การเตรียมตัวเข้าสู่วัยสูงอายุของพยาบาล: การศึกษาแบบตัดขวาง ในโรงพยาบาลมหาวิทยาลัย จังหวัดนครนายก Preparing for Ageing among Nurses: A Cross-sectional Study in a University Hospital in Nakhon Nayok Province

บทคัดย่อ วัตถุประสงค์: เพื่อศึกษาระดับการเตรียมตัวเข้าสู่วัยสูงอายุและปัจจัยที่สัมพันธ์กับการเตรียมตัวเข้าสู่วัยสูงอายุของพยาบาลตามหลัก 3 เสาแนวคิดพฤฒพลัง วิธีการศึกษา: การวิจัยแบบตัดขวางในพยาบาลที่ปฏิบัติงานโรงพยาบาลมหาวิทยาลัยในจังหวัดนครนายก เมื่อปีพ.ศ. 2560  โดยใช้แบบสอบถามที่ประกอบด้วยตัวแปร เพศ อายุ สถานภาพสมรส การศึกษา หน่วยงาน ประสบการณ์ทำงาน ที่อยู่อาศัย โรคประจำตัว และรายได้ รวมถึงการเตรียมตัวเข้าสู่วัยสูงอายุตามกรอบแนวคิดพฤฒพลัง ด้านสุขภาพ ด้านการมีส่วนร่วมและด้านหลักประกัน ผลการศึกษา: แบบสอบถามได้รับการตอบกลับจำนวน 303 ฉบับจาก 342 ฉบับ อายุเฉลี่ย 29.9 ปี (SD = 6.3) เป็นเพศหญิงร้อยละ 97.7 พบว่า การเตรียมตัวเข้าสู่วัยสูงอายุด้านสุขภาพและด้านการมีส่วนร่วมอยู่ในระดับมาก และด้านหลักประกันอยู่ในระดับปานกลาง ส่วนปัจจัยที่ส่งผลต่อการเตรียมตัวเสาหลักด้านสุขภาพและด้านการมีส่วนร่วมมีลักษณะคล้ายกันคือ กลุ่มอายุ 31 - 59 ปี สถานภาพสมรส การศึกษาปริญญาโท แผนกห้องตรวจโรค ห้องคลอด และหน่วยไตเทียม หน่วยสวนหัวใจ ประสบการณ์การทำงาน 10 ปีขึ้นไป และที่อยู่อาศัยมีบ้านตนเอง ส่วนปัจจัยที่ส่งผลต่อการเตรียมตัวด้านหลักประกันคือการมีรายได้เสริม สรุป: การศึกษานี้ชี้ให้เห็นถึงความจำเป็นในการเตรียมความพร้อมด้านหลักประกันให้กับพยาบาล เช่น การวางแผนด้านการเงิน การสร้างรายได้ รวมถึงการตระหนักถึงการสมดุลงานกับการเตรียมชีวิตสู่วัยสูงอายุในอนาคต คำสำคัญ: เตรียมสูงอายุ,  พยาบาล, พฤฒพลังAbstract Objective: To examine the level of ageing preparation of nurses working in a university hospital according to the three pillars of the Active Ageing Framework and explore factors related to their preparation. Methods: With the cross-sectional study design, the sample consisted of nurses working in a university hospital in Nakhon Nayok province in 2017. Data were collected through questionnaires that included such variables as gender, age, marital status, education level, working units, length of work experience, housing, underlying diseases and income as well as the ageing preparation according to the Active Ageing Framework’s three pillars, namely health, participation and security. Results: A total of 303 out of 342 questionnaires were returned. Participants average age was 29.9 years (SD = 6.3) and 97.7% of them were female. The ageing preparation of the health and participation pillars were at a high level, while that of the security pillar was at a medium level. The preparation of the health and participation pillars was more likely found in those aged between 31 and 59 years old and those who were married, obtained a Master’s degree, worked at the outpatient unit, the labor room, the kidney dialysis unit and cardiac care unit, had gained over 10 years’ experience and lived in their own homes. The factor that affected the preparation of security was supplemental income. Conclusion: There is a need for preparation of the security pillar in financial planning, income improvement, awareness of work-life balance and ageing preparation. Keywords: ageing preparation, nurses, active agein

Overweight, obesity and sickness absence among the workers in an automotive parts factory

The objective of this study was to identify the difference of sickness absence between overweight or obese workers and normal weight workers in an automotive parts foctory. The incidence and length of sickness absence were studied as well. The samples were 556 workers who work in an automotive parts factory in the Lad Krabang industrial estate, Bangkok. The data were collected during 1 June to 30 November 2012 by using questionnaire and sickness absence record form. Percentage and mean were used to report, and chi-square and ANOVA were used to analyze data in this study. The results found that the overall incidence of sickness absence in 6 months was 28.6% while in normal weight, overweight and obese workers were 22.8, 32.1 and 38.3, respectively. Upon analysis of the difference of sickness absence incidence between groups, there is the statistically significant difference with p-value <0.01. It also shows a trend between incidence rate and BMI (p<0.01). For the average length of sickness absence in 6 monts, the overall wass 10.9 days while in normal weight, overweight and obese workers it was 0.85, 1.13 and 1.57 days, respectively. The length of sickness absence was also different between group with p-value=0.02. However, there is only significance between the obese and normal weight groups when tested by Bonferroni. In conclusion, not only is the health of overweight and obese workers affected, but also their work

The Comparative studies of Treatment Outcomes of Diabetes Thai patients in HRH Princess Mahachakri Sirindhorn Medical Center Using The ADA 2008 guideline.

The study aims to compare treatment outcomes and complication surveillance among diabetes mellitus type II patients in the service area of HRH Princess Mahachakri Srindhon Medical Center (MSMC) with the American Diabetes Associate guideline 2008 (ADA 2008) and comparing the difference in treatment outcomes between the primary care unit (PCU) and the tertiary care unit (TCU). Data were collected by questionnaires from all type 2 diabetes patients and their medical records during 2009 – 2010 in a cross-sectional study. There were 274 type 2 diabetes patients in this study, 131 cases in PCU and 143 cases in TCU. Glycemic controls in these patients were monitored by using HbA1c at 72.5% and 74.1% in PCU and TCU, respectively. Microalbuminuria was screened in all of patients when comparing treatment service between PCU and TCU, the patients in PCU were less accomplished and less monitored than TCU patients; however, the differences were not statistically significant according to the ADA 2008 except in eye and foot examinations. In conclusion, the majority of type II diabetes patients were monitored according to the ADA 2008. The patients in TCU successfully achieved glycemic and metabolic control better than the patients in PCU without statistical significance. In consequence, physicians should be concerned about complications among type II DM patients according to the  standard guidelines, especially, in PCU. Nevertheless, physicians also should be concerned about the quality of care index using the holistic approach

Heath profile of elderly people through active ageing framework in a community, Nakornnayok province

Health status of people in a community should be inspected in order to entering an ageing society. A health profile survey is an important first step. This study aimed to determine the health profile of an elderly population by using the active ageing framework. The survey was conducted in residents aged 60 or more in the Choomphol subdistrict, Ongkharak, Nakhonnayok, Thailand. Volunteers were selected by a stratified random sampling technique. The health profile questionnaire was used for interviewing and data collecting Among 195 participants, 59.0% were females and 41.0% were males, aged 60-94 years. According to active ageing framework health dimension, the first dimension – health condition- the results showed that 43.6% had health problems including visual problems (62.1%), memory loss (48.7%), sleeping problem (38.5%), depression (13.3%), dementia (21.6%). Their self dependency measured by Barthel ADL Index, the results indicated that 1.0% had no or little self dependence. In the second dimension security dimension, 60% were living with their spouse and their offspring played a major role in their living security and financial support. On the participation dimension, 65.6% engaged in religious practice and 55.9% engaged in community service. The presenting survey results emphazied further preparation for these 3 dimensions within the context of community

Knowledge, attitudes and practice of premarital, preconceptional blood tests and thalassemia among pregnant women and their spouses during the first prenatal visit

The Objective of this study was to assess the knowledge, attitudes and practice of premarital, preconceptional blood tests and thalassemia of pregnant women and their spouses who came for the first prenatal visit at Maha Chakri Sirindhorn Medical Center. Pre-test and post-test questionnaires were administered to the subjects (including pregnant women and their spouses who came for the first prenatal visit between 1st October 2009 and 31st January 2010) after viewing the informative video of the prevention and control of Thalassemia. The results showed that of the 300 participants (200 pregnant women and 100 husbands), the differences between the pre- and post-test scores were statistically significant (p<0.01). Seventy three percent of the participants showed an improvement in their scores. Regarding their evaluation of the information presented in the video, virtually all of the participants rated the details, difficulty level, visual presentation and length of the video as good and very good. Although 96.3 percent of participants claimed to recognize the benefits of premarital/preconceptional blood tests, only 39.7 percent had premarital/ preconceptional blood tests and 34.3 percent used to advice their relatives/friends to undergo such a medical procedure. Finally, post-test questionnaires revealed that 85.0 percent decided to have their blood screened for thalassemia, and 93.3 percent would advice their relatives/ friends to take premarital/preconceptional blood tests. Taken together, these data suggest that the informative video can increase the level of the knowledge of prevention and control of thalassemia

Family History And Risk Of Breast Cancer: A Case-Control Study In Thailand

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Movement Disorders in Non-Wilsonian Cirrhotic Patients: A Report of the Prevalence and Risk Factors from a Study Done in a Medical School in an Agricultural-Based Community

Objective Parkinsonism and other movement disorders have previously been reported in the acquired hepatocerebral degeneration associated with portosystemic shunting. However, there is no study to date about their prevalence as has been noted in general practice. Methods One hundred and forty-three patients with hepatic cirrhosis from the gastroenterology clinic and internal medicine wards were enrolled. Liver data included the diagnoses, etiologies, assessments of complications, and treatments for cirrhosis. Hepatic encephalopathy was classified with regard to the West Haven criteria for semi-quantitative grading for mental status. Neurological examination results and abnormal involuntary movements were recorded as primary outcomes. Neuro-radiology was used for the detection of severe brain lesions. Results Alcoholism was the most common cause of liver cirrhosis. Eighty-three patients (58%) presented with movement disorders. Asterixis was found in one of the cases. The most common movement disorder seen was an intentional tremor at 37.1%, which was followed by bradykinesia, Parkinsonism, and postural tremors at 29.4%, 10.5%, and 6.3%, respectively. The prevalence of movement disorders simultaneously increased with a high Child-Turcotte-Pugh score. The hepatic encephalopathy was grade 1 and 2. With the inclusion of age-range adjustments, we found that alcoholic cirrhosis and hepatic encephalopathy are statistically significant factors [p < 0.05, odds ratio (OR) = 6.41, 95% confidence interval (CI) 1.38–29.71 and p < 0.001, OR = 13.65, 95% CI 4.71–39.54] for the development of movement disorders in non-Wilsonian cirrhotic patients. Conclusions Intentional tremor is a common abnormal movement. Alcoholic cirrhosis and hepatic encephalopathy are significant risk factors in the development of movement disorders in non-Wilsonian cirrhotic patients

The impact of the quality of care and other factors on progression of chronic kidney disease in Thai patients with Type 2 Diabetes Mellitus: A nationwide cohort study.

The present study investigates the impact of quality of care (QoC) and other factors on chronic kidney disease (CKD) stage progression among Type 2 Diabetes Mellitus (T2DM) patients.This study employed a retrospective cohort from a nationwide Diabetes and Hypertension study involving 595 Thai hospitals. T2DM patients who were observed at least 2 times in the 3 years follow-up (between 2011-2013) were included in our study. Ordinal logistic mixed effect regression modeling was used to investigate the association between the QoC and other factors with CKD stage progression.After adjusting for covariates, we found that the achievement of the HbA1c clinical targets (≤7%) was the only QoC indicator protective against the CKD stage progression (adjusted OR = 0.76; 95%CI = 0.59-0.98; p<0.05). In terms of other covariates, age, occupation, type of health insurance, region of residence, HDL-C, triglyceride, hypertension and insulin sensitizer were also strongly associated with CKD stage progression.This cohort study demonstrates the achievement of the HbA1c clinical target (≤7%) is the only QoC indicator protective against progression of CKD stage. Neither of the other clinical targets (BP and LDL-C) nor any process of care targets could be shown to be associated with CKD stage progression. Therefore, close monitoring of blood sugar control is important to slow CKD progression, but long-term prospective cohorts are needed to gain better insights into the impact of QoC indicators on CKD progression