การพัฒนาระบบบริการและพัฒนารูปแบบการให้คำปรึกษา แบบคู่สามีภรรยา by nontalee verachai

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°“√æ—≤π“√–∫∫∫√‘°“√·≈–æ—≤π“√Ÿª·∫∫ °“√„Àâ°“√ª√÷°…“·∫∫§Ÿà “¡’¿√√¬“ ¿“¬„µâ‚§√ß°“√ªÑÕß°—π°“√∂à“¬∑Õ¥ ‡™◊ÈÕ HIV ®“°·¡à Ÿà≈Ÿ° “∏“√≥ ÿ¢‡¢µ 15-16 ≈—°…¡’ ¡–‚π«ß»å »Ÿπ¬åÕπ“¡—¬∑’Ë 10 ‡™’¬ß„À¡à

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∫∑§—¥¬àÕ °“√»÷°…“¡’«—µ∂ÿª√– ß§å‡æ◊ËÕæ—≤π“√–∫∫∫√‘°“√·≈–æ—≤π“√Ÿª·∫∫°“√„Àâ°“√ª√÷°…“·∫∫§Ÿà “¡’¿√√¬“„π æ◊Èπ∑’Ë “∏“√≥ ÿ¢‡¢µ 15-16 ‡ªìπ°“√«‘®—¬·≈–æ—≤π“ ‚¥¬ 1) «‘‡§√“–Àå ∂“π°“√≥å¢âÕ¡Ÿ≈∑ÿµ‘¬¿Ÿ¡‘¢ÕßÀ≠‘ßµ—Èß§√√¿å ∑’Ë¡“Ω“°§√√¿å∑ÿ°√“¬∑’Ë¡“§≈Õ¥ „π‚√ßæ¬“∫“≈»Ÿπ¬å ‚√ßæ¬“∫“≈∑—Ë«‰ª ‚√ßæ¬“∫“≈™ÿ¡™π ‚√ßæ¬“∫“≈‡Õ°™π „π 8 ®—ßÀ«—¥ ¢Õß “∏“√≥ ÿ¢‡¢µ 15/16 µ—Èß·µàªï æ.». 2549 - 2551 2) »÷°…“§«“¡ ”‡√Á®¢Õß°“√„Àâ°“√ª√÷°…“·∫∫§Ÿà „π “¡’ ¿√√¬“∑’Ë¡’º≈°“√µ‘¥‡™◊ÈÕ ‡Õ™‰Õ«’ µà“ß°—π ‚√ßæ¬“∫“≈ àß‡ √‘¡ ÿ¢¿“æ 3) ª√–‡¡‘πºŸâºà“π°“√Õ∫√¡À≈—° Ÿµ√ °“√„Àâ°“√ª√÷°…“·∫∫§Ÿà “¡’¿√√¬“ ‡§√◊ËÕß¡◊Õ∑’Ë„™â„π°“√«‘®—¬ ‰¥â·°à ‚ª√·°√¡ ”‡√Á®√Ÿª PHIMS ( Perinatal HIV Intervention Monitoring System) ‚ª√·°√¡ ”‡√Á®√Ÿª Child 2.50b ·∫∫∫—π∑÷°¢âÕ¡Ÿ≈√“¬∫ÿ§§≈ ·∫∫ Õ∫∂“¡ ºŸâºà“π°“√Õ∫√¡À≈—° Ÿµ√°“√„Àâ°“√ª√÷°…“·∫∫§Ÿà “¡’¿√√¬“ «‘∏’°“√«‘‡§√“–Àå¢âÕ¡Ÿ≈·≈– ∂‘µ‘∑’Ë„™â «‘‡§√“–Àå¢âÕ¡Ÿ≈ ∑ÿµ¬‘ ¿Ÿ¡¥‘ «â ¬‚ª√·°√¡ ”‡√Á®√Ÿª Child 2.50b «‘‡§√“–Àå¢Õâ ¡Ÿ≈®“°·∫∫ —¡¿“…≥å ∂‘µ∑‘ „’Ë ™â ‰¥â·°à §à“§«“¡∂’Ë ·≈–√âÕ¬≈– ”À√—∫¢âÕ¡Ÿ≈„π‡™‘ß§ÿ≥¿“æ„™â°“√«‘‡§√“–Àå‡π◊ÈÕÀ“ º≈¢Õß°“√»÷°…“æ∫«à“ 1) À≠‘ßµ—Èß§√√¿å∑’ËΩ“°§√√¿å·≈–§≈Õ¥ „π ∂“π∫√‘°“√ “∏“√≥ ÿ¢ ‡¢µ 15/16 µ—Èß·µàªï æ.».2549 - 2551 √«¡ 97 ·Ààß ¡’Õ—µ√“°“√µ‘¥‡™◊ÈÕ¢ÕßÀ≠‘ßµ—Èß §√√¿å≈¥≈ßπâÕ¬°«à“‡ªÑ“À¡“¬∑’µË ß—È ‰«â Õ—µ√“§«“¡§«∫§ÿ¡°“√‰¥â√∫— ¬“µâ“π‰«√— ∑—ßÈ ¡“√¥“·≈–∑“√°Õ¬Ÿ„à π‡°≥±å¥’ §«“¡ §√Õ∫§≈ÿ¡°“√µ‘¥µ“¡‡¥Á°Õ“¬ÿ 18-24 ‡¥◊Õπ ‰¥â√âÕ¬≈– 66.8 ´÷ËßµË”°«à“‡ªÑ“À¡“¬∑’Ë«“ß‰«â§◊Õ √âÕ¬≈– 70 ·≈–Õ—µ√“ °“√∂à“¬∑Õ¥‡™◊ÈÕ ‡Õ™‰Õ«’ ®“°·¡à Ÿà≈Ÿ° Ÿß°«à“‡ªÑ“À¡“¬∑’Ë°”Àπ¥‰«â‰¡à‡°‘π√âÕ¬≈– 3 ®“°º≈¢Õß°“√«‘‡§√“–Àå·≈– —ß‡§√“–Àå¿“¬„µâ‚§√ß°“√°“√ªÑÕß°—π°“√∂à“¬∑Õ¥‡™◊ÈÕ‡Õ™‰Õ«’®“°·¡à Ÿà≈Ÿ°æ∫«à“ °) ªí≠À“°“√µ‘¥‡™◊ÈÕ‡Õ™‰Õ«’ ¡’ §«“¡´—∫´âÕπ¡“°¢÷Èπ „πª√–‡¥Áπº≈‡≈◊Õ¥µà“ß„π§Ÿà “¡’¿√√¬“ “‡Àµÿ¡“®“°°“√ª°ªî¥º≈‡≈◊Õ¥ ¢) °“√„Àâ°“√ª√÷°…“ √“¬∫ÿ§§≈·≈–√“¬°≈ÿ¡à ∑”„Àâ¢“¥§«“¡§√Õ∫§≈ÿ¡„π°“√µ√«®‡≈◊Õ¥À“°“√µ‘¥‡™◊ÕÈ ‡Õ™‰Õ«’ ‚¥¬‡©æ“–„π°≈ÿ¡à ¢Õß “¡’ §) °“√‡√‘Ë¡ª√—∫‡ª≈’Ë¬π°“√„Àâ°“√ª√÷°…“¡“‡ªìπ§Ÿà·∑π°“√„Àâ°“√ª√÷°…“·∫∫°≈ÿà¡·≈–√“¬∫ÿ§§≈ ‚¥¬°√¡Õπ“¡—¬¬—ß‰¡à ª√– ∫º≈ ”‡√Á®‡∑à“∑’§Ë «√ ¥—ßπ—πÈ °√–∫«π°“√„Àâ°“√ª√÷°…“·∫∫§Ÿ§à «“¡‰¥â√∫— °“√æ—≤π“π”‰ª„™âÕ¬à“ßµàÕ‡π◊ÕË ß∑—ßÈ „π ‚√ß æ¬“∫“≈»Ÿπ¬å ‚√ßæ¬“∫“≈∑—Ë«‰ª ‚√ßæ¬“∫“≈™ÿ¡™π ‚√ßæ¬“∫“≈‡Õ°™π ´÷Ëß°“√„Àâ°“√ª√÷°…“§«√§√Õ∫§≈ÿ¡∂÷ß ¢Õ∫‡¢µ¥â“π°“√ªÑÕß°—π°“√µ‘¥‡™◊ÈÕ√“¬„À¡à °“√™à«¬‡À≈◊Õ¥â“π®‘µ —ß§¡ ·≈–°“√‡¢â“∂÷ß∫√‘°“√ 2). »÷°…“§«“¡

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH

January - March 2012

∫ ∑ «‘ ∑ ¬ “ ° “ √ ”‡√Á®¢Õß°“√„Àâ°“√»÷°…“·∫∫§Ÿà„π “¡’¿√√¬“∑’Ëº≈°“√µ‘¥‡™◊ÈÕ‡Õ™‰Õ«’µà“ß°—π ‚√ßæ¬“∫“≈ àß‡ √‘¡ ÿ¢¿“æ ®.‡™’¬ß„À¡à „π°“√æ—≤π“√Ÿª·∫∫°“√„Àâ°“√ª√÷°…“·∫∫§Ÿà‡π◊ËÕß®“°ªí≠À“°“√æ∫º≈‡≈◊Õ¥µà“ß°—π„π§Ÿà “¡’¿√√¬“¡“°¢÷Èπæ∫«à“ ºŸâ√—∫ ∫√‘°“√¡’§«“¡æ÷ßæÕ„®∑’Ë‰¥â√—∫√Ÿâº≈‡≈◊Õ¥æ√âÕ¡°—π√âÕ¬≈– 98.7 ¡’º≈°√–∑∫∑“ß≈∫µàÕ —¡æ—π∏¿“æ„π§√Õ∫§√—«πâÕ¬·≈– ¡’§«“¡√à«¡¡◊Õ„π°“√™à«¬°—π¥Ÿ·≈§Ÿà¢Õßµπ‡Õß„π§Ÿà∑’Ë¡’º≈‡≈◊Õ¥µà“ß°—π¡“°¢÷Èπ√âÕ¬≈– 56.6 3). °“√ª√–‡¡‘πº≈ºŸâ„Àâ°“√ ª√÷°…“ 1 ªï À≈—ß‰¥â√—∫°“√Õ∫√¡À≈—° Ÿµ√°“√„Àâ°“√ª√÷°…“·∫∫§Ÿà ∑’Ë‰¥â√—∫°“√æ—≤π“‚¥¬°√¡Õπ“¡—¬√à«¡°—∫»Ÿπ¬å§«“¡ √à«¡¡◊Õ‰∑¬ - À√—∞¥â“π “∏“√≥ ÿ¢ √à«¡°—∫°“√„™âª√– ∫°“√≥å®“°°“√»÷°…“¢Õß‚√ßæ¬“∫“≈ àß‡ √‘¡ ÿ¢¿“æ ®.‡™’¬ß„À¡à æ∫«à“ ‡®â“Àπâ“∑’Ë„πÀπà«¬∫√‘°“√Ω“°§√√¿å¢Õß‚√ßæ¬“∫“≈™ÿ¡™π‰¥âπ”º≈®“°°“√Õ∫√¡‰ªªØ‘∫—µ‘¡“°∑’Ë ÿ¥ ∑—Èß°“√ „Àâ°“√ª√÷°…“°àÕπµ√«®‡≈◊Õ¥·≈–À≈—ß°“√µ√«®‡≈◊Õ¥ ·µà¬—ß¢“¥§«“¡¡—Ëπ„®„π°“√„Àâ°“√ª√÷°…“„π°√≥’º≈‡≈◊Õ¥µà“ß°—π

Developing a model of couple counseling service system for the prevention of HIV from mother to child transmission program in the 15-16 public health region. Laksamee Manowong B.Sc. (Public Health) Health Promotion Center Region 10 , Chiangmai Thailand

Abstract The aims of this Research and Development were to improve the services system and develop a model of couple counseling in the area of public health 15-16. The study focused on : 1) analysing data results of all pregnant women who delivered birth in regional hospitals, general hospitals, community hospitals, and private hospitals in eight provinces from the year 2007 to 2009 2) reviewing case studies and lessons learned from ùsuccessful development servicesû and ùcouple counseling modelû of Chiangmai Health Promoting Hospital. 3.) To evaluate the couple counseling training course. The research instruments applied were the PHIMS (Perinatal HIV intervention Monitoring System) programs, software Child 2.50b, interviewing couples who have been infected with HIV, Case Record Form, and questionnaires. Data analysis and statistical methods were used with the Child 2.50b software; data were gathered from interviews and questionnaires. Descriptive statistics were used as frequency and percentage. Qualitative data were used as content analysis. The results were as followed : 1) The coverage of HIV blood testing and ARV treatment in pregnant women and infant, as well as pregnant women who attended antenatal care unit and delivery from 2007 to 2009 in 97 Public Health Service area 15/16 were good. The HIV infection rate in pregnant women was still decreasing in an unsatisfactory rate. The coverage of the numbers followed up with children who were at the ages of 18-24 months for HIV blood testing was 66.8% which was lower than the target (70%). The vertical HIV transmission rate was higher than the target (more than 3%). The results based on the analysis and synthesis in the prevention of mother to child HIV transmission Program were the

¡°√“§¡ - ¡’π“§¡ 2555

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following: a) the HIV problems developed more complexity in the issue of discordant couple; there was no disclosure of HIV blood testing results, b) individual and group counseling could not cover HIV blood testing: especially in the husband group, c) changing from individual and group counseling by Department of Health did not become successful. The couple counseling should continue to be developed in regional, general, community, and private hospitals. Counseling should cover in the areas of prevention of new HIV infectious case, psychosocial support, and access to care. 2) The lesson learned of couple counseling in Chiangmaiûs Health Promoting hospitals, which develop couple counseling from increasing number of discordant couple, discovered that clients were satisfied with the services of couple counseling; there wasnût any negative impact on family relationships as they engaged in selfcare and family participation. 3) After the 1 year training couple counseling curriculum that was developed by Department of Health, Thailand MOPH-U.S. CDC Collaboration (TUC) and by experience of Chiangmaiûs Health Promoting Hospital, the counselors evaluation discovered that most counselors who use couple counseling were counselors that work in the ANC at the community hospital. They used couple counseling for pre and post test counseling, but they were less confident in discordant couple counseling.

∫∑π” °“√∑’Ë°√–∑√«ß “∏“√≥ ÿ¢ ‰¥â°”Àπ¥ π‚¬∫“¬°“√¥”‡π‘πß“π°“√ªÑÕß°—π°“√∂à“¬∑Õ¥ ‡™◊ÈÕ ‡Õ™ ‰Õ «’ ®“°·¡à Ÿà≈Ÿ° ·≈–°“√¥Ÿ·≈À≠‘ß À≈—ß§≈Õ¥·≈–§√Õ∫§√—«∑’Ëµ‘¥‡™◊ÈÕ ‡Õ™ ‰Õ «’ ‚¥¬ °√¡Õπ“¡— ¬ π— ∫ πÿ π „Àâ ¡’ ° “√¥”‡π‘ π ß“π §√Õ∫§≈ÿ¡∑ÿ°æ◊Èπ∑’Ë∑—Ë«ª√–‡∑» µ—Èß·µàªï æ.».2544 ‡ªìπµâπ¡“ ¡’‚√ßæ¬“∫“≈ ®”π«π 934 ·Ààß ¥”‡π‘π ß“πµ“¡·π«π‚¬∫“¬ °‘®°√√¡À≈—°¿“¬„µâ°“√ ¥”‡π‘πß“πª√–°Õ∫¥â«¬ °“√„Àâ∫√‘°“√ª√÷°…“ ·≈–µ√«®‡≈◊Õ¥‡Õ™‰Õ«’ ”À√—∫À≠‘ßµ—Èß§√√¿å¥â«¬ §«“¡ ¡—§√„® À≠‘ßµ—ßÈ §√√¿å∑¡’Ë º’ ≈‡≈◊Õ¥‡Õ™‰Õ«’∫«° ®–‰¥â√∫— ¬“µâ“π‰«√— ‡æ◊ÕË ≈¥°“√∂à“¬∑Õ¥‡™◊ÕÈ ‡Õ™‰Õ «’ ®“°·¡à Ÿà≈Ÿ° ‡¥Á°∑’Ë‡°‘¥®“°·¡à∑’Ëµ‘¥‡™◊ÈÕ ‡Õ™ ‰Õ «’ ®–‰¥â√—∫¬“µâ“π‰«√— À≈—ß§≈Õ¥∑—π∑’ ·≈–‰¥â√—∫ π¡º ¡∑¥·∑ππ¡·¡à‡ªìπ‡«≈“ 12-18 ‡¥◊Õπ ·¡à ·≈–≈Ÿ°À≈—ß§≈Õ¥®–‰¥â√—∫°“√¥Ÿ·≈Õ¬à“ßµàÕ‡π◊ËÕß À≠‘ßµ—Èß§√√¿å∑’Ë¡’º≈‡≈◊Õ¥ ‡Õ™ ‰Õ «’ ≈∫®–‰¥â √—∫§”·π–π”ª√÷°…“ À≈’°‡≈’Ë¬ßæƒµ‘°√√¡‡ ’Ë¬ß ‡æ◊ËÕ„Àâ§ßº≈‡≈◊Õ¥≈∫µ≈Õ¥‰ª ´÷Ëß°“√¥”‡π‘πß“π ¥—ß°≈à“« °√¡Õπ“¡—¬‚¥¬»Ÿπ¬åÕπ“¡—¬‡¢µ∑’Ë 1 - 12 ‰¥â ¡’ √ –∫∫§«∫§ÿ ¡ °”°— ∫ µ‘ ¥ µ“¡°“√¥”‡π‘ π ß“π

‡æ◊ËÕ√«∫√«¡«‘‡§√“–Àå ·≈–π”‡ πÕº≈°“√¥”‡π‘π ß“πÕ¬à“ßµàÕ‡π◊ËÕß ´÷Ëßº≈°“√¥”‡π‘πß“π®π∂÷ß ªí®®ÿ∫—π‰¥âº≈‡ªìπ∑’Ëπà“æÕ„®·µà°Á¬—ß‰¡à∫√√≈ÿ‡ªÑ“ À¡“¬¢Õßª√–‡∑» §◊Õ Õ—µ√“°“√∂à“¬∑Õ¥‡™◊ÈÕ ‡Õ™ ‰Õ «’ ®“°·¡à Ÿà≈Ÿ° µâÕß‰¡à‡°‘π√âÕ¬≈– 3(1) °“√«‘‡§√“–Àå√–∫∫°“√¥”‡π‘πß“πªÑÕß°—π °“√∂à“¬∑Õ¥‡™◊ÈÕ ‡Õ™ ‰Õ «’ ®“°·¡à Ÿà≈Ÿ° æ∫«à“ Õÿª √√§∑’Ë∑”„Àâ°“√¥”‡π‘πß“π‰¡à∫√√≈ÿ‡ªÑ“À¡“¬ ‡π◊Ë Õ ß®“° ¿“æªí ≠ À“∑’Ë ´— ∫ ´â Õ π¡“°¢÷È π ∑—È ß „π ª√–‡¥Áπ¢Õßº≈‡≈◊Õ¥µà“ß °“√ª°ªî¥º≈‡≈◊Õ¥ ´÷Ëß π—∫«à“‡ªìπÕÿª √√§∑’Ë ”§—≠¡“°„π°“√ªÑÕß°—π∑—Èß °“√µ—Èß§√√¿å °“√∂à“¬∑Õ¥‡™◊ÈÕ ‡Õ™ ‰Õ «’ ·°à§Ÿà ·≈– √–∫∫„Àâ ° “√ª√÷ ° …“∑’Ë à « π„À≠à ‡ ªì π °“√„Àâ ° “√ ª√÷°…“·∫∫‡¥’Ë¬« À√◊Õ°≈ÿà¡ ‚¥¬∑’Ë§Ÿà‰¡à‰¥â√—∫°“√ ª√÷ ° …“´÷Ë ß ‰¡à Õ¥§≈â Õ ß°— ∫ ¿“æ§«“¡‡ªì π ®√‘ ß ¢Õßªí≠À“∑’Ë§ŸàµâÕß√—∫√Ÿâ·≈–™à«¬°—π·°â‰¢ªí≠À“ ¥—ß π—Èπ‚¥¬¿“æ√«¡·≈â«°“√∫√‘À“√®—¥°“√√–∫∫°“√ ¥”‡π‘ π ß“π¥— ß °≈à “ « ¡’ § «“¡®”‡ªì π µâ Õ ßÕ“»— ¬ ‡§√◊ËÕß¡◊Õ∑’Ë ”§—≠§◊Õ °√–∫«π°“√„Àâ°“√ª√÷°…“ ·∫∫§Ÿà ´÷ßË ®– àßº≈¥’µÕà ºŸ√â ∫— ∫√‘°“√ “¡ª√–°“√§◊Õ ª√–°“√·√°‡æ◊Ë Õ ª√–‚¬™πå „ π°“√ªÑ Õ ß°— π °“√ ∂à“¬∑Õ¥‡™◊ÈÕ ‡Õ™ ‰Õ «’ ª√–°“√∑’Ë Õß‡æ◊ËÕ°“√

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH

January - March 2012

∫ ∑ «‘ ∑ ¬ “ ° “ √ «—µ∂ÿª√– ß§å°“√»÷°…“

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1. °“√»÷°…“ ∂“π°“√≥å 1.1 ∂“π°“√≥å°“√µ√«® 1. ¢âÕ¡Ÿ≈®“°‚ª√·°√¡ Child 2.50 b. µ—ßÈ - ®”π«π/√âÕ¬≈– ·µàªï æ.».2549-2551 ´÷Ëß¥”‡π‘π - °“√«‘‡§√“–Àå À“‡™◊ÈÕ‡Õ™‰Õ«’ ·≈– °“√„Àâ∫√‘°“√ ·≈– ¢âÕ¡Ÿ≈¬âÕπÀ≈—ß °“√‡°Á ∫ ¢â Õ ¡Ÿ ≈ ¢ÕßºŸâ √— ∫ º‘ ¥ ™Õ∫ß“π §«“¡™ÿ°¢Õß°“√µ‘¥ ∂“π°“√≥åªí≠À“„π ®“°‚√ßæ¬“∫“≈™ÿ¡™π, ‚√ßæ¬“∫“≈ ‡™◊ÈÕ‡Õ™‰Õ«’ ¢ÕßÀ≠‘ß “∏“√≥ ÿ¢‡¢µ 15/ ∑—Ë«‰ª ‚√ßæ¬“∫“≈»Ÿπ¬å √«¡ 97 ‚√ß µ—Èß§√√¿å ∑’Ë¡“Ω“° 16 æ¬“∫“≈„π 8 ®— ß À«— ¥ ‰¥â · °à §√√¿å ≥ §≈‘π‘°Ω“° §√√¿å·≈–¡“§≈Õ¥∑’Ë ®.‡™’¬ß„À¡à ≈”æŸπ ≈”ª“ß ·¡àŒÕà ß Õπ ‡™’¬ß√“¬ æ–‡¬“ ·æ√à ·≈–πà“π ÀâÕß§≈Õ¥¢Õß‚√ß æ¬“∫“≈µà“ß Ê 2. »÷°…“§«“¡ ”‡√Á®¢Õß 2.1 §Ÿà “¡’¿√√¬“∑’Ë¡’°“√ 2.1 Àπ— ß ◊ Õ · ¥ß§«“¡¬‘ π ¬Õ¡°“√‡¢â “ - ®”π«π√âÕ¬≈– µ‘¥‡™◊ÈÕ‡Õ™‰Õ«’ µà“ß √à«¡„π‚§√ß°“√«‘®—¬ °“√„Àâ°“√ª√÷°…“ °—π∑’Ë¡“√—∫∫√‘°“√ ≥. 2.2 ‡°Á ∫ ¢â Õ ¡Ÿ ≈ ‚¥¬°“√„™â · ∫∫∫— π ∑÷ ° ·∫∫§Ÿà„π “¡’¿√√¬“∑’Ë ¢âÕ¡Ÿ≈√“¬∫ÿ§§≈®”π«π 38 §Ÿà µ—Èß·µà §≈‘π‘°Ω“°§√√¿å·≈– º≈‡≈◊Õ¥‡Õ™‰Õ«’µà“ß ¡’π“§¡ 2552 -‡¡…“¬π 2553 ‚¥¬ §≈‘π‘°„Àâ§”ª√÷°…“ °—π ≥. ‚√ßæ¬“∫“≈ π—°«‘™“°“√·≈–ºŸâ√—∫º‘¥™Õ∫ß“π„Àâ§” àß‡ √‘¡ ÿ¢¿“æ»Ÿπ¬å ª√÷°…“„πÀ—«¢âÕ¥—ßπ’È Õπ“¡—¬∑’Ë 10 (3) 2.2.1 ¢âÕ¡Ÿ≈∑—Ë«‰ª ‡™’¬ß„À¡à 2.2.2 §«“¡æ÷ßæÕ„®„π°“√√—∫°“√ ª√÷°…“·∫∫§Ÿà 2.2.3 º≈°√–∑∫µàÕ —¡æ—π∏¿“æ„π §√Õ∫§√—« 2.2.4 °“√¡’ à«π√à«¡„π°“√¥Ÿ·≈ µπ‡Õß·≈–§√Õ∫§√—« ¥â“π°“√ª√—∫ µ—«·≈–°“√«“ß·ºπ™’«‘µ ¥â“π°“√µ—¥ ‘π

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3. °“√æ—≤π“»—°¬¿“æ 3.1 ºŸâ√—∫º‘¥™Õ∫ß“π‡Õ¥ å „π·¡à·≈–‡¥Á°¢Õß∑ÿ° ‡®â“Àπâ“∑’Ë‚¥¬°“√®—¥ ‚√ßæ¬“∫“≈„π Õ∫√¡À≈—° Ÿµ√°“√ “∏“√≥ ÿ¢‡¢µ 15/ „Àâ°“√ª√÷°…“·∫∫§Ÿà∑’Ë 16 Õ¬à“ßπâÕ¬‚√ß æ—≤π“‚¥¬»Ÿπ¬å§«“¡ æ¬“∫“≈≈– 1 §π √à«¡¡◊Õ‰∑¬- À√—∞ ®”π«π102 §π ¥â“π “∏“√≥ ÿ¢ (π”√àÕß) ·≈–ª√–‡¡‘π ºŸâºà“π°“√Õ∫√¡ 1 ªï

3.2 °“√ª√–‡¡‘πº≈ºŸâºà“π °“√Õ∫√¡À≈—° Ÿµ√ °“√„Àâ°“√ª√÷°…“ ·∫∫§Ÿà (À≈—° Ÿµ√ π”√àÕß) À≈—ß°“√ Õ∫√¡ 1 ªï

‡§√◊ËÕß¡◊Õ/«‘∏’°“√√«∫√«¡¢âÕ¡Ÿ≈ „®√—∫¬“µâ“π‰«√— , ¥â“π°“√„Àâπ¡ ∫ÿµ√ °“√§ÿ¡°”‡π‘¥, °“√√—∫ª√–∑“π Õ“À“√ ·≈–°“√ÕÕ°°”≈—ß°“¬ ¥â“π °“√¡“µ“¡π—¥ 2.3 ·∫∫ —¡¿“…≥å‡®“–≈÷° ‡ªìπ°“√‡°Á∫ ¢âÕ¡Ÿ≈‚¥¬π—°«‘™“°“√„πª√–‡¥Áπ 2.3.1 Õß§å§«“¡√Ÿâ‡√◊ËÕß°√–∫«π°“√ „Àâ§”ª√÷°…“·∫∫§Ÿà 2.3.2 ∑—°…–°“√„Àâ§”ª√÷°…“ 2.3.3 º≈¢Õß°“√„Àâ§”ª√÷°…“·∫∫§Ÿà 2.3.4 ªí≠À“Õÿª √√§¢Õß°“√„™â°“√ „Àâ§”ª√÷°…“·∫∫§Ÿà °“√√—∫§”ª√÷°…“ 3.1 À≈—° Ÿµ√°“√„Àâ°“√ª√÷°…“·∫∫§Ÿà ∑’Ë æ—≤π“‚¥¬»Ÿπ¬å§«“¡√à«¡¡◊Õ‰∑¬ À√—∞ ¥â“π “∏“√≥ ÿ¢ ´÷Ëß¥”‡π‘π °“√ Õπ‚¥¬∑’¡«‘∑¬“°√√–¥—∫‡¢µ ‚¥¬¡’¢—ÈπµÕπ·≈–ª√–‡¥Áπ¥—ßπ’È 3.1.1 °“√∑” Pre - Test ¢ÕßºŸâ‡¢â“ √—∫°“√Õ∫√¡ 3.1.2 ∑—°…–®”‡ªìπ„π°“√„Àâ°“√ ª√÷°…“·∫∫§Ÿà 3.1.3 °“√„Àâ°“√ª√÷°…“·∫∫§Ÿà°àÕπ °“√µ√«®‡≈◊Õ¥À“°“√µ‘¥‡™◊ÈÕ ‡Õ™‰Õ«’ 3.1.4 °“√„Àâ°“√ª√÷°…“·∫∫§ŸàÀ≈—ß °“√µ√«®‡≈◊Õ¥À“À“°“√µ‘¥‡™◊ÈÕ ‡Õ™‰Õ«’ °√≥’º≈‡≈◊Õ¥≈∫À√◊Õº≈‡≈◊Õ¥∫«° ∑—Èß§Ÿà 3.1.5 °“√„Àâ°“√ª√÷°…“·∫∫§ŸàÀ≈—ß °“√µ√«®‡≈◊Õ¥À“°“√µ‘¥‡™◊ÈÕ°√≥’º≈ ‡≈◊Õ¥µà“ß 3.1.6 Post - Test À≈—ßÕ∫√¡ 3.1.7 °“√ª√–‡¡‘πº≈À≈—ßÕ∫√¡ 3.2 ·∫∫ Õ∫∂“¡ºŸâºà“π°“√Õ∫√¡ ´÷Ëß®—¥ ∑”‚¥¬ºŸâ√—∫º‘¥™Õ∫ß“π‡Õ¥ å„π·¡à ·≈–‡¥Á° °≈ÿà¡ àß‡ √‘¡ ÿ¢¿“æ »Ÿπ¬å Õπ“¡—¬∑’Ë 10 ‡™’¬ß„À¡à ·≈–®—¥ àß„Àâ ºŸâµÕ∫∑“ß‰ª√…≥’¬å ´÷Ëß¡’ª√–‡¥Áπ À—«¢âÕ¥—ßπ’È

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH

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- °“√«‘‡§√“–Àå®“° °“√∑” Pre - Post Test - §à“§«“¡°â“«Àπâ“ / §«“¡µà“ß ¢Õß §–·ππ Pre Post Test - °“√∂“¡-µÕ∫„π ÀâÕß‡√’¬π

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January - March 2012

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3.2.1 ¢âÕ¡Ÿ≈∑—Ë«‰ª 3.2.2 ¿“√–ß“π„Àâ∫√‘°“√ª√÷°…“ ·∫∫§Ÿµà Õà ‡¥◊Õπ 3.2.3 °“√π”«‘∏’°“√·∫∫§Ÿà‰ª„™â 3.2.4 °“√π”∑—°…–·∫∫§Ÿà‰ª„™â 3.2.5 ªí®®—¬§«“¡ ”‡√Á®¢Õß°“√π” °√–∫«π°“√„Àâ°“√ª√÷°…“·∫∫§Ÿà‰ª„™â 3.2.6 ªí≠À“Õÿª √√§ 3.2.7 §«“¡§‘¥‡ÀÁπ¢Õß°“√π”°“√„Àâ §”ª√÷°…“·∫∫§Ÿà‰ª„™âÕ¬à“ßµàÕ‡π◊ËÕß 3.2.8 §«“¡µâÕß°“√„π°“√æ—≤π“ µπ‡Õß¢ÕßºŸâ„Àâ§”ª√÷°…“

º≈°“√»÷°…“ 1. °“√»÷°…“ ∂“π°“√≥å°“√„Àâ∫√‘°“√ ·≈– ∂“π°“√≥åªí≠À“„π “∏“√≥ ÿ¢‡¢µ 15/16 ¢Õß°“√¥”‡π‘πß“π‚§√ß°“√ªÑÕß°—π°“√∂à“¬∑Õ¥ ‡™◊ÈÕ ‡Õ™ ‰Õ «’ ®“°·¡à Ÿà≈Ÿ° æ∫«à“ Õ—µ√“§«“¡ §≈Õ∫§≈ÿ¡¢Õß°“√µ√«®‡≈◊Õ¥¢ÕßÀ≠‘ßµ—Èß§√√¿å

∑’Ë¡“Ω“°§√√¿å„π “∏“√≥ ÿ¢‡¢µ 15 ·≈– 16 „πªï 2551 ‡ªìπ√âÕ¬≈– 98.6 ·≈– 98.0 µ“¡≈”¥—∫ ·≈– µ—ßÈ ·µàªï æ.». 2549-2551Õ—µ√“°“√µ‘¥‡™◊ÕÈ ‡Õ™ ‰Õ «’ ¢ÕßÀ≠‘ßµ—ßÈ §√√¿å‡ªìπ√âÕ¬≈– 1.62 0.93 0.84 ·≈– „π “∏“√≥ ÿ¢‡¢µ 16 §‘¥‡ªìπ√âÕ¬≈– 1.15 1.15 ·≈– 1.07 µ“¡≈”¥—∫

µ“√“ß∑’Ë 1 ®”π«π/Õ—µ√“§«“¡§√Õ∫§≈ÿ¡/√âÕ¬≈–¢Õßº≈‡≈◊Õ¥∫«° ¢ÕßÀ≠‘ßµ—ßÈ §√√¿å (√“¬„À¡à) ¢Õß‚√ßæ¬“∫“≈µà“ß Ê „π “∏“√≥ ÿ¢ ‡¢µ 15/16 µ—Èß·µàªï æ.». 2549 - 2551 ªï “∏“√≥ ÿ¢ ®”π«πÀ≠‘ß ®”π«π‰¥â√—∫°“√ ß∫ª√–¡“≥ ‡¢µ µ—Èß§√√¿å µ√«®‡≈◊Õ¥ √“¬„À¡à (√“¬) (√“¬)

2549 2550 2551 2549 2550 2551

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21,197 20,853 18,207 15,735 16,179 16,550

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1.62 0.93 0.84 1.15 1.15 1.07

2. °“√»÷°…“§«“¡ ”‡√Á®¢Õß°“√„Àâ°“√ ª√÷°…“·∫∫§Ÿà„π “¡’¿√√¬“∑’Ëº≈‡≈◊Õ¥ ‡Õ™ ‰Õ «’ µà “ ß°— π „π‚√ßæ¬“∫“≈ à ß ‡ √‘ ¡ ÿ ¢ ¿“æ »Ÿ π ¬å Õπ“¡— ¬ ∑’Ë 10 ‡™’ ¬ ß„À¡à æ∫«à “ ¡’ º ≈¥’ À ≈“¬ ª√–°“√‚¥¬„π¥â“π¢Õß‡®â“Àπâ“∑’Ë‰¥â·°à àß‡ √‘¡ „Àâ»—°¬¿“æ¢Õß§«“¡‡ªìπ§Ÿà ™à«¬„Àâ¡’°“√¬Õ¡√—∫ º≈‡≈◊Õ¥ √—∫√Ÿâ«à“¡’°√≥’∑’Ëº≈‡≈◊Õ¥ ‡Õ™ ‰Õ «’ µà“ß °—πÕ¬Ÿà¡“° àßº≈„Àâ¡’°“√ª√–‡¡‘πæƒµ‘°√√¡‡ ’Ë¬ß √à«¡°—π ´÷Ëß®–π”‰ª Ÿà§«“¡√à«¡¡◊Õ„π°“√ª√—∫ æƒµ‘ ° √√¡°“√ªÑ Õ ß°— π °“√µ‘ ¥ ‡™◊È Õ ·≈–°“√¥Ÿ · ≈ √—°…“ Õ’°∑—Èß¬—ß‡ªìπª√–‚¬™πå„π°“√ªÑÕß°—πÕ’° ΩÉ“¬‰¡à„Àâ¡’°“√µ‘¥‡™◊ÈÕ‰¥â ‚¥¬‡©æ“–°√≥’∑’ËÀ≠‘ß µ—Èß§√√¿å∑’Ë‰¡àµ‘¥‡™◊ÈÕ®–∑”„Àâ¡’‚Õ°“ ªÑÕß°—π°“√ ∂à“¬∑Õ¥‡™◊ÈÕ ‡Õ™ ‰Õ «’ ·°à∑“√°„π§√√¿å πÕ°®“° π’È¬—ß™à«¬≈¥ªí≠À“°“√ª°ªî¥º≈‡≈◊Õ¥µàÕ°—π‰¥â ≈¥ ªí≠À“º≈°√–∑∫¥â“π —¡æ—π∏¿“æ„π§√Õ∫§√—« µ≈Õ¥®π¡’°“√µ—¥ ‘π„®«“ß·ºπ™’«‘µ¥Ÿ·≈µπ‡Õß

·≈–§√Õ∫§√—«√à«¡°—π‰¥â¥’°«à“°“√µ—¥ ‘π„®‡æ’¬ß ΩÉ“¬‡¥’¬« ®“°º≈°“√»÷°…“¬—ßæ∫«à“ºŸâ√—∫∫√‘°“√ à«π„À≠àæß÷ æÕ„®µàÕ°“√√—∫°“√ª√÷°…“·∫∫§Ÿà ·≈– ∫√√¬“°“»„π§√Õ∫§√—«À≈—ß°“√√—∫°“√ª√÷°…“ ·∫∫§Ÿà æ ∫«à “ ∫√√¬“°“»„π§√Õ∫§√— « ¥Ÿ · ≈‡Õ“ „®„ à°—π¡“°¢÷Èπ(√âÕ¬≈– 56.6) ¡’‡æ» —¡æ—π∏å πâ Õ ¬≈ß(√â Õ ¬≈– 56.6) ‡À¡◊ Õ π‡¥‘ ¡ ‰¡à ¡’ Õ –‰√ ‡ª≈’Ë¬π·ª≈ß(√âÕ¬≈– 44.7) æ∫«à“ à«π„À≠à¬—ß§ß ‰¡à∂°Ÿ ∑Õ¥∑‘ßÈ ®“°¢âÕ¥’∑’Ë°≈à“«¡“®–™à«¬„Àâ ‘Ëß∑’ËºŸâ„Àâ°“√ ª√÷°…“‡§¬«‘µ°°—ß«≈«à“°“√„Àâ°“√ª√÷°…“·∫∫§Ÿà¡’ §«“¡¬ÿßà ¬“°‡ ’¬Ë ßµàÕ°“√‡°‘¥§«“¡√ÿπ·√ß„π∑“ß≈∫ π—Èπ‰¡à‡ªìπ‰ªµ“¡∑’Ë‡§¬«‘µ°°—ß«≈·µà°≈—∫‡ªìπ ‘Ëß∑’Ë ‡ √‘ ¡ §«“¡¡—Ë π „®·°à ºŸâ „ Àâ ° “√ª√÷ ° …“„π°“√π” °√–∫«π°“√„Àâ°“√ª√÷°…“·∫∫§Ÿà‰ª„™âÕ¬à“ß°«â“ß ¢«“ß¡“°¬‘Ëß¢÷Èπ(4)

µ“√“ß∑’Ë 2 ®”π«π/√âÕ¬≈– ¢Õßº≈°√–∑∫µàÕ —¡æ—π∏¿“æ„π§√Õ∫§√—« ‡π◊ÈÕÀ“ 1. ∫√√¬“°“»„π§√Õ∫§√—« (µÕ∫‰¥â¡“°°«à“ 1 ¢âÕ) - ¥Ÿ·≈‡Õ“„®„ à°—π¡“°¢÷Èπ - ¡’‡æ» —¡æ—π∏åπâÕ¬≈ß - ‡À¡◊Õπ‡¥‘¡‰¡à¡’Õ–‰√‡ª≈’Ë¬π·ª≈ß - ‰¡à¡’‡æ» —¡æ—π∏å°—π‡≈¬ 2. ¿“«–°“√∂Ÿ°∑Õ¥∑‘Èß - ‰¡à∂Ÿ°∑Õ¥∑‘Èß - “¡’∑Õ¥∑‘Èß¿√√¬“ / ¿√√¬“∑Õ¥∑‘Èß “¡’ / §Ÿà„πÕ¥’µ∑Õ¥∑‘Èß

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THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH

January - March 2012

∫ ∑ «‘ ∑ ¬ “ ° “ √ ∑”ß“π¢Õß∑’ ¡ ·≈–°“√„Àâ ¢â Õ ‡ πÕ·π–„π°“√ ∑”ß“π®“°°“√»÷°…“¢âÕ¡Ÿ≈¢Õß∑’Ëª√÷°…“ (πæ. Õ√à“¡ ≈‘È¡µ√–°Ÿ≈) π”∑—°…–·≈–°√–∫«π°“√„Àâ§” ª√÷°…“·∫∫§Ÿà¡“∑”·∫∫≈Õßº‘¥≈Õß∂Ÿ° °àÕπ¡’ °“√®—¥Õ∫√¡√–¥—∫‡¢µ (À≈—° Ÿµ√π”√àÕß TUC) ∑”„Àâ¡’°“√ √ÿª‡ªìπ§«“¡ ”‡√Á®¢Õß°“√„Àâ°“√ ª√÷°…“·∫∫§Ÿà “¡’¿√√¬“∑’Ëº≈‡≈◊Õ¥ ‡Õ™ ‰Õ «’ µà“ß °—π ‰¥â·µà°Á¡’ªí≠À“Õÿª √√§∑—ÈßΩÉ“¬ºŸâ„Àâ∫√‘°“√ ·≈–ºŸâ√—∫∫√‘°“√ 3. °“√æ—≤π“»—°¬¿“æ‡®â“Àπâ“∑’Ë‚¥¬°“√ ®— ¥ Õ∫√¡À≈— ° Ÿ µ √°“√„Àâ ° “√ª√÷ ° …“·∫∫§Ÿà ∑’Ë æ—≤π“‚¥¬°√¡Õπ“¡—¬·≈–»Ÿπ¬å§«“¡√à«¡¡◊Õ‰∑¬ À√—∞ ¥â“π “∏“√≥ ÿ¢ (π”√àÕß) ´÷Ëß®—¥Õ∫√¡‚¥¬ ºŸâ√—∫º‘¥™Õ∫ß“π‡Õ¥ å„π·¡à·≈–‡¥Á° °≈ÿà¡ß“π àß ‡ √‘¡ ÿ¢¿“æ »Ÿπ¬åÕπ“¡—¬∑’Ë 10 ‡™’¬ß„À¡à ®”π«π 3 √ÿàπ Ê ≈– 3 «—π √«¡ 102 §π ‚¥¬∑’¡«‘∑¬“°√ √–¥— ∫ ‡¢µ‰¥â π”À≈— ° Ÿ µ √¥— ß °≈à “ «¢â “ ßµâ π ¡“ ª√–¬ÿ°µå Õπ„ÀâºŸâ√—∫º‘¥™Õ∫ß“π‡Õ¥ å„π·¡à·≈– ‡¥Á°¢Õß∑ÿ°‚√ßæ¬“∫“≈„π “∏“√≥ ÿ¢‡¢µ 15/16 Õ¬à“ßπâÕ¬‚√ßæ¬“∫“≈≈– 1 §π ‡æ◊ËÕ«—µ∂ÿª√– ß§å „π°“√π”√Ÿª·∫∫°“√„Àâ°“√ª√÷°…“·∫∫§Ÿà ‰ª ∑¥≈Õß„™â°—∫ß“π°“√„Àâ§”ª√÷°…“∑’Ë√—∫º‘¥™Õ∫Õ¬Ÿà ”À√—∫°“√ª√–‡¡‘πÀ≈—ßºà“π°“√Õ∫√¡·≈â«

1 ªï (®—¥Õ∫√¡™à«ß‡¥◊Õπ¡’π“§¡-‡¡…“¬π 2552) ‚¥¬°“√„™â·∫∫ Õ∫∂“¡ ´÷Ëß®—¥∑”‚¥¬ºŸâ√—∫º‘¥ ™Õ∫ß“π‡Õ¥ å„π·¡à·≈–‡¥Á° °≈ÿà¡ß“π àß‡ √‘¡ ÿ¢ ¿“æ »Ÿπ¬åÕπ“¡—¬∑’Ë 10 ‡™’¬ß„À¡à ·≈–ºà“π°“√ µ√«® Õ∫§«“¡∂Ÿ°µâÕß¢Õß‡π◊ÈÕÀ“ ‚¥¬∑’Ëª√÷°…“ ‚§√ß°“√·≈–À—«Àπâ“∑’¡«‘∑¬“°√√–¥—∫‡¢µ (πæ. Õ√à“¡ ≈‘È¡µ√–°Ÿ≈) ·≈–π”¡“ª√—∫ª√ÿß°àÕπ àß„ÀâºŸâ ºà“π°“√Õ∫√¡∑“ß‰ª√…≥’¬å ®”π«π 102 §π ¡’ °“√µÕ∫°≈—∫ ®”π«π 66 ™ÿ¥ §‘¥‡ªìπ√âÕ¬≈– 64.7 ‚¥¬¡’‡π◊ÈÕÀ“‚¥¬ √ÿª¥—ßπ’È ºŸâ ºà “ π°“√Õ∫√¡∑’Ë µ Õ∫·∫∫ Õ∫∂“¡ ∑”ß“π∑’Ë ‚ √ßæ¬“∫“≈™ÿ ¡ ™π √â Õ ¬≈– 71.2 ‚√ßæ¬“∫“≈»Ÿπ¬å/‚√ßæ¬“∫“≈∑—Ë«‰ª√âÕ¬≈– 16.7 ·≈–Õ◊ËπÊ √âÕ¬≈– 12.1 µ“¡≈”¥—∫ ‚¥¬¡’°“√ °√–®“¬‰ªµ“¡Àπà«¬ß“π¬àÕ¬µà“ßÊ ‚¥¬ à«π„À≠à ºŸâ∑’Ë¡“®“°‚√ßæ¬“∫“≈»Ÿπ¬å/‚√ßæ¬“∫“≈∑—Ë«‰ª‰ª ªØ‘∫—µ‘ß“π∑’ËÀâÕß§≈Õ¥(√âÕ¬≈– 36.4) √Õß≈ß¡“ §◊Õ Ÿµ‘-π√’‡«™ (√âÕ¬≈– 27.3) ÀâÕßΩ“°§√√¿å·≈– ΩÉ“¬°“√æ¬“∫“≈(√âÕ¬≈– 18.2) à«πºŸâ∑’Ë¡“®“° ‚√ßæ¬“∫“≈™ÿ¡™π à«π„À≠àªØ‘∫—µ‘ß“π∑’Ë°≈ÿà¡ß“π ‡«™ªØ‘∫—µ‘§√Õ∫§√—«™ÿ¡™π(√âÕ¬≈– 27.6) ·≈– Àâ Õ ßΩ“°§√√¿å (√â Õ ¬≈– 21.3) ¥— ß · ¥ß„π µ“√“ß∑’Ë 3

µ“√“ß∑’Ë 3 ®”π«π/√âÕ¬≈– ¢Õß≈—°…≥–Àπà«¬∫√‘°“√ (Àπà«¬¬àÕ¬) ∑’ËºŸâºà“π°“√Õ∫√¡ªØ‘∫—µ‘√—∫ º‘¥™Õ∫Õ¬Ÿà ≈—°…≥–Àπà«¬∫√‘°“√∑’ËºŸâºà“π°“√ Õ∫√¡ªØ‘∫—µ‘ß“π√—∫º‘¥™Õ∫Õ¬Ÿà 1. ÀâÕßΩ“°§√√¿å 2. ÀâÕß§≈Õ¥ 3. ÀâÕßΩ“°§√√¿å·≈–ÀâÕß§≈Õ¥ 4. °≈ÿà¡ß“π‡«™ªØ‘∫—µ‘§√Õ∫§√—«™ÿ¡™π

¡°√“§¡ - ¡’π“§¡ 2555

∂“π∑’∑Ë ”ß“π √æ»./√æ∑. √æ™. Àπà«¬∫√‘°“√Õ◊ËπÊ ¿“æ√«¡ ®”π«π √âÕ¬≈– ®”π«π √âÕ¬≈– ®”π«π √âÕ¬≈– ®”π«π √âÕ¬≈– (§π) (§π) (§π) (§π) 2 4 -

18.2 36.4 -

°√¡Õπ“¡—¬ àß‡ √‘¡„Àâ§π‰∑¬ ÿ¢¿“æ¥’

10 8 3 13

21.3 17.0 6.4 27.6

1 -

12.5 -

12 13 3 13

18.2 19.7 4.5 19.7

µ“√“ß∑’Ë 3 ®”π«π/√âÕ¬≈– ¢Õß≈—°…≥–Àπà«¬∫√‘°“√ (Àπà«¬¬àÕ¬) ∑’ËºŸâºà“π°“√Õ∫√¡ªØ‘∫—µ‘√—∫ º‘¥™Õ∫Õ¬Ÿà (µàÕ) ≈—°…≥–Àπà«¬∫√‘°“√∑’ËºŸâºà“π°“√ Õ∫√¡ªØ‘∫—µ‘ß“π√—∫º‘¥™Õ∫Õ¬Ÿà 5. ΩÉ“¬ àß‡ √‘¡ ÿ¢¿“æ 6. Ÿµ‘ - π√’‡«™ 7. §≈‘π‘°π‘√π“¡/§≈‘π‘°æ‘‡»… 8. ΩÉ“¬°“√æ¬“∫“≈ 9. ß“π§«∫§ÿ¡·≈–ªÑÕß°—π‚√§ 10. ‰¡àµÕ∫ √«¡

∂“π∑’∑Ë ”ß“π ¿“æ√«¡ √æ»./√æ∑. √æ™. Àπà«¬∫√‘°“√Õ◊ËπÊ ®”π«π √âÕ¬≈– ®”π«π √âÕ¬≈– ®”π«π √âÕ¬≈– ®”π«π √âÕ¬≈– (§π) (§π) (§π) (§π) 3 2 11 11

27.3 18.2 100.0 16.7

ºŸâºà“π°“√Õ∫√¡„π·ºπ°Ω“°§√√¿å π”«‘∏’ °“√„Àâ°“√ª√÷°…“·∫∫§Ÿà ‰ª„™â§‘¥‡ªìπ√âÕ¬≈– 71.2 ‚¥¬·¬°‡ªìπ°√≥’°“√„Àâ°“√ª√÷°…“°àÕπ°“√µ√«®

4 2 4 2 1 47 47

8.5 4.2 8.5 4.2 2.1 100.0 71.2

1 1 5 8 8

12.5 12.5 62.5 100.0 12.1

4 3 3 7 2 6 66 66

6.1 4.5 4.5 10.6 3.0 9.1 100.0 100.0

‡≈◊Õ¥√âÕ¬≈– 68.2 ·≈–°√≥’°“√„Àâ°“√ª√÷°…“ À≈—ß°“√µ√«®‡≈◊Õ¥ √âÕ¬≈– 60.6 µ“¡≈”¥—∫ ¥—ß · ¥ß„πµ“√“ß∑’Ë 4

µ“√“ß∑’Ë 4 ®”π«π/√âÕ¬≈– ¢Õß°“√π”«‘∏’°“√„Àâ°“√ª√÷°…“·∫∫§Ÿà‰ª„™â¢ÕßºŸâºà“π°“√Õ∫√¡∑’Ë µÕ∫·∫∫ Õ∫∂“¡ „π™à«ß‡¥◊Õπ¡’π“§¡ 2552 - ‡¡…“¬π 2553 (µÕ∫‰¥â¡“°°«à“ 1 ¢âÕ) Àπà«¬∫√‘°“√ ¿“æ√«¡ À≈—ß°“√Õ∫√¡‰¥âπ”°“√„Àâ°“√ª√÷°…“ Õ◊Ëπ ·∫∫§Ÿà‰ª„™â„π°√≥’„¥∫â“ß ®”π«π(§π) ®”π«π(§π) ®”π«π(§π) ®”π«π(§π) √âÕ¬≈– (n=66) 1. ·ºπ°Ω“°§√√¿å 1.1 °“√„Àâ°“√ª√÷°…“°àÕπ°“√µ√«®‡≈◊Õ¥ 1.2 °“√„Àâ°“√ª√÷°…“À≈—ß°“√µ√«®‡≈◊Õ¥ 2. °“√„Àâ°“√ª√÷°…“°àÕπµ√«®‡≈◊Õ¥∑—Ë«‰ª 3. §≈‘π‘°„Àâ¬“µâ“π‰«√— 4. Õ◊Ëπ Ê

√æ»./√æ∑.

√æ™.

6 6 5 6 1 4

41 39 35 18 8 10

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH

0 0 0 0 0 2

47 45 40 24 9 16

January - March 2012

71.2 68.2 60.6 36.4 13.6 24.2

∫ ∑ «‘ ∑ ¬ “ ° “ √ ∑—°…–°“√„Àâ°“√ª√÷°…“·∫∫§Ÿà∑’ËºŸâºà“π°“√ Õ∫√¡¡’°“√π”‰ª„™â ‰¥â·°à ∑—°…–æ◊Èπ∞“π√âÕ¬≈– 86.4 ∑—°…–§«“¡‡ªìπ§Ÿà √âÕ¬≈– 74.2 ·≈–∑—°…–

°“√∑”„Àâ¡Õß‡ªìπ‡√◊ÕË ßª°µ‘√Õâ ¬≈– 60.6 µ“¡≈”¥—∫ ¥—ß· ¥ß„πµ“√“ß∑’Ë 5

µ“√“ß∑’Ë 5 ®”π«π/√âÕ¬≈–¢Õß°“√π”∑—°…–°“√„Àâ°“√ª√÷°…“·∫∫§Ÿà “¡’¿√√¬“‰ª„™â¢ÕßºŸâºà“π °“√Õ∫√¡„π™à«ß‡¥◊Õπ¡’π“§¡ 2552 - ‡¡…“¬π 2553 (µÕ∫‰¥â¡“°°«à“ 1 ¢âÕ)

∑—°…–∑’Ë„™â „π°“√„Àâ°“√ª√÷°…“ ·∫∫§Ÿà “¡’¿√√¬“ 1. ∑—°…–æ◊Èπ∞“π„π°“√„Àâ°“√ª√÷°…“ ‰¥â·°à °“√øíß °“√∂“¡ °“√∑«π§«“¡ °“√ √ÿª§«“¡ œ≈œ 2. ∑—°…–°“√‡™◊ËÕ¡µàÕªØ‘ —¡æ—π∏å√–À«à“ßºŸâ„Àâ °“√ª√÷°…“ °—∫ºŸâ√—∫∫√‘°“√ ·≈–√–À«à“ß ºŸâ√—∫°“√ª√÷°…“°—π‡Õß 3. ∑—°…–°“√∑”„Àâ¡Õß‡ªìπ‡√◊ËÕßª°µ‘ À√◊Õ∏√√¡¥“ 4. ∑—°…–°“√‡ª≈’Ë¬π·ª≈ß°√Õ∫À√◊Õ ·π«§«“¡§‘¥„π¥â“π∫«° 5. °“√„™âÀ≈—°°“√§«“¡‡ªìπ§Ÿà (°“√§‘¥°“√µ—¥ ‘π„®√à«¡°—π)

√æ»./√æ∑.

√æ™.

Àπà«¬∫√‘°“√ ¿“æ√«¡ Õ◊ËπÊ ®”π«π(§π) ®”π«π(§π) ®”π«π(§π) ®”π«π(§π) √âÕ¬≈– 6

86.4

56.1

60.6

54.5

74.2

°“√æ—≤π“µπ‡Õß ¢ÕßºŸâ„Àâ§”ª√÷°…“∑’Ë ºà“π°“√Õ∫√¡‰ª·≈â« 1 ªï ¡’§«“¡µâÕß°“√∑’Ë®– æ—≤π“‡æ◊ËÕ √â“ß§«“¡¡—Ëπ„®µàÕ°“√„Àâ°“√ª√÷°…“ ·∫∫§Ÿà ·≈–®“°°“√π‘‡∑»µ‘¥µ“¡¡’¢âÕ‡ πÕ·π–„Àâ ¡’°“√‡æ‘Ë¡‡«≈“„π°“√®—¥Õ∫√¡„Àâ¡“°¢÷Èπ À√◊Õ¡’ °“√øóôπøŸ§«“¡√ŸâÕ¬à“ßµàÕ‡π◊ËÕß·≈–¡’°“√µ‘¥µ“¡ ª√–‡¡‘πº≈ºŸâºà“π°“√Õ∫√¡‡ªìπ√–¬– Ê ·≈–Õ¬à“ß µàÕ‡π◊ËÕß ¡Ë”‡ ¡Õ(5) ºŸâºà“π°“√Õ∫√¡¡’§«“¡µâÕß°“√æ—≤π“ µπ‡Õß„π°“√„Àâ°“√ª√÷°…“·∫∫§Ÿà ‚¥¬«‘∏’ª√–™ÿ¡ ·≈°‡ª≈’Ë ¬ πª√– ∫°“√≥å À √◊ Õ Õ¿‘ ª √“¬°√≥’ ∑’Ë ¡’ 76

¡°√“§¡ - ¡’π“§¡ 2555

°√¡Õπ“¡—¬ àß‡ √‘¡„Àâ§π‰∑¬ ÿ¢¿“æ¥’

ªí≠À“ / πà“ π„® √âÕ¬≈– 68.2 √Õß≈ß¡“‰¥â·°à Õ∫√¡‡æ‘Ë¡‡µ‘¡ √âÕ¬≈– 51.5 µ“¡≈”¥—∫

Õ¿‘ª√“¬º≈ √–∫∫°“√„Àâ∫√‘°“√ª√÷°…“°àÕπµ√«®‡≈◊Õ¥ ·°àÀ≠‘ßµ—Èß§√√¿å„π ∂“π∫√‘°“√ ÿ¢¿“æ¬—ß§ß„Àâ ∫√‘°“√ª√÷°…“·∫∫√“¬∫ÿ§§≈ ∑”„Àâ‡ ’¬‚Õ°“ „π °“√∑’ Ë “¡’®–‡¢â“¡“¡’ «à π√à«¡„π°“√µ√«®‡≈◊Õ¥ °“√ ¥Ÿ·≈À≠‘ßµ—ßÈ §√√¿å·≈–∑“√° ´÷ßË ®–¡’º≈‡ ’¬§◊Õ À≠‘ß µ—Èß§√√¿å¡—°®– √ÿª¿“«°“√≥åµ‘¥‡™◊ÈÕ¢Õß§Ÿàµπ‡Õß µ“¡º≈‡≈◊Õ¥¢Õßµπ ·≈–¬—ßæ∫«à“°√≥’À≠‘ßµ—Èß

µ“√“ß∑’Ë 6 ®”π«π/√âÕ¬≈– ¢Õß§«“¡µâÕß°“√„π°“√æ—≤π“µπ‡Õß„πß“π°“√„Àâ°“√ª√÷°…“·∫∫ §Ÿà “¡’¿√√¬“ (µÕ∫‰¥â¡“°°«à“ 1 ¢âÕ) ∂â“∑à“π®–„Àâ°“√ª√÷°…“·∫∫§ŸàµàÕ‰ª ∑à“πµâÕß°“√æ—≤π“µ—«‡ÕßÕ¬à“ß‰√

1. ª√–™ÿ¡·≈°‡ª≈’Ë¬πª√– ∫°“√≥å/Õ¿‘ª√“¬ °√≥’∑’Ë¡’ªí≠À“/πà“ π„® 2. Õ∫√¡‡æ‘¡Ë ‡µ‘¡ 3. Õ◊Ëπ Ê √–∫ÿ

√æ»./√æ∑.

√æ™.

Àπà«¬∫√‘°“√ ¿“æ√«¡ Õ◊ËπÊ ®”π«π(§π) ®”π«π(§π) ®”π«π(§π) ®”π«π(§π) √âÕ¬≈– (n=66) 3

68.2

3 1

31 4

0 0

34 5

51.5 7.6

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THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH

January - March 2012

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