Academic Journal for Primary Care and Public Health Development

Nursing care for patients with pneumonia 2 case study

2025-09-27T15:07:21+07:00

This study employed a case study design with the objective of comparing nursing care for patients with pneumonia. Two patient cases were examined to compare the application of the nursing process for pneumonia among two inpatients admitted to Ranong Hospital, Ranong Province, during August 2025 (B.E. 2568). The research instruments comprised data-extraction forms for patient medical records, caregiver/relative interviews, and direct observation. Data were analyzed by comparing pathophysiology, signs and symptoms, and treatments; nursing problems were assessed using Gordon’s 11 Functional Health Patterns. Nursing diagnoses were established, nursing care was provided, and outcomes were evaluated across three phases: at admission, during care, and at discharge.

The findings indicated that the two pneumonia cases were older adults who presented with similar clinical manifestations and chest radiograph (CXR) findings of pulmonary infiltrates. They differed in comorbidities: Case 2 had pulmonary tuberculosis, anemia requiring packed red cells (PRC), and an electrolyte imbalance, and received supplemental oxygen; the overall management was more complex than for Case 1. Both patients were discharged home. The study suggests that comorbidity-related abnormalities necessitate more complex nursing care and longer lengths of stay. Therefore, nurses require sufficient knowledge and skills to care for patients with pneumonia and should apply the nursing process to provide holistic care to patients and families in collaboration with the multidisciplinary team, thereby enhancing patient safety, preventing complications, and reducing mortality.

The Influence of Health Literacy on the Desirable Behaviors of the Elderly in Khao Phra Subdistrict, Phipun District, Nakhon Si Thammarat Province

2025-10-06T13:10:25+07:00

This cross-sectional research aimed to study the level of health literacy, the level of desirable health behaviors, and the influence of health literacy on desirable health behaviors among older adults in Khao Phra Subdistrict, Phipun District, Nakhon Si Thammarat Province. The population consisted of 803 socially active older adults in the area under the responsibility of Ban Chulabhorn Phatthana 2 Subdistrict Health Promoting Hospital. The sample size was determined to be 267 people using simple random sampling by drawing names without replacement, with a response rate of 98.13% (262 people). The research instrument was a three-part questionnaire comprising general information, health literacy, and desirable health behaviors, using a 5-point rating scale. The instrument was validated for content validity and reliability. Data were collected through interviews and analyzed using descriptive statistics and multiple regression analysis.

The results showed that the majority of participants were female (59.54%), with a mean age of 70.98 years, had primary education (85.11%), were engaged in agriculture (58.78%), and had an average monthly income of 5,187.40 baht. Most older adults had an adequate level of health literacy (46.18%), with access skills showing the highest proportion of good literacy levels (66.03%), while inquiry skills showed the most problems (50.38%). Desirable health behaviors were mostly at a moderate level (65.27%). Multiple regression analysis revealed that comprehension skills, inquiry skills, and decision-making skills together predicted desirable health behaviors at 71.00% (R² = 0.710, F = 153.587, p = 0.003), with inquiry skills having the highest influence (Beta = 0.201), followed by decision-making skills (Beta = 0.161) and comprehension skills (Beta = 0.132). Programs should be developed to promote inquiry skills by organizing training activities to build confidence in older adults to communicate with healthcare personnel, as well as conducting in-depth studies using mixed-methods research to develop more effective strategies.

Factors influencing performance in the family doctor team role of village health volunteers, Sai Khao Subdistrict, Hua Sai District, Nakhon Si Thammarat Province.

2025-10-06T21:52:48+07:00

This cross-sectional research aimed to study the level of performance in family doctor team roles and factors influencing the performance of village health volunteers in Sai Khao Subdistrict, Hua Sai District, Nakhon Si Thammarat Province. The sample consisted of 86 village health volunteers selected through simple random sampling. The research instrument was a questionnaire with a content validity index (IOC) of 0.718 and reliability of 0.724. Data were analyzed using descriptive statistics and multiple linear regression analysis.

The results showed that regarding motivation levels for work performance, growth needs had the highest level at 95.35%, followed by social relatedness needs at 77.91%, and existence needs at 74.42%. The level of performance in family doctor team roles was high at 82.56%. Multiple regression analysis revealed that all three motivational variables—existence needs, social relatedness needs, and growth needs—significantly influenced work performance (p < 0.05). Growth needs had the greatest influence (Beta = 0.204), followed by social relatedness needs (Beta = 0.192), and existence needs (Beta = 0.141). These three variables explained 72.10% of the variance in work performance.

Recommendations include that relevant agencies should develop systems to support career advancement, promote relationships and teamwork, and improve appropriate compensation and welfare. Future research should examine other factors influencing work performance and conduct qualitative studies to gain deeper understanding of work experiences.

Knowledge, Attitude, and Participation in Health Promotion and Disease Prevention Projects of Village Health Volunteers in Krabi Province.

2025-11-02T20:09:49+07:00

This cross-sectional descriptive research aimed to study the knowledge, attitudes, and participation of Village Health Volunteers in Krabi Province concerning health promotion and disease prevention projects. It also examined the relationships between personal factors, knowledge, and attitudes with their participation. The sample consisted of 383 VHVs in Krabi Province, selected through simple random sampling. Data were collected via an online questionnaire and analyzed using descriptive statistics, Chi-Square, and Pearson's Correlation at a statistical significance level of 0.05.

The results showed that the majority of Village Health Volunteers demonstrated a high level of knowledge in implementing community health promotion and disease prevention projects (66.06%). Regarding attitudes, most respondents exhibited a good level (70.23%), and notably, no volunteers were found to have a poor attitude. Participation was also high, with 74.67% demonstrating a high level of involvement. The aspect of participation with the highest mean score was participation in receiving benefits M = 4.11 The analysis of relationships revealed that the highest education level was significantly related to participation (χ² = 23.957, p = 0.008) Knowledge had a low-level positive correlation (r = 0.215, p = 0.001), and attitude had a moderate-level positive correlation (r = 0.415, p = 0.001) with participation. Other factors, including gender, age, occupation, income, duration of service, and project planning training, were not significantly related to participation.

Factors related to dengue fever prevention behavior in Thung Song Subdistrict, Na Bon District, Nakhon Si Thammarat Province.

2025-11-02T23:23:03+07:00

This research aimed to study the level of dengue fever prevention behaviors and to examine the relationships between personal factors, knowledge about dengue fever, perception of dengue fever, and dengue fever prevention behaviors in Thung Song Subdistrict, Nabon District, Nakhon Si Thammarat Province. This was a cross-sectional descriptive study. The sample consisted of 331 household heads calculated using the Krejcie and Morgan table. The research instrument was a questionnaire that passed content validity testing and reliability testing with a Cronbach's alpha coefficient of 0.78, consisting of 4 parts: general information, knowledge about dengue fever, perception of dengue fever based on the Health Belief Model, and dengue fever prevention behaviors. Data were collected between August and September 2025 and analyzed using descriptive statistics and Pearson's correlation coefficient.

The results showed that most samples were female (67.67%), with a mean age of 54.09 years, primary education level (43.81%), household income of 5,001-10,000 baht per month (49.85%), and engaged in agriculture (64.95%). Regarding the level of prevention behaviors, it was found that samples had high-level behaviors (48.34%), moderate-level (45.02%), and low-level (6.34%). Correlation analysis revealed that factors significantly related to prevention behaviors at the 0.001 level were perceived susceptibility to disease and perceived barriers to disease prevention, both with correlation coefficients of 0.18, indicating a low positive relationship. Age, knowledge about dengue fever, perceived severity of disease, and perceived benefits of disease prevention showed no statistically significant relationships. Based on the findings, it is recommended that public health agencies develop behavior promotion programs emphasizing increased risk perception through disease situation presentations, mosquito breeding site survey activities, and addressing barriers such as providing abate sand and establishing community funds to support mosquito prevention equipment. Special attention should be given to groups with low-level behaviors through home visits and individualized counseling. Future research should study other factors such as social support and community leaders' roles, conduct qualitative studies for deeper understanding, and develop intervention programs to evaluate long-term effectiveness.

Factors Associated with Influenza Prevention Behaviors among Older Adults in Nabon District, Nakhon Si Thammarat Province

2025-11-03T21:41:45+07:00

This cross-sectional study aimed to examine the levels of knowledge, perception, and prevention and control behaviors regarding influenza among elderly people, as well as to investigate factors associated with influenza prevention behaviors among elderly people in Na Bon District, Nakhon Si Thammarat Province. This descriptive research employed a cross-sectional survey method. The sample consisted of 258 elderly people aged 65-69 years who had lived in Na Bon District for more than 5 years, selected through purposive sampling. The research instrument was a questionnaire developed by the researcher based on literature review and related research, applying the Health Belief Model as a conceptual framework. The questionnaire comprised 5 sections: personal information, knowledge about influenza, perception of influenza, and influenza prevention and control behaviors. Data were analyzed using descriptive statistics and Pearson's Correlation.

The results revealed that elderly people had good levels of knowledge about influenza (56.98%), good levels of perception of influenza (57.75%), and good levels of influenza prevention and control behaviors (72.87%). Correlation analysis showed that age was not significantly correlated with influenza prevention behaviors (r = -0.005, p-value = 0.942), while knowledge about influenza (r = 0.248, p-value < 0.001) and perception of influenza (r = 0.153, p-value = 0.014) were positively correlated with influenza prevention behaviors at a statistically significant level. The research findings demonstrate that promoting knowledge and perception about influenza is an important strategy for enhancing disease prevention behaviors among elderly people. Therefore, public health agencies should develop programs to continuously promote knowledge and perception, using the Health Belief Model as a guideline for activity development.

Factors Related to Accessibility of Dental Care Service among Working AgeGroup, Tha Muang Muslim Community,Thong Nian Municipality, Amphoe Khanom, Nakhon Si Thammarat Province

2025-11-05T15:41:05+07:00

This cross-sectional study was conducted on Factors Related to Accessibility of Dental Care Service among Working AgeGroup, Tha Muang Muslim Community,Thong Nian Municipality, AmphoeKhanom, Nakhon Si Thammarat Province. The objectives were 1) to study the dental service utilization among working-age Muslims in Tha Muang Muslim Community,Thong Nian Municipality, Amphoe Khanom, Nakhon Si Thammarat Province 2) to study the perceived factors and associated factors associated withdental service utilization among working-age Muslims in Tha Muang Muslim Community,Thong Nian Municipality, Amphoe Khanom, Nakhon Si Thammarat Province and 3) to study the relationship between associated factors and dental service utilization among working-age Muslims in Tha Muang community, Thong Nian Subdistrict, Khanom District, Nakhon Si Thammarat Province. The sample size in this study consisted of 293 persons. Chi-square test was used.

The results revealed that,the majority of the sample (70.99%) received dental services. The main reason for not receiving dental services was not having symptoms (54.11%). The perception was at a moderate level (41.64%). The knowledge was at a high level (36.68%). The attitude and experience regarding disease prevention and receiving dental services were at a high level (45.73%). The influences that led to practice were at a very high level (99.66%). The relationship analysis revealed that education level, monthly income,working period (days/week,hours/day), and knowledge about oral diseases were significantly related to receiving dental services at the 0.05 level (p-value = 0.001, 0.004, 0.002, 0.005, 0.040, respectively). Gender, age, having underlying diseases, medical treatment rights, perceived benefits and perceived barriers to oral health care, attitudes, experiences regarding disease prevention, and influences that led to practice were not related to receiving dental services among the working-age group in the Tha Muang Muslim community.Tong Nian Subdistrict Municipality, Khanom District, Nakhon Si Thammarat Province, with statistical significance at the 0.05 level (p-values = 0.007, 0.741, 0.434, 0.190, 0.217, 0.860, and 0.632, respectively).

Development of a Care Model for Depression in Patients with Chronic Diseases in Sri Banphot District, Phatthalung Province

2025-11-11T08:12:00+07:00

This research and development project aimed to investigate the situation and challenges in caring for patients with chronic diseases who experience depression, to develop a care model based on community participation, and to evaluate the effectiveness of the developed model. The study was conducted in three phases. Phase 1 involved a situational assessment through document review, in-depth interviews, and focus group discussions. Phase 2 focused on developing the care model by integrating Cognitive Theory, the Chronic Care Model, and the Community-Based Participatory Research (CBPR) approach. Phase 3 implemented and evaluated the model using 42 patients with chronic diseases, selected through a multistage sampling process. The instruments included the 9-Question Depression Screening (9Q), the WHOQOL-BREF quality of life questionnaire, and a satisfaction survey. Quantitative data were analyzed using paired t-tests, and qualitative data were analyzed using content analysis.

The results showed that 35.7% of patients with chronic diseases had comorbid depression, with the main risk factors being low income (66.6%) and low education levels (81.0%). The developed care model consisted of four core components: initial screening and diagnosis, ongoing monitoring and surveillance, psychosocial counseling, and a referral system, combined with a 10-week group activity program integrating local wisdom. The implementation of the program demonstrated significant improvements, with depression scores (9Q) decreasing from 3.79 to 2.45 (p = 0.020), quality of life scores increasing by 7.80 points (p < 0.001), and high participant satisfaction (mean score of 4.27 out of 5.0). The community-participatory and culturally integrated care model significantly reduced depression and improved the quality of life among patients with chronic diseases.

Effectiveness of Discharge Planning Program for Colorectal Cancer Patients on the Knowledge of Adverse Reactions Management After Receiving Chemotherapy, Uttaradit Hospital

2025-11-11T09:19:25+07:00

This quasi-experimental research utilized a two-group pretest–posttest design with an interrupted time series to compare knowledge of adverse reaction management, adverse reactions, and anxiety after chemotherapy between colorectal cancer patients who participated in the discharge planning program based on the METHOD-P model and those who received routine care. The study was conducted among seventy colorectal cancer patients admitted to the female surgical ward at Uttaradit Hospital from February to May 2024, comprising 35 participants in the experimental group and 35 in the control group. The intervention consisted of a patient handbook, a self-care manual, an educational video, and a chemotherapy regimen booklet. Data were collected using (1) an adverse reaction monitoring form and (2) a knowledge test on managing chemotherapy-related adverse reactions. Both instruments demonstrated strong validity and reliability, with KR-20 coefficients of 0.95 and 0.97, respectively. Data were analyzed using both descriptive statistics and inferential statistics, including paired t-tests and independent t-tests.

Results revealed that the experimental group had significantly higher mean scores of knowledge and lower mean scores of adverse reactions and anxiety after participating in the METHOD-P discharge planning program compared to pre-intervention and the control group (p < .001).

Factors Affecting Accessibility of Health Care Services among People with Mueang Uttaradit District, Uttaradit

2025-11-19T04:18:58+07:00

This study aimed to examine the level of access to health services among persons with disabilities in Mueang District, Uttaradit Province, and to identify factors influencing their access to care. A cross-sectional descriptive design was employed. The sample consisted of 254 persons with disabilities selected through multistage sampling. Data were collected using a researcher-developed interview questionnaire comprising personal characteristics, awareness of health services, health service utilization, social support, and satisfaction with health services. Content validity was verified by expert review, and reliability was assessed using KR-20 and Cronbach’s alpha coefficients ranging from .79 to .89. Data were analyzed using descriptive statistics, Chi-square test, and multiple logistic regression.

The results revealed that the majority of persons with disabilities had a high level of access to health services (88.8%). Those with mobility and visual impairments demonstrated higher access compared to other groups. Among personal factors, sex was significantly associated with health service access (p < .05), while age, education, income, underlying disease, and type of disability showed no significant association. Regarding awareness of available health services, three dimensions—health promotion, disease prevention, and rehabilitation—were significant predictors of access. Participants with high awareness were 17 to 46 times more likely to access services compared to those with low awareness. Social support showed no statistical association with service access. The final regression model explained 48.3% of the variance in health service access. In conclusion, awareness of health services plays a critical role in enabling access to care among persons with disabilities. Efforts should focus on strengthening communication strategies related to service information and health rights, tailoring information formats to different types of disabilities, and expanding proactive services such as home visits and community-based rehabilitation. Enhancing the capacity of primary care units may further improve equitable access and continuity of care for this vulnerable population.

Drug related problems and intervention in the use of insulin injections among diabetic inpatients at NueaKlong hospital, Krabi Province

2025-11-21T15:02:01+07:00

This descriptive study aimed to identify drug-related problems associated with insulin injection use among diabetic patients admitted to the inpatient department of NueaKhlong Hospital, Krabi Province, and to propose appropriate solutions to improve insulin administration practices. Data were collected using a general information record form and a questionnaire on insulin pen use. The data were analyzed using frequency distribution, percentage, mean, and content analysis for open-ended responses. The study population consisted of 50 diabetic inpatients using insulin injections who met the inclusion criteria during April–August 2025. The study period lasted for six months. The results revealed that most insulin-using diabetic patients were female, with the majority aged between 66–75 years. Most participants had primary education, followed by those who were illiterate but could read, together accounting for 80%. A total of 84% of patients performed insulin injection steps incorrectly, while only 16% performed all steps correctly. The most frequently incorrect step in preparing the insulin pen was handwashing or hand cleaning before preparing the injection, with only 52% performing it correctly. In the injection procedure, the least correctly performed step (62%) was mixing the suspension insulin by rolling the pen horizontally ten times, followed by dose adjustment according to the physician’s order (74%). Regarding storage and basic knowledge of insulin injection, the most incorrectly performed step (78% correct) involved storing unused insulin in the middle compartment of the refrigerator rather than the freezer, vegetable compartment, or door. However, a critical step—pressing and holding the injection button until the full dose was delivered—was performed incorrectly by only one patient, who consequently developed severe hyperglycemia leading to hyperosmolar hyperglycemic state (HHS), highlighting the importance of this step in patient education. The findings serve as a foundation for developing pharmaceutical care guidelines for insulin use among diabetic patients in NueaKhlong Hospital. Since this study was conducted in a single hospital, the context may differ from other healthcare settings. Future studies should explore insulin injection-related problems in other contexts to develop more specific and effective pharmaceutical care interventions.

Development of patient referral system, Emergency Department, Nabon Hospital, Nabon District, Nakhon Si Thammarat Province

2025-11-29T17:27:55+07:00

This action research aimed to develop an emergency referral system for critical patients at Nabon Hospital, Nakhon Si Thammarat Province, and to study the outcomes of this development. The study was conducted from June to August 2025, collecting data through problem surveys, referral system assessment forms, and service recipient satisfaction questionnaires.

The results revealed that the referral system was concretely developed in four key aspects: 1) Emergency medical services and referral system, involving personnel capacity building, the formulation of operational guideline manuals, and the expansion of patient data communication channels via various applications; 2) Patient referral system, focusing on the preparedness of both personnel and equipment, capacity development for staff at all levels, the establishment of care guidelines for key patient groups, and a consultation system for cases exceeding facility capabilities; 3) Emergency room services, including improving treatment guidelines, implementing a fast-track system to streamline service procedures, developing personnel, creating QR codes for consultation, and upgrading equipment readiness; and 4) Community referral network, involving the development of emergency rescue network structures covering every sub-district and establishing surveillance systems for major diseases. The evaluation of the comprehensive emergency referral system indicated that the sample group had a high level of satisfaction (Mean = 3.85, S.D. = 0.62), reflecting the efficiency and success of the emergency referral system development in the study area..

Clinical Outcomes of Infants Born to HIV-Positive Mothers Following the Implementation of Care Guidelines at Ranong Hospital

2025-11-29T18:29:42+07:00

This was a retrospective descriptive study aiming to investigate the clinical outcomes following the implementation of care guidelines for infants born to HIV-positive mothers at Ranong Hospital. Data were collected from the medical records of 103 infants born to HIV-positive mothers who received services at Ranong Hospital between October 1, 2017, and September 30, 2024. Data were analyzed using frequency, percentage, mean, standard deviation, and the Chi-square test for association.

Results demonstrated significant improvement in the quality of care after the implementation of the One-Page care guideline in a subgroup of 50 infants during the fiscal years 2020–2024. The rate of receiving prophylactic antiretroviral drugs according to the treatment plan increased to 100%. Furthermore, the rates of HIV DNA PCR testing at specified ages, receiving formula feeding, growth and developmental assessment, and follow-up attendance all reached 86%. Additionally, the rate of mother-to-child HIV transmission, the rate of confirmed HIV infection at 18 months of age, and the rate of complications were significantly associated with the use of the guidelines (p-value < .05). Conversely, the mortality rate showed no statistically significant association with the guidelines (p-value > .05). The findings indicate that the newly developed care guideline effectively elevated the quality of care for infants born to HIV-positive mothers to meet the established standards.

Research and Development of a Participatory Care Model for Patients with Sepsis at Sribanphot Hospital, Sribanphot District, Phatthalung Province

2025-12-07T14:52:16+07:00

This research aimed to (1) examine problems and gaps in the sepsis care system at Sribunpot Hospital, (2) develop a participatory sepsis care model appropriate for community hospital contexts, and (3) evaluate outcomes of the model, including clinical processes, knowledge, attitudes, practices of healthcare personnel, and patient satisfaction. The study employed a 4-phase Research and Development (R&D) methodology combined with a Participatory Action Research (PAR) approach. Participants included 45 sepsis patients and 15 nursing staff. Six research instruments were validated for content validity (IOC ≥ 0.80) and reliability (α = 0.82–0.88). Data analysis utilized descriptive statistics, paired t-tests, and qualitative content analysis.

Results revealed that (1) pre-intervention problems included delayed screening, fragmented communication between Emergency Room (ER) and Inpatient Department (IPD), incomplete Sepsis Bundle compliance, and inadequate documentation; (2) the developed care model comprised Sepsis Pathway Version 2, SCN-01 communication form, Sepsis Emergency Kit, and participatory communication system, validated by experts (IOC = 0.92); (3) evaluation outcomes showed significant improvements in staff knowledge from 5.60±1.41 to 7.10±1.53 (p<0.001), attitudes from 3.47±0.32 to 3.99±0.35 (p<0.001), and practices from 3.32±0.28 to 3.92±0.33 (p<0.001). Sepsis Bundle compliance improved across all components, with time-to-antibiotic within 1 hour increasing from 46% to 72%. Staff satisfaction was high (x̄=4.39, S.D.=0.51). The findings demonstrate that the participatory sepsis care model effectively enhanced knowledge, attitudes, and practices among healthcare personnel while improving care quality to align with international standards. The model is suitable for implementation in community hospitals with similar contexts.