Academic Journal of Mahasarakham Provincial Public Health Office

Factors Associated with Mortality during Treatment among Patients with Pulmonary Tuberculosis at Borabue Hospital, Maha Sarakham Province, Thailand, 2020–2024

Kanittha Kunha — Tue, 23 Jun 2026 00:00:00 +0700

Abstract

This retrospective cohort study aimed to identify factors associated with mortality during treatment among patients with pulmonary tuberculosis at Borabue Hospital,
Maha Sarakham Province, Thailand, from 2020 to 2024. Data were obtained from hospital tuberculosis registers and medical records. The study population included 755 patients with laboratory-confirmed pulmonary tuberculosis who received treatment during the study period. Data were analyzed using descriptive statistics, the Chi-square test, and multiple logistic regression, with a statistical significance level set at p < 0.05.

The results showed that most patients were male (66.5%) with a mean age of 54.8 years. The majority were new cases (82.9%). The most common comorbidities were diabetes mellitus (20.1%) and HIV infection (9.0%). The overall mortality rate during treatment was 13.9%, which was higher than the national average. Factors significantly associated with mortality included age ≥ 60 years (p < 0.001), a history of previous TB treatment (p = 0.012), diabetes mellitus (p = 0.021), and HIV infection (p = 0.018). In contrast, sex, sputum results, chronic obstructive pulmonary disease (COPD), and chronic kidney disease (CKD) were not significantly associated with mortality.

In conclusion, mortality among pulmonary tuberculosis patients at Borabue Hospital was associated with individual and comorbid factors, particularly advanced age, previous treatment history, and chronic diseases. Intensive monitoring and follow-up for high-risk patients are essential to improve treatment success and reduce tuberculosis-related mortality.

Keywords : Pulmonary tuberculosis, Mortality, Risk factors.

Risk Factors for Adverse Drug Reactions During Tuberculosis Treatment at Chiangyuen Hospital, Mahasarakham Province.

Pitchayapa Samranwong — Tue, 23 Jun 2026 00:00:00 +0700

Abstract

Tuberculosis is still a major health problem in Thailand. Adverse drug reactions (ADRs) are a significant concern during tuberculosis (TB) treatment, potentially leading to poor outcomes and drug resistance. This can cause treatment problems and drug resistance. This study aimed to identify the incidence of ADRs and their associated risk factors to complications during TB treatment at Chiang Yuen Hospital.

This research was a retrospective study. The data were collected from 289 pulmonary TB patients from 1 October 2021 to 30 September 2024. The data were analyzed using descriptive statistics, Chi-square test, and multivariate logistic regression with p < 0.05. The results were shown by Adjusted Odds Ratio (AOR) and 95% Confidence Interval (95%CI).

The study found that most patients were male (64.01%) with mean age 53.60 ± 14.80 years. There were 92 patients (31.83%) who had complications during treatment. The most common complications were hepatitis, skin rash, and joint pain. The significant risk factors were age 60 years and older
(AOR = 2.80; 95%CI = 1.60–4.90; p < 0.001), female sex (AOR = 2.10; 95%CI = 1.25–3.50; p = 0.005), having at least one comorbidity (AOR = 1.95; p = 0.006),
liver disease (AOR = 3.10; p = 0.040), and low BMI < 18.5 kg/m² (AOR = 1.85; p = 0.020).

In conclusion, advanced age, female sex, low BMI, and pre-existing liver disease were significant predictors of ADRs. These high-risk groups should be followed closely during TB treatment for safety and better outcomes.

Keywords : Pulmonary Tuberculosis, Adverse drug reactions, Risk factors, TB Treatment, Community Hospital.

การพยาบาลผู้ป่วยโรคหัวใจขาดเลือด ที่ได้รับการสวนขยายหลอดเลือดหัวใจ : กรณีศึกษา

Prapakorn Attachaiya — Tue, 23 Jun 2026 00:00:00 +0700

บทคัดย่อ

บทนำ : โรคหัวใจขาดเลือด Ischemic Heart Disease (IHD) เป็นปัญหาสุขภาพที่สำคัญในระดับโลก และในประเทศไทย ซึ่งเป็นสาเหตุการเสียชีวิตอันดับต้นๆ ของประชากร การรักษาด้วยการสวนขยายหลอดเลือดหัวใจ (Percutaneous Coronary Intervention : PCI) เป็นวิธีหนึ่งที่ลดอัตราการเสียชีวิตและภาวะแทรกซ้อนในระยะยาว การพยาบาลผู้ป่วย
โรคหัวใจขาดเลือดที่ได้รับการทำสวนขยายหลอดเลือดหัวใจ โดยเน้นการกระบวนการพยาบาล ทักษะและสมรรถนะของพยาบาล ครอบคลุมทั้งด้านร่างกาย จิตใจ สังคม เพื่อลดการเกิดภาวะแทรกซ้อน ป้องกันการกลับมารักษาซ้ำ ให้ผู้ป่วยสามารถกลับไปใช้ชีวิตกับครอบครัวและสังคมได้อย่างมีความสุข

วัตถุประสงค์ : ศึกษาการพยาบาลผู้ป่วยโรคหัวใจขาดเลือด ที่ได้รับการสวนขยายหลอดเลือดหัวใจ ห้องอภิบาลผู้ป่วยก่อน-หลังตรวจสวนหัวใจ (Pre-post Cath Unit)

วิธีการศึกษา : ศึกษาเปรียบเทียบผู้ป่วย 2 ราย ที่เข้ารับการรักษา ห้องอภิบาลผู้ป่วยก่อน – หลังตรวจสวนหัวใจ (Pre-post Cath Unit) เครื่องมือที่ใช้ คือ การสัมภาษณ์ การสังเกต และเวชระเบียน

ผลการศึกษา : ผู้ป่วยทั้งสองรายมาด้วยอาการคล้ายกัน ได้แก่ อาการเจ็บแน่นหน้าอก จุกแน่นลำคอร้าวไปกรามและไหล่ซ้ายระยะเวลา 10 – 30 นาที ได้รับการตรวจคลื่นไฟฟ้าหัวใจ (EKG 12leads) และส่งผลตรวจทางห้องปฏิบัติการ (Troponin I) ผู้ป่วยทั้งสองรายได้รับการวินิจฉัยมีภาวะหัวใจขาดเลือดเฉียบพลัน ชนิด ST segment ไม่ยกขึ้น (NSTEMI) และจำเป็นต้องได้รับการักษาด้วยยาต้านเกล็ดเลือดยาต้านการแข็งตัวของเลือดและทำหัตถการฉีดสีหลอดเลือดหัวใจ แต่มีลักษณะโรคประจำตัว พฤติกรรมสุขภาพ ตำแหน่งการใส่สายสวนขยายหลอดเลือดหัวใจ ภาวะแทรกซ้อนหลังการรักษา และปัจจัยเสี่ยงที่แตกต่างกัน ผู้ป่วยทั้งสองรายได้รับการดูแลตามมาตรฐาน โดยเน้นกระบวนการพยาบาล ใช้กรอบแนวคิดของ
กอร์ดอน (Gordon’s Functional Health Patterns) และทฤษฎีการพยาบาลของโอเร็ม (Orem’s Nursing Theory) ตั้งแต่ระยะแรกรับ ระยะก่อน ระยะหลัง ระยะต่อเนื่อง และระยะจำหน่าย เมื่อสวนขยาย หลอดเลือดหัวใจ กรณีศึกษารายที่ 1 มีความยุ่งยากในการดูแลเรื่องความซับซ้อนของโรค มีพฤติกรรมเสี่ยงด้านอาหาร ยา การออกกำลังกาย ที่ส่งผลต่อโรคและการกลับมาตีบซ้ำของหลอดเลือดได้ กรณีศึกษารายที่ 2 มีความยุ่งยากในการดูแล เนื่องจากตีบซ้ำในตำแหน่งที่เคยได้รับการทำหัตถการ พฤติกรรมเสี่ยง ขาดการออกกำลังกาย พักผ่อนนอนหลับไม่เพียงพอ ผู้ป่วยทั้งสองรายสามารถผ่านพ้นระยะวิกฤติได้อย่างปลอดภัย ไม่เกิดภาวะแทรกซ้อนรุนแรง

Development of a Diabetes Management Model for Patients with Uncontrolled Blood Sugar Levels at Ban Chieng Hian Subdistrict Health Promotion Hospital, Mueang District, MahaSarakham Province

Ratchanee Juntum — Tue, 23 Jun 2026 00:00:00 +0700

Abstract

This study is a quasi-experimental research with a one-group pre-post test design.The sample group consists of 30 participants selected through simple random sampling and purposive sampling.Research instruments include intervention tools and a set of four questionnaires: a general information questionnaire, a diabetes knowledge assessment, a self-care efficacy perception questionnaire, and a self-care behavior questionnaire for diabetic patients,along with the HbA1c (glycated- hemoglobin) test results. The study duration is six months, from July to December 2025. Data analysis will use descriptive statistics including frequency, percentage, mean, and standard deviation, and inferential statistics using the paired t-test. Statistical significance is set at 0.05.

The Ressearch Resuit The findings revealed that the majority of diabetic patients were female (83.33%) with a mean age of 63 years (SD = 5.72).The average duration since diabetes diagnosis was 13.00 years (SD = 4.98), and 63.33% of participants reported having complications. Regarding diabetes knowledge, prior to the intervention, 70.00% of participants had a high level of knowledge, with a mean score of 17.47. After the intervention, 90.00% had a high level of knowledge, with a mean score of 17.83. The mean score increased by 0.36 points (95% CI = 0.16 – 0.56), which was statistically significant (p < 0.001). For perceived self-care ability, before the intervention, 83.33% reported a high level, with a mean score of 4.45. After the intervention, 100% reported a high level, with a mean score of 4.74. The mean score increased by 0.29 points (95% CI = 0.21 – 0.37), also statistically significant (p < 0.001). In terms of self-care behavior, before the intervention, 83.33% demonstrated a moderate level of behavior, with a mean score of 3.29. After the intervention, 90.00% demonstrated a high level, with a mean score of 4.11. The mean score increased by 0.82 points (95% CI = 0.75 – 0.89), which was statistically significant (p < 0.001). Regarding blood sugar control, before the intervention, 60.00% of participants had high HbA1c levels, with an average of 8.01%. After the intervention, 66.66% had moderately high HbA1c levels, with an average of 7.24%. The mean HbA1c level decreased by 0.77% (95% CI = 0.19–1.35), which was statistically significant (p = 0.0085). In Conclusion summary, the developed model effectively enhanced awareness and promoted behavioral changes to help control blood sugar levels among diabetic patients in the target area. Furthermore, the application of this diabetes management model can also promote health behaviors among other at-risk groups in the community.

Keywords : 3A 2S behavior modification activities, perception, health behavior, diabetic patients, glycated hemoglobin (HbA1c)

The Development of Monitoring of Colon and Rectal Cancer Risk Groups with Positive FIT Test Results. Wapipathum Hospital, Maha Sarakham Province.

Sirinrat sujjacharee — Tue, 23 Jun 2026 00:00:00 +0700

Abstract

This study aimed to develop a follow-up service model for high-risk individuals with positive FIT tests for colorectal cancer and to evaluate the effectiveness of the developed model. This operational research was conducted from October 2024 to September 2025. The study sample included 232 high-risk individuals with positive FIT tests who attended preparation for colonoscopy. Data collection instruments included interview guides, service adherence assessment forms, patient questionnaires, and satisfaction evaluation forms. Data were collected through interviews, brainstorming sessions, and focus group discussions. Quantitative data were analyzed using descriptive statistics, while qualitative data were analyzed using content analysis.

The developed model emphasized comprehensive care, including screening, diagnosis, referral, follow-up, and counseling. Implementation of the model increased patient follow-up rates from 76% to 100% and colonoscopy completion rates from 68.33% to 83.62%. The integration of Fast Track and Teleconsultation systems enhanced follow-up efficiency, reduced time-related barriers, and resulted in high levels of satisfaction among both patients and healthcare providers. The findings indicate that establishing local networks combined with proactive follow-up and effective communication significantly improves the quality and safety of care for high-risk individuals.

Keywords : colorectal cancer, FIT test positive, patient follow-up system, Fast Track, Teleconsultation

The Effects of Implementing Guidelines to Prevent Catheter-Associated Urinary Tract Infection

Warinporn Patipattapirom — Tue, 23 Jun 2026 00:00:00 +0700

Abstract

Catheter-associated urinary tract infection (CAUTI) is a major hospital-acquired infection that significantly affects patient safety and the quality of nursing care. Therefore, the implementation of evidence-based guidelines for infection prevention is a crucial strategy for reducing its incidence.

This study employed a quasi-experimental research design to examine the effects of implementing CAUTI prevention guidelines on the incidence of infection and on professional nurses’ practices in caring for patients with indwelling urinary catheters, before and after guideline implementation. The sample consisted of 20 professional nurses selected by purposive sampling and patients who received indwelling urinary catheterization in the male surgical ward and the orthopedic ward of Uthai Thani Hospital. The patients were divided into a control group and an experimental group, with 32 patients in each group. The study was conducted from May 2025 to September 2025.

The instruments used for data collection included: (1) a demographic data record form for nurses and patients, (2) an observation form for CAUTI prevention practices, and (3) a hospital infection surveillance form. The intervention instrument was a set of CAUTI prevention guidelines comprising four activity domains: (1) assessment of the necessity for catheter insertion and timely removal, (2) use of aseptic technique during catheter insertion, (3) appropriate and proper catheter care, and (4) a surveillance and documentation system. These were implemented together with an educational program consisting of computer-based instruction, printed teaching materials, video media, and educational posters.

The research instruments were validated by three experts, yielding an Index of Item-Objective Congruence (IOC) of 0.97. The pilot testing demonstrated a Cronbach’s alpha coefficient of 0.96, indicating high reliability. Data were analyzed using descriptive statistics, including frequency, percentage, range, and median. Differences between groups were examined using the Chi-square test and Fisher’s exact test.

The results demonstrated that after implementation of the catheter-associated urinary tract infection (CAUTI) prevention guideline, the incidence of CAUTI showed a marked decreasing trend, declining from 2.28 to 0.69 episodes per 1,000 catheter-days. In addition, professional nurses’ adherence to the guideline significantly increased from 50.51% to 96.57% (p < 0.05). These findings indicate that the implementation of a structured, evidence-based CAUTI prevention guideline effectively reduces the risk of infection and substantially improves compliance with recommended catheter care practices. The guideline therefore provides a practical and efficient approach for enhancing the quality of nursing care and strengthening patient safety within the hospital setting.

Keywords : clinical practice guidelines, catheter-associated urinary tract infection: CAUTI nursing practice, infection prevention and control

Development of Care Model for Neonatal Jaundice at Phayakkhaphumphisai Hospital, Mahasarakham Province

Somkhuan Thanapiboonpol — Tue, 23 Jun 2026 00:00:00 +0700

Abstract

This action research aimed to 1) develop a care model for newborns with jaundice, and 2) study the outcomes of the developed care model. The study utilized the PAOR process over 2 cycles between October 2024 and September 2025. The sample consisted of 28 multidisciplinary healthcare personnel, and mothers with newborns before development 120 persons (60 pairs) and after development 46 persons (23 pairs). Data were analyzed using descriptive statistics and Independent t-test.

Result Phase 1 : Situation Analysis revealed major problems including no screening and risk stratification system (0%), delayed detection (73.3%), and high NICU referral rate (13.3%). Cycle 1 developed a preliminary model with 5 main steps, piloted with 20 cases, and identified problems in service systems, personnel, and equipment. Cycle 2 refined into the "JAUNDICE-CARE Model" comprising 11 components and 7 main processes. Evaluation results showed improved clinical outcomes across all indicators: jaundice incidence requiring phototherapy decreased from 8.0% to 3.9%, detection rate within 24 hours increased to 96.7%, risk stratification rate increased to 95.0%, NICU referral rate decreased to 1.7%, healthcare personnel compliance ranged from
85.7-100% with high satisfaction (Mean = 4.32), and mothers reported highest satisfaction (Mean = 4.68).

In conclusion, the JAUNDICE-CARE Model was effective in reducing severe jaundice incidence, increasing early detection, reducing referrals, and achieving high satisfaction from both healthcare personnel and mothers.

Keywords : neonatal jaundice, care model, action research, JAUNDICE-CARE Model

Factors related to organizational commitment Borabue Hospital

Tippawan Nusriun — Tue, 23 Jun 2026 00:00:00 +0700

Abstract

Objective : To study the level of commitment and factors related to organizational commitment of Borabue Hospital personnel.

Methods : Descriptive research using questionnaires to collect data. The sample consisted of 120 personnel working at Borabue Hospital, selected purposively, between 16 October 2024 and 15 November 2024. The research instrument was a questionnaire consisting of two parts of data: general information and an organizational commitment measure. The questionnaire was examined for content validity by experts and tested for reliability using Cronbach's alpha method. and analyzed the data using descriptive statistics including percentage, mean, standard deviation and inferential statistics including peer correlation.

Results : Overall organizational commitment was at a moderate level ( = 3.45). Age, length of employment, marital status, level, nature of work, organizational factors, and job happiness were positively related to organizational commitment.

Conclusion : Increasing the budget for personnel development, defining duties and assigning workloads that are appropriate to individual abilities and skills. There is also a process for continuously strengthening and developing organizational values, emphasizing the merit-based evaluation system, rewards, and various welfare benefits, which help increase organizational commitment. To create motivation in work and to stimulate personnel at all levels to be united and have more morale in working.

Keywords : Commitment to the organization, Borabue Hospital personnel, Factors that are related

Development of a Model for Glycated Hemoglobin (HbA1C) Control in Diabetic Patients at Ban Baeg Health Promoting Hospital, Nathong Subdistrict, Chiang Yuen District, Maha Sarakham Province

Katariyaporn Kumphichit — Tue, 23 Jun 2026 00:00:00 +0700

Abstract

Objective : To study the problem situation and develop a model for glycated hemoglobin (HbA1c) control in diabetic patients at Ban Baeg Health Promoting Hospital.

Methods : This participatory action research (PAR) was conducted from October 2023 to September 2024 in three phases: 1) Preparation : Situational analysis via focus groups, participant observation, and data review. 2) Development : Model development using two PAOR cycles with a target group of 75 diabetic patients (HbA1c ≥ 7%) and 180 stakeholders (relatives, Village Health Volunteers, role models). 3) Evaluation : Data were collected using qualitative (in-depth interviews, focus groups, medical records) and quantitative (HbA1c results, My PCU data) methods. Qualitative data were analyzed using content analysis and triangulation, while quantitative data were analyzed using descriptive statistics.

Results : Most patients were female (86.74%) and aged 60 or older (71.70%). Key challenges included dietary habits (sticky rice, sweets), self-adjustment of medication, and lack of exercise. The BAC Model was developed, comprising : 1) Buddy : VHVs as "disease buddies," 2) Access to problems : Individualized needs assessment, and 3) Care management : Utilizing Motivational Interviewing (MI), self-care promotion, and establishing a "Diabetes School." Post-intervention, HbA1c levels decreased in 89.33% of patients, with 73.33% achieving the target of HbA1c < 7%. Positive changes in other health indicators, such as reduced waist circumference and improved blood pressure control (in 84 % of patients), were also observed.

Conclusion : The community-based BAC Model effectively enhanced motivation and facilitated behavior change, leading to significant improvements in glycemic control. The initiative resulted in sustainable social innovations, including the "Diabetes School" and robust community health networks, fostering overall well-being.

Keywords : Model Development, Glycated Hemoglobin (HbA1c) Control, Diabetes Mellitus, Participatory Action Research, BAC Model

The Effects of Honey on Oral Mucositis in Cancer Patients Receiving FOLFOX4 Chemotherapy

Wawdow Seesod — Tue, 23 Jun 2026 00:00:00 +0700

Abstract

Oral mucositis is a common complication among cancer patients receiving chemotherapy and can significantly affect their well-being and treatment outcomes. This quasi-experimental study aimed to compare the incidence of oral mucositis, oral pain levels, and the number of days with oral mucositis among cancer patients receiving FOLFOX4 chemotherapy. The sample consisted of 60 patients who received chemotherapy at Uthai Thani Hospital between June and December 2024. Participants were purposively selected and assigned to either a control group receiving standard oral care or an experimental group receiving a honey-based oral care protocol (n = 30 per group). Data collection instruments included: (1) a general patient information form, (2) an oral mucositis assessment form, (3) the Numeric Rating Scale for oral pain, and (4) a record form for the number of days with oral mucositis. The intervention tools consisted of (1) a honey-based oral care practice guideline and (2) an instructional manual for honey application. Data were analyzed using descriptive statistics, Chi-square test, Fisher's Exact Test and Mann–Whitney U test.

The study results revealed that the experimental group demonstrated significantly lower incidence of oral mucositis (p = .019), lower oral pain levels
(p = .001), and fewer days with oral mucositis (p = .003) compared to the control group receiving standard oral care.

The findings indicate that the honey-based oral care practice guideline is effective in reducing the incidence, severity, and duration of oral mucositis among cancer patients receiving FOLFOX4 chemotherapy. This intervention may be applied as a supportive care practice for improving oral health outcomes during chemotherapy.

Keywords : Honey, Oral mucositis, Chemotherapy, FOLFOX4

Development of a Public Health Emergency Response Model for Mosquito-Borne Disease Outbreaks in Maha Sarakham Province, Thailand, Following the Transfer of Primary Health Care Services to Provincial Administrative Organizations.

Sooksun Sirisuriyasunthorn — Tue, 23 Jun 2026 00:00:00 +0700

Abstract

Continuous outbreaks of mosquito-borne diseases in Maha Sarakham Province, coupled with the context of transferring all 175 Subdistrict Health Promoting Hospitals (SHPHs) to the Provincial Administrative Organization (PAO), have posed significant challenges to the local public health emergency response system. This action research aimed to 1) examine factors influencing the public health emergency response, and 2) develop a new response model for subdistrict and district levels tailored to this new context. The PAOR (Plan-Action-Observation-Reflection) process was employed with 130 participants involved in emergency response. Data were collected through questionnaires, focus group discussions, and in-depth interviews, and were analyzed using descriptive statistics and content analysis.

The findings revealed that key influencing factors under the new administrative context include the command structure, personnel competency, surveillance data systems, and risk communication. The primary outcome was the development of the “6S ICE DAL Model,” a novel emergency response framework that integrates the 2P2R principles (Preparedness, Prevention, Response, Recovery) into the PAO's context. This model emphasizes key components across four dimensions: Preparedness (EOC structure, incident action plans), Prevention (proactive surveillance, risk communication), Response (SRRT capacity, data centers), and Recovery (lesson learned, evaluation). The developed model serves as a crucial guideline for strengthening the unity and effectiveness of the local public health emergency response system following health service decentralization.

Keywords : Public health emergency response, Model development, Mosquito-borne infectious diseases

Editorial

Rutchaneevipa Jitrakul — Tue, 23 Jun 2026 00:00:00 +0700

Editorial

Cover

Rutchaneevipa ๋Jittrakun — Tue, 23 Jun 2026 00:00:00 +0700

Cover

การเตรียมและส่งต้นฉบับ

Rutchaneevipa ่Jitrakun — Tue, 23 Jun 2026 00:00:00 +0700

การเตรียมและส่งต้นฉบับเพื่อตีพิมพ์ในวารสารวิชาการสำนักงานสาธารณสุขจังหวัดมหาสารคาม

Content

Rutchaneevipa Jitrakul — Tue, 23 Jun 2026 00:00:00 +0700

Content

Editorial Board

Rutchaneevipa ๋Jittrakun — Tue, 23 Jun 2026 00:00:00 +0700

Editorial Board