Academic Journal of Mahasarakham Provincial Public Health Office

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Rutchaneevipa Jitrakul — 2026-06-26

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การเตรียมและส่งต้นฉบับ

Rutchaneevipa Jitrakul — 2026-06-26

การเตรียมและส่งต้นฉบับ

Factors Associated with Acute Exacerbation among Patients with Chronic Obstructive Pulmonary Disease at Borabue Hospital, Maha Sarakham Province, 2025

Parnrawee Sukawat — 2026-06-26

Abstract

Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a major cause of mortality and significant healthcare expenditure.
This retrospective analytical study aimed to identify the factors associated with acute exacerbation among 358 patients diagnosed with COPD at Borabue Hospital, Maha Sarakham Province, in 2025. Data were retrieved from electronic medical records and analyzed using descriptive statistics and multiple logistic regression to determine the adjusted odds ratio (AOR) with a 95% confidence interval.

The results showed that the incidence rate of acute exacerbation was 8.66%. Multivariate analysis revealed that factors significantly and independently associated with acute exacerbation (p < 0.05) included a history of missed medical appointments, which presented the highest risk
(AOR = 8.94; 95% CI: 2.95–27.08), followed by disease severity at GOLD groups C–D (AOR = 3.58; 95% CI: 1.39–9.21) and current smoking (AOR = 2.73;
95%CI: 1.18–6.32). Personal factors, such as sex, age, and alcohol consumption, showed no significant association with the exacerbation of the disease.
In conclusion, treatment adherence, smoking status, and disease severity are crucial predictors of acute exacerbation. Therefore, healthcare facilities should implement proactive monitoring systems, particularly for patients with poor follow-up records and those in high-risk categories (GOLD C-D), alongside intensive smoking cessation programs to reduce hospital readmission rates and enhance long-term disease management.

Keywords : Chronic Obstructive Pulmonary Disease (COPD), Acute Exacerbation, Retrospective Study, Treatment Adherence

Effectiveness of the Home Ward Model for Hypertensive Patient Care in Phayakkhaphumphisai District, Mahasarakham Province

Orathai Yatpramot — 2026-06-26

Abstract

This quasi-experimental research aimed to examine the effectiveness of a Home Ward care model for hypertensive patients and to compare outcomes between the Home Ward group and a standard care group in Phayakkhaphumphisai District, Mahasarakham Province. A total of 60 hypertensive patients were recruited through purposive sampling and allocated equally into an experimental group receiving Home Ward care (n = 30) and a control group receiving standard care (n = 30). The study period spanned 6 months. Data collection instruments included a general information questionnaire,
a self-care behavior assessment scale, a medication adherence record, and a standardized digital blood pressure monitor. Data were analyzed using descriptive statistics, Paired Samples t-test, and Independent Samples t-test.

Results revealed that the experimental group demonstrated statistically significant reductions in systolic blood pressure (mean decrease : 15.88 mmHg) and diastolic blood pressure (mean decrease : 9.10 mmHg) compared to baseline (p < .001). Moreover, 73.3% of the experimental group achieved target blood pressure control (BP < 140/90 mmHg), significantly higher than the control group (p < .001). Medication adherence scores were markedly superior in the experimental group (5.00 vs. 3.97; p < .001). Self-care behavior scores improved significantly across all four domains: dietary control, physical activity, sleep and rest, and stress management, shifting from a moderate to a good level (p < .001), while the control group showed no significant changes in any domain.

These findings provide empirical evidence supporting the expansion of the Home Ward model as a sustainable community-based strategy for chronic disease management in rural Thailand.

Keywords : Home Ward, hypertension, self-care behavior, medication adherence, Orem's Self-Care Deficit Theory

Nursing Care of a Patient with Thyroid Cancer after Total Thyroidectomy in the Outpatient Clinic : Case Study

Ladda Lienyong — 2026-06-26

Abstract

This study aims to examine nursing care for thyroid cancer patients who have undergone total thyroidectomy in outpatient clinics. Research Method: A comparative study of 2 case studies was conducted by purposive sampling, selecting thyroid cancer patients who had undergone total thyroidectomy and received treatment at Trang Hospital. The study was conducted from 01 October 2025 to 31 March 2026 The tools used were interviews, observations, patient medical records, and 11 health assessment forms based on Gordon's patterns.

From the comparative study of the 2 cases, it was found that using the nursing process to care for patients systematically is extremely important in the care of thyroid cancer patients who have undergone total thyroidectomy. It helps nurses provide comprehensive care covering physical, psychological, and social aspects, as well as effectively preventing complications and promoting health rehabilitation.

Case Study 1: A 40-year-old Thai female patient with a pre-existing condition of diabetes, who had lapses in continuous treatment, came to the hospital with a rapidly growing mass on the right side of her neck. She underwent examination and a total thyroidectomy. The diagnosis was Aplastic Thyroid Carcinoma, and she received ongoing treatment with radiotherapy and chemotherapy. The patient was capable of self-care and aware of her good health status. Despite experiencing anxiety regarding her appearance, she was able to adapt and follow medical advice well, resulting in smooth treatment. Case Study 2: A 75-year-old Thai female patient with comorbidities including hypertension and hyperlipidemia, who did not take her medications consistently, had previously refused surgery. Later, she developed a growing mass in her neck and was diagnosed with advanced-stage Follicular Carcinoma. She underwent a total thyroidectomy combined with radical neck dissection. She experienced complex problems before, during, and after surgery. The patient was at risk for multiple complications, including airway obstruction due to swelling, subcutaneous bleeding, hypocalcemia from total thyroid removal, lymphatic leakage, and surgical wound infections. Therefore, nurses must closely monitor symptoms, assess breathing, vital signs, convulsions from low calcium, wound care, and infection prevention, as well as prepare patients for ongoing treatment with mineral swallowing. Although patients are at high risk, they can safely undergo surgery and recovery, receive continuous care, and adapt well under the multidisciplinary team's supervision.

In summary, the nursing process is an important tool that helps ensure post-operative care for thyroid cancer patients is of high quality and safe.
It can appropriately respond to each patient's problems and needs, covering both physical and psychological aspects, resulting in continuous rehabilitation, reduced complications, and improved quality of life in the long term.

Prevalence and Determinants of Hypertension among Healthcare Workers at Kalasin Hospital, Thailand

Thiti Pongsuteethavorn — 2026-06-26

Abstract

This analytical cross-sectional study aimed to determine the prevalence and analyze the factors associated with hypertension among personnel at Kalasin Hospital. Secondary data were collected from the 2025 annual health examination records. The sample consisted of 1,777 hospital staff members with complete records. Data were analyzed using descriptive statistics and multiple logistic regression.

The results showed a hypertension prevalence of 15.98% (95% CI: 14.33–17.74), with a higher prevalence in males (23.96%) than females (13.60%). Multivariate analysis revealed that factors significantly associated with hypertension (p < 0.05) were male sex (AOR = 1.78; 95% CI: 1.34–2.36), age 40–49 years (AOR = 2.41; 95% CI: 1.42–4.09), and age 50–60 years (AOR = 4.12; 95% CI: 2.41–7.05) compared to the younger age group. Regarding BMI, obesity class 1 (AOR = 1.89) and class 2 (AOR = 2.67) were significantly associated with hypertension. No significant association was found between shift work and hypertension. In conclusion, the prevalence of hypertension among healthcare personnel warrants attention. Health promotion interventions focusing on weight control, particularly for males and staff over 40 years old, should be prioritized.

Keywords : Hypertension, Healthcare Personnel, Prevalence, Associated Factors, Annual Health Examination

Development of Health Literacy among Older Adults to Enhance Their Quality of Life in Phayakkhaphumphisai District, Mahasarakham Province

Chawanakon Chanyaroongtawee — 2026-06-26

ABSTRACT

This mixed methods research, employing an Explanatory Sequential Design, aimed to: 1) develop a health literacy program for elderly individuals to enhance quality of life, and 2) evaluate the program's effectiveness in Phayakkhaphumphisai District, Mahasarakham Province. The study comprised two phases. Phase 1 assessed health literacy and quality of life among 400 elderly participants selected by simple random sampling, using a 6-domain health literacy questionnaire and the WHOQOL-BREF-THAI. Data were analyzed using descriptive statistics and Pearson's correlation coefficient. Phase 2 developed a health literacy enhancement model through the PAOR action research cycle. Sixty-six participants were divided equally into experimental and control groups (n = 33 each) and analyzed using Paired sample t-test and Independent t-test.

Phase 1 findings revealed that elderly participants had a moderate overall health literacy level (Mean = 53.59, SD = 12.18), with media literacy skills scoring lowest at a low level. Overall quality of life was moderate (Mean = 88.83, SD = 14.63), with social relationships scoring lowest. Health literacy showed a strong positive correlation with quality of life (r = 0.62, p < 0.001). Phase 2 results demonstrated that after program participation, the experimental group showed statistically significant improvements in health literacy by an average of 16.91 points and quality of life by 15.11 points (p < 0.001), both significantly higher than the control group (p < 0.001). The PAOR-based health literacy enhancement program effectively improved elderly participants' health literacy and quality of life. Healthcare units should adopt and expand this program to areas with similar contexts.

Keywords : Health Literacy, Quality of Life, Elderly, Health Enhancement Program, Action Research

Development of an Insulin Injection Training Model Combined with Pharmaceutical Care to Enhance Knowledge and Skills among Patients with Uncontrolled Type 2 Diabetes

Threerut Vichayacheewin — 2026-06-26

Abstract

This action research aimed to study the situational context, develop an integrated education and pharmaceutical care model, and evaluate its effectiveness among type 2 diabetes patients using insulin syringes. The study was conducted in three phases at the Non-Communicable Diseases (NCD) Clinic, Community Health Center, Kosum Phisai Hospital. The participants included 30 patients and 12 healthcare professionals. Research instruments consisted of an insulin injection skill assessment, the 8-item Morisky Medication Adherence Scale (MMAS-8), and a knowledge assessment form. Data were analyzed using descriptive statistics and paired t-tests.

The initial phase identified significant situational barriers, including patients’ misconceptions regarding insulin therapy and a lack of proper administration skills, particularly in dose preparation, air bubble removal, and improper insulin storage. Consequently, the "PITT DM Model" was developed, comprising five key components: Prescribing (identifying drug-related problems), Introduction (providing in-depth information and attitude adjustment), Teaching/Testing (active skill training and demonstration), Dispensing (providing medication with supporting tools), and Monitoring (continuous proactive follow-up). After implementing the model, the results showed that the patients' mean scores for knowledge, medication adherence, and injection skills significantly increased (p < 0.001). Clinical outcomes also markedly improved, with the mean HbA1c level decreasing from 10.57% to 9.03% and the mean Fasting Blood Sugar (FBS) dropping from 208.70 to 171.20 mg/dL (p < 0.001). Overall, the patients reported a high level of satisfaction with the model. In conclusion, the PITT DM model effectively bridges the gap in medication administration through proactive pharmaceutical care, leading to sustainable improvements in glycemic control for patients with type 2 diabetes.

Keywords : Type 2 diabetes, Insulin injection, Pharmaceutical care, Injection skills

The effect of a palliative care enhancement program on the knowledge and competence of volunteer caregivers of dependent elderly people

Nitiya Ponsana — 2026-06-26

Abstract

This quasi-experimental study aimed to compare the knowledge and caregiving competency of volunteers for dependent older adults before and after participating in a Palliative Care Capacity-Building Program. The sample consisted of 50 volunteers under the responsibility of Kaeng Loeng Chan Health Promoting Hospital, Maha Sarakham Province, divided into experimental and control groups (25 participants each) through purposive sampling.
The experimental group received a program based on Bandura's Self-Efficacy Theory, consisting of four core activities: verbal persuasion, modeling, enactive mastery experiences, and emotional arousal, while the control group received standard care. Research instruments included the Palliative Care Enhancement Program, a knowledge assessment form (KR-20 = 0.89), and a caregiving competency assessment form (Cronbach’s alpha = 0.74). Data were analyzed using descriptive statistics, paired t-tests, and independent t-tests.

The results demonstrated that after the intervention, the experimental group’s mean scores for palliative care knowledge (9.72 ± 0.45) and caregiving competency (4.72 ± 0.14) significantly increased compared to the pre-test scores (p < .05). Furthermore, when comparing post-test scores between the groups, the experimental group achieved significantly higher mean scores in both knowledge and competency than the control group (p < .05), reaching
an "excellent" level of performance. In conclusion, the program focusing on boosting self-confidence through mastery experiences and practical training successfully empowered volunteers to provide care for dependent older adults approaching the end of life. This model is recommended for further application in enhancing primary healthcare volunteer capabilities in community settings.

Keywords : Palliative care, Volunteer caregivers, Dependent elderly, Self-efficacy

Development of an Integrated Post-Treatment Follow-up Model for High-Risk Psychiatric Patients with Substance Abuse and Violence Risk: A Case Study in Mueang Maha Sarakham District, Maha Sarakham Province.

Pranee Theeasna — 2026-06-26

Abstract

This action research aimed to study the current situation, develop an integrated network follow-up model for high-risk psychiatric patients with substance abuse and violence risk, and evaluate the model's effectiveness in Mueang Maha Sarakham District, Maha Sarakham Province. The study followed the action research framework consisting of three phases and two cycles. The participants included 82 stakeholders selected through purposive sampling from public health, local administration, police, local government, the prison, and the Provincial Office of Social Development and Human Security. Research instruments comprised the Ministry of Public Health’s screening forms (V.2), Overt Aggression Scale (OAS), 10-dimension follow-up assessment, 5 red flags warning signs checklist, and focus group discussion guides. Quantitative data were analyzed using frequency and percentage, while qualitative data were analyzed through content analysis.

The results in the initial phase revealed a continuous increase in high-risk cases from 239 in 2021 to 447 in 2023. Approximately 67% of these patients had more than three readmissions due to the lack of clear follow-up protocols and fragmented communication among agencies. In response, an "Integrated Follow-up Model" was developed based on the 3C framework—Client (accessible medication and self-reliance), Caregiver (understanding, access, and monitoring), and Community (acceptance, mutual aid, and opportunity). The model was implemented by a "4-Party Coordination Team" (public health, local administration, police, and local government), ensuring the first visit within 3–7 days post-discharge and subsequent follow-ups at 1, 3, 6, and 12 months. Following implementation, the continuous follow-up rate increased to 98.97%, and violent recidivism significantly decreased to 1.03%. Furthermore, 100% of the vulnerable patients received comprehensive social support and vocational rehabilitation. In conclusion, the integrated network model effectively bridged communication gaps and reduced violent incidents, fostering safety and sustainability in community-based psychiatric care.

Keywords : Psychiatric patients with substance abuse, High risk of violence, Post-treatment follow-up, Integrated network

The Effects of a Preconception Counseling Program on Knowledge and Preconception Preparedness Behaviors among Women of Reproductive Age

Yossawadee Chamnongnit — 2026-06-26

Abstract

Objectives : Studying the effects of a prenatal counseling program on the knowledge and preparation behaviors of women of reproductive age.

Meterials and Method : A quasi-experimental research study comparing two groups before and after the experiment. Study conducted on women of reproductive age residing in Kaeng Leang Chan Subdistrict. Purposive sampling was used, with a test power of 0.80 and significance level (α) = 0.05, resulting in a sample size of 50 people. They were divided into an experimental group and a control group, with 25 people in each group. The tools include : 1) a pre-pregnancy preparation counseling program, 2) a pre-pregnancy preparation guide. 3) an assessment form for knowledge about pre-pregnancy preparation, and 4) an assessment form for pre-pregnancy preparation behaviors. Data were analyzed using descriptive statistics and the T-test.

Results : The research findings showed that 1) the average knowledge score of the experimental group after receiving the pre-pregnancy preparation counseling program was significantly higher than that of the control group at the .05 statistical significance level, and 2) The average score for pre-pregnancy preparation behaviors in the experimental group after receiving the pre-pregnancy preparation counseling program was significantly higher than that of the control group at the .05 statistical significance level.

Conclusion : Prenatal counseling has an impact on knowledge and behaviors related to preparing for pregnancy. Therefore, it is important to provide better education and promote preparedness behaviors for women of reproductive age.

Keywords : Counseling Program, Preparation before pregnancy, women of reproductive age

Development of a Care Model for Patients with Sepsis in Inpatient Wards at Kantharawichai Hospital, Maha Sarakham Province, Thailand

Thanaporn Chinwong — 2026-06-26

Abstract

Background : Sepsis is a life-threatening condition associated with high mortality, particularly in community hospitals with limited resources. Developing an appropriate care model tailored to the local context is essential to improve the quality of care and clinical outcomes.

Objective : To examine the current situation and problems, develop a care model, and evaluate the outcomes of a sepsis care model in inpatient wards at Kantharawichai Hospital, Maha Sarakham Province, Thailand.

Methods : This study employed a Research and Development (R&D) design conducted from March to November 2025. The study consisted of three phases: situation analysis, model development, and outcome evaluation. The samples included medical records of patients with sepsis before and after implementation of the model (n = 30 per group). Data were collected using patient record forms, structured interviews, and the developed care model. Data were analyzed using descriptive statistics, Chi-square test, and Paired t-test or Wilcoxon signed-rank test as appropriate.

Results : After implementation, significant improvements were observed in nursing practices. The proportion of patients assessed using qSOFA/SIRS increased from 26.67% to 83.33%, and the use of SOS score increased from 16.67% to 90.00% (p < .001). The mean time from screening to diagnosis significantly decreased from 97.60 ± 41.80 minutes to 58.90 ± 24.70 minutes (p < .001). The proportion of patients diagnosed before the onset of septic shock increased from 70.00% to 93.33% (p = 0.020). The average length of hospital stay was significantly reduced (p = 0.041). Although the incidence of septic shock and mortality decreased, the differences were not statistically significant.

Conclusion : The developed sepsis care model improved the care process by enhancing early detection, systematic assessment, and timely management. It reduced the time to diagnosis and showed a trend toward improved clinical outcomes. This model may be applicable to other community hospitals with similar contexts.

Keywords : Sepsis, Care model, Sepsis bundles, Community hospital

การพัฒนารูปแบบการดูแลผู้ป่วยเบาหวานชนิดที่ 2 เพื่อส่งเสริมการควบคุมระดับน้ำตาลในเลือด และมุ่งสู่ภาวะเบาหวานระยะสงบ โรงพยาบาลกันทรวิชัย จังหวัดมหาสารคาม

Wanna Taroonchan — 2026-06-26

บทคัดย่อ

การวิจัยและพัฒนาครั้งนี้มีวัตถุประสงค์เพื่อ 1) ศึกษาสถานการณ์และปัญหาการดูแลผู้ป่วยเบาหวานชนิดที่ 2 2) พัฒนารูปแบบการดูแลผู้ป่วยเบาหวานชนิดที่ 2 เพื่อส่งเสริมการควบคุมระดับน้ำตาลในเลือดและมุ่งสู่ภาวะเบาหวานระยะสงบ 3) ประเมินผลของรูปแบบที่พัฒนาขึ้น ดำเนินการวิจัยระหว่างวันที่ 1 กุมภาพันธ์ – 1 ธันวาคม 2568 ณ โรงพยาบาลกันทรวิชัย จังหวัดมหาสารคาม โดยใช้กระบวนการ วิจัยและพัฒนา 4 ระยะ ได้แก่ การศึกษาสถานการณ์และปัญหา การพัฒนารูปแบบ การทดลองใช้และประเมินผล และการปรับปรุงรูปแบบ ระยะที่ 1 ศึกษาในผู้ป่วยเบาหวานชนิดที่ 2 จำนวน 282 คน และสัมภาษณ์บุคลากรสาธารณสุข ระยะที่ 3 ทดลองใช้รูปแบบ Kantarawichai Diabetes Remission-Oriented Care Model (KDR Model) กับผู้ป่วยเบาหวานชนิดที่ 2 จำนวน 79 คน เป็นเวลา 12 สัปดาห์ เครื่องมือวิจัยประกอบด้วยแบบประเมินพฤติกรรมสุขภาพและแบบบันทึกข้อมูลทางคลินิก วิเคราะห์ข้อมูลด้วยสถิติเชิงพรรณนา และ Paired sample t-test

ผลการศึกษาพบว่า รูปแบบ KDR Model ประกอบด้วย 4 องค์ประกอบ ได้แก่ การคัดกรองผู้ป่วยเป้าหมาย การปรับเปลี่ยนพฤติกรรมสุขภาพ การเสริมพลังและสนับสนุนการจัดการตนเอง และการติดตามประเมินผล ภายหลังการดำเนินงาน ค่าเฉลี่ย HbA1C ลดลงจาก 8.71 ± 1.32 เป็น 6.48 ± 0.94 อย่างมีนัยสำคัญทางสถิติ (t = 15.84, p < .001) ผู้ป่วยร้อยละ 35.44 มีค่า HbA1C ต่ำกว่า 6.5% และคะแนนพฤติกรรมสุขภาพโดยรวมเพิ่มขึ้นจาก 94.74 ± 11.85 เป็น 130.48 ± 9.27 อย่างมีนัยสำคัญทางสถิติ (t = 18.63, p < .001) สรุปได้ว่า KDR Model ช่วยส่งเสริมการควบคุมระดับน้ำตาลในเลือดและพัฒนาพฤติกรรมสุขภาพของผู้ป่วยเบาหวานชนิดที่ 2 ได้อย่างมีประสิทธิภาพ และสามารถประยุกต์ใช้ในการพัฒนาระบบบริการผู้ป่วยเบาหวานในระดับโรงพยาบาลชุมชนได้

คำสำคัญ : เบาหวานชนิดที่ 2, การควบคุมระดับน้ำตาลในเลือด, เบาหวานระยะสงบ, การจัดการตนเอง

Development of Guidelines for Identifying Drug Users through Community Participation in Chuen Chom District, Maha Sarakham Province

Pitsarinthun Smorin — 2026-06-26

Abstract

This action research aimed to: 1) develop community-based participatory guidelines for identifying drug users in Chuen Chom District, Maha Sarakham Province, and 2) evaluate the effectiveness of the developed guidelines. The participants consisted of 84 community network members in Chuen Chom District, Maha Sarakham Province, selected through purposive sampling. Research instruments included a demographic questionnaire, practice and participation assessment scales, and a focus group discussion guide. Data were analyzed using descriptive statistics and paired t-test, with the significance level set at 0.05.

The results revealed that the developed guidelines consisted of five key components: situation awareness building, capacity development of community networks, promotion of community participation, proactive household-based drug user identification, and systematic drug user database management. Following implementation, the mean practice score significantly increased from 39.2 ± 8.5 to 60.8 ± 7.9 (t = 28.60, p < 0.001), while the mean participation score significantly increased from 17.1 ± 4.2 to 27.6 ± 3.8
(t = 22.40, p < 0.001). In addition, the number of identified drug users increased from 138 to 265 individuals.

In conclusion, the community-based participatory guidelines effectively enhanced the practice and participation levels of community network members and improved the effectiveness of drug user identification in the community.

Keywords : community participation, drug users, identification, action research

Editorial

Rutchaneevipa Jitrakul — 2026-06-26

Editorial

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Rutchaneevipa Jitrakul — 2026-06-26

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Editorial Board

Rutchaneevipa Jitrakul — 2026-06-26

Editorial Board