Journal of Public Health and Development

Perception, attitudes and expectations among people toward emergency medical services system in Samut Songkhram Province, Thailand

Niwat Songsin — 2023-12-12

The emergency medical service system is a pre-hospital medical service that effectively helps reduce the severity of emergencies and mortality rates before transferring patients to the hospital. This cross-sectional study investigated people's perceptions, attitudes, and expectations toward the emergency medical services system and aimed to find the relationship between the perceptions, attitudes, and expectations toward the emergency medical services system in Samut Songkhram province, Thailand. The samples consisted of 491 individuals who were selected using a multi-stage sampling method. Data were collected through a self-administered questionnaire and analyzed using linear regression analysis to identify correlations. Results revealed that most participants demonstrated a good overall perception of the use of the emergency medical service system (M = 2.46, SD = 0.27), a good attitude towards the emergency medical service system (M = 2.40, SD = 0.23), and a high level of expectation towards the emergency medical service system (M = 2.85, SD = 0.25). Perception of the use of emergency medical services and attitude towards the emergency medical service system showed positive correlation with expectation towards the emergency medical service system, with R²= 0.23 (p-value < 0.05). These findings can be used to plan and develop strategies for improving the utilization of emergency medical services, ensuring that the public is informed, understands, and accesses the emergency medical service system correctly and effectively.

A crisis amidst many others: COVID-19 response satisfaction during the economic collapse and post-Beirut port explosion in Lebanon

Rania Itani — 2023-12-12

The COVID-19 pandemic in Lebanon has been compounded by the economic collapse and devastating ‎Beirut port explosion, leading to a severe humanitarian crisis. This study aimed to assess the satisfaction of ‎the Lebanese population with the government's response to the pandemic and evaluate the public ‎perception of the economic crisis and the Beirut port blast's impact on the COVID-19 situation. This is a web-based cross-sectional study that utilized a self-administered questionnaire comprising closed-ended ‎questions with predefined response options. To identify predictors of the governmental response score, a ‎multiple linear regression analysis was conducted. A total of 2,384 participants were enrolled, with a mean ‎COVID-SCORE of 15.38 ± 5.28 (out of 40 points). The majority of participants‎‏ ‏‎ (2,163, 90.7%) expressed ‎mistrust in the Lebanese government's ability to effectively address unexpected health threats related to the ‎COVID-19 pandemic. Two-thirds of the participants (1,849, 77.6%) ‎ believed that the economic crisis had ‎impacted the government's response to the pandemic. Nearly 70% of the participants perceived that the ‎Beirut port explosion contributed to COVID-19 transmission. Government mistrust, along with the ‎economic crisis impact, were significantly associated with lower satisfaction scores (P < 0.001). This study ‎revealed a significant level of dissatisfaction among the Lebanese population regarding the government's ‎response to the COVID-19 pandemic, underscoring a lack of trust in its ability to effectively manage the ‎crisis. The compounding challenges arising from the Beirut port explosion, economic collapse, and depleted ‎resources have further impeded Lebanon's ability to navigate the pandemic successfully. Urgent ‎interventions and collaborative efforts are required to effectively manage the economic and political ‎repercussions, rebuild a resilient healthcare system, and alleviate the humanitarian crisis in Lebanon. ‎

Information behaviour and factors influencing family planning knowledge of Myanmar ethnic migrants: a qualitative study

Nan San Thidar Ohn — 2023-12-12

The accessibility to quality family planning (FP) information and counselling for Myanmar ethnic migrants in Thailand is questionable. Inadequate knowledge and lack of informed choice to practice FP methods increase the risk of unmet needs and method failures in FP, which could result in unplanned pregnancies and induced abortions. This research aimed to understand the FP information behaviour of a Pa-O migrant group, as well as structural and agency influencing factors on FP knowledge acquisition in Chiang Mai. A qualitative research based on the Information Behaviour model and Structuration theory was conducted using participant observation, in-depth interviews, focus group discussions, and key informant interviews. A non-probability sampling method was employed, and 31 respondents participated in the study. The study found that actively seeking FP information from formal sources to make an informed decision was not common among Pa-O migrants. Instead, there was more reliance on informal information sources for choosing FP methods. Cultural norms related to sex, marriage, and age hinder migrant health information-seeking behaviour from formal and informal information sources. Pa-O migrants were alienated from structural resources, limiting the opportunities to promote FP knowledge. The personal and situational factors that significantly influenced the agency of migrants were lack of awareness of the right to information, language barriers, and perceived communication barriers with health staff. Limited resources of migrant-friendly health education programmes adversely affect migrant FP information behaviour. Reproductive health education programmes, including quality FP counselling services, should be accessible for marginalised migrants to ensure that their choices of FP are well-informed.

Knowledge and its Association with Menstrual Hygiene Practices Among School Going Adolescents of Tokha Municipality

Ashish Bhatt — 2023-12-12

Menstrual hygiene is crucial for women's health and well-being, but societal acceptance of menstruation remains a significant issue in Nepal. Despite government efforts to reduce stigma, the health of women, children, and adolescents is still affected by its widespread superstitions. As a result, studies on menstrual knowledge and hygiene practices among adolescents in Nepal are scarce. The primary goal of this study is to further understand the depth of adolescent girls' knowledge about menstruation and its association with menstrual hygiene practices. In order to address this, we performed a descriptive cross-sectional study in Tokha municipality of Kathmandu as the study area. The study population consisted of female teenagers studying in randomly selected schools. A total of 404 samples were collected. Statistical significance of the association between the independent and dependent study variables were assessed using the chi-square test and logistic regression. We found that about 78.5% of the total of respondent had knowledge about menstruation, and mothers were main source of information. Menstrual practices, such as type of material used (AOR=2.549 95%CI= 1.078-6.710), frequency of cleaning genitalia at least two times (AOR=1.639; 95% CI=1.214-6.328), at least 3 times (AOR= 3.119; 95% CI=1.429-9.328) and product used to clean genitalia (AOR= 0.623 95%CI= 1.429-9.328) were associated with knowledge of respondents. It can be stated that teenage schoolgirls generally have decent knowledge about menstruation. Menstrual health issues are a concern that has to be addressed. Our study implicates that adolescent menstrual hygiene practices are associated with menstrual knowledge.

Applying the transtheoretical model of health behavior change: using calendars for hypertension management in elderly individuals during the COVID-19 pandemic in Phrae Province, Thailand

Apichet Jumneansuk — 2023-12-19

Hypertension is a persistent global public health concern, particularly affecting elderly individuals and is further compounded by the challenges posed by the COVID-19 pandemic. Innovative interventions are essential to effectively manage blood pressure in this vulnerable demographic group. This quasi-experimental study implemented a calendar-based intervention among 84 elderly individuals in Phrae Province, Thailand. The intervention integrated dietary recommendations, physical activity guidelines, and hypertension education. Over eight weeks, the intervention group exhibited a significant reduction in systolic blood pressure (6.59 mmHg) and diastolic blood pressure (2.52 mmHg) levels (p-value<0.05), contrasting with the comparison group's increase. The calendar-based program effectively enhanced hypertension knowledge, empowering participants to make informed health decisions. The study's holistic approach, grounded in health behavior change models, effectively promoted hypertension awareness and facilitated healthier lifestyles. Results suggest the calendar-based program's suitability for elderly individuals at high risk of hypertension, especially during the COVID-19 pandemic, due to its cost-effectiveness and accessibility. This research underscores the potential of calendar-based interventions in supporting blood pressure management among elderly populations, with broader implications for public health strategies, especially during challenging circumstances such as pandemics.

Long-term effects of ambient particulate matter on hypertension among royal Thai army officers: a retrospective cohort study

Sarun Poobunjirdkul — 2024-01-04

Recent research on the link between exposure to ambient particulate matter with an aerodynamic diameter up to 2.5 microns (PM_2.5) and hypertension risk has primarily concentrated on spatial variation (or between-individual comparisons). Research into temporal variations (or within-individual comparisons over time) has largely been neglected. This study sought to examine the spatial–temporal effects of long-term exposure to PM_2.5on hypertension risk among military personnel in Thailand. A retrospective cohort study was conducted, encompassing 40,984 Royal Thai Army officers from 400 army units stationed across 51 provinces in Thailand. Medical check-up data from 2018 to 2021 were analyzed alongside ambient PM_2.5 data from 2015 to 2017, sourced from the Geo-Informatics and Space Technology Development Agency. Two parameters, PM_2.5-baseline and PM_2.5-change, were introduced to assess the impact of spatial and temporal PM_2.5 variations on hypertension incidence. Cox proportional hazard regression was used, with hazard ratios (HR) with 95% confidence intervals (95% CI) serving as the measure of association. The association between PM_2.5-baseline and hypertension incidence yielded hazard ratios in Quartiles 2 to 4 compared to Quartile 1 of: Q2 HR: 1.19, 95% CI: 1.10–1.28; Q3 HR: 1.10, 95% CI: 1.02–1.20; Q4 HR: 1.13, 95% CI: 1.05–1.22. Additionally, the PM_2.5-change showed a J-shaped association with hypertension incidence. Our findings underscore the role of both temporal and spatial factors in hypertension development and highlight the necessity for comprehensive investigations into the causal relationship between PM_2.5 exposure and hypertension risk. They also provide valuable insights for devising effective strategies to mitigate the adverse health impacts of PM_2.5 pollution.

Knowledge, attitudes, and practices toward dietary salt intake among adults in Haiphong, Vietnam

Duc Cap Minh — 2024-01-19

Excessive salt intake is a significant contributor to hypertension and cardiovascular diseases. Data on knowledge, attitudes, and practices relating to salt consumption in Vietnam are currently insufficient. This community-based cross-sectional study evaluated the knowledge, attitudes, and practices related to dietary salt intake among 400 Vietnamese adults. Data were collected through face-to-face interviews. Only 28.2% of participants demonstrated good knowledge, 40.5% had positive attitudes, and 42.5% exhibited good practices toward dietary salt intake. The percentage of participants who frequently checked information about the amount of salt in food and stated that it often influenced their purchasing decisions is around 40%. Additionally, 52% of participants often try to buy “low-salt” food. Most participants frequently add salt to their food when preparing and cooking (94.8%), add salt to food at the table (84%), and use spices for cooking (97%). Among the participants, 63.8% claimed to be attempting to reduce their salt intake in their daily diet. Multivariate logistic regression analysis showed that age, knowledge, and attitudes were associated with good salt-related practices. A communication program should be implemented to improve people’s knowledge and attitudes to reduce salt intake in the community.

Mental health status and associated factors with stress among healthcare workers during the COVID-19 pandemic: a cross-sectional study

Subhra Rani Das — 2024-01-24

COVID-19, being the most terrible occurrence of the 21st century, has profoundly affected the physical and mental well-being of healthcare workers (HCWs). Throughout this pandemic, HCWs have been at the forefront, confronting numerous physical and mental health problems. Our study aimed to identify the major mental health issues experienced by HCWs in Dhaka City, Bangladesh. Additionally, we aimed to uncover the contributing factors that led to their heightened stress. According to this purpose, this cross-sectional study was conducted from June 2021 to February 2022 with different categories of HCWs selected from twelve hospitals exclusively designated for COVID-19 patients. Data were collected through face-to-face interviews using semi-structured questionnaires. A 10-item Perceived Stress Scale (PSS) was used to assess the stress levels experienced by the respondents. Among the total of 483 HCWs, 76.6% were nurses, 19.9% were doctors, and 3.5% were medical technologists. Our study found that the prevalence of COVID-19 positive cases among HCWs (nurses, doctors, and medical technologists) was 28.6%. Based on the PSS, 93.2% experienced low to moderate levels of stress, and 6.8% reported high levels of stress. A number of sociodemographic, habitual, organizational, and family factors of the respondents were significant, with the PSS at a 5% level of significance and a p-value less than 0.05. However, the variable ‘experience of any negligence, torture, blaming/bullying/threat from society’ was insignificant to the stress experienced by the HCWs. In brief, the study highlights the mental health issues faced by HCWs amid the pandemic, emphasizing significant associated factors. Organizational support and the role of the HCWs' families are crucial in reducing their stress levels.

The combination between praziquantel treatment and fatty liver disease in relation to diabetes mellitus in Northeast of Thailand

Dutsadee Khaweewong — 2024-01-26

Diabetes mellitus (DM) is a growing global public health concern, including Thailand. Prior research has established an association between fatty liver disease (FLD) and DM. Moreover, the distribution of DM was also found in liver fluke endemic areas where praziquantel (PZQ) was used prevalently. However, limited information exists regarding factors associated with DM, specifically in FLD patients undergoing PZQ treatment. Our study aimed to evaluate the association between the combination of PZQ treatment and FLD diagnosis, and DM in Northeast Thailand. We conducted the study among participants in northeastern Thailand with self-reported DM diagnosis and PZQ treatment history using health questionnaires. Additionally, FLD diagnosis was confirmed through ultrasonography from the Cholangiocarcinoma Screening Program data collected from 2013-2022. We employed multilevel mixed-effect logistic regression to assess the association between the combination of PZQ treatments and FLD diagnosis, and DM, represented as adjusted odds ratios (AOR) and their 95% confidence intervals (CI). Of 756,431 participants, the overall DM prevalence was 7%. Notably, 10.45% of individuals with FLD+ and 8.23% with PZQ+ were found to have DM. Specifically, the prevalence of DM in individuals with PZQ+ and FLD-, PZQ- and FLD+, and PZQ+ and FLD+ combinations were 7.14%, 10%, and 11.81%, respectively. In comparison to PZQ- and FLD-, participants with PZQ+ and FLD-, PZQ- and FLD+, and PZQ+ and FLD+ were associated with DM (AOR = 1.27; 95% CI: 1.24-1.30, AOR = 1.8; 95% CI: 1.76-1.85, and AOR = 2.19; 95% CI: 2.12-2.27, respectively). In conclusion, the combination of PZQ and FLD plays a crucial role in the association with DM, particularly in individuals with PZQ+ and FLD+. Our findings emphasize the importance of DM screening, with special attention to individuals with a combination of PZQ treatment and FLD diagnosis, in order to promote early detection and management of DM in Northeast Thailand.

Relationship of shift work with liver enzyme abnormalities and nonalcoholic fatty liver disease: A retrospective cohort study of Thai workers in Bangkok, Thailand

Napas Taechasan — 2024-01-24

Shift work, particularly night shift work, has several detrimental health outcomes. This retrospective study investigated the associations of shift work with the incidence rates of liver enzyme abnormalities and nonalcoholic fatty liver disease (NAFLD) using the annual health check-up database between 2009 and 2016 and self-administered questionnaires from two large organizations in Thailand. Among 10,205 participants, 3620 eligible participants, classified into three subgroups by their shift work status, were followed up until abnormal liver outcomes were observed. The incidence rate of abnormal outcomes was calculated, and Cox proportional hazard models were used to assess the associations. Current shift work was not associated with abnormal liver outcomes, including elevated alanine aminotransferase and aspartate aminotransferase levels, elevated lipid accumulation product (e-LAP), and elevated hepatic steatosis index (e-HSI). However, when the frequencies and duration of shift work were investigated, the duration of shift work was associated with NAFLD outcomes. Healthcare personnel with 10–20 years of shift work experience had a higher risk of e-LAP (adjusted hazard ratio [HR] = 1.31, 95% confidence interval [CI] = 1.04–1.65), while workers with more than 20 years of shift work had a lower risk of e-LAP (adjusted HR = 0.77, 95% CI–0.62–0.97). Nonhealthcare shift workers with fewer than 10 years of work exposure had a higher risk of e-HSI (adjusted HR = 4.30, 95% CI = 1.28–14.47). In summary, the shift work status was not associated with liver abnormalities, but the duration of shift work was associated with NAFLD.

Clinical outcomes: analysis of quality of life and direct medical costs of outpatient hypertensive patients at Panembahan Senopati Hospital, Indonesia

Anis Febri Nilansari — 2024-01-24

Hypertensive patients need long-term therapy and control. Uncontrolled blood pressure can aggravate the incidence of hypertension and develop into a more dangerous disease that can have an impact on quality of life and medical costs. The study aimed to analyze the differences in clinical outcomes on quality of life and direct medical costs. The method employed was a cross-sectional study with 400 outpatient hypertensive patients in August 2023 at Panembahan Senopati Regional Hospital, Special Region of Yogyakarta, Indonesia. Data were collected by filling out questionnaires and observing medical and financial record data. Demographic data were analyzed descriptively and showed that the majority of female patients (65%), aged 46 - 65 years (51%) possessed a high school education (30%). Sixty-six percent of patients had hypertension with a duration of <5 years and 61% had comorbidities. This study attempted to measure the clinical outcomes on quality of life and direct medical costs of hypertensive patients. The EuroQol-5 Dimension (EQ-5D-5L) and Visual Analogue Scale (VAS) questionnaires were used to measure patients' quality of life. The data on direct medical costs included medications, laboratories, medical equipment, and administrative costs. Clinical outcome indicators were blood pressure measurements. The results showed that 316 of 400 patients showed uncontrolled clinical outcomes (79%) with an average score for a good quality of life based on the quality of life assessment with EQ5D5L and VAS and incurred direct medical costs of Indonesian Rupiah (IDR) 663,80. Based on the VAS measurement, there was a significant difference in quality of life between patients with controlled and uncontrolled clinical outcomes (p<0.001). Patients with controlled clinical outcomes had higher quality of life and incurred lower costs. Altogether, controlling hypertension in all patients with or without complications can be practical and cost-effective.

Association of socioeconomic conditions and quality of life with depression among Laos migrant workers in Northeast Thailand: multilevel-level logistics regression analysis

Supat Kongsrima — 2024-01-24

Currently, an increasing number of workers are migrating to Thailand; a trend that is increasing along with the economic growth of the country. However, the cultural conditions, traditions and adjustments of migrant workers in Thailand have a significant impact on their mental state, leading to mental health problems. This study used a cross-sectional analytical study design and secondary data. This study investigated the relationship of socioeconomic conditions and quality of life with depression among migrant workers from Laos employed in Northeast Thailand. The study was conducted from January 2019 to December 2020. Study participants included 1,205 Laos migrant workers working in Northeast Thailand. Data was analysed using Multi-level Logistic Regression Analysis to determine the relationship of socioeconomic conditions and quality of life with depression. The effects of covariates were controlled and adjusted odds ratio (AOR) values and 95% confidence intervals (CI) are presented. The results of the study revealed that the prevalence of depression was 9.29% (95%CI: 7.78–11.07) and factors affecting depression among Laos migrant workers included low-moderate psychological quality of life (AOR =6.69, CI: 2.96–15.10), low-moderate social quality of life (AOR =4.00, 95%CI: 2.32–6.99) and sufficient income but no savings (AOR=2.56, 95%CI: 1.57–4.19). Therefore, agencies related to migrant workers should focus on developing policies that promote their quality of life, as it directly affects their mental health. This should include the development of social and psychological quality of life as well as income and well-being security, which serves as the foundation for workers who contribute to the country’s sustainable economic and industrial development.

Workplace health promotion management of non-communicable disease prevention and implementation among organizational leaders and human resource executives in Thailand: A qualitative study

Jate Ratanachina — 2024-02-19

In Thailand, the Cabinet has outlined a national reform plan (public health), which emphasizes the concept of health promotion in alignment with the United Nations' Sustainable Development Goals. The plan focuses on policies and measures within the workplace and setting goals to establish workplace health policies. Workplace health promotion yields positive effects on businesses by enhancing work productivity and reducing costs. However, national policies specifically aimed at promoting good health and well-being in the workplace are still limited in scope and are predominantly implemented by governmental agencies in Thailand. This study aimed to investigate the management and implementation of health promotion policies in the workplace by organizational leaders and human resource (HR) executives. We conducted exploratory research using the inductive approach of conventional content analysis. Data were collected through in-depth interviews with senior-level and HR executives affiliated with influential bodies of the Joint Standing Committee on Commerce, Industry, and Banking (JSCCIB), the Personnel Management Association of Thailand (PMAT), industrial estates, and prominent businesses representing all eight industry groups in Thailand between May and November 2022. In-depth interviews were conducted with all key informants, totalling 35 individuals, representing 27 businesses and organizations.

The findings were categorized into three main themes: 1) Management including organizational policies, and leadership, 2) Operations including budget allocation, activities, and operational tips, and 3) Challenges including operational challenges and individual factors. This study has outlined strategies for more effective management and implementation to enhance workplace health promotion, and refined policies for improvement of health promotion initiatives in Thai workplaces.

A SARIMA time series forecasting for dengue cases for reporting to Yangon Region, Myanmar

Soe Htet Aung — 2024-02-19

Dengue fever is a significant public health challenge in Myanmar, which requires accurate monitoring to mitigate its impact. The study aimed to develop a forecasting model for dengue cases in Myanmar's Yangon region using historical data from January 2002 to December 2022, with the objective of enhancing epidemiological surveillance and outbreak management. This retrospective observational study examines dengue cases in Yangon from January 2002 to December 2022, employing Seasonal Autoregressive Integrated Moving Average (SARIMA) models for predictive analysis. The most accurate model identified was SARIMA (2,0,1) (1,1,1) ₁₂, with an AIC (Akaike Information Criterion) of 206.19 and MAPE (Mean Absolute Percentage Error) of 1.47%. According to the model, a peak in dengue cases was expected in July 2023, with an estimated 451 cases between January and December that year. Spatial variations in dengue incidence across Yangon's townships emphasize the need for targeted interventions. While the SARIMA model is valuable, it would also be important to consider many other risk factors like climate, migration patterns, virus characteristics, and socioecological factors to improve forecasting accuracy. These findings can aid public health policymakers in preventing and managing dengue outbreaks in Myanmar. However, additional research is needed to incorporate additional risk factors into the model to comprehensively understand dengue epidemiology and improve forecasting accuracy.

Investigating of augmented reality and cold vibration therapy on anxiety in children during intravenous insertion: a quasi-experimental study

Anis Laela Megasari — 2024-02-19

Anxiety tends to escalate when children undergo intravenous insertion. The success rate of the first attempt at intravenous insertion is suboptimal, leading to increased anxiety in children and prolonged treatment. Unfortunately, current interventions are not yet optimal. This study aimed to determine the influence of augmented reality and cold vibration on children's anxiety during intravenous insertion procedure. This research used an experimental pre-post-test nonequivalent control group design. Purposive sampling was employed, taking into consideration inclusion and exclusion criteria. The instrument used demographic data and Child Anxiety Meter (CAM). The independent variables in this study are augmented reality and cold vibration. The dependent variable is anxiety. The total sample consisted of 60 respondents divided into an intervention group (n=30) and comparison group (n=30). Descriptive statistics, frequency distribution, percentages, Paired T-test, Wilcoxon, and Independent T-test were applied for data analysis. Participants in the intervention group experienced a decrease in mean higher anxiety score (2.03), compared to the comparison group (0.59). The independent t-test indicated <0.001 (<0.05) for a p-value. Based on these results, the application of augmented reality and cold vibration can be considered as non-pharmacological therapy to reduce anxiety. The results of this research are very useful for preparing operational plans and developing inpatient service systems, especially in providing health services to pediatric patients during intravenous insertion.

Perception, attitude and stigma of community pharmacists toward patients with mental disorders: a cross-sectional study

Nisa Febrinasari — 2024-02-19

One of the potential barriers to providing pharmaceutical care services to patients with mental disorders is stigma. Therefore, this study aims to explore the perception, attitude and stigma of community pharmacists toward patients with mental disorders in Indonesia. A self-report questionnaire was used including a convenience sample of 1,878 Indonesian community pharmacists from January to March 2023. The regression analyses showed that the perception in confidence level was significantly affected by age (95% CL :0.468-0.851; p-value:0.003) and work experience (95% CL: 1.205-2.284; p-value :0.002). Furthermore, age also affected the attitude of the community pharmacists towards patients with mental disorders (95% CL: 0.705-0.985; p-value: 0.033). Gender and a history of mental illness in a family member or a close friend contributed significantly to social distance (95% CL: 0.584-0.937; p-value: 0.013 and 95% CL: 1.212-1.779; p-value: <0.001, respectively). However, the self-disclosure of pharmacists about mental disorders remained unfavourable. In conclusion, this study found that majority of respondents had good perception and a low level of stigma towards patients with mental disorders. Based on the results, the continuous promotion of mental health awareness and education is recommended. In addition, sharing the personal experiences of individuals with mental disorders is essential for reducing self-stigma. Further studies are required to support service development in this field.

Applying the concept of Thai nutrient profiling as a model for the Thai school lunch planner

Arisa Keeratichamroen — 2024-02-19

This study aimed to develop the Thai school lunch planning program using nutrient profiling (NP). The intention was to create a user-friendly tool that aids teachers in preparing nutritionally balanced school lunch menus. The Thai school lunch planner was developed by gathering 53 popular lunch menus from a school lunch outsourcing company in Bangkok. Menus were grouped into ten categories based on food characteristics and cooking methods. Then, menus were graded according to their energy and 13 nutrients using NP criteria as ‘grade A’ (score >16), ‘grade B’ (scores 12-16), and ‘grade C’ (score <12), and menu category codes were created. Lunch sets were matched across the menu category codes and based on the two formats of school lunch standards. Finally, lunch sets were graded based on energy and 13 nutrient contents using NP criteria, with cut-off macronutrients set at 30% of Thai DRI 2020. Regarding the two formats of school lunch standards, this study found 63 uniquely matched patterns, with the possibility of forming 5,160 lunch sets. Lunch pattern format 1 had 57 patterns and 5,085 menu sets, of which 2,706 menu sets met 30% of the Thai DRI macronutrient requirement. The lunch pattern format 2 could create up to 75 sets from six patterns. Thirty-seven menu sets (49.3%) met the 30% Thai DRI macronutrient requirement. NP could be a valuable alternative for planning school lunch sets to guarantee high-quality and nutritious meals. This technique can be combined with the existing school food menu guidelines. Teachers, with or without basic nutrition knowledge, can find this strategy relatively user-friendly. Even though this technique is suitable for primary schools that serve two side dishes, schools serving one side dish can apply it by increasing the portion of the side dish.

The impact of a comprehensive physical, mental and spiritual programme on fall risk, physical fitness and blood pressure in elderly residents of nursing homes: An RCT Study

Kanthi Suratih — 2024-02-19

As bodily functions decline, older people encounter various challenges in physical, mental and social well-being, for example risk of falls, hypertension and depression. Physical exercise is among the most recommended solutions to address the issues faced by the elderly. This study aimed to evaluate a holistic programme incorporating diverse physical exercises (aerobic exercise, muscle strength, flexibility), combined with mental and spiritual practices (breathing relaxation and gratitude) in reducing fall risk, enhancing physical fitness, and regulating blood pressure, in elderly residents of nursing homes. The study employed a Cluster Randomised Controlled Trial design in Surakarta, Indonesia. Seventy-one participants were randomly assigned to either the intervention group (n=42) or control groups (n=29). The intervention group engaged in the programme three times per week, for 60 minutes per session, over 16 weeks. The control group continued their routine activities, including sunbathing or other relaxing pursuits.

In the fall risk variable, the intervention group exhibited a higher mean score than the control group, specifically 49.79 ±2.70 compared to 46.21 ±3.16, p=0.05, while for physical fitness, 60.24 ±7.65 compared to 49.57 ±11.66, p=0.05. Concerning systolic blood pressure, the mean value for the intervention group was 146.11 ± 20.07, while the control group was 148.59 ± 23.20, p = 0.63. The intervention group recorded a mean value of 84.10 ± 13.75 for diastolic blood pressure, whilst the control group recorded 86.25 ± 9.83, p = 0.98.

This research underscored the influence of SPIRIT programme on reducing fall risk and enhancing physical fitness in elderly nursing home residents, although it is not effective in lowering blood pressure. Elderly people in nursing homes and communities can consider the SPIRIT programme as an attempt to prevent non-communicable diseases. Additional research is recommended to explore the impact of this programme on the blood pressure of older people.

Effects of the Reduce Sedentary Time (ReSeT) program applying socio-ecological model on sedentary behaviors among office workers

Wanwilai Outtarawichian — 2024-02-28

Sedentary behavior (SB) has been associated with non-communicable diseases and premature deaths. SB has wide-ranging adverse impacts on most office workers as the nature of their work requires prolonged sitting. Therefore, the purpose of this study was to examine the effects of the Reduce Sedentary Time (ReSeT) program using multilevel intervention approaches based on the Socio-Ecological model on the SB of office workers. A Quasi-experimental design with a comparison group was used. Office workers from two office-based departments in a university setting were purposively selected and divided into intervention (n=39) and control (n=39) groups. The intervention group received the ReSeT program for 3 months. Activities in reducing SB included motivating individuals to reduce SB using health information, smart watches, and video clips. The organizational measures including policies aimed at to reducing SB, as well as enhancements to the social and physical environment were reinforced. Participants in the control group received no intervention. SB time during work and non-work hours was assessed using ActiGraph for 7 days at baseline, post-intervention, and at 3 months follow-up. The data were analyzed by descriptive statistics, repeated measure ANOVA, paired t-test, R, and RStudio program. After implementing the ReSeT program, the intervention group showed a significant reduction in SB time both for work and non-work periods as compared to the baseline and the control group (p<0.05). The multilevel intervention approaches of SB addressing both individual and organizational factors were suitable for reducing SB time among office workers.

Unveiling quality, clinical, and financial Impacts of Pulmonary Tuberculosis Clinical Pathway Implementation in Magelang Public Hospital, Indonesia

Andriyani Dhaniaputri — 2024-03-04

Tuberculosis (TB) is a popular endemic disease in Indonesia with increased risk outcomes. The clinical pathway (CP) is crucial to enhancing healthcare services and resource efficiency despite discrepancies in service variability reduction, clinical outcomes improvement, and cost saving. Therefore, this study aimed to assess pulmonary TB CP and evaluate its impacts on clinical and financial results, as well as barriers to implementation at Tidar Hospital in Magelang, Indonesia. A sequential explanatory mixed-method design was used from July 2022 to January 2023. The study began with a retrospective analysis of medical records of TB patients (total sampling, n=92). In-depth interviews (IDIs) were conducted with healthcare workers including the quality and medical committee, case manager, CP team, inpatient and non-inpatient nursing sub-coordinators, and pulmonary specialists. In addition, eight multidiscipline healthcare professionals attended the focus group discussions (FGDs). The audio recordings were transcripted verbatim and subjected to thematic analysis. The results showed that the quality and content of CP based on TB evaluation using the Integrated Clinical Pathway Assessment Tool (ICPAT) was 62.6%. Four themes were obtained: 1) CP implementation techniques, 2) supportive factors in the success of CP, 3) organization support in CP implementation, and 4) TB patient outcomes. Furthermore, procedure compliance after CP implementation was 33%. There were no significant differences in the length of stay (p=0.77), diagnosis investigation and therapy appropriateness (100%), mortality (4 vs 3 patients; p=0.589), and cost efficiency with an average cost of care (Rp 6.994.508,- vs Rp 5.521.091,-; p=0.083) before and after CP implementation. Readmission rates were low before and after deployment (1 vs. 2 patients). This study found no significant clinical or financial benefits in TB CP implementation. These results imply the need for hospital leadership and a multidisciplinary team to overcome CP implementation hurdles.

Factors affecting preventive behaviors for unplanned pregnancy in female high school students

Orathai Panpecth — 2024-03-08

This cross-sectional study aimed to study the factors affecting preventive behavior for unplanned pregnancy in female high school students. The participants were 498 high school students selected through multi-stage sampling and the sampling of random students from the specified educational levels of Grades 10, 11, and 12 was conducted by using the following inclusion criteria: be a student aged 15-18 years; be a student attending Grade 10, 11, or 12. The data were analyzed by using mean, standard deviation, and binary logistic regression.

The results showed that seven factors affected behavior concerning unplanned pregnancy in female high school students including: the educational levels in Grade 12 (OR = 10.65, 95% CI = 1.35 - 83.50), the latest GPA ≥ 3.51 (OR = 9.00, 95% CI = 1.45 - 55.99), the knowledge of birth control (OR = 22.12, 95% CI = 2.43 - 201.81), the attitude toward birth control and pregnancy prevention (OR = 4.15, 95% CI = 1.38 - 12.43), perception of the risk of pregnancy from sexual relationships (OR = 3.79, 95% CI = 1.56 - 9.21), the perception of self-efficacy to prevent pregnancy (OR = 5.31, 95% CI = 2.89 - 9.73), and the self-esteem (OR = 4.24, 95% CI = 1.87 - 9.61). These factors had a 79.10% chance of predicting unplanned pregnancy preventing behaviors in high school students. This study suggests that schools or related organizations should develop health education programs for preventing unplanned pregnancies including knowledge, attitudes, self-efficacy, and self-esteem.

Effects of a community-based participatory educational program on knowledge, attitude, and practice for preventing work-related musculoskeletal disorders risks among rural workers: A quasi-experimental study

Manuchet Manotham — 2024-03-08

Work-related musculoskeletal disorders (WMSDs) have become a paramount concern in occupational health, significantly affecting the well-being and efficiency of laborers across diverse sectors. This research aims to investigate the effects of a community-based participatory educational program on enhancing knowledge, attitude, and practice (KAP) for preventing WMSD risks among rural workers in Phayao province, Thailand. A single-group quasi-experimental design was employed, with assessments conducted at the baseline (T₁), post-program (T₂), and follow-up post-program (T₃) stages. The participants attended an eight-week educational program. Data collection tools included demographic characteristics, assessment of KAP related to WMSDs, and evaluation of WMSD risks. The data were analyzed using descriptive statistics and repeated-measures analysis of variance. In total, 90 participants were included in the study, with an average age of 47.6 ± 10.6 years. More than two-thirds of the participants were classified as general workers. The results indicated a significant increase in knowledge scores, rising from 6.78 ± 1.59 at baseline to 9.56 ± 0.70 post-program and maintaining at 8.59 ± 1.06 after follow-up (p-value < 0.001, η² = 0.681). Attitude scores also demonstrated a significant improvement, increasing from 36.43 ± 6.92 to 46.66 ± 1.94 post-program and remaining at 45.97 ± 2.05 after follow-up (p-value < 0.001, η² = 0.674). Practice scores witnessed a substantial increase from 19.31 ± 6.49 at baseline to 38.54 ± 1.18 post-program, maintaining at 37.79 ± 1.34 after follow-up (p-value < 0.001, η² = 0.881). Furthermore, the results indicated a notable decrease in WMSD risks post-program intervention, sustained after follow-up. The study suggests that integrating a community-based educational program successfully enhanced participants’ KAP related to WMSD risks. These findings provide valuable insights to the expanding body of evidence, offering pertinent information for policymakers.

Predictive factors for resilience quotient among village health volunteers in Northern Thailand post-COVID-19

Orathai Katkhaw — 2024-03-05

Village Health Volunteers (VHVs) played an important role during the COVID-19 virus outbreak by coordinating with the public health team and closely engaging with community members. This study aimed to assess the resilience quotient levels of VHVs in Northern Thailand post-COVID-19. The research involved a random sample of 416 VHVs and utilized various tools such as questionnaires. Data analysis employed descriptive statistics and stepwise multiple regression. The study revealed that most of the sample group were women (81.3%), with an average age of 55.03 years (X̅ = 55.03, SD = 10.44). Most were in a relationship (79.3%), and 49.0% had completed primary education. Additionally, 47.8% were employed in agriculture, and 54.3% reported having sufficient income. A significant portion of them, 70.7%, had no history of chronic illnesses, whereas 53.1% had previously tested positive for COVID-19. The overall resilience quotient level of VHVs was high (X̅ = 61.88, SD = 9.14). The study identified the following four significant predictor variables: mental health, anxiety, depression, and mental health literacy, accounting for 40.30% of the variance. These findings were statistically significant at 0.05 (R = 0.639, Adjusted R² = 0.403, F = 71.071, P-value < 0.001). In conclusion, this study provides valuable insights for developing targeted interventions and support systems to enhance the resilience quotient of VHVs, particularly in the post-COVID-19 landscape and similar situations.

Antibiotics use, resistance and self-medication practices among healthcare workers in a federal teaching hospital in southwest, Nigeria

John Olujide Ojo — 2024-03-05

Antimicrobial resistance is a major threat to global health, and inappropriate drug use, including antibiotic self-medication, has been identified as an important factor in developing countries. This study assessed the knowledge, and attitude of antibiotic use and antibiotics resistance, as well as the practice of self-medication among healthcare workers. This is a cross-sectional study conducted in a federal teaching hospital in Southwest, Nigeria among 320 healthcare workers selected through a two-stage sampling technique. A thirty-four-item self-administered semi-structured questionnaire adapted from the questionnaire on antibiotic resistance: multi-country public awareness survey by the WHO was used for data collection. Descriptive statistics, cross-tabulation and logistic regression were carried out using SPSS version 25.0. The mean ±SD age of the participants was 36.3 ±9.2years and over one-third (37.5%) of them had 6-10years of experience. About two-thirds (66.3%) of the participants had good knowledge about antibiotic use and resistance while only 39.4% had positive attitudes. The prevalence of self-medication with antibiotics was 30%. The identified positive predictors of antibiotics self-medication included having primary education (AOR:5.874, 95%CI:1.020-33.836) compared with tertiary education, poor knowledge (AOR:1.683, 95%CI:1.015-2.789) compared with good knowledge about antibiotic use and resistance as well as negative attitude (AOR:1.861, 95%CI:1.102-3.143) compared with a positive attitude towards antibiotic use and resistance. The level of knowledge and attitude in this study was suboptimal. Self-medication was linked with a lower level of education, poor knowledge, and a negative attitude. Therefore, we recommend the provision of appropriate health education to promote the rational use of antibiotics.

Counseling intervention on iron-folic acid adherence and clinical outcomes among pregnant women and women planning to be pregnant: a scoping review

Rizka Atmadani — 2024-03-08

Anemia during pregnancy is a major health problem that affects 25-50% of the world's population and around 50% of pregnant women. One of the causes of stunting is Low Birth Weight, which most often occurs in mothers who suffer from anemia. Making sure pregnant women have access to iron-folic acid supplement programs is challenging. People's inability to comply often occurred as the result of a lack of understanding of the benefits or harms of the supplement. Providing counseling to pregnant women to improve adherence to taking blood-added supplements has resulted in significant benefits and impacts on changes discussed in several studies that have been conducted in several countries. Through a review of the literature, this study seeks to ascertain the contribution that counseling interventions have to improving iron-folic acid prescription adherence. This study used a literature study research method by examining 8 journals published on the SCOPUS, PubMed, and Garuda Websites. After that, descriptive analysis was used to examine the data from the selected journals. The 8 journals supported the idea that counseling can improve adherence to iron and folic-acid supplementation. There are numerous ways to provide counseling, including the traditional face-to-face approach, the 5A brief approach, leaflet/brochure-based approaches, and counseling through illustrated books. This study concludes that counseling interventions are more effective due to the careful planning of tailored interventions with more regular follow-ups, various forms of interactive educational media, patient characteristics, and direct health professional intervention related to counseling.