Predictive Factors of Dietary Consumption among Diabetes Mellitus Type 2 Patiens
Porntip Somtua Panan Pichayapinyo Weena Thiangtham Dusit Sujirarat

ABSTRACT
Diabetes mellitus is one of the serious chronic diseases and which as a major problem worldwide. The numbers of diabetes patients have increased steadily. Therefore, the government has launched the policy to establish the diabetes clinic and activities including health education and skill practice for enhancing people's lifestyle modification. Individual or group counseling is also offering patients regarding how to deal with diabetes conditions. However, the number of uncontrolled diabetic patients was still high. Using the health belief model as a conceptual framework. The purpose of this descriptive study was to determine the factors predicting dietary consumption among diabetes mellitus type 2 patients. The study was conducted from December 1st 2013 to January 31st 2014, The data were collected by self-administered questionnaires. Two hundred and ten diabetic patients (105 controlled and 105 uncontrolled) aged 35 – 60 years and were received care in outpatient clinic were randomly recruited. Statistical analysis was performed by using descriptive statistics, chi-square for a univariate analysis and stepwise logistic regression for multivariate analysis. All of which were done by the SPSS program. Results showed that factors predicted dietary consumption in controlled group were self-efficacy in their ability of practicing behaviors to glycemic control (p-value < .001), whereas those in uncontrolled group were perceived susceptibility of diabetes complication (p-value < .001) and cues to action to practicing behaviors glycemic control (p-value < .01). Implication of the study includes effectively providing health education in a participatory manner focusing primarily on perceived susceptibility and cues to action in uncontrolled diabetic patients, and self-efficacy in order to increase effectiveness of prevention in controlled diabetic patients.

Keywords: Dietary consumption/ Diabetes mellitus/ The Health Beliefs Model/ Self-efficacy

Healthcare Services based on Islamic Way in the Antenatal Care Clinic of Community Hospitals in the Three Southernmost Provinces as Perceived by Pregnant Women and Husbands
Sasigorn Unhabandit Nongnut Boonyoung Wimonrat Chongcharoen

ABSTRACT
The objectives of this descriptive research were to 1) study healthcare services based on Islamic way in the antenatal care clinic (ANC) of community hospitals in the three southernmost provinces as perceived by pregnant women, 2) study healthcare services based on Islamic way in the ANC of community hospitals in the three southernmost provinces as perceived by husbands, and 3) compare the perceptions of the pregnant women and husbands. The sample comprised 80 cases of Islamic pregnant women and 80 cases of Islamic husbands receiving services in the ANC of community hospitals in the three southernmost provinces. Subjects were selected by Quota sampling. The questionnaires comprised two sets, set one for pregnant women and set two for husbands. The instrument for set one was composed of two parts: part 1) demographic data and part 2) perception of pregnant women toward healthcare service based on Islamic way in the ANC; that for set two was composed of two parts: part 1) demographic data, and part 2) perception of husbands toward healthcare services based on Islamic way in the ANC. The questionnaire part 2 was tested for content validity by three experts and was tested for their reliability by using Cronbach's alpha coefficient yielding a value of .91 and .93 respectively. Data were analyzed using frequency, percentage, mean and standard deviation. The comparison for mean difference of the perception of the pregnant women and her husbands was tested by independent t-test. The results showed that for pregnant women the mean total score of healthcare services based on Islamic way in the antenatal clinic of community hospitals in the three southernmost provinces as perceived by pregnant women was at a good level (M=3.71, SD=.30). When considered by dimensions, the mean scores of all dimensions were at a good level, the perception regarding Islamic way of outpatient services was the highest mean score (M=3.91, SD=.34), followed by the medical services system (M=3.81, SD=.23). For husbands, the mean total score of perception regarding healthcare services based on Islamic way at the antenatal clinic was at a good level (M = 3.70, SD =.27). When considered by dimensions, the mean scores of all dimensions were at a good level, the Islamic way of outpatient services was the highest score (M=3.82, SD=.33), followed by the medical service system (M=3.78, SD=.23). A comparison between perceptions of pregnant women and husbands toward the healthcare services at ANC showed no significant difference (t=.33, p-value >.05). Results of this study can be used as baseline data in the development of healthcare services based on Islamic way in the antenatal care clinic of community hospitals in the three southernmost provinces for enhancing the quality of services and fully responding to the needs of Islamic patients.

Keywords: healthcare services/ Islamic way/ antenatal care clinic/ community hospital

Selected Factors Predicting Health Status among Persons with Knee Osteoarthritis
Suparb Aree-Ue Sommai Vanavanant Inthira Roopsawang

ABSTRACT
Osteoarthritis of the knee is known as age related diseases, which is common cause of disability in adults and older adults, and can affect their health status. Little is known about factors influencing health status in adult and older Thais with knee osteoarthritis. The major aim of this cross-sectional study was to investigate the predictive power of selected factors on health status in adult and older Thais with self-reported osteoarthritis of the knee. A total of 327 adult and older adults (mean age = 63.49 years; SD =9.8 years; range 50-90 years) with osteoarthritis of the knee living in communities in Bangkok and its vicinity who met inclusion criteria was recruited. The data were collected through home and health care center visits using questionnaires including the Disease Severity Scale, the Brief Illness Perception Questionnaire, the Knee Osteoarthritis Coping Behavior Questionnaire, the Self-Efficacy Expectation Questionnaire, the Social Support Survey, and the Arthritis Impact Measurement Scale Short Form. Data were analyzed using descriptive statistics, Pearson product-moment correlation, and multiple regressions. Results revealed that the sample perceived moderate illness threat, coping strategies, and health status, but perceived quite high level of self-efficacy and social support compared with reference values. In addition, regression analysis showed that, after controlling for external variables, illness representations, coping strategies, and selfefficacy explained 30% of variance in health status. Identity and serious consequences of illness representation dimensions were the strongest predictors. The findings demonstrate that illness representations, coping strategies, and self-efficacy are important factors in perceived health status among adult and older Thais with selfreported knee osteoarthritis. These findings can be beneficial for the design of intervention by mean of changing illness perceptions and coping strategies and of promoting self-efficacy that may improve health status in this population.

Keywords:osteoarthritis of the knee/ illness representation/ health status

Predictive Factors of Health-Related Quality of Life among Family Caregivers of Stroke Patients with Communication Problems
Anusorn Nanudorn Rungrat Srisuriyawate Pornnapa Homsin

ABSTRACT
Family caregivers are the important persons to help care stroke patients with communication problems, particularly those needing to face with difficult time to adapt themselves in order to respond to patients' needs. This predictive correlational study aimed to examine health-related quality of life (HRQOL) and predictive factors of HRQOL of life among family caregivers of stroke patients with communication problems. One hundred and six family caregivers who cared stroke patients with stroke patients with communication problems were recruited from the out-patient neurological clinic of a tertiary care hospital setting. Questionnaires composed of demographic information for family caregivers and patients, the Multidimensional Scale of Social Support Scale, the Zarit Burden Interview Questionnaire, the Caregiver and Patient Relationship Questionnaire, and the SF-36 Health Survey. The reliability of questionnaires with alpha-coefficient were .94, .91, .94, and .90, respectively. Descriptive statistics and Stepwise Multiple Regression Analysis were used to analyze data. The results revealed that the level of family caregivers' HRQOL was moderate (Mean = 68.29, SD = 14.90). Caregiver burden and caregivers' diseases could explain 17.6 % of variance for health-related quality of life (R2 adj =.176, p-value < .01). Caregiver burden positively affected health-related quality of life (B = .217, p-value < .05) whereas family caregivers' disease negatively affected health-related quality of life (B = -.342, p-value < .001). The findings indicated that resolving impacts of various diseases and reducing caregiver burden would help improve health-related quality of life among stroke caregivers with communication problem. This would in turn contribute to better of care and rehabilitation for these patients.

Keywords: Stroke patients/ Family caregiver/ Health-related quality of life

Factors Related to Job Strain among Workers in Bleaching, Dying, Printing and Finishing Enterprise
Anantasak Panput Ann Jirapongsuwan Surintorn Kalampakorn Sara Arphorn

ABSTRACT
Job strain is an imbalance of job demand, job control or decision latitude and social support. The objective of this study was to examine factors related to job strain among workers in bleaching, dying, printing and finishing enterprise. The Ecological model of health behavior was used as conceptual basis of this study. Job demand/ control model was used as assessment of job stress. The sample consisted of 200 workers randomly selected from a bleaching, dying, printing and finishing enterprise in Samutsakhon Province. Data were collected by using a self-administrative questionnaire. Descriptive statistic and Odd-Ratio were used for data analysis. The result of this study indicated that 80.0 percent of the worker had low job demand, 62.5 percent had high job control or decision latitude and 70.0 percent had low social support. The interaction of three components found that 8.0 percent of workers had high job strain. Factors related to job strain found that life crisis events had significant job strain (p-value = .019). Findings suggest that in order to prevent job strain, program promoting the use of coping strategies due to life crisis events should be provided. Health impact in who had high job strain should be enhanced to promoting enhance the performance and well-being in workers.

Keywords: Job Strain/ Workers in Bleaching/ Dying/ Printing and Finishing Enterprise

Participatory Ergonomics intervention to reduce risk factors of work related musculoskeletal disorders in smoked rubber plant, Rayong Province
Chantana Chantawong Nisakorn Krunkraipetch Yupa Daoraung

ABSTRACT
The objectives of this participatory action research were to identify, and reduce risk factors of work related musculoskeletal disorders (WMSD), developed model and implement model by workplace participation. The production process of smoked rubber using intensive labour force expose with ergonomic hazards which may lead to WMSD, The research subjects included 1 administrator, and 7 supervisors and 80 workers, from small scale plant which is willing to participate. The research activities were 1) Ergonomic team building: administrator, supervisors, representatives of the staff; 2) interviewing about knowledge, awareness, and symptoms of WMSD with standard Nordic instrument and risk factors for WMSD with the Rapid Entire Body Assessment (REBA); 3) training ergonomic team about risk factors and solving ergonomic problems; 4) training staff from all relevant department in reducing risk factors for WMSD; and 5) finding out WMSD risk factors from VDO of working behavior of this plant, training muscle stretching, improving working procedure, working posture , and tools by participatory methods. 6) evaluating knowledge, awareness, and symptoms of WMSD, working procedure, working posture. The statistical analysis using descriptive statistics: frequency, percentage distribution, mean and standard deviation. The ergonomic team, the staff, and the research team well participated throughout the entire processes. The results showed that mean scores of knowledge and awareness have significantly increased after the intervention, (t=4.543, p-value < .001) and (t=13.877, p-value < .001) there were some posture risk reductions of 11 activities out of 18 activities (61.0 percent) and significantly reduce musculoskeletal pain severity during the last 7 days (t=8.891, p-value < .001). ) Particularly, risk levels of separate rubber sheet above chest level, at waist level and clipping out foreign matter activities were reduce from high to moderate levels This study suggested that the ergonomics intervention and developed model can be used for surveillance, protect WMSD and help reducing the risk factors of WMSD and can resolve some symptoms of the WMSD. Therefore, the smoked rubber plant and occupational health work group should apply the intervention through all the process for all workers at risk.

Keywords: Participatory Ergonomics intervention/ work related musculoskeletal disorders/ Smoked Rubber Sheet Plant

Effects of a Four-Step Empowerment Program on Dash-Diet Consumption among Hypertensive Elderly in the Banthatong Elderly Club, Pitsanuloke Province
Piyaphan Trakultip Paranee Vatanasomboon Warapone Satheannoppakao

ABSTRACT
Dietary Approaches to Stop Hypertension (DASH) diet is important for controlling blood pressure among patients with hypertension in particular. This quasi-experimental twogroup design research, with repeated measures, aimed to study the effects of a four-step empowerment program on DASH-diet consumption among hypertensive elderly in the Banthathong Elderly Club, Muang District, Pitsanulok Province. The experimental group (n=26) received four times of the four-step empowerment intervention program consisting of step one - exploring the problem (identify and prioritize the problems); step two - making solution dialogue (analyze the problem and develop a plan); step three - declaring the solution (commit to and act on the plan) and step four - sharing experience (evaluate achievement of the plan and share experience). The comparison group (n=26) received only a booklet on DASH-diet after completing the experimentation. The study period covered 12 weeks. Data were collected at three different time points - at the pretest, at the 6th week posttest, and at the 12th week follow-up by using an interview questionnaire. The research results showed that the four-step empowerment intervention program affected the increasing of perceived self-empowerment of DASH-diet consumption (F= 48.49, p-value < .001) and DASH- diet consumption behavior (F=3.588, p-value = .031). After the 6th week of experiment, the experimental group had a significant increase in mean score of perceived self- empowerment (Mean difference=3.22, p-value < .001) and the score was still maintained until the 12th week of follow-up period. Whereas, the mean score of DASH-diet consumption behavior slightly increased significantly (Mean difference= 0.36, p-value = .001) and was also stable at the 12th week of follow-up period. There was no significant change in both the perceived self-empowerment and the DASH-diet consumption behavior in the comparison group during the study period. The research findings indicated that the intervention program was effective, especially for improving the perceived self-empowerment of DASH-diet consumption. It could therefore be applied in hypertension and other chronic-disease clinics in the health care settings. However, this program still needs to further study to retest its potential level for improving the DASH-diet consumption behavior.

Keywords: Empowerment/ Hypertension/ Self-empowerment/ DASH-diet consumption/ Elderly people