plueme/wizJson huggingface dataset:
Lactation consultant nurses play an important role in the promotion of breastfeeding practices and to ensure optimal age-appropriate feeding of children. Responsible for supporting mothers in overcoming breastfeeding difficulties, they also play a prominent role in providing knowledge, techniques and skills, as well as instructing mothers on appropriate behaviors and building confidence; the critical factors for successful breastfeeding. In Thailand, professional nurses assigned to lactation clinics in health facilities take on the role of a lactation consultant. To date, there have been no studies on service provisions and practices of lactation consultants in Thailand.  This study aimed to understand the situation of lactation consultants working in health facilities, including their roles, knowledge and qualifications as well as the scope of services provided, the challenges faced, and recommendations for improving competency of lactation consultants. A qualitative study was conducted by collecting data from 53 lactation consultants working in public and private health facilities, through focus group discussions and self-administered questionnaires. The results found that lactation consultants had the primary role of providing knowledge and building confidence for pregnant women, mothers and families on breastfeeding, from pregnancy until post-partum period. Lactation consultants’ scope of work was to provide nursing care without invasive interventions which required extensive knowledge focusing on breastfeeding practices, infant formula, maternal nutrition and child development. In addition, they required skills of nursing services, academic and technical skills, as well as communication and administrative capabilities. The large majority of lactation consultants faced difficulties due to their heavy workload, career path uncertainties, and insufficient knowledge of complex breastfeeding complications. These problems were resulted from national and organizational policies, management and the work environment of lactation consultants. Based on these results, in order to improve the capacity of lactation consultants, well-defined national policies and policy implementation on the guidelines and promotion of breastfeeding practices in health facilities, as well as building a network for lactation consultants and developing a mechanism for long-term capacity building and monitoring are recommended.
Reorienting health services to be more engaged in health promotion is a key health promotion
strategy that is widely accepted. The strategy has been implemented in Thailand. However, the scope
of health promotion work by Thai hospitals and its related functions were hardly known.
This research project explored health promotion activities in the hospital settings. It identified systematic
reviews of health promotion using PubMed database.
There were 10 systematic reviews that met the inclusion criteria. The reviews of health promotion
activities included body mass index monitoring during clinical consultation, individual exercise encouragement,
diet control, quit smoking and drinking, program to help release carers’ stress, and risk reduction
interventions among mental health patients.
This systematic review of systematic review can be beneficial for health promotion management
at each organization. The information can help expand work and research on health promotion activity
in hospitals in the future.
One of the missions of the Faculty of Medicine, Naresuan University is to produce medical graduates to serve the Collaborative Project to Increase Production of Rural Doctor (CPIRD). The project recruits 145 students who reside in any of the 5 provinces in Health Region 2 annually. After graduation, the medical graduates are deployed to work at rural hospitals of the five provinces. The Faculty of Medicine aims to apply outcome-based curriculum to develop the graduate’s attributes according to the expectations of all stakeholders particularly of the community hospital directors. Thus, the present study was carried out to find the expectations of the community hospital directors in Health Region 2 to provide the basis for developing a medical curriculum satisfying community needs. Method: A cross-sectional descriptive survey was done using a structured and validated questionnaire to all community hospital directors in Health Region 2. Results: Based on the expectations of the respondents, leadership skill and teamwork, patient empowerment, health promotion and disease prevention, patient-centered care, and patient safety were regarded as the top five instructional topics significant to medical practice in community hospitals. Problem-based learning (PBL) was cited as the most beneficial learning approach. On the contrary, the respondents indicated that the medical graduates did not have adequate knowledge on the community health system. Conclusion: The above specified instruction topics and PBL should be incorporated into the learning experience. Moreover, instruction topics related to the WHO 6 building blocks of a health system are useful for practicing at community hospital. As a result, there should be the health system sciences in the medical curriculum aside from basic and clinical sciences in order to produce graduates conforming to the needs of society.
The objective of this study was to estimate outpatient cost of HIV/AIDs services provided at hospitals.
The cost data for fiscal year 2015 were gathered from seven hospitals; the data consist of hospital
service statistics and financial information. Then, cost per visit was analyzed as cost-to-charge ratio using
a traditional method following the cost guideline of the Ministry of Public Health. The results show that
majority of service cost was of labor followed by material and capital cost, amounting to 52%, 42%, and
6%, respectively. The study found that an average cost per visit of the civil servant medical benefit (CS)
patients was the highest at THB 2,401. An average cost per visit of the universal coverage (UC) patients
was THB 1,778. An average cost per visit of the social security (SS) patients was THB 1,658; and an
average cost per visit of out-of-pocket (OOP) patients was THB 803. In terms of an average annual cost
per person, the study found that the CS patients also had the highest cost at THB 12,305. The second
highest was the UC patients at THB 9,483 per person per year and the third was the SS patients at THB
7,197. The OOP patients incurred the lowest annual cost per person at THB 1,570. However, it should
be noted that these seven hospitals were selected by purposive sampling with limitation on representation.
More hospitals should be involved in further research to represent actual cost by hospital types.
This study was to estimate cost of services for schizophrenia, schizotypal and delusional disorders. A retrospective analysis was undertaken. Cost data for the fiscal year 2016 were gathered using a purposive sampling. Eight hospitals were selected covering one regional hospital, three general hospitals and four community hospitals based on availability of hospital information on service and financial data. Cost per visit was calculated using the traditional method and cost to charge ratio according to the costing guideline of the Ministry of Public Health of Thailand. The result showed that labor cost was the major proportion of the total cost followed by material and capital cost. The average cost for schizophrenia, schizotypal and delusional outpatient was 831 Thai
baht (THB) per visit at the regional hospital, THB 483 - 1,030 per visit at the general hospitals and THB 189 - 567 per visit at the community hospitals. However, it should be noted that the present study was conducted in only eight hospitals of which
only one regional hospital. Generalizability of our findings was limited and might be applicable to only hospitals with similar characteristics.
There have been little empirical evidences available on a time-motion study of medical specialists,
the most vital human resources in Thailand. It is important to study the proportions medical specialist’s
workloads working in multiple units in the hospitals for greater visibility of labor distribution and cost
consistent with the actual work. The objective of the present study, therefore, was to describe the
proportion of work distribution as well as their working patterns in many tasks of specialists in public
hospitals. This would be beneficial for hospital cost allocation criteria.
A purposive sampling was employed to select eight public hospitals consisting of 3 regional hospitals,
3 general hospitals of the Office of Permanent Secretary, and 2 hospitals of the Ministry of Public
Health (with 600 and 1,000 beds). This study collected data from weekly and monthly work schedules
and direct interviews with medical specialists. The data were analyzed by descriptive statistics. Overall,
the medical specialists spent 33% to 36% of their time at inpatient department (IPD), followed by 27%
to 32% at outpatient department (OPD) and special clinics. In case of medical teachings, the medical
specialists spent no more than 4.7% of their total time, except pediatricians spent the highest 7.0% for
teaching. The administrative task took the smallest proportion of no more than 4.0%. The propotion of
time of each specialty was: otolaryngologists OPD : OR : IPD : teaching : administrative task = 27.6 : 24.8 :
41.7 : 2.6 : 3.3; ophthalmologists OPD : OR : IPD : teaching : administrative task = 30.8 : 19.2 : 42.0 : 4.6 :
3.4; internist OPD : IPD : ICU : teaching : administrative task = 28.3 : 55.8 : 11.0 : 3.2 : 1.7; pediatricians
OPD : IPD : ICU : NICU : teaching : administrative task = 32.6 : 33.8 : 10.4 : 14.3 : 7.0 : 1.9, obstetricians
and gynecologists OPD : OR : LR : IPD : teaching : administrative task = 30.4 : 15.3 : 17.4 : 33.1 : 2.7 : 1.1;
surgeons OPD : OR : IPD : ICU : teaching : administrative task = 29.1 : 16.6 : 42.1 : 7.3 : 3.7 : 1.2; orthopedic
surgeons OPD : OR : IPD : ICU : teaching : administrative task = 17.6 : 19.2 : 52.9 : 6.9 : 2.4 : 1.0; anesthesiologist
OPD : OR : ICU : anesthesia : teaching : administrative task = 2.2 : 45.2 : 13.5 : 34.7 : 1.5 : 2.9.
Proportions of work distribution in the present study may be used to assist decision makers in
hospital cost allocation criteria and human resource management. Additionally, this methodology can
be applied to other personnel who multitask and can be used to estimate the health workforce needs.
Thailand National Physical Activity Plan 2018 - 2030, the first national strategy addressing insufficient
physical activity of Thai people, was developed through a cross-sectoral cooperation processes in 2015,
led by the Department of Health, Ministry of Public Health. The development process took three years
before being approved by the Cabinet in August 2018. This article reviewed policy process since agenda
setting and policy formulation to policy adoption as well as policy content and context.
Key policy lessons were drawn from the development of the national plan. First was the identification
of principles, strategic objectives and implementing mechanisms of existing international policies
ensuring a comprehensive and effective national policy framework. Secondly, the engagement of all
relevant stakeholders in the policy process increased the ownership and the feasibility of policy adoption
despite a longer process. Lastly, capacity of central government agency and policy and strategic skills of
staffs were crucial throughout all policy processes. There should be more investment in human resource
management and development.
The main objective of this study is to develop interior environment of residential building suitable for recovery elderly with dementia. There are three main steps for this study: 1) an investigation of behavior of using, obstacle and limitation of existing building affecting dementia recovery in elderly; 2) a study of characteristics of the interior environment and facility suitable for recovery elderly with dementia; 3) a study of post evaluation of dementia symptom of elderly after environment modification according to the study results. The study explored in two types of residential building which are a private house and a hospital. The study also proposed a design guideline of residential building and facilities for elderly with dementia. Results of the study shows appropriate interior characteristics of residential building suitable for recovery elderly with dementia. The results in the last section showed that dementia symptom is not reduced, when using in examination room which environment was modified by results of this study. But, the modified examination room could give the subjects feel more navigable, more preferred, led subject feel better well-being and more interested in the examination room. However, compared to an existing house, the results in the last section illustrated that dementia symptom of subject is reduced, when living in the house that environment was modified by results of this study. The modified house can also give a better wayfinding for the subject and can give the subject a better well-being. The subject is also more interested in the modified house.
The main objective of this study is to develop interior environment of residential building suitable for recovery elderly with depression. There are three main steps for this study: 1) an investigation of behavior of using, obstacle and limitation of existing building affecting depression recovery in elderly; 2) a study of characteristics of the interior environment and facility suitable for recovery elderly with depression; 3) a study of post evaluation of depression symptom of elderly after environment modification according to the study results. The study explored in two types of residential building which are a private house and a hospital. This study, also, propose the design guideline of residential building and facilities for elderly with depression. Results of the study shows appropriate interior characteristics of residential building suitable for recovery elderly with dementia. The results in the last section showed that depression symptom is not different, when using in examination room which environment was modified by results of this study. But, the modified examination room could make the subject less anxious, more preferred, and led subject feel better well-being and more interested in the examination room. However,   the results in the last section illustrated that depression symptom of subject is reduced, when living in house that environment was modified by results of this study. The modified house made the subject less stressful, less anxious, more preferred, and led subject feel better well-being and more interested in the house.
Development of working system and application for report and alert the quality and safety of health care products project was conducted to develop web application TaWai for Health version 1.0 (prototype) which have been used since 2016. This application was used in communities of health region 10 and 12 to report and alert in 3 topics including 1) adverse healthcare product reactions 2) unhealthy or illegal healthcare product and 3) illegal healthcare product advertising. The aim of this research was conducted to develop the efficacy and usability of the application by TaWai network and develop healthcare product problems database for consumers communication by 4 steps of development including 1) web application research and development 2) database development 3) TaWai network development and 4) communication method and media development for consumers and patients. After 1 year of research and development in 4 steps we could obtained 1) web application TaWai for Health version 2.0 which more satisfy the need of user. For 2nd step, TaWai for Health database could display the statistic and incidents of healthcare product problems in each area better than our previous database. For 3rd step, we could increase TaWai networks though our workshop in each area and provide practical healthcare product problems management guideline in community using web application TaWai for Health version 2.0 as management tool by 8 categories of users including reporter, pharmacist, admin in district level, admin in province level, admin in region level, user in region level, user in Country level and super admin. For final step, all problems that reported in web application TaWai for Health was summarized and created in to 6 videos and 6 infographics for communicate healthcare product problems to increase healthcare product literacy of consumers and patients. For future work, we would like to develop and apply our new application and management guidelines to be the alternative tool for customer protection in country level.
Objective: To study intraocular pressure (IOP) reduction after trabeculectomy compared with antiglaucoma medications in open angle glaucoma, including complications and evaluate the effect on quality of life and cost-effectiveness between two arms. Methods: This is a randomized controlled trial study that divided patients into 2 groups to receive trabeculectomy or antiglaucoma medications and analyze the clinical outcomes, quality of life and cost-effectiveness at 4 and 12 months. Results: There were 38 enrollment subjects, 18 eyes in trabeculectomy (Trab) group and 20 eyes in medication (Med) group. At baseline, mean (SD) IOP in Trab and Med groups were 25.86 (8.80) mmHg and 27.48 (9.85) mmHg, respectively. At 4 months, there were 17 and 18 eyes remained in Trab and Med groups. Mean IOP reduction (SD) were 19.29 (7.48) mmHg (38.67%) and 10.91 (5.51) mmHg (22.50%) in Trab and Med groups, respectively. The quality of life was assessed using visual function questionnaire-28 and found that Med group had better quality of life than Trab group at 1 year (p = 0.002). However, the results were different since baseline. The total cost was not different between 2 groups at 4 months and 1 year (p = 0.08 and 0.09). Conclusion: Trabeculectomy is more powerful than medications in IOP reduction with acceptable complications at 4 months and 1 year. The cost in Trab group was higher with similar quality of life. However, the sample size in this study is not enough, even after the recruitment strategy was modified. And therefore, may affect the final result. Further study: Evaluation of the outcomes between trabeculectomy and medications is still needed to be addressed. Gathering information about cost from hospital database in combination with an estimation of other expenses may be helpful.
The present research examined the RDU Hospital/RDU Service Plan projects through an evaluation of the policy effects on quantitative outcomes using an analysis of facility-based, electronic drug and healthcare databases. The main approach was an interrupted, time-series analysis determining changes in levels and trends of selected indicators before and after the RDU policies. The RDU Hospital policy had a statistically non-significant effect on the use of antibiotics in target conditions and drugs to be concerned with safety conditions. The RDU Service Plan, however, was statistically associated with a decrease in the use of antibiotics and glibenclamide. Regarding patient outcomes, the RDU Hospital/RDU Service Plan policies were associated with a decrease in hospitalization with drug-induced hypoglycemia but were not associated with hospitalization with asthma. The policies did not decrease the expenditures for non-essential drugs that were reimbursed for outpatients under the Civil Servant Medical Benefit Scheme’s direct disbursement system. It was estimated that the RDU Hospital/RDU Service Plan policies could help saving the drug expenditures by 126 million Baht in total over the years 2015-2018, of which 104 million Baht was attributed to the RDU Service Plan in 2017-2018. As the RDU Service Plan policy was found to be effective in reducing the use of problematic drugs with a high baseline use rate, future interventions should focus on the use of inhaled corticosteroids for controlling asthma. Additional lists of drugs and conditions with priority concerns on safety should be established.
This quantitative study on “Muslim Widows and Physical Activity Spaces: Health Promotion in the Deep South Unrest” aimed to investigate collaborations of the Provincial Islamic Councils, the Mental Health Center 12, and other relevant authorities on Muslim widows’ physical activity spaces in the unrest context through the views of 348 sample Muslim widows. Their suggestions for their health promotion activity were also to be proposed. The obtained data were analyzed by using the SPSS program. The findings indicated the following. Collaborations of public authorities and private sectors were most found at a moderate degree on giving an opportunity to widows to join community activities (30.5%), followed by a high degree (30.2%). The collaboration on support of Muslim widows’ physical activities, such as attending religious lectures, were most found at a high degree (39.1%), followed by a moderate one (31.6%). A majority of views on collaborations in building Muslim widows’ awareness of physical activity engagement was at a high degree (33.3%). The collaborations covered public relations forms and provision of physical activities suitable to their ages and Muslim femininity. Collaboration in provision of physical activity tools was the most reported at a moderate degree. Provision of single sex spaces for physical activity were mostly found at the lowest degree (41.1%). Below are suggestions for promotion of Muslim widows’ physical activity. 1) Provision of a specific space for Muslim widows’ physical activity is needed to promote both their physical and mental health. 2) A policy should be specifically made for improvement in Muslim widows’ life quality focusing on their physical and mental health, promotion and development their living, and providing female physical activity spaces suitable to all ages in the Deep South. 3) Assistance covering promotion and development should be provided for both widows and their children. 4) Continuous mental health rehabilitation is required by integrating into usual public health services. Continuation is essential for healing them. 5) More activities and greater promotion of doing both voluntary and collaboration activities among Muslim women are required.
Every form of asbestos is carcinogenic. Workers and general population exposed to asbestos can suffer negative health effects. Although, the third National Health Assembly’s Resolution (2010) proposed asbestos ban measures and the cabinet on April 12, 2011 approved the resolution, asbestos is still in use in Thailand. Some government agencies have not followed the resolution arguing too few asbestos- related cases to reach cost-benefit of the asbestos ban. Recent data reveal the increased numbers of asbestos-related patients and new measures to reduce the risk of developing asbestos-related diseases. Therefore, it is necessary to revise the National Health Assembly Resolution at the twelfth National Health Assembly: Thailand’s asbestos ban measures.
Obesity is a globally and locally important problem as can be seen from the increasing prevalence every year. Physician is an occupation directly related to people’s healthcare. However, 40% of physicians are overweight. Half of the overweight physicians think that they are at normal weight. There are many contributing factors for weight gain such as stress, shift work, high calorie food intake and low workout. These factors are usually found in residents. Obesity may directly and indirectly affect patients through patient care process and competency. Therefore, the obesity problem among physicians must be emphasized and alleviated in order to prevent further complications.