JOURNAL OF LOEI PROVINCIAL PUBLIC HEALTH OFFICE

Development of a Nursing Supervision Model for Intermediate Phase Patients in Loei Province

Numfon Sornsuphap — Tue, 30 Dec 2025 00:00:00 +0700

Loei province has one of the highest proportions of elderly people in Thailand, leading to a continuous increase in intermediate care patients. Statistics from the Loei Provincial Public Health Office from 2022 to 2024 show that the incidence of pressure ulcers in intermediate care patients increased from 3.9 percent to 13.8 percent. This research aimed to develop and study the effectiveness of a Nursing Supervision Model for Intermediate Care Patients in Loei province. The model integrates Whitmore's GROW Model with the Nursing Council's nursing supervision process and the Department of Medical Services' Intermediate Care Patient Rehabilitation Manual.This was a one-group pre-test-post-test quasi-experimental Research and Development (R&D) study, consisting of three phases: situation analysis, model development and implementation, and evaluation. The sample was purposively selected, consisting of 14 professional nurse supervisors and 20 supervisees from 14 hospitals in Loei province. Research instruments included a knowledge test, an attitude questionnaire, a satisfaction questionnaire, and quality indicator tracking forms. Data were analyzed using descriptive statistics and the Paired t-test.

The research findings revealed that the developed supervision model comprises three components: roles and qualifications of the supervisor, supervision operational procedures, and evaluation. Following the implementation of the model, the knowledge scores of the supervisors significantly increased from 10.36±4.03 to 22.43±5.93 (t=9.39, p<.001). Attitude scores significantly increased from 66.07±7.26 to 93.21±4.21 (t=-16.68, p<.001). The satisfaction levels of both supervisors and supervisees increased significantly (p<.05). Furthermore, the rate of pressure ulcer incidence decreased from 13.8 percent to 5.0 percent and 70 percent of patients had a Barthel Index score increase of at least 2 points.

The developed Nursing Supervision Model for Intermediate Care Patients is effective in enhancing knowledge, attitude, and satisfaction, as well as elevating the quality of patient care. It can be applied to other healthcare units with similar contexts.

A Study of Knowledge, Attitudes, and Social Support Factors Related to Exercise Behavior among Working-Age Population

Sirinapha Butdalu — Tue, 30 Dec 2025 00:00:00 +0700

This cross-sectional survey research aimed to examine levels of exercise knowledge, attitudes toward exercise, social support, and exercise behavior among working-age population; to investigate relationships between personal factors, knowledge, attitudes, social support, and exercise behavior; and to identify predictive factors of exercise behavior. The sample consisted of 340 working-age adults aged 18-59 years residing in the catchment area of Ban Miang Subdistrict Health Promoting Hospital, Tha Li District, Loei Province, selected using multi-stage random sampling. Data were collected using a questionnaire validated for content validity and reliability. Statistical analyses included descriptive statistics, Chi-square test, Pearson correlation coefficient, and stepwise multiple regression analysis.

The results revealed that the majority of participants were female (53.82%), aged
45-59 years (48.82%), and engaged in agriculture (57.35%). Participants demonstrated high levels of exercise knowledge (57.35%), positive attitudes toward exercise (71.18%), and moderate levels of social support (62.94%). However, exercise behavior remained at a low level (67.06%). Personal factors significantly associated with exercise behavior included education level, occupation, and income (p < .05). Exercise knowledge (r = .262, p < .001) and social support (r = .215, p < .001) showed significant positive correlations with exercise behavior. Stepwise multiple regression analysis identified exercise knowledge (β = .262) and social support (β = .215) as significant predictors, collectively explaining 11.4% of the variance in exercise behavior.

The findings highlight a knowledge-action gap among working-age population. Health promotion programs should focus on providing practical knowledge alongside building social support networks from family and community members, as well as developing environments conducive to physical activity.

Development of Clinical Practice Guidelines and Referral System for Pediatric Thalassemia in Community Hospitals, Loei Province

Uraiporn Chomphukham — Tue, 30 Dec 2025 00:00:00 +0700

This action research aimed to explore the situation and problems, develop a service system, and evaluate the outcomes of a nursing care and referral system for pediatric patients with transfusion-dependent thalassemia (TDT) in Loei Province. The study was conducted using the action research process of Kemmis and McTaggart, consisting of four phases: planning, action, observation, and reflection. Participants were purposively selected, comprising 54 multidisciplinary team members, 109 pediatric TDT patients, and 109 family members. Research instruments included clinical practice guidelines, referral and coordination guidelines, treatment outcome reporting forms, and a satisfaction questionnaire. Content validity was verified by three experts, yielding a Content Validity Index (CVI) greater than 0.80 and an Index of Item-Objective Congruence (IOC) greater than 0.91. Quantitative data were analyzed using descriptive statistics and dependent t-test, while qualitative data were analyzed using content analysis.

The results revealed that the developed service system comprised: 1) clinical practice guidelines for pediatric TDT treatment, 2) referral and coordination guidelines among network hospitals, 3) service system guidelines for community hospitals, and 4) a treatment outcome reporting system. After implementation, all 14 hospitals achieved 100% compliance with the system. The mean hemoglobin level significantly increased from 8.55 to 9.05 g/dl, and the mean ferritin level significantly decreased from 1,668.79 to 1,394.57 ng/ml (p < .01). Patient and family satisfaction significantly improved in all dimensions (p < .01).

The findings demonstrated that the developed service system effectively improved clinical outcomes and enhanced patient and family satisfaction. This system should be disseminated to other regions with similar contexts.

The Development of a Service Model for the Geriatric Clinic at Phu Ruea Hospital, Loei Province

Kantapat Apinyathitiphong — Tue, 30 Dec 2025 00:00:00 +0700

Thailand officially became a complete aged society in 2024, with the elderly population accounting for 20.70% of the total population. Phu Ruea District, Loei Province, has an even higher proportion of elderly residents at 22.3%. However, the geriatric clinic service system at Phu Ruea Hospital faced significant challenges, including fragmented service delivery, lack of comprehensive health screening and assessment, and inadequate systematic linkage between hospital and community services. This study aimed to develop a geriatric clinic service model through stakeholder participation and to evaluate outcomes regarding satisfaction and service model appropriateness. Methods This research and development (R&D) study applied Donabedian's quality of care framework integrated with Comprehensive Geriatric Assessment (CGA) principles and the Continuity of Care concept. The study was conducted over 52 weeks within the Phu Ruea District health network, covering seven subdistrict health promotion hospitals. The sample consisted of 80 participants, comprising 50 elderly individuals and their caregivers and 30 multidisciplinary healthcare professionals. Both quantitative and qualitative data were collected and analyzed using descriptive statistics and content analysis.

Results: The developed service model comprised four key components: establishing a fast-track service channel, enhancing care quality through an eight-discipline multidisciplinary team, developing staff competencies, and building collaborative networks with communities. Elderly satisfaction increased across all dimensions, with service staff receiving the highest scores (Mean = 4.67) and service processes showing the greatest improvement from 2.33 to 4.33. Multidisciplinary professionals rated the service model appropriateness at high to highest levels (Mean = 4.13-4.47), with the referral and follow-up system receiving the highest score.

Conclusion: The developed geriatric clinic service model demonstrated effectiveness in enhancing holistic and continuous care quality. This model can serve as a prototype for other community hospitals to accommodate Thailand's aging society.

Development of an Occupational Disease Surveillance System for Gold Panning Workers: A Case Study of Pak Chom District, Loei Province

Narong Promsrichan, Piya Prasongsap — Tue, 30 Dec 2025 00:00:00 +0700

Gold panning is a supplementary occupation in Thailand, particularly in Pak Chom District, Loei Province, that poses high health risks due to mercury exposure, potentially causing chronic mercury poisoning affecting the nervous system, kidneys, and respiratory system. However, the occupational disease surveillance system for this occupation lacks continuity, comprehensiveness, and community participation. This research aimed to develop an effective, contextually appropriate, and sustainable occupational disease surveillance system for gold panning workers using a mixed-methods research approach conducted in three phases: (1) situational analysis using total population survey (N=56), physical examinations, and environmental assessment; (2) participatory system development through focus group discussions, in-depth interviews (n=15), and three workshops; and (3) system evaluation using Index of Item-Objective Congruence (IOC), Index of Objective Achievement (IOA), and a 5-point Likert scale satisfaction questionnaire.

The findings revealed that 73.21% of gold panners had never received knowledge about mercury poisoning, although 95.24% used mercury in gold extraction. Only 80.36% used chemical protective masks and 44.64% wore long pants while working, reflecting low self-protective behaviors, particularly in safe mercury storage (36.31%). Additionally, local government agencies lacked specific strategic plans, systematic occupational databases, and effective data analysis and communication systems. Through participatory processes, an integrated surveillance system was developed comprising four main components: clear objectives and scope definition, real-time data management through digital forms, multidisciplinary team analysis and interpretation, and two-way data communication. Expert evaluation (n=5) showed that the system achieved IOC=0.82 and IOA=0.89, indicating high appropriateness and feasibility. Meanwhile, 92.9% of system users rated their satisfaction as high to very high (mean=4.52, SD=0.48).

conclusion, the developed surveillance system is appropriate, effective, and practically implementable. It can serve as a prototype for other high-risk informal occupations in the Northeastern region, supporting the objectives of the Occupational Disease and Environmental Disease Control Act B.E. 2562 (2019) and the 13th National Economic and Social Development Plan.

The development of maternity nursing care model for antepartum intrapartum and postpartum mothers in the delivery room, Chiangkhan hospital.

Kannika Una — Tue, 30 Dec 2025 00:00:00 +0700

Effective maternal care during the antepartum, intrapartum, and postpartum periods is essential for ensuring the safety of both mothers and newborns. According to the statistics of Chiang Khan Hospital from 2021 to 2023, several complications were identified, including 2-3 cases of delivery on the waiting bed per year, neonatal asphyxia rates ranging from 8.41% to 33.11%, postpartum hemorrhage rates of 2.54% to 6.15%, and referral rates of mothers in the first stage of labor who delivered normal labor at the referral hospital ranging from 21.42% to 31.25%. This study aimed to develop a maternal care model for the antepartum, intrapartum, and postpartum periods in the delivery room at Chiang Khan Hospital. This action research employed purposive sampling. The sample consisted of 68 mothers who delivered vaginally and 22 healthcare personnel working in the maternal care unit between October 2024 and August 2025. Research instruments included the developed maternal care model, data recording forms, a labor pain coping questionnaire, and a satisfaction questionnaire. Data were analyzed using frequency, percentage, mean, and standard deviation.

Results The developed maternal care model comprised three phases: (1) the antepartum phase, utilizing Partograph for risk screening and educating mothers and relatives on slow deep breathing techniques and uterine massage; (2) the intrapartum phase, implementing the ATM (Assessment-Team preparation-Management) guidelines with fetal heart rate monitoring every 5-10 minutes; and (3) the postpartum phase, performing uterine massage every 15 minutes during the first two hours using an innovative loudspeaker reminder system. Following implementation, no cases of delivery on the waiting bed or neonatal asphyxia were observed. The referral rate decreased to 26.47%. The most frequently used labor pain coping method was slow deep breathing (80.88%). Maternal satisfaction was rated at the highest level for both the antepartum and intrapartum periods (Mean = 4.54, SD = 0.05) and the postpartum period (Mean = 4.59, SD = 0.04).

Conclusion The developed maternal care model effectively reduced the incidence of complications, enhanced mothers' labor pain coping skills, and increased client satisfaction.

Effectiveness of the D-METHOD-P Discharge Plan Model for Palliative Care Patients on managing distressing symptoms in the In-Patient Department, Chiang Khan Hospital, Loei Province.

Khajornsri Sornmala — Tue, 30 Dec 2025 00:00:00 +0700

The increasing elderly population and end-of-life patients in Thailand presents significant challenges for palliative care delivery. A contextual analysis of end-of-life care at Chiang Khan Hospital revealed that the existing discharge planning model lacked critical components for communicating disease understanding and prognosis. The researcher developed the
D-METHOD-P discharge planning model by integrating the D: Diagnosis component into the original METHOD-P framework, creating a comprehensive 8-component approach. This study aimed to compare knowledge and behaviors in managing distressing symptoms among patients and caregivers before and after implementing the D-METHOD-P model, and to examine satisfaction with the care model. A quasi-experimental, one-group pretest-posttest design was conducted with 30 end-of-life patients and 30 caregivers in the inpatient department of Chiang Khan Hospital, Loei Province, between March and May 2025. Instruments included the D-METHOD-P model, knowledge and behavior questionnaires, and satisfaction assessment tools. Data were analyzed using descriptive statistics and paired t-test.

The results showed that (1) end-of-life patients' mean knowledge scores for managing distressing symptoms increased from 9.37±2.84 to 17.83±1.66 (t = 16.89, p < .001, Cohen's
d = 3.91), and behavior scores increased from 8.63±3.12 to 18.27±1.44 (t = 18.42, p < .001, Cohen's d = 4.27); (2) caregivers' mean knowledge scores increased from 10.23±2.67 to 18.47±1.28 (t = 19.47, p < .001, Cohen's d = 4.52), and behavior scores increased from 9.47±2.95 to 18.90±1.06 (t = 20.18, p < .001, Cohen's d = 4.68), with all variables demonstrating very large effect sizes; and (3) both patients and caregivers reported the highest level of satisfaction with the D-METHOD-P model (4.68±0.34 and 4.73±0.31, respectively).

In conclusion, the D-METHOD-P discharge planning model demonstrated high effectiveness in improving knowledge and behaviors for managing distressing symptoms among end-of-life patients and their caregivers. The integration of disease understanding components with holistic care promoted patients' and families' readiness for continuous home-based care. This model can be adapted for implementation in community hospitals to enhance the quality of palliative care for end-of-life patients and improve their quality of life in the final stages of life.