plueme/wizJson huggingface dataset:
The objective of this study is to estimate unit cost per day of long term care for dependent elderly in
Lamsonthi district from government spending perspective. Long term care services comprised services
from hospital, services from formal care assistance and services from family. Unit cost of services from
hospital was calculated using data from cost accounting of Lamsonthi hospital, which used a traditional
costing method of Ministry of Public Health. Unit cost of services from local government mainly was
salary of formal care-assistants. Cost of long term care services from family member was estimated using
opportunity cost concept, which opportunity cost was assumed equal to labour cost of formal-care assistants.
Total cost of long term care of hospital services were disaggregated into 3 products; severe dependent
service, moderate dependent service and mild dependent service using allocation by labour approach.
Workload of physiotherapists using simple time motion study was used as an allocation criteria
for disaggregate 3 products of the long term care. The result showed that total actual cost of long term care
service unit in 2012 of Lamsonthi hospital was 4.5 million Baht and total actual cost of formal care assistant
was 420,000 Baht in the studied district. Unit costs per day of long term care from services of both
Lamsonthi hospital and formal care assistant without opportunity cost of family members were 41 Baht,
64 Baht, and 101 Baht for mild, moderate, and severe dependence, respectively. Sensitivity analysis for
estimation unit costs per day of long term care include opportunity cost of family members was done by
replacement of support from family members with formal care assistant using ratio of time spending for
dependent elderly among family members and formal care assistant from Siriphan Sasat et al.(9).Unit cost
per day of mild, moderate, and severe dependence increase to 41 Baht, 128 Baht, and 200 Baht, respectively.
However unit cost of long term care depends on level of dependence and level of support from
family. This study found that the cost of severe dependent elderly, who depend totally on formal careassistants,
is still only one fifth of the cost of long term care in private nursing home. However, further
studies are needed to confirm result of this study, which has limitation on statistics and came from only
one district.
This study aims to investigate the association between substitutes for leadership and organizational citizenship behavior of 534 public health officers in subdistrict health promoting hospitals under the inspection of Region 10, the Ministry of Public Health. The sample group was randomly chosen using stratified sampling. Data were collected by using questionnaires. Statistical analysis was performed using the computer program of Pearson’s Product Moment Correlation Coefficient and Multiple Regression. Results revealed that public health officers had moderate organizational citizenship behavior. Substitutes for leadership had a low positive association with the organizational citizenship behavior of public health officers (r = 0.266, p-value ≤ 0.05). Substitutes for leadership could explain 11.90% (Adjusted R2 = 0.119) of the variance in organizational citizenship behavior. To achieve effective substitutes for leadership of public health officers at subdistrict health promoting hospitals, the creation of a self-development manual is suggested for public health officers to develop the leadership and train public health officers at every level, introduce the mentoring system and promote on the job training approach.
Health workforce is one of the most important factors of health system. However, global society and Thailand have currently faced with shortage and maldistribution of health personnel especially rural doctors. This problem may affect the achievement of Millennium Development Goals and equity in accessing to health services. To solve the problem of rural doctor shortage, it needs systematic approach starting from medical education. Thai government has established the Collaborative Project to Increase Production of Rural Doctors: CPIRD with collaboration between the Ministry of Public Health and Ministry of Education to solve the problem since 1994. This article presents a good case study of transformative learning of Maharat Nakhon Ratchasima Hospital’s Medical Educational Center related to the activity “Medical camp for enhancing experiences of medical students”. This camp is an extra-curricular activity
using transformative learning. Outcomes of this activity are to enhance medical students to understand
rural people as a whole, be familiar with rural contexts, and be satisfied with rural work, as well as gain the skills required from the CPIRD and needed for the 21st century. This activity has also affected the development of teaching and learning processes of the medical instructors following the framework of transformative learning. Therefore, educational institutes producing physicians and other health professionals should organize this kind of co-curricular activity to enhance rural and inter-professional experiences of students who will become health professionals in the future. The Ministry of Public Health and the Ministry of Education may consider this activity to be policy for developing education of health professionals in the 21st century. However, systematic and continuous outcome evaluation of the activity is needed in order to develop a more beneficial and effective co-curriculum.
Although approximately 6,500 nurses graduate from over 80 nursing institutions each year, there
seems to be no end in sight to nursing staff shortage. This shortage is both in numbers and in terms of
essential skills to meet the complex needs of the community. In Khon Kaen province, public health care settings have also faced the nursing staff shortage problem, especially at health centers in the rural areas.
The health personnel data of Khon Kaen Provincial Office show that novice nurses prefer to work at the
hospitals more than at the health centers and the attrition rate of the nurses in all levels of health care
settings is high. To overcome the problem, the Community Nurse Production for Community and by
Community Project was launched in Nam Phong District in 2002. It was effectively run and sustained by
the collaboration of several organizations in the community. An evaluation revealed that the shortage was
decreasing while the retention rate was increasing. Thus, Khon Kaen Provincial Office, Khon Kaen Hospital,
readiness community hospitals and Boromarajonani College of Nursing, Khon Kaen agreed to expand
the project to produce 200 community nurses within seven years, from 2009-2015, to cover most areas of
Khon Kaen. After participating in the project, the college has adjusted teaching and learning activities of
both curricular and co-curricular activities by using integrated education approach to develop essential
knowledge and skills for community nursing students. Hence, it can be concluded that the Community
Nurse Production for Community and by Community Project has significantly transformed nursing education
and nursing workforce in Khon Kaen province.
Nursing shortage leads to health problems and health equity of people in rural areas of Thailand. Namphong and Ubolrat Hospitals are community hospitals in Khon Kaen province that used to have nursing shortage. Thus, they have integrated transformative learning to produce community nurses who can stay longer in community. They have collaborated with several stakeholders, such as sub-district administrative organization, Boromarajonani College of Nursing Khon Kaen and College of Asian Scholars to start çthe Community Nurse Production for Community and by Community Projecté. To enhance capability, newly qualified nurses have to participate in several activities, including: 1) learning community with experienced nursing mentor 2) training in “near home near heart” project, and 3) training in transformative learning for self reliance under a concept of the “Sufficient Economy and Sustainable Development Philosophy” of His Majesty King Bhumibol Adulyadej. The projects’ aim is to prepare newly graduated nurses to become change agents for self sufficiency and to live their life happily in their community.
Diabetes management is an essential strategy for better accessible to qualified health care services.
People with diabetes should have learned how they can live with diabetes by adjusting food intake, exercise,
medication regulation, monitoring blood sugar and interpretation. Theptarin Hospital is a role model
of public health that support people with diabetes for lifestyle modification through diabetes selfmanagement
education with varieties of activities of class, camp, and club. With public health concerns,
Theptarin Hospital builds partnership with the National Health Security Office and the Ministry of Public
Health to deliver diabetes case management and foot care education to nurses and physicians across
country. Family doctor should be a doctor who gives holistic care for a patient with diabetes. These
strategies propose that diabetes self-management education and multidisciplinary approach could prevent
complication and better diabetes control. Theptarin Hospital has developed a good practice of transformative
learning for better outcomes of diabetes management in Thailand.
This study is aimed at reviewing how elderly people in Thailand access to dental prosthesis service
comparing 2009 with 2013. Primary data was derived from two major household surveys conducted by
National Statistical Bureau in 2009 and 2013; health and welfare survey, and economic and social status
survey (n = 26,500 households in 2009 and 27,960 households in 2013). Extrapolation to total population
by weight was then calculated.
It was found that proportion of ageing population covered by health insurance in 2009 and 2013 was
97.3 and 97.9%, of which national health insurance scheme contributed 79.3% and 80.9% respectively.
Among them, dental health care utilization was low as 8.2-8.7%. Additionally, the percentage of accessing
to dental prosthesis services increased from 15.6% in 2009 to 15.8% in 2013. Most of the elderly (38.2-
40.3%) seeked dental prosthesis through private services. While a percentage of the omission of health
insurance scheme prevailed at 57.6 in 2009, reduced to 52.1 in 2013. On the other hand, utilization of
dental prosthesis among the elderly with high and low income in Bangkok and municipality areas in 2013
was found 2.8 times higher than the elderly with low income in rural areas. This viewed obviously the
inequity in access to dental prosthesis among elderly people in Thailand.
Despite substantial evidence about the benefits of fall prevention interventions, they have not been
well incorporated into primary care practice. Raising community awareness and attitude toward fall prevention
program is one of the effective strategies to translate the program into practice. The elderly patients need to be aware of the potentially deteriorating effects of their chronic diseases and falling, and
are prepared to manage to reduce fall risk. Educating the elderly and their family on fall prevention by
using audiovisual media and involving community volunteers can be key to successful intervention. This
embedded mixed methods study aimed to compare attitudes and awareness on fall prevention among
community-dwelling elderly (n =144) and their family (n = 100) before and after an educational program
that employed audiovisual media and involved community volunteers. A pre-test/post-test only design,
with structured questionnaires measuring attitudes and awareness on fall prevention, was used for the
quantitative arm. Focus groups were used to interview three groups (ntotal = 38: n1 = 8, n2 = 15, n3 = 15), and
these interviews generated narratives regarding the educational program for the qualitative arm. Quantitative
results showed that the attitudes and awareness scores were statistically higher after the educational
program. Statistically significant areas included exercise and fall prevention. In summary, educating
the elderly and their family by using audiovisual media and involving community volunteers was
found to be one of the important steps toward translating fall prevention guideline to Thai’s community
successfully.
The distribution problem and inequality of nurse workforce adversely affect health services in terms
of effectiveness and operational efficiency in health system and also affect the quality of health services.
Nurse workforce should be investigated for solving these problems. This study aimed to investigate
geographical distributions of Thai nurse workforce and to estimate nurse workforce inequality in Thailand.
Those data were obtained from two data sources, Thai Nurses Cohort Study: Health and Working
Life and surveys and the database of the Ministry of Public Health during the year 2005 - 2009. We
analyzed data by frequency and percentage to reflect the distribution of nurse workforce and Gini coefficients
were used to estimate the inequality. The study found that the distribution of nurse during the year
2005 - 2009, the north-east region has the highest ratio of population per nurse (825.30 to 1009.38) while
Bangkok has the lowest ratio (240.19 to 430.70). The level of nurse workforce inequality ranged between
11.42-18.91% and the trend of Gini coefficients demonstrated that the situation of nurse workforce inequality
tends to decrease in the year 2009.
This research is descriptive study. The objectives are:- 1) to study learning organization development
level 2) to study effectiveness level 3) to study the relationship between learning organization
development of nursing department and effectiveness of patient unit perceived by registered nurses in community hospitals in Phranakhon Si Ayutthaya Province 4) to study problems and obstacles in the
process of their works. The studying populalion of 156 registered nurses in 14 community hospitals in
Phranakhon Si Ayutthaya Province were involved. Data was collected by questionnaires devised by researcher
and tested for content validity and reliability. Data collection was done in November 2013, and
percentage, mean, standard deviation and Pearson’s product moment correlation coefficient were used
for data analysis.
The result showed that the overall learning organization development of nursing department in
community hospitals in Phranakhon Si Ayutthaya Province was at moderate level (x = 3.27, SD = 0.60).
The overall effectiveness of patient unit perceived by registered nurses in community hospitals in
Phranakhon Si Ayutthaya was at moderate level (x = 3.44, SD = 0.51). There was a significant positive
relationship at high level between learning organization development of nursing department and effectiveness
of patient unit perceived by registered nurses (r = 0.748) at P = 0.01 level. Problem and obstacles
were personnel shortage (16%) and lack of staff morale (12.82%).
Suggestions from this research:- head nurses should learn or study more about human resource
development and try to develop learning capacity of each personnel, promote team to participate in policy
development process, and provide other essential factors for organization development.
This study was aimed to compare health problems and health care behaviors between clinical nurses
and non-clinical nurses. This study used secondary data from Health and Working Life of Thai Nurses
Project that collected data from registered nurses who hold nursing licenses granted by the Thai Nursing
and Midwifery Council during 2002-2009. Data were analyzed using descriptive analysis with frequency,
percent, mean and standard deviation and using Chi-Square test for comparison.
Results: Total of 18,763 registered nurses includes 15,773 of clinical nurses (84.1%) and 2,992 of nonclinical
nurses (15.9%). Musculoskeletal diseases were the most common health problem in both clinical
and non-clinical nurses, 47.8% of clinical nurses and 53.7% of non-clinical nurses, followed by dyslipidemia,
hypertension and viral hepatitis. Clinical nurses experienced insomnia and job strain higher than nonclinical
nurses. In terms of health care behaviors, findings revealed that both clinical and non-clinical
nurses had awareness to get regular checkup. The non-clinical nurses preferred to visit medical specialist
more often than the clinical nurses, but used prescription drugs less often than clinical nurses.
The objective of this study was to determine outcomes of salmeterol/fluticasone (SFC) and budesonide
(BUD) for asthma control in real-life situation in community hospitals. A retrospective cohort study was
conducted to collect data from Easy Asthma Clinic database year 2007-2011 in seven community hospitals.
Uncontrolled asthmatic patients with medium-dose BUD who were prescribed SFC or BUD were
divided into three groups: 1) medium-dose BUD (n=170), 2) high-dose BUD (n=88) and 3) SFC 50/250 μg twice daily (n=128). The patients were followed for a year to measure the study outcomes. Comparative
treatment outcomes were analyzed using multivariable analyses to control potential confounders. The
results revealed that the proportions of well controlled patients were 7.6%, 20.0% and 28.9% in mediumdose
BUD, high-dose BUD and SFC group, respectively (p<0.001). The proportions of patients with emergency
room visit were 45.3%, 30.7% and 28.1% in medium-dose BUD, high-dose BUD and SFC group,
respectively (p=0.009) whereas the proportions of patients with hospitalization were 20.6%, 17.5% and
19.5% in medium-dose BUD, high-dose BUD and SFC group, respectively (p=0.902). Side effects of the
medications were 5.9%, 10.2% and 0% in medium-dose BUD, high-dose BUD and SFC group, respectively
(p=0.002). Comparing with medium-dose BUD group, SFC group achieved well controlled more than
9.16 times (OR=9.16, 95%CI: 3.88, 21.64) and decreased emergency room visits by 47% (HR=0.53, 95%CI:
0.35, 0.79). Differential outcome between high-dose BUD and medium-dose BUD was not found. In conclusion,
salmeterol/fluticasone provides better outcomes and fewer adverse effects than budesonide.
This study was conducted to determine the prevalence of medication non-adherence and identify
factors associated with medication non-adherence among 230 patients with type 2 diabetes mellitus in
Nongjik Hospital, Pattani province from August 2013 to December 2013. Medication adherence was assessed
by self-report patients in term of taking medications. Frequency, percentage, mean and standard
deviation were used to present the analysis results. Multiple logistic regression analysis was used to determine
factors associated with medication non-adherence. Adjusted odds ratios (aOR) and their 95%
confidence interval (CI) were used to present the strength of association.
Of the 230 study patients, 64.8% had medication non-adherence. Factors associated with medication
non-adherence included religion (aOR 2.68, 95% CI 1.10, 6.48) self- management (aOR 8.41, 95% CI 1.13,
62.72) combination of oral anti-diabetic drug and Insulin (aOR 7.16, 95% CI 1.35, 38.13) frequency twice
daily (aOR 4.44, 95% CI 1.51, 13.06) frequency three times daily (aOR 13.80, 95% CI 3.19, 59.78) and number
of tablets per day (aOR 2.28, 95% CI 1.16, 4.51)
The high prevalence of medication non-adherence among the study group needs corrective measures.
These may include assessment of medication adherence and modify treatment for each case especially
in Muslim patient with medication adherence.
One of the interventions in order to prevent unhealthy diet habits of children is law or regulations to
control advertising. This article is the review of an evolution and enforcement of the regulations in 6
countries, UK, USA, Brazil, Australia, Singapore and Thailand. A wide variety of publications, databases from websites, reports and books from 2001 to 2011 that involving about regulations of food advertisement
were studied. It was found that the content of laws and regulations related to advertising food and
drinks with high sugar, fat and sodium in all six countries indicated that advertising must not contain any
false, misleading, and deceptive statements, and/or misrepresentation on products. However the limitations
about times and duration of advertising were different. Brazil has a bill to ban advertising from
6 a.m. to 9 p.m. but Singapore has no time limitation.
In conclusion, Thai government should develop advertising legislation and regulations related to
food and drinks with high sugar, fat and sodium in order to reduce consumption of these risky foods and
beverages among children and youth in Thailand.
The research and development study aimed to develop a model of lifestyle intervention to prevent type 2 diabetes mellitus (DM) in high risk group. 
Methods:	The study was divided into two phases, phase one developed a lifestyle program and phase two evaluated the effectiveness of the model using quasi-experimental study. According to phase two, the participants were selected from high risk group of DM in the local community, Kudjub district, Udonthani province, north-eastern part of Thailand. The lifestyle program was applied from the diabetes prevention program (DPP). Researcher team and public health nurses in District Health Promoting Hospitals (DHPH) performed seven meetings to deliver education and empowerment consisted of healthy diet, physical activity, stress management and social behaviors. The participants in intervention group were encouraged to match as a “buddy” for coaching each other throughout 16 weeks of the program. The outcomes were body mass index (BMI), waist circumference (WC), fasting blood sugar (FBS), health behaviors, and satisfaction of the program.      
Results:    Totally, 30 persons in intervention and 30 in control group participated. Most of them were women (73.3%), and the mean age was 51.2 years. The mean of BMI was 28.4 kg/m2, FBS was 95.3 mg/dl, and waist WC was 93.8 centimeters. After 16 weeks, adjusted mean difference (MD) of FBS (90.1 mg/dl in intervention vs 95.3 mg/dl in control group) and BMI (25.7 vs 29.1 kg/m2) were not significant. WC was significantly decreased in intervention group compared to control group (MD –5.9 cm; 95%CI = –9.4 to –2.4; p=0.001) Health behavior score (MD 3.6 score; 95%CI = 0.3 to 6.9; p=0.035) and knowledge (MD 2.0 score; 95% CI=0.6 to 3.4; p=0.006) were significantly increased in intervention compared to control group. Overall, 96.7% of the intervention group was satisfied and very satisfied with the program.  
Conclusion: 	Lifestyle intervention program demonstrated significant improvement in WC, health behaviors and knowledge. The program could lead to prevent type 2 DM in the local community.
This research proposes using technique data mining modeling support an expert
system to advise nutrition and physical therapy for chronic disease elderly patient on
mobile device. The development of model with weka3.6.9 program, by using the algorithm
classification of patients with simple k-means and the apriori for generating association rules.
The distance measurement of data with percentage split66% from each of disease 250
samples. Then create rules in the group of 10 on minimum confidence level 0.9. That are
rules used for nutrition and physical therapy each of disease 80 rules for the use of
embedded code on the application to run through the user interface on mobile devices.
For example, patients with diabetes were K= 4 : 5 dimension and K= 4 : 4 dim, hypertension
K=4 : 5 dimension and K= 4 : 4, hepatitisB K=4 : 5 and K= 4 : 4, osteoarthritis K= 4 : 5 and K=
4 : 4, paralysis K= 4 : 5 and K= 4 : 4 and parkinson K= 4 : 5 and K= 4 : 4 for the physical and
nutrition therapy respectively.