Journal of Public Health and Development

Efficacy and perceived challenges in implementing psychological interventions in palliative care: a scoping review

2025-01-12T10:59:01+07:00

Ensuring the well-being of terminally ill individuals' mental health is just as crucial as their physical health. This review examines the perceived challenges and efficacy of providing psychological interventions to individuals receiving palliative care. This comprehensive literature review was conducted based on both Arksey and O’Malley’s and Joanna Briggs Institute (JBI) guidelines. The article was searched between March 2024 and June 2024 using several electronic databases such as Scopus, PubMed, and Web of Science. The applied inclusion criteria were articles published in English from 2005 to 2023, and studies conducted specifically in palliative care settings. PRISMA guidelines for scoping reviews were used for the selection process. After screening based on objective and specific inclusion criteria, 21 articles were chosen for extensive study of their full texts. The key themes derived from the review are the ‘psychological interventions and their implementation efficacy, mental health issues in palliative care, and challenges in implementing psychological interventions’. Patients receiving palliative care have experienced various psychological distresses, although these concerns are inadequately addressed and treated by healthcare providers. Psychological interventions are feasible and applicable in palliative care but their implementation efficacy is limited. The main challenges encountered include a lack of information, inadequate training and supervision, a well-defined role and framework for administering psychological care, and resources for implementing psychological interventions. This review highlights the existing challenges and the crucial implementation of a framework for effectively integrating psychological interventions alongside physical care. These challenges should be addressed in future research, and large-scale studies should be conducted to investigate the effects of psychological interventions.

The association of family history with the risk of lung cancer: a pooled analysis of case-control studies

2025-02-17T14:08:16+07:00

The risk of lung carcinoma is influenced by genetic predisposition and other risk factors. This study aimed to explore the association between a family history of any type of cancer and the risk of lung carcinoma through a pooled analysis of case-control studies. A systematic literature search was performed across Google Scholar, PubMed, and Science Direct up to January 31, 2024. Eight observational case-control studies met the inclusion criteria, which required multivariate logistic regression analysis and a focus on familial cancer history. Using Review Manager software, pooled estimates and 95% confidence intervals were calculated. Out of 603 identified studies, eight were included. The meta-analysis found that individuals with a family history of cancer had a significantly higher risk of lung cancer (aOR = 1.64; 95% CI = 1.17–2.29; p = 0.004). These findings highlight the need for targeted screening and early detection strategies for high-risk individuals.

The analysis study of the impact of service quality to patient satisfaction in regional general hospital in Indonesia: A comprehensive systematic

2025-02-17T10:05:13+07:00

Indonesia’s growing healthcare sector has intensified competition among hospitals, underscoring the importance of delivering high-quality care that aligns with patient expectations. Factors such as service quality, hospital infrastructure, employee communication, and administrative efficiency play crucial roles in enhancing patient satisfaction and shaping the future of healthcare delivery. This review aims to analyze the existing literature on the impact of service quality on patient satisfaction in regional general hospitals, especially in Indonesia. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used as a reference to review resources from three databases, which were ScienceDirect, PubMed and SagePub. Of the 738 publications identified, only 8 met the inclusion criteria for this review. The remaining 730 publications were excluded for various reasons, including duplication across databases, publication before 2014, inappropriate study design, failure to retrieve reports, and lack of relevance to the review topic. Based on the results of this study, several health service factors such as facilities, trust, interpersonal quality, communication quality, financial factors, duration of doctor consultations, and accessibility affect patient satisfaction with hospital services. Improving patient satisfaction can foster positive experiences and strengthen patient-provider relationships, thereby increasing patient loyalty. Therefore, improving health services should involve measures, such as providing comfortable patient waiting rooms, training programs to improve hospital staff communication skills, and other quality-enhancing initiatives. It is recommended that more in-depth research is needed to determine the health service factors that most influence patient satisfaction levels.

Factors influencing self-management of health behaviors among older adults with chronic kidney disease in Chiang Rai Province, Thailand

2024-10-30T09:38:37+07:00

The burden of chronic kidney disease (CKD) and its associated risk factors is expected to rise alongside the rapidly increasing global population of older adults. A new trend in CKD management emphasises the adoption of self-management (SM) approaches. This cross-sectional study aims to investigate the proportion of self-management of health behaviors (SMHB) and identify the factors influencing SMHB among older adults with CKD in Chiang Rai Province, Thailand. The study sample comprised 408 individuals aged ≥ 60 years, selected using a multi-stage sampling method. Data were collected through face-to-face interviews conducted from April to June 2024 and analysed using descriptive statistics, Pearson’s product-moment correlation, Spearman’s rank correlation coefficient, simple linear regression and multiple regression analysis. The average age of the participants was 70.0 ± 6.7 years, with over one-third (38.5%) reporting CKD stage 2 and 32.4% at stage 1. The findings indicated a good proportion of SMHB (79.4%) among older adults with CKD in Chiang Rai Province, with an average SMHB score of 44.0 ± 12.8. Multiple regression analysis revealed that self-condition management for health promotion (SCMHP), maintaining self-care for health (MSCH), participation in social health activities (PSHA), health literacy related to self-care practices (HLSCP) and occupation were significant predictors of SMHB. Collectively, these factors explained over half of the variance in SMHB levels (R² = 0.619, p < 0.05). Consequently, the study suggests that promoting sustainable SMHB among older adults with CKD should be a healthcare priority for precautionary prevention.

Relationship between mental health literacy, mental self-care behaviors, and depression among diabetic and hypertensive elderly patients in Chiang Kham, Phayao Province, Thailand

2025-01-07T15:05:25+07:00

Mental health literacy and self-care are essential for improving mental health outcomes, particularly among the elderly with chronic conditions. However, limited research has explored how these factors interact with depression in elderly individuals with both diabetes and hypertension. This cross-sectional study aims to examine mental health literacy and self-care behaviour, their interrelation, and their influence on depression among elderly individuals with diabetes and hypertension in the Chiang Kham District, Phayao Province. The sample comprised 405 elderly individuals diagnosed with diabetes and hypertension, who were interviewed by the research team utilizing questionnaires for data collection. The data were analysed using descriptive statistics and multiple regression analysis. The results revealed that the demographic was predominantly female (65.20%), with an average age of 68.29 years. Approximately 50.40% exhibited deficient mental health literacy, while 66.70% showed a low level of mental self-care behaviour. Additionally, 13.30% exhibited mild depression. Multiple Linear Regression Analysis identified six predictors of depression: education (B=-2.153, p-value<0.001), income (B=-1.743, p-value<0.01), family history of mental illness (B=1.477, p-value<0.01), alcohol consumption (B=1.035, p-value<0.05), mental health literacy (MHL) (B=-0.047, p-value<0.05), and mental self-care behaviour (MSCB) (B=0.093, p-value<0.001). Therefore, health agencies and related organisations should prioritize mental health activities and policies to alleviate depression among elderly individuals with diabetes and hypertension.

Addressing the nutritional status of secondary school students in Cambodia: a cross-sectional study

2024-12-20T13:16:48+07:00

This cross-sectional study assessed the nutritional status and dietary quality of 1,527 Cambodian secondary school students, focusing on gender, school type, location, socio-economic status, and maternal education. Data on demographics, BMI, and dietary intakes were collected, and dietary quality was evaluated using the Dietary Quality Index-International (DQI-I). Significant gender differences were found, with boys being older (16.80 ± 1.48 years vs. 16.38 ± 1.47 years, p<0.001), taller (167.83 ± 8.32 cm vs. 158.09 ± 6.10 cm, p<0.001), heavier (57.51 ± 12.55 kg vs. 49.19 ± 8.58 kg, p<0.001), and having higher BMI (20.365 ± 4.056 kg/m² vs. 19.66 ± 3.15 kg/m², p<0.001). Urban students exhibited higher dietary quality indices in variety, adequacy, and overall DQI (all p<0.01) compared to rural students. Private school students had better BMI and DQI score than public school students, with significant differences in height, weight, variety, adequacy, and overall DQI (all p<0.05). Socio-economic status significantly affected weight, BMI, variety, moderation, and overall DQI (all p<0.05). Higher maternal education levels were associated with improved dietary variety, adequacy, and overall DQI (all p<0.001). These findings underscore the need for targeted nutritional interventions and policies to address socio-economic disparities and improve educational opportunities for women, enhancing health outcomes for Cambodian students.

Effect of age, gender, and linezolid use on MDR-TB Patient survival rate with short-course treatment in Central Java, Indonesia: survival analysis and cox regression

2025-05-20T13:00:31+07:00

MDR-TB treatment regimens of 9 -12 months provide effectiveness and shorter duration of therapy. However, it was found that 9.22% of patients died during short-term treatment for MDR-TB from 2021-2023 in Central Java, Indonesia. This study aims to analyze the probability of survival and risk factors for mortality in patients undergoing short-term treatment for MDR-TB. A retrospective cohort study involving 236 MDR-TB patients who received a short-term regimen during 2022-2023 and had either a cure or death outcome. Kaplan-Meier analysis was used to describe incidence rates and median time to death. Cox-Proportional Hazard model was used to identify predictors such as age category, gender, employment status, treatment history, DM status, HIV, Linezolid use, and treatment initiation. Statistical analysis was performed using Rstudio with significance <0.005. Kaplan-Meier results showed a significant difference in survival probability across the three age groups. The young age group (19-35 years) had a higher survival probability than the middle age (36-55 years), and old age (≥56 years) (Chi-Square = 17, p < 0.001). Cox regression results showed that patients aged ≥56 years had a 3.705 times higher risk of death than younger patients (CI95% = 1.4896-3.646, HR = 3.705, p = 0.001). The results of this study emphasize the importance of special interventions for older patients (≥56 years) in the form of intensive monitoring and management of comorbidities of DM and HIV to reduce the risk of higher mortality. These findings support an age-based approach to MDR-TB therapy as an optimal measure to improve patient survival

Direct medical cost of non-small cell lung cancer patients treated with targeted therapy: A cross-sectional study in Vietnam

2025-01-03T09:47:09+07:00

Targeted therapy for the Epidermal Growth Factor Receptor (EGFR-targeted therapy) prolongs survival in patients with advanced stage (IV) non-small cell lung cancer (NSCLC), but its cost is slightly higher. Cost estimation and analysis of related factors are needed to reduce the economic burden for NSCLC patients and their households. We conducted a cross-sectional study from October 2022 to December 2023 at the Vietnam National Cancer Hospital. The characteristics and costs associated with 310 NSCLC patients were collected from medical records, medical bills, and patient interviews. The study utilized a social perspective and the bottom-up method. All costs have been adjusted for the Consumer Price Index (CPI) and standardized to 2023 USD. The mean total direct medical cost for 310 NSCLC patients was $839.7 ± 486.4 (Mean ± SD) per month, with EGFR-targeted therapy costs of $755.6 ± 471.0 per month, accounting for 90.0% of the total cost. In households with average or higher economic status, patients had higher costs for EGFR-targeted therapy than those in poor or near-poor households ($780.8 and $480.2 per month, respectively; p = 0.001). Compared with other individuals, NSCLC patients with higher education levels, residing in urban areas, having stable jobs, and average or higher household economic status had higher direct medical costs. However, these costs tended to decrease when the duration of illness increased, with p < 0.05 for each group. Direct medical costs are a significant burden for NSCLC patients living in poor or near-poor households, as well as for low-income or unemployed patients.

A causal relationship model of factors influencing glycemic control among pre-diabetes in Phrom Phiram district Phitsanulok province, Thailand

2024-12-04T09:57:28+07:00

This research aimed to study the causal relationships model of the factors influencing glycemic control among pre-diabetes population in Phrom Phiram district, Phitsanulok province. Determining the sample size under the assumptions of the structural equation analysis.
The sample consisted of 530 participants, who were recruited by a multistage sampling.
Data were collected by questionnaire with reliability value between 0.83- 0.95. Data were analyzed using descriptive statistics and Structural Equation Model (SEM) by LISREL 8.52 software. The study results revealed that 530 participants were Thai (80.8%), Lao Krang ethnic group (14.3%), and Thai of Chinese origin (4.9%) respectively. The majority of participants were female (58.5 %), The mean age was 49.59 years and S.D. of 7.15. 42.5% had primary school level of educational. The mean income was 10,000 bath and S.D. of 7,243.84. 76.6% had duration of pre-diabetes 1-6 years, 77.2% had a family history of diabetes and the mean fasting blood sugar level was 112.57 mg./dl. and S.D. of 8.80. Based on the analysis, a structural equation model that fit to the data was obtained with Chi-Square/df =1.17, P-value=0.0576, GFI=0.99, AGFI=0.97, SRMR=0.030, RMSEA=0.018 and CN= 706.08. A causal relationships model showed that social support explained the variance in health literacy at 46%. Meanwhile, social support, attitude towards glycemic control, norm, and health literacy co-explained the variance in intention at 100%. Then, health literacy, self-efficacy, and intention co-explained the variance in glycemic control behavior at 40%. And glycemic control behavior explained the variance in blood sugar levels at 100%. In conclusion, social support was the most important factor on health literacy. Meanwhile, the health promotion focused mainly on self-efficacy, intention, and health literacy toward glycemic control behavior. That could help to control blood sugar levels of pre-diabetes.

The relationship between weight bias internalization and psychological distress and health behaviors among obese high school students in Maha Sarakham Province, Thailand

2025-01-06T18:52:00+07:00

Adolescents with obesity are vulnerable to weight bias internalization (WBI) and may face its psychological and behavioral health consequences. However, little is known about WBI and its effects on psychological distress and poor health behaviors among obese Thai students. Thus, this study aimed to examine the association of WBI with psychological distress and health behaviors among obese Thai high school students. A cross-sectional study was carried out from August 2023 to March 2024 among 785 obese high school students in Mahasarakham, Thailand, with a multistage sampling method. The data were collected using a self-administered questionnaire. Hierarchical linear regression analyses and multiple logistic regression analyses were used to examine the association of WBI with psychological distress and health behaviors. Most students were girls (47.1%), with a mean age of 14.7 years (SD = 1.2) and a mean body mass index of 29.8 kg/m2 (SD = 1.6). The mean WBI, depression, and self-esteem scores were 38.9 (SD = 8.4), 20.1 (SD = 4.5), and 25.0 (SD = 5.0), respectively. Most participants reported unhealthy eating habits (52.2%) and inadequate physical activity (51.3%). WBI was associated with severe depressive symptoms (β = 0.292; P < 0.01), low self-esteem (β = -0.221; P < 0.01), unhealthy eating behaviors (adjusted OR = 1.15; 95% CI: 1.13, 1.18), and inadequate physical activity (adjusted OR = 1.14; 95% CI: 1.12, 1.17). WBI was associated with adverse psychological and behavioral health among these obese students. Thus, future interventions to prevent or reduce WBI are needed, such as individual- or school-based interventions or school anti-stigma campaign strategies.

Impact of telemedicine service quality on patient satisfaction: an empirical study using Servqual model and expectation confirmation theory

2024-12-27T18:44:49+07:00

The COVID-19 pandemic has expedited the digital transformation of healthcare, facilitating the adoption of telemedicine as an innovative model for enhancing the quality of patient care. This study aimed to investigate the factors influencing patient satisfaction with telemedicine and provide practical guidance for improving service quality. Specifically, this study examined how service responsiveness, reliability, assurance, and empathy affect patient satisfaction while considering the role of expectation confirmation. This study employed quantitative research methods to examine telemedicine’s effect on patient satisfaction, utilizing the SERVQUAL model and expectation-confirmation theory. A structured questionnaire using a seven-point Likert scale was developed to assess the dimensions of expectancy confirmation, responsiveness, reliability, assurance, and empathy. A random sample of 333 valid questionnaires was obtained through an online platform. Structural equation modeling (SEM) was employed to analyze the data; the findings indicated that all hypotheses were supported. Responsiveness significantly and positively influenced expectation confirmation, whereas expectation confirmation, responsiveness, reliability, assurance, and empathy significantly and positively affected patient satisfaction. The model exhibited strong explanatory power, indicating that these factors significantly influenced patient satisfaction with telemedicine. These findings provide valuable insights for healthcare providers to improve the quality of telemedicine services and patient satisfaction. These findings can guide healthcare organizations to develop more effective telemedicine platforms and training programs, contributing to the digital transformation of healthcare systems.

Association of nutritional status, protein and iron intake, and physical activity with hemoglobin levels in adolescent girls: a case-control study in Rural East Java, Indonesia

2025-01-09T18:49:24+07:00

Anemia among adolescent girls is a significant public health concern, negatively affecting physical development, cognitive function, and quality of life. This study aims to analyze the impact of nutritional status, dietary intake, and physical activity on hemoglobin levels. A case-control study design was employed on 116 adolescent girls aged 12-18 years. Data were collected through structured interviews. Statistical tests were used to determine the association between nutritional status, protein and iron intake, and physical activity with hemoglobin levels. Adolescent girls with good nutritional status had a significantly lower risk of anemia compared to those with poor nutritional status (p < 0.05). Low protein intake, both in quantity and frequency, increased the risk of anemia nearly sixfold (OR = 5.884, 95% CI = 2.634–13.146; p < 0.05). This finding underscores the critical role of sufficient protein intake in supporting hemoglobin synthesis and preventing anemia. Adequate consumption of iron-rich foods was significantly associated with higher hemoglobin levels. Regular physical activity was also found to have a protective effect, with physically active adolescent girls demonstrating better hemoglobin levels than their less active counterparts. This suggests that an active lifestyle not only improves circulation and red blood cell production but also helps maintain optimal hemoglobin levels. In conclusion, good nutritional status, sufficient protein and iron intake, and regular physical activity are key factors in preventing anemia among adolescent girls. These findings emphasize the importance of holistic nutritional interventions, including improved dietary quality and promotion of physical activity, to reduce anemia prevalence.

Perceptions, attitudes and practice on scientific research of final-year medical students: a cross-sectional study

2024-12-12T18:06:10+07:00

Scientific research is the foundation of progress in technology and medicine, but the number and quality of researchers in the medical field are decreasing. Medical students' perceptions, attitudes, and practices toward scientific research must be considered. This study was conducted to assess the perception, attitude, and practice of scientific research of medical students; as well as to determine the correlation between these factors. A cross-sectional study was implemented on 508 final-year students belonging to four medical major groups at Da Nang University of Medical Technology and Pharmacy, Vietnam. The questionnaire included two parts: general characteristics, and students’ perceptions, attitudes, and practice towards medical research. Data were analyzed using SPSS 20.0, with the descriptive analysis used for variables, and Pearson correlation was calculated to assess the relationship between perception, attitude, and practice contents. The study found that students have a positive perception (4.11±0.64) and attitude (3.88±0.54) towards scientific research, while the average score of scientific research practice was not high (3.71±0.70). In addition, students with positive perceptions had good attitudes and practices of scientific research (P<0.05), and the better the attitude, the better the practice of scientific research (P< 0.01). Motivating medical students to do research plays a key role, therefore, medical universities should consider providing training programs that focus on developing the perception, attitude, and efficient capacity of all students. In addition, the idea of a medical research volunteer program to support students in scientific research should be considered for implementation.

Effectiveness of a knee exercise intervention on knee osteoarthritis pain and severity in Buddhist monks receiving platelet-rich plasma injections: A quasi-experimental study

2025-01-26T15:25:06+07:00

Knee osteoarthritis (KOA) is a prevalent condition affecting individuals across all age groups, resulting in pain, diminished physical functioning, and disability. This study aimed to determine the effects of the knee exercise intervention on reducing KOA symptoms and enhancing the physical functioning of a vulnerable group (Buddhist monks) who receive platelet-rich plasma injections. We hypothesized that the knee exercise intervention would help alleviate symptoms of KOA and improve the monks’ physical function. A two-group, pretest-posttest design quasi-experimental study was conducted. Sixty Buddhist monks were purposively selected from one hospital’s outpatient orthopedic department in Thailand. Eligible participants were randomly assigned to an experimental group (n = 30) and a control group (n = 30). The experimental group received the Knee Exercise Program as an intervention, while the control group underwent the usual outpatient care. Data were collected from August 2022 to November 2022. Osteoarthritis severity and pain intensity were measured at baseline and program completion (12-week post-test). Data analysis included descriptive statistics and dependent and independent sample t-tests. The results showed that the average age of the 60 participants was 65 years (range: 50–83 years). No significant group differences were found in any outcome measures at baseline. At program completion, the experimental group reported significantly decreased pain intensity (t = 5.66, p < .001), stiffness (t = 0.68, p < .001), improved physical functioning (t = 7.99, p < .001), and less severity in KOA than the control group (t = 4.19, p < .001). Therefore, the Knee Exercise Program is effective in alleviating KOA symptoms, reducing KOA severity, and improving physical functioning in patients with KOA receiving platelet-rich plasma injections. A large-scale randomized controlled trial with long-term follow-up is warranted

The effects of a nutrition care process on protein-energy malnutrition among patients on continuous ambulatory peritoneal dialysis in Chaiyaphum Province, Thailand

2025-01-22T11:40:01+07:00

Nutritional status plays a critical role in managing end-stage renal disease (ESRD) in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Protein intake is particularly important, as insufficient protein intake can lead to protein-energy malnutrition (PEM), negatively impacting patients’ quality of life (QoL), and impairing patients’ ability to tolerate therapy and recover effectively. This randomized controlled trial aimed to assess the effects of a nutrition care process (NCP) on PEM in 66 patients receiving CAPD, who were randomly assigned to the intervention (n = 33) or the control group (n = 33). The intervention group participated in four sessions of NCP, while the control group received standard care. The program lasted 24 weeks, with follow-up conducted via telephone. Data were collected through structured interviews, and statistical analyses were performed using chi-square, Fisher’s exact test, Cochran’s Q test, repeated measures ANOVA, and independent-samples t-tests. The results indicated a significant reduction in the proportion of patients with PEM in the intervention group at follow-up (P = 0.004), as well as significantly higher mean energy intake, improved food consumption behavior scores, and better QoL than the control group (P < 0.05). The NCP was effective in reducing PEM, enhancing energy intake, improving food consumption behavior, and increasing QoL. We thus recommend extending the NCP to other healthcare settings to better support CAPD patients at risk of PEM and enhance their overall well-being.

Effects of a self-management support program delivered through telehealth services on self-management behaviors to delay renal impairment in public health volunteers with type 2 diabetes

2025-01-31T09:34:39+07:00

Diabetes is a major global public health problem, and patients have a high risk of complications and mortality. Changing patient behavior through telehealth monitoring can help reduce the risk of chronic kidney complications. This experimental study aimed to evaluate the effectiveness of a self-management support program delivered through telehealth services in improving self-management behaviors to delay kidney deterioration in healthy volunteers with type 2 diabetes. The sample was selected through multistage random sampling and consisted of 102 participants, who were divided into experimental and control groups with 51 participants each. The experimental group participated in a self-management support program based on Lorig and Holman’s self-management concept, focusing on six key self-management skills. The program included health education delivered through videos, self-management behavior tracking, and communication through the LINE application. A questionnaire was used to assess self-management behaviors related to delaying kidney deterioration, particularly in terms of food consumption and exercise. The study duration was 12 weeks. Data were analyzed using descriptive statistics, independent t-tests, and paired t-tests. After the experiment, the experimental group had significantly higher mean scores for eating and exercise behaviors (M = 71.47, SD = 9.31) than those recorded before the program (M = 47.39, SD = 9.06) (p < .001). These findings suggest that a self-management support program delivered through telehealth can effectively promote behavior modification, particularly in maintaining normal blood sugar levels, which may help prevent kidney failure in individuals with type 2 diabetes. The study recommends further research to compare blood sugar levels (hemoglobin A1C) and their effect on glomerular filtration rates before and after the intervention. It also highlights the importance of closely monitoring the behaviors of health volunteers with type 2 diabetes from its onset.

Cost-effectiveness analysis of colonoscopy for screening colorectal cancer in Indonesia using Markov Model

2025-01-16T20:26:40+07:00

Colorectal cancer (CRC) is one of the top three diagnosed cancers worldwide and the second leading cause of cancer-related deaths, imposing a significant economic burden. In this context, early detection is crucial for effective management. The primary detection method particularly for high-risk individuals is colonoscopy but screening has not been widely adopted and the participation rate and the colonoscopy screening compliance rate were low. Pharmacoeconomic investigations are essential for evaluating the costs and effectiveness of colonoscopy screening for colorectal cancer. Therefore, this research aimed to conduct a cost-effectiveness analysis using a Markov model for a cohort of 100,000 adults aged 45 to compare the outcomes of screened and unscreened scenarios. The Markov model developed in this study consists of three main stages: the health stage, the colorectal cancer stage, and the death stage. The parameters used in this study include the probabilities at each stage, costs, the sensitivity and specificity of colonoscopy, utilities at each stage, and the discount rate. One-way and probabilistic sensitivity analyses were conducted to address uncertainty. Meanwhile, the Incremental Cost-Effectiveness Ratio (ICER) of screening colonoscopy compared to no screening for adult patients was found to be cost-effective and valued at USD 6,191.15/QALY (Quality-adjusted Life Year). This value was significantly below the Cost-Effectiveness Threshold (CET) assumed to be USD 14,759.10. Based on the cost-effectiveness acceptability curve at a willingness to pay (WTP) threshold of USD 5,500, the probability of being cost-effective for colorectal cancer screening increased and consistently reached 100% at a WTP level of USD 9,000. Colonoscopy screening was cost-effective when analyzed using the Markov model, as suggested by ICER value exceeding three times the Gross Domestic Product (GDP) of Indonesia. Future research could explore alternative interventions, such as biennial colonoscopy, and compare the result with other screening methods.

Mental health literacy and mental well-being among senior high school students in Samut Songkhram Province, Thailand

2025-02-13T10:32:34+07:00

Senior high school students aged 15–19 are adolescents in the transitional phase from childhood to independent adulthood, during which stress can quickly arise. Developing Mental Health Literacy (MHL) can play a crucial role in preventing severe mental illnesses. This study aimed to explore the MHL and mental well-being of senior high school students in Samut Songkhram Province, Thailand. This descriptive-analytical cross-sectional study was conducted on 510 senior high school students in Samut Songkhram, Thailand, using stratified random sampling. Data were collected using the MHL and mental well-being questionnaire. The Pearson correlation coefficient and linear regression were used for analysis at a significance level of 0.05. This study included 510 senior high school students, the majority of whom were female (57.8%), aged 16 years (30.6%), and in Grade 11 (37.6%). Most students were enrolled in the Science and Mathematics program (57.5%). Regarding academic performance, most of them had grades of 3.01 or higher (53.5%). Most students’ families had incomes between 10,001 and 30,000 THB (49.6%). MHL was at a moderate level, while mental well-being levels were low. A positive relationship was observed between overall MHL scores and mental well-being scores (r = 0.103, p = 0.034). After adjusting for the study program, the overall MHL score was found to be significantly associated with mental well-being scores (Beta = 0.118). However, the overall MHL score showed a significant negative association with mental well-being scores (Beta = -0.137) when adjusted for the school-record program. The study revealed that senior high school students exhibited a moderate level of MHL and a low level of mental well-being. Therefore, extracurricular activities should be implemented to enhance MHL and improve the mental well-being of senior high school students in the future, alongside developing comprehensive strategies to address and prevent mental health issues faced by this group.

The 21st-century skills among public health undergraduate students in autonomous universities in Thailand after the COVID-19 pandemic

2025-01-25T18:50:25+07:00

Adopting new skills is essential for success in the 21st century, especially in education and public health. As career transitions and lifelong learning increase, educational institutions are adapting their approaches. They are integrating technology and resources to help students apply knowledge effectively. This cross-sectional study employed stratified-cluster random sampling approach to assess 21st-century skills and six related factors—academic year, esteem for oneself, esteem for others, active learning, qualities of effective teachers, and learning environment—among 537 second- to fourth-year undergraduate public health students from four autonomous universities in Thailand. Data were collected using self-administered questionnaires between January and March 2023. The reliability coefficients of the scales ranged from 0.78 to 0.93. Data were analyzed using descriptive statistics, one-way ANOVA, Pearson’s product-moment correlation, and stepwise multiple linear regression, with the significance level set at less than 0.05.

Research findings indicated that 60.5% of students had high levels of 21st-century skills, while 39.5% had moderate levels. Fourth-year students scored higher on these skills compared to those in the second and third years. Five factors, including two subscales of self-esteem and three dimensions of teaching and learning management during the COVID-19 pandemic, were identified as predictors of 21st-century skills, accounting for 54.2% of the variance.

To provide early-year students with the necessary skills and opportunities for lifelong learning, curriculum administrators should promote activities that enhance 21st-century skills, boost self-esteem, and provide adequate support for learners, instructors, and learning environments.

Can communication effectiveness promote patients' revisit intentions through trust and perceived value? A study of private hospitals in Yangon

2025-02-12T12:40:08+07:00

Due to the competitive Myanmar healthcare industry, this study investigated the impact of communication effectiveness on promoting patients' revisit intentions through the roles of patients' trust and perceived value as a mediator, framed by social capital theory, in private hospitals in Yangon, the previous capital city and one of the largest cities of the country. Given the unknown population of patients in Yangon, survey data were gathered using online questionnaires designed in Burmese through local private healthcare online communities for one month from 414 private hospital patients across 15 townships of Yangon, Myanmar, selected using stratified purposive sampling, representing a response ratio of 69%. The reliability of the data was confirmed, with all constructs achieving Cronbach's alpha values above 0.872, indicating strong internal consistency. According to the PLS-SEM analysis and the Sobel test results, communication effectiveness directly influenced revisit intentions (β= 0.0152, p< 0.014). Moreover, trust (t=2.104, p=0.000) and perceived value (t= 2.552, p= 0.000) indirectly mediated the relationship between communication effectiveness and revisit intentions as well as the perceived value mediated the relationship between the patient trust and revisit intentions (t= 8.836, p= 0.000). These findings contribute new knowledge and insights into the roles of communication effectiveness in promoting revisit intentions through trust and perceived value of patients in private hospitals in Yangon, Myanmar, and new expansion of social capital theory in healthcare literature, which has not yet been widely explored. Furthermore, the study provides valuable guidelines for healthcare service providers, policymakers, and marketers in promoting healthcare businesses' long-term success.

Effectiveness of mirror-assisted screening device in aiding pharyngitis diagnosis and raising patients’ awareness of rational antimicrobial use with related perceptions

2025-02-17T19:06:41+07:00

Antimicrobial drugs used for pharyngitis are prone to irrational use owing to ease of access to various sources and other risk factors. A mirror-assisted screening device (MASD) was developed to promote rational antimicrobial use, but it was not fully evaluated. This study aimed to assess the effectiveness of MASD in aiding the pharyngitis diagnosis and rational antimicrobial use of patients with pharyngitis and to elicit the perceptions of patients and healthcare providers about the use of MASD. A single-blinded, quasi-intervention study was conducted among Thai patients with pharyngitis attending primary care centers, called sub-district health promoting hospitals, in 10 provinces of three regions, i.e. the Eastern, Northern and North-eastern regions, during the 2019-2021 period. Eligible samples were conveniently allocated to an intervention group obtaining normal care plus MASD use or a control group receiving solely normal care. Patients in both groups completed a questionnaire pre- and post-interventions. All data were analyzed using descriptive statistics and a Chi-square test. The results showed that patients in the intervention and control groups (n = 2,031 and n = 235, respectively) were mostly female adults working in agricultural sectors in the North-eastern region. The rates of antimicrobial use in both groups were statistically different (17.0% vs. 24.7%, p = 0.004; RR 0.69, 95%CI [0.54, 0.88]); the relative risk reduction was 31.2%. Both groups had anticipated and intended needs for an antimicrobial and also requested it. They were mostly satisfied with MASD and willing to check their throat infections and antimicrobial use. The providers were also satisfied with and confident in using MASD to facilitate the diagnosis. Overall, MASD was effective as a pharyngitis diagnostic aid that helped patients raise their awareness of antimicrobial consumption. Further studies are required to evaluate the use of MASD in other primary care settings.

Exploring predictive factors of family relationships among older adults: a study in community settings

2025-02-07T20:32:22+07:00

This cross-sectional study aimed to identify predictive factors of family relationships among older adults in Ban Rong Subdistrict, Ngao District, Lampang Province. A total of 450 older adults were selected using multi-stage random sampling. Data were gathered from May to June 2024 through structured interviews. Descriptive and multiple linear regression analyses were performed to identify predictors of family relationships. Results indicated that the sample was predominantly female (mean age = 70.23 years), educated at the primary level, married, and engaged in agricultural occupations. The most common comorbidity was hypertension, while most participants reported having sufficient income. Social support emerged as the primary predictor of family relationships (β = 0.493, p < 0.001), followed by self-efficacy (β = 0.171, p < 0.001), income sufficiency (β = 0.130, p = 0.001), and leisure activities (β = 0.118, p = 0.001). These factors collectively accounted for 44.2% of the variance in family relationships (R² = 0.442). These findings underscore the importance of targeting social support to enhance family dynamics among older adults in community settings. Strengthening support mechanisms, advocating for health-promotion policies, and fostering an environment that encourages self-efficacy and leisure activities may collectively improve the quality of life and well-being of older adults in Thailand.

Risk factors for death including initial admission to COVID-19 quarantine before isolation vs. direct admission to isolation at King Edward VIII hospital in South Africa: A case-control study

2025-02-18T09:19:01+07:00

Worldwide, the emergence of the novel coronavirus disease 2019 (COVID-19) has resulted in millions of deaths. This study aims to investigate the relationship between death during admission and various risk factors thereof including admission to COVID-19 quarantine before isolation vs. direct admission to isolation, among COVID-19 patients at King Edward VIII Hospital. A case-control study design was employed, involving 400 COVID-19 patients (200 cases and 200 controls by a 1:1 ratio). Patient information was retrospectively abstracted from medical records. Associations between risk factors and mortality were assessed using chi-square tests, followed by univariate and multivariate logistic regression analyses. Among the 200 cases, 133 were referred from primary or secondary levels of care, compared to 71 out of 200 controls. The mean age of patients was 55.6 years (SD: 16.2 years), and 177 (44.2%) patients were male. Out of the total number of patients, 181 (45.2%) patients were initially admitted to the COVID-19 quarantine ward before isolation, while 219 (54.7%) patients were directly admitted to the COVID-19 isolation ward. Increasing age (adjusted odds ratio [aOR]:˃ 60 years: 6.49 [95%CI: 2.97-14.16]), admission directly to isolation ([aOR]: 2.49[95%CI:1.53-4.06]), Fever ([aOR]: 1.74[95%CI:1.03-2.91]) Shortness of breath ([aOR]: 4.86[95%CI:2.53-9.35]), CKD (Chronic Kidney Disease) ([aOR]: 10.39 [95%CI:2.09-51.61]), and obesity ([aOR]: 4.85[95%CI:1.88-12.46]) were associated with death among COVID-19 patients during admission on multivariate analysis. Understanding and addressing these factors can help healthcare systems develop targeted strategies to improve patient outcomes and reduce mortality rates.

The effect of climate variability on dengue disease in endemic areas: a study of Bandung City, Indonesia

2025-02-18T19:40:21+07:00

Dengue fever remains a significant public health issue, particularly in dengue-endemic areas such as Bandung City, Indonesia. Climatic variations have been shown to influence the transmission and incidence of dengue, emphasizing the need to analyze these relationships in endemic regions. This study aimed to analyze the relationship between climate variability and dengue incidence in Bandung City during 2021–2023 and to project trends for 2024 and 2025. An ecological study design was used, with secondary data collected from 30 sub-districts. Climate variables (temperature, humidity, rainfall, wind speed, and air pressure) and dengue incidence data were analyzed using multiple linear regression and exponential smoothing. The results showed that climatic variations collectively explained 24.5% of the variance in dengue incidence (R²=0.245, p=0.018), with temperature (p=0.024, r=0.375) and air pressure (p=0.015, r=-0.402) being the most influential factors. Humidity, rainfall, and wind speed showed no significant individual effects. Projections indicated an increasing trend in dengue cases in 2024 and 2025, supported by preliminary data showing 1,741 cases reported in Bandung City as of March 2024.These findings confirm the relevance of climate variability as a predictor for dengue incidence. Environment-based interventions, including climate-based early warning systems, proper water reservoir management, community education, and cross-sectoral collaboration, are essential to mitigate the impact of climate variability on dengue transmission. Further research is needed to explore spatial and temporal changes in dengue transmission to improve prevention and control efforts.

Public Health and Sustainable Development

2025-09-26T15:29:40+07:00

Public health is a cornerstone precondition and an outcome of the environmental, social and economic dimensions of sustainable development of nations.¹ Good health and well-being are listed as the second UN goal to achieve sustainable development of the society. Public health challenges are becoming more complex as the development progresses to the modern post COVID-19 world. Lucero-Prisno III et al. (2023) summarised the main challenges faced globally as healthcare system management, mental health, substance abuse, infectious diseases, malnutrition and food safety, sexual and reproductive health, environmental pollution, cancer, climate change, and diabetes.² The environmental factors and pollution in the fast-paced developing world will accelerate the public health concerns in the region and globally. The growing demand for economically accessible energy, accelerated amounts of generated waste, uncontrolled emissions of greenhouse gases, persistent pollutants and toxins in the air, water and land, are some of the unintended impacts of the development and economic growth of nations. The South East Asian region is specifically prone to environmentally driven disasters, such as droughts, fires, extreme temperatures and floods, imposing further pressures on the public health systems and economic development.³ The academic research has a critical role in addressing the challenges and advancing the public health systems and outcomes in the developing world. There is still intensive research required for commercial uptake of the modern technologies by the public health sector, such as artificial intelligence and machine learning, smart health sensors with real time monitoring and early detection of health problems, mobile health, virtual and augmented realities as emerging digital technologies to improve healthcare management.

The Journal of Public Health and Development aims to advance the scientific knowledge with scopes on primary and community health, health policy and management, health promotion and education, environmental and occupational health, addiction studies and behaviour, and global and one health research. The current issue covers the topics of the main importance globally and in the South East Asian countries, including mental health and wellbeing,^4-7 public health systems, services and technologies,^8-14 health behaviour and social determinants,^15-17 nutritional and metabolic health conditions,^18-23 infectious diseases,^17,24 environmental health^25,26 and life course health development.^27,28 The journal and this volume inform the academic research scholars, public administrators and general public on the recent developments and solutions to improve public health and promote sustainable development of modern societies.