Palliative care in Thailand.

In Thailand, several barriers exist that prevent people with life-limiting illnesses from accessing good-quality palliative care, namely: lack of palliative care providers; lack of training and education for the palliative care workforce; and issues with availability and distribution of opioids. Without palliative care, people suffer needlessly during the last months of their life. This paper gives an analysis of these issues and provides recommendations for clinical practice, research and health policy that may help to alleviate these issues.

Factors affecting failure to quit smoking after exposure to pictorial cigarette pack warnings among employees in Thailand.

This study was carried out to determine whether health warning pictures(HWP) affect smoking cessation using a structured equation model for intending-to-quit smokers in work places. Data from a 1-year longitudinal followup of attempt-to-quit employees was obtained to determine if pack warnings affect tobacco cessation rates. Stratified simple random sampling, and Structured Equation Modeling (SEM) were employed. Approximately 20% of intending-to-quit smokers were successful. The integrated model, combining internal, interpersonal factors and health warning pictures as external factors, fit the fail to quit pattern of the model. Having a smoking father was the most significant proximate indicator linked with failure to quit. Although HWL pictures were an external factor in the decision to stop smoking, the direct and indirect causes of failure to quit smoking were the influence of the family members. Fathers contributed to the success or failure of smoking cessation in their children by having an influence on the decision making process. Future HWP should include information about factors that stimulate smokers to quit successfully. The role model of a father on quitting is also important.

Participatory capacity building in occupational disease surveillance among primary care unit (pcu) health personnel.

This study aimed to demonstrate participatory capacity building regarding occupational disease surveillance (ODS) could enable the Primary Care Unit (PCU) health personnel provide satisfactory occupational health services for workers in the community. A needs assessment was carried out to identify gaps in PCU health personnel skills and knowledge so these areas could be strengthened. An ODS training program was developed. Fifty-nine health personnel participated in a 5 day workshop and received instructions regarding a wide range of occupational diseases, surveillance methods, prevention measures, and Ministry of Public Health (MOPH) surveillance systems. Participants self reported positive changes in knowledge and skills, as well as a high level of satisfaction with the workshop. However, many participants noted barriers to consistently implementing reporting procedures.

Hospital Readmission Risks Screening for Older Adult with Stroke: Tools Development and Validation of a Prediction.

Hospital readmission of stroke elderly remains a need for detecting preventable risks. This study aims to develop a Readmission Stroke Screening Tool or RRST. The mixed research design was employed, phase1; systematic reviews from 193 articles extracting to be 14 articles, 9 experts' consensus, and try out the RRST Internal consistency; IOC = .93, ICC = between .93 and .56, phase 2; Data collecting 150 of strokes patients in the stroke units during 2019 to 2020; 30 nurses employed the RRST to screen stroke elderly before discharge. Statistical analysis, Exploring Principal Factor Analysis to test the best predictor factor, and Confirmatory Factor Analysis to test the model identity were employed. Results: The multi-domain RRST; 4 factors: Intra, inter, and external factors of patients can predict the hospital readmission of Stroke elderly at a high level in 28 days. The ADL: Activities in the Daily life domain was the highest level of predicting (Eigen Value = 6.76, 1.15, Variances = 79.19%) significantly. 53.3% of user nurses reflected; the RRST tool's effectiveness was achievable in usefulness, benefit, accuracy, and easy to use; however, the rest users identified to improve the RRST easier and quicker. Conclusion; The new RRST; can predict the high-risk readmission effectively = 92.5%. User nurses satisfied the RRST predicted quality. the multi-domain RRST could be detecting the Thai Stroke's high-risk group for reducing avoidable risks, suggestion; more effort will be investigated prospectively in readmission by expanded volume of the Asian' Stroke elderly for increasing accuracy predicting and extended tool quality utilized standard scored correctly.

Occupational hazards, health conditions and personal protective equipment used among healthcare workers in hospitals, Thailand.

This cross-sectional study aimed to evaluate occupational hazards, health conditions and personal protective equipment used among healthcare workers. Information from the sample size of 1,128 healthcare workers were collected using questionnaires. The healthcare workers participated in this study were from five departments including inpatient, outpatient, surgery and anesthesia, nutrition service and hospital support services departments in five hospitals in Thailand. The results indicated that the majority of healthcare workers were female; these healthcare workers work 9.0 to 11.1 hours/day on average and were exposed to several chemical, biological and physical hazards. The healthcare workers in the nutrition service department reported the highest percentage of musculoskeletal disorder and respiratory problems. The highest percentage of skin problems were reported by healthcare workers in surgery and anesthesia department. The results showed musculoskeletal disorder, respiratory and skin problem significantly differed among healthcare workers in the five departments including the wrists/hands (p = 0.024), upper back (p = 0.009), chest pain symptoms (p = 0.004), and dry/wound symptoms (p = 0.013). Healthcare workers did not have adequate protection from work-related hazards in their workplace. Health education programs, control measures and organizational policies should be implemented to mitigate the hazards for healthcare workers in hospitals.

Health-Related Quality of Life After the 2015 Gorkha Earthquakes, Among Older Adults Living in Lalitpur District of Central Nepal.

OBJECTIVE: Health-related quality of life (HQL) among older adults is often neglected and underprioritized in developing countries and is further burdened during natural disasters, such as earthquakes. The main objective of this study was to explore the factors affecting HQL among older adults living in Lalitpur District of Nepal. METHODS: A total of 362 older adults participated in this study. Questionnaires were used to interview the respondents on various aspects, such as posttraumatic stress disorder (PTSD) and depression, functional ability, and social support. An analysis was made to explore the factors affecting HQL. RESULTS: HQL scores ranged between 3.13 and 90.63. A majority of the respondents (215/362; 59.4%) scored ≤ 50, indicating poorer HQL. The multivariate analysis found the impact of the following factors on HQL: functional status (ß = 0.295; P < 0.001), PTSD (ß = -0.225; P < 0.001), chronic disease (ß = -0.168; P < 0.001), social support (ß = 0.120; P = 0.019), injury (ß = -0.104; P = 0.024), age (ß = -0.116; P < 0.001), and accessibility to resources. CONCLUSION: Poor HQL of older adults was dependent on various factors. The disaster preparedness program in Nepal needs urgent attention to address the concerns of older adults by incorporating the findings from this study.

Modifiable Factors and Colon Cancer Risk in Thai Population.

To demonstrate the possible impact of modifiable factors on colon cancer development in Thai population, we conducted this case-control study from June 2016 until June 2017. The study was conducted in 11 Thai provincial hospitals. The hospitals in this study were selected by stratification by regions. Patients included 504 ones who were newly diagnosed with colon cancer within 1 month. In the control group, 997 health individuals were enrolled. Both case and control were adjusted by age. The results of this study showed that age and socioeconomic factors were associated with colon cancer risk. In addition, it was found that family history of colon cancer had very high association with colon cancer risk. Behavioral factors, including smoking, inadequate physical exercise, and salty food consumption were associated with colon cancer. We detected no association between obesity, alcohol consumption, and colon cancer. The results suggested that colon cancer might have higher association with genetic factors than behavioral factors among Thai patients. Based on the results of this study, stop smoking and promote adequate physical activity are suggested to reduce the incidence of colon cancrr among Thai patients.

Hazard Exposure with Health and Safety Outcomes Hinder the Work Ability of Salt Farm Workers in Thailand.

OBJECTIVE: Unsafe environments and occupational hazards have been documented and are contributing to health risks for salt farm workers in Thailand. Whether exposures with various health hazards and outcomes affect work ability among these workers is uncertain. This study aimed to examine the effects of hazard exposures with health risks and outcomes, including accidents, for work ability among salt farm workers. METHODS: A cross-sectional study was completed with 120 salt farm workers recruited from the largest salt farm company in Samutsakorn Province during January and February 2014. Face to face interviews were conducted using a structured questionnaire comprised of worker characteristics, working conditions, safety and health problems related to work, and a work ability index (questionnaire reliability =0.84) through a worksite visit. The MIMIC model was used to determine direct and indirect causal effects of work-related health hazards and outcomes on work ability. RESULTS: Among 120 salt farmers, 61% were female and 77% had primary educations. Average age and work experience was 49.5 years (SD = 13.7) and 23.7 years (SD = 13.5), respectively. 66% worked more than 5 days per week and 21.3% had at least one accident in the past 3 months. The results of structure equation analysis revealed that healthy skin was related to heat exposure (ß=.35, p=.01) and directly influenced work ability (ß=.37, p=.01), Eye irritation was influenced by length of work time (ß=.24, p=.05), and harmonized the predictive value of the model at a high level (χ2=94.51, df=73, p-value =0.05, χ2/df=1.29. RMSEA= 0.066). CONCLUSION: Results for the MIMIC model indicate that two factors, bright sunlight and strong wind exposure over an extended work period, could be having crucial impacts on skin and eye health of salt farm workers. These factors might be protected against using PPE and health examinations with positive health outcomes directly improving work ability. Substantial governmental action with community leadership is needed immediately so action plans are instituted to improve occupational safety and health.

Potential effectiveness of health warning labels among employees in Thailand.

OBJECTIVE: Explore and investigate the perceptions and responses of employees regarding the effects of a Health Warning Label (HWL) on their decision to encourage quitting and stages of change in smoking behavior. MATERIAL AND METHOD: One thousand six hundred thirty seven employees in workplaces from four regions, including Bangkok city, were studied during the year 2005-2006. Six hundred nine employees (both non- or cigarette smokers) were part of a cohort study using qualitative and quantitative approaches. Questionnaires were used to sample the cohort twice and two individuals per factory were interviewed in-depth. RESULTS: The New-HWL that made the best impression was the "cancer caused by cigarette smoking" and 3.8% stopped smoking after seeing the New-HWL. Moreover, New-HWL increased employees "pro" attitudes about smoking cessation. Decisional balance that reflected different "con" to quit, among non-quitting and quitting smokers. CONCLUSION: New-HWL significantly increased attitudes about smoking cessation.

Catching and Correcting Unreported, Under-Reported Accidents (Near-Misses) among Healthcare Provider in Thailand.

OBJECTIVES: Latent errors in an incident reporting system pose threats to accident and near-miss prevention in hospitals. The aims of this study were to gain insight into the incident reporting system by exploring and investigating the refinement of unreported and under-reported (near-miss) patterns and by estimating under-reported annual hospital accidents over three months in one hospital. METHODS: Sequential mixed-method research was undertaken using both qualitative and quantitative approaches. 120 health care providers were selected from 13 departments of a selected study hospital. Self-reported questionnaires, information from annual reports and focus group interviews among stakeholders were employed. Based on a quantitative mixed-model approach, estimation of lost cases from near-miss incidents was made. RESULTS: In 2015, 20% of accidents had been reported to the hospital center while under-reported accidents and near-miss incidents by self-report over 3 months equaled 18% and 25.9%, respectively. Recent trends were positive, driven by changing values about incident reporting. However, confusion and fear still remain among practitioners about near-miss reporting due to old beliefs. This study confirms that incident reporting needs improvement so that there is an enhanced organizational culture of safety, raised awareness for individual reporting, and recovery of lost cases using mixed-model estimation of near-misses.

Evaluating occupational health nursing units in Bangkok textile factories: exploring the world through international occupational health programs.

The purpose of this study was to examine the service quality of nursing units in Bangkok textile factories. Descriptive survey research was combined with a qualitative design using participative observation. The sample consisted of factory managers, nurses, and employees. Data were collected between November 2001 and February 2002 using questionnaires, observation, in-depth interviews, and focus groups. Nurses' education levels and quality of design and arrangement of nursing units explained 15.7% of the variance in service quality. Furthermore, qualitative data supported clients' satisfaction with service quality, except for the tangibility of the service. These findings suggest that the quality of nursing service units could be improved by management's attention to unit design, arrangement of nursing units, and nurses' education levels. Hiring registered nurses and restructuring nursing units are recommended.

Cotton Dust Exposure and Resulting Respiratory Disorders Among Home-Based Garment Workers.

Cotton dust exposures and resulting respiratory disorders among Thai home-based garment workers in Bangkok were explored. Structured interviews focused on occupational health assessments of respiratory disorders; workflow process observations, lung function screening tests, and garment dust density assessments were used to gather data. Results revealed that garment workers in this study had worked in home-based tailoring an average of 14.88 years; 88.5% reported average health status, only 2.6% currently smoked cigarettes, and 8.6% had impaired lung function. The prevalence of respiratory disorders in this occupational group was 25%. Significant respiratory tract signs and symptoms were associated with lung function capacity (odds ratio [OR] = 52.15, 95% confidence interval [CI] = [6.49, 419.60]). Long work hours and few preventive behaviors were significantly associated with respiratory disorders (OR = 2.89 and OR = 10.183, respectively). Improving working conditions at home and minimizing fabric dust exposure among garment workers are recommended.

Occupational Safety, Health, and Well-being Among Home-based Workers in the Informal Economy of Thailand.

The objective of this article is to provide a summary of the issues related to occupational safety and health and well-being among workers in the informal economy of Thailand, with a special emphasis on home-based workers. The reviewed literature includes documents and information sources developed by the International Labour Organization, the National Statistical Office of Thailand, peer-reviewed scientific publications, and master's theses conducted in Thailand. This work is part of a needs and opportunities analysis carried out by the Center for Work, Environment, Nutrition and Development--a partnership between Mahidol University and University of Massachusetts Lowell to identify the gaps in knowledge and research to support government policy development in the area of occupational and environmental health for workers in the informal economy.

The Impact of Cigarette Plain Packaging on Health Warning Salience and Perceptions: Implications for Public Health Policy.

The study employed a mixed methods design using focus group interviews with 6 student groups and self-administered questionnaires with 1239 students. The participants were nonsmoking, current smokers, and quit-smoking teenagers from secondary schools and colleges. Focus group revealed that although nonsmoking teenagers perceived fear appeals to warning messages, current smokers did not perceive fear appeals to health. Black and white backgrounds of the cigarette package were chosen as the best color for plain packaging. However, most participants suggested various pictorials and a bigger size of pictorial warnings for greater and more effective fear appeal. Odds ratio showed that males had 2.43 times the odds to perceive intention not to smoke. Teenagers who had never smoked and those who had quit smoking had 13.27 and 3.61 times the odds, respectively, to perceive intention not to smoke.

Musculoskeletal disorders among Thai women in construction-related work.

A cross-sectional study was conducted to determine the prevalence of musculoskeletal disorder symptoms and its risk factors among women rebar workers. A simple random sampling method was used and data were collected by face-to-face interview and ergonomic assessment from February to March 2011. A total of 272 women rebar workers with at least 6 months' job experience participated in this study. The findings revealed that 57.7% of workers reported musculoskeletal disorder symptoms with low back and shoulders as the most common body parts affected (46.0%). Multiple logistic regression analysis indicated 2 variables that are significantly associated with musculoskeletal disorders: prolonged working hours (adjusted odds ratio = 7.63; 95% confidence interval = 2.06-28.31) and awkward posture (adjusted odds ratio = 43.79; 95% confidence interval = 17.09-112.20). The high prevalence of musculoskeletal disorders among women rebar workers suggests that an appropriate ergonomic workstation design and ergonomic training for women rebar workers are necessary.