JOURNAL OF LOEI PROVINCIAL PUBLIC HEALTH OFFICE

An analysis of service accessibility for diabetes risk groups in community primary health centers, Loei Province

Sathaporn Sathaporn — 2026-03-31

Diabetes is a significant public health problem with increasing prevalence in Thailand. This cross-sectional analytical study aimed to analyze service accessibility among diabetes risk groups in Community Primary Health Centers in Loei Province. The study examined accessibility situations, influencing factors, barriers and limitations, and proposed service improvement guidelines. The study population consisted of 25,982 individuals at risk of diabetes from 142 community health centers in Loei Province during fiscal year 2568 (October 1, 2024 - September 30, 2025). Data were collected from secondary databases including patient registries and health service databases through approved access procedures. Descriptive statistics and logistic regression analysis were used for data analysis.
Results revealed that 81.11% of the risk group accessed screening services, primarily through village health volunteer appointments (84.72%). Factors significantly influencing service accessibility included education level (OR=8.54), distance less than 5 kilometers (OR=3.50), age 55 years or older (OR=0.16), convenient transportation (OR=1.37), adequate personnel (OR=1.33), and service hours (OR=1.25). Major barriers from the user perspective included long distance (46.08%), work obligations (41.92%), and insufficient personnel (43.34%). From the provider perspective, limitations included excessive workload (11 of 15 providers), limited budget (all 15 providers), and outdated equipment (15 of 15 providers).
In conclusion, although the majority (81.11%) of the diabetes risk group accessed screening services, approximately 18.89% (which exceeds the national target of 10% non-accessibility) still lacked access. Service development should focus on expanding mobile outreach services, increasing resources, developing integrated data systems, and promoting community participation to ensure comprehensive and efficient service accessibility for diabetes risk groups. Further qualitative research is recommended to understand barriers in depth and conduct long-term follow-up studies on service accessibility outcomes.

Factors Associated with Successful Treatment Outcomes among Drug Addicts in the Drug Rehabilitation Clinic of Ban Miang Sub-district Health Promoting Hospital

Namkang Sarasaen — 2026-03-31

This cross-sectional survey research aimed to investigate factors associated with successful drug addiction treatment outcomes at the Drug Treatment Clinic, Ban Miang Sub-district Health Promoting Hospital, Tha Li District, Loei Province.
The study population consisted of 53 drug patients who received treatment during fiscal years 2021–2023. Research instruments included a personal information questionnaire, Social Support Questionnaire (SSQ-12), Family Assessment Device (FAD), Social Stigma Scale (SSDS), Helping Alliance Questionnaire (HAQ-II), and WHOQOL-BREF. Data were analyzed using descriptive statistics, Chi-square test, Pearson's correlation coefficient, and Stepwise Multiple Regression Analysis.
The majority of participants were male (77.36%), with a mean age of 39.70 years (S.D. = 9.47), primary education level (54.72%), temporary employment (58.49%), methamphetamine as the primary substance (98.11%), and 4–6 years of drug use duration (54.70%). Treatment completion rate was 88.70%, while the one-year relapse rate was 79.20%. Factors significantly associated with treatment completion (p<0.05) included employment status, duration of drug use, and treatment attendance consistency. Factors significantly associated with non-relapse within one year (p<0.05) were social support and family relationships. Multiple regression analysis revealed that employment status and family relationships predicted treatment completion, while social quality of life and family participation predicted one-year abstinence.
This study identified key factors associated with drug addiction treatment success in a primary care context, providing an evidence base for developing community-appropriate treatment models. Strengthening employment support, family involvement, and social networks are critical strategies for improving treatment outcomes and reducing relapse rates in sub-district health promoting hospitals.

Development of a health promotion program for patients with Uncontrolled Type 2 Diabetes at Phurua hospital

Supaphorn boonsriphoom — 2026-03-31

Diabetes mellitus is a major public health problem with a rapidly increasing prevalence worldwide and in Thailand. At Phurua Hospital, many patients with type 2 diabetes are unable to achieve optimal glycemic control, defined as glycated hemoglobin (HbA1c) levels ≥7%, which increases the risk of long-term complications. This quasi-experimental study aimed to develop and evaluate the effectiveness of a health promotion program for patients with uncontrolled type 2 diabetes at Phurua Hospital, Thailand. A one-group pretest–posttest design was employed. The sample consisted of 280 patients with HbA1c ≥7%, recruited through consecutive sampling between October 2023 and June 2024. The program was developed based on Pender’s Health Promotion Model and included multidisciplinary education, skill training, and continuous follow-up. Data were collected using a diabetes knowledge questionnaire, a self-management skills assessment, and laboratory HbA1c measurements. Descriptive statistics and paired sample t-tests were used for analysis.
Results showed that diabetes knowledge significantly increased from 12.79 (SD = 2.66) to 17.97 (SD = 0.86) (mean difference = 5.18, t = 31.88, p < 0.001). Self-management skills significantly improved across all domains (p < 0.001). Mean HbA1c significantly decreased from 8.72% (SD = 1.77) to 8.21% (SD = 1.66) (mean difference = −0.51, t = −5.95, p < 0.001).
The health promotion program effectively improved diabetes knowledge, self-management skills, and glycemic control among patients with uncontrolled type 2 diabetes. The program shows potential as a practical and sustainable model for diabetes care in community hospitals and primary healthcare settings.

Development of a Model Community for Unsafe Health Product Management: A Case Study of Wang Saphung Subdistrict, Wang Saphung District, Loei Province

sawitree songsilp — 2026-03-31

Unsafe health products in communities pose a significant public health concern affecting the well-being of local populations. This study aimed to investigate the situation of unsafe health products in Wang Sapung Subdistrict, enhance the capacity of community leaders and networks for surveillance, and evaluate outcomes of the model community development for managing unsafe health products.
Methods: This action research was conducted in three phases. Phase 1 involved situational assessment and participatory data feedback using the Community Drug and Health Product Surveillance System (G-RDU & G-SHP) combined with the Appreciative Inquiry and Community (AIC) process among 25 members of the Bor-Wor-Ror-Ror network. Phase 2 focused on network capacity building and community measure development, involving 70 community leaders, 120 FDA Junior student leaders, 100 elderly individuals, and 60 grocery store operators. Phase 3 comprised outcome evaluation and lesson-learned sessions with 25 network members and 11 target grocery stores.
Results: Key community problems identified included polypharmacy drug set usage among the elderly, purchasing unsafe health products through online media, susceptibility to exaggerated advertising claims, insufficient knowledge of health product selection, overweight students, and grocery stores selling hazardous medicines. Four key interventions were implemented: knowledge-building training for communities and partner networks, development of health product surveillance leader networks, establishment of community measures through a Memorandum of Understanding (MOU) and a complaint center, and regulatory oversight of community retail outlets. Following the intervention, grocery stores meeting G-RDU criteria increased from 1 store (9.1%) to 10 stores (90.9%).
Conclusion: A model community approach that engages all sectors in problem identification and management demonstrates effective and sustainable resolution of unsafe health product issues within communities.

The Development of Information Management Process for Nursing Quality Indicators for Nursing Organization at Nonghin Hospital, Loei Province

Ruttikorn Mulkruakum — 2026-03-31

Information management for nursing quality indicators is essential for healthcare administration and quality improvement. However, many community hospitals face challenges in systematic data collection, analysis, and reporting processes, directly affecting administrative decision-making and patient safety. The objective to develop an information management process for nursing quality indicators and evaluate its outcomes at Nonghin Hospital Nursing Organization, Loei Province.
This research and development study was conducted from October 2024 to May 2025, involving 28 nursing staff members selected by purposive sampling.

The study employed the PDCA (Plan-Do-Check-Act) cycle and AIC (Awareness-Interest-Commitment) process. Research instruments included: (1) practice activity questionnaire (KR-20 reliability = 0.72), (2) quality assessment form (KR-20 reliability = 0.78), and (3) information management manual covering 9 nursing quality indicators. Data were analyzed using descriptive statistics and Wilcoxon signed-rank test.
The developed information management process consisted of five steps: data acquisition, data collection, data storage, data processing, and data dissemination. After six months of implementation, the quality of information management significantly improved from moderate level (mean = 11.2, SD = 2.6) to high level (mean = 19.4, SD = 1.2) (Z = −4.63, p < 0.001). Staff practice scores also increased significantly from moderate (mean = 10.8, SD = 2.4) to high level (mean = 18.6, SD = 1.8) (Z = −4.62, p < 0.001).
The developed information management process using the PDCA cycle with AIC process effectively improved nursing quality indicator management, resulting in reliable data for administrative decision-making and quality enhancement.

Development and Evaluation of a Yoga Training Program on Five-Dimensional Happiness in Elderly Individuals in Phu Rua Municipality

Jeeranun Yingyongwathanakit — 2026-03-31

Globally and in Thailand, population aging has become a prominent demographic transition. Elderly residents in Phu Rua Municipality, Loei Province, experience substantial health burdens related to chronic non-communicable diseases and psychosocial problems. Yoga is recognized as an appropriate holistic exercise for the elderly; however, limited research has examined its effects on multidimensional well-being in rural community settings. This study aimed to (1) develop a yoga program tailored for rural community-dwelling elderly, and (2) evaluate its effectiveness on the Five Dimensions of Happiness: Physical Comfort (Suk Sabai), Joy (Suk Sanuk), Dignity (Suk Sa-nga), Wisdom (Suk Sawang), and Serenity (Suk Sa-ngob).

This study employed a Research and Development (R&D) design in two phases. Phase 1 involved developing the yoga program through collaboration with a panel of 10 experts. Phase 2 used a quasi-experimental design with a pretest-posttest control group. A total of 82 elderly participants were randomly allocated into an experimental group (n = 41) and a control group (n = 41). The experimental group participated in a 12-week yoga program (once weekly supervised plus 3-4 home sessions). Outcomes were assessed using standardized measures of physical fitness, quality of life (WHOQOL-BREF-THAI), self-esteem (Rosenberg Self-Esteem Scale), cognitive function (TMSE), and mental health (Thai Mental Health Index). Data were analyzed using descriptive statistics and Analysis of Covariance (ANCOVA), adjusting for pre-test scores as covariates.

The experimental group demonstrated significantly higher post-test scores across all five dimensions of happiness compared with the control group after adjusting for pre-test scores (p < .001 for all measures). Physical fitness indicators (Back Scratch, Chair Stand Test, Agility Course, Step Up and Down), quality of life, self-esteem, cognitive function, and mental health index scores were all significantly superior in the experimental group. Effect sizes ranged from large to very large (Partial η² = .462-.972).

The developed yoga program is an effective intervention for enhancing holistic well-being among community-dwelling elderly and supports the promotion of active aging in rural settings.

An Evaluation of the Implementation of the Three Doctors Policy in Primary Care Units in Trat Province

Jirayut Prasittinawa — 2026-03-31

This cross-sectional descriptive research aimed to evaluate the effectiveness of the Three-Doctor (3 หมอ) Policy implementation in primary care units in Trat Province, to identify success factors, barriers, and to propose developmental guidelines. The study employed a quantitative approach using structured questionnaires. The sample consisted of 460 health personnel across three groups, selected using disproportionate stratified sampling to ensure adequate representation: Doctor 1 (Village Health Volunteers; n=372), Doctor 2 (Public Health Officers; n=70), and Doctor 3 (Family Medicine Physicians; n=18), along with 430 service recipients selected through multi-stage sampling calculated using Taro Yamane formula for personnel and Cochran's formula for citizens. Data were collected using two structured questionnaires validated by three experts, with Cronbach's alpha coefficients ranging from 0.87 to 0.93. Data were analyzed using descriptive statistics, one-way ANOVA with Tukey's HSD post-hoc test, Pearson correlation, and multiple regression analysis.
The results revealed that overall implementation effectiveness was at a high level. All personnel groups demonstrated high levels of policy knowledge (Mean = 3.85–4.03) and operational performance (Mean = 3.76–4.21), with Doctor 3 scoring highest. Operational performance differed significantly among the three groups (F = 3.672, p = 0.026), confirmed by Tukey's HSD showing Doctor 3 significantly higher than Doctor 2 (p = 0.019). Policy knowledge did not differ significantly (F = 1.318, p = 0.268). Knowledge showed a strong positive correlation with performance (r = 0.658, p < 0.01). The factor most influencing citizen satisfaction was the service quality of Doctor 3 (Beta = 0.321), with all predictors explaining 68.7% of satisfaction variance (R² = 0.687; VIF range = 1.32–2.18). Citizens reported high levels of policy awareness (Mean = 3.72) and satisfaction (Mean = 4.07). Primary barriers included excessive workload (38.2–66.7%), resource deficiency—particularly among Doctor 3 (77.8%)—and the lack of an integrated health information system (61.1%).
Recommendations include developing an integrated electronic health information system, reallocating personnel and resources commensurate with workload, and enhancing digital literacy training for elderly Village Health Volunteers.

Development of Service Model for Uncontrolled Hypertension Clinic at Outpatient Department, Phu Ruea Hospital, Loei Province

Buarisakorn Saenta — 2026-03-31

Hypertension is a major public health problem. Phu Ruea Hospital found that only 33.2% of patients could control blood pressure to target levels, lower than the Ministry of Public Health’s goal of 50%. Objectives: To study situation and factors affecting hypertension control, develop an effective service model, and evaluate effectiveness of the developed model. Methodology: This research and development study used a one-group pretest-posttest design. Samples were 72 uncontrolled hypertension patients at Phu Ruea Hospital outpatient department, selected by systematic random sampling from 819 eligible patients. Data were collected using questionnaires on knowledge (KR-20=0.91) and self-care behavior (Cronbach’s α=0.88), and standardized blood pressure measurements. Data were analyzed using descriptive statistics, paired t-test, McNemar’s test, and Cohen’s d effect size.
Results: The developed model was “3-Phase Integrated Hypertension Care Model” consisting of: Phase 1-Screening, assessment and care planning; Phase 2-Intensive care and monitoring; Phase 3-Evaluation and plan adjustment. After 12-week implementation, knowledge scores increased from 10.8±3.6 to 17.2±2.1 (mean difference=6.4, 95%CI: 5.7-7.1, Cohen’s d=2.17, p<0.001), self-care behavior scores increased from 72.4±18.2 to 116.8±14.6 (mean difference=44.4, 95%CI: 39.2-49.6, Cohen’s d=2.69, p<0.001), systolic blood pressure decreased from 156.8±12.4 to 132.6±8.2 mmHg (mean difference=-24.2, 95%CI: -26.3 to -22.1, Cohen’s d=2.31, p<0.001), and diastolic blood pressure decreased from 96.2±8.6 to 82.4±6.4 mmHg (mean difference=-13.8, 95%CI: -15.3 to -12.3, Cohen’s d=1.82, p<0.001). Blood pressure control rate increased from 0% to 80.6% (p<0.001). All 72 participants completed the study with no dropout.
Conclusion: The 3-Phase Integrated Hypertension Care Model demonstrated significant effectiveness in improving hypertension management outcomes. However, interpretation should consider the absence of a control group and potential regression to the mean effects. This model can be adapted for use in other community hospitals with similar contexts.

Development of an Integrated Proactive Health Promotion Model for Reducing Adverse Infant Outcomes Associated with Maternal Methamphetamine Use during Pregnancy at Chiangkhan Hospital, Loei Province

Anchalee Hongsa — 2026-03-31

Methamphetamine use among pregnant women in Chiangkhan District, Loei Province a Thai-Lao border area was 3.78%, exceeding the national average, resulting in high rates of preterm birth (42.59%), low birth weight (51.85%), and neonatal abstinence syndrome (NAS; 35.19%). This study aimed to develop and evaluate an integrated proactive health promotion model for reducing adverse infant outcomes. A quasi-experimental study with retrospective historical control, based on the research and development framework of Borg and Gall integrated with the PDSA cycle, was conducted over 24 months (July 2023–July 2025) in four phases: situation analysis using mixed methods (n=37), model development validated by five experts (IOC=0.89), quasi-experimental implementation comparing retrospective historical controls (n=54) and prospective intervention group (n=35), and model evaluation. Data were analyzed using SPSS version 26.0.
The CHIANGKHAN MODEL (5 components: C-H-I-A-N) significantly improved outcomes. Quality ANC increased from 48.15% to 77.14% (OR=3.63, p=0.005); continuous substance use decreased from 44.44% to 14.29% (OR=0.21, p=0.002). Preterm birth declined from 42.59% to 20.00% (Adjusted OR=0.29, p=0.017; NNT=4.4); birth weight increased by 329 grams (d=0.68); and Finnegan scores decreased from 8.47 to 5.83 (d=0.97). Hospital stay was reduced by 3.1 days and treatment costs decreased by 17,340 baht per case. Multiple testing correction using the Benjamini-Hochberg false discovery rate method confirmed significance in 11 of 12 outcomes (91.7%), demonstrating robust findings. Appropriateness (x̄=4.23), feasibility (x̄=4.18), and satisfaction (x̄=4.35) were rated at high or highest levels.
The CHIANGKHAN MODEL demonstrated statistically and clinically significant effectiveness with moderate-to-large effect sizes (d=0.52–1.21), robust to multiple testing corrections, and suitable as a clinical practice guideline for community hospitals in border areas.

Development of Pressure Injury Prevention Guidelines for Elderly Intubated Patients in Internal Medicine Ward 2, Female Geriatric Unit, Loei Hospital

Warisara Dawongsa — 2026-03-31

Pressure injuries (PIs) are a critical patient safety concern among older adults in intermediate care units. Intubated patients face a 2.5–3.5-fold higher risk than general ward patients. Ward-level surveillance data (2023) revealed a PI incidence of 3.67% (15/409 admissions), exceeding the Healthcare Accreditation Institute (HA) benchmark (≤2.0%), with 26.7% incidence among high-risk eligible patients. This study aimed to develop and evaluate an evidence-based PI prevention guideline for elderly intubated patients. Methods A participatory action research (PAR) design guided by Kemmis and McTaggart's (2005) framework was employed, with four iterative cycles from October 2023 to July 2024 in a 33 bed intermediate care unit, Loei Hospital, Thailand. Participants included 20 registered nurses and 42 unique elderly female intubated patients (15 at baseline; 27 post-intervention unique patients, yielding 59 patient-cycle observations). Ethics approval was obtained from the Human Research Ethics Committee, Loei Hospital (No. [xxx/2566]). Seven instruments were validated (CVI ≥ 0.83; Cronbach's alpha = 0.92; inter-rater agreement = 92.6%). Data were analyzed using descriptive statistics, Fisher's Exact Test (α = 0.05), and qualitative content analysis.
The finalized guideline comprised seven core components. PI incidence decreased significantly from 26.7% (4/15; 95% CI: 7.8–55.1%) at baseline to 0% in cycles 3–4 (0/37; 95% CI: 0–9.5%) (p = 0.005). Guideline adherence reached 93.5–98.4% in cycle 4. Nurses reported the highest satisfaction (mean = 4.68/5.0, SD = 0.32; 100% response rate). Qualitative analysis identified four key learning themes — documentation burden, repositioning technique, nutrition coordination, and MDRPI awareness — that guided iterative guideline refinement.
PAR enabled development of a contextually appropriate, evidence-based guideline achieving zero PI incidence in high-risk patients. The guideline demonstrates transferability to similar intermediate care contexts with appropriate local adaptation.

The Effect of the mission transfer from Chaloem Phrakiat 60th Anniversary Nawaminthrachini Health Station and Subdistrict Health Promoting Hospital to provincial administrative organization in Thailand.

Boonma Soontaraviratana — 2026-03-31

This mixed-methods study aimed to examine the impacts on the public and health personnel resulting from the transfer of responsibilities for the Chalermphrakiat 60^th Anniversary Her Majesty the Queen’s Health Stations and Subdistrict Health Promoting Hospitals to Provincial Administrative Organizations in Thailand. The study was conducted between July and September 2023. Data were analyzed using descriptive statistics and content analysis.
The findings were: (1) Among service users, no quantitative differences were found in health services before and after the transfer across all measured items; however, qualitative data reflected a decline in some primary care services, such as chronic disease clinics and dental services. (2) For health personnel, the overall impact score was 3.65/5 (SD = 0.655). The mean satisfaction relative to personnel expectations was 3.44/5 (SD = 0.651). Qualitative findings indicated that drivers of the transfer included low morale regarding career advancement and budgeting processes that require routing through contracted main service units, which posed significant obstacles. Initial impacts included an imbalance between the number of staff and the transferred service units, and barriers arising from laws, regulations, rules, and memorandum of cooperation agreements.
Preparedness prior to transfer specifically clear regulations, procedures, memoranda of cooperation, and ensuring a balance between the number of transferred service units and the number of transferred health personnel is necessary to mitigate negative impacts on both service providers and service recipients.