Chitkamon Srichomphoo

Background: Pressure injuries are a major patient safety concern, particularly among hospitalized patients at high risk. Identifying factors associated with pressure injuries is essential for effective prevention. Therefore, this study aimed to identify factors associated with pressure injuries among high-risk hospitalized patients. Methods: A case–control study was conducted among 80 inpatients, including 40 with hospital-acquired pressure injuries (HAPIs) and 40 without HAPIs, admitted to the Department of Medicine, Mahasarakham Hospital, between April 2023 and December 2025. Data were obtained from medical records and structured data collection forms. Descriptive statistics and bivariable analyses using chi-square or Fisher’s exact tests were performed. Variables with p < 0.25 were considered for multivariable logistic regression. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported. Results: Patients with HAPIs had higher proportions of edema, incontinence, hypoalbuminemia, and nil per os (NPO) status. Bivariable analysis identified associations with Braden score ≤17, impaired level of consciousness, mechanical ventilation, inotropic/vasopressor use, physical restraint, edema, incontinence, low serum albumin, and NPO status (p < 0.05). In the final multivariable model, endocrine and metabolic diseases (AOR = 25.92; 95% CI: 1.06–633.10; p = 0.046), mechanical ventilator use (AOR = 104.79; 95% CI: 11.78–932.05; p < 0.001), inotropic/vasopressor use (AOR = 17.26; 95% CI: 1.15–258.41; p = 0.039), and diarrhea (AOR = 24.34; 95% CI: 1.88–315.36; p = 0.015) were statistically associated with HAPIs. Cardiovascular diseases showed a borderline association (AOR = 18.78; 95% CI: 1.00–354.36; p = 0.050), while physical restraint was not statistically significant (AOR = 5.40; 95% CI: 0.80–36.66; p = 0.084). Conclusions: Several clinical factors were associated with HAPIs. However, large AORs and wide CIs indicate substantial uncertainty in the magnitude of these associations. Findings should be interpreted cautiously and confirmed in larger prospective studies. Prevention should emphasize early risk identification, management of critically ill patients, and appropriate moisture and pressure injury prevention.

Microplastic contamination has become a major environmental health concern because of its widespread occurrence and potential risks to human health. Although environmental health literacy (EHL) is recognized as an important determinant of health-related decision-making, evidence regarding its influence on behaviors that reduce potential microplastic exposure remains limited, particularly in riverine communities of developing countries. This study assessed EHL, environmental health behaviors associated with potential microplastic exposure, and factors associated with these behaviors among urban residents living along the Mekong River in Thailand. A community-based cross-sectional study was conducted among 420 adults in Mueang Nakhon Phanom District, Thailand, between October and December 2024 using multistage random sampling. Face-to-face interviews were performed using a content-validated questionnaire assessing six EHL domains and environmental health behaviors related to microplastic exposure. Multivariable logistic regression was used to examine factors associated with poor environmental health behaviors. Overall, 41.7% of participants demonstrated good environmental health behaviors, whereas 58.3% exhibited poor behaviors. Participants had a moderate level of EHL (mean score, 2.30 ± 0.46), with decision-making representing the weakest domain. Insufficient EHL was strongly associated with poor environmental health behaviors (AOR = 8.06, 95% CI: 2.86–10.04; p < 0.001). Additional factors associated with poor environmental health behaviors included consumption of untreated river or other water sources, no physician visit during the previous month, age older than 60 years, and obtaining aquatic foods through self-capture, whereas trade occupation was associated with lower odds of poor behaviors. These findings support community-based EHL programs led by local authorities and public health practitioners that strengthen critical appraisal and decision-making skills, provide accessible and evidence-based information on microplastic risks, and promote practical actions such as reducing single-use plastics and improving household waste management.

Background: Type 2 diabetes mellitus (T2DM) is a major public health problem in Thailand, particularly in rural areas where individuals have limited access to structured diabetes care and education. Poor self-management contributes to uncontrolled glycemic levels and long-term complications. Objectives: This study evaluated the effectiveness of a community-based health care program on glycemic control and self-care behaviors among adults with uncontrolled T2DM. Methods: A quasi-experimental study was conducted among 80 patients with uncontrolled T2DM in Kalasin Province. Participants were assigned to either an intervention group (n = 40) or a comparison group (n = 40). The 12-week intervention consisted of diabetes self-management education, individualized lifestyle support, and community/family engagement. Diabetes self-care behavior and glycated hemoglobin (HbA1c) were assessed at baseline and Week 12. Statistical analyses included paired t-test, independent t-test, and 95% confidence intervals. Results: The intervention group demonstrated a significant improvement in self-care behavior (MD = 14.83; p < 0.0001), compared with a minimal change in the comparison group (0.80; p = 0.756). HbA1c levels significantly decreased in the intervention group (−0.47%; 95% CI: −0.61 to −0.33; p < 0.0001), while a slight nonsignificant increase was observed in the comparison group (0.11%; p = 0.210). The between-group analysis showed a significant reduction in HbA1c favoring the intervention (−0.92%; p < 0.0001), supported by a large effect size (Hedges’ g = 0.87). Conclusions: This community-based health care program effectively enhanced diabetes self-management behaviors and improved glycemic control. Integrating such behavioral support into primary health care services may strengthen long-term diabetes management and reduce complications among patients with uncontrolled T2DM.

This cross-sectional analytical study examined treatment success rates and associated factors among pulmonary tuberculosis (TB) patients. Data from the National Tuberculosis Information Program (NTIP) were analyzed for 305 patients treated at Pak Phanang Hospital, Nakhon Si Thammarat, between October 1, 2018, and September 30, 2023. Binary logistic regression identified key factors influencing treatment success. The overall success rate was 80.98% (247 patients), while 19.02% (58 patients) experienced unsuccessful treatment. Significant factors associated with success included body mass index (BMI) (adjusted OR 2.72, 95% CI = 1.12-3.93, p = 0.035), adherence to medical appointments (adjusted OR 26.85, 95% CI = 16.24-35.56, p = 0.001), history of HIV screening, hospitalization for TB, and CD4 testing. To enhance TB treatment outcomes, hospitals should improve patient management, ensure continuous monitoring, and promote adherence and education. Strengthening these measures may reduce treatment failure and improve public health outcomes.

This cross-sectional study examined the prevalence and risk factors of gestational diabetes among 521 pregnant women receiving antenatal care at Hua Sai Hospital, Nakhon Si Thammarat province of Thailand, between October 1,2022, and September 30, 2023. Data were extracted from the HOSxP electronic database using a structured recording form, which included demographic information, biochemical parameters, and gestational diabetes screening results. Binary logistic regression analysis was performed to identify significant risk factors. Gestational diabetes was diagnosed in 21.88% of participants. Key risk factors included maternal age (adj.OR = 0.10, 95% CI = 0.03–0.32, p = 0.001), occupation (adj.OR = 0.47, 95% CI = 0.26–0.85, p = 0.013), and pre-existing medication use (adj.OR = 10.66, 95% CI = 2.55–44.54, p = 0.001). These findings underscore the need for targeted interventions to improve treatment efficacy, particularly among high-risk groups for reducing gestational diabetes incidence.