Vajira Medical Journal: Journal of Urban Medicine

343-356

Authors: Suksan Kittisupakorn

Objectives: (1) study of the quality of life development plan for the elderly in Bangkok Phase II (2018–2021); (2) study of factors affecting on the quality of life development plan for the effective implementation of the elderly’s quality of life plan in Bangkok–Phase II (2018–2021); (3) present the model for the effective implementation of the elderly’s quality of life plan in Bangkok–Phase 2 (2018–2021) ; and (4) prediction equations of public administration’s quality criteria for the effective implementation of the elderly’s quality of life plan in Bangkok–Phase 2 (2018–2021). Study design: Mixed research methodologies: Qualitative, Quantitative and Documentary Research, were employed in this work. For qualitative research , the sample was selected by purposive sampling 10 persons from stakeholders engaging to new public management; that were executive, academic and media which data gathered by In-Depth Interview. For quantitative research, a simple questionnaire was used to survey through the elderly aged of 60 years old and above of 438 persons. Data gathered were analyzed based on descriptive statistics, Pearson’s correlation coefficient and multiple regression analysis. Results: (1) most population in the sample had high level of new public management with the public sector management quality award (PMQA) (x̄ = 3.74), and high level of the effective implementation of the elderly’s quality of life plan in Bangkok–Phase II (2018–2021) (x̄ = 3.41). (2) According to Pearson’s correlation coefficient and multiple regression analysis, it was found that (2.1) new public management with the public sector management quality award (PMQA) of 7 criteria had positive correlation with the effective implementation of the elderly’s quality of life plan in Bangkok–Phase II (2018–2021) and was statistically significant at the level of 0.01 (2.2) Category 1: leadership, Category 2: strategy and Category 7: outcome together with the foresight of the effective implementation of the elderly’s quality of life plan in Bangkok–Phase II (2018–2021) was statistically significant at the level of 0.01. (3) Model for implementing the plan into effective practice is “MOVING FORWARD TO SUPER–AGED SOCIETY” (4) The prediction equation as SOL equation = 0.410+0.342 (ZCategory2: Strategy) + 0.239 (Z Category 7: Outcome) + 0.234 (ZCategory 1: Leadership). Conclusion: The strategic host organizations must create integration between the various agencies, set directions, frameworks for projects/activities, and communicate public relations to ensure mutual understanding in order to create a consolidated outcome of Bangkok. Factors affecting the effective implementation of the elderly’s quality of life plan in Bangkok – Phase II (2018 – 2021) are leadership, strategy and outcome.

363-372

Authors: Naphat Wutilertcharoenwong, Korrakot Pornchaichanakit, Tanun Ngamvichchukorn

Objective: Vitamin D deficiency is a common condition among chronic kidney disease (CKD) patients. It is associated with cardiovascular mortality. Giving calciferol to CKD patients could help reduce vascular stiffness and decrease the risks of coronary artery disease and mortality. The current recommendation for treating vitamin D deficiency in CKD patients is using the same treatment strategies for the general population. However, there is no recommendation on the exact dose and duration. The purpose of this trial is to compare the effects of pulse dose versus continuous dose of calciferol on vascular stiffness in diabetic kidney patients. Methods: 31 patients with type 2 diabetes mellitus (T2DM), eGFR 15-59 mL/min/1.73 m2, and 25(OH) D level < 30 ng/mL, were enrolled in this randomized, open-label trial to receive either pulse dose (200,000 IU at the 0th and 8th weeks) or continuous dose (40,000 IU weekly for 8 weeks then 20,000 IU weekly for 2 weeks) of calciferol. The primary outcome was the vascular stiffness measured by the changes in carotid-femoral pulse wave velocity (cfPWV) at 10th week. Results: The mean 25(OH)D level at the baseline was 18.7 ng/mL in the pulse dose versus 19.9 ng/mL in the continuous dose. In the pulse dose, 10 patients (66.7%) achieved optimal vitamin D level while 6 patients (40%) did in the continuous dose. The mean change of cfPWV between the two groups, which was -0.5 (95%CI -3.15 to 2.15) (p=0.703), was not statistically significant. No adverse effect was reported. Conclusion: 10 weeks of calciferol given to CKD patients with T2DM and 25(OH)D < 30 ng/mL could achieve a higher reduction of Cardio-ankle vascular index in the pulse dose group than in the continuous dose group. Despite the lack of statistically significant change in Carotid-femoral pulse wave velocity (cfPWV), there seemed to be a higher cfPWV reduction in the pulse dose, with the achievement of 25(OH)D level.

387-398

Authors: Patiporn Bunyaphatkun, Anan Manomaipiboon, Thananda Trakarnvanich, Sujaree Pupipatpab, Pongsathorn Chomdee, Anusang Chitsomkasem, Yutthana Apichatbutr

Background: Since the rapid spread of SARs-CoV-2 worldwide, the surgical masks and N95 respirators were needed for personal protective equipment. The VJR-NMU-N99 half-piece respirator has invented. The provider satisfaction involved the sustainable invention used. If they satisfied or perceived positive attitude toward the invention, it was expected high quality regarding responsive to their need and want. The study of provider satisfaction will guide the opportunity to ongoing developing. Objective: The study of provider satisfaction with the product quality of VJR-NMU-N99 half-piece respirator. Method: A descriptive study was conducted in April 2020. Recruited into the study were 47 healthcare providers who wore the VJR-NMU half-piece respirator at Vajira hospital and Phra Nakhon Si Ayutthaya hospital. The research instrument was developed from Evidence-based Practice Attitude Scale 36. Data were collected on April 2020 and were analyzed with descriptive statistic. Results: Nurses were most participants (91.5%). The overall mean score for provider satisfaction with the VJR-NMU half-piece respirator was fair (3.08±0.34) including both Vajira hospital (3.08±0.35) and Phra Nakhon Si Ayutthaya hospital (3.06±0.32). The quality level based on mean total score was good (76.9%). Four items were excellent including advantage (94.3%), divergence (93.4%), requirements (92.3%) and job security (92.0%) while the items of burden and fit were modified (42.6%) and fair (67.3%) respectively. Conclusion: The opportunities for development with the VJR-NMU half-piece respirator should consider the composite material for need responses, as well as controlling humidity, supporting effective communication sounds, comfortable wearing and reducing workload.

415-424

Authors: Wanwisa Pattamawilai, Jiraporn Kespichayawattana, Pachanut Nunthaitaweekul

Objective: To compare level of constipation in stroke patients before and after receiving nursing process with abdominal massage and to compare level of constipation in stroke patients after receiving nursing process with abdominal massage with those who received routine nursing care. Method: This quasi-experimental research was used the pathophysiology of constipation and nursing care for constipation was used as the conceptual framework. Subjects consisted of 50 stroke patients (age 18-59 years) with constipation. Age, location of lesion and type of medication treatment were matched. Constipation was assessed using a Constipation Scoring System evaluation form which was tested for content validity and reliability = 0.74. Data were analyzed using descriptive statistics and t-test. Results: 1. The mean score of constipation in stroke patients after receiving the nursing process with abdominal massage was significantly lower than before receiving the nursing process with abdominal massage at the 0.5 level. 2. The mean score of constipation in stroke patients after receiving the nursing process with abdominal massage was significantly lower than before receiving the routine nursing care at the 0.5 level. Conclusions: The effect of nursing process with abdominal massage can reduce constipation with stroke patient more than regular nursing.