199 research outputs found
Recommended from our members
Developing and Evaluating Effective Interventions to Reduce Healthcare-Associated Infection in A Resource-Limited Hospital in Thailand
The burden of disease due to hospital-acquired infections in developing countries is poorly quantified. Moreover, hand hygiene compliance (amongst the most effective control measures) is often low and high quality research into how to improve it is largely lacking outside high income settings.
I aimed to: I) describe the burden and trends in healthcare associated infections in Northeast Thailand; 2) investigate knowledge and beliefs amongst healthcare workers in a tertiary hospital in Northeast Thailand about hand hygiene and identify obstacles to improving it; 3) evaluate an intervention to improve hand hygiene compliance in this hospital based on World Health Organization guidelines.
To address the first aim, a retrospective study was conducted using data from 10 provincial hospitals in Northeast Thailand (2004-2010). This demonstrated a high and increasing incidence of hospital-acquired and healthcare-associated bacteraemia, an increasing proportion of extended spectrum beta-lactamase -producing isolates, and high associated mortality.
To address the second aim, a prospective study was conducted using qualitative and quantitative methods. This found that hand hygiene compliance was poor and differed markedly among categories of healthcare workers. Obstacles to good hand hygiene behaviour included intra-personal, inter-personal, and institutional factors.
The third aim was addressed with a cluster-randomized trial to evaluate a multimodal intervention. The intervention was associated with small increases in hand hygiene compliance (OR 1.12; 95% CI 1.01 to 1.24, p = 0.027), though lack of adherence to the intervention was a major problem. Larger improvements were seen in some units (obstetrics and gynecology: OR 3.96; 95% CI 1.88 to 8.31, p < 0.001) and for some types of opportunities (before patient contact: OR 1.72; 95% CI 1.32 to 2.25, p < 0.001).
The findings show that improvements in hygiene are possible, but multiple organizational factors need to be addressed to achieve acceptable hand hygiene levels in this setting
āļāļ§āļēāļĄāđāļŦāļĄāļēāļ°āļŠāļĄāđāļāļāļēāļĢāļāļąāļāļāļēāļĢāļāļ§āļēāļĄāļāļ§āļāļāđāļ§āļĒāļĒāļē āļāļąāļāļāļąāļĒāļāļĩāđāđāļāļĩāđāļĒāļ§āļāđāļāļāļāļąāļāļāļ§āļēāļĄāļāļ§āļ āđāļĨāļ°āļāļąāļāļĢāļēāļāļēāļĢāļĢāļāļāļāļĩāļ§āļīāļāļāļĩāđāļĢāļ°āļĒāļ° 5 āļāļĩ āļāļāļāļāļđāđāļāđāļ§āļĒāļĄāļ°āđāļĢāđāļāļāļēāļāļĄāļāļĨāļđāļāđāļāđāļĢāļāļāļĒāļēāļāļēāļĨāļŠāļĢāļ°āļāļļāļĢāļĩ Appropriateness of Pain Management with Medications, Factor Associated with Pain and 5-Year Survival Rate of Cervical Cancer Patients at Saraburi Hospital
āļāļāļāļąāļāļĒāđāļ
āļ§āļąāļāļāļļāļāļĢāļ°āļŠāļāļāđ: āđāļāļ·āđāļāļāļĢāļ°āđāļĄāļīāļāļāļ§āļēāļĄāđāļŦāļĄāļēāļ°āļŠāļĄāđāļāļāļēāļĢāļāļąāļāļāļēāļĢāļāļ§āļēāļĄāļāļ§āļāļāđāļ§āļĒāļĒāļē āļāļąāļāļāļąāļĒāļāļĩāđāđāļāļĩāđāļĒāļ§āļāđāļāļāļāļąāļāļāļ§āļēāļĄāļāļ§āļ āđāļĨāļ°āļāļąāļāļĢāļēāļāļēāļĢāļĢāļāļāļāļĩāļ§āļīāļ 5 āļāļĩ āđāļāļāļđāđāļāđāļ§āļĒāļĄāļ°āđāļĢāđāļāļāļēāļāļĄāļāļĨāļđāļāļāļāļāđāļĢāļāļāļĒāļēāļāļēāļĨāļŠāļĢāļ°āļāļļāļĢāļĩ āļ§āļīāļāļĩāļāļēāļĢāļĻāļķāļāļĐāļē: āļĻāļķāļāļĐāļēāļāđāļāļĄāļđāļĨāļĒāđāļāļāļŦāļĨāļąāļāđāļāđāļ§āļāļĢāļ°āđāļāļĩāļĒāļāļāļāļāļāļđāđāļāđāļ§āļĒāļāļĩāđāļĢāļąāļāļāļēāļĢāļĢāļąāļāļĐāļēāđāļāļāđāļ§āļ 1 āļĄ.āļ. āļāļķāļ 31 āļŠāļīāļāļŦāļēāļāļĄ 2560 āđāļĨāđāļ§āļāļīāļāļāļēāļĄāļāļāļāļĢāļ 5 āļāļĩāļŦāļĨāļąāļāļāļēāļĢāļ§āļīāļāļīāļāļāļąāļĒ āļ§āļīāđāļāļĢāļēāļ°āļŦāđāļāļ§āļēāļĄāđāļŦāļĄāļēāļ°āļŠāļĄāđāļāļāļēāļĢāļāļąāļāļāļēāļĢāļāļ§āļēāļĄāļāļ§āļāļāļēāļĄāļāļģāđāļāļ°āļāļģāļāļāļ WHO Analgesic Ladder āđāļāđ multiple linear regression āļāļāļŠāļāļāļāļąāļāļāļąāļĒāļāļĩāđāđāļāļĩāđāļĒāļ§āļāđāļāļāļāļąāļāļāļ°āđāļāļāļāļ§āļēāļĄāļāļ§āļāļāļĩāđāļĨāļāļĨāļ āđāļāđāļŠāļāļīāļāļī Log-rank test āđāļĨāļ° Kaplan-Meier survival analysis āļ§āļīāđāļāļĢāļēāļ°āļŦāđāļāļąāļāļĢāļēāļāļēāļĢāļĢāļāļāļāļĩāļ§āļīāļāļāļĩāđ 5 āļāļĩ āļāļĨāļāļēāļĢāļĻāļķāļāļĐāļē: āļāļđāđāļāđāļ§āļĒāļāļģāļāļ§āļ 127 āļāļ āļāļēāļĒāļļāđāļāļĨāļĩāđāļĒ 56.17 āļāļĩ āļŠāđāļ§āļāđāļŦāļāđāđāļāđāļāļĢāļ°āļĒāļ° IIb (26.0%) āđāļāđāļāļĄāļ°āđāļĢāđāļāļāļĩāđāļĒāļąāļāđāļĄāđāļĨāļļāļāļĨāļēāļĄ (74.0%) āļāļ§āļēāļĄāļāļ§āļāļāļēāļāļāļĨāļēāļ (4 â 6 āļāļ°āđāļāļ) (50.5%) āļāļāļāļ§āļēāļĄāđāļŦāļĄāļēāļ°āļŠāļĄāđāļāļāļēāļĢāļāļąāļāļāļēāļĢāļāļ§āļēāļĄāļāļ§āļāļāđāļ§āļĒāļĒāļēāļāļĩāđ 92.91% āļāļ°āđāļāļāđāļāļĨāļĩāđāļĒāļāļ§āļēāļĄāļāļ§āļāļŦāļĨāļąāļāđāļāđāļĢāļąāļāļĒāļē 48 āļāļąāđāļ§āđāļĄāļāļĨāļāļĨāļ 3.77 āļāļ°āđāļāļ āļāļķāđāļāļĄāļĩāļāļąāļĒāļŠāļģāļāļąāļāļāļēāļāļŠāļāļīāļāļī (P-value < 0.001) āļāļąāļāļāļąāļĒāļāļĩāđāđāļāļĩāđāļĒāļ§āļāđāļāļāļāļąāļāļāļ°āđāļāļāļāļ§āļēāļĄāļāļ§āļāļāļĩāđāļĨāļāļĨāļ āļāļ·āļ āļĢāļ°āļĒāļ°āļāļāļāļĄāļ°āđāļĢāđāļ āļāļāļēāļāļāđāļāļāļĄāļ°āđāļĢāđāļ āļāļģāļāļ§āļāļāļ§āļąāļĒāļ§āļ°āļāļĩāđāđāļāļĢāđāļāļĢāļ°āļāļēāļĒ āđāļĨāļ°āļāļģāļāļ§āļāđāļĢāļāļāļĢāļ°āļāļģāļāļąāļ§ (P-value < 0.05) āļāļąāļāļĢāļēāļĢāļāļāļāļĩāļ§āļīāļāļāļĩāđ 5 āļāļĩ āđāļāđāļ 65.40% āļŠāļĢāļļāļ: āļāļ§āļēāļĄāđāļŦāļĄāļēāļ°āļŠāļĄāđāļāļāļēāļĢāļāļąāļāļāļēāļĢāļāļ§āļēāļĄāļāļ§āļāļāđāļ§āļĒāļĒāļēāļāļāļāļāļđāđāļāđāļ§āļĒāļĄāļ°āđāļĢāđāļāļāļēāļāļĄāļāļĨāļđāļāđāļāđāļ 92.91% āļāļ°āđāļāļāļāļ§āļēāļĄāļāļ§āļāļĨāļāļĨāļ 3.77 āļāļ°āđāļāļ āļāļąāļāļāļąāļĒāļāļĩāđāđāļāļĩāđāļĒāļ§āļāđāļāļāļāļąāļāļāļ°āđāļāļāļāļ§āļēāļĄāļāļ§āļāļāļĩāđāļĨāļāļĨāļ āļāļ·āļ āļĢāļ°āļĒāļ°āļāļāļāļĄāļ°āđāļĢāđāļ āļāļāļēāļāļāđāļāļāļĄāļ°āđāļĢāđāļ āļāļģāļāļ§āļāļāļ§āļąāļĒāļ§āļ°āļāļĩāđāđāļāļĢāđāļāļĢāļ°āļāļēāļĒ āđāļĨāļ°āļāļģāļāļ§āļāđāļĢāļāļāļĢāļ°āļāļģāļāļąāļ§ āļāļąāļāļĢāļēāļāļēāļĢāļĢāļāļāļāļĩāļ§āļīāļ 5 āļāļĩāļāļĩāđ 65.40%
āļāļģāļŠāļģāļāļąāļ: āļāļēāļĢāļāļąāļāļāļēāļĢāļāļ§āļēāļĄāļāļ§āļ, āļĄāļ°āđāļĢāđāļāļāļēāļāļĄāļāļĨāļđāļ, āļāļąāļāļĢāļēāļāļēāļĢāļĢāļāļāļāļĩāļ§āļīāļ
Abstract
Objective: To determine appropriateness of pain management, factors associated with pain and 5-year survival rate of cervical cancer patients at Saraburi Hospital. Method: Data of cervical cancer patients receiving treatment between January 1 to August 31, 2017 with 5 years after diagnosis were used for analysis. Appropriateness of pain management was assessed according to the WHO Analgesic Ladder. Factors associated with the decreased pain score were tested using multiple linear regression analysis. 5-year survival rate was analyzed using Log-rank test and Kaplan Meier survival analysis. Results: A total of 127 patients were 56.17 years by average. Most patients were with stage IIb (26.0 %) and non-metastasized cancer (74.0%), and with moderate pain (4 â 6 points) (50.5%). Appropriateness of pain management was 92.91%. Pain score within 48 hours after pain medication decreased by 3.77 points with (P-value < 0.001). Decreased pain scores were associated with cancer stage, tumor size, number of metastasized organs, and number of underlying diseases (P-value < 0.05). 5-year overall survival rate was 65.40%. Conclusion: Appropriateness of pain management was 92.91%. Pain score decreased by 3.77 points. Decreased pain score was associated with cancer stage, tumor size, number of metastasized organs, and number of underlying diseases. 5-year overall survival rate was 65.40%.
Key words: pain management, cervical cancer, 5-year survival rat
Effects of the Supportive-Educative Nursing Program on Self-care Knowledge, Self-care Behavior and Clinical Outcomes of Hypertensive Patients at Risk of Renal Complications
Objective: To evaluate the effects of a supportive-educative nursing program on the self-care knowledge, self-care behavior and clinical outcomes (i.e. microalbuminuria and renal filtration rate) of hypertensive patients at risk of renal complications. Method: This quasi-experimental research employed a pre-test and post-test of two groups. The eligible sample was 50 hypertensive patients at risk of renal complications who were followed up at the chronic disease clinic of Banluam Hospital in Nakhon Ratchasima province during July â December, 2016. A total of 25 patients were in the study group and the rest in the control. The study group received the supportive-educative nursing program for eight weeks together with a handbook of self-care, video clips and food models, whereas the control group was provided by the usual care. Data were collected using a questionnaire that contained the demographic data, self-care knowledge, and self-care behaviour. The evaluation was performed in week 1 as a pre-test, week 8 as a post-test, and week 20 for the follow-up. The data were analysed using descriptive statistics, Chiâsquare test, independent tâtest and analysis of variance (ANOVA) with repeated measures. Results: The mean scores of self-care knowledge and self-care behaviour in the study group for the post-test and follow-up were significantly higher than those in the control group (P-value < 0.001). At follow-up, the microalbuminuria value in the study group was lower than that in the control group (P-value < 0.001), but the renal filtration rate between the two groups was not different. Conclusion: The supportive-educative nursing program improved the self-care knowledge, selfâ care behavior and microalbuminuria of hypertensive patients at risk of renal complications compared with the usual care. Keywords: supportive-educative nursing program, self-care knowledge, self-care behavior, clinical outcomes, hypertensive patient
Evaluation of Genetic Diversity of Natural Seablite (Suaeda maritima (L.) Dumort.) using SRAP Marker
āļāļāļāļąāļāļĒāđāļ āļāļ°āļāļĢāļēāļĄāļĄāļĩāļāļ·āđāļāļ§āļīāļāļĒāļēāļĻāļēāļŠāļāļĢāđāļ§āđāļē Suaeda maritima (L.) Dumort āļāļĒāļđāđāđāļāļ§āļāļĻāđ Chenopodiaceae āđāļāđāļāļāļ·āļāļāļ§āļāļāđāļģāļāļĩāđāļŠāļēāļĄāļēāļĢāļāļāļāđāļāđāļĄāđāļāđāđāļāļŦāļĨāļēāļĒāļĢāļ°āļāļąāļāđāļĨāļ°āļŠāļēāļĄāļēāļĢāļāļāļĒāļēāļĒāļāļąāļāļāļļāđāđāļāđāļāđāļēāļĒ āļāļķāļāļĄāļĩāđāļāļ§āđāļāđāļĄāļāļĩāđāļāļ°āļŠāļēāļĄāļēāļĢāļāļŠāđāļāđāļŠāļĢāļīāļĄāđāļŦāđāđāļāđāļāļāļ·āļāđāļĻāļĢāļĐāļāļāļīāļāđāļāđāđāļāļāļāļēāļāļ āđāļāļ·āđāļāļāļāļēāļāļāļģāļĄāļēāđāļāđāļāļĢāļ°āļāļāļāļāļēāļŦāļēāļĢāđāļĨāļ°āđāļāđāļāļŠāļĄāļļāļāđāļāļĢāđāļāđ āđāļāđāđāļāļāļąāļāļāļļāļāļąāļāļĒāļąāļāđāļĄāđāļĄāļĩāļāļēāļĢāļĻāļķāļāļĐāļēāļāļ§āļēāļĄāļŦāļĨāļēāļāļŦāļĨāļēāļĒāļāļēāļāļāļąāļāļāļļāļāļĢāļĢāļĄāļāļāļāļāļ°āļāļĢāļēāļĄ āļāļēāļāļ§āļīāļāļąāļĒāļāļĩāđāļāļķāļāļĄāļĩāļ§āļąāļāļāļļāļāļĢāļ°āļŠāļāļāđāđāļāļ·āđāļāļāļĢāļ°āđāļĄāļīāļāļāļ§āļēāļĄāļŦāļĨāļēāļāļŦāļĨāļēāļĒāļāļēāļāļāļąāļāļāļļāļāļĢāļĢāļĄāļāļāļāļāļ°āļāļĢāļēāļĄāļāļĩāđāļĢāļ§āļāļĢāļ§āļĄāļāļēāļ 4 āļāļąāļāļŦāļ§āļąāļ āđāļāđāđāļāđ āđāļāļāļĢāļāļļāļĢāļĩ āļŠāļĄāļļāļāļĢāļŠāļēāļāļĢ āļŠāļĄāļļāļāļĢāļŠāļāļāļĢāļēāļĄ āđāļĨāļ°āļāļĢāļļāļāđāļāļāļĄāļŦāļēāļāļāļĢ āļāļģāļāļ§āļ 18 āļāļąāļ§āļāļĒāđāļēāļ āđāļāļĒāđāļāđāđāļāļĢāļ·āđāļāļāļŦāļĄāļēāļĒ SRAP āļāļģāļāļ§āļ 10 āļāļđāđāđāļāļĢāđāļĄāļāļĢāđ āļāļāļ§āđāļēāļĄāļĩ 4 āļāļđāđāđāļāļĢāđāļĄāļāļĢāđāļāļĩāđāđāļŦāđāļāļ§āļēāļĄāđāļāļāļāđāļēāļāļāļāļāđāļāļāļāļĩāđāļāđāļāđāļ āđāļĄāļ·āđāļāļĻāļķāļāļĐāļēāļĨāļēāļĒāļāļīāļĄāļāđāļāļĩāđāļāđāļāđāļāļāļĩāđāđāļāļīāļāļāļķāđāļāļāļāļ§āđāļēāļĄāļĩāđāļāļāļāļĩāđāļāđāļāđāļāļāļĩāđāđāļāļāļāđāļēāļāļāļąāļ 17 āđāļāļ (94.44%) āļāļēāļāļāļąāđāļāļŦāļĄāļ 18 āđāļāļ āđāļĄāļ·āđāļāļĻāļķāļāļĐāļēāļāļ§āļēāļĄāļŠāļąāļĄāļāļąāļāļāđāļāļēāļāļāļąāļāļāļļāļāļĢāļĢāļĄāļāļāļ§āđāļēāļĄāļĩāļāđāļēāļŠāļąāļĄāļāļĢāļ°āļŠāļīāļāļāļīāđāļāļ§āļēāļĄāđāļŦāļĄāļ·āļāļāļāļĒāļđāđāļĢāļ°āļŦāļ§āđāļēāļÂ 0.27-1.00 āđāļāļĒāđāļĄāļ·āđāļāļāļģāļĄāļēāļāļąāļāļāļĨāļļāđāļĄāļāđāļ§āļĒāļ§āļīāļāļĩ UPGMA āļāļāļ§āđāļēāļāļĩāđāļāđāļēāļŠāļąāļĄāļāļĢāļ°āļŠāļīāļāļāļīāđāļāļ§āļēāļĄāđāļŦāļĄāļ·āļāļāđāļāđāļēāļāļąāļ 0.58 āļŠāļēāļĄāļēāļĢāļāļāļąāļāļāļĨāļļāđāļĄāļāļ°āļāļĢāļēāļĄāđāļāđ 6 āļāļĨāļļāđāļĄ āļāļ·āļ āļāļĨāļļāđāļĄāļāļĩāđ 1, 5 āđāļĨāļ° 6 āđāļāđāļāļāļąāļ§āļāļĒāđāļēāļāļāļ°āļāļĢāļēāļĄāļāļĩāđāđāļāđāļāļāļēāļāđāļāļāļĢāļāļļāļĢāļĩ āļāļĨāļļāđāļĄāļāļĩāđ 2 āđāļāđāļāļāļąāļ§āļāļĒāđāļēāļāļāļēāļāļāļĢāļļāļāđāļāļāļĄāļŦāļēāļāļāļĢ āļāļĨāļļāđāļĄāļāļĩāđ 3 āđāļāđāļāļāļąāļ§āļāļĒāđāļēāļāļāļēāļāđāļāļāļĢāļāļļāļĢāļĩāđāļĨāļ°āļŠāļĄāļļāļāļĢāļŠāļāļāļĢāļēāļĄ āđāļĨāļ°āļāļĨāļļāđāļĄāļāļĩāđ 4 āđāļāđāļāļāļąāļ§āļāļĒāđāļēāļāļāļēāļāļŠāļĄāļļāļāļĢāļŠāļēāļāļĢ āļāļĢāļļāļāđāļāļāļĄāļŦāļēāļāļāļĢ āđāļĨāļ°āļŠāļĄāļļāļāļĢāļŠāļāļāļĢāļēāļĄ āļāļēāļāļāļēāļāļ§āļīāļāļąāļĒāļāļĢāļąāđāļāļāļĩāđāļāļģāđāļŦāđāļāļĢāļēāļāļ§āđāļēāļāļąāļ§āļāļĒāđāļēāļāļāļ°āļāļĢāļēāļĄāļāļēāļāļāļąāļāļŦāļ§āļąāļāđāļāļāļĢāļāļļāļĢāļĩāļĄāļĩāļāļ§āļēāļĄāļŦāļĨāļēāļāļŦāļĨāļēāļĒāļāļēāļāļāļąāļāļāļļāļāļĢāļĢāļĄāļŠāļđāļāļāļĩāđāļŠāļļāļ āđāļāļĢāļēāļ°āļĄāļĩāļāļēāļĢāļāļĢāļ°āļāļēāļĒāļāļąāļ§āļāļĒāļđāđāđāļāļŦāļĨāļēāļĒāļāļĨāļļāđāļĄÂ ABSTRACT Seablite (Suaeda maritima (L.) Dumort), belonging to Family Chenopodiaceae, is succulent plant to highly tolerate to various level of salinity; moreover, it is very easy to propagate. Therefore, it is able to promote to be an economic crop in the future because of using in culinary and medicinal purposes. Currently, there is no report on the study of the genetic diversity of seablite. The objective of this research was to evaluate the genetic diversity of 18 samples of seablite collected from natural habitat in 4 provinces, namely Phetchaburi, Samut Sakhon, Samut Songkhram and Bangkok using SRAP markers. It was found that only 4 out of 10 primers produced 17 polymorphic bands (94.44%) from total of 18 bands. According to the genetic relationship among seablite samples, the similarity index ranged from 0.27-1.00. For cluster analysis using UPGMA, all smaples could be separated into six groups at the similarity coefficient of 0.58. Group 1, 5, and 6 was the samples collected from Phetchaburi. Group 2 was the samples from Bangkok. Group 3 was the samples from Phetchaburi and Samut Songkhram and group 4 was the samples from Samut Sakhon, Bangkok and Samut Songkhram. From this study, it was pointed that seablite from Phetchaburi were the most diversified because they were placed into many groups
Development and Evaluation of Compact Aquaculture System for the Application of Zero Water-Exchange Inland Aquacultures
This study evaluated the performance of land-based compact aquaculture system integrating fibrous nitrifying biofilters and solid removal unit. The first experiment indicated that the compact aquaculture system with total biofilter length of 6.0 m and single solid separating was able to accommodate aquaculture weight as high as 5.0 kg/m3, which corresponded to nitrogen loading rates of 8.4 mg N/L/day. In the second experiment, more effective solid-liquid separation and good water quality were achieved when solid separating unit was replaced by filtration unit with Japanese mats as filtered media, and cleaning of biofilters and filtration unit was conducted in every 4 days. Next, the compact aquaculture system was employed to cultivate tilapia without water-exchange for 60 days using the described strategies. TAN and nitrite were well below acceptable limit of 1.0 mg N/L; suspended solids varied between 20 and 35 mg SS/L; and harvesting fish weights were 10.4 kg/m3. Fish survival rate at 97% and average growth rate of 3.45 g/day were reported. Finally, solid removal remained the critical factor for successful aquacultures in the compact system even under extensive or semi-intensive aquaculture cultivation, and finally nitrogen mass balance indicated that nitrification-denitrification were main treatment pathways while solid removal only prolonged the activity of nitrifying biofilters
- âĶ