Greater Mekong Subregion Medical Journal

Violence in Healthcare Settings: A Scoping Review of Theoretical Foundations and Implications for Violence Prevention in Healthcare Systems

2026-04-16T21:17:47+07:00

Background: Workplace violence in healthcare settings is a growing occupational health concern affecting healthcare workers worldwide. Exposure to aggression and threats can negatively impact staff wellbeing and the quality of patient care.

Objective: This scoping review aimed to synthesize theoretical perspectives and empirical evidence related to workplace violence in healthcare settings and to examine implications for violence prevention strategies in healthcare systems.

Materials and Method: The review followed the methodological framework proposed by Arksey and O’Malley and further refined by Levac and colleagues. Literature searches were conducted in PubMed, CINAHL, PsycINFO, and the Thai-Journal Citation Index for studies published between 2014 and 2024. Titles and abstracts were screened independently by two reviewers, followed by full-text assessment based on predefined inclusion criteria.

Results: The search identified 1,847 records. After screening and eligibility assessment, 16 studies were included in the final synthesis. The literature highlighted several relevant theoretical perspectives, including emotional intelligence, ecological systems theory,
and communication-based approaches to conflict management. Empirical findings indicate that workplace violence is shaped by interactions among patient characteristics, staff communication practices, and organizational factors.

Conclusions: Effective violence prevention requires integrated strategies addressing individual competencies, organizational policies, and systemic conditions within healthcare systems.

Acquired Perforating Dermatosis Associated with Hodgkin Lymphoma: Rare Associated Manifestation

2026-01-12T17:47:49+07:00

Acquired reactive perforating collagenosis (ARPC) is a rare subtype of acquired perforating dermatosis (APD) that typically occurs in adults, often associated with diabetes mellitus or chronic renal failure. However, ARPC has also been reported in association with
malignancies and other systemic disorders. We presented the case of a 21-year-old Thai woman presented with multiple erythematous, pruritic papules with central keratotic plugs on the trunk, back, and extremities for five months. With history of chronic cough and significant weight loss of 10 kg over three months. Punch biopsy consistent with ARPC. Further investigations revealed an anterior mediastinal mass, multiple enlarged cervical and intraabdominal lymph nodes, and tiny pulmonary nodules with peribronchovascular consolidations at anterior segment of RUL; concerning for lymphatic or lung involvement. EBUS-guided biopsy showed atypical cells compatible with Classic Hodgkin lymphoma. The patient was diagnosed with ARPC with Hodgkin lymphoma stage IIIB with bulky disease, IPS 0. This case highlights the importance of recognizing ARPC as a potential cutaneous manifestation of underlying malignancy.

Community-Based Screening for Heterozygous α0-Thalassemia (--SEA and --THAI Deletions) Using Multiplex Gap-PCR in Pathum Thani Province

2026-01-12T17:42:39+07:00

Introduction: Alpha-thalassemia is a significant public health problem in Thailand, particularly the Southeast Asian (--SEA) deletion and the THAI deletion (--THAI), which are major causes of heterozygous α0-thalassemia and may lead to hemoglobin Bart’s hydrops fetalis, a life-threatening condition in fetuses.

Objectives: This study aimed to determine the prevalence of heterozygous α0-thalassemia due to --SEA and --THAI deletions in a community population and to evaluate its association with hematological parameters.

Materials and Method: A cross-sectional study was conducted on 95 individuals (aged ≥18 years) residing in Pathum Thani Province. Leftover EDTA blood samples from routine health check-ups were tested for α0-thalassemia (--SEA and --THAI deletions) using multiplex gap-PCR. Hemoglobin (Hb) levels and red blood cell indices were obtained from complete blood counts. Anemia was defined by World Health Organization (WHO) criteria (Hb < 13 g/dL in males, Hb < 12 g/dL in females). Statistical analysis used Fisher’s
exact test to compare proportions.

Results: Of the 95 participants, 90 (94.7%) had a normal genotype (αα/αα), and five (5.3%) were carriers of the --SEA deletion. No --THAI deletion carriers were detected. All individuals carrying the --SEA deletion exhibited anemia with microcytosis, whereas 30% of those with normal genotype were anemic. The association between --SEA carrier status and both anemia and microcytosis was statistically significant (p < 0.01).

Conclusion: The heterozygous α0-thalassemia (--SEA deletion) carrier rate was 5.3% in this community sample. Multiplex gap-PCR proved to be an effective tool for community-based thalassemia carrier screening. These findings provide essential baseline data for planning premarital screening programs and allocating resources for genetic counseling in Pathum Thani.

Causal Factors Influencing the Performance of General Administration Personnel in Maha Sarakham Provincial Hospital Organizational Determinants of Work Performance among General Administration Personnel in a Provincial Hospital

2026-01-18T20:56:03+07:00

Background: Provincial hospitals are key components of Thailand’s public health system. The performance of general administration personnel is essential for supporting clinical services and ensuring organizational efficiency; however, empirical evidence regarding organizational factors influencing their performance remains limited.

Objective: To examine the effects of organizational culture, work motivation, and Total Quality Management (TQM) on the work performance of general administration personnel at Maha Sarakham Provincial Hospital.

Method: A quantitative cross-sectional survey was conducted among general administration personnel at Maha Sarakham Provincial Hospital. Data were collected using a structured questionnaire with acceptable reliability. Descriptive statistics were used to summarize participant characteristics, and multiple linear regression analysis was applied to identify factors associated with work performance.

Results: Work motivation demonstrated a statistically significant positive effect on work performance (p < 0.01). Organizational culture and TQM showed positive but non-significant associations with work performance (p > 0.05). The overall regression model was statistically significant and explained a substantial proportion of variance in work performance.

Conclusion: Work motivation was identified as the most influential determinant of work performance among general administration personnel in a provincial hospital setting. Strengthening motivational strategies, alongside fostering supportive organizational culture and context-appropriate quality management practices, may enhance administrative performance and contribute to overall hospital effectiveness.

Nutritional Status of Lung Cancer Patients Receiving Chemotherapy

2026-03-09T14:22:10+07:00

Introduction: Malnutrition is common among lung cancer patients and adversely affects treatment outcome, quality of life, and survival. Data on nutritional status in this population, particularly during chemotherapy, remain limited in Myanmar.

Objectives: This study aimed to assess the nutritional status of lung cancer patients using the Subjective Global Assessment score (SGA) and Body Mass Index (BMI).

Materials and Method: This study evaluated the nutritional status of 70 patients with lung cancer at Yangon General Hospital, Myanmar using the SGA score and BMI. Changes in nutritional status were evaluated before and after chemotherapy.

Results: At baseline, 66% of patients were malnourished according to SGA, increasing to 68% after chemotherapy. Most patients experienced significant weight loss, as evidenced by a decline in BMI following chemotherapy. Although the overall change in SGA categories before and after chemotherapy was not statistically significant, individual-level analysis showed that a greater proportion of patients experienced deterioration than improvement, particularly in those with metastatic disease.

Conclusion: Malnutrition is highly prevalent among lung cancer patients in Myanmar. Routine nutritional assessment and early nutritional intervention should be integrated into cancer care to mitigate weight loss and improve treatment outcomes.

Evaluation of Leukocyte-Depleted Blood Components from Citrate Phosphate Dextrose / Saline Adenine Glucose–Mannitol Quadruple Blood Bag with an Integrated Leukocyte Filter

2026-04-08T13:31:59+07:00

Background: Leukocyte-depleted blood components are widely used to reduce transfusionrelated adverse reactions associated with residual leukocytes. When a new blood bag system is introduced into routine practice, evaluation of the quality of the resulting blood components is necessary to ensure compliance with the National Standards Criteria.

Objectives: This study aimed to evaluate leukocyte-depleted blood components, including leukocyte-depleted packed red cells in additive solution (LDPRC) and leukocyte-depleted fresh frozen plasma (LDFFP), prepared using a citrate phosphate dextrose/saline adenine glucose- mannitol (CPD/SAG-M) quadruple blood bag with an integrated leukocyte filter, and to evaluate the blood components quality according to the National Standards Criteria.

Materials and Methods:This descriptive evaluation study was conducted at the Blood Bank, Division of Clinical Pathology Mae Fah Luang University Medical Center Hospital. Whole blood was collected using CPD/SAG-M quadruple blood bags with an integrated leukocyte filter and processed into LDPRC and LDFFP. Evaluation was done in accordance with the National Standards Criteria for approval of validation of blood component characteristic, including component volume, hemoglobin content, residual white blood cell (rWBC) count,
and hemolysis during storage. Residual WBC enumeration was performed using an automated hematology analyzer in body fluid mode based on flow cytometric principles.

Results:All LDPRC units met the criteria for residual leukocyte content and other parameters throughout the storage period. Hemolysis remained within specified limits up to 42 days of storage. LDFFP units also complied with the criteria. Analysis of factor VIII activity is currently in progress.

Conclusions:Leukocyte-depleted blood components prepared using the evaluated CPD/SAG-M quadruple blood bag with an integrated leukocyte filter met the National Standards Criteria, supporting the suitability of this system for routine blood component preparation in a hospital-based blood bank.