JOURNAL OF LOEI PROVINCIAL PUBLIC HEALTH OFFICE

Endodontic Management of a Maxillary First Molar with a Separated Instrument and a Second Mesiobuccal Canal (MB2): A Case Report

2025-07-14T17:37:52+07:00

This report presents a case study of root canal treatment in an 18-year-old Thai female diagnosed with irreversible pulpitis with symptomatic apical periodontitis in the maxillary left first molar (#26). The treatment was complicated by the presence of a fourth canal (MB2 canal) and a separated instrument located in the middle third of the mesiobuccal (MB) canal. A staging platform technique combined with ultrasonic tips was employed to manage the separated instrument. The decision was made to discontinue retrieval efforts when the risk of root perforation became significant. The canal was subsequently cleaned, shaped, and obturated up to the level of the separated instrument. The previously undetected MB2 canal was located and treated during the procedure. The patient remained asymptomatic during the 6-month follow-up period, and radiographic evaluation showed no signs of additional periapical pathology, indicating a successful outcome. This case highlights the importance of appropriate treatment planning, sound clinical decision-making, and effective infection control in achieving successful root canal treatment, even in anatomically complex cases with procedural complications such as instrument separation.

The Effectiveness of Household Waste Management about The 5Rs Program in Kud Pong Sub-District, Muang Loei District, Loei Province.

2025-07-14T17:50:39+07:00

This quasi-experimental research aimed to compare household waste management knowledge and behavior among residents of Kud Pong Subdistrict, Mueang Loei District,
Loei Province, before and after participating in a household waste management program based on the 5Rs principles: Reduce, Reuse, Recycle, Repair, and Reject. The study sample consisted of 50 residents of Kud Pong Subdistrict. Data were collected using a single-group pretest-posttest design with general information questionnaires, knowledge tests, and behavior questionnaires on household waste management. The data collection period was from August 1, 2024, to January 31, 2025.

The results showed that the mean knowledge score before the intervention was low ( = 9.16, S.D. = 2.60) and significantly improved to a high level after the intervention ( = 16.90, S.D. = 1.74) at a statistical significance level of 0.05 (t = -26.85, p-value < 0.001). Regarding waste management behavior, the mean score was good both before ( = 70.28, S.D. = 5.12) and after the intervention ( = 81.20, S.D. = 6.92), with a statistically significant improvement at the 0.05 level (t = -11.50, p-value < 0.001). However, knowledge about types of waste and the behavior of avoiding items that cause pollution (Reject) were identified as the areas with the lowest scores.

Therefore, relevant agencies can adapt the household waste management program based on the 5Rs principles for use in areas with similar contexts to enhance public knowledge and promote appropriate behavior for sustainable waste management.

Effectiveness of Promoting Safe Health Behaviors to Prevent Pesticide Exposure in Kokdu Sub-district, Mueang Loei District, Loei Province

2025-07-15T10:44:30+07:00

This quasi-experimental research aimed to study the effects of applying Protection Motivation Theory to promote safe practices against pesticide exposure among farmers in the Kokdu sub-district of Mueang Loei District, Loei Province. The sample consisted of 57 farmers with unsafe blood cholinesterase enzyme levels, who participated in a four-week intervention based on Protection Motivation Theory. Data collection tools included questionnaires assessing Protection Motivation Theory, protective behaviors regarding pesticide use, and blood cholinesterase levels. The instrument quality was confirmed with an Item Objective Congruence Index (IOC) of over 0.5 for all items, resulting in an overall IOC of 0.86 and a Cronbach's alpha reliability coefficient of 0.92. Data were analyzed using descriptive statistics, including numbers, percentages, means, and standard deviations and inferential statistics included Dependent t-test.

The results revealed that the majority of participants were male (68.42%), with a mean age of 46.84 years (range: 23-60 years). Most participants were aged 31-40 years (36.84%), married (50.88%), completed lower secondary education (40.35%), and had 6-10 years of pesticide use experience (33.33%). Pre-intervention, all participants exhibited unsafe blood cholinesterase levels, while post-intervention, 35.09% remained at unsafe levels. Prior to the intervention, Protective behaviors before the intervention were at a moderate level ( = 58.32, SD. = 10.29) and significantly improved to a high level afterward ( = 77.28, SD. = 9.64), reflecting a statistically significant increase (t=24.65, p<0.01). These findings suggest that the health promotion program can be effectively applied to modify pesticide protective behaviors, leading to sustainable behavioral changes through improved awareness and practice.

The Delelopment of Health Promotion Models by body balancing movement for fall prevention in Dansai Crown Prince Hospital Elderly Clinic, Dansai District, Loei Province

2025-07-16T10:04:24+07:00

This study aimed to 1) develop a health promotion model using body balance exercises to prevent falls among elderly in the Geriatric Clinic at Somdej Phra Yupparaj Dan Sai Hospital, Dan Sai District, Loei Province, and 2) evaluate the outcomes of the model on behavior changes of participating elderly. Methods: A mixed-methods research and development design was employed, consisting of three phases over 12 months:
1) situational analysis, 2) model design and development, and 3) model implementation and evaluation. Data were collected from a multidisciplinary team (n=5), elderly (n=20), and caregivers (n=20) at the Geriatric Clinic through interviews, focus group discussions, and assessments.

The existing service model at the Geriatric Clinic included a multidisciplinary team providing individual assessments and advice. However, there was a lack of clear objectives to guide the screening of at-risk groups and shape the clinic's service model. After reviewing the process, the objective was revised to promote fall prevention among the elderly. The developed model comprised a comprehensive fall risk assessment system and a physical therapy program tailored to the elderly in Dan Sai District, utilizing the PDCA process for continuous improvement. Following the model's implementation, the elderly demonstrated improved balance and stability, reduced fall frequency, and the healthcare team expressed satisfaction with the model.

The model, developed through participatory processes and multidisciplinary collaboration while considering the specific context of Dan Sai District, appears to be effective in promoting health and preventing falls among the elderly living in this community. However, sustainable implementation requires cooperation from various local sectors in Dan Sai to manage the determinants of elderly health in an integrated manner. Further studies on factors influencing long-term effectiveness and applicability in other contexts within Loei Province are recommended.

The Development of a care model for stroke patients admitted to inpatient wards with family participation at Pak Chom Hospital, Loei Province

2025-07-16T10:13:34+07:00

This study aimed to develop a care model for stroke patients hospitalized in the inpatient ward through family participation at Pak Chom Hospital, Loei Province. It wasa participatory action research with purposive sampling. The sample consisted of 32 healthcare professionals working with stroke patients and 34 family members of stroke patients hospitalized in the inpatient ward. Data were analyzed using descriptive statistics, Paired t-test, and content analysis for qualitative data.

Research findings revealed that after developing the patient care model: 1) Satisfaction among healthcare professionals and patient families was at the highest level, with mean scores of 4.26 and 4.47, respectively. 2) Family participation was high (Mean=4.51, SD=0.11), with the most prominent forms of participation being: decision-making about patient care (100%), direct patient care activities such as body cleaning, positioning, feeding, and physiotherapy (94.12%), and demonstrating correct and safe activity performance (91.18%). The research results indicate that the developed care model can effectively promote family participation in stroke patient care.

Research recommendations suggest conducting further studies on knowledge of stroke patient care in inpatient wards and adherence to stroke patient care guidelines.

The Development of Psychiatric Medication Monitoring System in Schizophrenia Patients, Chiang Khan Hospital.

2025-07-16T10:20:15+07:00

This research employed a mixed-methods approach, utilizing both quantitative and qualitative methodologies, conducted in three phases: 1) a situational analysis, 2) the design and development of a psychiatric medication monitoring system for schizophrenia patients, and 3) an evaluation of the system's effectiveness. The objective was to develop a psychiatric medication monitoring system for schizophrenia patients at Chiang Khan Hospital. Purposive sampling was used to select 1) 30 individuals comprising 15 psychiatric staff from sub-district health promotion hospitals and 15 village health volunteers, 2) 30 family members of schizophrenia patients, and 3) 30 schizophrenia patients. Data collection tools included
1) focus group discussions to examine problems, models, needs, and goals in psychiatric clinics, 2) focus group discussions to assess the appropriateness and problems of the monitoring system, 3) the Medication Adherence Scale for Thais©, and 4) an overall capability assessment. Data were analyzed using content analysis, percentage, mean, standard deviation, and paired t-tests.

The results showed that 1) The mean medication adherence score before and after implementing the system was 26.23 (SD = 3.65) and 35.87 (SD = 2.65), respectively, with
a statistically significant difference (p < 0.05). 2) The mean overall capability score before and after implementation was 55.03 (SD = 5.27) and 82.78 (SD = 9.32), respectively, with
a statistically significant difference (p < 0.05). These findings suggest that the developed system can effectively enhance medication adherence and help patients better manage their psychiatric symptoms. Therefore, it is recommended that the system be adapted to local contexts and that patient records be integrated into an online system to improve service quality and patient monitoring.

Development of Diabetes Care System to Reduce Hemoglobin A1C Levels in Diabetes Clinic, Dansai Crown Prince Hospital, Loei Province

2025-07-16T10:35:46+07:00

This study aimed to develop and evaluate a diabetes care system to reduce hemoglobin A1C (HbA1C) levels at the diabetes clinic of Dansai Crown Prince Hospital, Loei Province. An action research methodology was employed over 6 months from April to September 2024, utilizing the Expanded Chronic Care Model (ECCM) with three components: self-care support, delivery system design, and clinical information systems. The study sample comprised 11 multidisciplinary healthcare team members and 208 diabetic patients with HbA1C levels ≥ 8%, selected through purposive sampling. Research instruments included questionnaires on diabetes knowledge and behavioral modification, and satisfaction assessment questionnaire. Content validity indices were 0.92 and 0.93, with reliability coefficients of 0.95 and 0.91, respectively. Data were analyzed using means and standard deviations.

Results showed that following implementation of the care system, patients achieved a mean knowledge score of 17.97 (SD=4.85), classified as high level, increased from 12.56 (SD=5.23). Mean behavioral score was 9.94 (SD=3.46), classified as high level, increased from 4.54 (SD=2.23). Mean HbA1C level was 6.87% (SD=0.57), significantly decreased from pre-implementation level of 8.76% (SD=0.76). Although still classified as uncontrolled, the 1.89% reduction was clinically significant. Overall satisfaction with the system was at the highest level (mean=4.63, SD=0.13).

Recommendations include broader implementation of the system with adaptations to fit individual hospital contexts to enhance flexibility and effectiveness. Study limitations include absence of a control group, short follow-up period of 6 months, and purposive sampling method.

Development of a Community-Based Care Model for Chronic Psychiatric Patients in Phu Ruea District, Loei Province, Thailand

2025-07-16T10:45:25+07:00

Community-based mental health care remains inadequate in rural Thailand, with psychiatric patients experiencing poor medication adherence, inadequate family support, and community stigma. Current hospital-centered care models fail to address comprehensive community needs for chronic psychiatric patients.

To develop and evaluate the effectiveness of a community-based care model for chronic psychiatric patients in Phu Ruea District, Loei Province, Thailand.

This research and development study employed a four-phase approach conducted from May 2024 to May 2025. Phase 1 involved problem assessment through home visits and in-depth interviews with 194 psychiatric patients and 30 stakeholders. Phase 2 utilized focus group discussions with 37 multidisciplinary team members to develop the care model. Phase 3 implemented a pilot study with 30 patients followed by full-scale implementation with 58 chronic psychiatric patients and their caregivers for three months. Phase 4 evaluated outcomes using standardized instruments including the Brief Psychiatric Rating Scale (BPRS), Global Assessment of Functioning (GAF) Scale, and WHO Quality of Life Brief Thai Version (WHOQOL-BREF-THAI). Data were analyzed using descriptive statistics and paired t-tests.

The developed model comprised four components: (1) establishing psychiatric care as a district priority through the District Health Board, (2) implementing a color-coded patient classification system for community follow-up, (3) conducting health education campaigns through online media and community broadcasting focusing on five warning signs, and (4) training caregivers and community members. Post-implementation evaluation showed significant improvements (p < 0.001): reduced psychiatric symptoms (mean difference = 14.24 points, t = 14.24), improved functional capacity (mean difference = 8.05 points, t = 7.83), enhanced quality of life (mean difference = 6.98 points, t = 7.26), and increased caregiver knowledge (mean difference = 13.99 points, t = 11.93).

The community-based care model significantly improved psychiatric symptoms, functional capacity, and quality of life among chronic psychiatric patients while enhancing caregiver knowledge and skills. This collaborative, multi-sectoral approach demonstrates potential for sustainable community mental health care in rural settings.

Development of a health promotion program for high risk pregnancy at Phurua Hospital

2025-07-16T10:55:15+07:00

Emergency deliveries among high-risk pregnant women at Phurua Hospital frequently resulted in neonatal hypoxia due to preterm births. The primary cause was delayed healthcare access attributed to pregnant women's lack of knowledge regarding warning signs requiring immediate medical attention.

To develop and evaluate the effectiveness of a health behavior promotion program for high-risk pregnant women by comparing knowledge and health behavior scores before and after program participation.

This research and development (R&D) study comprised two phases. Phase 1 involved program development by a multidisciplinary team. Phase 2 employed a quasi-experimental design with 45 high-risk pregnant women receiving antenatal care at Phurua Hospital from November 15, 2023, to March 31, 2024. The program consisted of two modules based on gestational age. Data were collected using validated knowledge and self-care skill assessment questionnaires (IOC = 1.00). Statistical analysis included descriptive statistics and paired t-tests.

After program participation, high-risk pregnant women demonstrated statistically significant improvements in knowledge and health behaviors across all domains. Knowledge scores increased from 13.26 (SD=3.38) to 15.67 (SD=1.96), p<0.001. All six health behavior dimensions - nutrition, physical activity, health responsibility, interpersonal relationships, stress management, and spiritual development - showed significant improvements (p<0.05 to p<0.001). Overall mean scores improved from 30.83 (SD=4.18) to 32.26 (SD=2.90), p=0.004.

The health behavior promotion program effectively enhanced knowledge and health behaviors among high-risk pregnant women. Integration into routine antenatal care services is recommended to prevent emergency delivery complications and improve maternal and neonatal health outcomes.