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Volume 29 No. 3 (September – December 2015)

Health Behavior Based on the Sufficiency Economy Philosophy in Persons with Chronic Illness in Selected Community
Nuntaporn Narinnok Somnuk Sakunhongsophon Sangthong Terathongkum

ABSTRACT
This descriptive qualitative research design was undertaken to study health behaviors based on the Sufficiency Economy Philosophy in persons with chronic illness in a selected community. Thirty three purposive samples were divided to five groups following their characteristics that consisted of five diseases. Data were collected by focus group discussions, and analyzed by using descriptive statistics and content analysis The sufficiently economic definition in participants' perspectives was divided into three aspects: reasonably sufficient use, adequate consumption, and economic use. In addition, the health sufficiency meaning had four attributes: not working hard, being happy, self sufficiency and sufficient spending related to health. Chronic Health behavior model was three E one S and three U. In addition, health behaviors based on the sufficiency economy consists of seven characteristics: sufficient food intake, daily life exercise, psychological management, medicine management, health service utilization, health information management and smoking management. These findings suggested that health care officers should plan to promote health behaviors based on persons with in the chronic illness's context, leading to health sufficiency. Not only three E (Eating, exercise, emotion) two S (Stop drinking, stop smoking) for healthy behavior, but also three U (Drug using, health service using, and health information using) need to be done in person with chronic illness.

Keywords: Persons with chronic illness/ The sufficiency philosophy/ Health behavior


Prediction of Coronary Artery Disease with the Assessment Tool of Gender Age and Type of chest-pain
Pachanat Tantikosoom

ABSTRACT
This predictive study aims to determine the correlation between factors in gender, age , type of chest-pain and Coronary Artery Disease (CAD), and to examine the predictability of CAD using the Diamond-Forrester model. Participants included 113 who had risk in cardiovascular patients and need to received Coronary Angiogram (CAG) in a tertiary hospital. The instruments were: 1) the assessment in personal data, 2) Thai short-version of the Rose Angina questionnaire, 3) Diamond-Forrester model and 4) the result of Coronary Angiogram (CAG). Data were analyzed using statistical Point biserial and Pearson correlation between of gender, age, type of chest pain and coronary artery disease. Logistic model for case was used to determine the sensitivity and specificity from the Diamond-Forrester model. Participants included 113 patients with coronary artery disease were male= 66(58.34%) and female=47(41.6%), mean age of group was 64.25+10.61 (65-75 years), Thai short -version of the Rose angina questionnaire had high content validity 0.91 and reliability were 0.80 ,the correlation found that gender factor and type of chest pain had a statistically significantly effects on CAD (p-value < 05). but sex factor had not. The sensitivity and specificity of the Diamond-Forrester model were 95.23% (60 of 63), 2.00% (1 of 50) respectively. Positive predictive value (PPV) was 55.05% ,Negative predictive value (NPV) was 25.00%, and accuracy=55.98% In conclusion, the prediction of coronary artery disease was very high sensitivity (95.23%) and the prediction of non-coronary artery disease has low specificity (2.00%). The accuracy of CAD prediction was essential for healthcare providers to accurately diagnose CAD, identify the severity of condition, and promptly treat CAD patients.

Keywords: Coronary Artery Disease/ Prediction/ Chest Pain/ Short version Rose angina questionnaire


Effects of Diet Control Program using Food Exchange on Knowledge, Health Behaviors, and Blood Glucose Levels among Persons with Type 2 Diabetes in District Health Promoting Hospital
Supranee Fuangfung Chularuk Kaveevivithcha Noppawan Piaseu

ABSTRACT
This quasi–experimental research aimed to examine the effects of a diet control program using food exchange on knowledge, health behaviors, and blood glucose among persons with type 2 diabetes in district health promoting hospitals. The sample of 60 type 2 diabetic patients were divided by purposive sampling into two groups, control (n=30) and experimental (n=30). The experimental group participated in a 12-week diet control program using food exchange based on the Health Belief Model concept. The program consisted of one education session for two hours using a video, a food exchange pamphlet, a plate model to enhance subjects' understanding, meal planning, and five home visit follow-ups. Data were collected via four instruments: a demographic data questionnaire, health information records, a preventive behaviors of persons with diabetes questionnaire, a knowledge test. The data was analyzed through descriptive statistics, Paired t–test, and Independent t-test. The results revealed a significant difference in the knowledge gained score between the two groups. The experimental group had a significantly higher knowledge gained score than the control group and significantly higher than the pretest score in knowledge of diabetes, complications, and prevention of diabetes aspects, but there was no significant difference in the food exchange aspect. After the program finished, it was found that the mean of health behaviors scores significantly increased compared to those in the control group and before the program. There was also a significant reduction in blood sugar (CBG) of the experimental group which was less than that in the control group. However, there was no significant difference of HbA1C levels between the two groups both before and after the program. It is recommended that nurses can use this program to effectively modify type 2 diabetic patients' health behavior in diet control leading to glycemic control.

Keywords:Diet control program using food exchange/ Knowledge/ food consumption behaviors/ Blood glucose


Factors Influening on Drug use Behaviors in Soldiers with Primary Hypertension
Thamonprus Boonjareon Vanida Durongritichai Jariyawat Kompayak

ABSTRACT
The objective of this descriptive research was to study and analyze factors influencing on drug use behaviors in soldiers with primary hypertension. The 260 samples were selected by purposive sampling following the criteria. Data were collected by a self-administered questionnaires used between March 2012 to December 2012. Five experts examined content validity and reliability of questionnaires with alpha-coefficient was 0.88. Data were analyzed by number and percentage, mean and standard deviation. T-test was used to analyze factors influencing drug used behaviors. The results revealed that majority of soldiers were 51-55 years old, finished high school, married, worked as formal and special task. Most of them were officers, working as general service officer and field service. Almost of them are non-commander, working as administration stator, paper works and field service. The mean scores of drug use behaviors in soldiers with primary hypertension was at the moderate level. (Mean 3.01, S.D. 0.65) The mean score of perceived benefits of drug use was at the high level. (Mean 3.81, S.D. 0.57) The perceived barriers to drug use was at the moderate level. (Mean 2.94, S.D. 0.60) And also perceived self efficacy to drug use was at the moderate level. (Mean 3.13, S.D. 0.64) The activity related affect, inter personal influence and situational influence to drug use was at the moderate level. (Mean 3.12, S.D. 0.48) Factors that effected to drug use behaviors were marital status, working status and income. (p-value < 0.05) In addition, perceived benefits, perceived barriers of drug use and perceived selfefficacy, including activity related affect (p-value < 0.01), inter personal influence and situational influence to drug use were the factors affecting drug use behaviors with a statistical significance. (p-value < 0.05) This study suggested that health care providers should bring the crucial factors to design nursing activity to promote drug use behaviors correctly for the soldiers with primary hypertension and follow up the out come.

Keywords: Primary Hypertension/Drug Use Behavior/ Soldier


Factors Affecting the Emergency Medical Service - related Work Engagement of Emergency Medical Service Providers under Thai Local Government Organization
Phichet Wongrot Rotsukon Varitsakul

ABSTRACT
A cross-sectional predictive design was used to study the relationships between the emergency medical service-related work engagement and the perceived support of emergency medical service (EMS) providers under Thai local government organizations. The sample group included 558 EMS providers who employed by local government organizations and had at least one year of working experience as EMS provider. The research outcomes were measured by the National Institute for Emergency Medicine (NIEM) supporting satisfaction questionnaires and the EMS-related Work Engagement scale. Descriptive statistics, Pearson's Correlation Coefficient and multiple linear regression were used for data analysis. The results revealed that EMS providers under Thai local government organizations perceived support was good (mean = 3.708, SD = .694), and the EMS-related work engagement was good (mean = 3.974, SD = .735). Perceived support had positive relationships with the EMSrelated work engagement (r = .630, p-value < .01). In contrast, age had negative relationships with EMS-related work engagement (r = -.100, p-value < .05). Finally, perceived support, age, and working experienced were statistically significant predictors of emergency medical service-related work engagement (F = 86.348, p-value < .01) and could explain variance of emergency medical service-related work engagement by 37.5%. The factors that significantly predicted emergency medical service-related work engagement were the perceived support (B = .620, p-value < .001) and EMS work experience (B = .147, p-value < .001), while age did not. The recommendations from this study, the trends to improve EMS provider engagement should emphasize on comprehensively supporting in manpower, standard procedures, and essential facilities should be taken into consideration by both the local government organizations and NIEM.

Keywords: Work engagement/ Perceived support/ Emergency Medical service


Incidence and Factors Related to Falls among Patients After Hospital Discharge
Anong Dittasung Nareemarn Neelapaichit Phatcharakoraphot Sreeprasarn

ABSTRACT
The purposes of this prospective cohort study were to determine the incidence of falls and its associated factors among patients after discharge from hospital. The study sample consisted of 153 patients who discharge from hospital and received care from home health care unit in Faculty of Medicine Ramathibodi Hospital. Data were collected at the patient's homes within one month after the patients discharged from the hospital. Data were collected includes data on sociodemographic, health status, caregivers, the environment of the house, activity of daily living (Barthel Index) and fall episodes. Then the data were analyzed using descriptive statistics, and Multiple logistic regression analysis. The results showed that the incidence of falls were 13.7 percents. Factors associating with higher risk for falls included activity of daily living (Barthel Index >5) (OR: 4.01, p-value < .05) and slippery ground (OR: 4.37, p-value < .05). The results of this study can be used to provide care for protecting and reducing the risk of falls especially within 1 week of the patients who were discharged from hospital.

Keywords: Falls/ Hospital Discharge/ Barthel Index


Spiritual Needs related to prevention of pre-marital sex among Thai adolescents
Sasitorn Roojanavech Kannikar Chatdokmaiprai Usa Tantapong

ABSTRACT
Early sexual behavior is an important public health concern because of related risky sexual behaviors. The purpose of this descriptive research was to study the spiritual level and spiritual needs of Thai adolescents to prevention of pre-marital sex among Thai adolescents. The respondents consisted of 60 students who were Buddhists, and were studying at a secondary school at Sampran District, Nakhon Pathom Province. The instrument consisted focus groups interview guideline, and Thai spirituality measurement. The instrument was validated by experts with an IOC from 0.67-1.00, and the reliability was 0.76. The descriptive statistics and content analysis were used for data analysis. The results revealed that most of key informants had a moderate spiritual level (88.3%) which included belief in karma (58.3%), and religious prayer or meditation when confronted with life stressful situation (31.7%). Adolescents needed the spiritual needs for finding meaning and purpose of life. The family plays an important role in developing adolescents' spirituality by teaching the Buddha's principles and religious practice included five precepts, and retrain from doing sin. The religious belief and practice included Tamboon/ Saibat, religious prayer, and meditation practice were useful for emotional relief, consciousness, and wisdom in abstinence of inappropriate behaviors. The key informants needed the school to provide the Dhamma camp with family's participation. They also needed interpersonal connection, loving and empowering from family and friends in order to enhance coping abilities and achieve the purpose of their lives. The researcher suggests that community nurse practitioner, relevant organization should participate with families, school, and community in promoting spiritual needs to adolescents. Therefore, the adolescents who attain the spiritual need will achieve their life goal and gain appropriate sexual behaviors.

Keywords: Spiritual needs/ Pre-marital sex/ Thai adolescents