Srinagarind Medical Journal

Effectiveness of Cognitive Behavioral Therapy on Psychological Distress among Myocardial Infarction Survivors: A Systematic Review

Jirawan Mala, Saowaluck Sukpattanasrikul, Virapun Wirojratana — Thu, 26 Feb 2026 00:00:00 +0700

Cognitive behavioral therapy (CBT) is effective in reducing depression, anxiety, and stress among individuals with cardiovascular disease; however, empirical evidence in myocardial infarction (MI) survivors remains limited. Furthermore, the design features of CBT that alleviate psychological distress require further investigation. This systematic review aimed to evaluate the effectiveness of CBT in reducing psychological distress among myocardial infarction (MI) survivors and to identify the design features that support emotional recovery. A systematic review was conducted using six databases with 13 randomized controlled trials (RCTs) published between 2014 and 2023 that met the inclusion criteria. Methodological quality was assessed using the Joanna Briggs Institute, and the data were synthesized narrative style. Metanalysis was not feasible. Thirteen RCTs involving 1,586 participants were included. CBT or CBT-based approaches—delivered face-to-face or through technology-assisted formats—were shown to significantly reduce depression, anxiety, and stress compared with standard care, and both combined and internet-based CBT programs showed comparable effectiveness. Additionally, several studies reported improved sleep quality and cardiac biomarkers. CBT is effective in the alleviation of psychological distress among MI survivors. Thus, integrating face-to-face or technology-assisted CBT into psychosocial nursing practice can enhance their emotional well-being and recovery outcomes.

Trends in Mortality Rate and Associated Factors among Cancer Patients Receiving Chemotherapy: Context of the Medical Oncology Clinic, Roi Et Hospital

Bhuritatt Sutthiprapa — Thu, 26 Feb 2026 00:00:00 +0700

Objectives: Evaluating treatment outcomes for cancer patients receiving chemotherapy is crucial due to cancer being a leading cause of death. This study aimed to analyze the trends in survival and mortality rates among cancer patients receiving chemotherapy at the Medical Oncology Clinic, Roi Et Hospital, and to identify demographic (sex and age) and clinical (cancer type) factors associated with mortality

Methods: This was a retrospective cohort study analyzing secondary data from 5,854 cancer patients who received chemotherapy between the fiscal years 2021–2025 (October 2020 to March 2025). Survival statistics were analyzed using the Kaplan-Meier method to estimate overall survival rates and the Cox proportional hazards regression model to identify predictors of mortality (hazard ratio, HR)

Results: The overall survival rates at 1 year and 3 years were 75.4% and 65.1%, respectively. The Cox model analysis revealed that significant factors increasing the risk of death included male sex (HR = 1.35), every 1-year increase in age (HR = 1.02), and cancer type, particularly lung cancer (HR = 4.21) and liver/bile duct cancer (HR = 3.89) compared to breast cancer. Furthermore, a positive trend in outcomes was observed, with patients registered in the fiscal year 2024 showing a reduction in the risk of death by 31% (HR = 0.69) compared to those registered in 2021

Conclusion: The trend in survival rates for cancer patients at this clinic shows a positive development. However, age, sex, and cancer type remain critical variables to consider in patient care and treatment planning. The study is limited by the lack of data on disease stage and specific chemotherapy regimens, thus providing fundamental survival data for more comprehensive quality of care studies in the future

Prevalence of Human Papilloma Virus Infection from Self-collected Sample versus Healthcare Providers-collected Sample for Cervical Cancer Screening at Loei Hospital: A Retrospective Descriptive Study

Yaowapa Jirawongprapa , Metha Songthamwat — Thu, 26 Feb 2026 00:00:00 +0700

Background and Objective: Cervical cancer is the most common gynecologic malignancy, ranking 4^th among cancers in women worldwide and 5^th among cancer-related causes of death in Thai women. This study aimed to compare the prevalence of high-risk human papillomavirus (HR-HPV) detection and cervical intraepithelial neoplasia (CIN) grade 2 or worse (CIN2+) between self-collected and healthcare provider-collected samples among women undergoing cervical cancer screening.

Methods: A retrospective descriptive study included Thai women aged 30 to 60 years who underwent cervical cancer screening using HPV DNA testing in Mueang Loei District, Loei Province, Thailand, between 1^st January and 31th December 2024. Data were retrieved from the Loei Hospital database. Exclusion criteria included a history of hysterectomy, previous diagnosis of cervical cancer, prior pelvic radiotherapy, previous loop electrosurgical excision procedure (LEEP) or cold knife conization (CKC), presence of a visible cervical mass, and pregnancy at the time of screening. A total of 2,898 women met the eligibility criteria, comprising 1,827 women in the healthcare provider-collected group and 1,071 women in the self-collected group. Women who tested positive for HPV types 16 or 18, or for other HR-HPV types in combination with abnormal cytology results of atypical squamous cells of undetermined significance (ASC-US) or worse, were referred for colposcopic examination and cervical biopsy for histopathological confirmation.

Results: HR-HPV was detected in 242 women (8.35%): 9.24% in the self-collected group and 7.83% in the healthcare providers-collected group (OR 1.20; 95% CI 0.92–1.57). Non-16/18 HPV types were most common (67.13%), followed by type 16 (20.28%) and type 18 (6.99%). Among those with non-16/18 HPV types who received cytology test, ASC-US or worse occurred in 37.50%. Women who underwent colposcopy, CIN2+ was found in 47.06% of the healthcare providers-collected group and 33.33% of the self-collected group, 35 cases of precancers and 3 cases of cervical cancers (2 cases stage IA1, 1 case stage IB2). In multivariable logistic regression, sampling method was not significantly associated with HR-HPV detection (adjusted OR=1.20; 95% CI 0.92–1.57; p=0.182), while age 40 years and older showed a statistically significant decreased risk of HR-HPV detection.

Conclusion: The prevalence of HR-HPV infection and CIN2+ did not differ significantly between self-collected and healthcare providers-collected sampling.

Factors Associated with Asthma Control in Pediatric Patients in a Small Community Hospital in the Northeast of Thailand

Prapasson Chamnapa — Thu, 26 Feb 2026 00:00:00 +0700

Background and Objective: Asthma is a significant global health concern, particularly in children. Effective symptom control is crucial for reducing disease severity and enhancing patients' quality of life. This research aimed to study the factors influencing asthma control in children to facilitate the development of more effective care plans. The specific objective was to examine the factors associated with asthma symptom control in children.

Methodology: This study utilized a descriptive correlational research design. The population consisted of 199 caregivers of children with asthma at Selaphum Hospital, with a purposive sample size of 170 participants. The research instrument was a multi-part questionnaire covering personal data, clinical data, and the Childhood Asthma Control Test (C-ACT). The instrument's validity and reliability were verified by experts and a pilot test (reliability coefficient alpha=0.70). Data were analyzed using descriptive statistics, comparison, and Pearson's correlation at a statistical significance level of p<0.05.

Results: The findings revealed that caregivers' demographic factors (gender, age, education), clinical factors (disease severity), and environmental factors (income, household size) were not statistically significantly associated with asthma symptom control in children. In contrast, the total knowledge score (r = 0.302, p < 0.001) and the self-management behavior score (r = 0.298, p < 0.001) demonstrated a statistically significant positive correlation with asthma symptom control.

Conclusion: This study suggests a policy recommendation that the development and implementation of programs promoting knowledge and self-management skills for caregivers of children with asthma are essential to help patients achieve better symptom control.

Clinical Scoring for Prediction of Abnormal Electroencephalography in Pediatric Patients with Seizure in Chaiyaphum Hospital

Natthawan Suangtho — Thu, 26 Feb 2026 00:00:00 +0700

Background and Objectives: Pediatric epilepsy is a significant public health issue. Electroencephalography (EEG) is a highly valuable tool for supporting the diagnosis and treatment of epilepsy. Limited EEG availability at many hospitals often necessitated patient referral to a tertiary care center. This study aimed to identify factors associated with abnormal EEG findings and to develop a clinical scoring system to predict abnormal EEG in children presenting with seizures.

Methods: This was a prognostic prediction research study, retrospectively collected data from the medical records of pediatric patients with seizures who were admitted to Chaiyaphum Hospital and underwent an EEG between January 1, 2022, and December 31, 2024. Patients were divided into two groups: normal EEG and abnormal EEG. Data analysis involved descriptive statistics and a multivariable risk difference regression approach to identify prognostic factors and assess the model's performance.

Results: Out of 60 patients, 18 (30%) had abnormal EEG findings. Five predictive factors associated with abnormal EEG (focal seizure, absence seizure, age of seizure onset ≥72 months, age <72 months, no fever) were identified and used to create a clinical scoring system. The system categorized patients into a low-risk group (<3 points) and a high-risk group (≥3 points). The scoring system showed an AUC (area under the receiver operating characteristic curve) of 0.789 (95% CI 0.655, 0.923) and demonstrated good predictive validity.

Conclusion: This study successfully developed an effective scoring system based on five prognostic factors (focal seizure, absence seizure, age of seizure onset ≥72 months, age <72 months, no fever) to predict abnormal electroencephalography (EEG) in children presenting with seizures. The scoring system may be used to help decide which patients with a high-risk score (≥3 points) should be referred for an EEG at a hospital with higher capability.

Self Concept Perception in School-Age Children with Chronic Illness at Kalasin Hospital

Paradee Choanarin, Yaowaret Kanmali, Picha Konkanghana, Chayamon Panyawarakom — Thu, 26 Feb 2026 00:00:00 +0700

Objective: The purpose of this study was to study the self concept perception among school-age children with chronic illness at Kalasin Hospital.

Methods: This was a descriptive study. The sample consisted of 75 school-age children with chronic illness who received treatment at the pediatric ward of Kalasin Hospital between January and December 2024. Participants were selected using simple random sampling according to predetermined inclusion and exclusion criteria. The research instruments developed by the research team consisted of three parts: Part 1, a questionnaire on personal factors; Part 2, a 50-item health promotion scale for school-age children with chronic illness; and Part 3, a 30-item self concept perception scale for school-age children with chronic illness. The instruments were validated by three experts for content validity, with reliability coefficients of 0.60 and 0.81 for Parts 2 and 3, respectively. Data analysis was performed using statistical software, including frequency distribution, percentage, mean, standard deviation, independent t-test, and one-way ANOVA.

Results: The results showed that (1) school-age children demonstrated the highest mean score for self concept perception in the dimension of adjustment and acceptance at a good level, followed by overall body satisfaction also at a good level. The perceived impact of illness on self concept was at a moderate level, while negative feelings and shame showed the lowest mean score at a low level. (2) comparison of mean differences in self concept perception among participants with different gender, family status, and parental marital status showed no statistically significant differences in any dimension. (3) comparison of mean differences in self concept perception when categorized by age, educational level, duration of illness, and primary caregiver revealed no statistically significant differences across all factors.

Conclusions: The research findings can be applied to develop universal care programs or care guidelines to promote appropriate self concept perception, while considering individual needs and maintaining flexibility to adapt to specific contexts of each case.

Time to Surgery and the Risk of Meniscus and Chondral Injury in Patients with Anterior Cruciate Ligament Tear in Chum Phae Hospital

Don Tharnphraisarn — Thu, 26 Feb 2026 00:00:00 +0700

Background and Objective: Anterior cruciate ligament (ACL) tear is common among young and active individuals. ACL tear leads to knee instability and is associated with secondary meniscal and chondral injuries, which may increase the risk of early osteoarthritis. Although anterior cruciate ligament reconstruction (ACLR) is the standard treatment, the optimal timing of surgery remains controversial. This study aimed to investigate the relationship between time to surgery and the risk of meniscal and chondral injuries in patients with ACL tear in Chumphae Hospital

Methods: A retrospective cohort study was conducted on 168 patients who underwent anterior cruciate ligament reconstruction in Chum Phae Hospital. Patients were stratified into two primary groups based on the time interval from injury to surgery: the early surgery group (within 3 months) and the delayed surgery group (after 3 months). Additionally, subgroup analyses were performed for intervals of 3–6 months, 6–12 months, and greater than 12 months to compare the incidence and risk of meniscal and chondral injuries between groups.

Results: Patients undergoing surgery after a delay of more than 12 months demonstrated a significantly higher risk of medial meniscus injury compared to the early surgery group (OR = 2.73, 95% CI = 1.16–6.41, p = 0.02). No significant association was observed for lateral or both meniscus injuries. Regarding chondral injury, although a higher odds ratio was noted in the > 12 months group (OR = 8.65), the difference was not statistically significant (p = 0.67).

Conclusion: Delayed ACLR, particularly after 12 months, was associated with an increased risk of medial meniscal injury. However, no significant association was found regarding lateral meniscal, both meniscal or chondral injuries.

Association Between Self-Monitoring Blood Glucose Frequency and Glycemic Control in Type 1 Diabetes Patients: A Retrospective Study at Khon Kaen Hospital

Thu, 26 Feb 2026 00:00:00 +0700

Background and Objective: Self-monitoring of blood glucose (SMBG) is an essential component of type 1 diabetes mellitus (T1DM) management, particularly in settings where continuous glucose monitoring remains inaccessible. Evidence from international cohorts suggests a strong inverse relationship between SMBG frequency and glycated hemoglobin (HbA1c), yet local data in Thailand remain limited. This study aimed to examine the association between SMBG frequency and glycemic control among adults with T1DM attending Khon Kaen Hospital.

Methods: A retrospective cohort study was conducted using electronic medical records from January 2024 to January 2025. Adults aged ≥15 years with T1DM and at least two clinic visits that documented SMBG frequency and HbA1c were included. Demographic characteristics, comorbidities, diabetes complications, and insulin regimens were recorded. SMBG frequency was categorized based on receiver operating characteristic analysis to discriminate poor glycemic control (HbA1c >9%). Statistical analyses included Wilcoxon rank sum tests, chi-square or Fisher’s exact tests, and univariate logistic regression.

Result: Fifty patients with 102 visits met eligibility criteria. The median age was 22 years, and most were female. The optimal SMBG threshold predicting poor glycemic control was 2.5 checks/day; this informed the categorization of SMBG <3 versus ≥3 times/day. Patients performing SMBG ≥3 times/day had significantly lower HbA1c values compared with those monitoring less frequently (8.4% vs. 9.5%, p=0.014). Higher education level was strongly associated with frequent SMBG (OR 9.00, 95% CI 1.46–55.48). Higher HbA1c was associated with reduced odds of frequent SMBG (OR 0.80 per 1% HbA1c increase, 95% CI 0.66–0.95). SMBG frequency also varied significantly across HbA1c categories, with patients achieving HbA1c <7% most likely to report ≥4 tests/day.

Conclusion: More frequent SMBG, especially three or more times a day, is associated with better glycemic control in Thai adults with T1DM. These findings align with global research and highlight the need for enhanced diabetes education, improved access to monitoring supplies, and targeted support for individuals with lower educational attainment to optimize glycemic outcomes.

Development of a Model for Searching and Registering New Tuberculosis Patients in Ratchaburi Provincial Hospitals

Nisachon Sriring, Wissanukorn Bangtum, Nawapat Mungmay — Thu, 26 Feb 2026 00:00:00 +0700

Background and Objectives: The registration of new tuberculosis patients is crucial for controlling and preventing the spread of the disease. This research aimed to study the situation of finding and registering new tuberculosis patients and to develop guidelines for accessing treatment in public hospitals in Ratchaburi Province.

Methods: This study employed a mixed-methods research approach. The quantitative sample consisted of 368 service users and 85 healthcare personnels. Data was collected using questionnaires assessing knowledge and needs and analyzed using descriptive statistics. Qualitative data was collected from 8 tuberculosis experts through in-depth interviews and analyzed using content analysis.

Results: The study found that over the past three years, Ratchaburi Province has not been able to achieve the target of registering new tuberculosis patients at a rate of over 90%, particularly in smaller hospitals. The public's knowledge level regarding tuberculosis detection and diagnosis was moderate, while healthcare personnel had higher knowledge of diagnosis than of screening and the use of tools to identify high-risk patients. The results proposed guidelines for developing a model for finding and registering new tuberculosis patients that is consistent with the context of the healthcare system in Ratchaburi Province.

Conclusion: Guidelines for developing a model for finding and registering new tuberculosis patients in hospitals in Ratchaburi Province are presented. These are crucial for controlling and preventing the spread of disease and comprise four aspects: 1) detection, 2) use of screening and confirmatory tools, 3) development of screening systems, and 4) diagnosis leading to treatment.

Effects of a Supportive and Educational Program on Knowledge of Self-Care Behaviors and International Normalized Ratio in Patients Following Surgical Artifical Cardiac Valve Replacement Therapy

Thu, 26 Feb 2026 00:00:00 +0700

Background and Objectives: Knowledge and preventive behaviors for complications after mechanical valve replacement are important indicators of patient-care outcomes. A supportive and educational program may help improve these outcomes. This study aimed to evaluate the effect of a supportive education program on knowledge, self-care behavior, and coagulation control (international normalized ratio, INR) in patients following mechanical valve replacement.

Methods: This quasi-experimental study used a two-group pre- and post-test design. A total of 54 participants who had undergone mechanical valve replacement for at least 5 years and whose INR was outside the therapeutic range, and who attended the cardiovascular thoracic surgical outpatient clinic at Srinagarind Hospital between September 2024 and July 2025, were enrolled. They were divided into an intervention group (n = 27) and a control group (n = 27). The intervention group received a 12-week supportive education program based on Orem’s self-care theory, while the control group received standard care. Data were collected via questionnaires assessing knowledge and self-care behaviors, and via measurements of INR. Analyses included descriptive statistics and inferential testing with generalized estimating equations (GEEs) and Bonferroni-adjusted multiple comparisons.

Results: The intervention group achieved significantly higher mean knowledge scores than baseline and the control group (mean difference = 4.33; 95% CI: 3.17-5.50; p < 0.001). Their self-care behaviors mean difference was 3.33 (95% CI: 1.49-5.18; p < 0.001) compared with baseline; however, the difference versus the control group was not statistically significant. In addition, 55.56% of the intervention group achieved INR values within the therapeutic range, compared with the control group, though this difference was not statistically significant (p = 0.655).

Conclusion: A supportive and educational program for self-care significantly increased knowledge and improved self-care behavior; it also increased the proportion of patients whose INR returned to the therapeutic range, although this latter improvement did not reach statistical significance.

Satisfaction of Scrub Nurses and Medical Personnel with Anesthetic Services at Queen Sirikit Heart Center of the Northeast Hospital, Khon Kaen Province

Thu, 26 Feb 2026 00:00:00 +0700

Background and Objectives: The collaboration between anesthesiologists and surgical instrument nurses and medical staff is linked to surgical outcomes and quality, which is an indicator of quality improvement. The Queen Sirikit Heart Center of the Northeast had no data regarding satisfaction with participation in anesthesia services among these personnel groups, which is a quality improvement indicator for The Joint Commission International (JCI) accreditation process. Therefore, the researchers aimed to study this satisfaction.

Methods: This was a cross-sectional descriptive study. The sample included all surgical instrument nurses and medical staff working in anesthesia services between May and July 2016. Questionnaires were distributed to 55 individuals, with 49 responses received. The questionnaire was validated for content validity by 2 senior anesthesiologists and pilot tested with 5 participants, yielding a Cronbach's alpha of 0.85. Scores ranged from 1 to 4 and were analyzed using descriptive statistics including frequencies, percentages, means, and standard deviations.

Results: Satisfaction with participation in anesthesia services among surgical instrument nurses and medical staff at the Queen Sirikit Heart Center of the Northeast was overall at high to very high levels across all phases: preoperative period (3.10 ± 0.74 to 3.57 ± 0.54), operating room (3.43 ± 0.54 to 3.57 ± 0.58), and post-anesthesia care unit (3.39 ± 0.61 to 3.57 ± 0.54). Areas requiring improvement included: coordination before surgery/procedures or changes in scheduled anesthesia service times, readiness of the anesthesia team to begin service when the team and equipment are ready, and appropriateness of management of infected patients in the post-anesthesia care unit.

Conclusion: The level of satisfaction with participation in anesthesia services among surgical instrument nurses and medical staff at the Queen Sirikit Heart Center of the Northeast was at high to very high levels.

Evaluation of Satisfaction with Quality of Life Promotion Activities among Cleft Lip and Palate Patients and Their Families in Northeastern Thailand

Thu, 26 Feb 2026 00:00:00 +0700

Background and Objectives: Improving the quality of life for patients with cleft lip and palate and their families is essential for promoting holistic well-being. The objective of this study was to evaluate the outcomes of activities organized to improve the quality of life for patients and their families. The findings will serve as empirical evidence for developing future activities that are appropriate and responsive to the needs of the target group.

Methods: This was a descriptive cross-sectional study conducted in August 2025. Data were collected using a questionnaire consisting of three parts: general information, satisfaction with activities across four dimensions (project organization process, project activities, project quality, and overall satisfaction)—with a reliability coefficient of 0.94—and additional suggestions. The total purposive sampling consisted of 94 participants, comprising 47 patients aged 10–25 years and 47 family members aged 15–65 years. Data were analyzed using descriptive statistics, including percentage, mean, standard deviation, and median.

Results: The majority of patients were female, aged 10–15 years, and were students. The majority of family members were female, aged 36–45 years, and worked as laborers or merchants. The satisfaction assessment for both patients and families were found to be at the highest level across all four dimensions (mean 4.72 ± 0.41 out of 5). Based on additional suggestions, both groups expressed a high level of impression and suggested increasing the diversity and continuity of activities.

Conclusion: The evaluation results reflect that the organization of quality of life promotion activities met the participants' satisfaction at the highest level, consistent with the needs of patients and their families. These findings can be used as a guideline for developing creative activities to enhance long-term quality of life.