Factors related to home visit behavior of village health volunteers for hypertensive patients who missed appointments.
Praphatsorn Kiatluedet Orawan Kaewboonchoob Plernpit Suwan-ampai

ABSTRACT
Hypertensive patients was at risk of severe complications especially stroke leading to disability or death. Continuous treatment was important.The village health volunteers (VHVs) were a voluntarily who were trained to visit the patients at homes and to encourage patients to continue their treatment. The purpose of this research was to examine factors related to home visit behavior of VHVs for hypertensive patients who missed appointments. This study was a Cross-sectional descriptive research. The sample consisted of 90 VHVs who worked in the Muang district of Nakhon Ratchasima province. Data were collected using a questionnaire that included questions related to personal characteristics, knowledge regarding hypertension and home visit patients (19 items), perceptions of empowerment (11 items) and home visit behaviors (20 items). The reliability of questionnair on knowledge and perceptions of empowerment was 0.63 and 0.61, respectively. Data were analyzed using descriptive statistics and Chi-square. The results showed that the average age of the samples was 54.0 ? 10.4 years. Most of them had graduated from elementary school (48.9%), monthly income less than 10,000 baht (82.2%), and had more than 5 years'experience of being VHVs (80.0%). Knowledge, perceptions of empowerment , and home visit behaviors were all at high level , 64.1%, 49.0%, and 52.2%, respectively. The factors that significantly correlated with home visit behaviors of VHVs were knowledge and income. The results indicated that training was important to the home visit behaviors and can be used as guideline for the development of the empowerment model of VHVs in follow-up visits to community homes.

Keywords: knowledge; empower perceptions; village health volunteers; Home visit behavior for hypertensive patients

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Behavior Factors Related to Recurrent Stroke
Sujittra Khumsa-ard Weena Thiangtham Plernpit Suwan-ampai

ABSTRACT
Cerebrovascular Disease (Stroke) is found that for every 15 million patients with Stroke around the world, 5,712,240, or 8.6% were death. It has been estimated that 23 million people around the world will be death from Stroke in 2030 and It is found that at least 1 in every 4 survival will face stroke recurrent for 14% during first year period, and increase to 25% in the fifth year This Case-control study aimed to study the behavior factors affecting the recurrent stroke among the stroke patient. 220 stroke patients at 35- 80 years old included 110 recurrent stroke patients as a case group and 110 post stroke patients as a control group. A structured interview questionnaire was applied for data collecting process data was analyzed using Chi-Square test and Stepwise Multiple Logistic Regression. The study revealed the statistically significant behavior factors related to recurrent stroke (p-value < 0.05) were low dietary control (OR = 4.79, 95 % CI = 1.98-11.54), sedentary behavior (OR = 4.23 ,95%CI = 1.00 -20.41) and discontinue follow up. (OR = 2.16 , 95 % CI = 1.01-4.59). Stepwise multiple logistic regression analysis revealed that low dietary control, and sedentary behavior were statistically significant, predicting recurrent stroke by 11.3%. Public health nurse and the organizations should cooperate in organizing events low dietary control and sedentary behavior for stroke patients to prevent recurrent stroke.

Keywords: Recurrent Stroke, Behaviors, Health Behavior Factors

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Factors Predicting Activities of Daily Living among Stroke Patients in Bangkok Metropolitan
Kanitha Tuida Patcharaporn Kerdmongkol Kwanjai Amnatsatsue Tassanee Rawiworrakul

ABSTRACT
Background/ Objective : Stroke is a major public health problem worldwide because of its prevalence and burden on quality of life and disability of the survivors. This descriptive study aimed to examine factors predicting living ( ADL) of stroke patients who lived in Bangkok. Method : Data was collected from 117 stroke patients at their houses, by using an interview method. Result : More than half were males (56.4%) with an average age of 65.31 (SD=12.14) years, and 58.1% had completed primary school. The duration of stroke was 3 to 17 months and 91.5% of the subjects had chronic diseases. Hypertension and stiffness were the most common chronic diseases and complications. The results from logistic regression showed a relatively strong effect of sex and initial Barthel index (BI) on ADL status (ORadj = 3.93%, 95% CI 1.22-12.70, and ORadj =9.67, 95% CI1.57-59.3, respectively). Males had about 3.9 times better ADL status, compared with females. Those who had a high (BI) score (50-70) had about 9.7 times better ADL status than those who had a low BI score (0-45). In addition, inverse effects on ADL status were found for chronic diseases (ORadj= 0.06, 95% CI 0.007-0.64), complications (ORadj=0.15, CI 0.05-0.46), and caregiving demand (ORadj= 0.17, CI 0.06-0.51). Conclusions : The results support focusing intervention on promotion patients' activities of daily living particularly for those who are female and have chronic diseases. The needs of stroke patient should be assessed and supported continuously. Home visits are recommended to reduce complications and caregiving demands for stroke patients who live in Bangkok.

Keywords:Recovery; Stroke; Factors; Activities of Daily Living

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Behavior Influencing Factors to Depession among UncontrolledDiabetic Type II Patients
Anusara Sutad Weena Thiangtham Panan Pichayapinyo Naruemon Auemaneekul

ABSTRACT
Diabetic is a crucial chronic disease in global public healthcare. It is also found that depression in diabetic patients increase both the disease's severity. The objective of this Cross - sectional survey aimed to study the behavior influencing factors the depression in uncontrolled diabetic type II patients dwelling in Bangkok Metropolitan. Uncontrolled diabetic type II patients at 35 years old and older n =390 were randomly selected by using multi-stage random sampling method as study samples. A structured interview questionnaire was used for data collection. Data was analyzed using Chi-Square test and Stepwise Multiple Regression Analysis From the study result, study showed that 74.2% (292 persons) of the patients had no depression while 25.1% of patients had depression. 21.3 % (83 persons) at a mild level, while 3.8% (15 persons) at a moderate level of depression. Females exceeded depression level in comparison to males 78.6% (77 persons) and 21.4% (21 persons) respectively. The statistically significant behavior factors related to depression were dietary control (OR=2.56,95%CI=1.34– 4.90) stress management (OR=4.45,95%CI=2.33– 8.52) and medication behavior (OR=3.03, 95%CI=1.37– 6.91) Stepwise multiple logistic regression analysis revealed factors influencing depression in uncontrolled diabetic type II patients were dietary control behavior, stress management behavior and medication behavior were statistically significant. The study result may be used as a guideline for surveillance among depressed uncontrolled diabetic type II patients for the prevention and resolution of these problem.

Keywords: Depression/ Uncontrolled diabetic type II patients/ Behavior

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Factors Predicting Activities of Daily Living among Stroke Patients in Bangkok Metropolitan
Cheunchom Sompol Thassanee Rawiworakul Patcharaporn Kirdmongkol

ABSTRACT
This quasi-experimental study was performed to examine the effects of a stroke prevention program for older adults with hypertension. Participants were elderly club members. Equally assigned into two groups, sixty four participants were assigned to an experimental group and a comparison group based on inclusion criteria. Duration of the study is 6 weeks. The activities were implemented for 4 weeks and evaluation of the program was done for 2 weeks. Activities in this program were modified from Protection Motivation Theory. The intervention program included: Health education by a nurse and watching media about stroke, self- assessment on risk of stroke, sharing experience on self-care behavior, practices and encouragement of medication management, diet control and exercise with an aim to reduce the risk of stroke. Data were collected by interview questionnaires: Perceived Severity, Perceived Susceptibility, Response Efficacy, Self Efficacy and Practices of preventive behaviors against stroke. Statistical analysis was performed by using percentage, mean, standard deviation, Chi-square test, independent t-test and repeated measure ANOVA. The results of this study indicated that, after implementation of all variables than before, the experimental group had higher mean difference score than the comparison group (p-value < 0.05). Results of this research have suggested the introduction of programs to prevent stroke, to promote health in the elderly with hypertension to prevent stroke, and to maintain elderly's ability on daily activities which suitable to their illnesses.Results of this research have suggested the introduction of programs to prevent stroke, to promote health in the elderly with hypertension to prevent stroke, and to maintain elderly's ability on daily activities which suitable to their illnesses.

Keywords: Protection Motivation Theory / Stroke Prevention / Older Adults With Hypertension

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Factors Related To Multiple Risk Behaviors among Vocational Students in Bangkok
Kopkanop Duangkaew Arpaporn Powwattana Naruemon Auemaneekul

ABSTRACT
Health risk behaviors was a major public health problem that affected health and quality of life of populations around the world especially adolescence. This cross-sectional study aimed to examine the factors related to multiple risk behaviors among vocational students by using Theory of planned behaviors theory. The sample group was both male and female second year and third year class level students and first year and second year vocational class students studying in vocational school. A sample group of 419 students was attained by stratified sampling. The data were collected using a self-administered questionnaires. Data were analyzed by descriptive statistics chi-square and logistic regression analysis. The results of the study revealed that 27.7% of the sample had 1 kind of risk behaviors which is alcohol drinking (87.9%) , 31.0% of the sample had 2 kinds of risk behaviors which is cigarette smoking together with alcohol drinking (73.7%) and 19.1% of the sample had 3 kinds of risk behaviors. Factors related to multiple risk behaviors among vocational students were male (OR = 2.80, 95% CI = 1.874 - 4.184), not living with both parents (OR = 1.51, 95% CI = 1.030 - 2.238), age 19-22 (OR = 1.55, 95% CI = 1.054 - 2.298), lower academic performance (OR = 2.12, 95% CI = 1.408 - 3.216), positive attitudes towards multiple risk behaviors (OR = 2.85, 95% CI = 1.903 - 4.289), low subjective norms (OR. = 1.77, 95% CI = 1.112 - 2.828), low perceived behaviors control (OR = 2.37, 95% CI = 1.602 - 3.511), and high intention of acting multiple risk behaviors (OR = 2.78, 95% CI = 1.347 - 5.755). The result of the study addressed a comprehensive program to prevent multiple risk behavior by providing an attitudes adjusted and supportive program to increase perceived behaviors control. Moreover, health care personnel and the school should work collaboratively and pay attention to screening and evaluating multiple risk behavior in the student to promote effective prevention to prevent multiple risk behavior among adolescents.

Keywords: Vocational Student, Multiple Risk Behavior, Theory of Planned Behavior

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Effects of a Nurse-Led Program on Fall Prevention Behaviors for Older Adultsin a Community in Bangkok
Sasima Cheepat Plernpit Suwan-ampai Tassanee Rawiworrakul

ABSTRACT
Falling is a major cause for the need for the elderly to receive care. This quasi-experimental research aimed to study the effects of a nurse-led program on fall prevention behaviors of the elderly living in a community in Bangkok. Sixty-one elderly adults living in Ladprao sub-district, aged 70-79 years old were selected. These subjects were capable of performing daily routines of the elderly by themselves, and had normal cognitive function; 28 subjects were assigned to the experimental group and the other 33 subjects were in the comparison group. The experimental group received a program applying Orem's Self-Care deficit theory that comprised of self-care development activities to prevent falling, demonstration and practice exercises to increase balance, home visits by health volunteer, and education of family members in fall prevention. Data related to fall prevention behaviors were collected by interview questionnaires at the pre-test and post-test. The data were then analyzed using independent-sample t-test and paired t-test. The results showed that, after the nurse-led program, the experimental group had statistically significant higher scores in fall prevention behaviors than before the intervention and also higher scores than the comparison group (p-value < .05). Results support the use of a nurse-led program to promote fall prevention behaviors among elderly in the community. The key component of the program, self-care training, was found to empower older adults to better take care of themselves to prevent falling and reduce dependency, which in turn improved elderly quality of life.

Keywords: Nurse-led program, fall, prevention, elderly, self-care behavior, Orem's Self-Care deficit theory

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Effect of Applying Motivation Protection Theory to Contact Lens Keratitis Prevention Program among Vocational Students in The Bangkok Metropolitan Area
Anongnut Sarachana Wonpen Kaewpana Panan Pichayapinyoa Jutatip Sillabutrab

ABSTRACT
At present, Keratitis is a common problem among teenagers. This is due to the incorrect use of contact lenses, which leads to complications that can ultimately result in vision loss. The objective of this quasi-experimental study was to examine the effect of applying motivation protection theory to contact lens keratitis prevention behaviors among first year vocational students in the Bangkok metropolitan area. The experimental group (n=30) received a contact lens keratitis prevention program that was based on motivation protection theory. The control group (n=30) received a guide to eye care and self-care instructions on the proper use of contact lenses, for study, over 5 weeks. Pre-test, post-test and follow-up data were collected by questionnaire. The data were analyzed using the repeated measures ANOVA and independent t-test.The results revealed that, the experimental group after the intervention had significantly better mean scores of perceived severity of keratitis, perceived susceptibility to keratitis, response efficacy expectations for prevention of keratitis, self-efficacy expectations for prevention of keratitis, and behaviors for the prevention of keratitis than at pre-test and better than those of the control group (p< .05).The results of this study suggest that the application of motivation protection theory in preventing contact lens related keratitis can modify the behavior of contact lens users. Teaching, demonstration, role model and communication, and increasing awareness of contact lens users can reduce health problems and prevent disability. This will ultimately help vocational students, who are teenagers, have good quality of life.

Keywords: Contact lens, Keratitis, Motivation protection theory

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Behavior among Adolescent Males in the Royal Thai Army
Tanannut Singwiset Pimpan Silpasuwan Pratana Satitvipawee Ram Rangsin

ABSTRACT
Risky sexual behaviors, including having sexual intercourse at young age, having multiple sexual partners, or not using a condom during the intercourse, all increased high risk of sexually transmitted diseases. This study aimed to examine factors associated with risky sexual behaviors and Sexually transmitted diseases among adolescent males in The Royal Thai Army. The conceptual framework was derived from the problem behavior theory highlighting on personal factors, personality factors, environmental perceptions, socialization factors and drug abuse. 235 adolescent males on duty in The Royal Thai Army completed self-administered questionnaires, as well as, gave information about their drug use and sexually transmitted diseases (via Methamphetamine urine test, Blood test and Physical Examination). Data analysis was performed using descriptive statistics, Chi-square test, Fisher's exact test, Mann-Whitney U Test, and Binary logistic regression. The results showed that the participants with high and low risk of sexual behavior were accounted for 79.6 % and 20.4 %, respectively. The prevalence rate of sexually transmitted diseases based on the blood test result was 1.3 %. The prevalence rate of urine methamphetamine was 29.8 %. The factors that were significantly and positively associated with risky sexual behaviors were marital status, alcohol used, attitude of personality factor, attitude of perceived environment and socialization factor, family, and drug abuse history (p ? 0.05). Regarding the sexual risk behavior aspect among the participants, no differences were found among those who used or did not use drugs (p = 0.356). Moreover, it was found that the marital status, alcohol used, attitude of personality factor and drug abuse history could enhance the ability to predict risky sexual behaviors by 18.0 %. Alcohol use and drug abuse should be prevented. In addition, there should be a guidance to prevent individuals from sexual behavior and sexually transmitted diseases.

Keywords: Risky Sexual Behavior; Adolescent Males; The Royal Thai Army, Drug Abuse

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Relationship Between Job Stress and Job Satisfaction in Nursing Instructor in Ministry of Public Health
Sawitree kaewnan Orawan Kaewboonchoo Tassanee Rawiworrakul

ABSTRACT
Producing nursing graduates invariably required a sufficient proportion of nursing instructors to ensure the delivery of capable nursing graduates critical for responding to the needs of health service system. This research study aimed to explore the relationship between job stress and job satisfaction in nursing instructors of Praboromarajchanok Institute for Health Workforce Development, Ministry of Public Health, based on the concept of JOB DEMAND-CONTROL MODEL. The samples in this study were 311 nursing instructors, who were selected by Multi-Stage Sampling. Data were collected through the use of Job Stress Questionnaire (JCQ) and Job Satisfaction Questionnaire (JSS). The data obtained were then analyzed by statistical methods, including percentage, mean, and standard deviation. This study also employed Chi-Square test and Pearson's product moment correlation coefficient. This research study found that the majority of nursing instructors were female (94.5%), and the age group frequently found was 31-40 years old (50.5%). Most of the samples were married (55.3%) and had the Master's Degree (89.7%), with 1-10 years of teaching experience (52.5%). The samples had job stress at a moderate level (69.5%), the stress in terms of control and decision-making power at a moderate level (62.1%), and the stress in terms of social support at a moderate level (75.2%). Factors associated with job satisfaction were workload (r = -0.152, p <0.01), control and decision-making power (r = 0.301, p <0.01), and social support (r = 0.592, p <0.01). Stress in terms of workload, control and decision-making power, and social support affected the career of nursing instructors in a way that they were required to be enthusiastic, work proactively and improve their performance on a continuous basis, and equip themselves with management skills. It was, therefore, essential that the executives consider adjusting or planning for the balanced workload, support nursing instructors in developing their knowledge and skills, provide welfare and assistance corresponding to the needs, and assure the environment conducive to effective work. These elements could significantly help improve job satisfaction in nursing instructors.

Keywords: Job stress, job satisfaction, nursing instructor

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Factors Related to Transformational Leadership Roles in Health Promotion of Chief Nurse Officer District
Sasitorn Poosakaew Arpaporn Powwattana Wonpen Kaewpan Sukhontha Siri

ABSTRACT
This research aimed to examine factors related to the transformational leadership roles in health promotion of the chief nurse officer district (CNO-D). By means of using stratified-cluster sampling, the sample consisted of 195 people. Data collection was conducted by the use of mailed self-administered questionnaires. The response rate was 80.5%. Data were analyzed using a SPSS software program to find the frequency, percentage, mean, and standard deviation. Relationships were analyzed using Pearson correlation as well as stepwise multiple regression analysis. A p value <0.05 was considered statistically significant. The study found that the CNO-D had high transformational leadership roles in overall health promotion, which accounted for 73.9%.It was found that encouraging, enabling others to act, demonstration and challenging process were all high (86.6%, 84.1%, 75.8% and 63.0%, respectively). The inspiration to share vision was found in a moderate level, (48.4%). The statistically significant factors related to transformational leadershiproles in health promotion of the CNO-D were education level, additional leadershiptraining, additional training in health promotion, motivational factors, hygiene factors,health promotion policies, and work resources (p<0.05). The predictor factors of the CNO-D the transformational leadership role in health promotion were motivational factors related to working performance and factors regarding health promotion policy, in which, they could predict a change in leadership role in health promotion of the CNO-D by 54.2%. The results recommended that a motivational program of working performance and policy advocacy should be developed to promote a change in the leadership role regarding health promotion.

Keywords: Transformational leadership role, Health promotion, Chief nurse officer district

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The 1st APACPH Bangkok Region Conference and the 8th International Public Health Conference Review
Plernpit Suwan-ampai Pimpan Silpasuwan

ABSTRACT
This review article aims to analyze the process and output of an international conference: "The 1st Asia-Pacific Academic Consortium for Public Health (APACPH) Bangkok Region Conference and the 8th International Public Health Conference: Towards Achieving Sustainable Development Goals, 2030" held at Faculty of Public Health, Mahidol University on 25-26 May 2017. The key concept of the conference was "Sustainable Development Goals: SDGs in 2030" which co-hosted by the Thai Public Health Nurses Association. Information gathered from meeting documents and reports, attending and observation the conference sessions,informal interview participants, and the evaluation forms found that the conference have clearly defined the objective. The thematic working groups and work processes were well and systematically prepared and organized. International experts, stakeholders, and national public health organizations were invited to share ideas, experiences, challenges, and progress of SDGs implementation in each South East Asian country. Group discussion in each session was particularly facilitated answers and suggestions from audiences which could create knowledge sharing. In addition, the conference format also added a variety of perspectives, helped avoiding problems from agencies and created action learned under some circumstances leading to desirable output. In the role of public health nursing, benefits gained from this conference were public health strategies that could apply to nursing practice to thoroughly and fairly enhance the well-being of people as well as the future perspective of research issues that will be beneficial for the country's sustainable development towards the health and well-being of people of all ages.

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