JOURNAL OF LOEI PROVINCIAL PUBLIC HEALTH OFFICE

Surgical Management of a Mandibular Right Third Molar with Transverse Impaction: A Case Report

2026-06-10T10:19:20+07:00

This case report aims to describe the clinical findings, radiographic features, diagnosis, treatment planning, surgical procedure, and postoperative follow-up of a patient with
a transversely impacted mandibular right third molar. A 16 years old Thai female patient presented to the dental clinic at Kham Khuean Kaeo Hospital, Yasothon Province, with pain in the right mandibular region, accompanied by a subjective limitation in mouth opening and difficulty eating for approximately one week. The patient reported no underlying systemic disease and no history of drug allergy. Extraoral examination revealed no facial swelling, tenderness, or palpable abnormality, and mouth opening was within normal limits at the time of examination. Intraoral examination showed that the mandibular right third molar was not visible in the oral cavity. The surrounding gingiva and oral mucosa appeared normal, with no clinical signs of inflammation or dental caries.

Periapical radiographic examination revealed that the mandibular right third molar, tooth 48, was impacted in a transverse or buccolingual angulation and was classified as Pell and Gregory Class II, Position C. The tooth was located away from the inferior alveolar canal, and no root resorption of the adjacent mandibular right second molar was observed. Surgical removal of the impacted tooth was performed under local anesthesia. The procedure included an envelope flap design, buccal bone removal, tooth delivery, socket irrigation, and wound closure. Postoperative instructions were provided, and follow-up appointments were scheduled at one week and three months. Healing was uneventful, with no postoperative pain, swelling, infection, dry socket, or neurosensory disturbance of the lower lip and chin.

This case demonstrates that careful clinical examination and appropriate surgical planning can contribute to a safe and successful outcome in the management of transverse mandibular third molar impaction while minimizing the risk of postoperative complications.

Development of a Treatment Model for Pregnant Women Using Methamphetamine

2026-05-21T11:54:27+07:00

Methamphetamine use among pregnant women is an escalating problem with complex impacts on both mother and fetus, while the standard Matrix Program is lengthy and difficult for pregnant women to access. This research and development (R&D) study aimed to develop a specialized treatment model for this vulnerable group in Wang Saphung District, Loei Province.

This 3-phase R&D pilot study enrolled 30 pregnant women with methamphetamine-positive urine screening (census sampling of the target population during the study period;
no control group). The model comprised screening, a 10-week CBT program, and continuous follow-up. Instruments showed a scale-level content validity index (S-CVI) of 0.85 and Cronbach's alpha of 0.78. Data were analyzed using descriptive statistics, paired-samples t-test (with Cohen's d), Chi-square goodness-of-fit, and Fisher's Exact Test.

Post-treatment, mean relapse-prevention attitude rose from M = 3.02 to M = 3.18
(t = 2.22, df = 29, p = .02, Cohen's d = 0.45). During the 10-week program, 86.67% improved (26.67% abstinent, 60.00% reduced use), with no participant increasing their consumption, significantly exceeding the 70% target (χ² = 4.81, p = .028). At 3-month follow-up, 60.00% tested negative, and in-treatment behavior was significantly associated with non-relapse (Fisher's Exact Test, p = .014). Overall satisfaction was high (M = 3.96).

This pilot study indicates the CBT-based model is feasible and shows promising preliminary effects on attitudes and substance-use behavior. Scale-up requires testing in larger, multi-site samples.

Development of a Road Safety Management Model Using the District Quality of Life Development Committee (D-QLDC) Mechanism to Drive Multi-sectoral Network Participation in Nong Hong District, Buriram Province

2026-05-26T09:22:54+07:00

Road traffic accidents are a critical public health issue in Nong Hong District, Buriram Province, with 44 cumulative fatalities recorded between 2019 and 2023. The primary causes involve driver behavior and environmental factors, compounded by fragmented inter-agency operations and a lack of integrated data.

The objectives are 1) to study the context and analyze road traffic injury problems
2) to develop a road safety management model utilizing the District Quality of Life Development Committee (D-QLDC) mechanism and 3) to evaluate the effectiveness of the developed model.

This Participatory Action Research was conducted in three phases from May to December 2025 with 30 purposively selected key stakeholders. The model was developed through the PAOR cycle together with SWOT Analysis and TOWS Matrix, and evaluated using the CIPP Model. Instruments comprised an effectiveness questionnaire (overall reliability 0.91) and in-depth interviews. Data were analyzed using descriptive statistics, paired t-test, and content analysis.

The Results are 1) The contextual analysis identified 12 critical risk points and fragmented working processes. 2) The developed “NH-RSI Model” comprises four components: Policy Integration, Shared Data System, Sectoral Collaboration, and Community-based Proactive Measures. 3) Overall effectiveness increased from a moderate level ( x = 2.75, S.D. = 0.64) to a very high level ( x = 4.58, S.D. = 0.43), a statistically significant improvement
(t = 13.00, df = 29, p < .001). All 12 risk points were managed, village-level MOU coverage reached 100%, severe injuries decreased by 14.71%, and zero fatalities occurred during major festivals in the target areas.

The developed model strengthens multi-sectoral integration and enhances road safety management at both systemic and community levels, leading to tangible improvements
in safety behavior.

Effects of Lifestyle Medicine-Based Behavior Modification on Pre-diabetic Working-Age Adults in Nong Bua Subdistrict, Phu Ruea District, Loei Province

2026-05-21T11:40:52+07:00

Type 2 diabetes is a growing public health problem globally, nationally, and locally in Nong Bua Subdistrict, Phu Ruea District, Loei Province, where pre-diabetes among working-age adults has risen sharply, while studies applying all six pillars of lifestyle medicine in rural communities remain limited.

To evaluate the effects of a lifestyle medicine-based behavior modification program on fasting plasma glucose (FPG), diabetes knowledge, self-efficacy, and preventive behaviors among pre-diabetic working-age adults.

A quasi-experimental two-group pretest-posttest study enrolled 40 pre-diabetic adults aged 35–59 years, allocated to an experimental (n = 20) and a control group (n = 20) by village-level cluster allocation (not individual randomization). The experimental group received a 20-week six-pillar program; the control group received usual care. Data were analyzed using descriptive statistics, paired t-test, and independent t-test, with Shapiro-Wilk normality testing and Cohen's d effect sizes.

Post-intervention, the experimental group's knowledge rose from 11.25 to 17.45,
self-efficacy from 62.35 to 98.75, preventive behavior from 74.25 to 128.45, and FPG fell from 112.45 to 98.35 mg/dL. After the intervention the experimental group scored significantly higher than the control group on all measures and had significantly lower FPG (p < .001).
In total, 85.0% returned to normal FPG.

The program appears to improve knowledge, self-efficacy, preventive behavior, and FPG. Given the small sample and quasi-experimental design, findings should be interpreted cautiously and confirmed in larger studies before scale-up.

Development of a care system for diabetic patients in Chiang Khan Hospital, Loei Province

2026-05-22T14:09:21+07:00

Type 2 diabetes is a major public health problem; in Chiang Khan District only 21.85% of patients achieved good glycemic control, reflecting a service-delivery gap requiring improvement.

Objectives to (1) develop a diabetes care system at Chiang Khan Hospital and
(2) examine its effects.

Action research following the PAOR cycle (planning, action, observation, reflection)
of Kemmis and McTaggart, in two phases: a development phase (qualitative data analyzed by content analysis) and an evaluation phase with 53 purposively selected type-2 diabetes patients. Activities ran for 12 weeks (monthly group sessions, 3 in total) with multidisciplinary follow-up. Data were analyzed using descriptive statistics and paired t-test.

A care system comprising five key activities was developed. After implementation, mean knowledge rose from 6.38 to 9.15 (p < .001, Cohen's d = 2.19), self-care behavior from 65.69 to 67.23 (p = .003, d = 0.42), and HbA1c decreased from 9.73% to 8.61% (p < .001,
d = 0.86). Twelve participants (22.64%) reached HbA1c below 7%. Satisfaction was at the highest level (M = 4.73).

The developed care system enhanced patients' knowledge, self-care behaviors, and clinical outcomes, and should be applied in primary care and community hospitals with similar contexts, together with continuous follow-up.

The Effects of a Self-Management Support Program via Social Media on Quality of Life of Type 2 Diabetes Patients with Comorbid Chronic Kidney Disease

2026-05-22T14:24:26+07:00

This study employed a quasi-experimental, single-group pre- and post-test design to examine the effectiveness of a social media-based self-management support program on the quality of life among patients with type 2 diabetes and comorbid chronic kidney disease.
A total of 45 participants completed the 12-week program, and their quality of life was evaluated using the Thai version of the WHOQOL-BREF questionnaire across four dimensions: physical, psychological, social relationships, and environment.

The findings demonstrated a statistically significant improvement in overall quality of life following program participation. The mean total score increased from 65.29 ± 12.50 to 82.11 ± 15.10 (Mean difference = 16.82, t = 17.611, p < 0.001), representing a shift from
a moderate to a good level of quality of life.

Analysis across individual dimensions revealed statistically significant improvements in all four areas (p < 0.001). The physical dimension improved from 19.56 ± 4.09 to 24.47 ± 4.69 (t = 16.304), reflecting enhanced pain management, daily functioning, and sleep quality. The psychological dimension increased from 15.27 ± 3.77 to 19.42 ± 4.40 (t = 12.469), indicating reduced anxiety and depression alongside greater self-esteem. The social relationships dimension rose from 8.51 ± 1.96 to 11.56 ± 2.44 (t = 14.789), suggesting stronger perceived support from family and friends. The environmental dimension improved from 21.96 ± 4.33 to 26.67 ± 5.43 (t = 13.070), reflecting a heightened sense of security, improved access to healthcare services, and greater satisfaction with living conditions.

These findings indicate that a social media-based self-management support program is an effective care model for patients with type 2 diabetes and chronic kidney disease, particularly in contexts where access to healthcare facilities is limited. The use of the Line OA application as a communication and health education platform demonstrates considerable potential and should be further promoted and integrated into broader healthcare delivery systems.

The Effectiveness of a Health Promotion Program on Perceived Self-efficacy, Outcome Expectation, and Self-care Behaviors among Adults with Metabolic Syndrome

2026-06-08T09:09:58+07:00

Metabolic syndrome is a major public health problem in Thailand and worldwide, closely associated with unhealthy lifestyle behaviors and increasing the risk of diabetes, hypertension, and cardiovascular disease. Enhancing perceived self-efficacy and outcome expectation may help individuals modify their health behaviors and self-care more effectively. This quasi-experimental study aimed to examine the effectiveness of a health promotion program on perceived self-efficacy, outcome expectation, self-care behaviors, and clinical outcomes among adults with metabolic syndrome in Nonghin District, Loei Province.

A two-group pretest–posttest design was employed. Participants were adults aged 25–59 years diagnosed with metabolic syndrome according to the NCEP ATP III criteria (at least 3 of 5 components). The sample size was determined using G*Power, yielding 42 participants per group (84 in total), allocated to an experimental group and a control group. The experimental group received a 12-week health promotion program developed from Bandura’s Self-efficacy Theory combined with the 3-Es-2-Ns health behavior modification principles (diet, exercise, emotional management, non-smoking, and non-alcohol use), while the control group received routine care. Data were collected using questionnaires with verified content validity (IOC = 1) and reliability (Cronbach’s alpha 0.84–0.90), together with clinical indicators including waist circumference, fasting blood glucose, and blood pressure. Data were analyzed using descriptive statistics, dependent t-test, and independent t-test, with effect sizes (Cohen’s d) and 95% confidence intervals reported.

After the intervention, the experimental group showed significantly higher scores of perceived self-efficacy, outcome expectation, and self-care behaviors than at baseline and than the control group (p < .05). Clinical outcomes in the experimental group improved significantly, with reductions in fasting blood glucose and in both systolic and diastolic blood pressure (p < .05), whereas waist circumference showed a decreasing trend that was not statistically significant (p = .483).

In conclusion, the health promotion program applying Bandura’s Self-efficacy Theory together with the 3-Es-2-Ns approach effectively enhanced perceived self-efficacy, outcome expectation, and self-care behaviors, and improved several clinical outcomes among adults with metabolic syndrome. The program can be applied in primary healthcare settings to promote self-care and prevent non-communicable diseases.

Effectiveness of a Telehomecare Program on Quality of Life of Homebound and Bedridden Elderly and Caregiver Stress in Phakhao Sub-district, Phakhao district, Loei Province

2026-06-04T11:13:25+07:00

Thailand is rapidly becoming an aged society, increasing the number of homebound and bedridden older adults, particularly in rural areas with limited access to healthcare, where family caregivers face substantial burden and stress. Telehomecare may improve healthcare access and quality of life while reducing caregiver stress.

To compare the effectiveness of a Telehomecare Program on quality of life of homebound and bedridden elderly (WHOQOL-OLD) and caregiver stress (ST-5), and to assess caregiver satisfaction.

A quasi-experimental two-group pretest-posttest design enrolled 58 homebound and bedridden elderly (ADL < 11) and 58 caregivers, allocated to intervention (n = 29) and control (n = 29) groups by probability proportional to size sampling. The intervention group received an 8-week Telehomecare Program via the LINE application; the control group received standard care. Data were analyzed using descriptive statistics, paired t-tests, and independent t-tests.

After the intervention, overall quality of life among elderly increased from 2.03 ± 0.99 to 3.13 ± 0.31 (t = -10.062, p < .001, d = 1.868) and exceeded the control group (3.13 vs 1.92, t = -23.416, p < .001). Caregiver stress decreased from 3.48 ± 0.63 to 2.54 ± 0.60 (t = 9.639,
p < .001, d = -1.790). Social Participation improved most (d = 3.182), followed by Death and Dying (d = 2.350); Sensory Abilities improved least (d = 0.490). Caregiver satisfaction was high (M = 4.302, SD = 0.831).

The Telehomecare Program significantly improved quality of life among homebound and bedridden elderly and reduced caregiver stress, supporting its integration into primary and community-based elderly care, particularly in rural settings.

Development of an Exercise Program for Fall Risk Reduction in Older Adults in Nong Bua Subdistrict, Phu Ruea District, Loei Province

2026-06-15T09:34:35+07:00

Falls are a significant public health problem and a leading cause of injury among the elderly. Multicomponent exercise is effective, but evidence in rural Thai community settings delivered by village health volunteers (VHVs) is lacking.

Objectives to develop, validate, and evaluate the effectiveness of a multicomponent exercise program for elderly at risk of falls.

This research and development study comprised three phases: situation analysis using secondary data; program development through a focus group with 8 experts and pilot testing; and evaluation using a one-group pretest-posttest design. Participants were 60 community-dwelling elderly aged 60 years and over at risk of falls (a fall in the past 12 months, or Thai FRAT ≥ 4, or FES-I ≥ 23), able to ambulate, selected by multi-stage sampling. The program comprised balance, strength, flexibility, and functional mobility training, three times per week for 24 weeks, delivered by VHVs. Data were analyzed using paired t-test with 95% CI and Cohen's d.

After the program, the fall rate decreased from 1.13±0.97 to 0.47±0.68 falls/person/
6 months (p = .001, d = 0.79), a 58.4% reduction. Thai FRAT decreased from 6.87±2.34 to 4.13±1.87 (p < .001, d = 1.29). Leg strength (30-Second Chair Stand) increased from 10.23±2.47 to 13.87±2.31 (p < .001, d = 1.52). Static balance (Single-leg Stance) improved from 8.47±4.83 to 16.23±6.51 s
(p < .001, d = 1.35). Functional balance (TUG) improved from 15.82±3.64 to 11.93±2.47 s (p < .001,
d = 1.25).

The program shows promise for reducing fall risk and incidence and improving physical fitness among rural community-dwelling elderly. As there was no control group, causal inference is limited and randomized controlled trials are recommended.

Development of a Participatory Road Safety Management Model for Secondary School Students in Chumphon Buri, Surin Province

2026-06-15T09:09:03+07:00

Road traffic injuries are a major problem among youth; Chumphon Buri District has the highest road-fatality rate in Surin Province, while local management lacks integrated network collaboration.

To examine the situation and roles of alliance networks, develop a participatory road safety management model, and evaluate its effectiveness.

This research and development study was conducted in Chumphon Buri Sub-district, Surin Province (August–December 2025). The qualitative sample comprised 15 alliance-network stakeholders selected purposively and analyzed by content analysis; the quantitative sample comprised 143 secondary-school students who commuted by motorcycle (Krejcie & Morgan, 1970), selected by simple random sampling. Instruments measured road safety knowledge (KR-20 = 0.79), attitudes (α = 0.82), and behaviors (α = 0.88). The model was implemented over eight weeks and analyzed using paired t-test.

The "CP-Strong Model", anchored by a four-station "TSY Camp", was developed. After the intervention, mean scores increased significantly in all dimensions: knowledge from 14.82 (SD = 3.01) to 16.41 (SD = 2.21); attitudes from 30.37 (SD = 7.36) to 34.09 (SD = 6.78); and behaviors from 33.23 (SD = 3.32) to 35.80 (SD = 2.76) (p < .001).

The CP-Strong Model effectively enhanced students' road safety knowledge, attitudes, and behaviors, and holds strong potential for replication in rural areas with similar contexts.

Development of an Ergonomic Problem-Solving Model to Prevent Work-Related Injuries Among Professionals in Workplaces in Loei Province

2026-06-08T09:23:06+07:00

Work-related musculoskeletal disorders (MSDs) are a major health problem among workers, especially in jobs involving prolonged standing and repetitive postures.

The objectives to investigate MSD situations, develop an ergonomic problem-solving model, and evaluate its outcomes among workers in Loei Province.

This research and development study comprised four stages: situation analysis, model development, implementation, and evaluation. As a preliminary validation of the model, the implementation stage used a one-group pretest-posttest quasi-experimental design with a purposive sample of 21 employees in a selected establishment, over three months (October–December 2025). The model's core component was a 10-posture muscle-stretching program using a traditional Thai cloth (Phakhaoma), combined with ergonomics training, participatory leadership, and weekly supervision. Data were analyzed using descriptive statistics and paired t-test.

All workers (100%) reported MSD symptoms in the preceding 12 months, most commonly in the shoulder (42.86%). After the program, workers meeting the knowledge criterion rose from 4.76% to 80.95% (t = 8.519); mean muscle-fatigue score (NRS) decreased from 2.19 to 1.09 (t = 4.914); and good-to-excellent physical fitness increased from 42.86% to 95.24% (t = 3.988). All outcomes were statistically significant (p < .001), and 90.48% reported high-to-highest satisfaction.

The Phakhaoma-based ergonomic model appears to improve knowledge, reduce fatigue, enhance physical fitness, and achieve high satisfaction, and is culturally appropriate. As these are preliminary findings, larger-scale confirmation is warranted before wide application.