Thammasat University Hospital Journal Online

The Vaccination against Human Papillomavirus Infection and New Alternatives in Laboratory Diagnosis

Aphiwit Lanut, Nattanai Atirujsitthangkul — Fri, 14 Mar 2025 00:00:00 +0700

The Human papillomavirus (HPV) is an infection transmitted through sexual contact. HPV infection can occur in both men and women. HPV infection leads to the development of genital warts, anal cancer, and cervical cancer. This article discusses the HPV infection that leads to the development of cervical cancer in women. This is a significant public health issue in Thailand.

There are various strains of HPV, with high-risk strains playing a crucial role in the cellular changes that lead to cervical cancer. HPV infection prevalence across regions in Thailand between 1989-2020, found that the total HPV infection rate was 40.47%. Vaccination against HPV is considered an effective method to reduce cervical cancer rates because condom use during sexual intercourse does not completely prevent HPV transmission. This article reviews the current knowledge on the prevalence of HPV infection and new alternatives to laboratory diagnostic methods and prevention strategies. A comprehensive understanding of HPV may contribute to reducing infection rates and lowering the incidence of cervical cancer in women.

The Role of Nurses in the Management and Prevention of Hand-Foot Syndrome in Colorectal Cancer Patients Receiving Chemotherapy

Kampon Introntakun — Fri, 14 Mar 2025 00:00:00 +0700

Hand-Foot Syndrome (HFS) is a common complication in colorectal cancer patients undergoing chemotherapy, particularly with capecitabine and 5-fluorouracil. The symptoms of HFS significantly affect patients' quality of life, starting with redness, swelling, and pain in the palms and soles of the feet. These symptoms can be severe enough to affect daily activities and work. Studies have indicated that the prevalence of HFS in patients receiving capecitabine is as high as 49.1%. Several risk factors are associated with the development of HFS, including tumor type, chemotherapy regimen, age, and serum albumin levels. The role of nurses in managing Hand-Foot Syndrome (HFS) is crucial. Nurses should adopt a comprehensive care approach tailored to symptom severity, ranging from providing education on initial prevention strategies to proactive management in cases of severe symptoms. Furthermore, the integration of new technologies for monitoring and tracking HFS symptoms, such as symptom-tracking applications and wearable devices, enhances nurses' ability to assess and adjust treatment plans according to patient needs. Effective management of HFS not only alleviates symptoms and improves patients' quality of life but also promotes recovery and enhances overall well-being.

An Integrative Review: Effects of hydrotherapy on the elderly through a holistic health perspective

Nathaporn Chansuk, Kitrawee Jiraratsatit — Fri, 14 Mar 2025 00:00:00 +0700

Thailand has fully transitioned into an aging society, where elderly people often face physical and mental changes due to the aging process, impacting their overall quality of life. This integrative review aims to study hydrotherapy's effects on the elderly through a holistic health perspective, encompassing four dimensions: physical, mental, social, and spiritual. Studies have shown hydrotherapy helps reduce pain, strengthen muscles, and enhance movement capacity. Additionally, it benefits mental health by stimulating the release of endorphins, which help alleviate anxiety and foster happiness. Hydrotherapy also promotes social interaction, helps relieve feelings of loneliness among elderly people, and enhances spiritual balance through connections to nature and religious beliefs. This review is based on studies extracted from three electronic databases (PubMed, ScienceDirect, and Google Scholar) between 2018 and 2024. Findings from this study may serve as a basis and guideline for applying hydrotherapy in communities or elderly care facilities in various forms and techniques, contributing to public health benefits in the future.

The Effects of Health literacy development program through Line application on self-care behavior of patients with coronary artery disease, Thungsong Hospital

Prissana Maneechay — Fri, 14 Mar 2025 00:00:00 +0700

Background : The global prevalence of cardiovascular diseases (CVD) is increasing. The World Health Organization (WHO) estimates that more than 13 million individuals are diagnosed with CVD each year, with 9.2 million deaths. Increasing health literacy and appropriate self-care behaviors can lower death rates and enhance patients’ quality of life.

Objective : This study examined the effect of a health literacy development program provided by the LINE application on health literacy skills, self-care behaviors, and readmission rates among patients with CVD at Thungsong Hospital.

Materials and methods : This quasi-experimental two-group design was a pretest-posttest design. The sample group consisted of patients with CVD who were treated at Thungsong Hospital. The participants were divided into an experimental group of 30 (n=30). They received a health literacy development program that applied Nutbeam's framework eight weeks and eight times. The program consisted of 1) building relationships and setting common goals, 2) developing information access skills, and 3) developing knowledge and understanding skills regarding the coronary arteries. 4) developing decision-making skills; 5) developing self-management skills; 6) encouraging and monitoring self-care behaviors; 7) checking and emphasizing the level of health literacy and correct and appropriate self-care behaviors; 8) summarizing the results of health literacy and self-care behaviors, and a comparison group of 30 people (n=30). Patients in the control group received standard care. Data were analyzed using descriptive statistics, Chi-square test, Wilcoxon signed-rank test, and Mann-Whitney U test.

Results : The experimental group showed significant improvements in health literacy and self-care behaviors compared to the pre-program scores (p < .05) and the control group (p < .05), and there was no readmission within three months.

Conclusion : The health literacy development program provided by The Line application improved CVD patients' ability to access health information and implement appropriate self-care behaviors, serving as a good model for other patients.

The Development of Health Behavior Modification Model among Risk Group of Diabetes Mellitus and Hypertension with Self-management Concepts in Phromkhiri District, Nakhon Si Thammarat Province

Kessarawan Pradubpoth, Kanjanaporn Krainara — Fri, 14 Mar 2025 00:00:00 +0700

Background : Diabetes and hypertension are chronic noncommunicable diseases that are major public health concerns. These are silent threats that significantly affect global health and mortality rates.

Objective : This study aimed to develop a health behavior modification model based on the self-management concept and evaluate its outcomes of the developed model among individuals at risk of diabetes and hypertension, focusing on blood sugar levels, blood pressure, and waist circumference in Phrom Khiri District, Nakhon Si Thammarat Province.

Material and methods : The study was divided into four phases: 1) analyzing the problem situation, 2) developing a self-management model for health behavior modification in high-risk groups, 3) implementing the model, and 4) outcome evaluation. Data were collected using focus group discussions and in-depth interviews and analyzed using descriptive statistics, chi-square tests, paired t-tests, and independent t-tests.

Result : This research was a self-management model for health behavior modification in high-risk groups of diabetes and hypertension in Phrom Khiri District, named the PKR Model, which was developed. The PKR Model consists of three key components: 1) Setting shared goals for self-management, 2) Developing knowledge and skills, and 3) Building motivation. These elements helped participants modify their behavior and achieve established goals. The results of the trial implementation of the PKR Model indicated that the experimental group had significantly lower mean blood sugar levels and blood pressure than the control group. However, no statistically significant difference was found in waist circumference (p-value > .05). When the PKR Model was expanded for health behavior modification, the overall satisfaction was rated at 96.36%, indicating excellent levels.

Conclusion : The research results will assist community health practice teams in planning health behavior modification to prevent new cases of diabetes and hypertension in the community. These findings also support the strategic planning of community health development in the coming years.

DHDR : A Detector holder for chest lateral decubitus radiography

Sunita Hayeedolohtoh — Fri, 14 Mar 2025 00:00:00 +0700

Background : The Radiology Department of Bannangsata Hospital reviewed chest X-ray data in 2023 and found 19 cases of chest X-ray taken from the lateral decubitus view, with six cases of repeat chest X-ray lateral decubitus positioning accounting for 31.58%. The cause of this was identified as a positional error. To address this issue, The Radiology Department developed The DHDR: A Detector Holder for Chest Lateral Decubitus Radiography.
Objective : This study was to reduce the rate of repeat chest X-ray lateral decubitus views due to positional errors.
Activities : The development process included: 1) Meeting with the clinical leadership team to present information on medical equipment, specifically DR panel holders available on the market, which were found to have limitations such as not being adjustable in height and not accommodating weak patients. This leads to innovation creation. 2) Designing a DHDR with features such as height adjustment, enabling weak patients to hold on, and eliminating the need for relatives or staff to hold the detector, thereby avoiding unnecessary radiation exposure. The device was stable, strong, and easy to move. 3) Constructing a DHDR that consists of nine components and involves eight steps in the manufacturing process. 4) Training staff in units using DHDR.
Results : The results of implementing the DHDR innovation (from January to September 2024) with patient consent showed that the rate of repeat chest X-ray lateral decubitus view owing to position error was zero. The images obtained covered the area from the lung apex to the costophrenic angle according to the doctor's orders. Further development of the innovation will be divided into two aspects: 1) using it in conjunction with X-ray imaging in the chest PA upright position for outside services with portable X-rays, and 2) disseminating the DHDR innovation in Phase 1 to the radiology network in Yala Province for further medical use.
Conclusion : DHDR innovation can reduce the rate of repeated chest X-ray lateral decubitus views according to purpose. The images were high quality, comprehensive, and clear, according to the doctor's orders. When compared, the costs were considered worth the benefits received.

Interactive Dashboard Thailand Vision 2030 Thailand Ophthalmology Database Metta Pracharak Hospital (Wat Rai Khing)

Vacharatit Patan — Fri, 14 Mar 2025 00:00:00 +0700

Background : According to the service plan policy of the Ministry of Public Health, the ophthalmology sector focuses on reducing the prevalence of blindness by the development of ocular quality that causes blindness, such as cataracts, glaucoma, retinal diseases, childhood blindness, and corneal diseases. In addition, the improvement of service quality has Metta Pracharak Hospital (Wat Rai Khing) to develop an interactive dashboard reporting system under Thailand Vision 2030. Thai Ophthalmology Database: This system collects ophthalmic disease data from 13 health service areas to standardize and ensure the accuracy of the data system. This allows ophthalmic data to be utilized to enhance service systems, referrals, ophthalmic resource management, and real time research.

Objective : This study was to develop a website for the ophthalmology data tracking and reporting system for 13 health service areas, covering 11,161 units, to display an interactive dashboard summarizing current operations to a uniform standard, and to link or integrate it into the Ministry of Public Health's Medical and Health Data Repository (Health Data Center).

Method : The committee and stakeholders from the relevant sectors of the 13 health districts met to develop the database, survey the reporting needs of the database, and design an Interactive Dashboard for Thailand Vision 2030. To establish and test the Thai ophthalmology database system, implement it, and evaluate the use of 11,161 agencies to access the website.

Result : The system can reduce the time spent searching for data according to the indicators for reporting by 13 health district agencies, and reduce the time for executives to use data for national-level ophthalmology policy decision-making. There are references for ocular data that can be used to develop service systems and for real-time policy decision making executives. Evaluate system usage from the agency; the satisfaction level is high.

Conclusion : The Interactive Dashboard Thailand Vision 2030 which is the database for ophthalmology in Thailand, is an innovative information technology tool that efficiently reports the necessary operational results of the agency in response to the Ministry of Public Health's service plan policy in real time.

Physical Therapy Care for Delayed Motor Development Children to Improved Quality of Life within the context of community hospitals in the three southern border provinces

Nasmee Maspathan — Fri, 14 Mar 2025 00:00:00 +0700

Background : Currently, many children have delayed motor development, especially in Yala Province, where the rate of delay is higher than the national average. There is also a lack of physical rehabilitation centers, which makes it difficult for children to access these services. Furthermore, parents lack the knowledge and understanding of caring for their children. Therefore, the physical therapy department at Raman Hospital has established a child motor development clinic to make it easier for children to access rehabilitation services and to improve their long-term quality of life.

Objective : This study aimed to include 1. Increased access to physical therapy services for children with delayed motor development. 2. To educate parents about how to care for children with developmental delays; and 3. To improve the skills of children with delayed motor development on at least one level.

Method : Phase 1: Setting up a child motor development clinic run by a physical therapist. However, the number of children visiting clinics remains low. Therefore, Phase 2 focused on providing education and information to parents and promoting the clinic. This led to an increase in children's access to services. As a result, it became necessary to expand the service hours to meet demand. Standardized treatment guidelines have been established for pediatric motor development clinics. Satisfaction surveys were conducted to improve the service model. A multidisciplinary team was coordinated to care for and progress to phase 5, which involved proactive home visits in the community.

Result : The target rate of access to physical therapy services for children with delayed motor development has increased to 68%. The parents’ knowledge and understanding about caring for children with delayed motor development increased by 93 %, and the children showed an 84% one-level improvement in their development.

Conclusion : Delayed motor development in preschool children in Yala Province requires urgent attention. Collaboration from all sectors involving the government, private sector, and community is key to helping children fully develop their potential and improve their quality of life.

Elevating Food Quality for a Better Experience at Bangkok Hospital Phuket

Patipat Prasertwittayakij, Supannika Poonthananiwatkul, Rainap Ratniyom — Fri, 14 Mar 2025 00:00:00 +0700

Background : Bangkok Hospital Phuket is a leading private hospital that serves Thai and international patients. A patient satisfaction survey on food services conducted in 2019 showed that 78.68% of the overall food service satisfaction score (target >79%) fell below the hospital’s target accompanied by continuous service complaints. Consequently, the hospital adopted the hospital food service satisfaction survey as a tool to assess satisfaction in areas such as food services, meal service quality, and staff and service issues.

Objective : The purpose of this study was to enhance the quality of food and service by utilizing the design thinking process to improve the overall dining experience, focusing on taste, presentation, and customer satisfaction.

Methods : This study used a hospital food service satisfaction survey with 22 items and an assessment of food service satisfaction at Bangkok Hospital Phuket.

Results : The results of satisfaction with food services after designing the food service with a redesign of food services were implemented using Design Thinking in 2020. During 2020-2021, patient satisfaction data were collected following research methodology, showing a statistically significant improvement in satisfaction (p < .005). In 2023, complaints surfaced regarding the limited menu variety, particularly restrictions on pork-based dishes. Consequently, a food service offering was developed that included pork dishes without affecting Muslim patients. Before establishing this service protocol, a Failure Mode and Effect Analysis tool was employed to assess potential risks and develop services aimed at minimizing and preventing these risks with the new service. In 2024, a Halal Assurance & Liability Quality System was implemented to ensure the quality of halal food production. This quality system was developed to meet halal standards, enhance service quality, and create an improved experience for all patients.

Conclusion : The quality of food and service can be improved by applying the design thinking process to enhance patient experience. This requires the integration of various quality tools and continuous monitoring to achieve ongoing improvements and better outcomes over time.

The Effects of Self-Management Promotion Program Using Telenursing on Blood Pressure Control among Stroke Patients in Thammasat University Hospital

Peeyanuch Lalaloes — Fri, 14 Mar 2025 00:00:00 +0700

Background : Treatment for high blood pressure is important in preventing recurrent vascular events in patients with previous strokes and decreasing mortality rates in stroke patients. To be consistent with the current situation, nurse case managers of ischemic stroke have developed guidelines for monitoring blood pressure levels in stroke patients by applying self-management theory combined with telenursing to control blood pressure levels within normal limits. As a result, it reduces the rate of recurrent stroke and mortality rates in stroke patients.

Objective : To reduce the level of blood pressure (BP<130/80 mmHg) in ischemic stroke patients with hypertension within 6 months after discharge.

Methods : 1) Selected ischemic stroke patients with hypertension who were admitted for treatment in the stroke unit and neurological ward. 2) Educate patients about stroke and hypertension including educating patients about self-care and self-management. 3) Encourage patients to choose self-care strategies to control their blood pressure levels using self-management theory. 4) Monitor blood pressure levels in ischemic stroke patients with hypertension at 14 days, 1 month, 3 months, and 6 months after discharge via the tele-nursing system.

Results : Ischemic stroke patients with hypertension were able to control their blood pressure level to normal (BP < 130/80 mmHg), increasing from 80.54% to 84.32%.

Conclusion : The results show that self-management combined with telenursing can help patients control their blood pressure. It may result in reducing the rate of recurrent stroke and death in ischemic stroke patients.

Quality comparison between food coloring and black powder for latent fingerprint detection on non-porous surface

Fri, 14 Mar 2025 00:00:00 +0700

Background : Fingerprints are common evidence at crime scenes and are used as crucial evidence in forensic investigations. Latent fingerprints are invisible and require special visualization methods. Dusting with the black powder method is commonly used on nonporous surfaces; however, it can be toxic and harmful to health.

Objective : To compare the quality of red kingcol ponceau 4R food coloring powder and black powder for latent fingerprint detection on nonporous surfaces.

Material and methods : Volunteers pressed their right thumbs onto beeswax and imprinted them on three non-porous surfaces (plastic, glass, and steel). Red kingcol ponceau 4R food coloring powder and black powder were used for latent fingerprint detection. The number of minutiae was counted using a MINI-Automated Fingerprint Identification System (MINI-AFIS). A total of 30 samples were analyzed using the paired samples t-test to assess the fingerprint quality.

Results : For latent fingerprints on plastic and glass using black powder and red kingcol ponceau 4R food coloring showed no significant difference in fingerprint quality. However, on steel surfaces, red kingcol ponceau 4R produced better results than black powder, with a significant statistical difference (p < 0.05).

Conclusion : Red kingcol ponceau 4R food coloring powder is a bright and clear powder that is readily available and inexpensive. It can be used as an alternative to black powder for collecting latent fingerprints on non-porous surfaces.

The Relationship Between Personal Factors and Full Denture Use Behavior on Quality of Life in the Oral Health Dimension Among Elderly Participants in the 'Ramadant Senior Citizens with Beautiful Smiles' Project at Raman Hospital, Yala Province

Jutharop Tunporn — Fri, 14 Mar 2025 00:00:00 +0700

Background : Most elderly people experience oral health problems that necessitate the use of full dentures. Full denture use allows them to chew food more easily. However, if they do not use their dentures properly, this can negatively impact various aspects of their daily lives and consequently reduce their quality of life in the oral health dimension.

Objective : This study aimed to examine the relationship between personal factors (gender, age, and education level), full denture use behavior, and quality of life in the oral health dimension among elderly participants in the 'Ramadant Senior Citizens with Beautiful Smiles' project at Raman Hospital, Yala Province.

Material and methods : This research was a correlational study. The sample consisted of 120 elderly individuals who were full dentures and were participants in the 'Ramadant Senior Citizens with Beautiful Smiles' project at Raman Hospital, Yala Province. Participants were selected through purposive sampling based on inclusion criteria and then randomly assigned using simple random sampling. The research instruments included (1) a personal information record form, (2) a questionnaire on full denture use behavior, and (3) a quality of life questionnaire in the oral health dimension. Data were analyzed using descriptive statistics, Pearson’s correlation, and Spearman’s rank correlation.

Result : Personal factors such as gender and age showed a strong positive correlation with quality of life in the oral health dimension (r=0.72 and 0.74, respectively), both with statistical significance (p-value<0.001). Education level also demonstrated a moderate positive correlation with quality of life in the oral health dimension (r=0.43), which was statistically significant (p-value<0.001). Regarding behavior related to full denture use, a strong positive correlation with quality of life in the oral health dimension was found (r=0.75), also statistically significant (p-value<0.001).

Conclusion : Gender, age, education level, and denture use behaviors are factors that affect oral health-related quality of life. Therefore, when caring for patients who use full dentures, it is important to consider these factors to ensure good oral health-related quality of life.

Oral Health Status and Factors Associated among Lower Secondary Students in Secondary School under Trang City Municipality, Trang Province

Fri, 14 Mar 2025 00:00:00 +0700

Background : Oral health problems among lower secondary school students tend to increase, potentially owing to insufficient promotion of knowledge, attitudes, and behaviors to prevent dental caries. This situation negatively affects the quality of life of lower secondary school students.

Objective : To examine oral health status, personal factors, knowledge, attitudes, and behaviors related to oral health care, awareness, and utilization of oral health services, as well as to investigate the factors associated with the oral health status of lower secondary school students in schools under the Trang Municipal Authority, Trang Province.

Materials and methods : A descriptive cross-sectional study was conducted using data collected in July 2024. The sample consisted of 319 lower secondary school students. The sample was collected by proportion estimation using a known population and two-stage random sampling method. The tools included an oral health status assessment and a questionnaire. Data were analyzed using descriptive statistics and simple binary logistic regression analysis. Associations with p < 0.05 were regarded as statistically significant.

Result : 64.26% of students had caries free in permanent teeth and 68.34% had cavity free in permanent teeth. The average age was 13.50 years (SD = 0.93 years), and the average daily expense for attending school was 65.09 Baht (SD = 29.07 Baht). The average daily expenditure on snacks and drinks was 30.88 Baht (SD = 16.04 Baht). Regarding 58.90% had a low level of knowledge, 54.23% had a moderate attitude, and 90.91% exhibited moderate oral health behavior. Additionally, 59.25% reported oral health problems and 62.38% expressed a desire to receive dental care. The factors significantly associated with caries free permanent teeth (p-value < 0.05) included grade level, the occupation of the primary caregiver, the presence of oral health problems, and the desire for dental care. Factors associated with cavity free permanent teeth (p-value < 0.05) included grade level, daily expenses for attending school, oral health problems, and desire for dental care.

Conclusion : It is recommended to promote continuous and sustainable dental care utilization among lower secondary school students who are aware of their oral health problems to reduce the incidence of oral diseases in the future.

Relationship between Digital Literacy and Psychological Capital to use Application “Smart AorSorMor” of Village Health Volunteer Leader in Nakhon Nayok Province

Phanthakan Yuenyong, Jaroenchai Ungcharoensuk, Parisa Saktongteerakun — Fri, 14 Mar 2025 00:00:00 +0700

Background : Digital literacy is a critical competency that influences the effective use of digital technology in public health administrations. Village health volunteer leaders (VHV), who serve as group leaders, possess digital literacy and will be equipped to guide the VHV group appropriately. Furthermore, a positive psychological capital is essential for facilitating the effective use of these applications.

Objective : This study aimed to examine the levels and relationships among personal characteristics, digital literacy, and positive psychological capital using the “Smart AorSorMor” application by village health volunteer leaders in Nakhon Nayok Province.

Material and methods : A cross-sectional survey was conducted with 196 village health volunteer leaders in Nakhon Nayok Province. The instruments used were questionnaires assessing personal characteristics, digital literacy, and positive psychological capital using the“Smart AorSorMor” application. The data analysis employed descriptive statistics, chi-square statistics, and Pearson's product-moment correlation coefficient, at a significance level of 0.01.

Results : Digital literacy and positive psychological capital in the utilization of the “Smart AorSorMor” application were observed to be at a high level ( = 3.83, SD = 0.68) and ( = 3.74, SD = 0.61), respectively. The analysis revealed that level of education and frequency of using digital devices and applications were significantly correlated with digital literacy, whereas age demonstrated a relationship with positive psychological capital. Furthermore, digital literacy was found to be positively correlated with the positive psychological capital in the context of the “Smart AorSorMor” application, exhibiting a high degree of correlation (p-value < .001, r = 0.768).

Conclusion : Overall and sub-dimensional digital literacy correlates with elevated levels of positive psychological capital in the utilization of the “Smart Aor Sor Mor” application. This correlation underscores the need to cultivate systematic analytical and problem-solving skills using digital tools, particularly in health data management and community communication, to foster long-term potential.