Issuu on Google+

∫ ∑ «‘ ∑ ¬ “ ° “ √

∫ ∑ «‘ ∑ ¬ “ ° “ √ °“√®—¥°“√°—∫§«“¡‡§√’¬¥¢Õ߇®â“Àπâ“∑’Ë  “∏“√≥ ÿ¢®—ßÀ«—¥‡™’¬ß„À¡à

Õ√ÿ≥√—µπå  ÿ§π∏¡“π  ”π—°ß“π “∏“√≥ ÿ¢ ®—ßÀ«—¥‡™’¬ß„À¡à

π—°«‘™“°“√ “∏“√≥ ÿ¢™”π“≠°“√摇»…

∫∑§—¥¬àÕ ®“°°“√‡ª≈’ˬπ·ª≈ß∑“߇»√…∞°‘®  —ߧ¡ °“√‡¡◊Õß Õ¬à“ß¡“° ‡ªìπ°“√ √â“ߧ«“¡°¥¥—π·≈–§«“¡‡§√’¬¥µàÕ ®‘µ„®¢Õß¡πÿ…¬å ´÷ßË  àߺ≈µàÕ°“√¥”√ß™’«µ‘ ª√–®”«—π ‚¥¬≈—°…≥–ß“π¢Õ߇®â“Àπâ“∑’ Ë “∏“√≥ ÿ¢ µâÕß√—∫º‘¥™Õ∫ Ÿß ‡°’¬Ë « °—∫§«“¡‡ªì𧫓¡µ“¬¢Õß¡πÿ…¬å ®÷ß°àÕ„À⇰‘¥§«“¡‡§√’¬¥ Ÿß„π¢≥–ªØ‘∫—µ‘ß“π °“√»÷°…“§√—Èßπ’È ¡’«—µ∂ÿª√– ß§å ‡æ◊ÕË »÷°…“√–¥—∫§«“¡‡§√’¬¥ ªí®®—¬∑’‡Ë °’¬Ë «¢âÕß°—∫¿“«–‡§√’¬¥ √«¡∑—ßÈ °“√®—¥°“√°—∫§«“¡‡§√’¬¥¢Õ߇®â“Àπâ“∑’ Ë “∏“√≥ ÿ¢ ®—ßÀ«—¥‡™’¬ß„À¡à ‰¥â ÿà¡°≈ÿࡵ—«Õ¬à“ß·∫∫‡®“–®ß √«¡ 347 §π ‚¥¬„™â·∫∫ Õ∫∂“¡§«“¡‡§√’¬¥¢Õß «πª√ÿß SPST60 (Suanprung Stress Test 60 ¢âÕ) °“√«‘‡§√“–Àå¢âÕ¡Ÿ≈ ‚¥¬·®°·®ß§«“¡∂’Ë √âÕ¬≈– ·≈–À“§«“¡ —¡æ—π∏å „™â°“√ ∑¥ Õ∫‰§ ·§«√å º≈°“√»÷°…“æ∫«à“ √–¥—∫§«“¡‰«µàÕ§«“¡‡§√’¬¥¢Õß°≈ÿ¡à µ—«Õ¬à“ßÕ¬Ÿ„à π√–¥—∫ª“π°≈“ß √âÕ¬≈– 41.2 ®“° “‡Àµÿ‡√◊ËÕߧ√Õ∫§√—« √âÕ¬≈– 38.6 ·≈–‡√◊ËÕß ‘Ëß·«¥≈âÕ¡ √âÕ¬≈– 40.6  à«πÕ“°“√§«“¡‡§√’¬¥∑’Ë· ¥ßÕÕ°∑“ß √–∫∫¢Õß√à“ß°“¬ Õ¬Ÿà„π√–¥—∫ª“π°≈“ß ∑’Ë√–∫∫°≈â“¡‡π◊ÈÕ·≈–‚§√ß°√–¥Ÿ° √âÕ¬≈– 47.7 °“√À“§«“¡ —¡æ—π∏å¢Õß ªí®®—¬ à«π∫ÿ§§≈°—∫√–¥—∫§«“¡‡§√’¬¥ æ∫«à“ §«“¡§‘¥∑’Ë®–¶à“µ—«µ“¬·≈–§«“¡§‘¥∑’Ë®–¶à“ºŸâÕ◊Ëπ ¡’π—¬ ”§—≠∑“ß ∂‘µ‘∑’Ë √–¥—∫ 0.05 «‘∏’°“√®—¥°“√°—∫§«“¡‡§√’¬¥¢Õ߇®â“Àπâ“∑’Ë “∏“√≥ ÿ¢ ®—ßÀ«—¥‡™’¬ß„À¡à §◊Õ °“√Õà“πÀπ—ß ◊Õ ¥ŸÀπ—ß øíß ‡æ≈ß √âÕ¬≈– 35.4 √Õß≈ß¡“ °“√ª√÷°…“À√◊Õ查√–∫“¬°—∫§π„π§√Õ∫§√—« √âÕ¬≈– 31.7 ·≈–µâÕß°“√„ÀâÀπà«¬ß“π®—¥  ∂“π∑’Ë À√◊ÕÀâÕß ”À√—∫æ—°ºàÕπ¬“¡«à“ß æ√âÕ¡¡’ ∑’«’ «‘∑¬ÿ §“√“‚Õ‡°– ·≈–Õÿª°√≥å°“√ÕÕ°°”≈—ß°“¬

Stress Management among Public Health Workers in Chiang Mai Province Arunrat Sukonthaman Public Health Technical Officer, Senior Professional Level Chiang Mai Provincial Health Office

122 ‡¡…“¬π - ¡‘∂ÿπ“¬π 2553

°√¡Õπ“¡—¬  à߇ √‘¡„Àâ§π‰∑¬  ÿ¢¿“楒


°“√®—¥°“√°—∫§«“¡‡§√’¬¥¢Õ߇®â“Àπâ“∑’Ë “∏“√≥ ÿ¢ ®—ßÀ«—¥‡™’¬ß„À¡à

Abstract A tremendous scale of economic, social and political changes have created a certain level of pressure and stress in the mind of people; and thus affected their daily lifestyle. Public health workers, in particular, hold a very high level of responsibility in their works dealing with the situation of life and death for people; so they have to bear a high level of stress while being on duty. This study aimed to explore the level of stress, the factors related to the stress, and the method used for dealing with stress of public health workers in Chiang Mai province. Study samples were recruited through a purposive sampling, totally 347 persons. The survey was conducted by using Suanprung Stress Test containing 60 question items (SPST-60). Data analysis was performed by using frequency distribution, the calculation of percentage, and by identifying the correlation through the Chi Square test. Study result showed that 41.2% of study samples had a moderate level of the sensitivity to stress; 38.6% developed stress due to a cause related to their family; and 40.6% developed stress with a drive from an environmental factor. With regard to the symptoms of stress appeared physically through body systems, 47.7% of samples had a moderate level of such symptoms involving skeletal and muscular systems. Correlation between personal factors and the level of stress showed that the suicidal idea and the idea about wanting to kill other people were significantly developed (P <0.05).The methods used for dealing with stress among public health workers were reading, watching movies and listening to music (35.4%), followed by discussing with a family member to release tension (31.7%). They wanted their work units to have a space or a common room for them to take a rest at leisure time, equipped with television, radio and karaoke sets, as well as the fitness equipment.

∫∑π” ªí®®ÿ∫—π¡’°“√‡ª≈’ˬπ·ª≈ß∑“߇»√…∞°‘®  —ߧ¡ °“√‡¡◊Õß Õ¬à“ß¡“° ´÷Ëß¡’º≈°√–∑∫µàÕ°“√ ¥”‡π‘π™’«‘µª√–®”«—π¢Õß¡πÿ…¬å °àÕ„À⇰‘¥§«“¡ °¥¥—π·≈–§«“¡‡§√’¬¥„𮑵„® ‡°‘¥§«“¡√Ÿâ ÷°‰¡à ‡ªìπ ÿ¢„π™’«‘µ ‡¡◊ËÕ∫ÿ§§≈¡’§«“¡‡§√’¬¥‡°‘¥¢÷Èπ®–  à ß º≈°√–∑∫µà Õ √à “ ß°“¬·≈–®‘ µ „® 1‰¥â ´÷Ë ß ‡ªì π  “‡Àµÿ ”§—≠¢Õß°“√‡®Á∫ªÉ«¬∑“ß°“¬‰¥âÀ≈“¬‚√§ ‡™àπ ¡’Õ“°“√ª«¥»’√…– ª«¥°≈â“¡‡π◊ÈÕ ·≈–‡æ‘Ë¡ §«“¡‡ ’¬Ë ß„π°“√‡°‘¥‚√§À—«„®·≈–À≈Õ¥‡≈◊Õ¥ ‡∫“ À«“𠧫“¡¥—π‚≈À‘µ Ÿß ‚√§‡°’ˬ«°—∫∑“߇¥‘π Õ“À“√·≈–≈”‰ â ¡’º≈‡ ’¬µàÕ ÿ¢¿“殑µ ®–‡°‘¥ °“√Àßÿ¥Àß‘¥ ∑âÕ·∑â ‡∫◊ËÕÀπà“¬ πÕπ‰¡àÀ≈—∫ «‘µ° °—ß«≈ ‚°√∏ßà“¬ ¢“¥ ¡“∏‘ ¢“¥§«“¡Õ¥∑π  àß º≈µàÕª√– ‘∑∏‘¿“æ„π°“√∑”ß“π §«“¡‡§√’¬¥‡ªì𧫓¡√Ÿâ ÷°∑’ËÕ¬Ÿà„πµ—«¢Õß ·µà≈–∫ÿ§§≈2 ´÷Ëß®–·µ°µà“ß°—π‰ª °“√∑’Ë∫ÿ§§≈®– ª√—∫µ—«µàÕ§«“¡‡§√’¬¥‰¥â¡“°πâÕ¬‡æ’¬ß„¥π—Èπ ¢÷Èπ

Õ¬Ÿà°—∫°“√®—¥°“√°—∫§«“¡‡§√’¬¥∑’Ë®–µÕ∫ πÕß µàÕ§«“¡√Ÿ â °÷ ‰¡à ∫“¬„® «‘µ°°—ß«≈ °≈—« ‡æ◊ÕË ·°â‰¢ ≈¥ À≈’°‡≈’ˬߵàÕ§«“¡√Ÿâ ÷°¥—ß°≈à“« ∂â“∫ÿ§§≈„¥¡’ §«“¡‡§√’¬¥·≈– “¡“√∂®—¥°“√°—∫§«“¡‡§√’¬¥‰¥â °Á ® – à ß º≈„Àâ ¡’  ÿ ¢ ¿“楒 „π¢≥–∑’Ë ∫ “ß§π‡°‘ ¥ §«“¡≈⡇À≈«„π°“√ª√—∫µ—« ®– àߺ≈°√–∑∫„Àâ ‡°‘¥§«“¡‡®Á∫ªÉ«¬ ·≈–ª√– ‘∑∏‘¿“æ°“√∑”ß“π ≈¥≈ß °“√ ”√«® ÿ¢¿“殑µ¢Õߧπ‰∑¬ æ∫«à“  “‡Àµÿ∑’Ë∑”„Àâ§π‰∑¬‡°‘¥Õ“°“√‡§√’¬¥ 5 Õ—π¥—∫ ·√° ‰¥â·°à 1)Àπâ“∑’Ë°“√ß“π 2)‡»√…∞°‘® 3)°“√ ‡√’¬π 4)ªí≠À“®√“®√ 5)ªí≠À“§√Õ∫§√—«3 ≈—°…≥–¢Õßß“π∑’˵âÕß¡’§«“¡√—∫º‘¥™Õ∫  Ÿß·≈–‡ ’ˬߵàÕ§«“¡‡ªì𧫓¡µ“¬¢Õß¡πÿ…¬å ´÷Ëß ∑”„À⇰‘¥§«“¡‡§√’¬¥ Ÿß §◊Õ ≈—°…≥–ß“π·æ∑¬å 欓∫“≈ °“√ªØ‘ ∫— µ‘ ß “π¥â “ π°“√·æ∑¬å °“√ 欓∫“≈ µ≈Õ¥®π°“√ “∏“√≥ ÿ¢ ‘Ëß·«¥≈âÕ¡ µà“ßÊ4 ‡ªìπÀπâ“∑’Ë ∑’ Ë ”§—≠¢Õ߇®â“Àπâ“∑’ Ë “∏“√≥ ÿ¢

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH April - June 2010

123


∫ ∑ «‘ ∑ ¬ “ ° “ √ À¡“¬∂÷ß°“√ªØ‘∫—µ‘ß“π∑’ˇ°’ˬ«¢âÕß°—∫∑√—欓°√ ¡πÿ…¬å‚¥¬µ√ß À“°‡®â“Àπâ“∑’Ë “∏“√≥ ÿ¢ª√– ∫ °—∫¿“«–‡§√’¬¥·≈â« ‰¡à “¡“√∂‡º™‘≠°—∫¿“«– ‡§√’¬¥µà“ßʉ¥âÕ¬à“߇À¡“– ¡ ®– àߺ≈°√–∑∫µàÕ §ÿ≥¿“æ™’«µ‘ ¢Õߪ√–™“™π ∑—ßÈ ∑“ßµ√ß·≈–∑“ßÕâÕ¡ πÕ°®“°π—Èπ¿“«–‡§√’¬¥¬—ßÕ“®®–‡ªìπªí≠À“µàÕ ‡®â“Àπâ“∑’Ë “∏“√≥ ÿ¢‰¥â ®“°‡Àµÿ º ≈¥— ß °≈à “ «ºŸâ »÷ ° …“ π„® ∑’Ë ® – »÷°…“¿“«–‡§√’¬¥¢Õ߇®â“Àπâ“∑’Ë “∏“√≥ ÿ¢„π ®—ßÀ«—¥‡™’¬ß„À¡à ´÷Ëß¡’ à«π‡°’ˬ«¢âÕß∑—Èß∑“ßµ√ß ·≈–∑“ßÕâÕ¡µàÕ§ÿ≥¿“æ™’«‘µ¢Õߪ√–™“™π„π‡¢µ §«“¡√—∫º‘¥™Õ∫  ”π—°ß“π “∏“√≥ ÿ¢®—ßÀ«—¥ ‡™’¬ß„À¡à ‰¥âµ√–Àπ—°∂÷ߪí≠À“·≈–§«“¡ ”§—≠ ¢Õß°“√‡ √‘¡ √â“ߧ«“¡‡¢â¡·¢Áß∑“ߥâ“𮑵„® ®÷ß ¥”‡π‘π°“√»÷°…“°“√®—¥°“√°—∫§«“¡‡§√’¬¥¢Õß ‡®â“Àπâ“∑’Ë “∏“√≥ ÿ¢®—ßÀ«—¥‡™’¬ß„À¡à ‡æ◊ËÕ„Àâ ∑√“∫ ∂“π°“√≥å · ≈–¥”‡π‘ π °“√ªÑ Õ ß°— π  à ß ‡ √‘¡ ÿ¢¿“æµàÕ‰ª

«—µ∂ÿª√– ß§å°“√»÷°…“ ‡æ◊Ë Õ »÷ ° …“√–¥— ∫ §«“¡‡§√’ ¬ ¥ ªí ® ®— ¬ ∑’Ë ‡°’Ë ¬ «¢â Õ ß°— ∫ ¿“«–‡§√’ ¬ ¥ ·≈–°“√®— ¥ °“√°— ∫ §«“¡‡§√’ ¬ ¥¢Õ߇®â “ Àπâ “ ∑’Ë   “∏“√≥ ÿ ¢ ®— ß À«— ¥ ‡™’¬ß„À¡à

«‘∏’°“√»÷°…“ √Ÿª·∫∫°“√»÷°…“ °“√»÷°…“§√—ßÈ π’‡È ªìπ°“√»÷°…“‡™‘ßæ√√≥π“ (Descriptive Study) „π™à«ß‡¥◊Õπ µÿ≈“§¡ 2552 ∂÷ß ‡¥◊Õπ∏—𫓧¡ 2552 ®”π«π 347 §π ª√–™“°√·≈–°≈ÿࡵ—«Õ¬à“ß ª√–™“°√∑’Ë„™â„π°“√»÷°…“§√—Èßπ’È ‡ªìπ‡®â“ Àπâ “ ∑’Ë   “∏“√≥ ÿ ¢ ∑’Ë ª Ø‘ ∫— µ‘ „ π®— ß À«— ¥ ‡™’ ¬ ß„À¡à ®”π«π∑—Èß ‘Èπ 2,575 §π ¢π“¥¢Õß°≈ÿࡵ—«Õ¬à“ß 124 ‡¡…“¬π - ¡‘∂ÿπ“¬π 2553

°√¡Õπ“¡—¬  à߇ √‘¡„Àâ§π‰∑¬  ÿ¢¿“楒

°”À𥂥¬„™â Ÿµ√¬“¡“‡πà (Yamane) ‰¥â°≈ÿà¡ µ—«Õ¬à“ß ®”π«π 347 §π ´÷Ëß„™â —¥ à«π¢Õ߇®â“ Àπâ“∑’Ë “∏“√≥ ÿ¢®—ßÀ«—¥‡™’¬ß„À¡à ‡∑’¬∫°—∫‡®â“ Àπâ“∑’Ë “∏“√≥ ÿ¢„π·µà≈–Õ”‡¿Õ ®–‰¥â —¥ à«π ¢Õß°≈ÿࡵ—«Õ¬à“ß„π·µà≈–Õ”‡¿Õ ·≈â«„™â°“√ ÿà¡ ·∫∫‡®“–®ß (Purposive Sampling) ‚¥¬„Àâ §≥–°√√¡°“√ª√– “πß“π “∏“√≥ ÿ¢√–¥—∫Õ”‡¿Õ (§ª Õ.) ‡ªìπºŸâ§—¥‡≈◊Õ°‡®â“Àπâ“∑’Ë “∏“√≥ ÿ¢„π Õ”‡¿Õ ∑’Ë¡’Õ“°“√‡ ’ˬߵàÕ§«“¡‡§√’¬¥ ‡§√◊ËÕß¡◊Õ∑’Ë„™â„π°“√»÷°…“ ‡§√◊Ë Õ ß¡◊ Õ ∑’Ë „ ™â „ π°“√»÷ ° …“§√—È ß π’È ‡ ªì π ·∫∫ Õ∫∂“¡ ¡’ 3  à«π ‰¥â·°à  à«π∑’Ë 1 ¢âÕ¡Ÿ≈∑—Ë«‰ª¢Õß°≈ÿࡵ—«Õ¬à“ß∑’Ë ºŸ»â °÷ …“ √â“ß·∫∫ Õ∫∂“¡¢÷πÈ ‡Õß ª√–°Õ∫¥â«¬‡æ» Õ“¬ÿ  ∂“π¿“æ ¡√  °“√Õ“»—¬Õ¬Ÿà ®”π«π∫ÿµ√ √“¬‰¥â √–¥—∫°“√»÷°…“ ·≈–Õ“¬ÿ√“™°“√ «‘‡§√“–Àå ¢âÕ¡Ÿ≈¥â«¬°“√·®°·®ß§«“¡∂’Ë·≈–√âÕ¬≈–  à«π∑’Ë 2 ·∫∫ Õ∫∂“¡§«“¡‡§√’¬¥¢Õß  «πª√ÿß SPST-60 (Suanprung Stess Test) ™ÿ¥ 60 ¢â Õ 5 ‰¥â À “§à “ §«“¡‡™◊Ë Õ ¡—Ë π ª√–°Õ∫¥â « ¬ §”∂“¡∑’Ë®–»÷°…“ ¿“«–‡§√’¬¥ 3 ª√–‡¥Á𠔧—≠ §◊Õ 1.√–¥— ∫ §«“¡‰«µà Õ °“√‡°‘ ¥ §«“¡‡§√’ ¬ ¥  ”√«®®“°°“√¥”‡π‘ π ™’ «‘ µ ª√–®”«— π ¢Õß·µà ≈ – ∫ÿ§§≈«à“ ¡’·π«‚πâ¡∑’Ë®–‡°‘¥§«“¡‡§√’¬¥‰¥âßà“¬ ·§à‰ÀπÀ√◊Õ¡’‚Õ°“ ∑’Ë®–ª√—∫µ—«√—∫§«“¡‡§√’¬¥‰¥â ¥’‡æ’¬ß„¥ 2. ∑’Ë¡“¢Õߧ«“¡‡§√’¬¥ „À⺟âµÕ∫ ”√«® µ—«‡Õß«à“ ¡’‡Àµÿ°“√≥å„¥‡°‘¥¢÷πÈ °—∫µ—«‡Õß∫â“ß „π™à«ß 6 ‡¥◊Õπ∑’˺à“π¡“ ·≈–√Ÿâ ÷°‡§√’¬¥µàÕ‡Àµÿ°“√≥åπ—Èπ ‡æ’¬ß„¥ ·≈– “¡“√∂∫Õ°∑’¡Ë “¢Õߧ«“¡‡§√’¬¥ ·∫àß ÕÕ°‡ªìπ 6 ‡√◊ËÕß §◊Õ ‡√◊ËÕßß“π, ‡√◊ËÕß à«πµ—«, ‡√◊ËÕß §√Õ∫§√—«, ‡√◊ËÕß∑“ß —ߧ¡, ‡√◊ËÕß ‘Ëß·«¥≈âÕ¡ ·≈– ‡√◊ËÕß°“√‡ß‘π


°“√®—¥°“√°—∫§«“¡‡§√’¬¥¢Õ߇®â“Àπâ“∑’Ë “∏“√≥ ÿ¢ ®—ßÀ«—¥‡™’¬ß„À¡à

3. Õ“°“√¢Õߧ«“¡‡§√’¬¥∑’·Ë  ¥ßÕÕ° „Àâ ºŸâµÕ∫ ”√«®µ—«‡Õß«à“ ¡’Õ“°“√„¥Ê ∑’ˇ°‘¥¢÷Èπ®“° §«“¡‡§√’¬¥∫â“ß À√◊ÕÕ“°“√µà“ßÊ ∑’ˇ°‘¥¢÷Èππ—Èπ ∑”„À⇰‘¥§«“¡‡§√’¬¥¢π“¥‰Àπ ‚¥¬·∫àß°“√ »÷ ° …“ÕÕ°µ“¡√–∫∫ √’ √ –«‘ ∑ ¬“ ¥— ß π’È Õ“°“√ ‡§√’ ¬ ¥∑’Ë ·  ¥ßÕÕ°∑“ß√–∫∫°≈â “ ¡‡π◊È Õ /‚§√ß °√–¥Ÿ°, √–∫∫ª√– “∑Õ—µ‚π¡—µ‘æ“√“´‘¡æ“‡∏µ‘°, √–∫∫ª√– “∑Õ—µ‚π¡—µ´‘ ¡‘ 擇∏µ‘° , Õ“√¡≥å, §«“¡ §‘¥, µàÕ¡‰√â∑àÕ ·≈–√–∫∫¿Ÿ¡‘§ÿâ¡°—π  à«π∑’Ë 3 ·∫∫ Õ∫∂“¡°“√®— ¥ °“√°— ∫ §«“¡‡§√’ ¬ ¥ ‡ªì π  à « π∑’Ë ºŸâ »÷ ° …“ √â “ ߢ÷È π ‡Õß √«∫√«¡®“°°‘®°√√¡∑’˧π‰∑¬™Õ∫°√–∑” ‡¡◊ËÕ ‡°‘¥§«“¡‡§√’¬¥¢÷Èπ ª√–°Õ∫¥â«¬ «‘∏’°“√µà“ßÊ ∑’Ë „™â·°â‰¢ ≈¥ À√◊Õ∫√√‡∑“§«“¡‡§√’¬¥ §”∂“¡‡ªìπ ·∫∫‡≈◊Õ°√“¬°“√·≈–·∫∫ª≈“¬‡ªî¥ °“√«‘‡§√“–Àå¢âÕ¡Ÿ≈ π”¢â Õ ¡Ÿ ≈ ∑’Ë ‡ °Á ∫ √«¡√«∫‰¥â ¡ “µ√«® Õ∫ §«“¡∂Ÿ°µâÕß·≈–«‘‡§√“–À奫⠬ ‚ª√·°√¡ ”‡√Á®√Ÿª SPSS „™â ∂‘µ‘‡™‘ßæ√√≥π“ ‚¥¬·®°·®ß§«“¡∂’Ë √â Õ ¬≈– ·≈–À“§«“¡ — ¡ æ— π ∏å „ ™â ° “√∑¥ Õ∫ ‰§ ·§«√å

º≈°“√»÷°…“ ¢âÕ¡Ÿ≈∑—Ë«‰ª¢Õß°≈ÿࡵ—«Õ¬à“ß °≈ÿࡵ—«Õ¬à“ß„π°“√»÷°…“§√—Èßπ’È à«π„À≠à

‡ªìπ‡æ»À≠‘ß √âÕ¬≈– 74.9 ·≈–‡æ»™“¬ √âÕ¬≈– 25.1 Õ“¬ÿ 31-35 ªï √âÕ¬≈– 21.9  ∂“π¿“æ  ¡√ ·≈â« √âÕ¬≈– 69.5 ¡’®”π«π∫ÿµ√ 2 §π √âÕ¬≈– 34.0 ªí®®ÿ∫π— Õ“»—¬Õ¬Ÿ°à ∫— §√Õ∫§√—« √âÕ¬≈– 75.8 ¡’√“¬‰¥â‡©≈’ˬ 20,001-30,000 ∫“∑ √âÕ¬≈– 23.9 √–¥—∫°“√»÷°…“ª√‘≠≠“µ√’À√◊Õ‡∑’¬∫‡∑à“ √âÕ¬≈– 62.5 ·≈–¡’Õ“¬ÿ√“™°“√ 11-20 ªï √âÕ¬≈– 34.3 √–¥—∫§«“¡‰«µàÕ°“√‡°‘¥§«“¡‡§√’¬¥ ®“°°“√»÷°…“ §«“¡‰«µàÕ§«“¡‡§√’¬¥ ¢Õß°≈ÿࡵ—«Õ¬à“ß  à«π„À≠àÕ¬Ÿà„π√–¥—∫ ª“π°≈“ß ®”π«π 143 §π √âÕ¬≈– 41.2 √Õß≈ß¡“Õ¬Ÿà„π √–¥—∫µË”®”π«π 96 §π √âÕ¬≈– 27.7 Õ¬Ÿà„π√–¥—∫  Ÿß®”π«π 95 §π √âÕ¬≈– 27.4 ·≈–Õ¬Ÿà„π√–¥—∫  Ÿß¡“°¡’ πâÕ¬∑’Ë ÿ¥ ®”π«π 13 §π √âÕ¬≈– 3.7 µ“¡µ“√“ß∑’Ë 1 √–¥— ∫ §«“¡‡§√’ ¬ ¥µ“¡∑’Ë ¡ “¢Õß §«“¡‡§√’¬¥ ®“°°“√»÷ ° …“ ∑’Ë ¡ “À√◊ Õ  “‡Àµÿ ¢ Õß §«“¡‡§√’¬¥¢Õß°≈ÿࡵ—«Õ¬à“ß  à«π„À≠à®–¡’√–¥—∫ §«“¡‡§√’¬¥‚¥¬√«¡®“°∑ÿ° “‡ÀµÿÕ¬Ÿà„π√–¥—∫µË” √âÕ¬≈– 45.2 ®”·π°µ“¡∑’Ë¡“¢Õߧ«“¡‡§√’¬¥∑’Ë Õ¬Ÿà„π√–¥—∫µË” §◊Õ ‡√◊ËÕß à«πµ—«, ‡√◊ËÕßß“π, ‡√◊ËÕß ∑“ß —ߧ¡ ·≈–‡√◊ËÕß°“√‡ß‘π √âÕ¬≈– 62.5, 51.3, 48.7 ·≈– 39.8 µ“¡≈”¥—∫ ·µà‡√◊ËÕß ‘Ëß·«¥≈âÕ¡

µ“√“ß∑’Ë 1 ®”π«π·≈–√âÕ¬≈–¢Õß√–¥—∫§«“¡‰«µàÕ°“√‡°‘¥§«“¡‡§√’¬¥¢Õß°≈ÿࡵ—«Õ¬à“ß √–¥—∫§«“¡‰«µàÕ°“√‡°‘¥§«“¡‡§√’¬¥ µË” ª“π°≈“ß  Ÿß  Ÿß¡“° √«¡

®”π«π(§π)

√âÕ¬≈–

96 143 95 13 347

27.7 41.2 27.4 3.7 100

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH April - June 2010

125


∫ ∑ «‘ ∑ ¬ “ ° “ √ √âÕ¬≈– 40.6 ·≈–‡√◊ËÕߧ√Õ∫§√—« √âÕ¬≈– 38.6 ¡’ √–¥—∫§«“¡‡§√’¬¥Õ¬Ÿà„π√–¥—∫ ª“π°≈“ß  à«π °≈ÿ¡à µ—«Õ¬à“ß∑’¡Ë √’ –¥—∫§«“¡‡§√’¬¥Õ¬Ÿ„à π√–¥—∫√ÿπ·√ß ®“° “‡Àµÿ‡√◊ËÕß°“√‡ß‘π¡“°∑’Ë ÿ¥ √âÕ¬≈– 7.2 √Õß ≈ß¡“§◊Õ‡√◊ËÕߧ√Õ∫§√—« √âÕ¬≈– 6.9 µ“¡µ“√“ß∑’Ë 2 Õ“°“√‡§√’¬¥∑’Ë· ¥ßÕÕ°

®“°°“√»÷°…“ Õ“°“√‡§√’¬¥∑’Ë· ¥ßÕÕ° √–∫∫µà“ßÊ ¢Õß√à“ß°“¬„π¿“æ√«¡∑ÿ°√–∫∫Õ¬Ÿà „π√–¥— ∫ µË” √â Õ ¬≈– 40.1 ®”·π°µ“¡Õ“°“√ ‡§√’¬¥∑’Ë· ¥ßÕÕ°∑’ËÕ¬Ÿà„π√–¥—∫µË” §◊Õ ∑“ߧ«“¡ §‘¥, ∑“ß√–∫∫ª√– “∑Õ—µ‚π¡—µ‘æ“√“´‘¡æ“‡∏µ‘°, ∑“ß√–∫∫¿Ÿ¡‘§ÿâ¡°—π, ∑“ßÕ“√¡≥å, ∑“ß√–∫∫µàÕ¡

µ“√“ß∑’Ë 2 ®”π«π·≈–√âÕ¬≈–√–¥—∫§«“¡‡§√’¬¥¢Õß°≈ÿࡵ—«Õ¬à“ßµ“¡∑’Ë¡“¢Õߧ«“¡‡§√’¬¥ ∑’Ë¡“¢Õߧ«“¡‡§√’¬¥

1. 2. 3. 4. 5. 6.

‡√◊ÕË ßß“π ‡√◊ÕË ß à«πµ—« ‡√◊ÕË ß§√Õ∫§√—« ‡√◊ËÕß∑“ß —ߧ¡ ‡√◊ÕË ß ‘ßË ·«¥≈âÕ¡ ‡√◊ËÕß°“√‡ß‘π √«¡∑ÿ° “‡Àµÿ

√–¥—∫§«“¡‡§√’¬¥ ‡§√’¬¥µË” ‡§√’¬¥ª“π°≈“ß ‡§√’¬¥ Ÿß ‡§√’¬¥√ÿπ·√ß ®”π«π √âÕ¬≈– ®”π«π √âÕ¬≈– ®”π«π √âÕ¬≈– ®”π«π √âÕ¬≈– 178 51.3 122 35.2 39 11.2 8 2.3 217 62.5 101 29.1 26 7.5 3 0.9 94 27.1 134 38.6 95 27.4 24 6.9 169 48.7 128 36.9 49 14.1 1 0.3 133 38.3 141 40.6 68 19.6 5 1.5 138 39.8 114 32.8 70 20.2 25 7.2 157 45.2 123 35.5 57 16.4 10 2.9

‰√â∑àÕ ·≈–∑“ß√–∫∫ª√– “∑Õ—µ‚π¡—µ‘´‘¡æ“‡∏µ‘° √âÕ¬≈– 53.9, 43.5, 42.4, 39.8, 38.9 ·≈– 38.6 µ“¡≈”¥—∫ ·µà∑“ß√–∫∫°≈â“¡‡π◊ÈÕ‚§√ß°√–¥Ÿ° ¡’ √–¥—∫§«“¡‡§√’¬¥Õ¬Ÿà„π√–¥—∫ª“π°≈“ß √âÕ¬≈– 44.7  à«π°≈ÿࡵ—«Õ¬à“ß∑’Ë¡’√–¥—∫§«“¡‡§√’¬¥Õ¬Ÿà„π √–¥— ∫ √ÿ π ·√ßµ“¡Õ“°“√‡§√’ ¬ ¥∑’Ë ·  ¥ßÕÕ° ¡“°∑’Ë ÿ¥ ¡’Õ¬Ÿà 3 ∑“ß §◊Õ ∑“ß√–∫∫ª√– “∑ Õ—µ‚π¡—µ‘´‘¡æ“‡∏µ‘°, ∑“ß√–∫∫µàÕ¡‰√â∑àÕ ·≈– √–∫∫¿Ÿ¡‘§ÿâ¡°—π √âÕ¬≈– 6.1 µ“¡µ“√“ß∑’Ë 3 §«“¡ — ¡ æ— π ∏å √ –À«à “ ßªí ® ®— ¬  à « π ∫ÿ§§≈°—∫√–¥—∫§«“¡‡§√’¬¥ ®“°°“√»÷°…“ ªí®®—¬ à«π∫ÿ§§≈ ‰¥â·°à ‡æ» Õ“¬ÿ  ∂“π¿“æ ¡√  °“√Õ“»—¬Õ¬Ÿà°—∫§√Õ∫§√—« ®”π«π∫ÿµ√ √“¬‰¥â¢Õߧ√Õ∫§√—« √–¥—∫°“√»÷°…“ ·≈–Õ“¬ÿ√“™°“√ ‰¡à¡’§«“¡ —¡æ—π∏å°—∫√–¥—∫ 126 ‡¡…“¬π - ¡‘∂ÿπ“¬π 2553

°√¡Õπ“¡—¬  à߇ √‘¡„Àâ§π‰∑¬  ÿ¢¿“楒

§«“¡‡§√’¬¥Õ¬à“ß¡’π¬—  ”§—≠∑“ß ∂‘µ∑‘ √’Ë –¥—∫ 0.05  à«π§«“¡§‘¥∑’Ë®–¶à“µ—«µ“¬·≈–§«“¡§‘¥∑’Ë®–¶à“ºŸâ Õ◊Ëπ æ∫«à“ ¡’§«“¡ —¡æ—π∏å°—∫√–¥—∫§«“¡‡§√’¬¥ Õ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘µ‘∑’Ë √–¥—∫ 0.05 ´÷Ëß°≈ÿà¡∑’Ë ‡§¬¡’ § «“¡§‘ ¥ ∑’Ë ® –¶à “ µ— « µ“¬ Õ¬Ÿà „ π√–¥— ∫ §«“¡‡§√’¬¥√ÿπ·√ß √âÕ¬≈– 26.0 ¡“°°«à“°≈ÿà¡∑’Ë ‰¡à‡§¬¡’§«“¡§‘¥∑’Ë®–¶à“µ—«µ“¬ √âÕ¬≈– 1.2 ·≈– °≈ÿà¡∑’ˇ§¬¡’§«“¡§‘¥∑’Ë®–¶à“ºŸâÕ◊Ëπ Õ¬Ÿà„π√–¥—∫ §«“¡‡§√’¬¥√ÿπ·√ß √âÕ¬≈– 13.2 ¡“°°«à“ °≈ÿà¡∑’Ë ‰¡à‡§¬¡’§«“¡§‘¥∑’Ë®–¶à“ºŸâÕ◊Ëπ √âÕ¬≈– 1.6 µ“¡ µ“√“ß∑’Ë 4 ®“°°“√»÷°…“ «‘∏°’ “√®—¥°“√°—∫§«“¡‡§√’¬¥ ¢Õ߇®â“Àπâ“∑’ Ë “∏“√≥ ÿ¢®—ßÀ«—¥‡™’¬ß„À¡à  à«π„À≠à „™â«∏‘ °’ “√ Õà“πÀπ—ß ◊Õ ¥ŸÀπ—ß øí߇æ≈ß √âÕ¬≈– 35.4 √Õß≈ß¡“ „™â «‘ ∏’ ° “√ª√÷ ° …“À√◊ Õ æŸ ¥ √–∫“¬°— ∫


°“√®—¥°“√°—∫§«“¡‡§√’¬¥¢Õ߇®â“Àπâ“∑’Ë “∏“√≥ ÿ¢ ®—ßÀ«—¥‡™’¬ß„À¡à

µ“√“ß∑’Ë 3 ®”π«π·≈–√âÕ¬≈–√–¥—∫§«“¡‡§√’¬¥¢Õß°≈ÿࡵ—«Õ¬à“ßµ“¡Õ“°“√‡§√’¬¥∑’Ë· ¥ßÕÕ° Õ“°“√‡§√’¬¥∑’Ë· ¥ßÕÕ° 1. ∑“ß√–∫∫°≈â“¡‡π◊ÈÕ ‚§√ß°√–¥Ÿ° 2. ∑“ß√–∫∫ª√– “∑Õ—µ‚π¡—µ‘ æ“√“´‘¡æ“‡∏µ‘° 3. ∑“ß√–∫∫ª√– “∑Õ—µ‚π¡—µ‘ ´‘¡æ“‡∏µ‘° 4. ∑“ßÕ“√¡≥å 5. ∑“ߧ«“¡§‘¥ 6. ∑“ß√–∫∫µàÕ¡‰√â∑Õà 7. ∑“ß√–∫∫¿Ÿ¡§‘ ¡ÿâ °—π √«¡∑ÿ°√–∫∫

√–¥—∫§«“¡‡§√’¬¥ µË” ª“π°≈“ß  Ÿß √ÿπ·√ß ®”π«π √âÕ¬≈– ®”π«π √âÕ¬≈– ®”π«π √âÕ¬≈– ®”π«π √âÕ¬≈– 144 41.5 155 44.7 34 9.8 14 4.0 151

43.5

103

29.7

80

23.1

13

3.7

134

38.6

112

32.2

80

23.1

21

6.1

138 187 135 147 139

39.8 53.9 38.9 42.4 40.1

113 102 103 108 89

32.5 29.4 29.6 31.1 25.6

85 46 88 71 83

24.5 13.2 25.4 20.4 23.9

11 12 21 21 36

3.2 3.5 6.1 6.1 10.4

§π„π§√Õ∫§√—« √âÕ¬≈– 31.7  à«π°‘®°√√¡∑’Ë°≈ÿà¡ µ—«Õ¬à“ßµâÕß°“√„ÀâÀπà«¬ß“π ®—¥ ∂“π∑’Ë À√◊Õ ÀâÕß ”À√—∫æ—°ºàÕπ¬“¡«à“ß √âÕ¬≈– 57.9 æ√âÕ¡

®—¥„Àâ¡’ ‚∑√∑—»πå «‘∑¬ÿ §“√“‚Õ‡°– √âÕ¬≈– 40.6 ·≈–Õÿª°√≥å°“√ÕÕ°°”≈—ß°“¬ √âÕ¬≈– 40.4 ‡æ◊ËÕ ºàÕπ§≈“¬§«“¡‡§√’¬¥ ‡√’¬ß≈”¥—∫

µ“√“ß∑’Ë 4  —¡æ—π∏å√–À«à“ßªí®®—¬ à«π∫ÿ§§≈°—∫√–¥—∫§«“¡‡§√’¬¥ ªí®®—¬ à«π∫ÿ§§≈

1. §«“¡§‘¥∑’Ë®–¶à“µ—«µ“¬ ‡§¬ ‰¡à‡§¬ 2. §«“¡§‘¥∑’Ë®–¶à“ºŸâÕ◊Ë𠇧¬ ‰¡à‡§¬

√–¥—∫§«“¡‡§√’¬¥ µË” ª“π°≈“ß  Ÿß √ÿπ·√ß ‰§«å ·§«å p-value ®”π«π ®”π«π ®”π«π ®”π«π (√âÕ¬≈–) (√âÕ¬≈–) (√âÕ¬≈–) (√âÕ¬≈–) 3 (13.1) 154 (47.5)

3 (13.1) 120 (37.0)

11 (47.8) 46 (14.3)

6 (26.0) 4 (1.2)

15 (39.5) 142 (45.9)

6 (15.8) 117 (37.9)

12 (31.5) 45 (14.6)

5 (13.2) 5 (1.6)

69.945

0.00*

26.567

0.00*

¡’π—¬ ”§—≠∑“ß ∂‘µ‘∑’Ë√–¥—∫ 0.05 THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH April - June 2010

127


∫ ∑ «‘ ∑ ¬ “ ° “ √ Õ¿‘ª√“¬º≈ ®“°°“√»÷°…“æ∫«à“ ‡®â“Àπâ“∑’Ë “∏“√≥ ÿ¢ ®— ß À«— ¥ ‡™’ ¬ ß„À¡à ¡’ √ –¥— ∫ §«“¡‰«µà Õ °“√‡°‘ ¥ §«“¡‡§√’¬¥ à«π¡“°Õ¬Ÿà„π√–¥—∫ª“π°≈“ß ¡“ ®“° “‡Àµÿ‡√◊ËÕߧ√Õ∫§√—«  ‘Ëß·«¥≈âÕ¡ ·≈–Õ“°“√ ‡§√’¬¥∑’Ë· ¥ßÕÕ°∑“ß√à“ß°“¬„π√–∫∫°≈â“¡‡π◊ÈÕ ‚§√ß°√–¥Ÿ° Õ¬Ÿà„π√–¥—∫ª“π°≈“ß ‡™àπ‡¥’¬«°—π ´÷Ëß„°≈⇧’¬ß°—∫°“√»÷°…“¢Õß«√√≥«‘‰≈ ™ÿà¡¿‘√¡¬å ·≈–§≥– ¡À“«‘∑¬“≈—¬‡™’¬ß„À¡à6 ªí ® ®— ¬  à « π∫ÿ § §≈∑’Ë ¡’ § «“¡ — ¡ æ— π ∏å °— ∫ §«“¡‡§√’¬¥Õ¬à“ß¡’π—¬ ”§—≠ §◊Õ¡’§«“¡§‘¥∑’Ë®– ¶à“µ—«µ“¬·≈–§‘¥∑’Ë®–¶à“ºŸâÕ◊Ëπ ´÷Ëß Õ¥§≈âÕß°—∫ °“√»÷°…“‡ª√’¬∫‡∑’¬∫√–¥—∫§«“¡‡§√’¬¥ §«“¡ §‘¥Õ¬“°¶à“µ—«µ“¬·≈–ºŸâÕ◊Ëπ ¢Õߢâ“√“™°“√„π  —ß°—¥°√–∑√«ß “∏“√≥ ÿ¢ ¢â“√“™°“√§√Ÿ ·≈– ¢â“√“™°“√µ”√«® „π®—ßÀ«—¥‡™’¬ß„À¡à7 °“√®—¥°“√°—∫§«“¡‡§√’¬¥¢Õ߇®â“Àπâ“∑’Ë  “∏“√≥ ÿ¢®—ßÀ«—¥‡™’¬ß„À¡à §◊Õ °“√Õà“πÀπ—ß ◊Õ ¥ŸÀπ—ß œ≈œ, °“√ª√÷°…“À√◊Õ查√–∫“¬°—∫§π„π

§√Õ∫§√—« ·≈– µâÕß°“√„ÀâÀπà«¬ß“π®—¥ ∂“π∑’Ë Õÿª°√≥å°“√ÕÕ°°”≈—ß°“¬ ‡æ◊ËÕ‡ªìπ·√ß π—∫ πÿπ ·≈–·√ß®Ÿß„® „π°“√ÕÕ°°”≈—ß°“¬¡“°¢÷Èπ8

¢âÕ‡ πÕ·π– 1. Àπ૬ߓπ§«√®—¥„Àâ¡’°“√ ”√«®¿“«– §«“¡‡§√’ ¬ ¥ °“√®— ¥ °“√§«“¡‡§√’ ¬ ¥¢Õ߇®â “ Àπâ“∑’Ë “∏“√≥ ÿ¢Õ¬à“ß ¡Ë”‡ ¡Õ µ≈Õ¥®π°≈ÿà¡ ß“π∑’ˇ°’ˬ«¢âÕß°—∫°“√æ—≤π“∑√—欓°√∫ÿ§§≈¢Õß Àπ૬ߓπ§«√µâÕߥ”‡π‘π°“√‡ΩÑ“√–«—ß·≈–„À⧔ ª√÷°…“ ¢âÕ™’È·π– ·π–π”·°à‡®â“Àπâ“∑’Ë “∏“√≥ ÿ¢ ∑’ˇ°‘¥¿“«–‡§√’¬¥Õ¬Ÿà„π√–¥—∫ Ÿß·≈–√–¥—∫ Ÿß¡“° 2. Àπ૬ߓπ§«√¡’°“√»÷°…“Õ¬à“߇ªìπ√Ÿª ∏√√¡™— ¥ ‡®π„𧫓¡µâ Õ ß°“√¢Õ߇®â “ Àπâ “ ∑’Ë  “∏“√≥ ÿ¢∑’˵âÕß°“√„ÀâÀπ૬ߓπ π—∫ πÿπÕ—π®–  à ß º≈µà Õ °“√≈¥¿“«–‡§√’ ¬ ¥¢Õ߇®â “ Àπâ “ ∑’Ë  “∏“√≥ ÿ¢ ´÷ËßµâÕß¡’§«“¡√—∫º‘¥™Õ∫µàÕ™’«‘µ¢Õß ª√–™“™π ·≈–‡ªìπ¿“√–ß“π∑’ˇ°‘¥§«“¡‡§√’¬¥ Ÿß Õ¬à“ß¡“°

‡Õ° “√Õâ“ßÕ‘ß 1. ®”≈Õß ¥‘…¬«≥‘™ ·≈–æ√‘È¡‡æ√“ ¥‘…¬«≥‘™. §«“¡‡§√’¬¥§«“¡«‘µ°°—ß«≈·≈– ÿ¢¿“æ. ‡™’¬ß„À¡à : ‚√ßæ‘¡æå· ß»‘≈ªá ; 2545. 2.  ¡®‘µ Àπÿ‡®√‘≠°ÿ≈. °“√¥Ÿ·≈µπ‡Õß : »“ µ√å·≈–»‘≈ª–∑“ß°“√欓∫“≈. °√ÿ߇∑æ¡À“π§√ : ∫√‘…—∑Õ‘π‡µÕ√å‚ø°—  ¥“µâ“ ; 2536. 3. ª√’™“ Õ‘π‚∑.«“√ “√ «πª√ÿß ªï∑’Ë14 ©∫—∫∑’Ë 2 情¿“§¡ -  ‘ßÀ“§¡ 2541 ; 11-17. 4.  ‘π’π“Ø ®‘µµå¿—°¥’. ¿“«–§«“¡‡§√’¬¥·≈–ªí®®—¬®“°≈—°…≥–ß“π∑’Ë∑”„À⇰‘𧫓¡‡§√’¬¥¢Õß欓∫“≈‚√ß欓∫“≈ «π ª√ÿß : ∫—≥±‘µ«‘∑¬“≈—¬ ¡À“«‘∑¬“≈—¬‡™’¬ß„À¡à ; 2538. 5.  ÿ«—≤πå ¡À—µπ‘√—π¥√å°ÿ≈ ·≈–§≥–. °“√ √â“ß·∫∫«—¥§«“¡‡§√’¬¥ «πª√ÿß. «“√ “√ «πª√ÿß ©∫—∫∑’Ë 13 ; 2540 : Àπâ“ 1-20. 6. «√√≥«‘‰≈ ™ÿà¡¿‘√¡¬å ·≈–§≥–.√“¬ß“π°“√«‘®—¬ ‡√◊ËÕß §«“¡‡§√’¬¥·≈–«‘∏’®—¥°“√°—∫§«“¡‡§√’¬¥¢Õß∫ÿ§≈“°√ §≥– 欓∫“≈»“ µ√å ¡À“«‘∑¬“≈—¬‡™’¬ß„À¡à : §≥–欓∫“≈»“ µ√å ¡À“«‘∑¬“≈—¬‡™���¬ß„À¡à ; 2547. 7. ¡πµ√’ π“¡¡ß§≈ ·≈–«π‘¥“ ™ÿࡉ滓≈™—¬. °“√‡ª√’¬∫‡∑’¬∫§«“¡‡§√’¬¥ §«“¡§‘¥Õ¬“°¶à“µ—«µ“¬ ·≈–§«“¡§‘¥ Õ¬“°¶à“ºŸâÕ◊Ëπ ¢Õߢâ“√“™°“√„π®—ßÀ«—¥‡™’¬ß„À¡à. °√¡ ÿ¢¿“殑µ °√–∑√«ß “∏“√≥ ÿ¢; 2540. 8. Arizen I., Fishbein M. Understanding attitudes and Predictory sexual Behavior. N.J. : Prentice Hall. HEALTH

128 ‡¡…“¬π - ¡‘∂ÿπ“¬π 2553

°√¡Õπ“¡—¬  à߇ √‘¡„Àâ§π‰∑¬  ÿ¢¿“楒


HEALTH_Vol33No2_11