Medical Journal of Sakon Nakhon Hospital

Editorial

2026-08-31T18:03:40+07:00

The effectiveness of SGLT-2 inhibitors in patients with type 2 diabetes mellitus at Phang Khon Hospital

2026-06-16T13:40:32+07:00

การศึกษาเชิงวิเคราะห์แบบย้อนหลังนี้มีวัตถุประสงค์เพื่อประเมินประสิทธิผลของการใช้ยากลุ่ม SGLT-2 inhibitors ในผู้ป่วยโรคเบาหวานชนิดที่ 2 ที่เข้ารับการรักษาในคลินิกโรคไม่ติดต่อเรื้อรัง โรงพยาบาลพังโคน จังหวัดสกลนคร รวบรวมข้อมูลจากเวชระเบียนผู้ป่วยโรคเบาหวานชนิดที่ 2 ที่ได้รับยากลุ่ม SGLT-2 inhibitors ต่อเนื่องไม่น้อยกว่า 1 ปี จำนวน 86 เวชระเบียน ข้อมูลที่ศึกษาประกอบด้วย น้ำหนัก ดัชนีมวลกาย ระดับน้ำตาลในเลือดขณะอดอาหาร ระดับน้ำตาลสะสม ค่าครีเอตินิน และอัตราการกรองของไต วิเคราะห์ข้อมูลพื้นฐานด้วยสถิติเชิงพรรณนา และเปรียบเทียบผลลัพธ์ในภาพรวมโดยใช้สถิติ Friedman test กำหนดนัยสำคัญทางสถิติที่ p < 0.05 และเปรียบเทียบรายคู่ใช้สถิติ Wilcoxon signed-rank test กำหนดระดับนัยสำคัญทางสถิติที่ p < 0.0167 (Bonferroni correction)

ผลการศึกษาพบว่าโดยภาพรวมน้ำหนักตัวและดัชนีมวลกายของผู้ป่วยโรคเบาหวานชนิดที่ 2 ลดลงอย่างมีนัยสำคัญทางสถิติ ( = 66.14, df = 2, p < 0.001, และ = 67.82, df = 2, p < 0.001) ระดับน้ำตาลในเลือดขณะอดอาหารและระดับน้ำตาลสะสมลดลงอย่างมีนัยสำคัญทางสถิติ ( = 18.50, df = 2, p < 0.001, และ = 7.13, df = 2, p = 0.027) ค่าครีเอตินินเพิ่มสูงขึ้นอย่างมีนัยสำคัญทางสถิติ ( = 21.61, df = 2, p<0.001) ส่วนอัตราการกรองของไตลดลงอย่างมีนัยสำคัญทางสถิติ ( = 30.24, df = 2, p < 0.001) แต่เมื่อพิจารณาจากค่ามัธยฐานอัตราการกรองของไตทุกระยะของการติดตามพบว่ายังอยู่ในเกณฑ์ปกติ (Median T1 = 90.71 mL/min/1.73 m², IQR 69.95-100.70; Median T2 = 84.83 mL/min/1.73 m², IQR 66.31-97.68; Median T3 = 80.92 mL/min/1.73 m², IQR 61.98-97.49) อาการไม่พึงประสงค์ที่พบคือ ภาวะน้ำตาลในเลือดต่ำ ร้อยละ 3.5 ติดเชื้อในระบบทางเดินปัสสาวะ ร้อยละ 2.3

Factors Associated with Sleep Quality in Patients with Non-Communicable Diseases, Sukkasem Primary Care Unit, Sakonnakhon Hospital

2026-06-10T19:20:05+07:00

This cross-sectional descriptive study aimed to evaluate sleep quality and associated factors that affected sleep quality in patients with non-communicable diseases (NCDs). The sample consisted of 270 patients who visited the Diabetes and Hypertension Clinic at Sukkasem Primary Care Unit, Sakon Nakhon Hospital, between July and August 2025. The data collection was performed using a questionnaire. The data were analyzed using descriptive statistics, and factors affecting sleep quality were analyzed using multiple logistic regression, with statistical significance set at p < 0.05.

The results showed that among the 270 participants, the majority were female (64.4%) with a mean age of 58.91±10.68 years. The most prevalent comorbidities were hypertension, diabetes, and dyslipidemia. Poor sleep quality was reported by 166 participants (61.5%). Multiple regression analysis revealed that smoking (adjusted OR = 4.17, 95% CI=1.091–15.932, p = 0.037), nocturia (adjusted OR = 1.85, 95% CI = 1.085–3.178, p = 0.024), depression (adjusted OR = 3.34, 95% CI = 1.271–8.769, p = 0.014), and stress (adjusted OR = 2.11, 95% CI = 1.198–3.718, p = 0.010) were significantly associated with an increased risk of poor sleep quality.

The majority of patients with NCDs experienced poor sleep quality. Therefore, screening and health promotion programs should be provided to these patients to help them achieve better sleep quality.

Factors Influencing Nursing Quality Accreditation (NQA) of M1-Level Hospitals in Health Region 8

2026-06-14T10:35:37+07:00

This research is a descriptive predictive study to investigate factors that can predict Nursing Quality Accreditation (NQA) among professional nurses in M1-level hospitals in Health Region 8. The sample consisted of 187 professional nurses working at the operational level in M1-level hospitals in Health Region 8. The research instrument was a questionnaire developed by the researcher, consisting of personal information, selected factors, and Nursing Quality Accreditation (NQA). Content validity was checked by 5 experts, yielding content validity indices of 1.00, 0.96, and 0.99, respectively, and Cronbach's alpha reliability coefficients of 0.89 and 0.96, respectively. Data were analyzed using descriptive statistics, Pearson correlation coefficients, and stepwise multiple regression analysis.

The research findings revealed that: 1) The overall Nursing Quality Accreditation (NQA) of professional nurses in M1-level hospitals in Health Region 8 was at a high level
( = 3.82, S.D. = 0.60); 2) Personal factors had no relationship with Nursing Quality Accreditation (NQA) 3) Selected factors, including adaptive organizational culture, transformational leadership, information technology support, and participation, had a high to very high positive correlation with Nursing Quality Accreditation (NQA) (r = 0.66, 0.84, 0.65, and 0.67, respectively and 4) Transformational leadership, information technology support, and participation could collectively predict 79.5% of the variance in Nursing Quality Accreditation (NQA) (R² = 0.795, p < 0.001)

Effectiveness of Discharge Planning Program on Knowledge and Self-Care Skills among Pneumonia Patients in Romchattra 1 Ward, Sakon Nakhon Hospital

2026-08-26T21:18:22+07:00

This quasi-experimental study, using a two-group posttest-only design, aimed to compare the mean scores of knowledge and self-care skills among patients with pneumonia between a group receiving usual nursing care and a group receiving a discharge planning program based on the D-M-E-T-H-O-D model, and to examine patients’ satisfaction with the program. The sample consisted of 70 patients with pneumonia admitted to Rom Chat 1 Ward, Sakon Nakhon Hospital, between September 2025 and January 2026. Participants were alternately assigned to either the control group, which received usual nursing care (n = 35), or the experimental group, which received the discharge planning program (n = 35). The research instruments comprised the D-M-E-T-H-O-D discharge planning program, a demographic data questionnaire, a 15-item pneumonia knowledge assessment based on the D-M-E-T-H-O-D framework, a 20-item self-care skills assessment, and an eight-item program satisfaction questionnaire. The instruments demonstrated acceptable content validity (CVI = 0.80) and reliability (Cronbach’s alpha = 0.85). Data were analyzed using descriptive statistics, the chi-square test, and the independent-samples t-test.

The findings indicated that the two groups were comparable in terms of sex, age, educational level, occupation, and healthcare coverage (p > .05); however, a statistically significant difference was found in smoking history (χ² = 6.98, p = .030). The experimental group had a significantly higher mean knowledge score (M = 57.43, SD = 4.10) than the control group (M = 37.49, SD = 6.26; t = 15.77, p < .001). Similarly, the experimental group had a significantly higher mean self-care skills score (M = 16.49, SD = 1.70) than the control group (M = 11.23, SD = 3.09; t = 8.82, p < .001). Both outcomes demonstrated very large effect sizes (Cohen’s d = 3.77 and 2.11, respectively). In addition, patients in the experimental group reported the highest level of satisfaction with the program (M = 4.26, SD = 0.36). These findings suggest that the D-M-E-T-H-O-D-based discharge planning program can enhance knowledge and self-care skills among patients with pneumonia and should be adopted as a standard nursing guideline for discharge planning in this population.

Factors Influencing High Performance Organization as Perceived by Registered Nurses at Sakon Nakhon Hospital

2026-06-14T10:50:55+07:00

This research is a descriptive and predictive study to investigate factors that can collectively predict the perception of a high performing organization among professional nurses at Sakon Nakhon Hospital. The sample consisted of 168 professional nurses at Sakon Nakhon Hospital. The research instrument was a questionnaire divided into three parts: 1) a questionnaire on personal factors, 2) a questionnaire on selected factors influencing the perception of a high performing organization, and 3) a questionnaire on the perception of a high performing organization. Content validity was checked by five experts, yielding content validity coefficients of 1.00, 0.94, and 0.97, respectively. Reliability was checked using Cronbach's alpha coefficient, yielding values of 0.91 and 0.98, respectively. Data were analyzed using descriptive statistics, Pearson correlation coefficients, and stepwise multiple regression analysis.

The results revealed that: 1) the overall perception of high performance organization among registered nurses at Sakon Nakhon Hospital was at a high level ( = 4.13, S.D. = 0.41). 2) Personal factors had no relationship with being a high-performing organization (P > 0.05). 3) Selected factors, namely work environment, organizational support, adaptive organizational culture, and participation, had a moderate positive correlation (r = 0.54, r = 0.52, r = 0.57, r = 0.63, respectively, p < 0.001) with being a high-performing organization as perceived by professional nurses at Sakon Nakhon Hospital. 4) Participation and work environment factors together could predict 46.0% of the variance in being a high performing organization as perceived by professional nurses at Sakon Nakhon Hospital (R²= 0.46, p < 0.001).

Factors Influencing Telemedicine Care Management as Perceived by Professional Nurses in Network Hospital of Sakon Nakhon Province

2026-06-10T21:03:16+07:00

This descriptive correlational and predictive research aimed to study factors that could predict the management of telemedicine care by professional nurses in network hospitals in Sakon Nakhon Province. The sample consisted of 137 outpatient professional nurses with at least one year of service, excluding ward heads. The research instrument was a questionnaire comprising personal information, factors related to the use of telemedicine, attitudes towards the use of telemedicine, and the management of telemedicine. Content validity was checked by five experts, yielding content validity indices of 1.0, 0.97, and 1.0, respectively. Reliability was checked using Cronbach's alpha coefficient, yielding values of 0.96, 0.95, and 0.98, respectively. Data were analyzed using descriptive statistics, Pearson correlation coefficients, and stepwise multiple regression analysis.

The research results showed that 1) the management of telemedicine care by professional nurses in network hospitals in Sakon Nakhon Province. Overall, the correlation between telemedicine management and telemedicine management was high ( x̄= 3.73, S.D. = 0.79). 2) Personal factors were not correlated with telemedicine management (p > 0.05). Factors related to telemedicine adoption, including perceived usefulness and perceived ease of use, showed a high positive correlation (r = 0.76, 0.74, respectively, p < 0.001). Factors related to attitudes towards telemedicine use, including cognitive, emotional, and behavioral aspects, showed a high positive correlation (r = 0.83, 0.83, and 0.73, respectively, p < 0.001) with telemedicine management among professional nurses in network hospitals in Sakon Nakhon Province. 3) Cognitive, perceived usefulness, and emotional factors together accounted for 78.5% of the variance in telemedicine management (R² = 0.785, p < 0.001).

Eการศึกษาประสิทธิผลและความปลอดภัยของสูตรยา Sofosbuvir/Velpatasvir ในการรักษาผู้ป่วยโรคไวรัสตับอักเสบซี ในโรงพยาบาลสกลนคร

2026-06-10T13:01:50+07:00

Hepatitis C Virus (HCV) infection is a major global public health problem that leads to chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Treatment with the Sofosbuvir/Velpatasvir regimen helps reduce the risk of cirrhosis, hepatocellular carcinoma and mortality rates. The purpose of this study is to analyze the effectiveness and safety of the Sofosbuvir/Velpatasvir regimen in patients with chronic hepatitis C infection in Sakon Nakhon Hospital. This study was retrospective cohort study involving 199 patients with chronic hepatitis C from January 2023 to April 2025. Statistical analysis included descriptive statistics, t-test, and Mann-Whitney U test. Treatment effectiveness was assessed based on sustained virological response (SVR) at 12 weeks after treatment.

The sample consisted of 199 patients, divided into 78 patients in the group none receiving Ribavirin and 121 patients in the group receiving Ribavirin. The majority were male (55.3%) with a mean age of 57.3 ± 11.19 years. A total of 197 patients (99.0%) achieved a cure. Among patients with cirrhosis, the cure rate was not significantly different from those without cirrhosis, with SVR rates of 100.00% and 97.4%, respectively (p-value = 0.15). Some patients experienced mild adverse events such as anemia, and fatigue. All treated patients completed the medication course without severe side effects.

Conclusion: The Sofosbuvir/Velpatasvir regimen is highly effective and safe for treating chronic hepatitis C patients, both with and without cirrhosis.

The Development of Nursing Practice Guideline for Awareness and Prevents Complication in General Anesthesia of Endoscopic Lumbar Spine Surgery, Bandung Crown Prince Hospital

2026-08-07T13:29:18+07:00

This research and development (R&D) study aimed to develop a nursing practice guideline for the prevention and surveillance of anesthesia-related complications in patients undergoing endoscopic spine surgery by nurse anesthetists at Bandung Crown Prince Hospital. The study was conducted in three phases. Phase 1 involved an assessment of the existing situation and problems through meetings with healthcare personnel, retrospective data review, and analysis of annual anesthesia quality indicators. Phase 2 involved the development of the nursing practice guideline based on a review of relevant literature and empirical evidence. A draft guideline was developed and its content validity was evaluated by three experts, yielding a Content Validity Index (CVI) of 0.88. Phase 3 evaluated the outcomes of guideline implementation using a quasi-experimental two-group pretest–posttest design. The study sample consisted of four nurse anesthetists and 70 patients undergoing endoscopic spine surgery, with 35 patients assigned to the experimental group and 35 to the control group. Data were analyzed using the Chi-square test, dependent t-test, and independent t-test.

During 2023–2024, anesthesia-related complications among patients undergoing endoscopic lumbar spine surgery were primarily associated with inadequate preoperative preparation and incomplete prevention and surveillance of anesthesia-related risks. Following implementation of the nursing practice guideline, nurse anesthetists achieved an overall compliance rate of 94.28%. Their satisfaction with the guideline was at the highest level (Mean = 4.51, SD = 0.51). In addition, their knowledge scores improved after implementation of the guideline, and all nurse anesthetists met the established competency criteria.

The developed nursing practice guideline promoted standardized nursing practice, enhanced the knowledge and confidence of nurse anesthetists, and contributed to reducing the risks and complications associated with anesthesia in patients undergoing endoscopic spine surgery.

Binding Purse-string and Transfixing Mattress Sutures Pancreaticogastrostomy as Pancreatico-enteric Anastomosis in Pancreaticoduodenectomy: Sakon Nakhon Hospital Initial Experience.

2026-06-10T16:56:20+07:00

Objective: The primary objective is to study the effects of Binding Purse-string and Transfixing Mattress Sutures Pancreaticogastrostomy, particularly regarding POPF, in comparison with the POPF outcomes of previously performed PJ

The secondary objective is to study various complications such as delayed gastric emptying, surgical site infections, postoperative bleeding, bile leakage, and mortality of Binding Purse-string and Transfixing Mattress Sutures Pancreaticogastrostomy

Method: From 2015 to 2024, there were 60 pancreaticoduodenectomy (PD) operations for benign and malignant diseases in Sakon Nakhon Hospital (SKH); in these patients, there were 50 patients underwent PJ and 10 patients underwent PG with binding purse-string suture transpancreatic transfixing sutures as pancreatico-enteric anastomosis method. Patient demographic data, tumor characteristics, intraoperative data, and perioperative complications were gathered and analyzed with appropriate descriptive and inferential statistics.

Result: The POPF 4/10 to 24/26 p = 0.214, The median Bloodloss 765 to 992.70 p =0.42, The median operative time 392.50 to 433.70 p = 0.42, The median bloodtranfusion 214.10 to 466.10 p = 0.11

no statistical difference in the outcomes between the PG and PJ groups

Conclusions: PG with binding purse-string suture and transpancreatic transfixing sutures is simple and safe operation for PD. There was no difference in POPF and other complicationsin comparison with PJ in our study. However, further study with adequate participants is needed to confirm benefit of PG with purse-string suture and transpancreatic transfixing suture over PJ.

Development of a Service Model for Thai Traditional and Integrative Medicine Clinics

2026-06-15T11:27:36+07:00

Thai traditional medicine and integrative medicine play an increasingly important role in supporting holistic healthcare. The provision of integrated services requires multidisciplinary collaboration and a service system that responds effectively to patients’ needs and expectations.

To examine the integrated service model for Thai traditional and integrative medicine, assess service quality, and synthesize recommendations for future development of the service model.

This research and development study was conducted at an integrated Thai traditional and integrative medicine clinic in Health Region 4 during April–May 2026. Participants were purposively selected and comprised healthcare providers, service recipients, and administrators, with a total of 30 participants. Data were collected through in-depth interviews and the SERVQUAL service quality assessment. Qualitative data were analyzed using thematic analysis and integrated with quantitative findings to formulate recommendations.

The service model involved multidisciplinary collaboration among conventional physicians, Thai traditional medicine practitioners, Chinese medicine practitioners, and nurses. Services were primarily provided according to professional roles, with consultation and referral between disciplines when necessary. Ninety percent of service recipients perceived the clinic as different from conventional healthcare settings because multiple therapeutic approaches could be accessed during a single visit and information could be obtained from various healthcare professionals. However, perceived service quality was lower than expectations across all five SERVQUAL dimensions. Statistically significant gaps were found in reliability and responsiveness.

The clinic demonstrated strengths in providing access to multiple disciplines and facilitating multidisciplinary collaboration. Nevertheless, gaps remained between the services delivered and patients’ expectations. Future development should therefore move beyond the presence of multidisciplinary professionals toward an integrated service system with a clearly defined clinical pathway and coordinated interprofessional processes. The WHO Six Building Blocks framework can be applied to guide development across service delivery, health workforce, health information systems, access to essential medicines and technologies, health financing, and leadership and governance, thereby supporting a healthcare service system that is accessible, safe, high-quality, and responsive to patients’ needs.

Future development should establish clear clinical pathways and referral mechanisms among professional groups, strengthen workforce competencies and information systems to support interprofessional collaboration, ensure access to essential medicines and technologies, and establish appropriate management mechanisms and service quality indicators for continuous monitoring and improvement..

Validation and Reliability of the Clinical Frailty Scale for Predicting Postoperative Outcomes in Hip Fracture Surgery at Sakon Nakhon Hospital: A Prospective Validation Study

2026-06-16T22:44:29+07:00

This prospective study aimed to validate the predictive validity and inter-rater reliability of the Clinical Frailty Scale (CFS) for predicting postoperative complications and 30-day mortality in 104 patients aged 60 years and older undergoing hip fracture surgery at Sakon Nakhon Hospital. Patients were assessed preoperatively using the CFS by both physicians and nurses. Data were analyzed using ROC curve analysis, binary logistic regression, Spearman's correlation, and Intraclass Correlation Coefficient (ICC).

Postoperative complications occurred in 66.35% of patients. The overall AuROC of the CFS was 0.77 (95% CI: 0.67–0.86) for predicting postoperative complications and 0.76 (95% CI: 0.53–0.98) for 30-day mortality. A CFS cut-off score of ≥ 5 provided the optimal balance between sensitivity and specificity. Frail patients had 5.74-fold higher odds of developing postoperative complications compared with non-frail patients (OR = 5.74, p < 0.001). Inter-rater reliability between physicians and nurses was excellent (ICC = 0.94). The CFS is a suitable tool for preoperative frailty assessment in older patients with hip fractures in the general hospital setting of Thailand

The Outcomes of Advanced Cardiovascular Life Support (ACLS) Training on Confidence and Knowledge Application in Registered Nurses at Sakon Nakhon Hospital

2026-06-10T21:52:31+07:00

Cardiac arrest is a life-threatening emergency with high mortality. Advanced Cardiovascular Life Support (ACLS) requires a multidisciplinary team with adequate knowledge, skills, and confidence. Sakon Nakhon Hospital has established a Cardiac Life Support Training Center and continuously conducted ACLS training for registered nurses; however, systematic long-term outcome evaluation has been lacking.

To evaluate the outcomes of ACLS training on confidence levels and knowledge application in clinical practice among registered nurses at Sakon Nakhon Hospital, at least one-year post-training.

This descriptive cross-sectional study was conducted at Sakon Nakhon hospital among 250 registered nurses who had completed ACLS training at the Cardiac Life Support Training Center at least one year prior. Participants were selected by purposive sampling. Data were collected using a researcher-developed questionnaire about confidence levels before and after ACLS training and knowledge application in clinical practice, which passed content validity and reliability testing. Data were analyzed using descriptive statistics, Fisher’s Exact Test, and Wilcoxon Signed-Rank Test.

Confidence levels in performing Advanced Cardiovascular Life Support in all 5 domains statistically significantly increased after the training (p < 0.001). Most registered nurses were able to completely apply the knowledge in practice, with the High-Quality CPR domain having the highest proportion of complete application (98.50%). Gender, age group, and the working ward were significantly associated with knowledge application (p < 0.05).

Advanced Cardiovascular Life Support training resulted in a statistically significant increase in the confidence levels of registered nurses, and the knowledge was effectively applied in actual clinical practice.

Editorial Board

2026-08-31T18:07:12+07:00

Content

2026-08-31T18:07:51+07:00