Medical Social Science Journal Uttaradit Hospital

The Effectiveness of a Self-Care Monitoring Program for Non-Insulin Dependent Diabetes Mellitus Patients and Home Visit Follow-Up

Sukritta Panichwilai — 2025-08-29

Objective: To study the effectiveness of a self-care monitoring program combined with home visits, considering the outcomes of blood sugar level (HbA1c), knowledge and self-care behavior of diabetic patients compared with diabetic patients who received regular health education at a community health center.
Methods: This is a quasi-experimental study. The sample consisted of 60 non-insulin-dependent diabetic patients, divided into an experimental group of 30 patients and a control group of 30 patients. The study was conducted in the service area of Uttaradit Community Health Center 1. The developed program focused on providing knowledge, recommendations, and guidelines for diabetic patients. Each diabetic patient visited their home. The home visit was planned and the health-related factor assessment form was used to identify problems and determine the purpose of the home visit from the health-related factor assessment form continuously for 12 weeks.
Results: The experimental group had a significant reduction in the mean HbA1C level from 8.2%(S.D.=0.90) to 6.9%(S.D.=0.50). The statistical analysis showed that there was a statistically significant change at the 0.05 level. The trial indicated that participation in a self-care monitoring program and home visits significantly affected glycemic control in patients with non-insulin-dependent diabetes while in the control group, no statistically significant (p>0.05) change in HbA1C levels (8.1% to 7.9%) was observed after the end of the study period. In addition, the results of the knowledge and behavior assessment found that the self-care behavior scores (= 82.3, S.D.=5.8) and daily self-care behaviors (M=43.25, S.D.=2.90) of the experimental group increased significantly at the 0.05 level.
Conclusions: The results of this study showed that the application of self-care monitoring program for non-insulin dependent diabetes patients and continuous home visits resulted in significantly better HbA1c control in patients at the 0.05 level. It has the potential to effectively promote self-care and blood sugar control in non-insulin dependent diabetes patients, leading to a tangible reduction in the burden of disease in the community.

Development of Nursing Care Model for Acute Ischemic Stroke Patients at Uttaradit Hospital

Pornchanida Kaewpea — 2025-12-09

Objective: To develop a nursing care model for acute ischemic stroke patients at Uttaradit Hospital and to evaluate the outcomes of its implementation.
Methods: This study employed a research and development (R&D) design conducted in three phases. Phase 1 involved a situational analysis Phase 2 focused on developing the acute ischemic stroke patient care model
and Phase 3 assessed the outcomes of the implemented nursing model. The participants were selected from 31 professional nurses from the Accident and Emergency Department and the Stroke Patient Unit and 60 stroke patients who received thrombolytic medication, divided into two development cycles. The research will be conducted between May 2023 and May 2024. Data collection instruments included medical record review forms, in-depth interview guides, nursing knowledge and supervision knowledge assessments. Content validity was verified with an IOC value of (IOC=0.97), reliability was tested with an ICC value of (ICC=0.96), and (KR-20=0.98 and 0.95). Qualitative data were analyzed using content analysis, and quantitative data were analyzed using descriptive statistics, t-test, Wilcoxon signed rank test and the Mann-Whitney U test.
Results: The developed nursing model for acute ischemic stroke patients comprised three key components: 1) Clinical nursing practice guidelines covering pre-hospital care, nursing in emergency room and continuous nursing care in the stroke unit. 2) Nursing competence enhancement. 3) A nursing supervision framework aligned with Proctor’s model. Following the implementation of the nursing model, nurses achieved 100% adherence to the established clinical practice guidelines. The average competency score was 4.46 (SD=0.49). Both nurse and patient satisfaction were at the highest level. Regarding clinical outcomes, the average
Door-to-Needle time decreased to 45.90 minutes. No complications from rt-PA administration were found. The number of hospital days showed statistically significant improvement (p<0.05). The knowledge score on the Proctor model of nursing supervision increased significantly (p<0.001).
Conclusions: The developed nursing model enhances care efficiency, reduces treatment time, costs, increases the satisfaction of both nurses and patients. and provides a guideline for improving care for patients with other conditions.

Factors Affecting the Readiness to Prepare Academic Works for Promotion of Government officials under Phichit Hospital

Wanintorn Opaspongpipat — 2025-12-16

Objective: To study the factors influencing readiness and to examine the relationships of factors affecting readiness in preparing academic works for civil service promotion among staff at Phichit Hospital.
Methods: The study was conducted with 246 government officials at Phichit Hospital who had the qualifications for civil service promotion by rank. A questionnaire was used as the research instrument to investigate factors affecting entry into the civil service promotion process and the desire to assume higher positions among government officials at Phichit Hospital. The data were analyzed for the level of opinions using mean and standard deviation. Subsequently, the relationships of factors affecting readiness to prepare academic works for civil service promotion were analyzed using multiple regression analysis with statistical tools.
Results: The findings revealed that eight internal and external factors had a multiple correlation coefficient of 0.69, which explained 47.9 percent of the variance in the decision to enter the civil service promotion process and assume higher positions among government officials at Phichit Hospital. The standard error of prediction was 0.71. Three internal factors were significant predictors at the 0.05 level: achievement motivation, affiliation motivation, and self-development.
Conclusion: The factors that significantly affect readiness to prepare academic works for civil service promotion among government officials at Phichit Hospital are the internal factors of achievement motivation, affiliation motivation, and self-development. However, the internal factors of professional attitude and power motivation, as well as the external factors of promotion criteria and procedures, hospital policy, and supervisory support, do not significantly affect readiness to prepare academic works for civil service promotion among government officials at Phichit Hospital.