Phichit Hospital Journal-วารสารโรงพยาบาลพิจิตร

Assessment of Disability, Socio–economic and Rehabilitation Needs of People Affected by Leprosy in Tak Province, 2017

Kittiphat Iemrod — 2017-12-18

Rehabilitation of leprosy patients with proper care or self-reliance is important for equity and human rights. This study aimed to assess disability, socio–economic and rehabilitation needs of people affected by leprosy in Tak Province, 2017. The disability screening form with 8 items from the Raj Pracha Samasai Institute was used. The patient was considered to have disability if at least one of the eight items was found. Of the 81 registered patients in the leprosy database of Department of Disease Control, Ministry of Public Health, 41 were found in the communities and were screened. Of these 41 cases, 19 had disabilities from leprosy and were included in the study. Of them, 16 (84.2%) were male. The mean age of them was 62.7 years old. About 68.4% of them had no work and 84.2% had grade 2 of hand and foot disabilities. In-depth interviews revealed that people affected by leprosy had physical psychological social and economic problems. One case of them had many problems. The most crucial need was physical rehabilitation following by mental rehabilitation. The patients with hand and foot disabilities, their relatives and caregivers should be trained for self care. It is essential to encourage health care workers to follow up the patients with complete treatment at least once a year for surveillance and prevention of possible disabilities.

Keyword: Disability, rehabilitation, people affected by leprosy, Tak Province

Analgesic Effects of Adding Dexamethasone to Bupivacaine in Adductor Canal Block for Postoperative Pain After Total Knee Arthroplasty : A Randomized Controlled Clinical Trial

Preeyanuch Siriya — 2017-12-18

Postoperative pain after Total Knee Arthroplasty can be burdensome. Adductor canal block as multimodal analgesia have become increasingly use because of their low frequency of complication and excellence pain relief. Dexamethasone is commonly used in anesthesia to reduced postoperative pain and opioid requirement. The objective of this study is to evaluate effect of addition Dexamethasone to Bupivacaine on postoperative analgesia after Total Knee Arthroplasty. This research was a randomized, double-blinded, controlled clinical trial was conducted from November 2016 – May 2017. Seventy four patients scheduled for elective TKA in Nan hospital were randomized allocated into two groups to receive 0.25% bupivacaine and dexamethasone 4 มก. or 0.25% bupivacaine. Student t- test and Wilcoxon signed Rank test were used to compared duration of analgesia, postoperative pain score, pain score at 24 hours and total morphine consumption at first 24 hours.

Result: There were no signification difference in demographic data, surgical time and tourniquet time. There was no difference in first postoperative pain score. However the group received 0.25% bupivacaine and dexamethasone 4 mg had significantly longer duration of analgesia (664.72±116.53 vs 446.62±124.86, p = 0.05) and had lower pain score at 24 hour (2.40 ± 1.8 vs 3.73±1.98, p = 0.003). Total morphine consumption were less in dexamethasone group 24 hours after surgery (2.68 ±1.85 vs 4.32±3.37, p = 0.023)

Keyword: Adductor Canal Block, Total Knee Arthroplasty, Dexamethasone, Bupivacaine, Post-operative pain

Factors that Affecting Catheter-associated Urinary Tract Infection among Retained Urinary Catheter Patient, Inpatients Department, Phichit Hospital

Banjerd Thungklin — 2017-12-18

The catheter associated urinary tract infection: CAUTI is an important and frequent infection of the hospital. According to a report by the National Health Care Safety Network (NHSN), CAUTI rate in adult patients in 2011 AD was 0.2-4.8 times per 1,000 devised-days¹. At the hospital for Thailand, infection control unit of Prince Songkla Hospital CAUTI rate in ICU patients in 2008-2010 BE was 9.63, 5.03 and 4.49 times per 1,000 devised-days, respectively, 2-3 times higher than hospital indicators². And from the infection report inpatient department, in the 2557-2559 BE, Phichit Hospital is likely to rise incidence of CAUTI infection³. Urinary tract infection from urinary catheter caused by many factors. Phichit Hospital has not studied the factors that cause urinary tract infection. The researchers want to study such factors. The objective to study factors affecting urinary tract infection in urinary catheter patients. Data sources from reported patients receiving urinary catheters, both infected and non-infected inpatient department of hospital. Systematic Random Sampling was collected from 392 patients. By retrospective study, between October 2558 BE and September 2559 BE, General data analysis by percentage Mean and standard deviation. Analysis of factors related to urinary tract infection from Chi-Square catheter and factors influencing infection by logistic regression analysis. Find a chance with Odd Ratio.

RESULTS: There were five factors that affecting the incidence of urinary tract infection: including kidney disease, length of stays, devised days, the severity of the disease, co-respiratory disease. All this factors had effect of urinary tract infection inpatients. This can be accurately predicted by 85.1 percent of patients with renal disease. The risk of urinary tract infection was founded approximately three times more likely in patients with kidney disease than other patients, (OR = 3.057) or 95% CI between 1.462 - 6.399. Patients with respiratory disease had 2.5 times more chance of urinary tract infection than other patients, (OR = 2.463) or 95% CI between 1.184 - 5.124. Level of severe of disease, urinary tract infection than patients with more than 2-fold (OR = 2.046) 95% CI between 1.183 to 3.539. The equation is as follows.

-5.088 + 1.12 X1 + 0.07 X2 + 0.05 X3 + 0.72 X4 + 0.90 X5

By Y = occurrence of the catheter associated urinary tract infection, X1 = kidney disease, X2 = devised days, X3 = length of stays, X4 = severity of the disease, X5 = severe respiratory disease

Keyword: Catheter associated urinary tract infection, Factors affecting urinary tract

Factors Affecting Effectiveness of COSO’s Internal Control : A Case Study of Sukhothai Hospital

Rungthip Pongkitkarncharoen — 2017-12-18

Internal control system is an important mechanism and management tool for the organization both in the public or private sector to occure for confidence and lead the organization to good governance. Internal control system can control or reduce the risk of the organization, so a study factors affecting effectiveness of COSO’s internal control can brings the results of the study to set guidelines for the management of internal control system to achieve efficiency and effectiveness. This research was a descriptive research aimed to study effectiveness levels and operation factors influencing the effectiveness internal control according to the guidelines COSO of Sukhothai Hospital. The samples were personnel in Sukhothai Hospital from 260 samples and randomized by using multi-stage random sampling. The data were collected by questionnaire during 1 January 2017 to 31 January 2017. The data were analyzed by Pearson’s product moment correlation coefficient and Stepwise multiples regression.

The results showed that most of sample were female (73.5%), aged between 25-35 years (33.8%), bachelor’s degree (55.0%), work in the Cluster Nursing (40.8%), other personnel members (60.8%), civil servant status (50.0%), working experience more than 16 years (37.3%), rates of salary between 20,000 -30,000 baht (38.5%). Knowledge and understanding of internal control was high (57.31%). The factor of knowledge, commander, workmate, supported by administrators, characteristic and workloads, communication and the rules, all these there are no relationship with effectiveness internal control. And the result showed that 61.5 percentage of the variability in internal control was affected by knowing scores on these 2 independent variables such as supported by administrators and communication. So that the increasing the effectiveness of internal control must be : 1) Development of communication system 2) learning the rules of internal control and 3) the administrator should establish policies about internal control agenda that all personnel will be jointly implemented.

Keyword: effectiveness, COSO’s internal control, Sukhothai Hospital

Factors related to the Effectiveness of Internal Audit in the View of the Recipient Audited Agencies under the Phichit Provincial Public Health Office

Sumilika O.Sanguan — 2017-12-18

Education in “Factors related to the effectiveness of internal audit in the view of the recipient audited agencies under the Phichit Provincial Public Health Office.” The purpose of this education was to investigate the factors that are relevant to the effectiveness of internal audit, in the view of the recipient audited.

Population used in education Purposive Sampling is used by the inspector who has been inspected by the Internal Audit Committee of the Provincial Internal Audit Network in 2016 and the Health Services Network Development Committee. Internal audit branch and internal control, Provincial level in 2016. The government officials, permanent employees, Government Employees, Ministry staff And temporary employees, those working in various positions of the audited agency is Phichit Provincial Public Health Office, Phichit Hospital, Community Hospitals, District Public Health Office and Tambon Health promotion Hospital a total of 148 people.

The results of the education found that the factors related to the effectiveness of internal audit in the view of the recipient audited agencies under the Phichit Provincial Health Office the 3 factors: 1) factors qualifications of the internal auditors. 2) factors to receive support from the management and the environment within the organization. 3) quality factors of the inspection. They all affect to the degree of effectiveness of internal audits by significant level and have the same relationship.

Factors related to the effectiveness of internal audit in the view of the recipient audited agencies under the Phichit Provincial Public Health Office. The overall is on a satisfy scale with average score was 4.11. On the other section, it was found that the qualifications of the internal auditors were at the highest level of 4.16, followed by the quality of the audit with the average is 4.09 and the receive support from the management and the environment within the organization with average was 4.07 respectively, and it was found that the overall recipients were satisfied with the results of internal audit. Internal Audit Committee of the Provincial Internal Audit Network in 2016 and the Health Services Network Development Committee. Internal audit branch and internal control, Provincial level in 2016, with the highest level of satisfaction is 4.05.

Keyword: Internal audit, Internal audit effectiveness, View of the recipient audited

Factors affecting the obesity of the novice Wat Tha Luang, Muang Distric, Phichit Province

Kristsana Iamplian — 2017-12-18

Currently, the global prevalence of obesity has increased rapidly. The results of the survey of Buddhist Scripture School in Phrae Province, Nan Province, Lampang Province, showed that novice obese and obese increased from 16.19 to 18.02 percent (May 8, 2560). Thai people The prevalence was 45 - 59 years old, 28.4% male and 40.7% female. 2 And from the 4th Thai Health Survey 2008-2009, 12-14 year-old children were prevalent. Overweight and obese up to 11.93 percent. From this problem, Phichit Province has not studied the factors that cause obesity in the novice before. Researchers would like to study such factors. The purpose of this study was to investigate the factors affecting the obesity of novice Wat Tha Luang. By using the novices population at Luangporhet School, Wat Tha Luang, Amphur Muang, Phichit Province, academic year 2016, with the maturation period of not less than 6 months, 89 samples were sampled. By collecting questionnaire answers between June - August 2017. Descriptive statistics wered to analyze frequency, percentage, average amount and standard deviation and the inferential statistic Logistic Regression Analysis statistic define significance at 0.05

The result showed that the factors that affect novice obesity are five factors for the age of the ordination. Diets, rice flour, sweet fruits and vegetables were statistically significantly correlated with obesity. The results of the analysis were to find the equation for predicting the use of logistic analysis by factor-related factors. Obesity in five novices found that there are three factors : the period of ordination rice and flour And eating sweet fruit has a common effect on obesity in the novice. Predictably 78.7% of the risk of novice obesity found that the novice ordination period was longer than twice (OR = 1.869) or between 1.167 Facts about sweet fruit are more likely to be obesity than those who do not have the sweetness of 1.5 times more (OR = 1.648) or between 1.152 - 2.354 (95% CI). Eating rice flour is more likely to obesity 1 times more (OR = 1.165) Or 1.008 - 1.346 (95% CI)

Keyword: Factors affecting the obesity of the novice, obesity

Editor's Note

busakorn rugsouy — 2017-12-18

Nursing Care for Head Injury with Shock Patient

Waree Musikawan — 2017-12-18

Shock in patients with head injury is an emergency critical condition in accident patients, which is complicated in diagnosis and medical treatment. The patients must be promptly and correctly rescued since delayed treatment could bring about death or disability. This study aims to study the nursing process of patients with head injury and shock in emergency stage, applying the principles of crisis nursing in the operation, including shock management, caring for the risk of death, relieving anxiety for relatives, with close surveillance throughout the period of care until referring to the node hospital. The results reflected that the patients received help that is consistent with problems and needs with referral for ongoing care in a timely manner.

Keyword: Head injury, Shock