plueme/wizJson huggingface dataset:
This quasi-experimental research study was aimed at assessing the effect of the positive
self-talk training program on anxiety in patients with generalized anxiety disorder.
All subjects were outpatients of the Takfa Hospital, Nakhon Sawan Province, seen during
the period October through December 2007. The study was one of a group of pre-post
tests conducted on 15 subjects obtained from random sampling. Research instruments
comprised (1) a demographic data form, (2) the translated version of State-trait Anxiety
Inventory of Spielberger, and (3) the Positive Self-talk Training Program based on the
concept of Nelson-Jones. Data were analyzed using descriptive statistics and paired ttest.
The findings were that the state-anxiety score of the patients decreased significantly
after they joined the Positive Self-talk Training Program (p < 0.05). The finding suggests
that the methodology could be taken as a guideline for ameliorating anxiety in patients
with generalized anxiety disorder.
This cross-sectional study was conducted with the objective of determining the hospital
staff’s health behavior, health conditions and differentials in health behavior conforming
to the six-habits policy of the Ministry of Public Health. Data were collected by
questionnaires administered among 120 hospital staff in September 2007.
The results indicated that almost all of the hospital’s staff were in good health, without
remarkable underlying disease and had no work-related injury or illness. The problems
that disturbed them, making them worried or nervous, were their job and debt, but
they were able to manage somehow. Minor problems were indigestion and constipation.
Overall health behavior, including food consumption, environmental sanitation,
wealth, temptation, and temperament, was at a moderate level. By contrast, their exercise
behavior was at a low level. The differences in age, working hours and educational levels
were not related to health behavior; however, gender, marital status, job position, work
experience, job description and health conditions were related to their health behavior.
The objectives of this study were to: (1) examine the quality of life of HIV-infected
persons and patients; (2) identify the factors related to their quality of life, and (3) map
out the problems and seek ways to improve their quality of life.
A questionnaire was employed as the research instrument to obtain information
from 180 HIV-infected persons and patients who had been members of the Ruam Nam Jai
Rim Nam Lao Group in Mae Lao district, Chiang Rai Province, for at least three mouths.
Frequency, percentage, t-test and F-test were used for data analysis. About 50.6 percent of
the subjects were females, aged below 35 years (43.9%) and married. The majority (68.9%)
had finished elementary school. The majority (60%) were engaged in general employment
or in agriculture (33.9%), among others. The average monthly income was below
1,000 baht (42.80%). Most of them had been members of the Ruam Nam Jai Rim Nam Lao
Group for four years or more. The reason for joining the group was to access the facilities
to look after their own health and to get anti-AIDS medicines. They participated in the
group activities 1-4 times. They learned that they were HIV-infected at least six years
previously. They experienced a mild ill-feeling approximately once a month. The period
of treatment with anti-HIV medicines was one and a half years to three years. To a great
extent, they looked after their own health ( x = 0.74 out of 1).
Overall, the quality of life of the HIV-infected persons and patients was moderate
(x = 3.59 out of 5). When the individual dimensions were considered separately, it was
found that the quality of family life and that of community life were high ( x = 4.07 and
3.84, respectively). Their health and economic security were found to be moderate ( x =
3.43 and 3.03, respectively).
The factors relating significantly to their quality of life at the 0.05 level were gender,
marital status, income, length of time knowing about their HIV infection, and the nature
of their illness, respectively. In contrast, education, number of years of taking anti-HIV
medication and self-care were all found to have no relationship to their quality of life.
From the findings of the study, the researchers were able to compile some suggestions
for improving the situation of the HIV-infected persons and patients in the communities;
the details of the study are described in the text.
The objective of this study was to explore the performance of the diabetic patients’
care system that referred patients to the primary care unit (PCU) in the Kantang network
health service one year ago. It was to compare the output of care between, before and
after patients were referred for diabetic care from Kantang Hospital to the PCU. A self-administered questionnaire, using the PRECEDE PROCEED Model, was used
among 14 PCU personnel and 97 patients between October 1 and 31, 2007. The study
found that most of the participants were in the age group 41-55 years (40.2%), females
reprecented the majority of them at 79.4 percent, couples at 81.4 percent, the level of education
at the primary school level at 76.3 percent, agricultural occupation at 32.0 percent,
duration of disease 1-5 years at 83.5 percent. The participants with no related disease
comprised 51.5 percent of the total; those with hypertension, 32.0 percent, normal body
mass index (BMI), 55.7 percent and higher level at 41.2 percent. The levels of blood sugar
both before and after referral were not different. Loss to follow-up after referral decreased
significantly (p-value < 0.05). The level of knowledge about diabetes was found to be at
high at 76.63 percent. With regard to the level of behavior for diabetic control, the highest
behavior was drug use at 92.58 percent; the least behavior that patients performed was
exercise activity at 52.80 percent. The association between knowledge and behavior with
regard to eating, drug use and general health care was moderate, but with stress management,
low there seemed to be no effect on exercise activity behavior. Concerning the
service that patients got at the PCU after referral, almost all items were high at more than
90 percent, except participation in group practice activity, which was moderate at 14.4
percent. The level of the patients’ satisfaction toward the service was found to be moderate
to high, at 86.94 percent.
The overall findings indicated that the output of care both at the DM clinic in the
hospital and the PCU was not different; thus, this system can continue to perform but
there should be concern about the problems and attendance.
Handwashing is an important method for the prevention of nosocomial infection,
especially in light of the fact that all health personnel, i.e., doctors, nurses, and others,
have contact with patientsû blood, excreta and secretions. The objectives of this cross-sectional study were to determine the rate of handwashing
practiced, the accuracy of handwashing and average times spent in handwashing among
health-care personnel in Khuankalong Hospital. The study was carried out in the period
from April 1 to 30, 2006. Participant observation with a check-list form was used for data
collection on 43 subjects, comprising physicians, nurses, dental health workers and laboratory
technicians, using purposive sampling. Descriptive statistics were used for data
analysis.
The results of the study disclosed that, from 118 observations, the handwashing and
accuracy rates of health-care personnel were 88.98 percent and 17.14 percent, respectively.
The handwashing rates among physicians, nurses, technical nurses, dental health workers
and laboratory technicians were 43.75 percent, 100 percent, 100 percent, 100 percent
and 50 percent, respectively. It was evident that the health-care personnel of Khuankalong
Hospital had a very high rate of inaccuracy in handwashing (82.86%) while their
handwashing rate was only 88.98 percent. Thus, it is mandatory that all health-care personnel
in this hospital should be encouraged to attend the intensive training course focusing
on handwashing in order to reduce the occurrence of nosocomial infection.
This study was aimed at evaluating the clinical practice guidelines for the management
of dengue hemorrhagic fever by evaluating the knowledge of doctors, nurses and
subdistrict health officers in Nonthai district and by evaluating the care map of dengue hemorrhagic fever patients in Nonthai Hospital. The results showed that the knowledge
accuracy rates of doctors, nurses and subdistrict health officers concerning dengue hemorrhagic
fever were 87.5, 81.0 and 78.7 percent, respectively. Incorrect knowledge concerned
the proper time to order a tourniquet test, the proper type and volume of intravenous
fluid to administer to patients in the febrile stage, the proper volume of intravenous
fluid to administer to patients in shock.
Conformity to the clinical practice guidelines for dengues hemorrhagic fever was
89.6 percent and the non-conformity with the guidelines was as follows: the order of
tourniquet test, 73.9 percent correct; the order of intravenous fluid in the febrile stage, 67
percent correct. The frequency of recording the vital signs in the shock stage was 68.2
percent correct; that of intake/output in the shock stage, 60.2 percent and urine specific
gravity, 3.4 percent correct.
The treatment outcomes of dengue hemorrhagic fever were 94.3 percent recovery,
5.7 percent referral, 4.5 percent complication, and zero deaths. The research found that
the main problems in the management of dengue hemorrhagic fever were incorrect knowledge
and non-conformity with the clinical practice guidelines by the Patient Care Team.
The research findings will be used as baseline data for improving the clinical practice
guidelines and the teaching programme in Nonthai district and Nakhon Ratchasima Province.
This descriptive research study was aimed at assessing the progress of antivirus
treatment, the difference in CD4 related antivirus treatment formulation before and after
treatment. The sample population comprised cases of HIV/AIDS who were treated at
Wanghin Hospital, Srisaket Province in the period from 2003 to July 31, 2007. The study
used secondary data on 89 cases of HIV/AIDS. Data analysis was carried out by using a
computer program. The mean difference was calculated by chi-square, t-test and paired
t-test. The samples comprised male patients (52.8%), female patients (47.2%); and 56.2 percent of the samples were aged 31-40 years. The CD4 counts in the five-year period
exceeding 200 cells/mm3 were 35.5, 40.0, 60.7, 65.5 and 84.4, respectively. There were two
antivirus treatment formulas, i.e., GPO vir, which was used in 80.9 percent of the cases,
and the formula of D4T, 3TC and Efavirenz in 19.1 percent of them. There was no difference
in the CD4 count between the two drug formulations, but the differences were significant
at the 0.001 level between, after and before treatments. CD4 cells exceeding 200
cells/mm3 were found in 93.8 percent of the female patients and in 75 percent of the male
patients, which was significantly differnt (p< 0.05). Based on the present research, it is
recommended that the patients should receive drugs continuously and follow-up, evaluation,
and patient care should be provided continuously.
The purpose of this cross-sectional survey was to determine the factors influencing
village health volunteers’ performance in the prevention and control of dengue hemorrhagic
fever in Phisalee district, Nakhon Sawan Province. The participants consisted of
303 village health volunteers in that district, who were studied from July 1 to August 31,
2007. A questionnaire was used for collecting information and the data were analyzed by Pearson’s product moment correlation coefficient and stepwise multiple regression. The
findings disclosed significant relationships between the village health volunteers’ performance
and the following factors, i.e., their income, experience with motivational and
supporting factors. These four factors had a 46.7 percent power of prediction. Therefore,
public health offices should pay attention to and continue the development of public
health volunteers. This should be done through motivational training that promotes sustainable
performance and organization loyalty. In addition, the public health offices should
provide sufficient public health resources for the prevention and control of dengue hemorrhagic
fever. Future studies might focus on the effectiveness model of village health
volunteer performance in preventing the occurrence of dengue hemorrhagic fever cases
in villages.
Distal sensory polyneuropathy (DSPN) has commonly been found in HIV patients.
This cross-sectional study was carried out in the period January 1 to December 31, 2007 in
order to determine the prevalence and risk factors of distal sensory polyneuropathy (DSPN)
in 100 outpatients treated for HIV infection at the infectious clinic of Kanthrarawichai Hospital.
The criteria for the diagnosis of DSPN was one of the following neurological signs,
i.e., decreased or absent ankle jerks, decreased or absent vibratory perceptions at the toes, or
decreased pinprick or temperature sensation in the area of stocking distribution. Subjects
were classified at each visit as being asymptomatic DSPN (ADSPN) (signs only) or symptomatic
DSPN (SDSPN), on the notification of numbness, paresthesia or pain.
Of the total, 32 percent of the subjects met the criteria of DSPN, 28 percent were classified
as ADSPN, and 72 percent SDSPN. Height, cigarette smoking, hypoalbuminemia and
taking fluconazole were risk factors, with the P-values being 0.021, 0.045,0.047 and 0.032,
respectively, using univariate analysis. However, multivariate analysis did not show significant
risk factor association between HIV patients and those with DSPN. It was concluded
that there were no significant risks factors for DSPN in HIV-infected patients.
To examine the correlation between capillary whole blood glucose and plasma glucose
determined by a capillary glucose biosensor (Accu-Chek Advantage) and the standard
venous glucose oxidase test, a descriptive cross-sectional study was conducted on
267 diabetic patients who attended the DM Clinic of Srichiangmai Hospital from August
to September 2007. A pair of finger-tip capillary whole blood and venous blood samples were collected from each subject for glucose determination by the capillary glucose biosensor
(Accu-Chek Advantage) and the standard venous glucose oxidase test. Correlation
of the results from both methods was performed by using the correlation coefficient
and linear regression methods.
The mean level of capillary whole blood glucose was 156.08 mg/dl, and of plasma
glucose, 171.73 mg/dl. The mean plasma glucose level was 9.1 percent higher than that of
the capillary whole blood. The correlation coefficient (r) of the two methods was 0.913.
The plasma glucose level may be estimated from the known capillary whole blood glucose
level by the linear regression equation: Y = 0.824X + 14.574.
The glucose levels determined by the capillary glucose biosensor (Accu-Chek Advantage)
correlated well with those obtained by the standard method (Glucose oxidase
test) which represents the actual blood glucose level. Accu-Chek Advantage can be used
for both DM screening and patient follow-up; the actual glucose level, which was determined
by the glucose oxidase technique, can be calculated using the linear regression
equation.
The viral load (VL) test is not widely available in Thailand for HIV follow-up, which
relies mostly on CD4 count and clinical manifestations. Kuchinarai Crown Prince Hospital
(KCPH) has implemented the VL test in collaboration with MSF-Belgium. Coherent
PHA (N=128) for 2-7 years, including VL, CD4 count, clinical symptoms and Karnofsky
score 90-100, were used. The first arm reading involved 88 cases (68.75%) with undetectable
VL (<50 copies/ml), 84 (95.45%) having good CD4 count with no OI symptoms; that
of arm 2 involved 33 cases (25.78%) with VL between 50 and 1,000 copies/ml, with 30
cases (90.91%) having good CD4; that of the last arm involved 7 cases (5.47%) with VL >
1,000 copies/ml, of which 4 cases (57.14%) has good CD4.
Arm 2 received adherence counseling, followed by second and third VL follow-up
(3-month interval) resulting in undetectable VL after the second interval.
Arm 3 (last arm) showed no improvement in 4 cases (57.14%). They were put on
second line ART. At the end of the study, 124 cases (96.88%) out of 128 cases were undetectable
(VL < 50 copies/ml); while 4 cases (3.13%) with VL > 1000 copies/ml became
resistant to the first line ART and were switched to the second line ART.
The study shows that the systematic VL test should be included in HIV treatment to
detect treatment failure (i.e. virologic failure). The VL test is a tool for PHA active involvement
addressing adherence.
Viral load test should comprise a minimum package for HIV treatment in Thailand.
Our study shows that proper follow-up with systematic (client center) VL test reduces
the cost of second line treatment.
A study was conducted to determine the outcome of treatment following the GINA
(Global Initiative for Asthma) guidelines 2006 on asthmatic patients visiting Kanthararom
Hospital, Srisaket Province. The guidelines stressed the reduction of bronchial hyperresponsiveness
and treatment of bronchospasm. A total of 128 asthmatic patients (having
340 visits) during the period January 1 to July 31, 2007 were interviewed and the peak
expiratory flow rate (PEFR) measured by experienced nurses. The patients were then
treated according to the guidelines. Of the total cases, 61.72 percent were female. The
mean age of the first asthmatic attack was 35 years. The admission rate within one year of
the interview was 30.47 percent and the incidence of acute severe symptoms (ER visit)
was 76.57 percent. The drugs used in the patients comprised inhaled corticosteroid (ICS)
35.15 percent, oral corticosteroid 5.45 percent, B2-agonist combined with corticosteroids
inhalant 18.75 percent, and ICS combined with long-acting B2-agonist 12.50 percent. These
patients made visits to the asthma clinic an average of 2.65 times in four weeks. The
results of treatment producing total asthma control were 12.94 percent, good control 30.58
percent, and poor control 56.47 percent. Since a significant number of treated cases remained
in the poorly controlled category, it is reasonable to conclude that the increased
practice of ICS may be effective in reducing ER visits and hospitalization.
Objective : To assess the coverage of the type 2 diabetes screening program among
the high-risk population in the catchment area of Phonphisai Hospital, Nongkhai Province
before and after the implementation of the application of the Ministry of Public
Health’s operative plan for diabetes screening.
Methodology : The target population comprised residents of the catchment area
aged 40 years and older who were covered by health insurance during the period 2003-
2005. Verbal screening of the Ministry’s Bureau of Non-communicable Disease was used
in the diabetes mellitus screening program. Annual data about the number of the target
population, persons screened, and detected diabetes cases relevant to the catchment area
of Phonphisai Hospital were collected for the years 2003 to 2007. The coverage and prevalence
rates of diabetes mellitus were then analyzed and presented.
Results : The coverage rates of diabetes mellitus (DM) screening in 2003-2004 and
in 2005-2007 and the application of the Ministry’s operative plan for DM screening were
49.76 and 78 percent, respectively. The population with the highest coverage rates were
females and those in the 50-59 year age group. The overall DM prevalence rate during
the period 2005-2007 was 2.46 percent. Detailed analyses showed that males had lower
prevalence rates than females, and the 50-59 age group had the highest DM prevalence
rate compared with the other age groups. Compared with the whole Nongkhai Province,
DM was more/less prevalent in the catchment area of Phonphisai Hospital. The DM
prevalence rates for these two areas for 2005 were 419.02 and 286 per 100,000 population,
respectively.
Conclusions : The application of the Ministry’s operative plan for DM screening
resulted in clarification of its policy and importantly that of the Chief Provincial Health
Officer as well as the vision of the administrator as the Director of the District Hospital
applies to his operating staff with regard to the participation and integration of the community
and to increases in the effectiveness of efforts to detect DM cases in the catchment
area of Phonphisai Hospital. Thus, the Ministry’s operative plan for DM screening should
be continued and applied to other areas.
A study was conducted to determine the factors associated with depression and
suicidal risk among 359 residents aged 35 years and older living in Ko Sichang district,
Chonburi Province. The subjects were recruited by random sampling from the household registry. Information was obtained using the questionnaires prepared for the detection of
depression and suicidal risk by the Department of Mental Health of Thailand’s Ministry
of Public Health. Chi-square test and probit regression analysis were used to determine
the factors associated with depression and suicidal risk. Of the 359 persons interviewed,
35.93 percent were male and 64.06 percent female; 34.26 percent of them were aged 40-49
years and 64.35 percent had an educational level of primary school; 59.33 percent had a
monthly income of less than 5,000 baht; and 38.44 percent suffered a chronic disease. The
care-givers who accompanied the study population to the health-care centers for treatment
were mainly their family members (53.20%). Of the persons surveyed, 22.56 percent
suffered depression (depressive score > 6) and 13.37 percent were at risk of suicide
(suicidal score > 2). It was apparent that chronic illness was a significant factor associated
with depression, while higher educational levels and having intimate care from family
members or relatives such as accompanying them for health-care services seemed to reduce
depression. Having a chronic disease was also a significant factor associated with
an increase in suicidal risk. Further prevention or reduction of depression or suicidal risk
among people with a chronic disease is essential. Family members and relatives may help
this population at risk to reduce their depression.
The objective of this quasi-experimental study was to determine the effects of counseling
on self-care behavior among diabetic patients in Nongpok Community Hospital,
Roi Et Province. The subjects included 30 diabetic out-patients with a fasting plasma
glucose level > 140 mg/dl who were selected by purposive sampling from those attending
the diabetic clinic and agreed to participate in the study. They received counseling on
self-care issues in respect of food modification, treatment and drug use, foot care, emotional
control, prevention of complications, and proper exercise. Data on self-care behavior,
fasting plasma glucose, and body mass index were obtained from the participants
before and three months after the program ended. Percentage and mean were used for
descriptive analysis; Pearson’s correlation, chi-square test or paired t-test were used to
determine the association between data before and after the program.
The results showed the mean scores of self-care behavior following the counseling
program were significantly higher than those obtained on commencing the program, and
the levels of fasting plasma glucose were significantly reduced after the counseling program.
The body mass index of the patients, however, remained unchanged. Counseling
on self-care behavior may be advocated for use in diabetic patients.