Development of health literacy assessment scale for Thai stroke patients.

BACKGROUND: One important factor influencing the treatment and rehabilitation results for stroke patients is their level of health literacy. In order to acquire comprehensive information for appropriate treatment and rehabilitation programs that will promote the optimal possible health outcomes, health literacy assessment should be done in stroke patients from the earliest stages of stroke onset. OBJECTIVES: This research aimed to develop a health literacy assessment scale for Thai stroke patients and to evaluate the HL levels of those patients using that assessment scale. METHODS: A draft version of the scale has been developed based on the literature review and focus group discussions. After tryout, content validity, corrected item-total correlation and internal consistency were examined. A confirmatory factor analysis (CFA) was conducted in 400 patients with stroke to test the construct validity. RESULTS: The Health Literacy Assessment Scale for Thai Stroke Patients was successfully developed. The complete version featured 50 health literacy-related questions, along with seven demographic-related questions. This tool demonstrated good psychometric properties, including content validity (Item-objective congruence; IOC > 0.50), internal consistency (Cronbach's alpha = 0.951 to 0.955, overall = 0.94). Confirmatory factor analysis (CFA) also revealed good construct validity. CONCLUSIONS: The Health Literacy Assessment Scale for Thai Stroke Patients (HLS-Th) is measuring five components cover all health literacy aspects necessary for Thai stroke patient. This novel measurement scale is an accurate psychometric tool for assessing the level of health literacy among Thai stroke survivors.

Health Services Provided at the Primary Care Network of the Faculty of Medicine, Thammasat University.

Background: Health care network of Faculty of Medicine, Thammasat University is one of Contracting Unit for Primary Care (CUP) under Thai Universal Coverage (UC) scheme. It comprises four primary care units (PCUs): Khukhot Subdistrict Health Promoting Hospital (KSHPH), Lamsamkaeo Municipality Health Center (LMHC), Khukhot Municipality Health Center (KMHC), and Thammasat Health Center (THC, also acted as CUP).A primary objective of this research was to study health service indicators of these four health centers. Material and Method: A retrospective study was performed. Data between January 1, 2014 and December 31, 2014 were collected. Following indicators for health service quality were collected and analyzed: 1) numbers of patients visiting PCU/number of patients visiting CUP (OP visit), 2) charge on drugs and medical supplies for outpatient services, 3) newborn and children under five mortality, 4) maternal mortality, 5) low birth weight 6) nutrition status of children under five, 7) diabetes mellitus (DM) patients with Hemoglobin A1C, low density lipoprotein, urine microalbumin tests, diabetic retinopathy screening, and feet examination, 8) hypertension (HT) patients with lipid profile, urine protein and fasting blood sugar tests, 9) controlled DM patients, and 10) controlled HT patients. Results: OP visit of KSHPH, LMHC, and KMHC were 0.22, 0.19, and 0.05, respectively. Charge on drugs and medical supplies for services of KSHPH, LMHC, KMHC, and THC were 102.39, 91.47, 162.04, and 463.85 baht/visit, respectively. There was no newborn, children-under-five and maternal deaths. Percentages of low birth weight of KSHPH, LMHC, KMHC, and THC were 14.3, 14.3, 0, and 9.1%, respectively. Percentage of children under aged five with underweight of KSHPH, LMHC, KMHC, and THC were 12.6, 12.0, 5.6, and 9.1%, respectively. Percentages of children under aged five with overweight of KSHPH, LMHC, KMHC, and THC were 3.7, 22.2, 1.9, and 12.8%, respectively. Percentages of DM patients with HbA1c test of KSHPH, LMHC, KMHC, and THC were 95.4, 87.6, 74.3, and 90.8%, respectively. Percentages of DM patients with LDL tests of KSHPH, LMHC, KMHC, and THC were 98.5, 90.0, 75.7, and 81.5%, respectively. Percentages of DM patients with urine micro albumin tests of KSHPH, LMHC, KMHC, and THC were 6.9, 3.3, 10.0, and 10.2%, respectively. Percentages of DM patients with DR screening of KSHPH, LMHC, KMHC, and THC were 0, 18.7, 0, and 22.6%, respectively. Percentages of DM patients with feet examination of KSHPH, LMHC, KMHC, and THC were 0, 18.7, 0, and 22.7%, respectively. Percentages of HT patients with lipid profile tests of KSHPH, LMHC, KMHC, and THC were 90.8, 73.2, 60.2, and 92.2%, respectively. Percentages of HT patients with urine protein tests of KSHPH, LMHC, KMHC, and THC were 7.3, 17.3, 0.4, and 7.8%, respectively. Percentages of HT patients with FBS screening of KSHPH, LMHC, KMHC, and THC were 92.2, 84.3, 61.0, and 78.1%, respectively. Percentages of controlled DM patients of KSHPH, LMHC, KMHC, and THC were 54.8, 57.9, 54.8, and 61.4%, respectively. Percentages of controlled HT patients of KSHPH, LMHC, KMHC, and THC were 75.7, 19.3, 35.7, and 66.3%, respectively. Conclusion: Several health service indicators need to be improved including: low OP visit, low birth weight, high underweight and overweight among children under aged five, low coverage of urine micro albumin, DR screening, and feet examination among DM patients, low coverage of urine protein among HT patients, and high percentage of uncontrolled DM and HT patients.

What are the health needs, familial and social problems of Thai migrants in a local community in Australia? A focus group study.

This study explored the health needs, familial and social problems of Thai migrants in a local community in Brisbane, Australia. Five focus groups with Thai migrants were conducted. The qualitative data were examined using thematic content analysis that is specifically designed for focus group analysis. Four themes were identified: (1) positive experiences in Australia, (2) physical health problems, (3) mental health problems, and (4) familial and social health problems. This study revealed key health needs related to chronic disease and mental health, major barriers to health service use, such as language skills, and facilitating factors, such as the Thai Temple. We concluded that because the health needs, familial and social problems of Thai migrants were complex and culture bound, the development of health and community services for Thai migrants needs to take account of the ways in which Thai culture both negatively impacts health and offer positive solutions to problems.