(PMJCS) Phrae Medical Journal and Clinical Sciences

The impact of the distribution planning program combined with the use of application technology on providing knowledge and enhancing self-care abilities of patients with cataract receiving treatment at the eye ear nose and throat aard, Phrae hospital

2023-08-30T10:37:47+07:00

Background: Preparation of patients before surgery and proper post-operative care are of utmost importance. Planning program combined with the use of a mobile application for knowledge provision can help patients understand the disease, treatment, and proper self-care practices that are suitable for their condition. This can aid in preventing post-operative complications and ensuring a successful surgical outcome for cataract patients according to the planned treatment regimen.

Objective: To compare the levels of knowledge, abilities, and satisfaction in self-care between the group receiving the distribution planning program combined with the use of a mobile application for knowledge provision and the group receiving regular care.

Study design: This research is a quasi-experimental research of the two-group pretest-posttest design. It was conducted between February and April 2023 with a sample group consisting of 40 patients receiving treatment at the eye ear nose and throat ward, Phrae Hospital. The sample group was divided into an experimental group (n=20) and a control group (n=20). The research instruments used a mobile application, personal data, knowledge assessment, self-care ability assessment, and patient satisfaction assessment questionnaires. Data analysis was performed using frequency, percentages, means, S.D, chi-square, paired samples t-test, and independent samples t-test.

Result: The knowledge of cataract patients in the experimental group and the self-care abilities of patients in the experimental group and control group were significantly higher than control group (p<0.001, <0.001). Additionally, the satisfaction level of patients was high.

Conclusion: The group receiving the distribution planning program combined with the use of a mobile application affects the patient's knowledge and self-care ability. the satisfaction level of patients with the distribution planning program was high.

Keywords: Planning Program, Application Technology, Cataract patients, Self-Care

Prevalence and association factors of stress and depression in palliative caregivers for end-stage cancer patients

2023-10-24T09:56:21+07:00

Background: The caregivers of end-stage cancer patients play a crucial and significant role in providing assistance to the patients. They often require medical care, physical support, and emotional support more than caregivers of general patients. This role can be demanding and affect caregivers in various aspects. It can lead to caregivers experiencing stress, depression, anxiety, and having negative effects on their ability to care for end-stage cancer patients.

Objective: The study aimed to determine the prevalence and factors associated with stress and depression among caregivers of end-stage cancer patients.

Study design: The cross-sectional analysis study of caregivers of end-stage cancer patients receiving consultation at the Palliative Care Clinic, Rong Kwang Hospital. Data were collected through personal information questionnaires, stress assessment (ST-5), and the PHQ-9 depression assessment.

Results: Among the 85 caregivers of end-stage cancer patients, most of the participants were female (74.1%). The average age is 49.3 years. The prevalence of moderate to severe stress and depression among this group of caregivers were 50.6% and 49.4%, respectively. Multivariate logistic regression analyses indicated that the statistically significant risk factors associated with stress are : caregivers who need to care for patients for more than 16 hours a day (OR=11.73, 95% CI=1.32-103.93, p=0.03), and caregivers of patients with loss of appetite (OR=13.55, 95% CI=1.31-139.75, p=0.03). However, none of these factors is significantly associated with depression in caregivers from multivariate logistic regression analyses.

Conclusion: Stress and depression are found quite often in caregivers of patients with end-stage cancer. A comprehensive assessment of these conditions is important to provide initial support and ensure timely and appropriate access to treatment for those who are ill.

Keywords: end-stage cancer patients, Caregiver, Stress, Depression

The effects of coaching on pain management practice guideline compliance and on clinical outcomes of post-orthopedic surgery patients

2023-10-10T09:13:36+07:00

Background: Post-orthopedic surgery patients suffer from acute pain. In other words, the sufferings might be occurred from poor pain management process. The efficient pain management derived from the nurse’s compliance with the established guideline. The coaching process was thus one of the methods that could help nurses to achieve the improved pain management.

Objective: To examine the effects of pain management practice guideline implemented in conjunction with nurse coaching on pain management practice guideline compliance and on clinical outcomes of post-orthopedic surgery patients.

Study design: This quasi-experimental research with Independent t-test adopted Herminia Ibera’s coaching concept of as a conceptual framework of this study, which was conducted in May to June 2023. Its sample consisted of 8 professional nurses in male orthopedic ward, and 40 post-orthopedic surgery patients treated at male orthopedic ward of Phrae hospital. The data were analyzed by means of descriptive statistics, Wilcoxon Signed Rank Test, and Mann-Whitney U Test.

Result: After receiving coaching, the professional nurses had a higher score of pain management practice guideline compliance than the pre-test one at a statistical significance. The sample treated with pain management practice guideline in conjunction with nurse coaching (experimental group) had higher mean scores of perception towards nursing practices in pain management than their counterparts treated with pain management practice guideline alone at a statistical significance.

Conclusion: Coaching could enable nurses to provide efficient patient care leading to good clinical outcomes for post-orthopedic surgery patients. The coaching process should be applied to the development of the quality of nursing care

Keywords: Pain, coaching, post-operative

Effects of the self – management on volume overload in end stage renal disease patients receiving hemodialysis

2023-10-24T09:50:56+07:00

Background: Volume overload in end stage renal disease patients receiving hemodialysis results in fluid retention in the circulatory system. Causing heart failure, shortness of breath and eventually died following. Self-management helps patients make the right changes in their health behavior.

Objective: To compare end-stage renal disease patients’ self-management behavior mean score and average pre-hemodialysis weight gain before and after being treated with self–management program for volume overload prevention.

Study design: The methodology of this study is quasi-experimental one-group design. The sample, chosen by simple random sampling, included 37 end-stage renal disease patients undergoing hemodialysis. The research instruments used in this study comprised self–management program for volume overload prevention, patient's general information record form, and questionnaire on self-management behaviors of end-stage renal disease patients. It was analyzed through descriptive statistics, Wilcoxon Signed Ranks Test, and pair t-test, and .05 statistical significance level.

Research: End-stage renal disease patients treated with self–management program for volume overload prevention had a higher self-management behavior mean score than their pre-treatment one at a statistical significance level. Their average pre-hemodialysis weight gain was found to be lower in comparison to their pre-treatment period.

Conclusion: It was suggested that self–management program for volume overload prevention should be implemented.

Keywords: end stage renal disease, self – management, volume overload

Effects of developing a surveillance and monitoring model for pregnant women at risk of preterm birth using a line application

2023-10-24T09:33:36+07:00

Background: Preterm birth is a major public health problem and requires a system of close monitoring and monitoring. To reduce the problem of preterm birth.

Objective: To develop the model and effectiveness of surveillance and monitoring of pregnant women at risk of preterm birth using LINE application.

Study design: It is research and development. The sample consisted of 24 registered nurses in the Obstetric-Gynecological Outpatient Nursing Group, Obstetrics-Gynecology Building and Delivery Room Department at Lamphun Hospital, and pregnant women who received services at the antenatal clinic. Lamphun Hospital: 30 people. The tools used to conduct the research include counseling to monitor and monitor pregnant women at risk of preterm birth using a LINE application. Data collection tools include questionnaires for pregnant women, questionnaires for registered nurses and preterm birth incidence records. Analyze data with descriptive statistics, including frequency, percentage, mean, standard deviation, and inferential statistics including Paired t-test with a statistical significance level of 0.05.

Results: Consultation model to monitor and monitor pregnant women at risk of preterm birth using LINE application "Clinic Preterm" account is a form of education and consultation with infographics and online videos on risks, effects, risk factors and prevention of preterm birth. In terms of the effectiveness of the model, it was found that after the use of the model, pregnant women had knowledge of the risk of preterm birth and were able to better behave in preventing preterm birth statistical significance (p<0.05). And the majority 93.3% gave birth as scheduled. In terms of satisfaction with the model found that the sample of pregnant women and registered nurses had the highest satisfaction with the format (mean= 4.40 and 4.21)

Conclusions: This model helps to increase knowledge and results in pregnant women are aware of the importance of their practices in preventing preterm birth.

Keywords: Surveillance and Monitoring, Pregnant Women, Preterm Birth Risk, Line Application

Effectiveness of spraying the endotracheal cuff with flurbiprofen for postoperative sore throat and hoarseness after general anesthesia: a randomized control trial

2023-10-26T11:58:25+07:00

Background: Postoperative sore throat (POST) is a common postoperative complication after general anesthesia. Flurbiprofen oral spray is one of topical NSAIDs that used to reduce sore throat from oral inflammation.

Objectives: To study the effectiveness of Flurbiprofen oral spray for postoperative sore throat after general anesthesia.

Study design: A prospective, randomized, double-blind, controlled study was performed on 80 patients, scheduled for surgery under general anesthesia with endotracheal intubation. All patients were randomized into two groups. Group F (Flurbiprofen, n=40) patients received flurbiprofen spray on lubricated endotracheal tube cuff and Group C (Control, n=40) patients received only lubricating gel on endotracheal tube cuff. Incidence and severity of postoperative sore throat at 1,4 and 24 hours after surgery, hoarseness, adverse effects and patient satisfaction were recorded by a blinded anesthetic nurse after surgery.

Results: The incidence and severity of postoperative sore throat of Group F is significantly less than Group C at 1, 4 and 24 hours after surgery (p<0.001). Incidence and severity of hoarseness at 24 hour and side effect were not different in both groups.

Conclusions: Spraying the endotracheal cuff with Flurbiprofen helps to reduce the incidence and severity for postoperative sore throat without additional side effect.

Keyword: sore throat, intubation, flurbiprofen, spray

The development of guidelines for patients arteriovenous fistula for hemodialysis with one day surgery, Phrae hospital

2023-12-22T08:22:23+07:00

Background: The arteriovenous fistula for hemodialysis with one day surgery is one of the most popular surgical services in outpatient surgery, and it is on the rise.

Objective: To develop patient care guidelines and the results of using guidelines in arteriovenous fistula for hemodialysis with one day surgery, Phrae Hospital.

Study design: It is research and development. The samples include registered nurses in the operating room 15 people and patients undergoing surgery between 1 June 2023 and 31 August 2023, 30 people. The instruments used to conduct the research include patient care guidelines. The tools used to collect data include personal records of registered nurses, patient personal data record form, nurse performance assessment form, satisfaction assessment form for registered nurses and patients, and incidence record form of cancelling or postponement of surgery due to preoperative patient unavailability and postoperative complications within 24 hours. Analyze qualitative data with content analysis and analyze quantitative data with frequency, percentage, mean and standard deviation.

Results: Guidelines for patient care for Arteriovenous Fistula for hemodialysis with one day surgery, Phrae Hospital developed from empirical evidence, consists of 4 activities:1) one-day surgery appointment, 2) preoperative care, 3) intra operative care and 4) postoperative care. Results of using guidelines for patient care for arteriovenous fistula for hemodialysis with one day surgery was found that more than 86.7% nurses were able to follow the activities of care. The highest level of satisfaction with the guidelines (mean= 4.29). Patients who underwent surgery had the highest level of satisfaction with the nursing care approach. (mean= 4.39). No incidence of cancelling or postponement of surgery due to preoperative patient unavailability included postoperative bleeding within 24 hours. Only pain was found accounting for 6.7 percent

Conclusions: The development of guidelines for patient care for Arteriovenous Fistula for hemodialysis with one day surgery. It is a process to improve the quality of services that benefit patients to receive safe and quality services.

Keywords: Arteriovenous Fistula, Chronic Kidney Disease, One Day Surgery

The effect of pre-operation preparing program on recovery in post abdominal surgery patients in surgery male ward, Phrae hospital

2023-12-22T14:32:56+07:00

Background: Open abdominal surgery is the major surgery that causes tissue injury within the body. Patients have problems recovering after surgery. Appropriate preparing patients can help them to behave correctly and appropriately starting from before surgery to after surgery, and promote recovery after surgery. The patients will have no postoperative complications and reduce the length of hospital stay.

Objective: To compare the quality of recovery after surgery among patient groups receiving a preparation program to promote recovery after abdominal surgery and the group receiving normal nursing care

Study design: The sample of this quasi-experimental research consisted of male patients aged 18 years and older who had scheduled abdominal surgery of the gastrointestinal tract, liver and biliary system, and received whole body anesthesia admitted to the male surgery ward at Phrae Hospital between February 2023 and August 2023. Descriptive statistics, such as frequency distribution, percentage, and Mann-Whitney U test, were used to analyze the data.

Results: The results indicated that the post operative quality of recovery scores of the experimental group at the1^st day (x̅ =184.71, SD=5.08) and day3^rd (x̅=192.28, SD=2.53) were significantly higher than the scores of the control group at the 1^st day (x̅ = 171.99, SD=16.48) and 3^rdday (x̅ =183.06, SD=10.24) after the operation (p-value=0.001).

Conclusions: Preparation program promoting the recovery of patients after abdominal surgery could promote postoperative recovery in abdominal surgery patients.

Keywords: Post abdominal surgery recovery, Enhancing postoperative recovery, ERAS

The effectiveness of constipation prevention program among spine patients at Phrae hospital

2023-12-26T09:54:42+07:00

Background: Constipation is a common problem in spine patients with restricted movement and infrequent bowel movements. Constipation prevention programs can reduce this problem.

Objective: To determine the effectiveness of the constipation prevention program among spine patients at Phrae Hospital.

Study design: The interrupted time design among spine patients at Phrae Hospital. The intervention group received a constipation prevention program, while the reference group received routine care. Record excretion, disturbing symptoms, and method to help in the excretion. Data was analyzed by using ordinal logistic regression analysis and presented with the risk reduction.

Results: Constipation prevention program can reduce constipation or difficult stool passage by 90.1% (95%CI=74.8, 96.1, p<0.001), abdominal bloating or nausea by 90.1 (95%CI=74.8, 96.1, p<0.001), and also reduced enema or the use of laxative 95.0 (95%CI=86.4, 98.2, p<0.001). Overall satisfaction with the constipation prevention program was at the highest level of 74.1%.

Conclusions: An effective and continuous constipation prevention program should be used in all spine patients. Our study found that it helped to alleviate constipation, abdominal bloating, and enema.

Keywords: constipation prevention program, bowel management, spine disease, constipation, difficult stool passage