∫ ∑ «‘ ∑ ¬ “ ° “ √
∫ ∑ «‘ ∑ ¬ “ ° “ √ °“√»÷°…“§ÿ≥¿“æ™’«‘µºŸâ ŸßÕ“¬ÿ ·≈–°“√ à߇ √‘¡ ÿ¢¿“æ∑—πµ ÿ¢¿“æ ‚¥¬∑’¡ ÿ¢¿“æ™ÿ¡™π „π 3 Õ”‡¿Õ ®—ßÀ«—¥‡™’¬ß„À¡à
∫ÿ≠‡Õ◊ÈÕ ¬ß«“π‘™“°√ ”π—°∑’˪√÷°…“ °√¡Õπ“¡—¬ ÿ≥’ º≈¥’‡¬’ˬ¡ ÿæ√√≥’ ÿ§—π«√“π‘≈ ”π—°∑—πµ “∏“√≥ ÿ¢ °√¡Õπ“¡—¬
∑∫. ¡.Õ∑. (∑—πµ “∏“√≥ ÿ¢) ∑∫. ¡.Õ∑. (∑—πµ “∏“√≥ ÿ¢) «∑.¡.(ª√–™“°√&æ—≤π“)
∫∑§—¥¬àÕ °“√»÷°…“π’È¡’«—µ∂ÿª√– ߧå‡æ◊ËÕ»÷°…“§ÿ≥¿“æ™’«‘µ„π¡‘µ‘ ÿ¢¿“æ¢ÕߺŸâ ŸßÕ“¬ÿ¢Õ߉∑¬ ·≈–°“√ à߇ √‘¡ ÿ¢¿“æ ∑—πµ ÿ¢¿“æ‡æ◊ÕË æ—≤π“§ÿ≥¿“æ™’«µ‘ ‚¥¬∑’¡ ÿ¢¿“æ„π»Ÿπ¬å ¢ÿ ¿“æ™ÿ¡™π ‡ªìπ°“√»÷°…“‡™‘ߪ√‘¡“≥·≈–§ÿ≥¿“æ °≈ÿ¡à µ—«Õ¬à“ߧ◊Õ ºŸ â ߟ Õ“¬ÿ„π™¡√¡ºŸ â ߟ Õ“¬ÿ¢Õß»Ÿπ¬å ¢ÿ ¿“æ™ÿ¡™π ∑’ Ë “¡“√∂‡¢â“√à«¡‚§√ß°“√„π 3 Õ”‡¿Õ¢Õß®—ßÀ«—¥‡™’¬ß„À¡à ¡’Õ“¬ÿÕ¬Ÿà√–À«à“ß 60-82 ªï ®”π«π 231 §π ‡ªì𙓬 100 §π À≠‘ß 131 §π °“√ à߇ √‘¡ ÿ¢¿“溟⠟ßÕ“¬ÿ„πæ◊Èπ∑’Ë »÷°…“ ¥”‡π‘πß“π‚¥¬Õ“ “ ¡—§√´÷Ë߉¥â√—∫°“√Õ∫√¡·≈– π—∫ πÿπ®“°‡®â“Àπâ“∑’Ë∑—Èߧ«“¡√Ÿâ «‘™“°“√ ∑—Èßπ’ȇªìπ‰ª‡æ◊ËÕ æ—≤π“ ÿ¢¿“æ·≈–§ÿ≥¿“æ™’«‘µ¢ÕߺŸâ ŸßÕ“¬ÿ„Àâ “¡“√∂Õ¬Ÿà„π¿“«–§«“¡ ¡∫Ÿ√≥å¢Õß™’«‘µ¥â“π√à“ß°“¬ ®‘µ„® ·≈– —ߧ¡ ‰¡à„™à‡æ’¬ß§«“¡ª√“»®“°‚√§À√◊Õ§«“¡æ‘°“√ √Ÿª·∫∫°‘®°√√¡°“√¥”‡π‘πß“π à߇ √‘¡ ÿ¢¿“æ„π 3 Õ”‡¿Õ¡’√“¬ ≈–‡Õ’¬¥¢Õß°“√∫√‘À“√®—¥°“√∑’Ë·µ°µà“ß°—πµ“¡∫√‘∫∑¢Õß™ÿ¡™π·≈–§«“¡æ√âÕ¡¢Õ߇®â“Àπâ“∑’Ë ‚¥¬ºŸâ ŸßÕ“¬ÿ·≈– §π„π™ÿ¡™π√à«¡°—∫∫ÿ§≈“°√ “∏“√≥ ÿ¢√à«¡°—π°”Àπ¥·≈–¡’ à«π√à«¡À≈—°„π°“√¥”‡π‘π°“√ ‡°Á∫√«∫√«¡¢âÕ¡Ÿ≈‚¥¬ ·∫∫ —¡¿“…≥å ·≈–·∫∫ª√–‡¡‘π§ÿ≥¿“æ™’«‘µ∑’Ëæ—≤π“®“°‡§√◊ËÕß™’È«—¥§ÿ≥¿“æ™’«‘µ¢ÕßÕߧ尓√Õπ“¡—¬‚≈°™ÿ¥¬àÕ©∫—∫ ¿“…“‰∑¬ ‚¥¬·∫∫ª√–‡¡‘π¡’§«“¡‡∑’ˬߵ√ß(reliability) ‡∑à“°—∫ 0.6845 «—¥°àÕπ·≈–À≈—ß°‘®°√√¡ à߇ √‘¡ ÿ¢¿“æ 3 ‡¥◊Õπ ™à«ß‡«≈“∑’Ë»÷°…“§◊Õ ¡‘∂ÿπ“¬π-µÿ≈“§¡ 2550 °≈ÿࡺŸâ ŸßÕ“¬ÿ∑’Ë»÷°…“ ‡ªìπ‡æ»À≠‘ß¡“°°«à“§‘¥‡ªìπ√âÕ¬≈– 56.7, ®∫ª√–∂¡»÷°…“ √âÕ¬≈– 80.1, ‡ªìπ‚√§§«“¡¥—π‚≈À‘µ Ÿß√âÕ¬≈– 35.5, ‡ªìπ‚√§‡°’ˬ«°—∫ “¬µ“√âÕ¬≈– 17.7, ‡ªìπ‚√§ À—«„®√âÕ¬≈– 7.8 ‡ªìπ‚√§‡∫“À«“π√âÕ¬≈– 7.4 ”À√—∫ ÿ¢¿“æ™àÕߪ“°æ∫√âÕ¬≈– 18.6 Ÿ≠‡ ’¬øíπ∑—Èߪ“° ´÷Ëß¡“° °«à“°“√ ”√«®∑—πµ ÿ¢¿“æ·Ààß™“µ‘§√—ßÈ ∑’6Ë (ªï2549-2550)´÷ßË æ∫«à“¡’√Õâ ¬≈– 10.47, ¡’øπí πâÕ¬°«à“ 20 ´’Ë √âÕ¬≈– 34.2 ¡’øíπ¡“°°«à“ 20 ´’Ë√âÕ¬≈– 47.2,®”π«π´’Ëøíπ‡©≈’ˬ 15.74 ´’Ë/§π ºŸâ ŸßÕ“¬ÿ “¡“√∂‡§’Ȭ«Õ“À“√‰¥â¥’√âÕ¬≈– 57.1 ¡’ ªí≠À“„π°“√‡§’Ȭ«Õ“À“√ √âÕ¬≈– 22.1 ºŸâ ŸßÕ“¬ÿ∑’ˇ§’Ȭ«Õ“À“√‰¥â¥’¡’§ÿ≥¿“æ™’«‘µ∑’Ë¥’°«à“ºŸâ∑’Ë¡’ªí≠À“„π°“√‡§’Ȭ«Õ“À“√ ºŸâ ŸßÕ“¬ÿ à«π„À≠à “¡“√∂™à«¬‡À≈◊Õµπ‡Õß„π°“√∑”°‘®«—µ√ª√–®”«—π‰¥â¥’√âÕ¬≈– 74.5 ·≈– “¡“√∂∑”°‘®°√√¡∑’Ë ‡ªìπ°“√ à߇ √‘¡ ÿ¢¿“扥â√âÕ¬≈– 90 ®“°°“√„™â‡§√◊ËÕß¡◊Õ«—¥§ÿ≥¿“æ™’«‘µºŸâ ŸßÕ“¬ÿ°àÕπ·≈–À≈—ß æ∫«à“‡¡◊ËÕ‡®â“Àπâ“∑’Ë “∏“√≥ ÿ¢√à«¡°—∫™ÿ¡™π¥”‡π‘π°“√ à߇ √‘¡ ÿ¢¿“æ·≈â« 3 ‡¥◊Õπ ºŸâ ŸßÕ“¬ÿ¡’§ÿ≥¿“æ™’«‘µ¥’¢÷È𠧔 ”§—≠ : ÿ¢¿“æ™àÕߪ“°, §ÿ≥¿“æ™’«‘µ, ºŸâ ŸßÕ“¬ÿ
58
¡°√“§¡ - ¡’π“§¡ 2554
°√¡Õπ“¡—¬ à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒
°“√»÷°…“§ÿ≥¿“æ™’«‘µºŸâ ŸßÕ“¬ÿ ·≈–°“√ à߇ √‘¡ ÿ¢¿“æ∑—πµ ÿ¢¿“æ ‚¥¬∑’¡ ÿ¢¿“æ™ÿ¡™π „π 3 Õ”‡¿Õ ®—ßÀ«—¥‡™’¬ß„À¡à
Quality of Life of the Elderly: Health and Oral Health Promotion 3 Ampurs in Chiangmai Province DDS.,M.P.H.,Diplomate (Thai Board of Dental Public Health ) Bureau of Technical Advisors, Department of Health, Ministry of Public Health Sunee Pholdeeyiam DDS.,M.P.H.,Diplomate (Thai Board of Dental Public Health ) Supanne Sukunwaranin M.Sc (Human Development ) Bureau of Dental Health, Department of Health, Ministry of Public Health Boonaur Yongvanichakorn
Abstract This research aimed at assessing health and oral health status and models of health and oral health promotion for elderly in community health centers to enhance quality of life. Two hundred and thirty one samples aged 61-82 years old were drawn from community senior citizen clubs in 3 purposively selected districts, Chiangmai province. Instruments used were questionnaires, interview guidelines, applied WHOQOL - BRIEF (reliability 0.6845) and the elderlyûs perception on QOL. Tests for quality of life (QOL) were done before performing heath promotion activities and three months later. Activities of the studied health and oral health promotion models were designed by the elderly and their community. Results showed that 56.7 % of samples were female, 80.1 % finished primary school, 35.5 % had high blood pressure, 17.7 % had problems with their eyes, 7.8 % had coronary heart disease and 7.4 % had diabetes mellitus. 24.2 % had oral health problem. Mean numbers of natural tooth were 15.74 teeth per person. 18.6% had no natural tooth, 34.2% had less than 20 teeth, and 47.2 % had more than 20 teeth. 57.1% were able to chew effectively while 22.1% had some difficulty to chew. Those who capable to chew had better QOL than those who incapable (p = .000). It was showed that the elderly had better QOL after 3 months implementation (p=.000). It suggests that the model of health and oral health promotion to enhance the QOL of the elderly should be designed by themselves and community members. After training senior volunteers were able to do health promotion activities with the supports from health personnel. Keyword: Oral Health,Quality of Health,Elderly THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH J a n u a ry - M a r c h 2011
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∫ ∑ «‘ ∑ ¬ “ ° “ √ ∫∑π” ª√–‡∑»‰∑¬¡’®”π«πºŸâ ŸßÕ“¬ÿ‡æ‘Ë¡¢÷Èπ„π Õ—µ√“∑’ˇ√Á«¡“° —¥ à«π‡æ‘Ë¡®“°√âÕ¬≈– 7.16 „πªï 2533 ·≈–§“¥°“√≥å«“à ®–‡æ‘¡Ë ‡ªìπ√âÕ¬≈– 15.28 „π ªï 2563 (1) ´÷ËßÀ¡“¬§«“¡«à“ —¥ à«πª√–™“°√ «—¬∑”ß“πµàÕºŸâ ŸßÕ“¬ÿ®–≈¥≈ß ¿“√–¢Õß§π«—¬ ∑”ß“π®–‡æ‘Ë¡¢÷ÈπÕ¬à“ß√«¥‡√Á« ª√–‡∑»‰∑¬¡’ ‡«≈“ ”À√—∫‡µ√’¬¡°“√‡æ◊ËÕ√—∫¡◊Õ°—∫ªí≠À“π’ȧàÕπ ¢â“ß —Èπ ‡¡◊ËÕ‡∑’¬∫°—∫ª√–‡∑»Õ◊Ëπ∑’˺à“π¿“«–π’È¡“ °à Õ π(2) √—∞®”‡ªìπµâÕ߇µ√’¬¡°“√‡æ◊ËÕ√—∫¡◊Õ°—∫ ¿“«–ª√–™“°√ ŸßÕ“¬ÿ„Àâ∑—π°“√≥å √«¡∑—Èß°“√®—¥ √–∫∫∫√‘°“√ “∏“√≥ ÿ¢·≈–∑—πµ “∏“√≥ ÿ¢∑’Ë ‡À¡“– ¡·°àª√–™“°√ ŸßÕ“¬ÿ¡“°¢÷Èπ ªí≠À“ ”§—≠∑’ Ë ¥ÿ ¢ÕߺŸ â ߟ Õ“¬ÿ¡’ 2 ª√–°“√ §◊Õªí≠À“‡√◊ËÕß ÿ¢¿“æ·≈–¢“¥√“¬‰¥â ªí≠À“∑—Èß Õß — ¡ æ— π ∏å °— π ∂â “ ªí ≠ À“Àπ÷Ë ß ‡æ‘Ë ¡ ¢÷È π §«“¡ √ÿπ·√ߢÕßÕ’°ªí≠À“Àπ÷Ëß®–‡æ‘Ë¡¢÷Èπ¥â«¬(2) ªí≠À“ ÿ¢¿“æ∑’Ë ”§—≠¢ÕߺŸâ ŸßÕ“¬ÿ πÕ°®“°‡ªìπ‚√§ ‡√◊È Õ √— ß µà “ ßÊ·≈â « §◊ Õ ªí ≠ À“ ÿ ¢ ¿“æ™à Õ ßª“° P.Finbarr Allen(3) ™’È„Àâ‡ÀÁπ«à“ ªí≠À“ ÿ¢¿“æ ™àÕߪ“°¡’º≈°√–∑∫Õ¬à“ß™—¥‡®π µàÕ§ÿ≥¿“æ™’«‘µ „πª√–‡¥Áπ °“√¥”‡π‘π™’«‘µÕ¬à“ߪ°µ‘ ÿ¢ °“√ »÷°…“ºŸ â ߟ Õ“¬ÿ„π®—ßÀ«—¥‡™’¬ß„À¡à ‚¥¬„™â‡§√◊ÕË ß¡◊Õ OIDP ·≈–·∫∫ Õ∫∂“¡æƒµ‘°√√¡ ÿ¢¿“æ√à«¡ °— ∫ °“√µ√«® ÿ ¢ ¿“æ™à Õ ßª“° æ∫«à “ ºŸâ Ÿ ß Õ“¬ÿ √âÕ¬≈– 52.8 ‰¥â√—∫º≈°√–∑∫∂÷ß°‘®°√√¡ª√–®” «—π®“° ÿ¢¿“æ™àÕߪ“°Õ¬à“ßπâÕ¬ 1 °‘®°√√¡ ‚¥¬ °‘ ® °√√¡∑’Ë ° √–∑∫¡“° ÿ ¥ §◊ Õ °“√°‘ π Õ“À“√ √âÕ¬≈– 47.2 ´÷ßË ‡°‘¥®“°°“√∑”Àπâ“∑’‰Ë ¥âÕ¬à“ß®”°—¥ ·≈–Õ“°“√‡®Á∫ª«¥(4) °“√®—¥∫√‘°“√ à߇ √‘¡ ÿ¢¿“æ·≈– ÿ¢¿“æ ™àÕߪ“°„πºŸâ ŸßÕ“¬ÿ(5) πÕ°®“°≈¥¿“«–°“√‡ªìπ ‚√§·≈–§«“¡‡®Á∫ªÉ«¬·≈â« §«√‡ªìπ‰ª‡æ◊ËÕæ—≤π“ §ÿ≥¿“æ™’«‘µ¢ÕߺŸâ ŸßÕ“¬ÿ„À⥒¢÷Èπ¥â«¬ §ÿ≥¿“æ 60
¡°√“§¡ - ¡’π“§¡ 2554
°√¡Õπ“¡—¬ à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒
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°“√»÷°…“§ÿ≥¿“æ™’«‘µºŸâ ŸßÕ“¬ÿ ·≈–°“√ à߇ √‘¡ ÿ¢¿“æ∑—πµ ÿ¢¿“æ ‚¥¬∑’¡ ÿ¢¿“æ™ÿ¡™π „π 3 Õ”‡¿Õ ®—ßÀ«—¥‡™’¬ß„À¡à
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«‘∏’°“√»÷°…“ 1. §—¥‡≈◊Õ°æ◊Èπ∑’Ë»÷°…“ ‚¥¬‡≈◊Õ° 3 ‚´π (¬°‡«âπ‚´π∑’Ë¡’Õ”‡¿Õ‡¡◊Õß)®“°°“√·∫à߇¢µ°“√ ∫√‘À“√®—¥°“√‡ªìπ 4 ‚´π¢Õß®—ßÀ«—¥‡™’¬ß„À¡à ‡π◊Ë Õ ß®“°‡ªì π æ◊È π ∑’Ë’ ∑’Ë ¡’ ° “√»÷ ° …“∂÷ ß º≈°√–∑∫ §ÿ≥¿“æ™’«‘µ∑’ˇ°’ˬ«¢âÕß°—∫∑—πµ ÿ¢¿“æ 2. §—¥‡≈◊Õ°Õ”‡¿Õ∑’ˇªìπæ◊Èπ∑’Ë»÷°…“®“° ‚´π≈– 1 Õ”‡¿Õ ‚¥¬°“√ ÿ¡à ®—∫©≈“°‰¥â 3 Õ”‡¿Õ 3. ª√– “π°—∫‚√ß欓∫“≈„π 3 Õ”‡¿Õ ‡æ◊ËÕ¢Õ∑’¡√à«¡«‘®—¬„πæ◊Èπ∑’Ë ª√–™ÿ¡™’È·®ß∑’¡«‘®—¬ ´÷Ë ß ª√–°Õ∫¥â « ¬ ∑— π µ·æ∑¬å , π— ° «‘ ™ “°“√ “∏“√≥ ÿ¢,‡®â“Àπâ“∑’Ë “∏“√≥ ÿ¢ 4. ∑’ ¡ «‘ ®— ¬ æ◊È π ∑’Ë §— ¥ ‡≈◊ Õ °»Ÿ π ¬å ÿ ¢ ¿“æ ™ÿ¡™π∑’Ë¡’™¡√¡ºŸâ ŸßÕ“¬ÿ∑’ˇ¢â¡·¢Áß ‡®â“Àπâ“∑’Ë„π »Ÿπ¬åœ¡’§«“¡æ√âÕ¡ ‰¥âæ◊Èπ∑’Ë»÷°…“„π‡¢µ√—∫º‘¥ ™Õ∫¢Õß»Ÿπ¬å ÿ¢¿“æ™ÿ¡™π 3 ·Ààß„π 3 Õ”‡¿Õ 5. ∑’¡«‘®—¬„πæ◊Èπ∑’Ë√à«¡°—∫ºŸâπ”™¡√¡ºŸâ Ÿß Õ“¬ÿ·µà≈–Õ”‡¿Õ°”Àπ¥√Ÿª·∫∫°“√∫√‘À“√®—¥°“√ ·≈–¥”‡π‘πß“π‚§√ß°“√»÷°…“«‘®—¬ µ≈Õ¥®π§—¥ ‡≈◊Õ°Õ“ “ ¡—§√ºŸâ¥”‡π‘πß“π à߇ √‘¡ ÿ¢¿“楟·≈ æ— ≤ π“§ÿ ≥ ¿“æ™’ «‘ µ ºŸâ Ÿ ß Õ“¬ÿ ° ≈ÿà ¡ ‡ªÑ “ À¡“¬„π æ◊Èπ∑’Ë√—∫º‘¥™Õ∫ ´÷Ëß®–‰¥â√Ÿª·∫∫°“√¥”‡π‘πß“π °‘ ® °√√¡„π 3 Õ”‡¿Õ¡’ § «“¡·µ°µà “ ß°— 𠵓¡ ∫√‘∫∑·≈–§«“¡æ√âÕ¡¢Õßæ◊Èπ∑’Ë 6. Õ“ “ ¡— § √¥”‡π‘ π ß“π°‘ ® °√√¡ à ß ‡ √‘¡ ÿ¢¿“懪ìπ‡«≈“ª√–¡“≥ 3 ‡¥◊Õπ √–À«à“ß °“√¥”‡π‘π°“√¢Õßæ◊Èπ∑’Ë ¡’°“√ª√–‡¡‘𠵑¥µ“¡ ª√—∫ª√ÿß√à«¡°—π√–À«à“ß∑’¡«‘®—¬·≈–™ÿ¡™π 7. ∑’¡«‘®—¬æ◊Èπ∑’Ë Õ“ “ ¡—§√ ¡’°“√‡°Á∫ ¢âÕ¡Ÿ≈ «—¥º≈°àÕπ·≈–À≈—ß°“√¥”‡π‘π°“√ ¥â«¬ ·∫∫ — ¡ ¿“…≥å ‚ §√ß°“√ à ß ‡ √‘ ¡ ÿ ¢ ¿“æ‡æ◊Ë Õ
æ—≤π“§ÿ≥¿“æ™’«‘µºŸâ ŸßÕ“¬ÿ:∫∑∫“∑¢Õß∫ÿ§≈“°√ „π»Ÿ π ¬å ÿ ¢ ¿“æ™ÿ ¡ ™π √–¬–‡«≈“¥”‡π‘ π °“√ ¡‘∂ÿπ“¬π-µÿ≈“§¡ æ.».2550 8. ‡§√◊Ë Õ ß¡◊ Õ ∑’Ë „ ™â ‡ªì π ·∫∫ — ¡ ¿“…≥å ¢âÕ¡Ÿ≈∑—Ë«‰ª ·≈–ª√–‡¡‘π§ÿ≥¿“æ™’«‘µ ´÷Ë߉¥â æ—≤π“®“°º≈°“√»÷°…“𑬓¡§ÿ≥¿“æ™’«‘µ√à«¡ °—∫‡§√◊ËÕß™’È«—¥§ÿ≥¿“æ™’«‘µ¢ÕßÕߧ尓√Õπ“¡—¬ ‚≈°™ÿ¥¬àÕ©∫—∫¿“…“‰∑¬´÷ßË æ—≤π“‚¥¬ ÿ«≤ — πå ¡À—µ (6) π‘√—π¥√å°ÿ≈·≈–§≥– ‚¥¬‰¥â∑¥ Õ∫¡’§à“§«“¡ ‡∑’ˬߵ√ß (reliability) ‡∑à“°—∫ 0.6845 9. ∂‘µ‘∑’Ë„™â„π°“√«‘‡§√“–Àå ‰¥â·°à §à“√âÕ¬ ≈– §à“‡©≈’ˬ §à“¡—∏¬∞“π Chi-square T-test
º≈°“√»÷°…“ 1 ¢âÕ¡Ÿ≈∑—Ë«‰ª ºŸ â ߟ Õ“¬ÿ°≈ÿ¡à ‡ªÑ“À¡“¬ ¡’Õ“¬ÿ°√–®“¬µ—ßÈ ·µà 60-87 ªï ‡ªìπ‡æ»À≠‘ß¡“°°«à“§◊Õ√âÕ¬≈– 56.7 Õ“¬ÿ‡©≈’ˬ 72.4 ªï à«π„À≠à√âÕ¬≈– 80.1 ®∫ ª√–∂¡»÷°…“ √âÕ¬≈– 14.3 ‰¡à‰¥â»°÷ …“ √âÕ¬≈– 3.5 ®∫¡—∏¬¡»÷°…“ √âÕ¬≈– 0.4 ®∫ ª«™.·≈–ª« . ·≈– √âÕ¬≈– 1.7 ®∫ª√‘≠≠“µ√’ 2 ¢âÕ¡Ÿ≈ ÿ¢¿“æ·≈– ÿ¢¿“æ™àÕߪ“° 2.1®”·π°ºŸâ Ÿ ß Õ“¬ÿ µ “¡®”π«π‚√§∑’Ë ‡ªìπ ºŸâ ŸßÕ“¬ÿ à«π„À≠à‡ªìπ‚√§Õ¬à“ßπâÕ¬§π≈– 12 ‚√§ ‚√§∑’ˇªìπ 5 Õ—π¥—∫·√° §◊Õ §«“¡¥—π ‚≈À‘µ Ÿß√âÕ¬≈– 35.5 ‚√§‡°’ˬ«°—∫ “¬µ“√âÕ¬≈– 17.7 ‚√§À—«„®√âÕ¬≈– 7.8 ‚√§‡∫“À«“π√âÕ¬≈– 7.4 ·≈–‚√§„π™àÕߪ“°/‚√§ª«¥¢âÕª«¥‡¢à“√âÕ¬≈– 6.1 2.2√Ÿ ª √à “ ß·≈–§«“¡ ¡∫Ÿ √ ≥å ¢ Õß √à“ß°“¬ºŸâ ŸßÕ“¬ÿ °“√®”·π°√Ÿª√à“ß·≈–§«“¡ ¡∫Ÿ√≥å¢Õß√à“ß°“¬ºŸâ ŸßÕ“¬ÿ ‰¥â„™â‡°≥±å«—¥¥â«¬ ¥—™π’¡«≈°“¬ (Body Mass Index=BMI) ¢Õß °√¡Õπ“¡—¬·≈–°“√ —߇°µ¢ÕߺŸâ —¡¿“…≥å ´÷Ëß ‰¥âº≈°“√ª√–‡¡‘π∑’Ë·µ°µà“ß°—π
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∫ ∑ «‘ ∑ ¬ “ ° “ √ µ“√“ß∑’Ë 1 ®”π«π·≈–√âÕ¬≈–ºŸâ ŸßÕ“¬ÿ®”·π°µ“¡‡æ»·≈–Õ“¬ÿ Õ“¬ÿ(ªï)
™“¬
60-65 66-70 71-75 76-80 81-87 √«¡
˭ԧ
√«¡
®”π«π
√âÕ¬≈–
®”π«π
√âÕ¬≈–
®”π«π
15 25 23 21 16 100
15.0 25.0 23.0 21.0 16.0 100.0
27 27 38 25 14 131
20.6 20.6 29.0 19.1 10.7 100.0
42 52 61 46 30 231
√âÕ¬≈– 18.2 22.5 26.4 19.9 13.0 100.0
µ“√“ß∑’Ë 2 √âÕ¬≈–ºŸâ ŸßÕ“¬ÿ®”·π°µ“¡®”π«π‚√§∑’ˇªìπ ®”π«π‚√§∑’ˇªìπ
√âÕ¬≈–¢ÕߺŸâ ŸßÕ“¬ÿ
1 ‚√§ 2 ‚√§ 3 ‚√§ ¡“°°«à“ 3 ‚√§ √«¡
57.3 30.0 9.2 3.5 100
µ“√“ß∑’Ë 3 √âÕ¬≈–ºŸâ ŸßÕ“¬ÿ®”·π°µ“¡√Ÿª√à“ß·≈–§«“¡ ¡∫Ÿ√≥å¢Õß√à“ß°“¬ ‡°≥±å°“√®”·π°
ºÕ¡
¡ à«π
Õâ«π
‚√§Õâ«π
®”·π°µ“¡ BMI ®”·π°®“°°“√ —߇°µ
25.5 14.7
60.6 76.6
12.6 8.2
1.3 0.5
µ“√“ß 4 √âÕ¬≈–ºŸâ ŸßÕ“¬ÿ®”·π°µ“¡®”π«π´’Ëøíπ„π™àÕߪ“° ®”π«π´’Ëøíπ ‰¡à¡’øíπ 1-19 ´’Ë 20-32 ´’Ë √«¡
62
¡°√“§¡ - ¡’π“§¡ 2554
®”π«πºŸâ ŸßÕ“¬ÿ 43 122 66 231
°√¡Õπ“¡—¬ à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒
√âÕ¬≈–ºŸâ ŸßÕ“¬ÿ 18.6 34.2 47.2 100
°“√»÷°…“§ÿ≥¿“æ™’«‘µºŸâ ŸßÕ“¬ÿ ·≈–°“√ à߇ √‘¡ ÿ¢¿“æ∑—πµ ÿ¢¿“æ ‚¥¬∑’¡ ÿ¢¿“æ™ÿ¡™π „π 3 Õ”‡¿Õ ®—ßÀ«—¥‡™’¬ß„À¡à
2.3®”π«πøíπ„πºŸ â ߟ Õ“¬ÿ°≈ÿ¡à ‡ªÑ“À¡“¬ ºŸâ ŸßÕ“¬ÿ°≈ÿࡇªÑ“À¡“¬∑’Ë»÷°…“æ∫«à“ √âÕ¬≈– 18.6 Ÿ≠‡ ’¬øíπ∑—Èߪ“° ´÷Ëß¡“°°«à“°“√ ”√«®∑—πµ ÿ¢¿“æ·Ààß™“µ‘§√—Èß∑’Ë 6 (ªï2549-2550) æ∫ √âÕ¬≈– 10.47, °≈ÿࡇªÑ“À¡“¬¡’øíπ‰¡àπâÕ¬°«à“ 20 ´’Ë æ∫√âÕ¬≈– 47.2 ¡’øíπ‚¥¬‡©≈’ˬ 15.74 ´’Ë/§π „π¢≥–∑’°Ë “√ ”√«®∑—πµ ÿ¢¿“æ·Ààß™“µ‘ªï 25492550 æ∫√âÕ¬≈– 54.8 ·≈– 13.38 ´’Ë/§π µ“¡ ≈”¥—∫ 3. ¢â Õ ¡Ÿ ≈ ¿“«–·≈–ªí ® ®— ¬ ∑’Ë ¡’ º ≈µà Õ §ÿ≥¿“æ™’«‘µºŸâ ŸßÕ“¬ÿ 1) ÿ¢¿“æ™àÕߪ“° 1.1) ®”π«πøí π °— ∫ ªí ≠ À“„π°“√ ‡§’Ȭ«Õ“À“√ ºŸâ Ÿ ß Õ“¬ÿ ¡’ ªí ≠ À“„π°“√‡§’È ¬ «Õ“À“√ √âÕ¬≈– 22.1 §π∑’Ë¡’øíπ 1-19 ´’Ë¡’ªí≠À“°“√ ‡§’Ȭ«Õ“À“√¡“°°«à“§π∑’ˉ¡à¡’øíπ·≈–§π∑’Ë¡’øíπ ¡“°°«à“ 20 ´’Ë ®“°°“√„™â Chi-Square Tests æ∫«à “ ºŸâ ∑’Ë ¡’ øí π ¡“°°«à “ ªí ≠ À“°“√‡§’È ¬ «Õ“À“√ πâÕ¬°«à“(p=001) 2) °“√∑”°‘®«—µ√ª√–®”«—π¢ÕߺŸ â ߟ Õ“¬ÿ ºŸâ ŸßÕ“¬ÿ∑’Ë “¡“√∂∑”°‘®«—µ√ª√–®”«—π ´÷Ëß¡’ 9 Õߧåª√–°Õ∫§◊Õ Àπ÷Ëß°“√°‘πÕ“À“√ Õß °“√≈â“ßÀπâ“ ·ª√ßøíπ À«’º¡ ‚°πÀπ«¥ “¡ °“√„ à‡ ◊Èպⓠ’Ë°“√Õ“∫πÈ” Àâ“°“√‡¢â“ÀâÕßπÈ” À°°“√Àÿߢ⓫ ∑”°—∫¢â“« ‡®Á¥°“√∑”ß“π∫â“π ´—° ‡ ◊Èպⓠ·ª¥°“√´◊ÈÕ¢Õß §‘¥‡ß‘π ®à“¬‡ß‘π ·≈– ‡°â“ §«“¡Õ¬“°Õ“À“√„π™à«ß 3 ‡¥◊Õπ∑’˺à“π¡“ ·µà≈– ¢âÕ∂â“∑”‰¥âÀ√◊Õª°µ‘®–‰¥â 1 §–·ππ πÕ°π—πÈ ®–‰¥â 0 §–·ππ ºŸâ∑’ˉ¥â 9 §–·ππ‡ªìπºŸâ∑’Ë∑”‰¥â¥’ 5-8 §–·ππ∑”‰¥âª“π°≈“ß 0-4 ∑”‰¥âπâÕ¬ ºŸ â ߟ Õ“¬ÿ°≈ÿ¡à ‡ªÑ“À¡“¬ à«π„À≠à√Õâ ¬≈– 74.5 ∑”°‘®«—µ√ª√–®”«—π∑—ÈßÀ¡¥ ∑’Ë∑”‰¥âπâÕ¬¡’‡æ’¬ß √âÕ¬≈– 2.6
3) °“√∑”°‘®°√√¡ à߇ √‘¡ ÿ¢¿“æ¢Õß ºŸâ ŸßÕ“¬ÿ ºŸâ ŸßÕ“¬ÿ∑’Ë∑”°‘®°√√¡ à߇ √‘¡ ÿ¢¿“æ 9 Õ¬à“ߧ◊Õ Àπ÷Ëßøíß«‘∑¬ÿ ÕߥŸ‚∑√∑—»πå “¡Õà“π Àπ—ß ◊Õ ’Ë∑”∫ÿ≠ Àⓙ૬ߓπ¢Õß™ÿ¡™π À°√à«¡ °‘®°√√¡°“√‡¡◊Õß ‡®Á¥√à«¡°‘®°√√¡™¡√¡ ·ª¥√—∫ øí ß ªí ≠ À“ √à « ¡æŸ ¥ §ÿ ¬ °— ∫ ºŸâ ¡’ ªí ≠ À“ ·≈– ‡°â “ µ‘¥µ“¡¢à“« “√ ∑”°‘®°√√¡ ¡“°‰¥â 4 §–·π𠪓π °≈“߉¥â 3 §–·ππ,πâÕ¬‰¥â 2 §–·ππ ·≈–‰¡à‰¥â ∑”‰¥â 1 §–·ππ ºŸâ∑’ˉ¥â§–·ππ√«¡ 28-36 §◊ÕºŸâ ∑’Ë∑”‰¥â¡“° §–·ππ 19-27 §◊ÕºŸâ∑”‰¥âª“π°≈“ß ·≈– 9-18 §◊ÕºŸâ∑’Ë∑”‰¥âπâÕ¬ ºŸâ ŸßÕ“¬ÿ à«π„À≠à∑”°‘®°√√¡ à߇ √‘¡ ÿ¢ ¿“扥⪓π°≈“ߧ◊Õ√âÕ¬≈– 66.2 4) §ÿ≥¿“æ™’«‘µºŸâ ŸßÕ“¬ÿ ·≈–√Ÿª·∫∫ °“√ à߇ √‘¡ ÿ¢¿“æ 4.1°“√«—¥§ÿ≥¿“æ™’«‘µ°àÕπ·≈–À≈—ß°“√ à߇ √‘¡ ÿ¢¿“æ ·∫∫ª√–‡¡‘π§ÿ≥¿“æ™’«‘µ¡’ 20 ¢âÕ ª√–°Õ∫¥â«¬ Àπ÷Ëß√Ÿâ ÷°™’«‘µ¡’§«“¡ ÿ¢ Õß Õ¬“°√Ÿâ¢à“« “√„À¡àÊ “¡™’«‘µ¡’§«“¡ ÿ¢∑“ß„® ’ˇªìπ‚√§‡√◊ÈÕ√—ß Àâ“°—ß«≈·≈–‡ªìπ∑ÿ°¢å‡°’ˬ«°—∫ ‚√§‡√◊ÈÕ√—ß À°¡’ºŸâ擉ªÀ“À¡Õµ“¡π—¥ ‡®Á¥¡’ ‚√§„π™àÕߪ“° ·ª¥°—ß«≈·≈–‡ªìπ∑ÿ°¢å°—∫‚√§„π ™àÕߪ“° ‡°â“‡¢â“°—∫§π„π§√Õ∫§√—«‰¥âÕ¬à“ߥ’ ‘∫ §π„π§√Õ∫§√—«√—°„§√à·≈–ºŸ°æ—π°—π ‘∫‡ÕÁ¥‡¢â“ °—∫§πÕ◊ËππÕ°§√Õ∫§√—«‰¥â¥’ ‘∫ Õßæ÷ßæÕ„®°—∫ ∞“𖧫“¡‡ªìπÕ¬Ÿà¢≥–π’È ‘∫ “¡‡ÀÁπÕ°‡ÀÁπ„® ‡¡◊ÕË §πÕ◊πË ¡’∑°ÿ ¢å ‘∫ ’¬Ë π‘ ¥’°∫— §«“¡ ”‡√Á®¢ÕߺŸÕâ π◊Ë ‘∫Àⓙ૬‡À≈◊ÕºŸâÕ◊Ëπ∑’Ë¡’ªí≠À“‡¡◊ËÕ¡’‚Õ°“ ‘∫ À°‰¥â√—∫§«“¡™à«¬‡À≈◊Õ®“°‡æ◊ËÕπ∫â“πÀ√◊Õ§πÕ◊Ëπ ‘∫‡®Á¥™’«‘µ¡’§«“¡¡—Ëπ§ß ª≈Õ¥¿—¬ ‘∫·ª¥‰¥â√—∫ §«“¡‡§“√æπ—∫∂◊Õ®“°§π„π§√Õ∫§√—« ‘∫‡°â“‰¥â √—∫§«“¡‡§“√æπ—∫∂◊Õ®“°§π„π™ÿ¡™π ·≈– ¬’Ë ‘∫
THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH J a n u a ry - M a r c h 2011
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∫ ∑ «‘ ∑ ¬ “ ° “ √ √Ÿâ ÷°ª√– ∫§«“¡ ”‡√Á®„π™’«‘µ ºŸâ∑’˵Õ∫¡“°∑’Ë ÿ¥‰¥â 4 §–·ππ ºŸâ∑’˵Õ∫ ¡“°‰¥â 3 §–·ππ ºŸâ∑’˵Õ∫‡≈Á°πâÕ¬‰¥â 2 §–·ππ ·≈–ºŸâ∑’˵Õ∫‰¡à‡§¬‰¥â 1 §–·ππ À“§–·ππ‡©≈’ˬ §ÿ≥¿“æ™’«‘µ¢ÕߺŸâ ŸßÕ“¬ÿ„π·µà≈–Õ”‡¿Õ ·≈–√«¡ 3 Õ”‡¿Õ ‡ª√’¬∫‡∑’¬∫§√—Èß∑’Ë 1 ·≈– 2 ‰¥âµ“¡ µ“√“ß∑’Ë 8 ®“°°“√ ”√«® æ∫«à“Õ”‡¿Õ 1,2 ·≈– 3 ¡’ §–·ππ§ÿ≥¿“æ™’«µ‘ °àÕ𥔇π‘π°“√‡©≈’¬Ë 63.79, 61.49 ·≈– 61.20 µ“¡≈”¥—∫ ·≈–À≈—ß®“°°“√ ¥”‡π‘ π °“√ à ß ‡ √‘ ¡ ÿ ¢ ¿“æ‡æ◊Ë Õ æ— ≤ π“§ÿ ≥ ¿“æ ™’«‘µ·≈â« 3 ‡¥◊Õπ ºŸâ ŸßÕ“¬ÿ¡’§–·ππ§ÿ≥¿“æ™’«‘µ ‡©≈’ˬ 66.81,60.36 ·≈– 65.89 æ∫«à“Õ”‡¿Õ 1 ·≈– 3 ¡’§–·ππ§ÿ≥¿“æ™’«‘µ¥’¢÷Èπ ¡’Õ”‡¿Õ 2 ∑’Ë ¡’§–·ππ§ÿ≥¿“æ™’«‘µ≈¥≈ß À≈—ߥ”‡π‘πß“π à߇ √‘¡ ÿ¢¿“æ‚¥¬æ◊Èπ∑’Ë 3 ‡¥◊Õπ æ∫«à“Õ”‡¿Õ 1 ·≈– 3 ¡’§ÿ≥¿“æ™’«‘µ¥’¢÷Èπ ·≈–„π¿“æ√«¡¢Õß 3 Õ”‡¿ÕºŸâ ŸßÕ“¬ÿ¡’§ÿ≥¿“æ ™’«‘µ¥’¢÷ÈπÕ¬à“ß¡’π—¬ ”§—≠ 4.2√Ÿ ª ·∫∫°“√ à ß ‡ √‘ ¡ ÿ ¢ ¿“æ‚¥¬»Ÿ π ¬å ÿ¢¿“æ™ÿ¡™π„π 3 Õ”‡¿Õ Õ”‡¿Õ∑’Ë 1 ∑’¡«‘®—¬æ◊Èπ∑’ˇªìπÀ—«Àπâ“ ∂“π’Õπ“¡—¬ ·≈– ∑—πµ“¿‘∫“≈„π ∂“π’Õπ“¡—¬ ‡ªìπÀ≈—°„π°“√®—¥°“√ ¡’°“√®—¥∑”§Ÿà¡◊Õ ·≈–À≈—° Ÿµ√°“√Õ∫√¡™—¥‡®π æ√âÕ¡®—¥Õ∫√¡ 1 «—π „Àâ°—∫Õ“ “ ¡—§√ 10 §π ∑’Ë ‰¥â√∫— °“√§—¥‡≈◊Õ°®“°À¡Ÿ∫à “â π‡¥’¬«°—π°—∫ºŸ â ߟ Õ“¬ÿ ª√–°Õ∫¥â « ¬ºŸâ Ÿ ß Õ“¬ÿ 5 §π·≈–Õ“ “ ¡— § √ “∏“√≥ ÿ¢ 5 §π ·≈â«®÷ß„À⥔‡π‘π°‘®°√√¡ àß ‡ √‘¡ ÿ¢¿“æ‚¥¬°“√‡¬’ˬ¡∫â“πµ“¡§Ÿà¡◊Õ°“√µ√«® ‡¬’ˬ¡ ´÷Ëߪ√–°Õ∫¥â«¬§”·π–π”°“√查§ÿ¬ °“√ ¥Ÿ·≈ ÿ¢¿“æ‚¥¬‡©æ“–Õ¬à“߬‘Ëß‚√§‡√◊ÈÕ√—ß ºŸâ Ÿ ß Õ“¬ÿ ° ≈ÿà ¡ ‡ªÑ “ À¡“¬∑’Ë »÷ ° …“¡’ ®”π«π 100 §π ‰¥â√—∫°“√Õ∫√¡„À⧫“¡√Ÿâ‡√◊ËÕß°“√¥Ÿ·≈ 64
¡°√“§¡ - ¡’π“§¡ 2554
°√¡Õπ“¡—¬ à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒
ÿ¢¿“æ·≈–∑—πµ ÿ¢¿“æ 1 «—π ·≈–‰¥â√—∫°“√ ‡¬’ˬ¡∫â“π®“°Õ“ “ ¡—§√ 2 §√—ÈßµàÕºŸâ ŸßÕ“¬ÿ 1 §π µ“¡§Ÿà¡◊Õ ¡’°“√‡°Á∫¢âÕ¡Ÿ≈°“√«‘®—¬°àÕπ·≈–À≈—ß ‚¥¬∑’¡«‘®—¬æ◊Èπ∑’Ë Õ”‡¿Õ∑’Ë 2 ∑’¡«‘®—¬æ◊Èπ∑’ˇªìπ∫ÿ§≈“°√ “∏“√≥ ÿ¢„π ‚√ß欓∫“≈ ‡ªìπºŸâ π—∫ πÿπ„À♡√¡ºŸâ ŸßÕ“¬ÿ´÷Ëß ¡’ § «“¡‡¢â ¡ ·¢Á ß ‡ªì π À≈— ° „π°“√∫√‘ À “√®— ¥ °“√ ¡’°“√§—¥‡≈◊Õ°Õ“ “ ¡—§√ 6 §π ®“° ¡“™‘°™¡√¡ (Õ“¬ÿ45ªï¢÷Èπ‰ª) ∑’Ë¡’ ÿ¢¿“楒 ‰ª‰Àπ¡“‰Àπ‰¥â §≈àÕß·§≈à« ∂’∫®—°√¬“π‰¥âÀ√◊Õ¢’Ë¡Õ‡µÕ√剴¥å‰¥â Õà“πÀπ—ß ◊ÕÕÕ° ¡’§«“¡ ¡—§√„® ·≈–¡’‡«≈“«à“ß Õ“ “ ¡—§√‰¥â√—∫°“√Õ∫√¡‡√◊ËÕß°“√¥Ÿ·≈ ÿ¢¿“æ √à“ß°“¬·≈– ÿ¢¿“æ™àÕߪ“°¢ÕߺŸâ ŸßÕ“¬ÿ °“√ ÕÕ°°”≈— ß °“¬ °“√„™â ¬ “ “¡— ≠ ª√–®”∫â “ π ”À√—∫ºŸâ ŸßÕ“¬ÿ§√÷Ëß«—π Õ“ “ ¡—§√ √â“߇§√◊Õ ¢à “ ¬°“√¥Ÿ · ≈ºŸâ Ÿ ß Õ“¬ÿ ® “°√“¬™◊Ë Õ ∑–‡∫’ ¬ π∫â “ π ®”π«π 89 §π¡’°“√‡¬’¬Ë ¡∫â“πºŸ â ߟ Õ“¬ÿ 3 §√—ßÈ ‚¥¬ ¡’ ° √–‡ªÜ “ ¬“‡¬’Ë ¬ ¡∫â “ 𠇪ì π °“√‡æ‘Ë ¡ »— ° ¬¿“æ Õ“ “ ¡—§√´÷Ë߇¥‘¡¡’°‘®°√√¡°“√‡¬’ˬ¡∫â“πÕ¬Ÿà·≈â« Õ“ “ ¡—§√‰¥â√—∫°“√§«“¡√Ÿâ §”·π–π”¡“°¢÷Èπ π—∫ πÿπ¬“∑’„Ë à„π°√–‡ªÜ“ÕÕ°‡¬’¬Ë ¡¡“°¢÷πÈ ∑”„Àâ Õ“ “ ¡— § √¡’ § «“¡¡—Ë π „®·≈–¡’ § «“¡ ÿ ¢ „π°“√ ∑”ß“π¡“°¢÷È π ‡π◊Ë Õ ß®“°‰¥â √— ∫ °“√¥Ÿ · ≈·≈– π—∫ πÿπ®“°‡®â“Àπâ“∑’ˇ¡◊ËÕ¡’ªí≠À“ √Ÿª·∫∫π’È Õ¥§≈â Õ ß°— ∫ «‘ ∂’ ™’ «‘ µ ¢Õß™ÿ ¡ ™π ∑”„Àâ ºŸâ ¥â Õ ¬ ‚Õ°“ ¡’‚Õ°“ ‰¥â√—∫°“√¥Ÿ·≈¡“°¢÷Èπ‚¥¬¡’°“√æ∫ ºŸâ ŸßÕ“¬ÿ∑’ËπÕπªÉ«¬∑’Ë∫â“π·≈–‰¥â√—∫°“√ àßµàÕ‰ª ‚√ß欓∫“≈ ‡°Á∫¢âÕ¡Ÿ≈°“√«‘®—¬°àÕπ·≈–À≈—ß‚¥¬ Õ“ “ ¡— § √∑’Ë ‰ ¥â √— ∫ °“√æ— ≤ π“»— ° ¬¿“æ‚¥¬∑’ ¡ «‘®—¬„πæ◊Èπ∑’Ë Õ”‡¿Õ∑’Ë 3 ‡π◊ËÕß®“°æ◊Èπ∑’ËÕ”‡¿Õ à«π„À≠à‡ªìπ¿Ÿ‡¢“ ºŸ â ߟ Õ“¬ÿ¡°’ “√√«¡µ—«°—π∑”°‘®°√√¡‡°◊Õ∫∑ÿ°‡¥◊Õπ
°“√»÷°…“§ÿ≥¿“æ™’«‘µºŸâ ŸßÕ“¬ÿ ·≈–°“√ à߇ √‘¡ ÿ¢¿“æ∑—πµ ÿ¢¿“æ ‚¥¬∑’¡ ÿ¢¿“æ™ÿ¡™π „π 3 Õ”‡¿Õ ®—ßÀ«—¥‡™’¬ß„À¡à
µ“√“ß∑’Ë 5 √âÕ¬≈–¢ÕߺŸâ ŸßÕ“¬ÿ∑’Ë¡’ªí≠À“°“√‡§’Ȭ«Õ“À“√·¬°µ“¡®”π«πøíπ„π™àÕߪ“° ®”π«π´’Ëøíπ ‰¡à¡’øíπ 1-19 ´’Ë 20-32 ´’Ë √«¡
®”π«π§π
¡’ª≠ í À“
‰¡à¡’ªí≠À“
√«¡
§π √âÕ¬≈– §π √âÕ¬≈– §π √âÕ¬≈– §π √âÕ¬≈–
13 27.7 29 33.0 9 9.4 51 22.1
34 72.3 59 67.0 87 90.6 180 77.9
47 100 88 100. 96 100. 231 100.
µ“√“ß∑’Ë 6 §«“¡ “¡“√∂„π°“√∑”°‘®«—µ√ª√–®”«—π¢ÕߺŸâ ŸßÕ“¬ÿ ºŸâ ŸßÕ“¬ÿ ®”π«π √âÕ¬≈–
∑”‰¥â¥’
∑”‰¥âª“π°≈“ß
∑”‰¥âπâÕ¬
√«¡
172 74.5
53 22.9
6 2.6
231 100
µ“√“ß∑’Ë 7 §«“¡ “¡“√∂„π°“√∑”°‘®°√√¡ à߇ √‘¡ à߇ √‘¡ ÿ¢¿“æ¢ÕߺŸâ ŸßÕ“¬ÿ ºŸâ ŸßÕ“¬ÿ
®”π«π √âÕ¬≈–
∑”‰¥â¡“°
∑”‰¥âª“π°≈“ß
∑”‰¥âπâÕ¬
√«¡
57 24.7
153 66.2
21 9.1
231 100
‚¥¬ Õ∫µ. π—∫ πÿπ√∂‰ª√—∫µ“¡À¡Ÿ∫à “â π °‘®°√√¡ ∑’Ë¥”‡π‘π°“√§◊Õ ª√–™ÿ¡∑’Ë ∂“π’Õπ“¡—¬ ·≈–‰ª ∑”∫ÿ≠∑’Ë«—¥ ∑¬Õ¬‰ª‡¥◊Õπ≈–1 «—¥(¡’ 6 «—¥) ∑’¡ «‘ ®— ¬ „πæ◊È π ∑’Ë π— ∫ πÿ π °‘ ® °√√¡ª√–®”‡¥◊ Õ π¢Õß ºŸâ ŸßÕ“¬ÿ‚¥¬ π—∫ πÿπß∫ª√–¡“≥°“√∑”°‘®°√√¡ „π«— ¥ „π°“√ª√–™ÿ ¡ ºŸâ Ÿ ß Õ“¬ÿ ∑ÿ ° §√—È ß ¡’ ° “√ π—∫ πÿπ∑—πµ∫ÿ§≈“°√·≈–欓∫“≈‰ª„À⧫“¡√Ÿâ ‡√◊Ë Õ ß°“√¥Ÿ · ≈ ÿ ¢ ¿“æÕπ“¡— ¬ ·≈–¡’ ∫ √‘ ° “√ ÿ¢¿“æ™àÕߪ“°
”À√— ∫ ºŸâ Ÿ ß Õ“¬ÿ ∑’Ë ‰ ¡à “¡“√∂¡“√à « ¡ ª√–™ÿ¡·≈–°‘®°√√¡ ‰¥â·°à ºŸªâ «É ¬ ºŸæâ °‘ “√ À¡Ÿ∫à “â π ≈– 4-5 §π ®”π«π 11 À¡Ÿà∫â“π ∑’¡«‘®—¬„π»Ÿπ¬å ÿ¢¿“æ™ÿ¡™π√à«¡°—∫Õ“ “ ¡—§√®“°™¡√¡ºŸâ Ÿß Õ“¬ÿ Õ Õ°‰ª‡¬’Ë ¬ ¡∑’Ë ∫â “ π ‚¥¬·°ππ”·µà ≈ – À¡Ÿà ∫â “ π√Ÿâ ¢â Õ ¡Ÿ ≈ ·≈–‡ªì π ºŸâ °”Àπ¥«à “ „§√¡’ § «“¡ ®”‡ªìπ∑’Ë®–µâÕ߉ª‡¬’ˬ¡ ‰¡à¡’°“√Õ∫√¡·°ππ” ‰ª‡¬’ˬ¡‡πâπ ¿“æ®‘µ„® ‰¡à‡πâπ‡√◊ËÕߧ«“¡√Ÿâ ‡πâπ „Àâ°”≈—ß„® ∑’¡«‘®—¬„π»Ÿπ¬å ÿ¢¿“æ™ÿ¡™π«—¥§«“¡
THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH J a n u a ry - M a r c h 2011
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∫ ∑ «‘ ∑ ¬ “ ° “ √ µ“√“ß∑’Ë 8 §–·ππ‡©≈’ˬ§ÿ≥¿“æ™’«‘µ·¬°µ“¡Õ”‡¿Õ·≈–√«¡3Õ”‡¿Õ§√—Èß∑’Ë 1 ·≈–§√—Èß∑’Ë 2 ”√«®
æ◊Èπ∑’Ë»÷°…“
®”π«π
§à“‡©≈’¬Ë
SD
§√—Èß∑’Ë 1
Õ”‡¿Õ 1 Õ”‡¿Õ 2 Õ”‡¿Õ 3 √«¡ Õ”‡¿Õ 1 Õ”‡¿Õ 2 Õ”‡¿Õ 3 √«¡
107 89 35 231 106 88 35 229
63.79 61.49 61.20 62.52 66.81 60.36 65.89 64.19
5.936 6.072 5.206 5.982 6.605 5.561 6.407 6.877
§√—Èß∑’Ë 2
95% Confidence Interval for Mean Upper Lower 62.66 64.93 60.22 62.77 59.41 62.99 61.74 63.29 65.54 68.08 59.19 61.54 63.68 68.09 63.30 65.09
µ“√“ß∑’Ë 9 ‡ª√’¬∫‡∑’¬∫§à“‡©≈’ˬ§ÿ≥¿“æ™’«‘µ°àÕπ·≈–À≈—ߥ”‡π‘πß“π à߇ √‘¡ ÿ¢¿“æ §√—Èß∑’Ë 1
§√—Èß∑’Ë 2
Mean Difference
p-value
Sig.(2 tailed)
Õ”‡¿Õ1 Õ”‡¿Õ2 Õ”‡¿Õ3 √«¡ 3 Õ”‡¿Õ
63.83 61.73 61.20 62.62
66.81 60.36 65.89 64.19
-2.98 1.36 -4.69 -1.57
.000 .000 .000 .000
¥—π µ√«® ÿ¢¿“æ 查§ÿ¬ ®–¡’欓∫“≈‰ª‡¬’¬Ë ¡¥â«¬ ‡æ◊ËÕµ√«® ÿ¢¿“æ ‡°Á∫¢âÕ¡Ÿ≈°“√«‘®—¬°àÕπ·≈– À≈—ß‚¥¬∑’¡«‘®—¬æ◊Èπ∑’Ë
«‘®“√≥å §ÿ ≥ ¿“æ™’ «‘ µ „π¡‘ µ‘ ÿ ¢ ¿“æ¢ÕßÕß§å ° “√ Õπ“¡—¬‚≈° (World Health Organization) ‡º¬ ·æ√à „ πªï §.».1946 (æ.». 2489) °≈à “ ««à “ ÿ¢¿“æ§◊Õ ¿“«–§«“¡ ¡∫Ÿ√≥å¢Õß™’«µ‘ ¥â“𰓬 ®‘µ ·≈– — ß §¡ ‰¡à „ ™à ‡ æ’ ¬ ߧ«“¡ª√“»®“°‚√§À√◊ Õ §«“¡æ‘°“√ (7) Health is a state of complete 66
¡°√“§¡ - ¡’π“§¡ 2554
°√¡Õπ“¡—¬ à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒
physical, mental and social well-being and not merely the absence of disease and infirmity µàÕ¡“‰¥â‡æ‘Ë¡¿“«–§«“¡ ¡∫Ÿ√≥å¢Õß™’«‘µ ¥â“πªí≠≠“À√◊Õ®‘µ«‘≠≠“≥ (spiritual well-being) ‡¡◊ÕË °“√ª√–™ÿ¡°“√ à߇ √‘¡ ÿ¢¿“æ‚≈°§√—ßÈ ∑’6Ë ªï§.».2005 (æ.».2548)≥ °√ÿ߇∑æ¡À“π§√ ª√–‡∑»‰∑¬ (8) ´÷Ë ß Õ¥§≈â Õ ß°— ∫ π‘ ¬ “¡§”«à “ ÿ¢¿“æ„πæ√–√“™∫—≠≠—µ‘ ÿ¢¿“æ·Ààß™“µ‘ æ.». 2550 (9) ¡“µ√“ 3 «√√§Àπ÷Ë ß ç ÿ ¢ ¿“æé À¡“¬§«“¡«à“ ¿“«–¢Õß¡πÿ…¬å∑’Ë ¡∫Ÿ√≥å∑—Èß∑“ß °“¬ ∑“ß®‘µ ∑“ߪí≠≠“ ·≈–∑“ß —ߧ¡ ‡™◊ËÕ¡‚¬ß
°“√»÷°…“§ÿ≥¿“æ™’«‘µºŸâ ŸßÕ“¬ÿ ·≈–°“√ à߇ √‘¡ ÿ¢¿“æ∑—πµ ÿ¢¿“æ ‚¥¬∑’¡ ÿ¢¿“æ™ÿ¡™π „π 3 Õ”‡¿Õ ®—ßÀ«—¥‡™’¬ß„À¡à
°—π‡ªìπÕߧå√«¡Õ¬à“ß ¡¥ÿ≈ °“√»÷°…“§√—Èßπ’ȇªìπ°“√»÷°…“∂÷ߧÿ≥¿“æ ™’ «‘ µ „π¡‘ µ‘ ÿ ¢ ¿“æ¢ÕߺŸâ Ÿ ß Õ“¬ÿ „ π™π∫∑¢Õß ª√–‡∑»‰∑¬ µ≈Õ¥®π√Ÿª·∫∫°“√ à߇ √‘¡ ÿ¢ ¿“æ∑’Ë ¡’ ° “√æ— ≤ π“®“°»Ÿ π ¬å ÿ ¢ ¿“æ™ÿ ¡ ™π‚¥¬ Õ“ “ ¡—§√„πæ◊πÈ ∑’∑Ë ’Ë ßà µàÕ§ÿ≥¿“æ™’«µ‘ ºŸ â ߟ Õ“¬ÿ √Ÿª ·∫∫¢Õß°“√ à߇ √‘¡ ÿ¢¿“æ¢Õß∑—Èß 3 Õ”‡¿Õ¡’ ‡ªÑ“À¡“¬‡æ◊ÕË °“√æ—≤π“§ÿ≥¿“æ™’«µ‘ ¢ÕߺŸ â ߟ Õ“¬ÿ Õ—π‡ªìπ∑‘»∑“ß°“√æ—≤π“¢ÕßÀ≈“¬ª√–‡∑»·≈– ¢ÕßÕß§å ° “√Õπ“¡— ¬ ‚≈°∑’Ë ¡ Õß«à “ °“√æ— ≤ π“ ÿ¢¿“æ¡‘„™à°“√≈¥‚√§§«“¡æ‘°“√À√◊Õ§«“¡µ“¬ ‡∑à“π—Èπ ¬—ß√«¡∂÷ߺ≈°√–∑∫∂÷ߧÿ≥¿“æ™’«‘µ∑’Ë¥’ ¢÷Èπ¢Õߪ√–™“™π¥â«¬ ´÷Ëßµ√ß°—∫‡ªÑ“À¡“¬∑—πµ ÿ¢¿“æ 2563 (10) ∑’˵—Èß Ultimate Goal «à“ ç§π ‰∑¬¡’ ÿ¢¿“æ™àÕߪ“°∑’ˇÕ◊ÈÕµàÕ°“√¡’§ÿ≥¿“æ™’«‘µ ∑’Ë¥’é ºŸâ ŸßÕ“¬ÿ‡ªìπ°≈ÿà¡∑’ˇÀÁπº≈°√–∑∫™—¥‡®π ®“°ªí≠À“ ÿ¢¿“æ °“√»÷°…“π’È∑”„Àâ‡ÀÁπ«à“‡¡◊ËÕ ‡°‘¥§«“¡√à«¡¡◊Õ√–À«à“ß¿“§√—∞§◊Õ»Ÿπ¬å ÿ¢¿“æ ™ÿ¡™π´÷Ë߇ªìπ¥à“π·√°¢Õß√–∫∫∫√‘°“√∑’˪√–™“ ™π®–‡¢â“∂÷ß∫√‘°“√·≈–™ÿ¡™π§◊Õ™¡√¡ºŸâ ŸßÕ“¬ÿ´÷Ëß ‡ªìπÕߧå°√™ÿ¡™π∑’ˇ¢â¡·¢Áß·≈–¡’Õ¬Ÿà„π™ÿ¡™π∑ÿ° ·Ààß ®– “¡“√∂‡æ‘Ë¡ª√– ‘∑∏‘¿“æ¢Õß°“√¥Ÿ·≈ºŸâ Ÿ ß Õ“¬ÿ ∑’Ë ¡’ º ≈°√–∑∫∂÷ ß §ÿ ≥ ¿“æ™’ «‘ µ ‰¥â ¢≥– ‡¥’¬«°—𠇪ìπ°“√æ—≤𓇧√◊ËÕß¡◊Õ°“√«—¥§ÿ≥¿“æ ™’«‘µÕ¬à“ßßà“¬¢Õß™ÿ¡™π‚¥¬™ÿ¡™π ‚¥¬¡’‡§√◊ËÕß ¡◊Õ°“√«—¥§ÿ≥¿“æ™’«‘µ¢ÕßÕߧ尓√Õπ“¡—¬‚≈° ·≈–¢Õß°√¡ ÿ¢¿“殑µ‡ªìπµâπ·∫∫ ªí ≠ À“∑’Ë æ ∫®“°∫ÿ § ≈“°√ “∏“√≥ ÿ ¢ „π æ◊Èπ∑’ËÕ’°ª√–°“√§◊Õ°“√¢“¥¢âÕ¡Ÿ≈æ◊Èπ∞“π∑’Ë®”‡ªìπ ‡æ◊ËÕ«“ß·ºπ¥”‡π‘πß“π √Ÿª·∫∫∑’Ë¡’°“√¥”‡π‘π ß“π„π∑—Èß 3 Õ”‡¿Õµ√ß°—∫°“√»÷°…“∑’Ë¡’°“√‡ πÕ ·π–®“°À≈“¬°“√»÷°…“∑’ºË “à π¡“ ‡™àπ √–æ’æ√√≥ §”ÀÕ¡·≈–§≥–(12)查∂÷ß °“√¡’∞“π¢âÕ¡Ÿ≈ºŸâ Ÿß
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THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH J a n u a ry - M a r c h 2011
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∫ ∑ «‘ ∑ ¬ “ ° “ √ √ÿª·≈–¢âÕ‡ πÕ·π– §ÿ≥¿“æ™’«‘µ„π¡‘µ‘ ÿ¢¿“æ ‡ªìπ·π«§‘¥∑’Ë °”‡π‘¥·≈–æ—≤π“¡“π“𠇥‘¡‡ªìπ·π«§‘¥‡™‘ßπ“¡ ∏√√¡ ‰¡à‰¥â‡™◊ËÕ¡‚¬ß„Àâ‡ÀÁπ∂÷ß·π«∑“ß°“√π”¡“ ª√–¬ÿ°µå„™â¡“°π—° ®π°√–∑—Ëß §.».1984 Õߧ尓√ Õπ“¡—¬‚≈° ‰¥âª√–°“»π‚¬∫“¬°“√ à߇ √‘¡ ÿ¢ ¿“æ„π™◊ËÕ çHealth for Allé ´÷Ëß∂◊Õ‡ªìπ®ÿ¥‡√‘Ë¡ µâπ∑’∑Ë ”„Àâ°“√ √â“ß ÿ¢¿“æ¡’¡¡ÿ ¡Õß∑’°Ë «â“߉°≈¢÷πÈ ¡Õß ÿ¢¿“懪ìπ à«πÀπ÷ËߢÕß™’«‘µª√–®”«—π·≈– ‡ªìπÕߧåª√–°Õ∫∑’ Ë ”§—≠¢Õß°“√¡’§≥ ÿ ¿“æ™’«µ‘ ∑’¥Ë ’ °“√»÷°…“§ÿ≥¿“æ™’«‘µ„π¡‘µ‘ ÿ¢¿“æ ·≈–°“√ àß ‡ √‘ ¡ ÿ ¢ ¿“æ ·≈–∑— π µ ÿ ¢ ¿“æ ‡æ◊Ë Õ æ— ≤ π“ §ÿ≥¿“æ™’«‘µ¢ÕߺŸâ ŸßÕ“¬ÿ‰∑¬ „πæ◊Èπ∑’Ë™π∫∑ ¢Õß®—ßÀ«—¥‡™’¬ß„À¡àπ’È ∑”„Àâ‡ÀÁπ√Ÿª·∫∫°“√ àß ‡ √‘¡ ÿ¢¿“æ‚¥¬Õ“ “ ¡—§√∑’Ë¡’°“√∫√‘À“√®—¥°“√ ·µ°µà“ß°—π„π 3 Õ”‡¿Õµ“¡∫√‘∫∑·≈–§«“¡ æ√âÕ¡¢Õß·µà≈–æ◊Èπ∑’Ë ´÷Ëß¡’º≈∑”„À⺟⠟ßÕ“¬ÿ∑’ˉ¥â √— ∫ °“√ à ß ‡ √‘ ¡ ÿ ¢ ¿“æ‚¥¬°“√‡¬’Ë ¬ ¡∫â “ π¡’ §ÿ≥¿“æ™’«‘µ¥’¢÷Èπ ·¡â«à“®–¥”‡π‘π°“√„π™à«ß ‡«≈“∑’Ë —Èπ¡“°·§à 3 ‡¥◊Õπ ‡ß◊ËÕπ‰¢ ”§—≠§◊Õ‡ªìπ √Ÿª·∫∫∑’ˇ®â“Àπâ“∑’Ë “∏“√≥ ÿ¢ ºŸâ ŸßÕ“¬ÿ„π™ÿ¡™π ‡ªìπºŸ°â ”Àπ¥ ·≈–¡’ «à π√à«¡À≈—°„π°“√¥”‡π‘πß“π πÕ°®“°π’Ȭ—߇ªìπ°“√»÷°…“‡æ◊ËÕæ—≤𓇧√◊ËÕß¡◊Õ Õ¬à “ ßßà “ ¬ ”À√— ∫ °“√ª√–‡¡‘ π §ÿ ≥ ¿“æ™’ «‘ µ „π ∫√‘ ∫ ∑·≈–π‘ ¬ “¡¢ÕߺŸâ Ÿ ß Õ“¬ÿ „ π™π∫∑¢Õß ª√–‡∑»‰∑¬ ´÷Ë ß §ßµâ Õ ß°“√°“√æ— ≤ π“·≈– ∑¥ Õ∫‡æ‘Ë ¡ ‡µ‘ ¡ „π°“√„™â ‡ §√◊Ë Õ ß¡◊ Õ «— ¥ §ÿ ≥ ¿“æ
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¡°√“§¡ - ¡’π“§¡ 2554
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