Public Health Innovation Research and Development - การวิจัยและพัฒนานวัตกรรมสาธารณสุข

The Development of a Discharge Planning Model for End-Stage Lung Cancer Patients Wishing to Die at Home

2023-11-22T14:57:21+07:00

ABSTRACT

Background: Cancer is currently one of the major public health problems in the world. The most common problem is caring for cancer patients, where patients and their relatives often lack the readiness to face the end-stage changes of the disease and a handful of patients wish to die at home.

Aim: to develop a discharge planning model for end-stage lung cancer patients wishing to die at home.

Methods: 30 persons used purposive sampling. The instrument was a questionnaire that the researcher created, the validity (IOC) equals 0.67-1.00, and the reliability equals 0.75; the data were analyzed using percentage frequency and content analysis.

Results: The discharge planning model takes 3-5 days. There are 3 topics, 1) Advance planning consists of an Advance Care Plan, Family meeting, and Discharge Planning. 2) Inpatient Care consists of Nursing care according to circumstances, Symptom Management, Counseling process, and Health Education. 3) Continuing care consists of home visits, Counseling patients and relatives over the phone, and Bereavement Care. Patients and caregivers had the highest satisfaction with the patient discharge planning model in terms of 1) advance planning (57.78%) 2) hospital care (65.56%), and 3) continuing care (60%).

Conclusion: Planning helps prepare to serve patients effectively. Taking care of patients throughout their time in the hospital helps patients recover faster. Providing continuous services to patients and their families helps patients to be as self-reliant as possible.

Keywords: Discharge planning model, End-stage lung cancer, End-Stage Lung Cancer Patients Wishing to Die at Home

Analytical of Canonical Correlation between Cognitive in health and Health Behavior of People in Khao Kho District, Phetchabun Province

2023-10-14T12:30:36+07:00

Objective Burnout syndrome can significantly reduce the performance of health workers. Although many factors have been identified as antecedents of burnout, few studies have investigated the role of organisational commitment in its development. The purpose of the present study was to examine the relationships between subdimensions of burnout syndrome (emotional exhaustion, depersonalisation and personal accomplishment) and subdimensions of organisational commitment (affective commitment, continuance commitment and normative commitment).

Methods The present study was a cross-sectional survey of physicians and other healthcare employees working in the Ministry of Health Ordu University Education and Research Hospital. The sample consisted of 486 healthcare workers. Data were collected using the Maslach Burnout Inventory and the Organisation Commitment Scale, and were analysed using the canonical correlation approach.

Results The first of three canonical correlation coefficients between pairs of canonical variables (U_i , burnout syndrome and V_i, organisational commitment) was found to be statistically significant. Emotional exhaustion was found to contribute most towards the explanatory capacity of canonical variables estimated from the subdimensions of burnout syndrome, whereas affective commitment provided the largest contribution towards the explanatory capacity of canonical variables estimated from the subdimensions of organisational commitment.

Conclusions The results of the present study indicate that affective commitment is the primary determinant of burnout syndrome in healthcare professionals.

Results of an Emergency Medical Services Systems Development Model at the Scene of Wangthong Hospital in Phitsanulok Province

2023-10-13T23:03:16+07:00

Abstract

Background: Management and service organization of the emergency medical services systems at the scene are critical to the survival and quality of life of people with chronic illnesses. It is important to evaluate and analyze the situation of the service system in order to know the problems and obstacles and to find solutions to develop an effective emergency medical service system.

Aimed: The aim of this study was to develop a emergency medical service systems at the scene of Wangthong Hospital in Phitsanulok Province under the Malcolm Baldrige National Quality Award (MBNQA). The emergency medical service plan was put into the practical by applying to develop systems. The efficiency of the plan was investigated with regard to quality tools i.e., Why-Why Analysis, Critical-to-Quality and Service Quality Model.

Methodology: This study was research and development and was conducted in four stages. The samples in this study research were people who have been injured in emergency medical services at the scene of the accident of the Wangthong Hospital in Phitsanulok Province during 1 September, 2017 to 31 January, 2018. The instruments used for data collection were emergency medical service plan, skill test, and satisfaction interviews. Descriptive statistics such as means, standard deviations were computed, and t-test dependent was used to compare post-test and criteria means.

Results: The findings were as follows: 1) the developed emergency medical service systems at the scene of Wangthong Hospital consisted of nine components; 1) get notified, 2) inquiries for information 3) assess the situation to work out. 4) Reporting command center5) operations of ALS Team 6) operations of FR team and others, 7) assess the situation at the scene. And ask for help 8) first aid and transport of injured persons according to severity level, and 9) Report the situation to the emergency room. 2) The quality of the systems checked by experts was good. 3) The results of the experiment showed that the emergency medical service systems following the stage were smooth. The emergency medical service team’ service in 9 steps after the intervention was significantly higher than criteria at 0.01. 4) The level of satisfaction towards the emergency medical service of emergency medical service team and the injured were at a high level.

Discussion and conclusion: It can be confidently concluded that the emergency medical service systems at the scene development procedure outlined here in is suitable and can be applied successfully. The model developed by this work can be applied to other service units to increase the efficiency of the service.

Keywords: Emergency medical service systems at the scene, Malcolm baldrige national quality award

The effect of a diet program for elderly diabetic patients with uncontrolled glycemia levels: A case study in Lom Sak District of Phetchabun Province

2023-09-30T13:07:32+07:00

Background: Diabetes is a chronic non-communicable disease that remains a global health problem. Currently, the world is giving great importance to it because a disease that cannot be cured, especially in elderly patients who are uncontrolled by the factor that affects sugar level control is eating behavior.

Aim: The main objective of this research is to study the results of a dietary program for diabetic patients in elderly patients who cannot control their sugar levels: a case study in Lom Sak District of Phetchabun Province.

Methods: This study is a four-step research and development process that includes 1) Studying basic information and program development guidelines, 2) Creating and checking program quality, 3) Experimenting and analyzing the results of using the program, and 4) Studying satisfaction with using the program. The sample groups in steps 1 and 2 were multidisciplinary teams. Public health volunteers with diabetes selected a specific one. The tools used in the research include accumulated sugar data recorded from questionnaires and focus groups to draw up a pattern. In steps 3 and 4, the sample groups were elderly diabetic patients who could not control their blood sugar levels. Those who received treatment at the family doctor clinic of Lom Sak Municipality, totaling 62 samples, were purposively selected and were randomly assigned to an experimental group of 30 samples and a control group of 32 samples. The experimental group received a developed food program with three activities, followed up continuously for three months, and the control group received pre-development services. The tools used in this research as follows: 1) a food self-management awareness assessment form, 2) a blood sugar recording form, 3) a dietary guide, and 4) a satisfaction questionnaire used in the program. Data were analyzed using average values, standard deviation, and t-test statistics.

Results: 1) showed that the number of diabetic patients tends to increase at the national level, Phetchabun Province, and Lom Sak District. From this situation, there has been continuous corrective action. However, it found that diabetic patients who came to receive services at the Lom Sak Municipality Community Health Center Only 38.89%, 40.43%, and 40.68%, respectively, were able to control their sugar levels well consistent with eight diabetic patients with high blood sugar were interviewed and found that most had behavioral problems, eating mainly starchy foods. As for the service, it provides knowledge and general advice, but no clear set goals with the patient. The method for developing programs is consistent with King's theory that focuses on setting clear goals together with patients 2) The results of creating the developed food program have five main elements (Principle, Objective, Content, Process, Measurement & Evaluation) with sub-elements of the process section for trial use as follows: (1) Building relationships of help and trust (2) Self-assessment (3) Setting goals (4) Self-determination (5) Taking action (6) Self-regulation and (7) giving self-reinforcement, are as for the results of the quality inspection of the food program by experts had quality at good level 3) The results of the experiment and study of the use of the food program found that the experimental group had a higher average score of food self-management awareness. The experimental group had a higher mean score for food self-management skills and had a lower average blood sugar level than the control group immediately after the experiment, statistically significant at the .05 level, and 4) Results of the study of satisfaction with the developed program at a high level.

Conclusions: The dietary program for elderly diabetes patients who uncontrolled their sugar levels has increased effective awareness of food self-management until the practice of eating food occurred. As a result, the accumulated sugar level in the blood will decrease to an appropriate level.

Effective of a mutual goal setting nursing program for control glycosylated hemoglobin (HbA1c) in uncontrol diabetic patient

2023-09-20T15:52:33+07:00

Background: Diabetes is a chronic non-communicable disease that remains a health problem. Nowadays, the world is giving great importance because it is a disease that cannot be cured, especially uncontrolled diabetes.

Aims: 1) To study the situation, problems, glycosylated hemoglobin (HbA1c) control in uncontrolled diabetic patients in Lablae District, and guidelines for controlling the glycosylated hemoglobin in uncontrolled diabetic patients. 2) To create and examine the elements of a mutual goal-setting nursing program to control the glycosylated hemoglobin (HbA1c) level in patients with uncontrolled diabetes mellitus. 3) To trial and study the results of using a mutual goal-setting nursing program to control the glycosylated hemoglobin (HbA1c) level in patients with uncontrolled diabetes mellitus. 4) To assess stakeholder satisfaction with the use of a mutual goal-setting nursing program to control the glycosylated hemoglobin (HbA1c) level in patients with uncontrolled diabetes mellitus.

Methods: This study is research and development. Objective number 1 is used to summarize the work results for the year 2023 of Lablae Hospital, literature review, and participation of health teams and patients. Data recording and semi-structured interviews and data were analyzed using percentage, mean, and standard deviation. Statistical analysis: Pearson's correlation coefficient, content analysis, document analysis. Objective number 2 used a literature review and evaluated the quality of (draft) program components. Analyze data by content analysis and document analysis Percentage average and standard deviation. Objective number 3 used a quasi-experimental design. Data were analyzed by percentage, mean, standard deviation, and F statistic in ANOVA of repeated measures experimental plan and t-test statistic. The study of objective number 4 Uses a stakeholder satisfaction questionnaire using percentage, mean, and standard deviation.

Results: Situation and Problems to Control the glycosylated hemoglobin (HbA1c) level in patients with uncontrolled diabetes mellitus in Laplace District not yet passed the indicators. A survey research study found that there are leading factors, contributing factors, and additional factors of health literacy in patients with uncontrolled diabetes. It affects nursing practice by setting common goals. Stakeholders must participate in creating guidelines for controlling cumulative average blood sugar levels in patients with uncontrolled diabetes. The guidelines obtained from participation consist of 4 steps: condition assessment, planning, implementation, and evaluation. The results of creating the elements of the program were the 8th sub-components, namely: having purposeful interactions; Evaluation aspect In terms of decision-making skills; Problem determination together; The selection of procedures planning/goal setting; In terms of following the chosen method/modifying self-management behavior according to the set goals and evaluating success according to the goals. Each component can used to (draft) a nursing program that sets a common goal to control the average cumulative sugar level in patients with uncontrolled diabetes.