Journal of Preventive Medicine Association of Thailand

ยกระดับบริการด้านสาธารณสุขไทย ปฐมภูมิถึงตติยภูมิ นโยบายเร่งด่วนกระทรวงสาธารณสุขปี 2566

สุรชัย โชคครรชิตไชย — Thu, 31 Aug 2023 00:00:00 +0700

นโยบายกระทรวงสาธารณสุขในปัจจุบัน โดยนายแพทย์โอภาส การย์กวินพงศ์ ปลัดกระทรวงสาธารณสุข ประกาศนโยบายการยกระดับบริการสาธารณสุข โดยมีเป้าหมายพัฒนาระบบบริการสุขภาพ ให้ตอบสนอง ความต้องการของประชาชนและปัญหาสุขภาพในพื้นที่ให้มีประสิทธิภาพมากยิ่งขึ้น โดยการจัดทำแผน การจัดระบบบริการสุขภาพ Service Delivery Blueprint ในระดับเขตสุขภาพ เพื่อให้ประชาชนสามารถเข้าถึงบริการสุขภาพที่มีคุณภาพ ลดการป่วยตายด้วยโรคสำคัญ เช่น โรคหัวใจ โรคหลอดเลือดสมอง โรคมะเร็ง และ อุบัติเหตุ การสร้างความเท่าเทียมในการเข้ารับบริการรวมถึงการลดความเหลื่อมล้ำและสนับสนุนให้ใช้เทคโนโลยีดิจิตอลและการแพทย์ทางไกล เพื่อช่วยลดภาระงานโดยครอบคลุมการบริการตั้งแต่ระดับปฐมภูมิ ทุติยภูมิ ตติยภูมิและพัฒนาไปถึงศูนย์ความเชี่ยวชาญเฉพาะด้าน โดยส่งเสริมให้มีการบริหารจัดการทรัพยากรร่วมกันในระดับจังหวัด และส่งเสริมการบริหารงานบุคคลเพื่อสร้างขวัญและกำลังใจให้กับบุคลากร เพื่อยกระดับการบริการสาธารณสุขไทยให้เป็นที่พึ่งของประชาชนได้อย่างยั่งยืน

Cleaning Products and Occupational Asthma

Sivakorn Suntinipanon, Jate Ratanachina, Pornchai Sithisarankul — Thu, 31 Aug 2023 00:00:00 +0700

Exposure to cleaning products is a common cause of occupational asthma. Several epidemiological studies have found the association between cleaning products and asthma. Causative agents of asthma are composed of 1) sensitizers such as quaternary ammonium compounds and glutaraldehyde and 2) irritants such as bleach. Cleaners and health care workers are common occupations at risk of exposure. Occupational risk factors consist of spraying cleaning products and duration of work. Occupational asthma is a preventable disease so that learning on these causative agents of asthma is useful for preventive measures and medical surveillance.

Occupational Health Hazards in Firefighter

Suttinate Wannatrong, Wiroj Jiamjarasrangsi — Thu, 31 Aug 2023 00:00:00 +0700

In the present day, disasters are occurring more frequently and with greater intensity, stemming from both natural and man-made causes. Fire incident is a type of disaster which can extensively damage both public property and human life. When a fire breaks out, firefighters are often the first responders on the scene, risking their lives to extinguish the flames and rescue those in danger within a limited timeframe. As a result, firefighters face serious risks on the job due to their exposure to various occupational health hazards such as physical hazards, chemical hazards, biomechanical hazards, psychosocial hazards and biological hazards. Consequently, these health hazards can impact both the firefighters' well-being and their lives. The objective of this article is to identify the various types of health hazards that can lead to injuries, illnesses, and even loss of life among firefighters in their line of duty.

Pragmatic Treatment Patterns and Clinical Outcomes of Outpatients with Residual Respiratory Symptoms from COVID-19 Infection at Chao Phya Abhaibhubejhr Hospital : A retrospective study

Soraya Dhamaraks — Thu, 31 Aug 2023 00:00:00 +0700

Objectives: To assess treatment pattern and clinical outcomes of patients with respiratory symptoms residual from COVID-19 infection and develop the recommendation to improve efficiency of hospital services Research methodology: Retrospective study was conducted in patients with residual respiratory symptoms from COVID-19 infection, age 18 years and over, with the main symptoms of fatigue and/or shortness of breath. The patients visited to respiratory clinic of Chao Phya Abhaibhubejhr hospital between December 2022 to March 2023 and only those with assessment of clinical outcomes in pulmonary obstruction based on four key aspects; severity of fatigue, shortness of breath, quality of life and symptom relief were selected. Statistical analysis by paired t-test for normal data distribution and Wilcoxon signed rank test for abnormal distribution were used for data analysis. Conclusion: Treatment of patients with residual symptoms in the respiratory system is effective in relieving fatigue, shortness of breath and other associated symptoms. Moreover, holistic care by applying lifestyle medicine principles to care for this group of patients would help improving patients’ quality of life.

Unit cost analysis of COVID-19 field hospital in Bang Bua Thong District, Nonthaburi

Tharit Mongkol — Thu, 31 Aug 2023 00:00:00 +0700

The field hospital had been established to support the treatment of COVID-19 patients and also to prevent the spread of the virus to families, communities, and other patients in their hospital. But at the same time, the establishment of a field hospital requires a large amount of resources of the responsible hospital such as medical personnel, materials and medical equipment. However, very few researches have been done to analyze these issues. The purpose of this study was to determine the unit cost and cost recovery of field hospital for the treatment of COVID-19 patients. This research was a descriptive study by retrospectively collecting data from hospital records and cost databases of Bang Bua Thong Field Hospital under the responsibility of Bang Bua Thong Hospital, which was opened from July 15 - October 4, 2021. The researcher analyzed data from the perspective of service providers, considering only accounting costs. The results showed that the field hospital had a total of 979 patients with a total cost of 8,081,868 baht, representing a cost of 8,256 baht per patient. The field hospital received compensation from the public health insurance schemes for a total of 32,086,067.26 baht with a cost recovery of 6.00. The findings of this research may benefit not only the development of efficient and appropriate use of resources of field hospitals, but also the development and optimization of compensation rates from public health insurance schemes.

The Comparative Study of Domestic Violence among Patients in One Stop Crisis Center (OSCC) Before and During COVID-19 Pandemic, Lampang Hospital

Thu, 31 Aug 2023 00:00:00 +0700

Introduction: Due to lockdown measurement as a result of COVID-19 pandemic, people were forced to self-quarantine at home for a long time which increased stress level among people. Furthermore, self-quarantine also increased a longer periods of time that victims and abusers were together. Therefore, the risk of domestic violence had increased. However, there is lack of information about domestic violence during COVID-19 pandemic in Lampang province. Objective: The aim of this study was to compare the type of domestic violences and emergency level in patients of OSCC, Lampang hospital before and during COVID-19 pandemic. Method: A descriptive study was conducted using medical records from OSCC at Lampang hospital before and during COVID-19 pandemic. Results: A total number of 747 domestic violence cases were identified with 389 cases before COVID-19 and 358 cases during COVID-19. Most of the cases were female both before and during COVID-19 (87.7% and 82.1%). Physical violence was found to be the most common type of domestic violences with 76.6% before COVID-19 and 81% during COVID-19. The emergency level of the cases which divided by first three level of triage (level I – III) during COVID-19 (63.7%) was higher than before COVID-19 (45.2%). Conclusion: The study found that although there were fewer domestic violence cases during COVID-19 than the time before COVID-19, but the emergency level of the cases was significantly higher.

The Association Between Substance Use Disorder Patients with Cognitive Impairment and Road Traffic Accidents

Manus Pothapron , Nanta Chaipichitpan, Jittarat Srivilert — Thu, 31 Aug 2023 00:00:00 +0700

Road traffic accidents, a global problem, tends to continuously increase in societies where vehicles are common modes of transportation. Factors such as human, vehicles and environmental have been associated with road traffic accidents. Drugs are one of the major causes of cognitive impairment resulting in traffic accidents. Objective: To study the association of drug addicts with cognitive impairment and road traffic accidents. Secondary objectives were to explore 1) factors contributing to road traffic accidents in drug addicts and 2) numbers and the proportion of substance used disorder patients with cognitive impairment. Methods: This study was a cross-sectional analytical study. Data were collected from all types of drug-addicted patients admitted to seven drug treatment facilities across the country. The sample consisted of 607 participants. The research tools were composed of five questionnaires, including personal characteristics questionnaire, Trail Marking Test A & B, the Stroop Color-Word test, Digit Symbol (WAIS-III) and road traffic accidents questionnaire. The Personal characteristics and road traffic accident questionnaires were validated by three independent experts and the value for Cronbach's alpha efficiency was 0.88. The other sets of questionnaires were the standardized psychological tests. Data were analyzed and presented by descriptive statistics, comprising frequency distribution, percentage, mean, standard deviation, and analytical statistics, comprising chi-square test (c²), Fisher's exact test, odds ratio and 95%CI. Data were collected between October 15, 2022 - January 31, 2023. Results: Factors affecting road traffic accidents were driving experience with less than 20 years, by which road traffic accidents were reported as high as 18.3% and had a statistically significant relationship with road traffic accidents at the .05 level. The top three most addictive drugs that caused cognitive impairment were methamphetamine, alcohol and heroin at 43.7%, 23.6% and 2.1%, respectively. Patients who used methamphetamine, alcohol and heroin had 2.34, 2.30 and 0.44 times the odds for cognitive impairment, respectively than that of patients using other drugs. Conclusion: The results of this study did not find an association between cognitive impairment and a history of road traffic accidents. However, it was found that methamphetamine and alcohol dependence patients were more likely to have cognitive impairment than of patients using other drugs.

Prevalence of Anemia among Hospitalized Children Under 5 Year-Old at Maharat Nakhon Ratchasima Hospital

Prawin Tanthaprabha, Angkana Winaichatsak — Thu, 31 Aug 2023 00:00:00 +0700

Background: Anemia is a global public health problem, especially in developing countries. It is among the five most common childhood health problems and is associated with impaired cognitive development, immune system, and brain function in children. Objective: To study the prevalence and etiology of anemia in hospitalized children under 5 years of age at Maharat Nakhon Ratchasima Hospital. Methods: A retrospective descriptive study was conducted between January and March 2021 involving children aged 6 months to 5 years hospitalized at a tertiary care hospital in northeastern Thailand. We analyzed demographic data, age, sex, disease, and hematologic parameters. Children with hemoglobin concentration less than 11 g/dL were classified as anemia. Results: One hundred seventy-four patients were enrolled in the study. The prevalence of anemia was 36.3%, with females more commonly affected than males and children in the 6-12 months, 12-24 months, and 36-48 months age groups most commonly affected (27%, 25.4%, and 19.1%, respectively). The most common condition was respiratory symptom. The severity of anemia was mild (63.5%), moderate (31.7%), and severe (4.8%). The most common cause of anemia in this study was iron deficiency anemia, which was due to inadequate dietary intake, inadequate nutrition, and inadequate oral intake of iron supplements in health promotion. Conclusions: The prevalence of anemia in this study is 36.2%, which is still higher than the country's target of less than 10%, and it was a moderate public health problem in Thailand, especially iron deficiency anemia. A health promotion campaign on iron-rich foods and prevention of iron deficiency by increasing the iron supplement dose to 1-2 mg/kg/day under a health policy program for appropriate dose of demand and consistency of intake may reduce the prevalence of anemia in the future.

Risk Factors Related to Fall in Elderly Patients Treated in Lerdsin Hospital

Napatsawan Vongsavan — Thu, 31 Aug 2023 00:00:00 +0700

Background: Falling is a common problem among the elderly patients that cause injuries, disability and premature death. Objective: To determine the risk factors related to fall in elderly patients treated in Lerdsin hospital. Methods: This study was cross-sectional descriptive study that performed by collecting the random sample of 329 older patient aged 60 years and over from 21,475 older patients in Lerdsin hospital. The data was collected by using direct question-answers via questionnaire between February to June 2022 at Lerdsin hospital, Bangkok Thailand. The descriptive statistics, independent t-test, univariate & multivariate analysis and logistic regression analysis were performed, with intrinsic and extrinsic fall risk factors as independent variable and falls in elderly patients as dependent variable. Results: The total of 180 elderly patients (54.7%) as the study group had a history of falls in one year and 149 patients (41.5%) as a control group had no history of falls in one year. 41.3% of fall causes were slipping floor. Seventy-eight percent of the study group resulted in a fall related minor injury. Those who having underlying disease which including dyslipidemia (odds ratio = 2.022, 95% CI=1.143-3.575, p =0.016), musculoskeletal disease (odds ratio = 2.596, 95% CI = 1.447-4.658, p =0.001) and psychotropic and sedative medication (odds ratio = 4.565, 95% CI = 1.597-13.045, p = 0.005) were related to risk factors to fall in elderly patients. Conclusions: This study concluded that patients taken psychotropic or sedative medication, patients with dyslipidemia or musculoskeletal disease were the strongest independent risk factors related to fall in elderly patients in Lerdsin Hospital.

Investigation of Salinity in Readily Prepared Foods at Naresuan University Canteens

Thu, 31 Aug 2023 00:00:00 +0700

Objective: To survey the sodium content in foods from Naresuan University canteens. Materials and methods: This study was the cross-sectional descriptive study. 242 samples were collected twice in the same week, first time on Tuesday, and second time on Thursday. Data were recorded in the form, and salinity was measured by Salinity meter AZ8363. Mean, standard deviation and percentage were used to analyze the data. Results: The amount of sodium content per one serving were categorized into three groups: green group was less than 1,000 mg of sodium content per one serving, yellow group was 1,000-2,000 mg of sodium content per one serving, and red group was more than 2,000 mg of sodium content per one serving. From 94 samples of noodles (Clear Noodle Soup, Tom Yum Noodle and Nam Tok noodle); 2 samples (2.1%) were classified as green group [795±97.58 mg], 10 samples (10.6%) as yellow group [1,732±269.69 mg] and 82 samples (87.2%) as red group [3,377±760.09 mg]. From 124 samples of side dishes with rice (soup, stir-fried vegetable, curry with coconut milk, and Thai five spice pork and egg stew); 24 samples (19.4%) were classified as green group [705±173.31 mg], 66 samples (53.2%) as yellow group [1,469±262.54 mg], and 34 samples (27.4%) as red group [2,562±581.28 mg]. From 16 samples of spicy salad, 1 sample (6.2%) was classified as green group [988 mg], 7 samples (43.8%) as yellow group [1,200±143.03 mg] and 8 samples (50%) as red group [2,742±781.12 mg]. From 8 samples of Suki; 3 samples (37.5%) were classified as yellow group [1,449±270.01 mg] and 5 samples (62.5%) as red group [2,548±225.08 mg]. Conclusion: The yellow and red group were the samples that have 1,000 mg to more than 2,000 mg of sodium content per one serving. 100% of Suki samples, 97.8% of noodles samples, 93.8% of spicy salad samples, and 80.6% of side dishes with rice were classified as yellow and red group. Consuming 1-2 servings of readily prepared food at Naresuan University canteens may exceed the recommended daily sodium intake.

Incidence and Factors of Spinal Anesthesia induced Hypotension in Cesarean Section at Phra Nakhon Si Ayutthaya Hospital

Supawadee Supboon — Thu, 31 Aug 2023 00:00:00 +0700

Objectives: To study the incidence and factors of hypotension after spinal anesthesia in women undergoing cesarean section at Phra Nakhon Si Ayutthaya Hospital. Methods: This study was a prospective study in which data were collected from pregnant women undergoing a cesarean section under spinal anesthesia between January 1, 2023, and March 31, 2023. A total of 149 pregnant women participated in the study. Data were analyzed as mean, standard deviation, number, and percentage. Moreover, simple and multiple logistic regression analyses were used to establish relationships between the variables and reported in terms of OR and 95% confidence interval. Results: Of 149 pregnant women who underwent cesarean section, 78 women had hypotension (52.35%). Factors affecting the incidence of hypotension were heart rate>90 beats per minute (bpm) (Adjust OR = 1.05; 95%CI: 1.01-1.10, p = 0.009), birth weight >2800 gram (Adjust OR = 1.00; 95%CI: 1.00-1.01, p <0.001) and anesthetic level above T6 (Adjust OR = 12.27; 95%CI: 2.14-70.26, p= 0.005). Conclusions: The incidence of hypotension after spinal anesthesia in women undergoing a cesarean section at Phra Nakhon Si Ayutthaya Hospital was 52.35%. The associated risk factors with hypotension were heart rate>90 beats per minute (bpm), increased neonatal weight >2800 gram, and an anesthetic level above T6. These findings can be used as surveillance data to prevent hypotension induced by spinal anesthesia in cesarean section.

The Development of Competency in Performing the Roles of Family Doctors of Village Health Volunteers, Sai Ngam District, Kamphaeng Phet Province

Weerasak Damrongpong — Thu, 31 Aug 2023 00:00:00 +0700

This action research; the purpose was to assess the performance of family doctor roles of village health volunteers in Sai Ngam District, Kamphaeng Phet Province. The study was divided into 3 phases as follows: phase 1–situation analysis, a questionnaire was used with a sample of 274 people. Data were analyzed by descriptive statistics, analytical t–test, one–way ANOVA, Chi–square test, Pearson correlation coefficient. The level of significance was set at 0.05. Phase 2–program development, purposive samples of 15 people were selected, using a semi–structured interview. Data were analyzed with content analysis. Phase 3–trial, improvement and evaluation of the program. The target population was 35 village health volunteers who needed competency development. Data were analyzed by paired t–test. It was found that, after joining the program, the samples had performance scores passed the criteria, and had a high level of motivation. The family doctor’s role was performed at a moderate level: and the average performance score, motivation and fulfillment the role of family doctor were significantly higher than those before joining the program (p<0.05). Guidelines for competency development to increase effectiveness in performing the family doctor roles include: (1) development of application potential, (2) building relationships and strengthen morale, (3) supporting materials–equipment/operational manuals. From the findings, there are suggestions that: motivation for the performance of the volunteers and the capacity building model should be developed to be used as a framework for developing the potential of the volunteers.

Knowledge, Attitude and Practice (KAP) Survey Regarding to using Pre-treatment Antiseptic Mouthwashes in COVID-19 Pandemic Situation among Dental Students in Western University

Chayanuch Angkaew, Thitithorn Rojpaibool, Pauline Lamsam — Thu, 31 Aug 2023 00:00:00 +0700

Objective: To evaluate the knowledge, attitude and practices among dental student in Western university regarding the use of antiseptic mouthwashes in COVID-19 pandemic situation. Methods: A descriptive, cross-sectional study was conducted among year 5 and year 6 dental students in Western university. A total of 42 dental practitioner students responded the online questionnaire comprised of demographic details (sex, age and study year), 11 questions of knowledge part, which were closed-ended yes or no questions, 5 questions of attitude part and 6 questions of practice part, which were evaluate in 5-point Likert scale. The 7^th question in practice part is a checklist question. Results: Of the 42 participants, 14 were male and 28 were female. Twenty-one were in fifth-year and sixth-year each. The Majority of respondents, 85.7 percents, score a high score of knowledge regarding COVID-19 pandemic situation and the use of antiseptic mouthwashes prior to dental procedure. All of the participants agreed that dental practitioners are exposed to the high risk of getting infected during the dental procedure. About 52% strongly agreed that coronavirus can be controlled by pre-procedural use of antiseptic mouthwashes. About 97.6% agreed that they use pre-treatment mouthwashes prior to dental procedure during COVID pandemic. Conclusion: This study presented that, dental students in Western university are knowledgeable about the nature of COVID-19, the transmission mode, including the preventive measures in using antiseptic mouthwashes. Majority of dental students regularly use antiseptic mouthwashes prior to dental procedure in COVID-19 pandemic situation.

Breast Cancer Awareness and the Behavior of Breast Self-Examination of Female Students at a University

Penporn Numkaroonaroonroj — Thu, 31 Aug 2023 00:00:00 +0700

Objective: This research aims to explore breast cancer awareness and the behavior of breast self-examination of female students at a university because they are at the age when they should do breast self-examination. Methods: The sample is 397 university students (205 from health science fields and 192 from other fields) selected with the simple random sampling. The assessments were distributed between July to December 2022 to gather the data about personal information, breast cancer awareness, and the behavior of breast self-examination. Later, the data analysis was conducted through descriptive statistics, including percentage, mean, and standard deviation. The analytical statistics — independent t-test, Chi-square test, and one way ANOVA — were also performed. Results: The results indicated that 25 percent of the sample did breast self-examination, and 4.5 percent did it consistently. Breast cancer awareness was high among the students. Its association with the behavior of breast self-examination was statistically significant (p<0.05). The research showed that only a few female students conducted breast self-examination and there was the lowest of knowledge in breast cancer. Conclusions: It is essential to provide knowledge about breast cancer and breast self-examination to university students in order to raise their awareness concerning the risks and the illness of breast cancer and improve healthcare in the future.