Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5256_Библиотеки_им_академика_М_И_Перельмана.pdf
23
2.4 Adaptation Strategies ofThai Nurses forPatient Care
During theCOVID-19 Pandemic
During the COVID-19 pandemic, Thai nurses implemented diverse adaptation strat-
egies to ensure effective patient care under drastically changed circumstances. As
key gures in the healthcare response, nurses took a leading role in the establish-
ment and management of various quarantine facilities, including COHORT wards,
eld hospitals, hospitals, and different isolation settings such as home and commu-
nity. These facilities were critical for isolating patients based on their infection sta-
tus and care needs, thereby minimizing the spread of the virus within communities
and healthcare settings. Like the rest of the world, the pandemic necessitated a sig-
nicant transformation in Thailand’s healthcare delivery platforms.
Traditional face-to-face interactions were quickly replaced with digital solutions.
Telemedicine and telenursing became the new norms, enabling Thai nurses to pro-
vide care remotely. This shift also helped protect both healthcare workers and
patients from unnecessary exposure to the virus. Numerous application technolo-
gies to support COVID-19 prevention and control activities in Thailand were gener-
ated, such as the Self-Screening Application (SSA) for COVID-19, Self-Health
Check for COVID-19, and COVID-19 Hospital Information System [22]. Thai
nurses increased their use of communication technologies, signicantly utilizing
telephone calls and social media platforms such as “LINE” to interact with patients
[23]. This approach allowed for the efcient monitoring of patients’ health status
and provided a channel for patients to receive advice and support without visiting
healthcare facilities [22, 24]. Virtual meetings became essential for team communi-
cations, training, and coordination of care, ensuring that all healthcare professionals
were updated with the latest guidelines and practices [21]. One of the innovative
approaches adopted was the enhancement of medication delivery systems known as
“Telepharmacy.” Prescription medications, including home chemotherapy treat-
ments, were delivered to patients’ homes via mail or through health volunteers [25].
This service was particularly vital for vulnerable populations, such as cancer
patients, who required ongoing treatment but needed to avoid public places and
potential virus exposure. A study by Kookanok etal. [16] found that the prevalence
of uncontrolled blood pressure in a group of hypertensive patients during the
COVID-19 pandemic was lower than in 2019. The researchers attributed this
improvement to the hospital’s implementation of a home delivery pharmacy service
for patients with NCDs, which made it easier for patients to adhere to their hyper-
tensive medication regimen.
The use of PPE was rigorously adopted, though adaptations were made due to
Thailand’s warm climate. For instance, the traditional white nurse cap was omitted
to reduce heat discomfort while maintaining safety protocols [26]. Additionally,
innovation played a signicant role in safeguarding both healthcare workers and
patients. An example of this is the introduction of medical devices such as the
“CMU Aiyara Robot” and “CURoboCovid.” These devices assisted in delivering
food and medicine, as well as measuring vital signs, thereby reducing human con-
tact and potential virus transmission in hospital settings [27, 28]. To oversee these
2 Impact oftheCOVID-19 Pandemic onNursing Care andPatients withIncontinence
24
myriad adaptations, the Nursing Emergency Response Operations Center was
established by the Thailand Ministry of Public Health. This center functioned as the
command hub for nursing operations nationwide, ensuring that resources were
appropriately allocated and that nurses were supported in their new roles and
responsibilities [29].
Thai nurses also played a pivotal role in broader collaborative efforts, working
alongside multidisciplinary teams and partnering with local, central, and non-
governmental sectors. These collaborations were crucial in ensuring a cohesive
response to the pandemic that aligned with both health and safety regulations and
community needs [30]. Approximately 90% of hospitals in Thailand reported PPE
shortages during the COVID-19 pandemic, including N95 masks, surgical masks,
respirators, gowns, gloves, and face shields [31]. Thai nurses engaged in fundraising
and volunteer efforts to produce and distribute PPE.At the community level, they
collaborated with volunteers and local administrative organizations to provide
transportation solutions for healthcare access. These initiatives supported health-
care logistics and strengthened community resilience and solidarity during the pan-
demic. Overall, the adaptation strategies employed by Thai nurses were instrumental
in navigating the challenges posed by COVID-19. Their efforts exemplied exibil-
ity, innovation, and unwavering commitment to patient care and public health safety
during an unprecedented global health crisis.
2.5 Impact ofCOVID-19 onNursing Care
forIncontinent Patients
The COVID-19 pandemic signicantly affected the delivery of nursing care to
incontinent patients in Thailand, leading to a signicant increase in the rate of
incontinence, UTIs, and irritant contact dermatitis due to incontinence among
patients. Several factors have contributed to these poor outcomes, making it chal-
lenging for healthcare providers to manage and prevent complications effectively,
particularly for patients who rely on family support and consistent healthcare pro-
vider attention.
During the COVID-19 pandemic, limited family visits and a shortage of health
care providers in hospital settings were particularly detrimental. Family members
often provide essential assistance with toileting and personal care of these patients
[32]; however, restrictions on visits left many patients unaccompanied for long peri-
ods. This lack of assistance, as well as conning patients to their rooms, resulted in
infrequent toileting, leading to increases in incontinence episodes, urinary retention,
and UTIs. Urinary retention creates an environment conducive to bacterial growth
and increases the risk of UTIs [33, 34]. Regular physical activity is essential for
maintaining bladder control, but when patients are conned to their beds or rooms,
their ability to move around is signicantly reduced. This lack of mobility leads to
decreased bladder function, resulting in more frequent incontinence episodes and a
higher likelihood of infections. The restrictions on patient mobility, implemented
to control the spread of the virus, unintentionally exacerbated the prevalence of
P. Juntasopeepun et al.
25
UTIs [35]. Prolonged exposure to leaked feces from fecal incontinence and delayed
cleansing of feces in the perineal area can increase the risk of UTIs. Due to the peak
of COVID-19in 2021 and a shortage of nurses, routine record-keeping was sus-
pended, resulting in a lack of medical records on the rates of incontinence and UTIs
related to incontinence for that year. However, data from 2020, the rst year of the
pandemic, revealed an increase in the hospital-acquired UTIs incidence rate from
1.21% in 2019 to 1.67% in 2020 at the largest university hospital in northern
Thailand [36].
Similarly, the prevalence of irritant contact dermatitis among incontinent
patients rose. Hospital statistics indicate that the incidence of irritant contact
dermatitis due to incontinence increased from 1.87% in 2019 to 3.22% in 2020
[36]. Limited family visits and staff shortages have resulted in patients being left
unaccompanied for long periods, leading to infrequent repositioning, delayed
changing of absorbent products, and inadequate personal hygiene. These factors
are essential for maintaining skin integrity. The connement to beds or limited
spaces increases pressure on certain areas of the skin, promoting breakdown,
pressure injury, and dermatitis. Prolonged exposure to moisture and irritants
from leaked urine and feces signicantly raises the risk of skin breakdown and
irritant contact dermatitis [37].
During the COVID-19 pandemic, Thailand, like many other countries, faced a
shortage of medical supplies [38]. The lockdowns, as well as international supply
chain disruptions, exacerbated the scarcity of absorbent products and wound dress-
ing supplies, particularly affecting those in community settings. As a result, caregiv-
ers and patients were compelled to use suboptimal alternatives, such as washable
adult absorbent products, which may not offer adequate skin protection and hygiene
[39]. The lack of essential supplies made it challenging to manage incontinence
properly and prevent skin complications. Consequently, the risk of irritant contact
dermatitis increased, further complicating the care of incontinent patients during the
COVID-19 pandemic.
Additionally, the loss of regular follow-up care due to lockdown measures and
fear of contracting the virus has prevented many incontinent patients from visiting
hospitals for their scheduled appointments. During the COVID-19 pandemic, the
number of hospital visits by Thai patients decreased signicantly [40]. A signicant
number of incontinent patients dropped out of a clinical trial during the COVID-19
outbreak in Thailand [41]. The restriction on family members, who typically accom-
pany and support patients during these visits, further exacerbated the situation. This
disruption in follow-up care means that patients did not receive necessary medical
attention and adjustments to their treatment plans, leading to deteriorating condi-
tions and increased rates of incontinence and UTIs. Pelvic oor muscle therapy and
bladder and bowel training are important interventions for managing incontinence,
but the COVID-19 pandemic made it difcult for many patients to continue these
therapies effectively. When patients returned home from the hospital, they often
struggled to perform the therapies that were taught and monitored in a more struc-
tured healthcare setting. Without the consistent support and guidance of healthcare
professionals, these therapeutic activities were frequently unsuccessful.
2 Impact oftheCOVID-19 Pandemic onNursing Care andPatients withIncontinence
26
In summary, the COVID-19 pandemic posed multiple challenges to the care of
incontinent patients in Thailand. Staff shortages, limited family visits, restricted
mobility, loss of follow-up care, and shortages of essential supplies all contributed
to poorer health outcomes, including those related to fecal and urinary incontinence.
Addressing these issues during and after the pandemic requires comprehensive
strategies that consider the unique needs of incontinent patients during such unprec-
edented times.
2.6 Adapting Care Delivery
During the COVID-19 pandemic, Thai nurses employed innovative and adaptive
care delivery methods to ensure that incontinent patients receive the necessary sup-
port and care despite the challenges posed by the crisis. These adaptations have
been crucial in maintaining patient health and managing incontinence effectively.
One of the key strategies adopted by Thai nurses has been the use of telemedicine
and the LINE application to conduct virtual home visits. The LINE platform allowed
nurses to provide wound care instructions, monitor patient conditions, and educate
both patients and caregivers remotely. By leveraging this technology, nurses were
able to maintain regular contact with their patients, ensuring continuity of care
while minimizing the risk of COVID-19 transmission. For example, Mamon and
Daovisan [42] successfully trained caregivers of bedridden older adults with incon-
tinence using the telenursing approach in Thailand during the COVID-19 pandemic.
Thai nurses collaborated with various volunteer groups, including Village Health
Volunteers (VHVs) and caregivers, to deliver home-based care. The VHV program
in Thailand was originally developed to address the shortage of healthcare person-
nel in rural areas. This initiative empowers local community members to take on
essential healthcare roles, ensuring that even remote populations have access to
basic health services [43]. During the COVID-19 pandemic, VHVs were especially
valuable in supporting communities, particularly when the shortage of healthcare
personnel became more acute. These volunteers have been trained to assist with the
daily needs of incontinent patients, such as toileting and hygiene, reducing the bur-
den on the healthcare system [44]. They also played an essential role in community
surveillance of COVID-19in Thailand [45].
Due to the shortage of medical supplies, such as adult incontinence absorbent
briefs and wound dressing supplies, patients with incontinence, both in hospitals
and the community, have been signicantly impacted. In hospitals, strict visitation
restrictions prevented family members from bringing essential supplies like absor-
bent briefs to their loved ones with incontinence. Consequently, nurses had to adapt
by using donated absorbent incontinence briefs or washable, reusable cloth prod-
ucts as alternatives. At the community level, the Thai government implemented a
policy during the COVID-19 outbreak to provide free absorbent incontinence briefs
to incontinent patients, limited to three pieces per patient per day [46]. This initia-
tive has been crucial in supporting patients who might otherwise face nancial dif-
culties due to the pandemic. To ensure that patients have access to essential
P. Juntasopeepun et al.
27
supplies, community nurses were proactive in assessing and screening patients for
eligibility to receive free absorbent products [47]. This initiative helped identify
those most in need, providing them with the necessary materials to manage their
condition effectively. Additionally, local health centers in the community played a
vital role in supporting the care of incontinent patients by supplying wound dressing
materials. These centers ensured that patients and caregivers have access to the nec-
essary supplies to manage wounds and prevent infections.
After the COVID-19 pandemic, despite the end of lockdowns, many preventive
measures, family visiting restrictions, connement, and certain innovations introduced
during the crisis have endured. These include the use of telemedicine and digital appli-
cations for patient care and follow-ups. Virtual consultations and remote care have
proven effective in maintaining essential healthcare services. Telepharmacy, though not
widely available before the pandemic, became a common practice in hospitals and has
remained a valuable part of healthcare delivery. While mask- wearing is no longer
enforced, it continues to be widely adopted in healthcare settings. Additionally, the
Thai government’s initiative to provide free absorbent products to incontinent patients,
introduced during the pandemic, has now become a permanent healthcare policy. This
has signicantly reduced the nancial burden on patients and families, particularly in
underserved areas, ensuring ongoing access to necessary care.
2.7 Impact oftheCOVID-19 Pandemic onNursing Home
Care intheUnited States
2.7.1 Impact onNursing Home Residents
During the COVID-19 pandemic, long-term care facilities in the United States (US)
were faced with numerous challenges in managing the health and well-being of their
residents with and without incontinence, similar to those described in Thailand in the
sections above. By December 2020, nursing homes lost about 16% of their resident
population compared to 2019. Analyzing data of 15,342 nursing homes, the Centers for
Disease Control and Prevention (CDC) reported that COVID-19 cases among nursing
home residents during June and July 2020 reached 11.5 cases per 1000 resident-weeks
[48]. COVID-19 cases decreased during August–September 2020 to 6.3 per 1000 resi-
dent-weeks but rose again in November to 23.2 cases per 1000 resident-weeks.
Although incidence rates of residents were higher than those of nursing home staff, the
trends were similar [48]. The CDC developed numerous resources to support nursing
homes during and after the pandemic, such as an infection control assessment and
response tool, a checklist to assess and improve preparedness for responding to coro-
navirus disease, a sample letter to communicate to residents, families, and volunteers
the actions being taken to protect its residents and staff, and a system to track infections
and prevention process measures in a systematic way.
Nonetheless, health outcomes of nursing home residents in the US worsened
during the COVID-19 pandemic as seen in an increase in rates of depressive symp-
toms, unplanned weight loss, worsened functional status, cognitive decline,
2 Impact oftheCOVID-19 Pandemic onNursing Care andPatients withIncontinence
28
incontinence, both urinary and fecal, and pressure injury [49]. There was a combi-
nation of factors that contributed to disruptions in usual care and care for residents
with incontinence in nursing homes. These factors, experienced in numerous coun-
tries including the US, included infection control measures, limited mobility, short-
ages and increased workload of nursing staff, decreases in healthcare services, and
emotional stress [50, 51] (see Box 2.1). One study reported that fecal incontinence
was a signicant risk factor for COVID-19 infection in nursing home residents [52].
The investigators suggested that the close, direct contact needed to cleanse residents
who had fecal incontinence may have raised the risk of spreading/contracting the
virus. There was also a functional decline in residents from decreased mobility,
exercise, and physical therapy during the COVID-19 pandemic, resulting in high
rates of fecal and urinary incontinence and setbacks in progress in functional status
that were previously achieved before the pandemic [53]. The major focus and prior-
ity of care by nursing staff during the pandemic was to try to save lives, and usual
prevention and management interventions of chronic conditions, such as inconti-
nence, were drastically reduced [54].
An increase in skin problems experienced by both healthcare workers and
residents in nursing home facilities was observed during the COVID-19 pandemic.
Notably, the increased use of personal protective equipment (PPE) such as masks,
gloves, and gowns in response to the pandemic led to a rise in contact dermatitis.
Prolonged and repeated exposure to these protective materials, coupled with the use
of harsh disinfectants and hand sanitizers, irritated the skin and caused allergic reac-
tions, resulting in redness, itching, and discomfort [55]. The prolonged periods of
immobility due to lockdowns and restrictions placed on residents to prevent the
spread of COVID-19 increased the risk of developing pressure injuries. The lack of
regular repositioning and limited access to specialized equipment like pressure-
relieving mattresses contributed to the development of these painful and potentially
serious wounds [56].
Box 2.1 Factors Impacting Nursing Care for Incontinence and Associated Skin
Problems in US Nursing Home Residents During the COVID-19 Pandemic
1. Infection Control Protocols and Use of Personal Protective Equipment
(PPE): Strict infection control procedures, including wearing masks,
gloves, and gowns, interfered with communication and usual care for
nursing home residents, increasing the frequency of incontinence [54] and
risks for irritant contact dermatitis and pressure injury.
2. Reduced Mobility: Lockdowns and mobility restrictions limited residents’
movement, decreasing nursing assistance with toileting, urgency, and
accessibility to toilets. The risk of pressure injuries was increased due to
inadequate repositioning and a lack of specialized equipment for turning
and lifting residents [53, 54].
3. Staff Strain: Nursing staff shortages (due to illness of staff from COVID-19),
altered and redirected care routines, and staff burnout resulted in declines
(continued)
P. Juntasopeepun et al.
29
The implementation of strict infection control protocols in long-term care
facilities, including frequent handwashing and disinfection of surfaces, created an
environment conducive to the growth of fungi [59]. Residents with compromised
immune systems were particularly vulnerable to fungal infections. The warm and
moist conditions in shared living spaces facilitated the spread of these infections
among residents.
2.8 Impact oftheCOVID-19 Pandemic onUS Nursing
Home Staff
The pandemic placed additional strain on caregivers and healthcare staff in long-
term care facilities, leading to staff shortages and increased workload for those who
remained. The nursing home workforce lost 221,000 jobs during the COVID-19
pandemic, equating to 14% of its total workforce [48]. Certied nurse assistants
(CNAs), who provide much of the continence care and skin injury prevention, expe-
rienced the greatest decreases. Staff shortages, staff burnout, altered routines, and
disruptions in care delivery may have impacted the quality of skin care provided to
residents, increasing the risk of incontinence and associated skin issues. Nurses are
essential in promoting continence and healthy skin among patients, particularly in
preventing and managing irritant contact dermatitis [51].
Advanced practice nurses conduct risk assessment, timely identication, and
collaborate with the multidisciplinary team to develop prevention and management
plans for residents. Due to the stafng shortages, the number of nursing staff to
implement these plans was drastically strained [60]. Restrictions on non-essential
healthcare services and limited access to continence and wound care specialists dur-
ing the pandemic hindered the timely evaluation and management of incontinence
and skin problems, resulting in greater resident morbidity. For example, during the
second quarter of 2020, pressure injury rates increased by 41.8% in skilled nursing
homes [48].
During the COVID-19 pandemic, it was necessary to modify and implement
specic preventive skin care strategies to manage incontinence and identify and
in the quality of care for maintaining continence and skin health and
integrity; residents’ susceptibility to skin breakdown and other problems
increased [51].
4. Restricted Healthcare Access: Limited availability of non-essential health-
care services delayed the evaluation and treatment of various symptoms
and existing health conditions that were not immediately life threatening,
worsening wellness and health outcomes for many residents.
5. Emotional Stress: The psychological toll of the pandemic led to increased
emotional stress among residents and nursing staff [57, 58].
Box 2.1 (continued)
2 Impact oftheCOVID-19 Pandemic onNursing Care andPatients withIncontinence
30
reduce the risk of pressure injuries and irritant contact dermatitis due to inconti-
nence. After the pandemic, the advanced practice nurse can assist nursing home
staff in re-instituting strategies to improve health outcomes of nursing home resi-
dents [61]. These strategies are described in Box 2.2 [55, 56].
Box 2.2 Strategies for the APRN to Assist Nursing Sta in Skilled Nursing Care
Facilities to Reinstitute Quality Care for Residents with Incontinence After the
COVID-19 Pandemic
• Incontinence Management: Develop comprehensive incontinence manage-
ment protocols to prevent and manage incontinence.
• Pressure Injury Prevention: Implement pressure injury prevention strate-
gies, such as repositioning schedules, the use of pressure-relieving devices
(e.g., cushions, mattresses), identifying medical device-related injuries and
promoting mobility and activity to reduce prolonged pressure on vulnera-
ble areas of the skin.
• Irritant Contact Dermatitis Prevention and Management: Develop proto-
cols for prevention and management of irritant contact dermatitis in col-
laboration with continence or wound care specialist, including timely
assessment, treatment, and monitoring of irritant contact dermatitis to pre-
vent complications and promote healing. Use appropriate and high-quality
absorbent products, maintain skin hygiene, and provide prompt inconti-
nence care to minimize skin exposure to moisture and irritants. Utilize
protective lm products to provide long lasting protection from
incontinence.
• Skin Hygiene Practices: Encourage regular skin hygiene practices, includ-
ing gentle cleansing moisturizing dry skin, and avoiding harsh chemicals
or irritants that can compromise the skin barrier and increase susceptibility
to skin issues. Choosing hypoallergenic and fragrance-free products for
cleaning and skincare can reduce the risk of contact dermatitis and allergic
reactions.
• Regular Skin Assessments: identify key nursing team members to conduct
biweekly skin assessments for all residents to identify early signs of skin
breakdown, especially for residents at high risk, such as those with fecal or
double incontinence.
• Nutrition and Hydration: Ensure residents receive adequate nutrition and
hydration to support skin health and integrity. A well-balanced diet rich in
nutrients and sufcient uid intake can promote skin healing and reduce
the risk of skin breakdown.
• Mobility and Activity Promotion: Encourage residents to maintain mobility
and engage in regular physical activity to improve circulation, reduce pres-
sure on bony prominences, and support skin health. Include toileting as
part of a physical mobility program.
(continued)
P. Juntasopeepun et al.
31
In summary, nurses in Thailand and the United States have demonstrated resil-
ience and adaptability in caring for incontinent patients during the COVID-19 pan-
demic. By utilizing technology, collaborating with volunteers, and ensuring the
provision of essential supplies, they were able to maintain a high standard of care
despite the challenges. These strategies not only addressed the immediate needs of
patients but have also established a framework for continued support in future
healthcare crises.
References
1. Triukose S, Nitinawarat S, Satian P, Somboonsavatdee A, Chotikarn P, Thammasanya T, etal.
Effects of public health interventions on the epidemiological spread during the rst wave of the
COVID-19 outbreak in Thailand. PLoS One. 2021;16(2):e0246274.
2. Rajatanavin N, Tuangratananon T, Suphanchaimat R, Tangcharoensathien V.Responding to
the COVID-19 second wave in Thailand by diversifying and adapting lessons from the rst
wave. BMJ Glob Health. 2021;6(7):e006178.
3. World Health Organization. Number of COVID-19 cases reported to WHO. 2024.
4. Department of Disease Control. Situation of COVID-19in Thailand. 2024.
5. World Health Organization. Behavioural considerations for acceptance and uptake of
COVID-19 vaccines: WHO technical advisory group on behavioural insights and sciences for
health, meeting report, 15 October 2020. 2020. Report No.: 9240016929.
6. Department of Health Ministry of Public Health. Guidance for COVID-19 vaccine in the 2564
pandemic situation in Thailand. 2021.
7. COVID-19 vaccination report February 17th, 2024 [Internet]. 2024. Available from: https://
ddc.moph.go.th/vaccine- covid19/getFiles/10/1678949903705.pdf.
8. International Council of Nurses. The role of nurses in immunisation: a snapshot from OECD
countries. 2018.
9. Apisarnthanarak A, Apisarnthanarak P, Siripraparat C, Saengaram P, Leeprechanon N, Weber
DJ.Impact of anxiety and fear for COVID-19 toward infection control practices among Thai
healthcare workers. Infect Control Hosp Epidemiol. 2020;41(9):1093–4.
10. Gaesawahong R, Peasui N, Warapapong O, Yongprawat T, Dawudom N.A survey of stress and
impacts in registered nurses during the COVID-19 pandemic. Bangkok Med J. 2022;18(2):106.
• Staff Education and Training: Start with educating key members of the
nursing staff about best practices for incontinence and skin care. Empower
these staff to teach other nursing staff who will deliver quality care to resi-
dents [57].
• Communication and Collaboration: Foster interdisciplinary collaboration
among healthcare team members, including nurses, nursing assistants,
physicians, wound care specialists, and dietitians, to coordinate care, share
information, and address skin care needs comprehensively [51]. For resi-
dents with complex problems, utilize telemedicine with specialists to
develop an individualized plan and follow up [62].
Box 2.2 (continued)
2 Impact oftheCOVID-19 Pandemic onNursing Care andPatients withIncontinence
32
11. Sirijatuphat R, Leelarasamee A, Horthongkham N. Prevalence and factors associated
with COVID-19 among healthcare workers at a university hospital in Thailand. Medicine.
2022;101(38):e30837.
12. Thanapluetiwong S, Chansirikarnjana S, Sriwannopas O, Assavapokee T, Ittasakul P.Factors
associated with COVID-19 vaccine hesitancy in Thai seniors. Patient Prefer Adherence.
2021:2389–403.
13. World Health Organization. Thailand provides COVID-19 vaccination at migrant workers’
doorstep. 2022.
14. Pitayarangsarit S, Bhagaman N, Yodmai K, Thangsirikul N, Tipayamongkholgul M.The resil-
iency of noncommunicable diseases services during the public health crisis: a lesson from
Bangkok, Thailand. BMC Health Serv Res. 2023;23(1):409.
15. Sukmanee J, Butchon R, Karunayawong P, Saeraneesopon T, Boonma C, Teerawattananon
Y, et al. Pattern of OPD utilisation during the COVID-19 pandemic under the Universal
Coverage Scheme in Thailand: what can 850 million records tell us? BMC Health Serv Res.
2023;23(1):116.
16. Kookanok C, Rojndumronggarn P, Charoensakulchai S, Rangsin R, Sakboonyarat B.The study
of association between COVID-19 pandemic and blood pressure control among hypertensive
patients in Tha Luang Hospital, Lopburi Province, Thailand. Greater Mekong Subregion Med
J. 2021;1(3):115–24.
17. Chinvararak C, Kerdcharoen N, Pruttithavorn W, Polruamngern N, Asawaroekwisoot T,
Munsukpol W, etal. Mental health among healthcare workers during COVID-19 pandemic in
Thailand. PLoS One. 2022;17(5):e0268704.
18. Yubonpunt P, Kunno J, Supawattanabodee B, Sumanasrethakul C, Wiriyasirivaj B.Prevalence
of perceived stress and coping strategies among healthcare workers during the COVID-19
outbreak at Bangkok metropolitan, Thailand. PLoS One. 2022;17(7):e0270924.
19. Komwong D, Prasanthanakul J, Phanasathit M, Wongwan T.Prevalence of mental health prob-
lems and associated factors of Thai healthcare workers during the rst wave of COVID-19
pandemic. J Public Hlth Dev. 2022;20(1):106–19.
20. Somboonviboon D, Wittayawisawasakul Y, Wacharasint P.Prevalence and risk factors of burn-
out syndrome during COVID-19 pandemic among healthcare providers in Thailand. J Environ
Public Health. 2023;2023(1):5719241.
21. Sarnkhaowkhom C, Promkanya A, Pomisrikeaw S, Ritthapanya N. “Novice nurse and novel
coronavirus”: experiences of novice nurses caring for patients diagnosed with COVID-19in
Thailand. Nurs Open. 2022;9(6):2887–98.
22. Intawong K, Olson D, Chariyalertsak S.Application technology to ght the COVID-19 pan-
demic: lessons learned in Thailand. Biochem Biophys Res Commun. 2021;534:830–6.
23. Harindhanavudhi T, Areevut C, Sahakitrungruang T, Tharavanij T, Kietdumrongwong P,
Ngimruksa O, etal. Implementation of diabetes care and educational program via telemedicine
in patients with COVID-19in home isolation in Thailand: a real-world experience. J Diabetes
Investig. 2022;13(8):1448–57.
24. Kittipimpanon K, Noyudom A, Panjatharakul P, Visudtibhan PJ.Use of and satisfaction with
mobile health education during the COVID-19 pandemic in Thailand: cross-sectional study.
JMIR Form Res. 2023;7:e43639.
25. Chaomuang N, Dede AJ, Saokaew S, Umnuaypornlert A. Effects of home drug delivery
on drug-related problems: preliminary evidence for improved patient outcomes during the
COVID-19 pandemic in Thailand. J Am Pharm Assoc. 2022;62(4):1206–13. e3
26. Thailand Nursing Council. Guidelines on nurse caps for Thai nursing uniforms during
the COVID-19 pandemic. 2019.
27. Chulalongkorn University News. “CU-RoboCovid”: a medical support project during the
COVID-19 pandemic. 2020.
28. Chiang Mai University News. COVID19 robot “CMU Aiyara” serving patients. 2020.
29. Sathira-Angkura T, Leelawongs S, Srisuthisak S, Puttapitukpol S, Yonchoho N, Jamsomboon
K.Development of nursing administration model in the COVID-19 outbreak situation of hos-
pitals under the Ministry of Public Health. J Health Sci. 2021;30(2):320–33.
P. Juntasopeepun et al.