Medical Journal of Sakon Nakhon Hospital

Editorial

Sirayusm Waramitra — 2025-08-29

Editorial Board

2025-08-29

Content

2025-08-29

OCULAR INJURY in SENA HOSPITAL

Prapaporn Tienamporn — 2025-08-29

Ocular trauma is one of the leading causes of vision loss worldwide. The etiology of eye injuries varies significantly according to geographical regions, making it essential to understand the characteristics and factors associated with ocular trauma to develop effective prevention strategies and reduce future incidence rates.

This retrospective descriptive study analyzed medical records of patients with eye injuries who received treatment at Sena Hospital from August 1, 2018, to September 30, 2024. A total of 550 cases were included in the analysis, with general data examined using descriptive statistics.

The study revealed that most patients (84.36%) were treated as outpatients, and the majority (72%) showed improved visual acuity following treatment. Male patients predominated, accounting for 67.45% of all cases, with the largest age group being 41-50 years (20%). General laborers constituted the majority of patients (51.82%). Work-related accidents involving welding and metal grinding were identified as the most common cause, occurring in 81 cases (14.73%), followed by chemical injuries in 73 cases (13.27%). Corneal abrasion was the most frequent diagnosis, accounting for 20.36% of all cases.

Since ocular trauma patterns vary by geographical region, study results may differ across different locations. The findings from this study of patients treated at Sena Hospital demonstrate that most accidents occurred in males of working age with general labor occupations, with primary causes being welding, metal grinding, and chemical exposure. Encouragingly, most patients showed improved vision after treatment. These results suggest that public health campaigns aimed at increasing knowledge, understanding, and awareness of the importance of using eye protection equipment during work could significantly help reduce both the incidence and severity of ocular trauma in similar populations.

Effectiveness of Support and Education Program on Self-care Behaviors and HbA1c in type 2 Diabetes patients Phon Na Kaeo Hospital

Trinnapong Teerapongtanasuk — 2025-08-29

This study is quasi-experimental research with a one-group design. The objective was to assess the impact of a support and education program on self-care behaviors and HbA1c in Type 2 Diabetes Patients at Phon Na Kaeo Hospital. The population group included patients diagnosed with type 2 diabetes who are undergoing treatment at the chronic disease clinic at Phon Na Kaeo Hospital, Phon Na Kaeo District, Sakon Nakhon Province. The sample group consisted of 34 patients with type 2 diabetes from the Na Tong Watthana Subdistrict, Phon Na Kaeo District, who were specifically selected. The study duration was 3 months, from 20^th January 2024 to 20^th April 2024. The tools used in the experiment include a program to provide support and knowledge and a self-care guide for diabetic patients. Data collection tools included a General Information Questionnaire and a Diabetes Self-Care Behavior Questionnaire. The data analysis involved Frequency Distribution, Percentage, Mean and Standard Deviation, and Paired t-test.

Research findings indicate that the experimental group had a significantly higher overall score in diabetes self-care behaviors after receiving the program (x̅ = 82, S.D. = 6.5) compared to before the program (t = 12.2, P < 0.001). Additionally, the glycated hemoglobin levels of type 2 diabetes patients after receiving the program were significantly lower (x̅ = 8.7, S.D. = 1.8) than before the program

(t = 5.3, P < 0.001).

Recommendations: It is recommended to promote the implementation of the support and education program for improving self-care behaviors and HbA1c in type 2 diabetes patients at Phon Na Kaeo Hospital. Expand the implementation of the program in sub – district health promotion hospitals.

A Retrospective Comparative Study of Open Reduction and Internal Fixation (ORIF) versus Open Reduction in Zygomaticomaxillary Complex (ZMC) Fractures at Sakon Nakhon Hospital

Watcharasak Jara — 2025-08-29

This retrospective comparative study was conducted to evaluate clinical outcomes, postoperative complications, and cost-effectiveness of open reduction and internal fixation (ORIF) versus open reduction alone in the management of zygomaticomaxillary complex (ZMC) fractures. The comprehensive review of medical records and three-dimensional computed tomography imaging of 210 patients with unilateral ZMC fractures who underwent surgical treatment at Sakon Nakhon Hospital from June 2018 to June 2023 were performed. The patients were stratified into three distinct therapeutic groups: Group 1 underwent open reduction alone, Group 2 received open reduction with two-point ORIF, and Group 3 was treated with open reduction combined with three-point ORIF. Primary outcome measures included malar height restoration, vertical dystopia correction, osseous stability, and postoperative complications.

The results showed significantly superior malar height restoration in patients treated with two-point and three-point ORIF compared to those managed with open reduction alone at the 6-week follow-up assessment (p < 0.04). Vertical dystopia was significantly lower in both ORIF cohorts relative to the open reduction monotherapy group at the 6-week postoperative evaluation (p < 0.001). Osseous stability proportions were markedly higher in the two-point and three-point ORIF groups compared to the open reduction alone cohort. Operative duration was prolonged for the three-point ORIF technique. The three-point ORIF technique demonstrated superior therapeutic efficacy in achieving anatomical malar height restoration, minimizing vertical dystopia, and establishing robust osseous stability compared to open reduction monotherapy. However, the extended operative time associated with three-point ORIF warrants careful consideration in surgical planning and patient selection. These findings provide evidence-based guidance for clinicians in optimizing treatment algorithms for ZMC fractures, enabling individualized therapeutic decision-making based on fracture morphology, patient comorbidities, and functional requirements.

TThe Effects of a Stress Management Program on Stress Levels of First Year Nursing Students, Boromarajonani College of Nursing, Khon Kaen

Pasinee Thoin — 2025-08-29

This quasi-experimental, single-group, pre- and post-program study aimed to examine the effects of a stress management program on the stress levels of nursing students. The sample consisted of 125 first-year nursing students from Boromarajonani College of Nursing, Khon Kaen, who scored 27 or higher on the Department of Mental Health's Stress Assessment (DMA) in the Bachelor of Nursing Science Program, academic year 2023. The experimental instrument used was a stress management program, which included music relaxation, exercise, adaptation strategies, and counseling. Content validity was tested, with a IOC of 0.70 and a reliability of 0.80. The sample used the stress management program for three weeks, three times a week, for a total of nine 45-minute sessions. The study was conducted between October and December 2023. Data were collected using a self-assessment form from the Department of Mental Health, Ministry of Public Health. Data were analyzed using percentages, means, and standard deviations. Paired t-tests were used to compare stress levels before and after participating in the program.

The results revealed that the average scores of nursing students were significantly higher than those of the previous year. Before participating in the stress management program, the mean score was 29.44 (S.D. = 4.74), while after participating in the program, the mean score was 9.37 (S.D. = 5.99) significantly (t = 14.44, p < .001). It can be concluded that the sample group had reduced stress after using the stress management program, with scores significantly lower than before participating in the experiment.

Situation and Factors of Child Development Promotion Affecting of Pediatric Nurses in Trang Province

Naruemon Prampate — 2025-08-29

This study was a predictive research. It aimed to study the situation and factors affecting the promotion of development of sick children by nurses in pediatric wards of government hospitals in Trang Province using Pender's health promotion framework. The sample consisted of 100 pediatric nurses working in pediatric wards of 10 government hospitals in Trang Province. Data were collected from May 3 to July 31, 2022. The research instrument was a questionnaire that was validated by 3 experts. The IOC of the question and the objectives was 0.67 - 1.00 and the reliability of Cronbach's Alpha was .869. The data were analyzed using descriptive statistics such as frequency, percentage, mean, and standard deviation. Correlations were analyzed using Pearson's correlation coefficients, and predictive factors were analyzed using simple linear regression.

The results revealed that the development promotion practice situation (M = 2.39, SD = 0.19) and nurses' self-efficacy (M = 3.84, SD = 0.09) were high. The factor that significantly influenced the development promotion of sick children among pediatric nurses (p < 0.01) was self-efficacy.

Recommendations: Nurses working in pediatric wards should be encouraged to enhance their self-efficacy skills to enhance their ability to promote development in sick children and improve their quality of life.

Assessment and Control of Measurement Uncertainty in Complete Blood Count to Meet Acceptable Criteria in the Hematology Laboratory of Sakon Nakhon Hospital

Sakondet Kaipraiwan — 2025-08-29

This descriptive cross-sectional study was conducted to evaluate measurement uncertainty and establish tolerance limits for complete blood count (CBC) parameters. Data collection encompassed 40 internal quality control (IQC) values and external quality assessment (EQA) data from 2024. The analysis focused on five hematological parameters: white blood cell count (WBC), red blood cell count (RBC), hemoglobin concentration (Hb), hematocrit (Hct), and platelet count (PLT).

The primary objective of this investigation was to calculate measurement uncertainty values and establish acceptable tolerance limits for CBC analytical results utilizing IQC and EQA data from the hematology laboratory at Sakon Nakhon Hospital. The methodology involved computing combined uncertainty (Uc) and expanded uncertainty (U) following Nordtest guidelines, with subsequent comparison against Clinical Laboratory Improvement Amendments (CLIA) acceptance criteria.

Analytical findings demonstrated that expanded uncertainty values for all assessed parameters remained within CLIA-acceptable thresholds: WBC ± 4.96%, RBC ± 0.66%, Hb ± 3.88%, Hct ± 4.04%, and PLT ± 9.82%. These results substantiate that quality control data derived from laboratory operations can be appropriately utilized for measurement uncertainty assessment. The findings indicate the feasibility of integrating measurement uncertainty evaluation into the laboratory's quality management system, thereby supporting future ISO 15189 accreditation requirements and enhancing analytical reliability in clinical hematology diagnostics.

Results of the rehabilitation program for intermediate care elderly patients at home using the telemedicine service system In Mueang Sakon Nakhon District, Fiscal year 2024

Chabaprai Kaewkongpan — 2025-08-29

This research is a quasi-experimental study with a two-group design, consisting of an experimental group and a control group, with pre- and post-intervention measurements. The objective is to examine the effects of a rehabilitation program for homebound elderly patients in intermediate care using telemedicine services in Mueang Sakon Nakhon District. The study focuses on homebound elderly patients diagnosed with the following conditions: stroke, traumatic brain injury, spinal cord injury, and hip fractures. The experimental group consisted of 30 participants, as did the control group. Research Tools: The tools used in the study are divided into two parts: Tools used for the intervention:1.1) A practical rehabilitation program for homebound elderly patients in intermediate care. Tools used for data collection: 2.1) An assessment form for daily living activities.2.2) A questionnaire on motivation for daily care routines.2.3) A knowledge questionnaire about elderly care for caregivers (CGs).2.4) A questionnaire on attitudes toward elderly care for caregivers (CGs). All tools were validated for content accuracy by three experts and tested for reliability using Cronbach's alpha coefficient, yielding reliability scores of .92, .92, .94, .92, and .92, respectively. Data Analysis: Data were analyzed using descriptive and inferential statistics, including Paired Sample t-tests and Independent t-tests. Results: After the intervention, there were statistically significant differences (p-value < 0.05) in the motivation for daily care routines, quality of life of homebound elderly patients, knowledge about elderly care, and attitudes of caregivers (CGs) in the experimental group (30 participants). Key findings include: Motivation for daily care routines and quality of life showed significant differences before and after the intervention within the experimental group (p-value = 0.00).Timed Up and Go Test (TUGT) results showed significant improvement (p-value < 0.001).Comparing the experimental group (30 participants) and the control group (30 participants) after the intervention, significant differences were observed in motivation for daily care routines, quality of life, and the use of the rehabilitation program (p-value = 0.000), as well as in TUGT results (p-value < 0.001).Comparing the experimental group (30 participants) and the control group (30 participants) after the intervention, significant differences were observed in motivation for daily care routines, quality of life, and the use of the rehabilitation program (p-value = 0.000), as well as in TUGT results (p-value < 0.001).Satisfaction with the use of Telemedicine Rehabilitation among healthcare teams was rated as high (x̄ = 4.34, S.D. = 0.729).Satisfaction with the use of the rehabilitation program for homebound elderly patients was rated as very high (x̄ = 4.67, S.D. = 0.506). Conclusion: The results demonstrate that the rehabilitation program for homebound elderly patients in intermediate care using telemedicine services in Mueang Sakon Nakhon District successfully achieved its objectives.

Development of Nursing Practices for Spinal Surgery Patients at Bueng Kan Hospital Bueng Kan Province

Rungrit Head — 2025-08-29

This research and development project aims to develop and study the outcomes of using nursing practices for spinal surgery patients at Bueng Kan Hospital by applying holistic nursing theory concepts in the development of nursing practices. The sample group consists of 15 professional surgical nurses and 15 patients undergoing spinal surgery from January to April 2025, selected through purposive sampling. The research tools include the developed nursing practices for spinal surgery patients and data collection instruments such as interviews, general information questionnaires, knowledge and skills questionnaires, and satisfaction questionnaires. Data were collected using interviews, general information questionnaires, knowledge and skills questionnaires, and satisfaction questionnaires. Analyze the data using descriptive statistics and the Wilcoxon signed-rank test.

The study found that nursing practices developed for spinal surgery patients included
preoperative, intraoperative, and postoperative nursing manuals, as well as a video for instrument handling. After testing the nursing practices for spinal surgery patients, it was found that operating room nurses who received training on the practices had significantly increased knowledge and operational skills compared to before the implementation (p < .01). The overall satisfaction with the use of the guidelines by nurses and patients was high (mean = 4.52, S.D. = 0.43 and mean = 4.53, S.D. = 0.34, respectively).

Recommendations from this research suggest that clinical outcomes should be studied, such as readmission rates and quality of life. Additionally, the practices should be implemented in the spinal surgery patient care systems of other hospitals, adjusted to fit the context of each location, to further enhance the quality of care.

Development of A Palliative Care System for Terminally Ill Patients Detudom Crown Prince Hospital

Prattana Srichan — 2025-08-29

Action research to develop a palliative care system for terminally ill patients at Detudom crown prince hospital. The participants in the research were professional nurses, doctors, and pharmacists who provide palliative care to terminally ill patients. They were purposively selected from 12 wards in 3 departments, divided into 2 groups: Group 1, a group that developed a palliative care system for terminally ill patients, consisting of 10 people, and Group 2, a group that implemented the developed palliative care system for terminally ill patients, consisting of 145 people. The operation process is divided into 4 steps: 1) Planning phase 2) Operation phase, which lasts for 4 weeks 3) Observation phase, which is observing and evaluating the performance of the developed system, which lasts for 4 weeks 4) Reflection phase. The research results found that when the palliative care system of Detudom Crown Prince Hospital was developed and used in the care of patients, it consisted of organizational structure, resource support, patient care coordination, data recording, explanatory meetings, patient care processes, operational flowcharts, community continuity care systems, and performance evaluation., It has an effect on professional nurses who use the system, as assessed by the average satisfaction score. = 4.09, S.D. = 0.71

Effectiveness of Wastewater Treatment System Development to Reduce TDS Value in Sakon Nakhon Hospital

Kittichai pharapheang — 2025-08-29

This retrospective descriptive research aimed to evaluate the effectiveness of a developed wastewater treatment system at Sakon Nakhon Hospital in reducing total dissolved solids (TDS) levels. A total of 184 wastewater samples were randomly collected from the hospital's wastewater treatment system. These samples were divided into two groups: 92 samples collected before system development and 92 samples collected after system development. The sampling period extended from May 2024 to May 2025. The research instruments included a wastewater quality monitoring form and test kits or basic tools for assessing the quality of treated wastewater. Data were analyzed using descriptive statistics, percentages, means, and standard deviations. The inferential statistics, paired t-test was employed to compare TDS value before and after the wastewater treatment system. The statistical significance level is set at 0.05.

The study found that before the development of the TDS reduction system for the hemodialysis unit, the average TDS value was 548.50 mg/L. The maximum value recorded was 898 mg/L and the minimum was 139.00 mg/L. After the development of the TDS reduction system, the average residual TDS value in the treated wastewater was 401.61 mg/L. This represents a statistically significant reduction from the average TDS value observed before the system's development (95% CI = 112.71–171.06, T = 91, p-value < 0.001).

The Development of the Clinical Nursing Practice Guidelines to Prevent Shivering in Patients Undergoing Surgery

Narumon Jiaviriyaboonya — 2025-08-29

Shivering is a common problem in the post anesthesia period. Both neuraxial and general anesthesia are associated with a significant incidence of shivering. The aim of this study was to develop the clinical nursing practice guideline (CNPG) to prevent shivering in patients undergoing surgery based on IOWA Model. It consisted of 2 phases: the nursing clinical practice guideline’s development and evaluation of effectiveness. Phase 1 is development guideline from 17 relevant evidences which composed of nursing care in pre operation, intra operation and post operation times. Phase 2 is evaluation of the content validity and its effectiveness. After the CNPG implementation in 40 patients and 14 nurse anesthetists for 3 months, it could decrease incidence of postanesthetic shivering from 33.3% to 5.0%.

Prevalence and risk factors of patients with myocardial infarction with non-obstructive coronary artery in Udon Thani Hospital

Apitch Apiwattanaporn — 2025-08-29

Ischemic heart disease is a leading cause of death worldwide. The development of healthcare system, highly sensitive investigation and early revascularization strategies, has revealed that a substantial group of patients with the presence of acute myocardial infarction and absence of obstructive coronary artery disease (≥50% stenosis), referred as myocardial infarction with non obstructive coronary artery (MINOCA). Patients with MINOCA are often younger, more likely to be women, less likely to have dyslipidemia, and have major adverse cardiac endpoints (MACE) more than normal population.

This is a retrospective descriptive analytic study for prevalence and risk factors of MINOCA in Udon Thani hospital between 2016 to 2021 and 2023 to 2024 There were 46 patients with MINOCA among all 603 myocardial infarction patients. Prevalence of MINOCA is 7.6 %. The factors which significantly affected with MINOCA were Sepsis (OR = 21.14 ; 95%CI: 2.05 - 218.10, p = 0.01 and higher left ventricular ejection fraction (LVEF) (OR = 1.10 ; 95%CI: 1.03 - 1.16 , p=0.003). There was no significant difference between MINOCA and obstructive coronary disease patients in MACE outcomes - cardiac arrest in 48 hours, all-cause mortality in a month, all-cause mortality in a year and cerebrovascular event in a year after event.