plueme/wizJson huggingface dataset:
The main objective of this study was to determine the people’s perspectives and expectations on devolution of health promoting hospital to local administration organization. The alternative aims of this study to impact of devolution of health promoting hospital to local administration organization, health database management system, problem and obstacles on devolution. Conceptual framework based on system theory and six building blocks. The study design was conducted Mixed methods. Study areas were regional health 1 and 4. Data collection method both questionnaire and in-depth interviews from health promoting hospitals both devolution and not devolution. Study subjects composed of 3 groups: 1) executives in the area, including both ministry of public health and local administrative organizations (n=48), 2) Officer of health promoting hospitals (n=104), and 3) people in each area (n=3,912). Results found that people whose experiences services of all 46 health promoting hospitals had perspectives and expectations do not difference between devolution and non-devolution. They would doctor home visit, drug quality, receipt drug from health promoting hospitals and do not need got drug at hospital, laboratory in community, and staff enough to services. Although, the satisfaction of people towards the service of between health promoting hospitals that devolution was higher than non-devolution with statistical significance (P value <0.05). Impact of health promoting hospitals devolution found that local administrative organizations were affected in terms of personnel that were not transfers as well, budget issue was not clear to use, and issue of the land and buildings that need process with another organization, and including health database management system, referring, there were no clear guideline. Problems and obstacles encountered in operation due to unclear communication, distrustfulness, untrustworthiness, and the recently started responsible office for public health in local administrative organizations make the devolution are many obstacles to implementation. Therefore, clarifying communication and trustfulness between the Ministry of Public Health and local administrative organizations will make the transfer. able to meet the expectations of the people.
This research aimed to evaluate situations of primary care services and to examine influencing factors towards providing desirable primary care in 7 dimensions: service delivery, health workforce, health information systems, accessibility to essential medicines, financing, leadership/governance, and community participation. A total of 468 respondents from the community health centers and subdistrict health promoting hospitals in the Northeast of Thailand responded to the questionnaires based on guidelines for health service systems improvement. The data were analyzed using descriptive statistics (frequency, percentage, mean and standard deviation); and inferential statistics (binary logistic regression). The results showed that the overall mean score in providing desirable primary care services was 2.29 (SD = 0.39) from full score 3. Service delivery and health workforce had the lowest scores at 1.73 (SD = 0.51) and 1.92 (SD = 0.68), respectively. Of these respondents, 66.0% reported that their patients were cared for by family doctors, 52.4% was the proactive care service provided by the 3-healthcare teams (family doctor, public health professional and village health volunteer) and 50.2% by village health volunteers. Ten of the 76 primary care providers had doctors working after office hours, 96 primary care providers had no doctors even on the rotating schedule. Village health volunteers were reported to be an active health information sender by 78.0%. Moreover, 73.7% requested for improvement of the 3-healthcare team service. The five lowest-score services needed improvement were rehabilitation, consumer protection of the health products, physical activity promotion, emergency medical service, and sanitation. Influencing factor towards the provision of desirable primary care services was the registered primary care unit (adjusted odds ratio = 5.16, 95%CI 1.33 to 20.12, p value = 0.018), while the factors of health region, size of population, size and standard of primary care units were not statistically significant. To improve primary care services, the adequate human resources as the requirement for registered primary care unit according to the Primary Care System Act should be adhered. This would help provide essential primary care services entirely, adequately, and appropriately for Thais.
Objective: To study the cultural competency among hospital pharmacists, under the Office of the Permanent Secretary, Ministry of Public Health, Thailand. The findings would serve as an input for cultural competency development plans for Thai pharmacists. Method: The researchers used the online Thai Pharmacists’ Cultural Competency Self-Assessment Scale (TPCCS) developed by the researchers to perform a cross-sectional survey to hospital pharmacists under the Office of the Permanent Secretary, Ministry of Public Health Thailand. Stratified sampling was carried out based on the health service region and the size of the facility. Between March and August 2021, 241 pharmacists responded to the survey (response rate 31.26%). The TPCCS had 16 factors, 92 questions and 5 cultural competency dimensions: 1. cultural awareness, 2. cultural skills, 3. cultural knowledge, 4. cultural encounter, and 5. cultural desire. On a 5-point Likert scale, pharmacists were asked to rate their ability to practice. Results: Thai hospital pharmacists had a moderate level of cultural competency. On the full scale of 5, the mean values for each dimension ranged from 2.39 to 4.24. On average, they had low scores on some cultural awareness dimension. They had the highest score on cultural desire. Conclusion: There was a need to improve pharmacists’ cultural competency, particularly in terms of cultural awareness. A strong desire for cultural competency may be an excellent foundation for continuing growth.
Organizational health literacy [OHL] helps health care organizations achieve high-quality, efficient, and meaningful care to service users, called health literate health care organizations [HLO]. OHL is defined by the Institute of Medicine as “the degree to which an organization implements policies, practices, and systems that make it easier for people to navigate, understand, and use information and its services to take care of their health.” As OHL was a new term in Thailand, there were needs to raise awareness and promote OHL practices at governmental health care organizations. This study was to evaluate the effect of “SASUK OON-CHAI”, a supportive web-based processes for OHL at governmental health care organizations under the Ministry of Public Health. The supportive processes were initiated by the Division of Health Literacy and Health Communication, Department of Health. An evaluative study design was employed to investigate the effects of SASUK OON-CHAI on OHL of governmental health care organizations that registered to participate in interactive online monthly meetings (group 1) and compared with organizations voluntarily chose to self-study the OHL (group 2). The OHL practices were reflected by the staff and service users before and after each health care organization developed and submitted their development plans. The percentages of staff and service users who perceived the OHL practices were compared between the pre-test and post-test using the Wilcoxon signed rank test, and between the two groups using the Mann-Whitney U test. The significance level is .05. Cohen’s D was calculated to indicate the effect size. Results: 455 organizations assessed their OHL practices at least twice with a minimum time interval of one month and their OHL practices were used for the evaluation. 248 chose to participate in the interactive online monthly meetings and 207 chose to self-study. There were statistically significant improvements in the OHL practices of both groups with a small effect size [group 1: pre-test 95.47%, SD = 5.99, post-test 96.95%, SD = 5.51, p = 0.000; group 2: pre-test 96.61%, SD = 6.77, post-test 97.83%, SD = 4.01, p = 0.002). At the pre-test, group 1 had a significantly lower percentage of the OHL practices (p = 0.000), but at the post-test, this percentage was not statistically different from that of group 2 (p = 0.139). Conclusion: Either OHL practices by registering in SASUK OON-CHAI and participating monthly online meetings or self-studying the OHL practices helped improve OHL.
Background: Non-communicable diseases (NCDs) are serious health issues in many countries. This paper aimed to evaluate a wellness center or health promotion program using the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework and to investigate financial feasibility of NCDs prevention and promotion program in Thailand. Methodology: A retrospective plus interview study was used in this paper. Data were obtained from two wellness centers in public hospitals, Thailand. RE-AIM model was used to evaluate the program. Financial feasibility was performed with the home exercise and fitness center models based on financial and service assumptions. Results: A total of 217 participants were included in this study. After attending the prevention and promotion program for more than two months, the participants’ body weights and body mass indexes reduced significantly. Regarding the RE-AIM framework, the wellness centers reached target groups and continued providing services in the public hospitals. In terms of a financial feasibility study, the model could break-even in the first year (0.36 year for home exercise, while a fitness center model was 5.44 years with a fee of 4,500 THB per person). For the internal rate of return (IRR), both models showed positive investment. Discussion: RE-AIM model indicated that the wellness centers successfully reached its target groups. The findings provided a positive outcome and positive investment by financial feasibility study despite small sample size. Further studies are recommended to involve more hospitals to improve the generalizability of our findings.
The purpose of this study was to measure the satisfaction of caregivers employed by service units/centers to improve the quality of life of the elderly/local governments to give care to dependent persons in the communities; and to determine the factors that influenced caregivers’ satisfaction with the employment after wage adjustment made since 2017. This was a cross-sectional study in January and February 2022. Data were collected using questionnaires from 563 caregivers who worked under the long-term care funds for dependent elderly from the north, the south, the east, the northeast, and Bangkok. Samples were selected using the simple random sampling method. Data were analyzed descriptively and the relationships between variables were tested using multiple regression analysis. The results showed that the majority of the samples were female (95.4%), age between 40 and 59 years (62.3%), worked as a caregiver for 3 to 5 years (47.2%), and had completed 70 hours of training (89.6%). Regarding employment contracts, 31.3% contracted through service units, 30.6% contracted through local governments, and 17.6% had no contracts. In terms of frequency of payment, 25.8% were paid monthly and 17.9% paid every three months. This study revealed that 48.7% of caregivers experienced late or no payment at all. In this regard, caregivers earned an average wage of 1,620 baht per month (maximum 3,054/minimum 764), but had to pay for travel to work at 214 baht per month (maximum 356/minimum 115). In terms of satisfaction with employment, 51.6% of caregivers had a high level of satisfaction, followed by 26.3% with the highest level. The factors affecting employment satisfaction were quality of work life (B = 1.433, p < 0.01), job support (B = 0.923, p < 0.01), and wages (B = 0.001, p < 0.01). Policy recommendations on wages are: wages should not be lower than the minimum wage, or wages should be increased as step ladder based on experience of the caregivers. If wages cannot be increased, travel expenses, or opportunity losses should be covered. Policies to support the work of caregivers are: equipment such as blood pressure monitors, refresh trainings to improve caregiver knowledge and practices, and caregiver uniforms or team vests, recognition badges, or symbols should be provided to caregivers for public recognition.
The objective of this mixed-method research was to study the lessons learned from organizing health service systems at the tertiary level in the northeastern region of Thailand during the critical pandemic of COVID-19. The study focused on the health care capacity and utilization and the six building blocks frameworks, examining the tertiary hospitals in Khon Kaen, Udon Thani, Surin, and Ubon Ratchathani in the northeastern region of Thailand. The data sources included health region administrators, provincial and hospital managers, COVID-19 committees, medical personnel, environmental workers, and stakeholders from the community. The research was conducted from September 2021 to February 2022, using health-care capacity and utilization assessment tools including in-depth interviews, focus group discussions, and lesson learned extraction. Quantitative data were analyzed using percentages and averages, and qualitative data by content analysis. The research findings plus lessons learned were as follows. 1) The emergency operation center committee’s province played a crucial leadership role. 2) Managers and practitioners collaborated, participated, managed, and took responsibility together. 3) Intersectoral networks supported cooperation and resource sharing. 4) Information and communication technology was used for decision-making by managers. 5) The screening principles for COVID-19 of rapid knowing, detecting, isolating, quarantining, and treating were followed. 6) Preparedness of personnel capacity framework. 7) Competency development of personnel through mentorship, peer support, and networking. 8) Employed SMART principle in management and administration. 9) Enforced seamless referral of patients. 10) Provided knowledge and understanding to practitioners and service recipients. These lessons learned could be effectively applied to tertiary hospitals in future contexts.
The increasing number of COVID-19 patients during the pandemic posed a great challenge for health care services. Nurses have a vital role, not only in providing care, but also in managing other health care services, in regard to the varied hospital resources challenges. This qualitative research aimed to synthesize lessons learned from the COVID-19 crisis experiences regarding nursing competencies and workforce management in Health Region 10 of Thailand. Document analysis, in-depth interviews, and focus group discussions were used to collect data from October 2021 to April 2022. The 293 key informants included the Ministry of Public Health (MOPH) inspector of Health Region 10, representatives of the Thailand Nursing and Midwifery Council, representatives of the Nursing Division of the MOPH, the provincial chief medical officer, a group from the emergency operation center (EOC) committee, hospital directors, heads of nursing departments, physicians, infection control (IC) nurses, and nurses engaged in COVID-19 patient care. The data were analyzed using content analysis. The study revealed that: 1) workforce management in response to the crisis included 1.1) implementation of nursing staff pooled from different units through nurses volunteer co-operation or direct command; 1.2) modifying working hours from 8-hour shifts to 12-hour shifts; and 1.3) assigning head nurses of lower workload units as supervisors to the COVID-19 cohort wards. And 2) strengthening nursing competency focusing on: 2.1 designing educational modules on nursing care for COVID-19 patients with regard to infection control and prevention; 2.2) on-the-job training; 2.3) training self-directed learning skills to nurses to independently online search available COVID-19 knowledge resources; and 2.4) the IC nurses played a major role in infection control competency of the hospital staff, as well as informing the most update COVID-19 practice guidelines. The most common training sessions included the donning (putting on) and doffing (removing) of personal protection equipment (PPE) and the powered air purifying respirators (PAPR), intubation in COVID-19 patients, automatic cardiopulmonary resuscitation (auto-CPR), prone positioning in ARDS (acute respiratory distress syndrome) COVID-19 patients, and mechanical ventilation care. The key success factor for coping the crisis was the collaboration from all partners and stakeholders. The policy recommendations for the present study included setting measures for comprehensive nursing workforce management and essential competency to handle crisis situations, developing the nurse workforce system and mechanisms in order to retain nurses in the system, implementing education and training programs to promote nurses’ competency, continuously, and creating working environments conducive to nurses providing direct patient care professionally.
This emancipatory action research with action research aimed to develop essential nursing competencies for COVID-19 and nursing competency development models for primary, secondary, and tertiary health service units through the case study of Songkhla province where strong government management policy existed in collaboration with stakeholders. A total sample of 53 registered nurses (10 from primary, 31 secondary and 12 tertiary health service units) and 6 physicians were recruited. Research instruments consisted of 1) quantitative data collection tools including the questionnaire of essential nursing competencies for emerging infectious disease COVID-19 and the questionnaire of satisfaction on nursing competency development models for COVID-19. 2) Qualitative data collection tools included the behavioral-based interview, the in-depth interview, and the focus group discussion guidelines. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed using content analysis. Research results revealed that 1) registered nurses had an overall higher mean score of essential nursing competencies for COVID-19 at each loop of research. Higher mean scores were found on both professional and technical competencies. 2) Nursing competency development model consisted of 3 components including practice guidelines, competency development method, and factors promoting competency development. Practice guidelines consisted of 5 main steps including 1) specification of essential performance competencies; 2) development of monitoring system, support, and empowerment; 3) specification of self-competency development guideline; 4) implementation of the competency development plan; and 5) summarization and report of development result. The competency development method consisted of 6 activities including 1) workshop, 2) on-the-job training, 3) learning from experts, 4) coaching, 5) self-study, and 6) knowledge sharing. Factors promoting competency development included the role of nursing leaders, explicit policy and practice guidelines, and a good attitude towards the profession. Conclusion: research findings could be used as guidelines for the competency development of nursing staff working in primary, secondary and tertiary health service units to have skill and nursing competency for patients with COVID-19 and emerging diseases in the future.
This study was a convergent parallel design mixed methods study collecting quantitative and qualitative data in Yala, Pattani, and Narathiwat provinces. The study aimed to determine the roles of primary care network in screening and monitoring the COVID-19 risk groups. Purposive sampling and quota sampling were used to recruit samples from two districts with the highest infection rate in each province, 2 subdistricts per district, and a total of 6 subdistricts. The samples were consisted of 80 people per subdistrict, including 10 village health volunteers, 10 local government officials, 10 community leaders, 10 religious leaders, and 10 other people, totaling four hundred eighty-one people for quantitative data collection. A questionnaire on knowledge and practice in screening and prevention in risk groups of COVID-19 was the instrument used. The data collection was from January to December 2021. In parallel 270 people provided qualitative data through either focus group discussions or in-depth interviews. Quantitative data were analyzed using frequency and percentage, while qualitative data by thematic analysis. The quantitative results showed that the average scores of primary care network roles for screening and monitoring COVID-19 risk groups were rated as high (mean = 3.19, SD = 0.51). The highest score (mean = 3.33, SD = 0.56) was found for the screening and monitoring of people exposed to COVID-19, followed by the community control of the COVID-19 pandemic and communicating the risk of infection (mean = 3.25, SD = 0.59, mean = 3.22, SD = 0.60 respectively). Findings from qualitative methods were as follows. 1) Village health volunteers played an important proactive role in screening and monitoring risk groups by zoning households under responsibility, and providing communication on risk of infection. 2) Health professionals had the role of health system management based on cultural beliefs, fostering unity among all professionals, and working proactively to control the spread of COVID-19. 3) Local governments supported people’s daily livelihoods and worked with all sectors in the community. 4) Community leaders supervised people to comply with public health measures, took care of safety and shared household responsibility zoning with village health volunteers. 5) Religious leaders directed people based on Islamic principles and practices to implement public health measures to control the spread of COVID-19 at community acceptance level. The outbreak of COVID-19 in the 3 southern border provinces was under control through synergy of cooperation of primary care networks. These collaborations and participations could be important in other areas of community health management.