The Development of a Multimedia Interactive Learning (MIL) Program in Diabetes Care for Health Care Professionals in Northeastern Thailand.

Objective: This paper reports the development of a multimedia interactive learning (MIL) program in diabetes care for health care professionals in northeastern Thailand. It aims to be a supplementary tool for health care professionals to enhance their knowledge and skills in diabetes treatment. Methods: The program was developed via software called “Authorware Professional 7.1Ò”. Additionally, audio and video clips were implemented into the program as part of the multimedia interactive functions. The program covers different aspects of diabetes care including; basic knowledge of diabetes, available treatments (e.g., oral medications, insulin, non-medication treatments), patient monitoring (e.g., diet, exercise, blood glucose check up), case studies (e.g., patient cases), and assessments (e.g., multiple choice questions). Moreover, the insulin injection techniques were demonstrated via video clips. Interestingly, the program itself will be running via a mouse-clicking with automatic audio sounds. After the completion of the program, an attitude survey towards a MIL program was conducted next. Results: The overall results were positively favorable. Some changes were made into the program based on the recommendations. A further evaluation of the effectiveness of the program with the health care professionals needs to be conducted via a well designed study. More surveys regarding the attitudes toward the program will be continually performed. Conclusion: a multimedia interactive learning (MIL) program was completely developed. The usefulness of the program in diabetes care management via health care professionals is still needed. Further evaluations of attitudes toward to the program need to be done.

Personal and environmental factors related to amphetamine addiction and quitting in northeastern Thailand.

Objective: The study aimed to investigate both personal and environmental factors related to amphetamine addiction and quitting of drug-using people in Leu-Amnat sub-district, Amnatchareon Province, Thailand. Methods: Questionnaires were completed by one hundred and nineteen persons, in addition to them attending basic knowledge activities and a matrix program. Pre-tests, immediate post-tests, and 6 month post-tests were performed before and after the activities and program. Questionnaire responses and comparisons of scores of the tests were statistically analyzed. Results: Overall, the results showed that coming from a small family was a statistically significant personal factor related to drug addiction and quitting. Numbers of houses, and family and income problems were environmental factors significantly related to drug addiction and quitting. Basic knowledge regarding drug addiction increased statistically at different periods of time. The study found that the best solutions for drug addiction were the establishment of communities and the provision of knowledge regarding the dangers of drug addiction for children. Strategies involving drug addiction prevention programs, medical treatment, mental therapy, and education focusing on family and school levels were considered necessary. Conclusion: Some personal and environmental factors may be related to a person’s increased likelihood of exposure to drugs. These results may imply that the Thai government should reconsider those factors involved in drug addiction and quitting.

A comparison of dengue hemorrhagic fever control interventions in northeastern Thailand.

This study compared the effectiveness of the currently available interventions of dengue vector and dengue hemorrhagic fever (DHF) control used in northeastern Thailand, an area with a high incidence of the disease. Also, the basic knowledge of dengue vector and DHF control of a group of 568 participants from local communities was measured. These communities were divided into two groups that had no reported cases in the previous year (non-DHF) and a group that had reported cases (DHF). Three current interventions of dengue vector and DHF control were assessed: insecticide fogging, 1% w/w temephos sand granules, and a combination of these two. Assessment included numbers of DHF cases, vector indices [house index (HI), container index (CI), and Breteau index (BI)], and cost. A multiple choice questionnaire was used to measure participants' basic knowledge desirable for knowledge retention. Data was statistically analyzed by the use of means, standard deviations, percentages, ANOVA repeated measure, and logistic regression. The results showed 1% w/w temephos sand granules as the most effective intervention of dengue vector and DHF control and there was a statistically significant difference between the control measures (p =0.001). Most participants had either a very low or very high level of knowledge and basic knowledge was statistically significantly associated with vector index (BI) (p = 0.008). Participants stated that they mainly gained knowledge about dengue vector and DHF control from public health workers followed by television and public media. Overall, the findings of this study illustrated the importance of public health workers and communities in health issues at the local level and the need to assess the benefits of current interventions and combinations of current and new interventions of dengue vector and control.

An investigation of HIV-preventive behavior of female prostitutes in the city of ubon ratchathani.

Objective: This study aimed to investigate the HIV-preventive behavior of a group of female prostitutes in the city of Ubon Ratchathani in Northeast Thailand. Methods: Basic knowledge and perceptions regarding HIV/AIDS were also assessed. The relationship between knowledge, perception, educational levels and HIV-preventive behavior were identified. A questionnaire was trialed before the survey proper, and content validation and reliability were established prior to the launch of the study (average a = 0.75). Results: Information was collected by the completion of a descriptive survey by 293 female prostitutes from 35 entertainment centres from February to April 2005. Data collected was subjected to statistical analysis. Results showed the participants had a good basic knowledge of HIV/AIDS and reasonable perceptions of the condition. Approximately one-third (37.5%) had sound behavior related to HIV infection, but an equivalent proportion (39%) needed to review their behavior. There was a statistically significant relationship between knowledge, perceptions, marital status and educational levels and HIV-preventive behavior (p<0.05). Conclusion: Conclusively, the prostitutes had an overall average HIV/AIDS knowledge, except some issues such as HIV/AIDS in pregnancy. Additionally, the HIV/AIDS perception was mainly good, whereas the HIV-preventive behavior was needed to be adjusted including; a regular condom use.

Evaluation of the effectiveness of a computer-based learning (CBL) program in diabetes management.

OBJECTIVE: Evaluate the effectiveness of a computer-based program (CBL) introduced to improve the clinical and patient history taking skills of clinical pharmacists in the area of diabetes management. This program involved a self-learning approach utilizing interactive digital videos, video simulations, and audio clips. MATERIAL AND METHOD: The present study compared the pre- and post-test results of two groups of final year pharmacy students. The study group used the CBL program and the control group was exposed to formal lectures and discussions. RESULTS: Eighty-three volunteers entered the present study. Forty-three were constituted into the study group, and forty acted as the control group. The overall results showed that the study group post-test scores in all basic knowledge areas were significantly higher than the control group (p = 0.001). Whereas, there was no statistical difference between groups in patient history taking skills (p = 0.645). Nevertheless, the post-test scores of SOAP writing skills in the study group were statistically higher than the control group (p = 0.001). CONCLUSION: Overall, the CBL program was considered effective in the development of basic knowledge of diabetes and in the improvement of patient history taking skills.

The development of a computer based learning (CBL) program in diabetes management.

OBJECTIVE: To develop a computer based learning (CBL) program in diabetes management for health care providers and academic staff MATERIAL AND METHOD: A CBL program was developed using "Authorware Professional ver. 6. 0" software. Content validation, computer background survey and investigation of the usability of the program, was conducted as part of the production of this program. The involved participants were university staff hospital care providers (e.g., doctors, nurses and pharmacists) and nursing & pharmacy students. RESULTS: Overall, the results were positive. Some limitations regarding computer background were revealed Few of the participants were familiar with self-learning materials. The usability of the CBL program was generally encouraging however some comments were made regarding program function, such as the duration of the program, and minor problems with the audiovisual effects. All comments were noted and addressed for future implementation. CONCLUSION: The CBL program was found to be a user-friendly, interactive multimedia program for diabetes management.

The relationship between health behavior and pain scale in patients with low back pain in Thailand.

The purpose of the study was to evaluate the relationship between health behavior and pain scale in patients with low back pain. One hundred eighty patients with low back pain attending the Orthopedic Unit at Sapasithiprasong Hospital in Thailand participated in the study. The participants completed a questionnaire related to demographic data and preventive health behavior, illness health behavior and sick role health behavior. Statistical analysis was used to calculate means, standard deviations and percentages, multiple regression evaluated the relationship between demographic data and pain scale, and Pearson's correlation assessed the relationship between the three health behaviors and pain scale. Generally, the results showed most participants had a lower quality of health behavior. The most common causes of low back pain were lifting heavy loads, incorrect positioning and everyday activity (43.9, 17.8 and 10.6%, respectively). The level of participant's income was found to be statistically relevant to pain scale (p < 0.05). There was also a statistically significant association between the three health behaviors and pain scale (p = 0.0001, 0.005, 0.0001, respectively). The findings of this study illustrate the crucial role that Thai health care professionals play in changing the health behavior of patients with low back pain in order to improve the patient's quality of life.

Stress and coping behavior of out-patients in yasothon province.

Objective: Due to current lifestyles that forces people to struggle their lives, we are going to a stage of mind control problems which can lead to stressful conditions. This can cause health and mind problems which contribute to a crime, sadness, loneliness, hopelessness, etc. In addition, types of health services play a major role in stress conditions which may be caused by internal and external factors affecting the patients. Methods: The study aimed to assess the relationship between stress levels and personnel characteristics, especially the evaluation of stress levels in relationship to different health services and other factors. A total of 809 outpatients visited different health care services (e.g., governmental hospital, private hospitals, health care centres, etc) at Yasothon. They were asked to collaborate on this project by filling out a questionnaire survey. The contents of a survey related to volunteers’ feeling and stress coping behaviors over the last 2 months after visitng different health care services. This project was conducted from March to June in 2003. The data were analyzed by using SPSS which included; 1) frequency, 2) percentage, 3) mean, 4) standard deviation (S.D.), 5) t-test, 6) Chi-square, 7) Correlation and 8) One-way ANOVA. Results: The results revealed that most of volunteers had normal stress level (43.1%). When compared between stress levels and the characteristics of economic and social status, we found that gender was not related to statistically significant difference (p>0.05) in stress level. However, other factors including age, education, occupation, and income, related to stress levels were statistically and significant difference (p<0 .05). The elderly people had higher levels of stress than middle aged groups. Moreover, different occupations had different levels of stress; farmers had a highest level. People with a higher income had more stress than those with a lower income. Similarly, those who had illnesses had more stress than those who did not have illnesses (p =0.001). Levels of health care services also affected the stress levels; those admitted to private hospital had less stress than those admitted to governmental hospitals. The major causes of stress can be divided into 2 categories: 1) salary status, and 2) health/conflict/personal issues. The main solutions of stress included; 1) finding the causes and solving the problems, 2) entertaining themselves, etc. People who could possibly help stress victims included; lovers, spouses, teachers, and friends. Conclusion: There is a relation between stress levels and other factors, including: gender, age, educational status, marital status, income, etc. In addition, there are some major causes of stress such as salary, personal issues, and health which can eventually lead to some metal problems. The author suggests that further study should concentrate on wider areas, and not just only Yasothon Province, in order to see the overall picture of stressful situations. The methods of assessing stress levels should be modified in different ways such as creating a standard mental status tool, or introducing control-study groups. Also, attitude sharing should be conducted within the volunteer group in order to exchange ideas regarding stressful conditions. Thus, the data received will be more adequate and complete. Finally, some external factors which were not able to be controlled in this study might have effected the results. Therefore, we should limit those factors for the next study.

Computer-aided learning program in congestive heart failure (CHF) patient history taking for pharmacy students.

Introduction: Throughout the years, the learning process is still on going in the way of class lecturing, reading textbooks, and demonstrating via multimedia. However, there are some limitations regarding this issue such as time limit, lack of staff, budget, etc. Because of that, we are currently introducing a new multimedia to improve the knowledge and skill learning process. This project aims to develop a computer-aided learning program (CAL) to improve patient case history taking skills for health care professional students. Methodology: This project aims to assess the effectiveness of the CAL program regarding Congestive Heart Failure (CHF) patient history taking skills. There were a total of 45 volunteers, divided into three different groups, a CAL, a lecture, and a control group. The CAL group went through the CAL session and filled out patient information throughout both a case form and an attitude survey form. Meanwhile, the lecture group attended a CHF lecture and went for patient interviews approximately 20 minutes later. They would ask the questions to the patient and fill in the patient information in a case form provided. The control group went through a process similar to that of the lecture group, except that they did not go through the CAL program or take a class lecture. All volunteers were assigned to write the SOAP notes and send them back to the researchers. All data were then analyzed using statistical tests including the one-way ANOVA, Scheffe tests, and Likert’s scales. Results: There were 30 volunteers in this project; 9 males and 21 females. Regarding the total score CHF patient data, the CAL group was statistically higher than the other groups (p<0.05), especially in topics of underlying diseases, medication history, and social & family histories. However, the SOAP note scores were not statistically significantly different between groups (p>0.05). Nevertheless, the total scores of the CAL group were significantly higher than those of the other groups (p = 0.025, 0.002, respectively). Regarding attitudes toward the CAL, SOAP note: a clinical pharmacy note which contains subjective, objective, assessment, and plans for health care professionals program, for the most part participants appreciated the program, although there were some limitations such as the time limit of running the program, language, etc. Conclusion: Overall, the computer-aided learning program (CAL) for CHF patient history taking helped users learn more about history taking skills compared with a lecturing method. This means the program provided adequate patient information and accurately simulated a patient interview. Users will develop their skills gradually. A lecturing methods, however, which includes learning from class and taking a real patient interview, might not be practical because it takes too much time and involves some other limitations, including the busy schedule of health care professionals, expenses, numbers of patients and professional mistakes. Nevertheless, the CAL program will continue to be improved in order to modify the functions and the quality of the program. Finally, this material can certainly be a good supplement for a traditional learning process.