This research was to develop optimal self-care behavior among seniors in the senior club, Bangtoey sub-district, Sampran district, Nakhon Pathom Province by implementing health promotion campaign. This study is a mixed-method design, quantitative and participatory action researches were employed to fulfill the research objectives. A study population comprises of 231 seniors (aged 60 years old or above) in a senior club of Bangtoey sub-District, Nakhon Pathom Province. The researcher collected information on illness condition (i.e., congenital disease), using a questionnaire responded by 197 seniors, recruiting by a simple random sampling technique. In addition, seventy-seven and 38 seniors who attended all health promotion campaigns were purposively recruited into the study of a trend of illness condition after each optimal health promotion campaign and the comparison study of a pre-and-post hypertension condition of senior who has a chronic hypertension condition. The findings revealed that most seniors have hypertension condition (69%), followed by physical pain and aches (45.2%). The research provided four self-care behavior campaigns for seniors, in total of 12 hours, from October 2012 to January 2013. The Least square method predicted a downward trend of illness condition among seniors in January 2014. Moreover, an analysis of blood pressure assessment of seniors who have a chronic hypertension condition revealed that their blood pressure values significantly decreased in post self-care campaign.
A cross-sectional study was conducted to examine the nutritional status of children (aged 1-5 years) who lived in the Klong Toey slum, Bangkok; the factors related to nutritional status were also determined. Anthropometric measurements were made for 232 children; socioeconomic background information was obtained by interviewing their mothers using a structured questionnaire. The prevalence of malnutrition among the study sample was 25.4% by weight-forage, 18.1% by height-for-age, and 6.9% by weight-for-height; the prevalence among pre-school children in Thailand and in the Bangkok metropolitan area by weight-for-age was reported to be 8.73% and 5.25% respectively. Potential related factors were examined: family characteristics, (mother's age, marital status, educational background, family size, family income, and mothers' occupation); children's characteristics (age, gender, birth order, immunization status, and history of illness); mothers' knowledge and perception of nutrition and mothers' food practice. Multiple logistic regression analysis was used to identify the association with the nutritional status of children by height-for-age. The results showed that family income (adjusted OR=0.9998; 95% CI: 0.9997-1.0000), maternal housewifery or unemployment (adjusted OR=6.5; 95% CI: 1.74-24.3), food practice (adjusted OR=0.7123; 95% CI: 0.5390-0.9414), and a maternal educational level lower than primary school (adjusted OR=10.1; 95% CI: 1.13-91.9) were associated with the nutritional status of children. This finding implies that although malnutrition is no longer considered to be a major health problem in Thailand, it remains a threat to the health of the urban poor in Bangkok. This finding should not be overlooked and countermeasures are indicated.
The rate of type-2 diabetes mellitus (T2D) is dramatically increasing worldwide. Continuing diabetes mellitus (DM) care needs effective self-management education and support for both patients and family members. This study aimed to review and describe the impacts of diabetes mellitus self-management education (DSME) that involve family members on patient outcomes related to patient health behaviors and perceived self-efficacy on self-management such as medication adherence, blood glucose monitoring, diet and exercise changes, health outcomes including psychological well-being and self-efficacy, and physiological markers including body mass index, level of blood pressure, cholesterol level and glycemic control. Three databases, PubMed, CINAHL, and Scopus were reviewed for relevant articles. The search terms were “type 2 diabetes,” “self-management,” “diabetes self-management education (DSME),” “family support,” “social support,” and “uncontrolled glycaemia.” Joanna Briggs Institute (JBI) guidelines were used to determine which studies to include in the review. Details of the family support components of DSME intervention and the impacts of these interventions had on improving the health outcomes patients with uncontrolled glycaemia patients. A total of 22 intervention studies were identified. These studies involved different DSME strategies, different components of family support provided, and different health outcomes to be measured among T2D patients. Overall, family support had a positive impact on healthy diet, increased perceived support, higher self-efficacy, improved psychological well-being and better glycemic control. This systematic review found evidence that DSME with family support improved self-management behaviors and health outcomes among uncontrolled glycaemia T2D patients. The findings suggest DSME models that include family engagement can be a useful direction for improving diabetes care.
Studies in China on ethnic disparities in access to health care in remote and rural population remain insufficient. This study aimed to assess the disparities in utilization of maternal and child health (MCH) services, including antenatal care (ANC), hospital birth, child growth monitoring, and immunization compliance between Han and ethnic minority women in Yunnan Province.A multi-stage sampling scheme was used to randomly recruit women from 40 townships in 14 remote prefectures of extremely remote areas in Yunnan. From birth records, we identified and recruited 303 Han women and 222 ethnic minority women who had given birth to a child within 3 years for an interview.Overall, 96% of women used the ANC checkups and more than 95% had infants born in hospitals. However, the proportion of women compliant with early ANC visits (having antenatal care in the first trimester) was 22.5% lower in minority women than in Han women (61.3% vs. 83.8%, p < 0.001) with an adjusted odds ratio (aOR) of 2.04 (95% confidence interval (CI) of 1.13-3.66) for the minority group. The proportion of children under one year old with immunizations completed in a timely manner was also lower in minority families than in Han families (80.2% vs. 86.8%, p < 0.05) with an aOR of 1.99 (95% CI = 1.16-3.40).Ethnic disparities remain in utilization of early ANC visits and timely immunization completion for newborns. Ethnic minority women tended to lag behind for both. Further intervention should focus on assisting minority women living in extremely rural areas to comply with the MCH policy. Culturally-sensitive policies and skills are needed, and priority should be given to improve utilization of early ANC and timely immunization completion.
Foot ulcers are a complication of diabetes which reduce quality of life. This study aimed to explore the perspectives of public health nurses regarding obstacles to carrying out effective neuropathy screening practices to prevent diabetic foot ulcers in public health centers. A qualitative study with a phenomenological approach was carried out using in-depth interviews and focus group discussions. The results of this study indicated five key themes of challenges: 1) inadequate knowledge and lack of skills in neuropathy screening; 2) insufficiency of health facilities in primary health care services; 3) high workload and job demands; 4) lack of human resources; and 5) inaccessibility of health care services. The findings provided important information regarding the challenges and constraints of implementing neuropathy screening practices in community health centers. The public health nurses need to improve their capabilities in implementing neuropathy screening and need to negotiate with stakeholders for the implementation of this screening policy to prevent foot ulcers in patients with diabetes mellitus at the community level.
Keywords: challenges in neuropathy screening practice, foot ulcer, public health nurses, diabetes mellitus, qualitative study
Women’s fertility decision is quite difficult in male-dominant rural culture due to their poor reproductive autonomy. A cross-sectional survey was conducted in rural community of Bangladesh between November 2017 and February 2018 among 1285 respondents selected by multi-stage stratified sampling to explore regional variations of rural women’s fertility control behavior and its determinants using hierarchical and other inferential statistics. Data collection was done by face-to-face interview using questionnaire. Average parity was 2.5 per woman and 41% respondents had three or more children. About 60% of them used modern contraceptives (MCs) and oral contraceptive pill (OCP) was their first choice. Male participation in contraceptive use was less than 5%. Regional variation, women’s empowerment, fertility control knowledge, family planning (FP) attitude, social influence, perceived behavioral control (PBC) and fertility intention were significant predictors of fertility control behavior (p < 0.05). Significant regional variations were determined in fertility control behavior of rural women (p < 0.05). Almost all of its predictors explained by Theory of Planned Behavior (TPB) also showed significant regional variations (p < 0.05). Current fertility control policy should be strengthened more not only to improve fertility behavior of rural women but also to establish regional equity in fertility control by improving their reproductive decision-making in a rational way.
Objective: A crosssectional survey research aimed at studying factors influencing health promoting behaviors (HPB) of the elderly under the universal coverage program. Materials and methods: The sample group was 341 elderly in Buriram Province. A multistage sampling technique was used to select the sample. Data were collected by using interview questionnaire during 17 31 October, 2005 and were analyzed by frequency, percentage, mean, standard deviation, Pearson’s Product Moment Correlation and stepwise multiple regression analysis. Results: The results showed that 53.7% of the elderly had HPB at moderate level and 30.2% had HPB at high level. Factors significantly predicting HPB among the elderly were having occupation, knowledge score on HPB, having current illness for one month, experience obtaining knowledge or information on HPB from health personnel, and social support from family. These factors were able to predict HPB of the elderly correctly 42.1%. Conclusion: From these findings, the authors recommend health providers to promote elderly HPB in all communities by giving knowledge on HPB through various means, enhancing social support from family and paying attention to unemployed groups to encourage them in daily practice of HPB.
Introduction: Breast cancer is an increasingly significant health problem for women all over the world. Moreover, most of the women lack of knowledge, understanding of breast cancer and how to correctly examine the breasts. This experimental research was carried out to evaluate the effects of a breast self-examination acquisition development program on female village health volunteers in Wangchan District, Rayong Province, using the concept of participatory learning in organizing the activities. Method: Simple random sampling was used to obtain the studied population; 30 in the experimental group and 32 in the control group. The experimental group went through the program for 4 weeks whilst the control group received regular training from the district hospital. The tools used in collecting data were questionnaire and evaluation form on breast self-examination. The data was collected twice; once before the experiment and another 1 month after the experiment. Data analysis was carried out using paired t-test and independent t-test. Result: The research found that after the experiment, the experimental group scored higher in knowledge and positive attitude of breast cancer and breast self-examination compared to before the experiment with statistical significance (p-value < 0.001). Furthermore, the experimental group also had higher degree of correction in breast self-examination than before the experiment and the control group with statistical significance (p-value < 0.001). Discussion and Conclusion: The research found that skill development for breast self-examination program could be applied as a guideline for health promoting personnel and the training of village health volunteers (VHVs) to transfer to general publics and increase the accuracy of practice of breast self-examination among the training of village health volunteers. Key words: Breast self-examination, Knowledge, Attitude, Accuracy ผลของโปรแกรมพฒนาทกษะการตรวจเตานมดวยตนเองตอความร เจตคต และความถกตองในการตรวจเตานมดวยตนเองของสตรอาสาสมครสาธารณสข อำเภอวงจนทร จงหวดระยอง วราพร วรยะอลงกรณ*, กนษฐา จำรญสวสด**, วรศกด เมองไพศาล***, สบวงศ จฑาภสทธ**** * นกศกษาหลกสตรวทยาศาสตรมหาบณฑต (วทยาการระบาด) สาขาวทยาการระบาด คณะแพทยศาสตรศรราชพยาบาล มหาวทยาลยมหดล ** ภาควชาอนามยครอบครว คณะสาธารณสขศาสตร มหาวทยาลยมหดล *** ภาควชาเวชศาสตรปองกนและสงคม คณะแพทยศาสตรศรราชพยาบาล มหาวทยาลยมหดล **** ภาควชาศลยศาสตร คณะแพทยศาสตรศรราชพยาบาล มหาวทยาลยมหดล ผใหตดตอ: ผชวยศาสตราจารย ดร.กนษฐา จำรญสวสด ภาควชาอนามยครอบครว คณะสาธารณสขศาสตร มหาวทยาลยมหดล ๔๒๐/๑ ถนนราชวถ เขตราชเทว กรงเทพมหานคร ๑๐๔๐๐ โทรศพท (๐๒) ๓๕๔-๘๕๓๖ อเมล kanittha.cha@mahidol.ac.th บทคดยอ บทนำ: มะเรงเตานมเปนปญหาสขภาพทสำคญของสตรในทกภมภาคทวโลก ซงนบวนยงทวความสำคญมากขน และยงพบวาสตรสวนใหญยงขาดความร ความเขาใจเรองโรคมะเรงเตานม และการตรวจเตานมทถกตอง การวจยกงทดลองนเพอประเมนผลของโปรแกรมพฒนาทกษะการตรวจเตานมดวยตนเอง ในสตรอาสาสมครสาธารณสขอำเภอวงจนทร จงหวดระยอง โดยประยกตใชการเรยนรแบบมสวนรวมในการจดกจกรรม วธการศกษา: คดเลอกกลมตวอยางโดยการสมอยางงายเพอเขาสการทดลอง กลมทดลอง จำนวน ๓๐ คน และกลมตวอยางจำนวน ๓๒ คน โดยในกลมทดลองไดรบโปรแกรมพฒนาทกษะการตรวจเตานมดวยตนเอง เปนระยะเวลา ๔ สปดาห สวนกลมควบคมไดรบการอบรมตามปรกตของโรงพยาบาลสงเสรมสขภาพตำบล เกบรวบรวมขอมลโดยใชแบบสอบถามและแบบประเมนความถกตองของการตรวจเตานมดวยตนเอง ทำการเกบขอมล กอนการทดลองและหลงสนสดการทดลองแลว ๑ เดอน วเคราะหขอมลโดยใชสถต paired t-test และ independent t-test ผลการศกษา: กลมทดลองมความรเรองโรคมะเรงเตานม เจตคตเชงบวกตอการตรวจเตานมดวยตนเองเพมขนกวากอนการทดลอง และสงกวากลมควบคมอยางมนยสำคญทางสถต และยงพบวากลมทดลองมความถกตองของการตรวจเตานมดวยตนเองสงกวากอนการทดลอง และสงกวากลมควบคม อยางมนยสำคญทางสถต วจารณ และสรปผลการศกษา: โปรแกรมพฒนาทกษะการตรวจเตานมดวยตนเอง สามารถนำมาประยกตใชเปนแนวทางสำหรบเจาหนาทสาธารณสขทเกยวของในดานสงเสรมสขภาพและอาสาสมครสาธารณสขในการสอนการตรวจเตานมดวยตนเอง คำสำคญ: การตรวจเตานมดวยตนเอง, ความรเกยวกบการตรวจเตานมดวยตนเอง, เจตคตตอการตรวจเตานมดวยตนเอง, ความถกตองของการตรวจเตานมดวยตนเอง
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