Incidence and risk factors for nosocomial pneumonia among intubated patients in a provincial hospital, Eastern Thailand.

The present study was conducted to determine the incidence and risk factors for nosocomial pneumonia (NP) among intubated patients in a provincial hospital, eastern Thailand. Three hundred five intubated patients who voluntarily participated and signed informed consent were observed and medical records were collected. The respiratory secretion specimens from NP patients, diagnosed by doctors under the definition of the International Statistical Classification of Disease and Related Health Problems Tenth Revision (ICD-10), were collected for bacterial culture. Data from patients with and without NP were analyzed to identify risk factors. The results revealed that the incidence of NP was 38.4% (117/305 cases). Of 117 NP patients, 35% were positive on bacterial culture. The most frequently isolated bacteria were Klebsiella pneumoniae and Klebsiella spp (32%), and the incidence of methicillin resistant Stapylococcus aureus (MRSA) was 6%. Risk factors for NP from univariate analysis were (a) age more than 60 years (OR = 9.2, p < 0.001), (b) admitted to the ICU (OR = 1.7, p=0.042), (c) comatose (OR = 12.2, p < 0.001), (d) chronic pulmonary disease (OR = 5.3, p < 0.001), tuberculosis (OR = 14.3, p < 0.001), (e) smoking (OR = 7.1, p < 0.001), and (f) duration of intubation greater than 5 days (OR = 8.8, p < 0.001). After controlling for confounders using multivariate analysis, the significant risk factors were (a) age greater than 60 years (OR = 9.9, p < 0.001), (b) comatose (OR = 9.4, p = 0.031), (c) chronic pulmonary disease (OR = 5.2, p < 0.001), tuberculosis (OR=I 1.4, p = 0.003), (d) smoking (OR = 3.6, p < 0.001), and (e) duration of intubation more than 5 days (OR = 18.9, p < 0.001). When an intubated patient has these risk factors, they should be considered a potential risk for NP and preventive measures should be taken to reduce the risk.

Factors related to health-promoting behaviors among Thai middle-aged men.

OBJECTIVE: To study factors related to health promoting behaviors of Thai middle-aged men. STUDY DESIGN: Descriptive research. MATERIAL AND METHOD: Nine hundred and five Thai males, aged between 40-59 years, living in six provinces of Thailand, were selected by multi-stage random sampling. Data were collected using interview, physical examination, and laboratory test. RESULTS: Thai middle-aged men mostly perceived their health status as fair (85.6%). Health screening showed that 7.2% had hormone deficiency, 65.7% had slight prostatic hypertrophy, and 27.3% had erectile dysfunction symptoms. Overall health promoting behaviors were at moderate level (50.7%). Marital status, having annual health examination, social support, receiving health information, and health belief were significantly related to health promoting behaviors (p < 0.05). CONCLUSION: Providing health information through materials, media, and family members would also increase accessibility to health services and promote effective health-promoting behavior of Thai middle-aged men.