated with peri-operative urine output and AKI in non-ruptured infrarenal AAA repair procedures. This result is a pilot data for further large multicenter prospective cohort to confirm this result.

Cultivating Leadership to Enhance Mental Well-being, Well-being, and Resilience in Oncology Healthcare Professionals

2025-06-07T07:39:53+07:00

The ESMO Resilience Task Force workshop, held from January 31 to February 1, 2025, in Barcelona, Spain. The workshop focused on promoting mental health and resilience among healthcare professionals, particularly medical oncologists, amidst increasing burnout due to workload and resource limitations. Lessons were drawn from international initiatives (e.g., NHS Practitioner Health, PAIME-PAIMM) to share best practices and identify workplace risk factors based on ISO 45003 standards. Personal experiences reflected how overtime, high patient volume, staff-disregarding policies, and a lack of support systems contribute to burnout.

Key outcomes included increased awareness, professional network building, and preliminary action plan development, such as self-assessment and establishing support programs. The core concept was "Take care of the carer," ensuring professionals can effectively care for others. Next steps involve presenting findings to management to drive policy changes and fostering international collaboration for future development.