Quality of life, Functional Assessment of Cancer Therapy-General.

Research on quality of life (QOL) in Thailand is still in its developing stages and requires cross-culturally valid QOL questionnaires to appropriately assess QOL as an endpoint in research and clinical trials. The English-language version of the FACT-G (Version 4) questionnaire was translated into Thai using an iterative forward-backward translation process. To determine if this instrument could cross a broad cultural divide and be used in Thailand, the reliability and validity of its Thai version was studied. The translated questionnaire was administered to 364 cancer patients. In evaluating its psychometric properties, internal consistency by Cronbach's alpha and test/retest reliability measured by Spearman rank-correlation coefficients were used. Cronbach's alpha coefficient ranged from 0.75 to 0.90. Spearman rank-correlation coefficient value for global QOL was 0.80. Validity was checked using two methods: factor analysis and known-groups comparison. Known-groups comparison analysis showed discrimination between subgroups of patients differing in clinical status as defined by disease stage (stage I/II vs stage III/IV, p < 0.001), treatment status (active treatment vs no treatment, p < 0.05), and financial burden (yes vs no, p < 0.001). In conclusion, the finding of this study indicate that the Thai version of the Functional Assessment of Cancer Therapy-General (FACT-G) is a reliable and valid measure of quality of life in cancer patients and can be used in clinical trials and studies of outcomes research in oncology.

Evaluation of training medical students in patient-interviewing skills by three modes of learning.

Teaching interpersonal and communication skills to practice history taking is a part of a course on Foundation to Clinical Approach provided for third year medical students. They were trained in three modes: performing with SP, with peers and with groups. This study was conducted to assess the effect of training by three methods. Analysis of the assessment forms by tutors and students indicated that all behaviour and all methods were significantly different at 0.001 and 0.003 and the highest score was found performing with SP. The behaviours which they performed were different among sections and the best performance was patient interview related to history taking and chief complaints. The students should improve their skills in beginning and ending the interview, asking open questions, clarifying the patient's understanding, increasing awareness of perceptions on patients especially the psychosocial aspects and feelings of patients. From the questionnaire, the tutors and students thought that this program was useful and every student should have a chance to practice with the extended time for a second performance after feedback or more than one rehearsal.

An application of TMSE for evaluation chronic alcholic patients.

Thai minimental state examination (TMSE) was used as a tool to evaluate mental state of 50 – chronic alcoholic patients at Srithanya Hospital. The patients were evaluated by a psychiatric nurse within one week after admission and one week later. It was found that mean of the first total TMSE score was 16; the second was 23. The mean score of orientation subtest was significantly different between clinically delirious and non-delirious groups. Total TMSE score negatively correlated with age. The result indicated that TMSE can be used by psychiatric nurse as an instrument to evaluate and follow up delirium symptoms of alcoholic patients.

Screening test for epilepsy.

A 10 – item dichotomous type screening test for epilepsy had been developed and validated by applying to 73 epileptic and 162 non-epileptic persons. At the cut-off score 4, its sensitivity and specificity are 100% and 98.14% respectively. The result indicates that it is a good screening test, however, this is a clinical-based validity study, so community based validity study needs to be done.