The Journal of Chulabhorn Royal Academy

Factors Influencing Health Status Among Buddhist Monks in Uttaradit Province

2025-09-19T14:13:44+07:00

Background and Purpose Buddhist monks have an increasing trend of non-communicable diseases with specific factors different from the general population. This study aimed to investigate the health status and analyze factors affecting the health status of Buddhist monks in Uttaradit Province.

Methods This cross-sectional descriptive research recruited 362 Buddhist monks in Uttaradit Province using multi-stage random sampling. Data were collected using validated questionnaires comprising general information, health status, health behaviors, health literacy, healthcare accessibility, and social support. Data were analyzed using descriptive statistics, Chi-square test, Pearson's correlation coefficient, and stepwise multiple regression analysis.

Results The monks had combined overweight and obesity rates of 54.4%, abdominal obesity of 45.6%, and hypertension of 37.3%. Their health behaviors, health literacy, healthcare accessibility, and social support were at moderate levels. Factors affecting the monks' health status included health behaviors (β = 0.386, p < 0.001), health literacy (β = 0.287, p < 0.001), healthcare accessibility (β = 0.175, p < 0.001), age (β = -0.145, p < 0.001), and social support (β = 0.118, p < 0.01), collectively explaining 68.4% of the variance in health status.

Conclusions Health promotion programs for Buddhist monks in Uttaradit Province should focus on developing appropriate health behaviors, especially exercise and dietary practices, coupled with enhancing health literacy, improving healthcare accessibility, and establishing monk healthcare networks with community participation.

The Effect of a Self-Care Support and Education Program via the LINE Application on Knowledge and Self-Care Behaviors among Patients with Hyperlipidemia

2025-09-03T08:38:55+07:00

Background: Hyperlipidemia is a major risk factor for cardiovascular and cerebrovascular diseases. Strengthening patients’ self-care behaviors and knowledge is therefore essential. Objective: To investigate the effects of a support and education program delivered via the LINE application on self-care behaviors and knowledge among patients with hyperlipidemia. Methods: This study employed a quasi-experimental design with an experimental group (n = 30) and a control group (n = 30). The research instruments included a LINE-based support and education program comprising e-books and educational videos with a content validity index (CVI) of 1.00, a knowledge assessment questionnaire with a CVI of 0.90, and a self-care behavior assessment questionnaire with a CVI of 0.85. The reliability of the knowledge questionnaire was tested using KR-20, yielding a value of 0.85, and the reliability of the self-care behavior questionnaire was tested using Cronbach’s alpha, yielding a value of 0.78. Data were analyzed using frequency, percentage, the chi-square test, the paired t-test, and the independent t-test. Results: After the intervention, the experimental group showed significantly higher mean scores for knowledge and self-care behavior compared to their pre-intervention scores and to those of the control group, with statistical significance at the 0.05 level. Conclusion: Healthcare personnel should implement the self-care support and education program delivered via the LINE application to enhance knowledge and promote self-care behaviors in managing hyperlipidemia, which can help reduce the risk of potential complications.

Standards for Chemical and Biological Indicators in Sterilization Processes: Enhancing Occupational Health, Safety, and the Work Environment in Hospitals

2025-10-01T14:07:13+07:00

Introduction: Ensuring the safety of patients and personnel in the Central Sterile Supply Department (CSSD) is a critical component of healthcare quality and infection prevention systems. Central to this safety assurance is the accurate monitoring and evaluation of sterilization processes through Chemical Indicators (CIs) and Biological Indicators (BIs). These indicators serve as essential mechanisms for verifying sterilization efficacy and reducing the risk of healthcare-associated infections. A comprehensive review of relevant international standards is therefore necessary to guide appropriate application within the context of Thai healthcare facilities. Methods: This study conducted a structured review, analysis, and synthesis of international standards related to the use of CIs and BIs in sterilization processes. The aim was to examine their role in ensuring sterilization quality, patient safety, and occupational health protection for CSSD personnel, particularly within the Thai healthcare context. Results: The review demonstrates that Chemical Indicators (CIs) as defined in ISO 11140-1, together with Bowie–Dick testing under ISO 11140-4/5, play a critical role in verifying air removal and steam penetration in pre-vacuum sterilization systems—conditions fundamental to effective sterilization. Concurrently, Biological Indicators (BIs) under the ISO 11138 series provide microbiological confirmation through D-values and Z-values, enhancing the precision and reliability of sterilization cycle validation. Appropriate use of CIs and BIs also contributes significantly to occupational safety by reducing unnecessary reprocessing and minimizing personnel exposure to contaminated instruments, thereby strengthening CSSD occupational health and safety (OHS) measures. However, a comparative analysis indicates several challenges in Thai healthcare facilities, including inconsistent testing practices, limited availability of advanced indicator types, and gaps in personnel competency for interpreting indicator results. These limitations affect both the quality of sterilization processes and overall safety in healthcare service delivery. Conclusion: The application of CIs and BIs in accordance with international standards is fundamental to ensuring effective and safe sterilization systems that protect both patients from infection risks and CSSD personnel from occupational hazards. This review provides a framework for the contextualized adoption of appropriate indicator systems in Thailand, supporting improvements in sterilization quality and promoting sustainable safety across healthcare settings.

The Effectiveness of A Model For Promoting Health Literacy And Health Behavior of People, Public Health Service Center 67, Thawi Watthana Bangkok

2025-10-14T14:02:59+07:00

Introduction:Health literacy is a crucial factor in enabling individuals to effectively manage their own health. Consequently, a health literacy enhancement program was developed to promote positive health behaviors. Objective: The objective of this study was to examine the effectiveness of a health literacy enhancement program on the health behaviors of people residing in Thawi Watthana District,Bangkok. Method: a quasi-experimental, two-group pre-test/post-test design. The sample comprised 78 individuals aged 18 years and older, who were divided into an experimental group (n = 39) and a comparison group (n = 39). The intervention consisted of a health literacy enhancement program featuring four participatory learning sessions over an 8-week period. The research instrument was a questionnaire on health literacy and health behaviors, developed by the researcher based on a literature review and the Thai public health. Data were analyzed using independent t-test, Paired t-test, and Repeated Measures
ANOVA. Results: The results revealed that post-intervention, the experimental group demonstrated
significantly higher mean scores in both health literacy and health behaviors compared to their pre-test scores and compared to the comparison group (p < .05). Conclusion: The developed health literacy enhancement program proved effective in enhancing participants’ health literacy and promoting positive changes in their health behaviors.

Outcomes of Non-nutritive Sucking (NNS) Program in Preterm Newborns at Naresuan University Hospital

2025-08-27T13:13:31+07:00

Background: Preterm infants often experience delayed development of coordinated sucking, swallowing, and breathing, which may impair feeding efficiency and postnatal growth. Non-nutritive stimulation (NNS) has been proposed as an intervention to enhance oromotor coordination and feeding readiness. Objective: To examine the effects of a structured NNS program on weight gain, length of stay, and complications related to oral stimulation in preterm neonates. Methods: A retrospective, observational, cross-sectional study was conducted in preterm infants with postconceptual age ≥34 weeks admitted at Naresuan University Hospital who had no facial anomalies, CNS anomalies, chromosomal anomalies, necrotizing enterocolitis (NEC), cleft lip/palate and not on mechanical ventilation. The intervention included an oromotor readiness assessment using the Neonatal Oral-Motor Assessment Scale (NOMAS), followed by oral massage and non-nutritive sucking using an empty pacifier for stimulation. The primary outcomes were body weight at key time points (initiation, completion of the program, and discharge), days of stimulation needed for oral feeding, and incidence of adverse events (e.g., cyanosis or oxygen desaturation) during stimulation. Statistical comparisons were made among three gestational age (GA) groups: <28 weeks, 28–32 weeks, and >32 weeks. Results: Forty-eight preterm infants (28 males, 20 females) were enrolled. Infants in the GA <28 weeks group showed significantly greater weight gain compared to those in the 28–32 weeks and >32 weeks groups (p <0.05). Conclusion: The NNS program appears to support weight gain in preterm neonates. Caution is warranted in infants with GA <28 weeks, who are more susceptible to respiratory complications during stimulation. Close monitoring is essential when implementing such interventions in this population.

Factors Influencing Organ Donation Decision Among Healthcare Personnel at Loei Hospital

2025-08-29T11:27:33+07:00

Background : Organ transplantation is the most effective treatment for patients with end-stage organ failure; however, the shortage of donated organs remains a major challenge. Healthcare personnel play a crucial role in promoting organ donation. This study aimed to identify factors influencing the organ donation decisions of healthcare personnel at Loei Hospital to inform the development of provincial-level donation campaigns. Methods: A cross-sectional study was conducted among 556 healthcare personnel from May 10 to June 10, 2025. Data were collected using a questionnaire covering demographic data, knowledge, attitudes, and willingness to donate organs. Generalized Estimating Equation (GEE) analysis was used to assess associations between these factors and organ donation decisions. Results: Among the participants, 128 individuals (23%) expressed willingness to donate organs. Moderate (score 4–7) and high (score >7) knowledge levels were significantly associated with donation decisions, with adjusted odds ratios (aOR) of 1.80 (95% CI: 1.51–2.30, p = 0.003) and 1.49 (95% CI: 1.31–1.74, p < 0.001), respectively. Similarly, moderate (score 25–40) and high (score >40) attitude levels showed stronger associations, with aORs of 4.81 (95% CI: 2.77–11.27, p = 0.04) and 5.78 (95% CI: 3.07–15.58, p = 0.014), respectively. Conclusion: Healthcare personnel with at least moderate knowledge and positive attitudes toward organ donation were more likely to choose to donate. Enhancing awareness and attitudes in this group may increase donation rates and support the development of effective institutional and community-based campaigns.

Challenges and Opportunities in Promoting Mental Health Communication to Enhance Mental Health Literacy in the General Population

2025-09-09T08:41:14+07:00

Mental health communication is a challenging issue that requires continuous development because it provides an opportunity to develop and strengthen mental health literacy in the general population. This article presents current problems, needs, and approaches for developing mental health communication. Key factors that hinder mental health literacy include social stigma, limitations in service accessibility, and lack of proper understanding among the public. The development of communication to promote mental health literacy should be flexible, modern, and applicable across diverse contexts. This should emphasize blended learning approaches, utilize technology as a supporting tool, and establish collaborative networks between relevant agencies. Key recommendations include developing mental health communicator curricula that cover fundamental knowledge, communication skills, and stigma reduction strategies to address public needs and promote mental well-being at the societal level.

Nursing Care of Patients with Sudden Sensorineural Hearing Loss Undergoing Intratympanic Steroid Injection Therapy

2025-09-22T09:48:18+07:00

Sudden hearing loss is a rapid-onset auditory impairment that significantly impacts quality of life, leading to difficulties in communication, social isolation, and emotional distress. Immediate treatment is crucial to restore hearing and prevent permanent damage. Intratympanic steroid injection-administered through the tympanic membrane into the middle ear-is an effective treatment option with fewer side effects compared to oral or intravenous steroid administration. Nurses play a vital role in caring for patients undergoing intratympanic steroid injection. Their responsibilities encompass pre-procedural patient preparation, monitoring during the procedure, and post-treatment care, including the management of any complications that may arise. Furthermore, nurses are responsible for providing education and emotional support to both patients and their families. This support helps foster understanding of the condition and the treatment process, encourages family involvement in care, and promotes adherence to follow up treatments.

Nurse's Roles in Promoting Health Literacy and Self-Management in Patients After a Transient Ischemic Attack

2025-10-14T08:25:54+07:00

A Transient Ischemic Attack (TIA) represents a neurological emergency and serves as a critical harbinger of a future ischemic stroke. However, the transient nature of its symptoms, which resolve spontaneously, often leads patients and their families to underestimate the condition's severity. This results in poor adherence to secondary prevention strategies, which in turn significantly increase the risk of a subsequent major and disabling stroke.

Health literacy, therefore, emerges as a cornerstone for empowering patients for effective self-management. This review analyzes the pivotal role of professional nurses in fostering health literacy among TIA patients. This role encompasses activities ranging from health literacy assessment and tailored education to promoting self-management skills and cultivating a supportive environment.

As healthcare professionals with the most intimate patient contact, nurses are uniquely positioned to reframe the patient's perception of TIA from a benign event into a critical window of opportunity for stroke prevention. Through targeted communication, education, and counseling, they play a proactive role in ultimately reducing the long-term incidence of and burden of stroke.

Guidelines for simulation-based learning on mass accident

2025-10-14T09:55:05+07:00

Virtual simulation–based learning management is an experiential educational strategy designed to enhance the analytical thinking, decision-making, and reflective abilities of learners through realistic and interactive simulated scenarios. Learners can assume professional roles and practice skills within a safe and supportive environment that promotes effective learning. The learning management process comprises three main phases. The preparation phase involves analyzing the course description and learning outcome standards, setting learning objectives, designing and developing learning activities, creating assessment tools, preparing teaching and support teams, and coordinating with relevant organizations. The implementation phase consists of four stages: learner preparation, simulation practice, learning debriefing, and session closure. The evaluation phase includes assessing learners’ performance according to the predetermined learning objectives, as well as evaluating the overall learning management process through reflective discussions among instructors to identify opportunities for improvement and enhance the quality of future instruction. This approach can be effectively applied to learning management in emergency preparedness and disaster response, particularly in contexts with limited opportunities for real-world practice. It fosters active learning, promotes analytical thinking, and strengthens learners’ readiness to respond effectively to emergency situations