Page 1

∫ ∑ «‘ ∑ ¬ “ ° “ √

∫ ∑ «‘ ∑ ¬ “ ° “ √ °“√æ—≤π“À≈—° Ÿµ√°“√„Àâ°“√ª√÷°…“ ‡°’ˬ«°—∫‡Õ™‰Õ«’„π§Ÿà “¡’¿√√¬“ ∑’Ë¡“Ω“°§√√¿å

√—µπ“ ‡æ™√æ√√≥ π—°«‘™“°“√ “∏“√≥ ÿ¢™”π“≠°“√摇»… »Ÿπ¬åÕπ“¡—¬∑’Ë 3 ™≈∫ÿ√’ «‘‰≈æ√√≥  «— ¥‘Ïæ“≥‘™¬å √Õß»“ µ√“®“√¬å §≥–欓∫“≈»“ µ√å ¡À“«‘∑¬“≈—¬∫Ÿ√æ“ æ‘»¡—¬ ÀÕ¡®”ª“ ºŸâ™à«¬»“ µ√“®“√¬å §≥– “∏“√≥ ÿ¢»“ µ√å ¡À“«‘∑¬“≈—¬∫Ÿ√æ“ ®‘πµπ“ «—™√ ‘π∏ÿå √Õß»“ µ√“®“√¬å §≥–欓∫“≈»“ µ√å ¡À“«‘∑¬“≈—¬∫Ÿ√æ“

∫∑§—¥¬àÕ °“√«‘®—¬π’È ‡ªìπ«‘®—¬‡™‘ߪؑ∫—µ‘°“√ ¡’«—µ∂ÿª√– ߧå‡æ◊ËÕæ—≤π“À≈—° Ÿµ√Ωñ°Õ∫√¡°“√„Àâ°“√ª√÷°…“‡°’ˬ« °—∫‡Õ™‰Õ«’„π§Ÿà “¡’¿√√¬“∑’Ë¡“Ω“°§√√¿å (Couple Counseling VCT in ANC) °“√«‘®—¬·∫à߇ªìπ 3 ¢—ÈπµÕπ §◊Õ °“√ÕÕ°·∫∫À≈—° Ÿµ√ °“√„™â ·≈–°“√ª√–‡¡‘πº≈À≈—° Ÿµ√ À≈—° Ÿµ√æ—≤π“¢÷Èπ·≈–ª√—∫ª√ÿß‚¥¬¡’ºŸâ ‡™’ˬ«™“≠„À⧫“¡√Ÿâ·≈–§”·π–π” ª√–°Õ∫¥â«¬·ºπ°“√ Õπ∑’Ë¡’‡π◊ÈÕÀ“™—¥‡®π·≈–§√Õ∫§≈ÿ¡ 9 ·ºπ °√–∫«π°“√æ—≤π“À≈—° Ÿµ√Õ“»—¬«ß®√∑’˪√–°Õ∫¥â«¬ °“√∑¥≈Õß„™â °“√ª√–‡¡‘π ·≈–°“√ª√—∫ª√ÿß °—∫°≈ÿà¡ µ—«Õ¬à“ߺŸâ‡¢â“Õ∫√¡∑—Èß ‘Èπ 6 √ÿàπ ¥—ßπ’È ¥”‡π‘π°“√µ“¡«ß®√°“√æ—≤π“√Õ∫∑’Ë 1 °—∫ºŸâ‡¢â“Õ∫√¡√ÿàπ∑’Ë 1 ‚¥¬π” À≈—° Ÿµ√∑’Ë √â“ߢ÷Èπ‰ª„™âÕ∫√¡√ÿàπ∑’Ë 1 ·≈⫪√–‡¡‘πº≈ ·≈–ª√—∫·ºπ°“√ Õπ„πÀ≈—° Ÿµ√ ·≈–π”À≈—° Ÿµ√¡“ ¥”‡π‘π°“√µ“¡«ß®√„π√Õ∫∑’Ë 2 °—∫°“√Õ∫√¡√ÿàπ∑’Ë 2 ·≈– 3 ·≈–π”À≈—° Ÿµ√∑’˪√—∫ª√ÿߥ’·≈⫵“¡«ß®√√Õ∫∑’Ë 2 ‰ª„™â„π°“√Õ∫√¡√ÿàπ∑’Ë 4-6 °“√«‘®—¬§√—Èßπ’È„™â‡«≈“»÷°…“„π√–À«à“߇¥◊Õπ°—𬓬π 2550 ∂÷ß°ÿ¡¿“æ—π∏å 2552 ‚¥¬°≈ÿࡵ—«Õ¬à“߇ªìπ欓∫“≈ªØ‘∫—µ‘ß“π∑’ËÀπ૬Ω“°§√√¿å‰¡àπâÕ¬°«à“ 6 ‡¥◊Õπ ®“°‚√ß欓∫“≈»Ÿπ¬å/∑—Ë«‰ª/ ™ÿ¡™π„π¿“§µ–«—πÕÕ°∑—ßÈ 9 ®—ßÀ«—¥ §◊Õ ™≈∫ÿ√’ √–¬Õß ®—π∑∫ÿ√’ µ√“¥ ©–‡™‘߇∑√“ ª√“®’π∫ÿ√’  √–·°â« π§√𓬰 ·≈– ¡ÿ∑√ª√“°“√ °“√‡≈◊Õ°°≈ÿࡵ—«Õ¬à“ß·∫∫‡®“–®ß (Purposive sampling) ®“°ºŸâ‡¢â“√—∫°“√Ωñ°Õ∫√¡√ÿàπ∑’Ë 1-3 (n = 40 §π) „™â·∫∫ Õ∫∂“¡·≈–°“√ π∑π“°≈ÿà¡ (Focus group) °“√ª√–‡¡‘πº≈ —¡ƒ∑∏‘Ï∑“ß°“√ ‡√’¬π¢ÕߺŸâ‡¢â“√—∫°“√Õ∫√¡ √ÿàπ∑’Ë 4-6 (n = 117 §π) „™â·∫∫∑¥ Õ∫§«“¡√Ÿâ ·≈–„™â·∫∫ª√–‡¡‘𧫓¡æ÷ß æÕ„®À≈—ß°“√Õ∫√¡ ∑”°“√«‘‡§√“–Àå¢âÕ¡Ÿ≈ ‚¥¬„™â ∂‘µ‘‡™‘ßæ√√≥π“  ”À√—∫¢âÕ¡Ÿ≈‡™‘ߪ√‘¡“≥  à«π¢âÕ¡Ÿ≈‡™‘ß §ÿ≥¿“愙⫑‡§√“–Àå‡π◊ÈÕÀ“ º≈°“√«‘®—¬æ∫«à“ À≈—° Ÿµ√¡’ 9 ·ºπ°“√ Õπ ‡π◊ÈÕÀ“ ∑—π ¡—¬ ™—¥‡®π  Õ¥§≈âÕß °—∫ ∂“π°“√≥åªí®®ÿ∫—π ºŸâ‡¢â“Õ∫√¡¡’§«“¡√Ÿâ·≈–∑—°…–„π°“√„Àâ°“√ª√÷°…“„π√–¥—∫¥’·≈–¥’¡“°  “¡“√∂π” ‰ª„™â„Àâ∫√‘°“√‰¥â®√‘ß  à«π°‘®°√√¡°“√æ—≤π“À≈—° Ÿµ√¡’§«“¡‡À¡“– ¡¥’¡“° ·≈–∑ÿ°§π‡ÀÁπ«à“µπ‡Õß∫√√≈ÿ 78

°√°Æ“§¡ - °—𬓬π 2555

°√¡Õπ“¡—¬ à߇ √‘¡„Àâ§π‰∑¬  ÿ¢¿“楒


°“√æ—≤π“À≈—° Ÿµ√°“√„Àâ°“√ª√÷°…“‡°’ˬ«°—∫‡Õ™‰Õ«’„π§Ÿà “¡’¿√√¬“∑’Ë¡“Ω“°§√√¿å

«—µ∂ÿª√– ߧå¢ÕßÀ≈—° Ÿµ√ §«“¡√Ÿâ·≈–ª√– ∫°“√≥å∑’ˉ¥â√—∫®“°À≈—° Ÿµ√¡’ª√–‚¬™πåµàÕµπ‡Õß ºŸâ√—∫∫√‘°“√ ·≈– Àπ૬ߓπ √«¡∑—Èß¡’§«“¡æ÷ßæÕ„®„πÀ≈—° Ÿµ√√–¥—∫¥’¡“° ¥—ߧ”°≈à“« ç¡’§«“¡√Ÿâ ÷°∑’Ë¥’µàÕÀ≈—° Ÿµ√°“√„Àâ∫√‘°“√ ª√÷°…“·∫∫§Ÿà‡æ√“–‰¥â™à«¬‡À≈◊Õ„À⧟ࠓ¡’¿√√¬“‰¥â™à«¬°—π·°â‰¢ªí≠À“∑”„Àâ§Ÿà‡¢â“„®°—π·≈–µ√–Àπ—°∂÷ߧ«“¡ ‡ ’ˬߵàÕ°“√µ‘¥‡™◊ÈÕ‡Õ™‰Õ«’ ∑”„À≥⥟·≈ºŸâ√—∫∫√‘°“√·∫∫Õߧå√«¡é πÕ°®“°π—Èπ¬—ß𔉪„™â„π ∂“π∫√‘°“√„π ¿“§µ–«—πÕÕ°∂÷ß 25 ·Ààß æ∫«à“ ¡’§Ÿà “¡’¿√√¬“√“¬„À¡à¡“√—∫∫√‘°“√Ω“°§√√¿å§‘¥‡ªìπ√âÕ¬≈– 25.4 ·≈–¡’º≈ ‡≈◊Õ¥µà“ß°—𧑥‡ªìπ√âÕ¬≈– 2.3 ¢âÕ‡ πÕ·π– ºŸâ„Àâ∫√‘°“√§≈‘π‘°Ω“°§√√¿å “¡“√∂π”À≈—° Ÿµ√‰ª„™â‡ªìπ§Ÿà¡◊Õ‡æ◊ËÕ ‡æ‘Ë¡ª√– ‘∑∏‘¿“æ„π°“√„Àâ∫√‘°“√°“√ª√÷°…“‡°’ˬ«°—∫‡Õ™‰Õ«’„π§Ÿà “¡’¿√√¬“∑’Ë¡“Ω“°§√√¿å ·≈– ”À√—∫»Ÿπ¬å Õπ“¡—¬‡¢µÀ√◊ÕÀπ૬ߓπÕ◊Ëπ∑’˵âÕß°“√π”À≈—° Ÿµ√‰ª„™â§«√ª√—∫‡π◊ÈÕÀ“„π·ºπ°“√ Õπ„Àâ‡À¡“– ¡°—∫∫√‘∫∑ ¢Õß®—ßÀ«—¥„π‡¢µæ◊Èπ∑’Ë√—∫º‘¥™Õ∫ §” ”§—≠ : °“√æ—≤π“À≈—° Ÿµ√ °“√ª√÷°…“§Ÿà “¡’¿√√¬“ §≈‘π‘°Ω“°§√√¿å

Development of the training curriculum on HIV couple counseling in antenatal care Ratana Petcharapun Public Health Officer, Senior Professional level. The Regional Health Promotion Center 3 Wilaiphan Sawatphannit Associated Professor. Faculty of Nursing, Burapha University Pissamai Homchampa Assistant Professor. Faculty of Public Health, Burapha University Chintana Wacharasin Associated Professor. Faculty of Nursing, Burapha University

Abstract This action research was aimed to develop a training curriculum on counseling of HIV positive couple attending in antenatal care clinics. It comprises 3 steps: curriculum design, curriculum application, and curriculum evaluation. The curriculum includes 9 lesson plans and comprehensive coverage of contents were developed under expert supervision. The development process, a cycle of application, evaluation and improvement was carried out through six training groups. The first and second cycles were applied to the 1st training group and the 2nd and 3rd training groups, respectively. Finally, the properly improved curriculum was applied and evaluated in the 4th to 6th training groups. This research was conducted between September 2007 to February 2009. The samples were nurses who have been working more than 6 months in antenatal care units of regional, general and community hospital of nine eastern Thailandûs provinces (Chonburi, Rayong, Chantaburi, Trad, Chachoengsao, Prachinburi, Srakaew, Nakornnayok and Smutprakarn). By purposive sampling, two sample groups were selected, one from trainees of the 1st to 3nd generation (n=40) and the other from trainees of the 4th to 6th training generation THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH

July - September 2012

79


∫ ∑ «‘ ∑ ¬ “ ° “ √ (n=117). Data from the first sample group were collected by means of questionnaires and focus group discussion, while those from the second were collected for learning achievement by knowledge tests and for overview satisfaction by post training program questionnaires. Quantitative data were analyzed by descriptive statistics analysis while qualitative data were analyzed by content analysis. The results revealed that all the 9 lessons plans included modern well-defined contents which were practical and consistent with current situation. The traineesû learning achievement scores were at good and very good level. Application of this training program to health care service is practical. Curriculum development activities were well suitable. All the trainees agreed that they achieved the curriculum objectives. Information and skills gained from this training program were useful for them, clients and their work units. In addition, the overview satisfactory was at very good level as that was stated that çFeeling good on the training curriculum on HIV couple counseling in antenatal care clinics was helpful to couples in solving problems that leading to understand each other and raised awareness in HIV infection risk. The clients received holistic care.é Furthermore, trials in 25 hospitals of eastern Thailand showed that 25.4 % were new couples and 2.3 % were discordant couples. It is suggested that antenatal care providers can apply the curriculum as guidelines to improve performance on HIV couple counseling in antenatal care clinics. For the regional health promotion center or other agencies that need to apply the curriculum, it was suggested that content improvement of teaching plans in accordance with roles and area of responsibility. Key words : Development of the training curriculum, couple counseling, antenatal care

∫∑π” °“√·æ√à ‡ ™◊È Õ ‡Õ™‰Õ«’ ¬— ß §ß‡ªì π ªí ≠ À“ ”§—≠∑’ËÀ≈“¬Àπ૬ߓπµâÕß√–¥¡§«“¡√à«¡¡◊Õ ‡æ◊ËÕªÑÕß°—π·≈–·°â‰¢ªí≠À“°—πÕ¬à“ßµàÕ‡π◊ËÕß1,2 ∑’Ë  ”§—≠§◊Õ°“√ª√—∫ª√ÿßæ—≤π“·π«§‘¥·≈–∑‘»∑“ß °“√¥”‡π‘πß“π„Àâ Õ¥§≈âÕß°—∫ ∂“π°“√≥å°“√ µ‘¥‡™◊ÈÕ·≈–‚√§‡Õ¥ å∑’ˇª≈’ˬπ·ª≈߉ª ´÷Ëß√«¡∑—Èß ß“πªÑÕß°—π°“√·æ√à‡™◊ÈÕ °“√µ‘¥‡™◊ÈÕ√“¬„À¡à ·≈– °“√≈¥º≈°√–∑∫®“°ªí≠À“‡Õ¥ å∑ß—È „π√–¥—∫∫ÿ§§≈ §√Õ∫§√—« ·≈–™ÿ¡™π ®“°º≈°“√µ√«®‡≈◊Õ¥À≠‘ß µ—ßÈ §√√¿åæ∫§Ÿ‡à æ» —¡æ—π∏塺’ ≈‡≈◊Õ¥µà“ß°—π §◊Õ  “¡’ À√◊Õ¿√√¬“µ‘¥‡™◊ÈÕ‡Õ™‰Õ«’ ·µàÕ’°ΩÉ“¬Àπ÷Ëßµ√«®‰¡à æ∫°“√µ‘ ¥ ‡™◊È Õ À√◊ Õ ‰¡à ¬ Õ¡‰ªµ√«®‡≈◊ Õ ¥ ®“° √“¬ß“π¢Õߧ≈‘π‘°Ω“°§√√¿å ‚√ß欓∫“≈™≈∫ÿ√’ ®—ßÀ«—¥™≈∫ÿ√’ √–À«à“ߪï æ.». 2541-2547 ®“° À≠‘ßµ—ßÈ §√√¿å∑µ’Ë ¥‘ ‡™◊ÕÈ ‡Õ™‰Õ«’¡“Ω“°§√√¿å®”π«π 430 §π·≈–¡’ “¡’¡“µ√«®‡≈◊Õ¥®”π«π 214 §π æ∫§Ÿ à “¡’¿√√¬“∑’¡Ë º’ ≈‡≈◊Õ¥µà“ß°—π ®”π«π 100 §Ÿà §‘¥‡ªìπ√âÕ¬≈– 46.7 ·≈–¢âÕ¡Ÿ≈∑’˧≈‘π‘°Ω“°§√√¿å 80

°√°Æ“§¡ - °—𬓬π 2555

°√¡Õπ“¡—¬ à߇ √‘¡„Àâ§π‰∑¬  ÿ¢¿“楒

‚√ß欓∫“≈ ¡‡¥Á®æ√–∫√¡√“™‡∑«’ ≥ »√’√“™“ ®—ßÀ«—¥™≈∫ÿ√’ √–À«à“ߪï æ.». 2546-2549 ¡’À≠‘ß µ—ßÈ §√√¿å∑µ’Ë ¥‘ ‡™◊ÕÈ ‡Õ™‰Õ«’ ¡“Ω“°§√√¿å ®”π«π 677 §π æ∫§Ÿà “¡’¿√√¬“∑’Ë¡’º≈‡≈◊Õ¥µà“ß°—π®”π«π 50 §Ÿà §‘¥‡ªìπ√âÕ¬≈– 7.4 1 πÕ°®“°π’Èæ∫«à“À≠‘ßµ—Èß §√√¿å∑’˵‘¥‡™◊ÈÕ‡Õ™‰Õ«’ ®”π«π 10 §πÕ“¬ÿ√–À«à“ß 18-29 ªï ¡’§Ÿà∑’Ë¡’º≈‡≈◊Õ¥µà“ß 4 §Ÿà3 °“√‡ªî¥‡º¬ º≈‡≈◊Õ¥·°à§Ÿà‡æ» —¡æ—π∏å ‡ªìπ‡√◊ËÕ߬ÿà߬“°µâÕß„™â «‘∏’°“√∑’Ë´—∫´âÕπ¡“°¢÷Èπ ‡æ◊ËÕªÑÕß°—πº≈°√–∑∫ ∑“ߥ⠓ π®‘ µ „®·≈– — ß §¡¢ÕߺŸâ µ‘ ¥ ‡™◊È Õ ·≈–§Ÿà ‡ æ»  —¡æ—π∏å °“√„Àâ°“√ª√÷°…“·∫∫§Ÿà‡°’ˬ«°—∫‡Õ™‰Õ«’ „π§Ÿà “¡’¿√√¬“∑’Ë¡“Ω“°§√√¿å πà“®–‡ªìπ«‘∏’°“√∑’Ë ™à«¬„À⧠Ÿà “¡’¿√√¬“ ‰¥â√∫— √Ÿ·â ≈–‡¢â“„®∂÷ß惵‘°√√¡ ∑’ˇ ’ˬߵàÕ°“√µ‘¥‡™◊ÈÕ‡Õ™‰Õ«’ æ√âÕ¡∑—È߇ªî¥‚Õ°“  „Àâ “¡’¿√√¬“ ¡’°“√查§ÿ¬ ◊ÕË  “√°—π‰¥â¥¡’ “°¬‘ßË ¢÷πÈ ™à«¬≈¥§«“¡√Ÿâ ÷°¬ÿà߬“°≈”∫“°„®„π°“√‡ªî¥‡º¬ º≈‡≈◊Õ¥µàÕ§Ÿà‡æ» —¡æ—π∏å¢Õßµπ ·≈–„π√“¬∑’˵‘¥ ‡™◊ÈÕ‡æ’¬ß§π‡¥’¬«¬—ß “¡“√∂ªÑÕß°—π‰¡à„À⇙◊ÈÕ·æ√à ®“°§π∑’˵‘¥·≈â« ‰ª Ÿà§Ÿà‡æ» —¡æ—π∏剥â 1,2,3,4,5,6,11,12


°“√æ—≤π“À≈—° Ÿµ√°“√„Àâ°“√ª√÷°…“‡°’ˬ«°—∫‡Õ™‰Õ«’„π§Ÿà “¡’¿√√¬“∑’Ë¡“Ω“°§√√¿å

ªïæ.». 2547- 2552 »Ÿπ¬åÕπ“¡—¬∑’Ë 3 ™≈∫ÿ√’ ‰¥â√—∫°“√ π—∫ πÿπß∫ª√–¡“≥®“°°Õß∑ÿπ‚≈° (Global Fund) „π°“√®—¥∑”‚§√ß°“√°“√¥Ÿ·≈ À≠‘ßÀ≈—ߧ≈Õ¥·≈–§√Õ∫§√—«∑’µË ¥‘ ‡™◊ÕÈ ‡Õ™‰Õ«’ ‡æ◊ÕË æ—≤π“»—°¬¿“æ∫ÿ§≈“°√¥â“π “∏“√≥ ÿ¢„π°“√ „Àâ ° “√ª√÷ ° …“∑’Ë ‡ °’Ë ¬ «¢â Õ ß°— ∫ °“√¥Ÿ · ≈À≠‘ ß µ—È ß §√√¿å·≈–À≠‘ßÀ≈—ߧ≈Õ¥ ´÷Ë߇ªìπÀ≈—° Ÿµ√∑’ˇ°’ˬ« °— ∫ ‡Õ¥ å „ π·¡à · ≈–‡¥Á ° ¢Õß°√¡Õπ“¡— ¬ ‡™à π À≈—° Ÿµ√°“√„Àâ°“√ª√÷°…“¬“µâ“π‰«√— „πÀ≠‘ß À≈—ߧ≈Õ¥·≈–§√Õ∫§√—«∑’µË ¥‘ ‡™◊ÕÈ ‡Õ™‰Õ«’ À≈—° Ÿµ√ °“√„Àâ°“√ª√÷°…“°√≥’‡ªî¥‡º¬º≈‡≈◊Õ¥ (Disclosure) À≈—° Ÿµ√°“√„Àâ°“√ª√÷°…“°√≥’¡“§≈Õ¥ ‚¥¬‰¡à¡’º≈‡≈◊Õ¥ (No ANC) ·≈–À≈—° Ÿµ√°“√ „Àâ°“√ª√÷°…“À≠‘ß∑’˵‘¥‡™◊ÈÕ‡Õ™‰Õ«’·≈–§√Õ∫§√—«  ”À√—∫∫ÿ§≈“°√∑’˪ؑ∫—µ‘ß“π„π»Ÿπ¬å ÿ¢¿“æ™ÿ¡™π ·≈– ∂“π’ Õ π“¡— ¬ æ∫«à “ ªí ≠ À“∑’Ë ºà “ π¡“ §◊ Õ À≠‘ßµ—Èߧ√√¿åÀ√◊ÕÀ≠‘ßÀ≈—ߧ≈Õ¥∑’˵‘¥‡™◊ÈÕ‡Õ™‰Õ«’ ®–‰¡à°≈Ⓡªî¥‡º¬º≈‡≈◊Õ¥¢Õßµπ‡Õß°—∫ “¡’ À√◊Õ ºŸâÕ◊Ëπ‡π◊ËÕß®“°°≈—«∂Ÿ°√—߇°’¬® ∂Ÿ°‡≈◊Õ°ªØ‘∫—µ‘ À√◊Õ  “¡’∑Õ¥∑‘Èß »Ÿπ¬åÕπ“¡—¬∑’Ë 3 ‰¥â‡≈Á߇ÀÁ𧫓¡ ”§—≠ ¢Õߪí≠À“¥—ß°≈à“« ®÷ߪ√– “𧫓¡√à«¡¡◊Õ∑“ß «‘ ™ “°“√°— ∫ §≥–欓∫“≈»“ µ√å ·≈–§≥–  “∏“√≥ ÿ ¢ »“ µ√å ¡À“«‘ ∑ ¬“≈— ¬ ∫Ÿ √ æ“ ‡æ◊Ë Õ æ—≤π“À≈—° Ÿµ√ Couple Counseling VCT: Voluntary Counseling Test7,8,9,13,14,15 À≈—° Ÿµ√ π’ȉ¥â√—∫Àπ૬§–·ππ°“√»÷°…“µàÕ‡π◊ËÕß ”À√—∫ 欓∫“≈ ®“° ¿“°“√欓∫“≈ ·≈–𔉪„™âΩñ° Õ∫√¡„Àâ°—∫‡®â“Àπâ“∑’˺Ÿâ„Àâ∫√‘°“√ª√÷°…“∑’˧≈‘π‘° Ω“°§√√¿å¢Õß‚√ß欓∫“≈µà“ßÊ „π 9 ®—ßÀ«—¥ ¿“§µ–«—πÕÕ°

«—µ∂ÿª√– ߧ尓√»÷°…“ ‡æ◊Ë Õ æ— ≤ π“À≈— °  Ÿ µ √°“√„Àâ ° “√ª√÷ ° …“

‡°’ˬ«°—∫‡Õ™‰Õ«’ „π§Ÿà “¡’¿√√¬“∑’Ë¡“Ω“°§√√¿å

«‘∏’°“√»÷°…“ ·∫à߇ªìπ 5 ¢—ÈπµÕπ §◊Õ 1. °“√°”Àπ¥ª√–™“°√·≈–°“√‡≈◊Õ° °≈ÿࡵ—«Õ¬à“ß §◊Õ æ¬“∫“≈¢Õß‚√ß欓∫“≈„π ¿“§µ–«— π ÕÕ°‰¥â · °à ‚ √ß欓∫“≈»Ÿ π ¬å / ∑—Ë « ‰ª/ ™ÿ¡™π ∑—Èß 9 ®—ßÀ«—¥ §◊Õ ™≈∫ÿ√’ √–¬Õß ®—π∑∫ÿ√’ µ√“¥ ©–‡™‘߇∑√“ ª√“®’π∫ÿ√’ √–·°â« π§√𓬰 ·≈– ¡ÿ ∑ √ª√“°“√ ‚¥¬§ÿ ≥  ¡∫— µ‘ ¢ Õß°≈ÿà ¡ µ—«Õ¬à“߇ªìπ欓∫“≈∑”ß“πÀπ૬Ω“°§√√¿å‰¡à πâÕ¬°«à“ 6 ‡¥◊Õ𠇧¬ºà“π°“√Õ∫√¡À≈—° Ÿµ√°“√ „Àâ°“√ª√÷°…“‡Õ¥ å„π·¡à·≈–‡¥Á°Õ¬à“ßπâÕ¬ 1 À≈—° Ÿµ√ ·≈– “¡“√∂‡¢â“√—∫°“√Õ∫√¡‰¥â§√∫ µ“¡‡«≈“°”Àπ¥ 2. °“√ÕÕ°·∫∫°“√«‘®—¬ „™â√–‡∫’¬∫«‘∏’ °“√«‘®—¬‡™‘ߧÿ≥¿“æ ‚¥¬„™â°√–∫«π°“√«‘∏’°“√ «‘®—¬‡™‘ߪؑ∫—µ‘°“√ (Action Research) ´÷Ëß¡’¢—Èπ µÕπ¥—ßπ’È ¢—ÈπµÕπ∑’Ë 1 ‡™‘≠ºŸâ∑√ߧÿ≥«ÿ≤‘ ‰¥â·°à »“ µ√“®“√¬å 𠓬·æ∑¬å  ÿ æ √ ‡°‘ ¥  «à “ ß √Õß »“ µ√“®“√¬å «‘ ‰ ≈æ√√≥  «—   ¥‘Ï æ “≥‘ ™ ¬å √Õß »“ µ√“®“√¬å¥√.®‘πµπ“ «—™√ ‘π∏ÿå ·≈–ºŸâ™à«¬ »“ µ√“®“√¬å¥√.æ‘»¡—¬ ÀÕ¡®”ª“ ¡“ª√–™ÿ¡ ∂à“¬∑Õ¥Õߧ姫“¡√Ÿâ·≈–ª√– ∫°“√≥å„Àâ°—∫∑’¡ «‘∑¬“°√√–¥—∫‡¢µ „π‡√◊ËÕ߇π◊ÈÕÀ“¢âÕ¡Ÿ≈‡°’ˬ«°—∫ Couple VCT in ANC ·π«§‘¥∑ƒ…Æ’‡°’ˬ«°—∫  ÿ¢¿“æ§√Õ∫§√—«  ÿ¢¿“æ∑“ß‡æ» °“√ ◊ÕË  “√ °“√ æ— ≤ π“ — ¡ æ— π ∏¿“æ„π§√Õ∫§√— « ∑— ° …–°“√ ª√÷°…“∑’Ë°àÕ„À⇰‘¥°“√‡ª≈’ˬπ·ª≈ß„π§√Õ∫§√—« ·≈–§«“¡ ”§— ≠ ·≈–§«“¡®”‡ªì π „π°“√®— ¥ ∑” ·ºπ°“√ Õπ§Ÿà ¡√ ∑’ËΩ“°§√√¿å ‡æ◊ËÕÀ“·π«∑“ß ®—¥∑”À≈—° Ÿµ√ „Àâ¡’·ºπ°“√ Õπ ¢—ÈπµÕπ∑’Ë 2 °“√«“ß·ºπ ‚¥¬ºŸâ∑√ߧÿ≥

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH

July - September 2012

81


∫ ∑ «‘ ∑ ¬ “ ° “ √ «ÿ≤√‘ «à ¡°—∫∑’¡«‘∑¬“°√ ®—¥∑”·ºπ°“√ Õπ  √ÿª‰¥â 9 ·ºπ ¢—ÈπµÕπ∑’Ë 3 ¡Õ∫À¡“¬ß“π „À⺟â∑√ß §ÿ ≥ «ÿ ≤‘ · ≈–∑’ ¡ «‘ ∑ ¬“°√·µà ≈ –∑à “ π‰ª‡¢’ ¬ π ·ºπ°“√ Õπµ“¡§«“¡‡™’ˬ«™“≠ ¢—πÈ µÕπ∑’Ë 4 °“√®—¥∑”·ºπ°“√ Õπ ‚¥¬ ¡’«—µ∂ÿª√– ß§å ¥—ßπ’È - «—µ∂ÿª√– ß§å∑—Ë«‰ª ‡æ◊ËÕ„Àâ欓∫“≈ À√◊ Õ ‡®â “ Àπâ “ ∑’Ë   “∏“√≥ ÿ ¢ ºŸâ „ Àâ ∫ √‘ ° “√ª√÷ ° …“¡’ §«“¡√Ÿâ §«“¡ “¡“√∂·≈–∑—°…–„π°“√„Àâ∫√‘°“√ ª√÷°…“‡°’ˬ«°—∫‡Õ™‰Õ«’„π§Ÿà “¡’¿√√¬“∑’Ë¡“Ω“° §√√¿å - «—µ∂ÿª√– ß§å‡©æ“– ‡¡◊ËÕ ‘Èπ ÿ¥°“√ Õ∫√¡ºŸâ‡¢â“√—∫°“√Õ∫√¡ “¡“√∂ 1. Õ∏‘ ∫ “¬π‚¬∫“¬·π«∑“ß°“√ ¥”‡π‘πß“π·≈– ∂“π°“√≥å°“√ªÑÕß°—π‚√§‡Õ¥ å „π·¡à·≈–‡¥Á°¢Õߪ√–‡∑»‰∑¬ (‡¢µ/®—ßÀ«—¥) 2. Õ∏‘∫“¬°“√√—°…“‡¬’¬«¬“‚√§‡Õ¥ å „πß“πÕπ“¡—¬·¡à·≈–‡¥Á° 3. Õ∏‘ ∫ “¬·π«§‘ ¥ ∑ƒ…Æ’ ‡ °’Ë ¬ «°— ∫  ÿ¢¿“æ§√Õ∫§√—«  ÿ¢¿“æ∑“ß‡æ» °“√ ◊ÕË  “√ °“√ æ—≤π“ —¡æ—π∏¿“æ„π§√Õ∫§√—« 4. ∫Õ°∑—°…–°“√ª√÷°…“∑’Ë°àÕ„À⇰‘¥ °“√‡ª≈’ˬπ·ª≈ß„π§√Õ∫§√—« 5. „Àâ∫√‘°“√°“√ª√÷°…“§Ÿà ¡√ °àÕπ °“√µ√«®‡≈◊Õ¥‡æ◊ËÕÀ“°“√µ‘¥‡™◊ÈÕ‡Õ™‰Õ«’ ‚¥¬ §«“¡ ¡—§√„® 6. „Àâ ∫ √‘ ° “√ª√÷ ° …“§Ÿà   ¡√ À≈— ß °“√ µ√«®À“°“√µ‘¥‡™◊ÕÈ ‡Õ™‰Õ«’ : °√≥’º≈‡≈◊Õ¥≈∫∑—ßÈ §Ÿà 7. „Àâ ∫ √‘ ° “√°“√ª√÷ ° …“§Ÿà   ¡√ À≈— ß °“√µ√«®À“°“√µ‘¥‡™◊ÈÕ‡Õ™‰Õ«’ : °√≥’º≈‡≈◊Õ¥ ∫«°∑—ÈߧŸà 8. „Àâ ∫ √‘ ° “√ª√÷ ° …“§Ÿà   ¡√ À≈— ß °“√ µ√«®À“°“√µ‘¥‡™◊ÈÕ‡Õ™‰Õ«’ : °√≥’º≈‡≈◊Õ¥µà“ß 82

°√°Æ“§¡ - °—𬓬π 2555

°√¡Õπ“¡—¬ à߇ √‘¡„Àâ§π‰∑¬  ÿ¢¿“楒

9. –∑â Õ π§«“¡√Ÿâ  ÷ ° ·≈–°“√𔉪 ª√–¬ÿ°µå„™â (After Affective Refection) 3. °“√„™â·≈–ª√–‡¡‘πº≈À≈—° Ÿµ√ π” À≈—° Ÿµ√‰ª„™â„π°“√Õ∫√¡√ÿàπ∑’Ë 1 ‚¥¬„À⺟⇢ⓠÕ∫√¡ª√–‡¡‘πº≈À≈—° Ÿµ√æ∫«à“¡’§«“¡´È”´âÕπ ¢Õ߇π◊È Õ À“„π·ºπ°“√ Õπ∫“ß·ºπ ®÷ ß ‰¥â ª√—∫ª√ÿß·≈–æ—≤π“·ºπ„À⥒¬‘Ëߢ÷Èπ ·≈â«π”¡“ Õ∫√¡„π√ÿàπ∑’Ë 2 ·≈– 3 ®“°π—È𵑥µ“¡ª√–‡¡‘πº≈ ·≈–øóôπøŸ§«“¡√Ÿâ·°àºŸâ‡¢â“Õ∫√¡∑—Èß 3 √ÿàπ ‚¥¬„™â ·∫∫ Õ∫∂“¡¢âÕ¡Ÿ≈∑—Ë«‰ª ·∫∫√“¬ß“π¢âÕ¡Ÿ≈ ∫√‘°“√ °“√ π∑π“°≈ÿà¡ ·≈–°“√ª√–‡¡‘𧫓¡æ÷ß æÕ„® ‚¥¬‡™‘≠ºŸâ‡™’ˬ«™“≠ §◊Õ »“ µ√“®“√¬å𓬠·æ∑¬å ÿæ√ ‡°‘¥ «à“ß ¡“„À⧫“¡√Ÿâ·≈–¢âÕ‡ πÕ ·π–‡æ‘¡Ë ‡µ‘¡ ·≈–π”À≈—° Ÿµ√‰ª„™âÕ∫√¡µàÕ„π√ÿπà ∑’Ë 4-6 æ√âÕ¡∑—Èß„À⺟âÕ∫√¡ª√–‡¡‘πº≈À≈—° Ÿµ√ ‡æ◊ËÕ π”¢âÕ¡Ÿ≈∑’ˉ¥â¡“ª√—∫ª√ÿß·≈–æ—≤π“·ºπ°“√ Õπ „Àâ ¡∫Ÿ√≥嬑Ëߢ÷Èπ 4. °“√‡°Á∫√«∫√«¡¢âÕ¡Ÿ≈ 4.1·À≈àߢâÕ¡Ÿ≈ §◊Õ ºŸâ‡¢â“Õ∫√¡∑’Ëπ” À≈—° Ÿµ√‰ª„™â„Àâ∫√‘°“√„π‚√ß欓∫“≈µà“ß Ê ®”π«π 251 §π 4.2 ‡§√◊ÕË ß¡◊Õ∑’„Ë ™â„π°“√«‘®¬— ‰¥â·°à ·∫∫ ∑¥ Õ∫§«“¡√Ÿâ ·∫∫ª√–‡¡‘πº≈À≈—ß°“√Õ∫√¡ ·∫∫ Õ∫∂“¡¢âÕ¡Ÿ≈∑—Ë«‰ª ·∫∫√“¬ß“π°“√‡°Á∫ ¢âÕ¡Ÿ≈ °“√ π∑π“°≈ÿà¡ ·≈–·∫∫ Õ∫∂“¡°“√ ª√–‡¡‘πº≈ 4.3«‘∏’°“√‰¥â¡“´÷ËߢâÕ¡Ÿ≈ ¥—ßπ’È 1) „™â ·∫∫∑¥ Õ∫§«“¡√Ÿâ°àÕπ-À≈—ß°“√Õ∫√¡ ·≈–·∫∫ ª√–‡¡‘πº≈À≈—ß°“√Õ∫√¡ 2)  àß·∫∫ Õ∫∂“¡ ¢âÕ¡Ÿ≈∑—Ë«‰ª ·≈–·∫∫√“¬ß“π°“√‡°Á∫¢âÕ¡Ÿ≈ „À⺟⠇¢â“Õ∫√¡µÕ∫æ√âÕ¡∑—Èßπ”¡“„π«—π®—¥Õ∫√¡øóôπøŸ §«“¡√Ÿâ ·≈– 3) ®“°°“√ π∑π“°≈ÿà¡ „π«—πÕ∫√¡ øóôπøŸ§«“¡√Ÿâ ‚¥¬„™â·∫∫ Õ∫∂“¡°“√ª√–‡¡‘πº≈ 4.4°“√ª√–‡¡‘ 𠧫“¡πà “ ‡™◊Ë Õ ∂◊ Õ ¢Õß


°“√æ—≤π“À≈—° Ÿµ√°“√„Àâ°“√ª√÷°…“‡°’ˬ«°—∫‡Õ™‰Õ«’„π§Ÿà “¡’¿√√¬“∑’Ë¡“Ω“°§√√¿å

¢âÕ¡Ÿ≈‡™‘ߧÿ≥¿“æ10,16,17 §«“¡‡∑’ˬߵ√ß (Validity) §≥–ºŸâ «‘ ®— ¬ ‰¥â ®— ¥ ∑”·π«§”∂“¡‡æ◊Ë Õ °“√ π∑π“°≈ÿà¡ ·≈–°“√ —¡¿“…≥凮“–≈÷° ‰¥â®“° °“√∑∫∑«π‡Õ° “√ ·≈–ß“π«‘®—¬∑’ˇ°’ˬ«¢âÕß Õ’° ∑—ÈߺŸâ„Àâ¢âÕ¡Ÿ≈¡’ à«π√à«¡„π°√–∫«π°“√«‘®—¬ ´÷Ëß  “¡“√∂¬◊π¬—π‰¥â‚¥¬µ√ß ¥â«¬‡∑§π‘§°“√µ√«®  Õ∫ “¡‡ â“ (Triangulation techniques) °“√ µ√«® Õ∫„π‡™‘ß∑ƒ…Æ’ (Theory triangulation) °“√µ√«® Õ∫¢âÕ¡Ÿ≈®“°·À≈àߢâÕ¡Ÿ≈∫ÿ§§≈∑’µË “à ß°—π ‚¥¬°“√ —¡¿“…≥å„π‡√◊ËÕ߇¥’¬«°—π ∑’Ë∑”ß“π„π ·ºπ°‡¥’¬«°—π·µàµà“ß‚√ß欓∫“≈ °“√µ√«® Õ∫ ¢â Õ ¡Ÿ ≈ ®“°‡®â “ ¢Õߢâ Õ ¡Ÿ ≈ ¬◊ π ¬— π °“√«‘ ‡ §√“–Àå ¢âÕ¡Ÿ≈∑’‰Ë ¥â®“°æ¬“∫“≈∑’√Ë «à ¡°≈ÿ¡à «‘®¬— ‡™‘ߪؑ∫µ— °‘ “√ §«“¡‡™◊ËÕ¡—Ëπ¢Õß°“√«‘®—¬ (Reliability) ‰¥â¡“ ®“°°“√∑’˧≥–ºŸâ«‘®—¬‡ªìπ欓∫“≈«‘™“™’æ ¡’∑—°…– ·≈–ª√– ∫°“√≥å „ π°“√ªØ‘ ∫— µ‘ ß “π„πÀπâ “ ∑’Ë æ¬“∫“≈ª√–®”°“√¡“°àÕ𠇪ìπºŸâ∑’ˇ°Á∫√«∫√«¡ ¢âÕ¡Ÿ≈¥â«¬µπ‡Õß∑—Èß°√–∫«π°“√∑”«‘®—¬ ‡æ◊ËÕ„Àâ ‰¥â¢âÕ¡Ÿ≈¡“«‘‡§√“–Àå ·≈–ª√– ∫°“√≥å„π°“√ ¥”‡π‘π°‘®°√√¡°≈ÿà¡ 5. °“√®—¥°√–∑”·≈–°“√«‘‡§√“–Àå¢Õâ ¡Ÿ≈ ¢âÕ¡Ÿ≈∑—«Ë ‰ª „™â ∂‘µ‡‘ ™‘ßæ√√≥π“ ¢âÕ¡Ÿ≈‡™‘ߧÿ≥¿“æ „™â°“√«‘‡§√“–Àå‡π◊ÈÕÀ“ ‚¥¬¡’¢—ÈπµÕπ¥—ßπ’È °“√ «‘‡§√“–Àå¢âÕ¡Ÿ≈‡∫◊ÈÕßµâπ ®–°√–∑”¿“¬À≈—ß„™â ·∫∫ Õ∫∂“¡·≈–°“√ π∑π“°≈ÿà¡ ·≈–°“√ª√– ‡¡‘πº≈°“√Õ∫√¡À≈—ß°“√Ωñ°Õ∫√¡‡ √Á® ‘Èπ≈ß∑ÿ° §√—Èß ¡’°“√®”·π°·≈–°“√®—¥À¡«¥À¡Ÿà¢ÕߢâÕ¡Ÿ≈ ´÷Ëß¡’≈—°…≥–§≈⓬°—π·≈–·µ°µà“ß°—π ‡æ◊Ëՙ૬„Àâ ‡°‘¥§«“¡‡¢â“„®‡∫◊ÈÕßµâπ°—∫¢âÕ¡Ÿ≈ ¡’°“√µ√«® Õ∫ ¢âÕ¡Ÿ≈°—∫·π«§‘¥‡™‘ß∑ƒ…Æ’ ·À≈àß„Àâ¢âÕ¡Ÿ≈∑’Ë·µ° µà“ß°—π ·≈–¥â«¬«‘∏’°“√∑’Ë·µ°µà“ß°—π æ‘¡æå∫∑  π∑π“∑’ˉ¥â®“°°“√ —¡¿“…≥å °“√ π∑π“°≈ÿà¡ ·≈–°“√∫—π∑÷°§«“¡§‘¥‡ÀÁπ¢ÕߺŸâ„Àâ¢âÕ¡Ÿ≈ ·≈â« π”¢âÕ¡Ÿ≈∑’ˉ¥â¡“«‘‡§√“–Àå‡π◊ÈÕÀ“

√ÿªº≈°“√»÷°…“ 1. °“√æ—≤π“À≈—° Ÿµ√‰¥â·ºπ°“√ Õπ 9 ·ºπ ¥—ßπ’È 1.1π‚¬∫“¬/ ∂“π°“√≥å°“√ªÑÕß°—π ‚√§‡Õ¥ å„π·¡à·≈–‡¥Á°¢Õߪ√–‡∑»‰∑¬ (‡¢µ/ ®—ßÀ«—¥) ‡«≈“ 1 ™—Ë«‚¡ß 1.2‡Õ¥ å...√Ÿâ®—°....√—°…“‰¥â ‡«≈“ 1.30 ™—Ë«‚¡ß 1.3·π«§‘ ¥ ∑ƒ…Æ’ ‡ °’Ë ¬ «°— ∫  ÿ ¢ ¿“æ §√Õ∫§√— «  ÿ ¢ ¿“æ∑“ß‡æ» °“√ ◊Ë Õ  “√ °“√ æ—≤π“ —¡æ—π∏¿“æ„π§√Õ∫§√—« ‡«≈“ 4 ™—Ë«‚¡ß 1.4∑—°…–°“√ª√÷°…“∑’Ë°àÕ„À⇰‘¥°“√ ‡ª≈’ˬπ·ª≈ß„π§√Õ∫§√—« ‡«≈“ 3 ™—Ë«‚¡ß 1.5°“√„Àâ°“√ª√÷°…“§Ÿà ¡√ °àÕπ°“√ µ√«®À“°“√µ‘¥‡™◊ÈÕ‡Õ™‰Õ«’ ‚¥¬§«“¡ ¡—§√„® (Couple VCT Pre-test Counseling) ‡«≈“ 3 ™—Ë«‚¡ß 1.6°“√„Àâ°“√ª√÷°…“§Ÿà ¡√ À≈—ß°“√ µ√«®À“°“√µ‘¥‡™◊ÕÈ ‡Õ™‰Õ«’ : °√≥’º≈‡≈◊Õ¥≈∫∑—ßÈ §Ÿà (Couple VCT Post-test Counseling Concordant Sero-negative) ‡«≈“ 2 ™—Ë«‚¡ß 1.7°“√„Àâ°“√ª√÷°…“§Ÿà ¡√ À≈—ß°“√ µ√«®À“°“√µ‘¥‡™◊ÕÈ ‡Õ™‰Õ«’ : °√≥’º≈‡≈◊Õ¥∫«°∑—ßÈ §Ÿà (Couple VCT Post-test Counseling Concordant Sero-positive ) 2 ™—Ë«‚¡ß 1.8°“√„Àâ ° “√ª√÷ ° …“À≠‘ ß µ—È ß §√√¿å ·≈– “¡’ : °√≥’º≈‡≈◊Õ¥µà“ß (Discordant Couple Counseling) ‡«≈“ 3 ™—Ë«‚¡ß 1.9°“√ –∑âÕ𧫓¡√Ÿâ ÷°·≈–°“√𔉪 ª√–¬ÿ°µå„™â (After Affective Refection) 1 ™—«Ë ‚¡ß 2. °“√ª√–‡¡‘πº≈À≈—° Ÿµ√ ·∫à߇ªìπ 4 ¥â“π 2.1 ¥â“πÀ≈—° Ÿµ√°“√„Àâ°“√ª√÷°…“ ‡°’¬Ë «°—∫‡Õ™‰Õ«’„π§Ÿ à “¡’¿√√¬“∑’¡Ë “Ω“°§√√¿å

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH

July - September 2012

83


∫ ∑ «‘ ∑ ¬ “ ° “ √ ¢âÕ¥’´÷Ëß∂◊Õ«à“‡ªìπ®ÿ¥·¢ÁߢÕßÀ≈—° Ÿµ√ §◊ Õ §«“¡§√Õ∫§≈ÿ ¡ ·≈–§«“¡≈–‡Õ’ ¬ ¥Õà Õ π¢Õß ‡π◊È Õ À“ ·≈–ª√–‚¬™πå ∑’Ë ‡ °‘ ¥ ¢÷È π ®“°°“√π” °√–∫«π°“√„Àâ°“√ª√÷°…“‰ªª√–¬ÿ°µå„™â ∫ÿ§≈“°√ ∑’Ë»÷°…“ à«π„À≠à√–∫ÿ‡°’ˬ«°—∫‡π◊ÈÕÀ“À≈—° Ÿµ√«à“ ·ºπ°“√ Õπ∑ÿ°·ºπ¡’§«“¡§√Õ∫§≈ÿ¡∑—ÈߢâÕ¡Ÿ≈ ∑“ß ∂‘µ‘ π‚¬∫“¬ ∑ƒ…Æ’∑’ˇ°’ˬ«¢âÕß ‚¥¬‡©æ“– ∑’‡Ë °’¬Ë «°—∫°“√„Àâ°“√ª√÷°…“ ÿ¢¿“æ§√Õ∫§√—« ·≈–  —¡æ—π∏¿“æ„π§√Õ∫§√—« ∑’Ë∑—π ¡—¬·≈–‡À¡“– ¡ °—∫ ∂“π°“√≥å °“√„Àâ°“√ª√÷°…“º≈°“√µ√«® ‡≈◊Õ¥‡æ◊ËÕÀ“°“√µ‘¥‡™◊ÈÕ‡Õ™‰Õ«’µà“ß Ê ∑—Èߺ≈‡≈◊Õ¥ ª°µ‘∑—ÈߧŸà º≈‡≈◊Õ¥∫«°∑—ÈߧŸà ·≈–º≈‡≈◊Õ¥µà“ß°—π ·π«∑“ß„π°“√ªÑÕß°—π„À⧟ࠓ¡’¿√√¬“¡’º≈‡≈◊Õ¥ ‡ªìπ≈∫µ≈Õ¥‰ª °“√ªØ‘∫—µ‘µπ‡æ◊ËÕ°“√ªÑÕß°—π‚√§ √«¡∑—Èߢ—ÈπµÕπ·≈–‡∑§π‘§°“√„Àâ°“√ª√÷°…“ ‚¥¬ ‡©æ“–°“√·®âߺ≈°“√µ√«®‡≈◊Õ¥ ∑”„Àâ∑√“∫∂÷ß ªí ≠ À“¢ÕߧŸà   “¡’ ¿ √√¬“ ¡Õ߇ÀÁ π ·π«∑“ß„π °“√𔉪ªØ‘∫—µ‘·≈–·°âªí≠À“‡°’ˬ«°—∫°“√„Àâ°“√ ª√÷°…“§Ÿà “¡’¿√√¬“‰¥â ¥—ߧ”°≈à“« ç¡’§«“¡√Ÿâ ÷° ∑’Ë¥’µàÕÀ≈—° Ÿµ√°“√„Àâ∫√‘°“√ª√÷°…“·∫∫§Ÿà‡æ√“– ‰¥â ™à « ¬‡À≈◊ Õ „Àâ §Ÿà   “¡’ ¿ √√¬“‰¥â ™à « ¬°— π ·°â ‰ ¢ ªí≠À“∑”„Àâ§Ÿà‡¢â“„®°—π·≈–µ√–Àπ—°∂÷ߧ«“¡‡ ’Ë¬ß µàÕ°“√µ‘¥‡™◊ÈÕ‡Õ™‰Õ«’ ∑”„À≥⥟·≈ºŸâ√—∫∫√‘°“√ ·∫∫Õߧå√«¡é ·≈–«‘∏°’ “√Ωñ°Õ∫√¡„πÀ≈—° Ÿµ√ ‚¥¬ ‡©æ“–·ºπ°“√ Õπ∑’Ë 6, 7, 8 ∑”„Àâ ‡ °‘ ¥ ª√–‚¬™πå∑—ÈßµàÕµπ‡Õß µàÕºŸâ√—∫∫√‘°“√ ·≈–µàÕ √–∫∫ß“π ¥—ß§”°≈à“« ç∑”„Àâß“π¡’¡“µ√∞“π‡ªìπ ¢—ÈπµÕπ„π°“√¥”‡π‘πß“π ·≈–∑”ß“π‡ªìπ√–∫∫ ¡“°¢÷Èπé ¢âÕ®”°—¥¢ÕßÀ≈—° Ÿµ√´÷Ë߇ªìπ®ÿ¥∑’˵âÕß ª√—∫ª√ÿß ∫ÿ§≈“°√∑’Ë»÷°…“¡’‡æ’¬ß à«ππâÕ¬ ∑’ˉ¥â „Àâ ¢â Õ §‘ ¥ ‡ÀÁ π ‡æ‘Ë ¡ ‡µ‘ ¡ «à “ ‡π◊È Õ À“„πÀ≈— °  Ÿ µ √ §√Õ∫§≈ÿ¡ ·µà‡ªìπ·∫∫°«â“ßÊ ‰¡à¡’§” ”§—≠À√◊Õ ¢âÕ§«“¡ —ÈπÊ ∑’Ë∑”„Àâ®”‰¥âßà“¬¢÷Èπ‡¡◊ËÕ𔉪„™â 84

°√°Æ“§¡ - °—𬓬π 2555

°√¡Õπ“¡—¬ à߇ √‘¡„Àâ§π‰∑¬  ÿ¢¿“楒

”À√—∫¢âÕ®”°—¥¢Õ߇π◊ÈÕÀ“Õ◊ËπÊ ¬—ߢ“¥‡π◊ÈÕÀ“ ∫“ß à«π ‡™à𠧫“¡√Ÿâ‡°’ˬ«°—∫°“√√—°…“‚√§‡Õ¥ å „π·¡à·≈–‡¥Á°∑’Ë®”‡ªìπ ”À√—∫‡®â“Àπâ“∑’˧≈‘π‘°Ω“° §√√¿å ‡°’Ë ¬ «°— ∫ °“√„™â ¬ “ °“√ªÑ Õ ß°— π ¿“«– ·∑√°´âÕπ ·≈–¬“µâ“π‰«√— ‡Õ¥ å ‡æ‘Ë¡°“√Ωñ° ∑—°…–°“√„Àâ°“√ª√÷°…“∑’Ë ”§—≠ À√◊Õ®—¥∑”‡ªìπ À≈—° Ÿµ√‡©æ“–‡°’¬Ë «°—∫∑—°…–°“√·®âߺ≈‡≈◊Õ¥µà“ß §«√¡’µ«— Õ¬à“ß∫∑ π∑π“„π°“√„Àâ°“√ª√÷°…“ °“√ ‡√’¬π√Ÿâ®“°µ—«·∫∫‚¥¬‡©æ“–®“°«’¥’∑—»πå ·≈– §«√¡’ ° “√ª√–‡¡‘ π º≈®“°·∫∫∫— π ∑÷ ° √“¬°“√ (Check list) ·≈–§«√‡æ‘Ë¡°≈«‘∏’°“√‚πâ¡πâ“«∑’ˉ¥â º≈¡“°°«à“π’È „π°“√™—°®Ÿß “¡’¡“‡®“–‡≈◊Õ¥ ∑—Èß„π √–¥—∫¡«≈™π ·≈–√–¥—∫™ÿ¡™π„πæ◊Èπ∑’Ë ªí≠À“Õÿª √√§¥â“πºŸâ „Àâ∫√‘°“√ª√÷°…“ ∫ÿ § ≈“°√∑’Ë »÷ ° …“ ®“°‚√ß欓∫“≈∑ÿ ° √–¥— ∫  –∑âÕπ∂÷ߪí≠À“¥â“πºŸâ„Àâ∫√‘°“√¢ÕßÀπ૬ߓπ«à“ ¡’ ®”π«π∫ÿ § ≈“°√∑’Ë ‰ ¥â √— ∫ °“√Ωñ ° Õ∫√¡·≈–  “¡“√∂„Àâ∫√‘°“√ª√÷°…“πâÕ¬ ¥—ߧ”°≈à“« 纟â„Àâ ∫√‘°“√¡’‡«≈“®”°—¥ ®”π«πºŸâ√—∫∫√‘°“√¡“° 30:1 ∑”„Àâ∫√‘°“√ Couple counseling ‰¡à§√Õ∫§≈ÿ¡é ªí ≠ À“Õÿ ª  √√§¥â “ π√–∫∫∫√‘ À “√ ®—¥°“√¢ÕßÀπà«¬ß“π ®“°‚√ß欓∫“≈∑ÿ°√–¥—∫ ¡’ªí≠À“À≈“¬¥â“π‰¥â·°à 1) ¥â“πºŸâ∫√‘À“√ ºŸâ∫√‘À“√¢ÕßÀπà«¬ß“π ‰¡à‰¥â„À⧫“¡ ”§—≠·≈– π—∫ πÿπß“π„Àâ∫√‘°“√ ª√÷°…“·∫∫§Ÿà∑—Èߥâ“π∫ÿ§≈“°√ ß∫ª√–¡“≥ ·≈–  ∂“π∑’Ë ‡æ√“–‰¡à‡ªìππ‚¬∫“¬ 2) ¥â“π√–∫∫ß“π·≈–°“√ª√– “πß“π ¢“¥ °“√∫Ÿ√≥“°“√ß“π„Àâ∫√‘°“√ª√÷°…“·∫∫§Ÿà ‚¥¬∑’Ë ¬—ß¡’°“√„Àâ∫√‘°“√∑’˪√–°Õ∫¥â«¬À≈“¬¢—ÈπµÕπ ‰¡à ‡Õ◊ÈÕÕ”π«¬µàÕ°“√„Àâ∫√‘°“√ “¡’ ∑”„À⺟â√—∫∫√‘°“√ ‰¡à·πà„®„π°“√√—°…“§«“¡≈—∫¢Õßµπ 3) ¥â“π§à“„™â®à“¬ ‡™àπ §à“„™â®à“¬„π°“√ µ√«®‡≈◊Õ¥‡æ◊ÕË À“°“√µ‘¥‡™◊ÕÈ ‡Õ™‰Õ«’ „π “¡’ √“§“


°“√æ—≤π“À≈—° Ÿµ√°“√„Àâ°“√ª√÷°…“‡°’ˬ«°—∫‡Õ™‰Õ«’„π§Ÿà “¡’¿√√¬“∑’Ë¡“Ω“°§√√¿å

Ÿß ∑”„À⇪ìπ¿“√–·°àºŸâ√—∫∫√‘°“√ ·π«∑“ß·°â ‰¢¥â“π√–∫∫∫√‘À“√®—¥°“√ ¢ÕßÀπà«¬ß“π ¥—ßπ’È 1) ‡ πÕ„À⺟â∫√‘À“√√–¥—∫ Ÿß ¡’°“√√—∫·≈– ™’·È ®ßπ‚¬∫“¬∑’™Ë ¥— ‡®π ‚¥¬‡©æ“–§«√°”À𥇪ìπ π‚¬∫“¬°“√„Àâ∫√‘°“√Ω“°§√√¿å·∫∫§Ÿà ‡æ◊ËÕ„À⺟â ∫√‘À“√„Àâ°“√ π—∫ πÿπ¥â“π∑√—欓°√ 2) Àπ૬ߓπ§«√¡’°“√ª√—∫√–∫∫°“√„Àâ

∫√‘°“√∑’ˇÕ◊ÈÕµàÕ “¡’ ·≈–∫√‘°“√·∫∫ One stop service 3) §«√ª√— ∫ §à “ „™â ®à “ ¬„π°“√µ√«®‡≈◊ Õ ¥ ¢Õß “¡’ „ÀâÕ¬Ÿà„π™ÿ¥ ‘∑∏‘ª√–‚¬™πå ‡À¡◊Õπ°—∫ °“√„Àâ∫√‘°“√ªÑÕß°—π‚√§∏“≈— ´’‡¡’¬ 2.2 ¥â“πªí®®—¬π”‡¢â“ «‘∑¬“°√ ·≈– ºŸâ ‡ ¢â “ Õ∫√¡ „™â · ∫∫∑¥ Õ∫§«“¡√Ÿâ ·≈–°“√ ª√–‡¡‘πº≈À≈—ß°“√Õ∫√¡ „π√ÿàπ∑’Ë 4-6 æ∫«à“

µ“√“ß∑’Ë 1 °“√∑¥ Õ∫§«“¡√Ÿâ°àÕπ-À≈—ß°“√Õ∫√¡√ÿàπ∑’Ë 4-6 (N = 117) §–·ππ

®”π«π X

√ÿàπ∑’Ë 4

√ÿàπ∑’Ë 5

√ÿàπ∑’Ë 6

Pre-test

Post-test

Pre-test

Post-test

Pre-test

Post-test

576 18.0

691 21.6

664 17.5

809 21.3

745 15.9

1,008 21.5

§–·ππ‡©≈’ˬ (X) À≈—ß®“°°“√Õ∫√¡ ∑—Èß 3 √ÿàπ ‡æ‘Ë¡¢÷Èπ 3.6, 3.8 ·≈– 5.6 µ“¡≈”¥—∫ ¥—ß µ“√“ß∑’Ë 1 √ÿªº≈§«“¡æ÷ßæÕ„®µàÕ°“√Õ∫√¡„π¿“æ √«¡ √–¥—∫¡“°∑’Ë ÿ¥√âÕ¬≈– 41.9 √–¥—∫¡“°√âÕ¬≈– 54.8 §«“¡√Ÿâ°àÕπ°“√Õ∫√¡Õ¬Ÿà√–¥—∫ª“π°≈“ß√âÕ¬

≈– 46.3 ¡’§«“¡√ŸâÀ≈—ß°“√Õ∫√¡‡æ‘Ë¡¢÷Èπ√–¥—∫¡“° √âÕ¬≈– 71.9 «‘∑¬“°√„π°“√Õ∫√¡‡À¡“– ¡ ·≈– ≈—°…≥–°“√∂à“¬∑Õ¥§«“¡√Ÿâ‡À¡“– ¡‡∑à“°—π§◊Õ √–¥—∫¡“°∑’Ë ÿ¥√âÕ¬≈– 76.3 ·≈–‡π◊ÈÕÀ“„π°“√ Õ∫√¡‡À¡“– ¡¡“°∑’Ë ÿ¥√âÕ¬≈– 66.9 ·≈–¡“° √âÕ¬≈– 33.1 ¥—ßµ“√“ß∑’Ë 2

µ“√“ß∑’Ë 2 √ÿª√«¡§«“¡§‘¥‡ÀÁπ¢ÕߺŸâ‡¢â“Õ∫√¡ 3 √ÿàπ §◊Õ √ÿàπ∑’Ë 4 - 6 (n = 117) √–¥—∫§«“¡§‘¥‡ÀÁ𠧫“¡§‘¥‡ÀÁπ

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

ß“π∑’Ë∑à“π∑”ªí®®ÿ∫—π‡°’Ë¬«¢âÕß°—∫°“√Õ∫√¡§√—Èßπ’ȇ撬߄¥ §«“¡√Ÿâ¢Õß∑à“π°àÕπ‡¢â“√—∫°“√Õ∫√¡§√—Èßπ’È §«“¡√Ÿâ¢Õß∑à“πÀ≈—߇¢â“√—∫°“√Õ∫√¡§√—Èßπ’È ∑à“π “¡“√∂𔧫“¡√Ÿâ‰ª„™âª√–‚¬™πå„π°“√æ—≤π“ß“π «‘∑¬“°√„π°“√Õ∫√¡‡À¡“– ¡ ≈—°…≥–°“√∂à“¬∑Õ¥§«“¡√Ÿâ‡À¡“– ¡

¡“° ∑’ Ë ¥ÿ

¡“°

ª“π °≈“ß

πâÕ¬

πâÕ¬ ∑’ Ë ¥ÿ

43.4 5.4 24.7 34.0 76.3 76.3

37.7 6.3 71.9 61.5 23.7 23.7

12.9 46.3 3.4 4.5 0.0 0.0

2.6 34.1 0.0 0.0 0.0 0.0

3.4 7.9 0.0 0.0 0.0 0.0

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH

July - September 2012

85


∫ ∑ «‘ ∑ ¬ “ ° “ √ µ“√“ß∑’Ë 2 √ÿª√«¡§«“¡§‘¥‡ÀÁπ¢ÕߺŸâ‡¢â“Õ∫√¡ 3 √ÿàπ §◊Õ √ÿàπ∑’Ë 4 - 6 (n = 117)(µàÕ) √–¥—∫§«“¡§‘¥‡ÀÁ𠧫“¡§‘¥‡ÀÁπ

7. ‡π◊ÈÕÀ“„π°“√Õ∫√¡‡À¡“– ¡ 9.  ◊ËÕÕÿª°√≥å„π°“√Õ∫√¡‡À¡“– ¡ 10. √–¬–‡«≈“„π°“√Õ∫√¡‡À¡“– ¡ 11. ∑à“π¡’§«“¡æ÷ßæÕ„®µàÕ°“√Õ∫√¡„π¿“æ√«¡

2.3 ¥â“π°√–∫«π°“√ °√–∫«π°“√‡√’¬π °“√ Õπ·≈–°“√«—¥º≈ „™â·∫∫ Õ∫∂“¡¢âÕ¡Ÿ≈∑—«Ë ‰ª ·≈–°“√ π∑π“°≈ÿà¡ ‚¥¬‡ªìπºŸâ‡¢â“Õ∫√¡√ÿàπ∑’Ë 1-3 ¥—ßπ’È 1) ∫ÿ§≈“°√‡¢â“√à«¡°“√ π∑π“°≈ÿà¡ ¡“ ®“°‚√ß欓∫“≈∑ÿ°√–¥—∫ ∑—ßÈ ‚√ß欓∫“≈»Ÿπ¬å·≈– ‚√ß欓∫“≈∑—Ë«‰ª (®”π«π 8 §π) ‚√ß欓∫“≈ ™ÿ¡™π√–¥—∫ 90-120 ‡µ’¬ß (®”π«π 8 §π) ·≈– ‚√ß欓∫“≈™ÿ¡™π√–¥—∫ 10-60 ‡µ’¬ß (®”π«π 24 §π) 2) ∫ÿ§≈“°√®“°·∫∫ Õ∫∂“¡ ‡ªìπ‡æ» À≠‘ß¡’®”π«π∑—Èß ‘Èπ 40 §π æ∫«à“ ¡“®“°‚√ß æ¬“∫“≈™ÿ¡™π√–¥—∫ 10-60 ‡µ’¬ß√âÕ¬≈– 67.5 ·≈– ‡ªìπºŸâ‡¢â“√—∫°“√Õ∫√¡„π√ÿàπ∑’Ë 1 ¡“°∑’Ë ÿ¥√âÕ¬≈– 35.0 √Õß≈ß¡“§◊Õ√ÿàπ∑’Ë 3 √âÕ¬≈– 27.5 √ÿàπ∑’Ë 2 √âÕ¬ ≈– 20.0 ¡’Õ“¬ÿ√–À«à“ß 28-51 ªï (Õ“¬ÿ‡©≈’¬Ë 39.5 ªï) ‡ªìπ欓∫“≈«‘™“™’懰◊Õ∫∑—ÈßÀ¡¥  à«π„À≠à¡’ °“√»÷°…“√–¥—∫ª√‘≠≠“µ√’√âÕ¬≈– 92.5 ·≈–‡ªìπ ºŸâªØ‘∫—µ‘ß“π√âÕ¬≈– 72.5  ”À√—∫·ºπ°∑’Ë„Àâ∫√‘°“√·≈–ª√– ∫°“√≥å „Àâ∫√‘°“√ æ∫«à“  à«π„À≠àªØ‘∫—µ‘ß“π„π§≈‘π‘° Ω“°§√√¿åπÕ°®“°π—Èπ‡ªìπºŸâªØ‘∫—µ‘ß“π„πÀπ૬ ÀâÕߧ≈Õ¥·≈–ÀÕºŸâªÉ«¬À≈—ߧ≈Õ¥ Àπ૬ߓπ∑’Ë„Àâ ∫√‘°“√Ω“°§√√¿å 2 «—πµàÕ —ª¥“Àå√âÕ¬≈– 45.0 ∂÷ß 86

°√°Æ“§¡ - °—𬓬π 2555

°√¡Õπ“¡—¬ à߇ √‘¡„Àâ§π‰∑¬  ÿ¢¿“楒

¡“° ∑’ Ë ¥ÿ

¡“°

ª“π °≈“ß

πâÕ¬

πâÕ¬ ∑’ Ë ¥ÿ

66.9 31.5 30.2 41.9

33.1 51.8 52.6 54.8

0.0 12.3 13.5 3.3

0.0 4.4 3.7 0.0

0.0 0.0 0.0 0.0

·¡â «à “ à « π„À≠à √ –∫ÿ «à “ ¡’ ª √– ∫°“√≥å „ Àâ ∫ √‘ ° “√ ª√÷°…“„π§≈‘π°‘ Ω“°§√√¿å·µà¬ß— æ∫«à“ √âÕ¬≈– 22.5 ‡ªìπºŸ∑â ‰’Ë ¡à‡§¬„Àâ∫√‘°“√∑’§Ë ≈‘π°‘ Ω“°§√√¿å ∫ÿ§≈“°√ ∑’ËÕ¬Ÿà„πÀπ૬ߓπ‡ªî¥„Àâ∫√‘°“√Ω“°§√√¿å·∫∫§Ÿà √âÕ¬≈– 62.5 ¡’ª√– ∫°“√≥å„Àâ∫√‘°“√ª√÷°…“ ·∫∫§ŸàπâÕ¬°«à“ 1 ªï √âÕ¬≈– 55.0 ·≈–¡’°“√„Àâ ∫√‘°“√¡“°°«à“ 5 §Ÿµà Õà «—π¡“°∑’ Ë ¥ÿ √âÕ¬≈– 32.0 ¥—ß µ“√“ß∑’Ë 3 2.4 ¥â“πº≈º≈‘µ·≈–º≈≈—æ∏å „™â·∫∫ √“¬ß“π°“√‡°Á∫¢âÕ¡Ÿ≈ º≈°“√¥”‡π‘ π ß“π„Àâ ∫ √‘ ° “√ª√÷ ° …“„π §≈‘π‘°Ω“°§√√¿å ®”π«π 40 ·Ààß ´÷Ëß¡’∑—Èß‚√ß æ¬“∫“≈»Ÿ π ¬å / ∑—Ë « ‰ª/™ÿ ¡ ™π ‡ªî ¥ „Àâ ∫ √‘ ° “√ ª√÷°…“À≠‘ßµ—Èߧ√√¿å·≈–§Ÿà ¡√ ∑’Ë¡“Ω“°§√√¿å §√—Èß·√° 25 ·Ààߧ‘¥‡ªìπ√âÕ¬≈– 62.5  à«πÕ’° 15 ·Àà߬—߉¡à‰¥â‡ªî¥„Àâ∫√‘°“√ √–∫ÿ “‡Àµÿ §◊Õ ¡’ ∫ÿ§≈“°√‰¡à‡æ’¬ßæÕ 4 ·Ààß °“√„Àâ∫√‘°“√Ω“° §√√¿å·∫∫§Ÿ‰à ¡àµ√ß°—∫π‚¬∫“¬¢ÕߺŸ∫â √‘À“√ 2 ·Ààß ‰¡à¡’ºŸâ√—∫º‘¥™Õ∫‚¥¬µ√߇π◊ËÕß®“°‡ª≈’ˬπß“π·≈– ∫“ß·Àà߉¡à¡’ºŸâ√—∫∫√‘°“√∑’Ë¡’ “¡’¡“¥â«¬ 9 ·Ààß  ”À√—∫ ∂“π∫√‘°“√∑’Ë„Àâ∫√‘°“√·≈â« (n = 25) π—Èπ æ∫«à“ ¡’§«“¡æ√âÕ¡·≈– “¡“√∂„Àâ∫√‘°“√ª√÷°…“ ‡°’Ë ¬ «°“√µ‘ ¥ ‡™◊È Õ ‡Õ™‰Õ«’ / ‡Õ¥ å  ”À√— ∫ À≠‘ ß µ—È ß §√√¿å·≈–§Ÿà ¡√  ®”π«π 3,242 §Ÿà ®“°®”π«π


°“√æ—≤π“À≈—° Ÿµ√°“√„Àâ°“√ª√÷°…“‡°’ˬ«°—∫‡Õ™‰Õ«’„π§Ÿà “¡’¿√√¬“∑’Ë¡“Ω“°§√√¿å

µ“√“ß∑’Ë 3 ®”π«π·≈–√âÕ¬≈–¢Õß∫ÿ§≈“°√ ®”·π°µ“¡¢âÕ¡Ÿ≈∑—Ë«‰ª‡°’ˬ«°—∫°“√„Àâ∫√‘°“√„π §≈‘π°‘ Ω“°§√√¿å ®”π«π«—π∑’„Ë Àâ∫√‘°“√ √–¬–‡«≈“∑’ªË Ø‘∫µ— ß‘ “π„π§≈‘π°‘ Ω“°§√√¿å Àπ૬ ß“π¡’°“√‡ªî¥„Àâ∫√‘°“√Ω“°§√√¿å·∫∫§Ÿà ª√– ∫°“√≥å„π°“√„Àâ∫√‘°“√Ω“°§√√¿å·∫∫§Ÿà ·≈– ®”π«πºŸâ¡“√—∫∫√‘°“√Ω“°§√√¿å·∫∫§Ÿà æ.». 2551 ¢âÕ¡Ÿ≈∑—«Ë ‰ª

®”π«π (n= 40) √âÕ¬≈– 100.0

‡ªìπ∫ÿ§≈“°√ºŸâ„Àâ∫√‘°“√„π§≈‘π‘°Ω“°§√√¿å ®”π«π«—π∑’Ë„Àâ∫√‘°“√ (§√—ÈßµàÕ —ª¥“Àå) 1 «—π 2 «—π 3 «—π 5 «—π √–¬–‡«≈“∑’˪ؑ∫—µ‘ß“π„π§≈‘π‘°Ω“°§√√¿å ‰¡à‡§¬„Àâ∫√‘°“√∑’˧≈‘π‘°Ω“°§√√¿å πâÕ¬°«à“ 1 ªï 1 - 2 ªï 3 - 4 ªï ¡“°°«à“ 5 ªï ∫ÿ§≈“°√∑’Ë¡’ª√– ∫°“√≥å„π°“√„Àâ∫√‘°“√Ω“°§√√¿å·∫∫§Ÿà ‰¡à¡’ª√– ∫°“√≥å ¡’ª√– ∫°“√≥å¡“·≈â«πâÕ¬°«à“ 1 ªï ¡’ª√– ∫°“√≥å¡“·≈â«¡“°°«à“ 1 ªï ∫ÿ§≈“°√∑’ËÕ¬Ÿà„πÀπ૬ߓπ‡ªî¥„Àâ∫√‘°“√Ω“°§√√¿å·∫∫§Ÿà ®”π«πºŸâ¡“√—∫∫√‘°“√Ω“°§√√¿å·∫∫§Ÿà (§ŸàµàÕ«—π) 1 - 2 §Ÿà 3 - 5 §Ÿà ¡“°°«à“ 5 §Ÿà „Àâ∫√‘°“√ª√÷°…“Ω“°§√√¿å‡ªìπ√“¬°≈ÿà¡

À≠‘ßµ—Èߧ√√¿å√“¬„À¡à∑—ÈßÀ¡¥„π™à«ß‡«≈“‡¥’¬«°—π 12,765 §π §‘¥‡ªìπ√âÕ¬≈– 25.4 ´÷Ëß„π®”π«ππ’È¡’ ‡æ’¬ß√âÕ¬≈– 57.9 ∑’˧Ÿà “¡’¿√√¬“µ√«®‡≈◊Õ¥À“ °“√µ‘¥‡™◊ÈÕ‡Õ™‰Õ«’æ√âÕ¡°—π ·≈–æ∫«à“„π§Ÿà “¡’ ¿√√¬“∑’Ë¡“¬Õ¡µ√«®À“°“√µ‘¥‡™◊ÈÕ‡Õ™‰Õ«’æ√âÕ¡ °—π∑—ÈߧŸàπ’ȇ°◊Õ∫∑ÿ°§Ÿà¡“øíߺ≈‡≈◊Õ¥æ√âÕ¡°—π√âÕ¬≈–

38

95.0

15 18 2 5

37.5 45.0 5.0 12.5

9 3 10 7 11

22.5 7.5 25.0 17.5 27.5

15 22 3 25 n= 25 7 5 8 5

37.5 55.0 7.5 62.5 √âÕ¬≈– 100.0 28.0 20.0 32.0 20.0

98.7 æ∫§Ÿà “¡’¿√√¬“∑’Ë¡’º≈°“√µ√«®‡≈◊Õ¥µ‘¥‡™◊ÈÕ ‡Õ™‰Õ«’∑—Èß ‘Èπ√âÕ¬≈– 3.3 ‚¥¬º≈‡≈◊Õ¥∫«°∑—ÈߧŸà √âÕ¬≈– 1.0 ‡ªìπ§Ÿà “¡’¿√√¬“∑’Ë¡’º≈‡≈◊Õ¥µà“ß√âÕ¬ ≈– 2.3 ´÷ßË ¿√√¬“¡’º≈°“√µ√«®æ∫°“√µ‘¥‡™◊ÕÈ ‡Õ™ ‰Õ«’„π —¥ à«π∑’Ë¡“°°«à“ “¡’ 1.3 : 1 ¥—ßµ“√“ß∑’Ë 4 º≈°“√«‘®—¬§√—Èßπ’È ‡ªìπª√–‚¬™πå ”À√—∫ºŸâ

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH

July - September 2012

87


∫ ∑ «‘ ∑ ¬ “ ° “ √ µ“√“ß∑’Ë 4 º≈°“√„Àâ∫√‘°“√Ω“°§√√¿å·∫∫§Ÿà „π ∂“π∫√‘°“√ ÿ¢¿“æ 25 ·Ààß æ.».2551 √“¬°“√

®”π«π (§Ÿà)

√âÕ¬≈–

®”π«πÀ≠‘ßΩ“°§√√¿å√“¬„À¡à∑—ÈßÀ¡¥ 12,765 §π(„π™à«ß‡«≈“‡¥’¬«°—π) 1. ®”π«π§Ÿà “¡’¿√√¬“√“¬„À¡à∑’Ë¡“√—∫∫√‘°“√ª√÷°…“‡ªìπ§Ÿà§√—Èß·√° 2. ®“°¢âÕ 1 ®”π«π “¡’∑’ˉ¡à¬Õ¡µ√«®‡≈◊Õ¥À“ HIV „Àâ¿√√¬“µ√«®§π‡¥’¬« 3. ®“°¢âÕ 1 ®”π«π§Ÿà “¡’¿√√¬“∑’ˬաµ√«®‡≈◊Õ¥À“ HIV æ√âÕ¡°—π∑—ÈߧŸà 3.1 ®“°¢âÕ 3 º≈°“√µ√«®‡≈◊Õ¥À“ HIV ≈∫∑—ÈߧŸà 3.2 ®“°¢âÕ 3 º≈°“√µ√«®‡≈◊Õ¥À“ HIV ∫«°∑—ÈߧŸà 3.3 ®“°¢âÕ 3 º≈°“√µ√«®‡≈◊Õ¥À“ HIV  “¡’∫«° ¿√√¬“≈∫ 3.4 ®“°¢âÕ 3 º≈°“√µ√«®‡≈◊Õ¥À“ HIV ¿√√¬“∫«°  “¡’≈∫ 4. ®“°¢âÕ 3 ®”π«π§Ÿà “¡’¿√√¬“∑’ˬաøíߺ≈°“√µ√«®‡≈◊Õ¥ HIV æ√âÕ¡°—π 5. ®“°¢âÕ 3 ®”π«π§Ÿà “¡’¿√√¬“∑’Ëøíߺ≈°“√µ√«®‡≈◊Õ¥ HIV ∑’Ë≈–§π

3,242 3,242 1,364 1,878 1,816 18 19 25 1,853 25

25.4 100.0 42.1 57.9 96.7 1.0 1.0 1.3 98.7 1.3

„Àâ∫√‘°“√ª√÷°…“‡°’ˬ«°—∫‡Õ™‰Õ«’„π§Ÿà “¡’¿√√¬“ ∑’Ë¡“Ω“°§√√¿å „π°“√𔧫“¡√Ÿâ∑’ˉ¥â√—∫®“°°“√ Ωñ°Õ∫√¡‰ª„™â„π°“√„Àâ∫√‘°“√®√‘ß„πÀπ૬ߓπ ∑”„À⧟ࠓ¡’¿√√¬“∑’˺≈‡≈◊Õ¥∫«°∑—ÈߧŸà ·≈–º≈ ‡≈◊Õ¥µà“ß°—𠉥âªÕÑ ß°—π°“√·æ√à°√–®“¬‡™◊ÕÈ ‡Õ™‰Õ«’ ·≈–§√Õ∫§√—«¡’§ÿ≥¿“æ™’«‘µ∑’Ë¥’¬‘Ëߢ÷Èπ

¢âÕ‡ πÕ·π–„π°“√π”º≈«‘®—¬‰ª„™â 1. ºŸâ„Àâ∫√‘°“√§≈‘π‘°Ω“°§√√¿å “¡“√∂π” À≈—° Ÿµ√‰ª„™â‡ªìπ§Ÿà¡◊Õ‡æ◊ËÕ‡æ‘Ë¡ª√– ‘∑∏‘¿“æ„π °“√„Àâ∫√‘°“√°“√ª√÷°…“‡°’ˬ«°—∫‡Õ™‰Õ«’„π§Ÿà “¡’ ¿√√¬“∑’Ë¡“Ω“°§√√¿å 2.  ”À√—∫»Ÿπ¬åÕπ“¡—¬‡¢µÀ√◊ÕÀπ૬ߓπ Õ◊Ëπ∑’˵âÕß°“√π”À≈—° Ÿµ√‰ª„™â§«√ª√—∫‡π◊ÈÕÀ“„π

·ºπ°“√ Õπ„Àâ‡À¡“– ¡°—∫∫√‘∫∑¢Õß®—ßÀ«—¥„π ‡¢µæ◊Èπ∑’Ë√—∫º‘¥™Õ∫

°‘µµ‘°√√¡ª√–°“» §≥–ºŸâ«‘®—¬¢Õ¢Õ∫æ√–§ÿ≥ ºŸâ∑’Ë∑”„Àâº≈ ß“π«‘®—¬©∫—∫π’È ”‡√Á®≈߉¥â §◊Õ »“ µ√“®“√¬å 𓬷æ∑¬å ÿæ√ ‡°‘¥ «à“ß ∑’Ë„À⧫“¡√Ÿâ‡π◊ÈÕÀ“«‘™“ °“√°“√Ω“°§√√¿å · ∫∫§Ÿà ºŸâ ™à « ¬»“ µ√“®“√¬å ¥√.√— ™ π’ ¿ √≥å ∑√— æ ¬å ° √“ππ∑å §≥∫¥’ § ≥– 欓∫“≈»“ µ√å ¡À“«‘∑¬“≈—¬∫Ÿ√æ“ ∑’Ë„À⧫“¡ √à«¡¡◊Õ∑“ß«‘™“°“√ ·≈–𓬷æ∑¬å™—¬æ√ æ√À¡  ‘ ß Àå ºŸâ Õ”π«¬°“√»Ÿ π ¬å Õ π“¡— ¬ ∑’Ë 3 ∑’Ë „ Àâ ° “√  π—∫ πÿπ„π°“√¥”‡π‘π°‘®°√√¡µà“ßÊ ‡ªìπÕ¬à“ߥ’

‡Õ° “√Õâ“ßÕ‘ß 1. Sawatphanit, W., Ross, R., & Suwansujarid, T. A paper presented at the 30th Midwest Nursing Research Society Conference. Hilton Milwaukee City Center, Milwaukee, WI. çImprovement of Selfesteem and HIV Transmission Prevention Behaviors among Seropositive Postpartum Thai Women.é Action Research, April 2;2006.

88

°√°Æ“§¡ - °—𬓬π 2555

°√¡Õπ“¡—¬ à߇ √‘¡„Àâ§π‰∑¬  ÿ¢¿“楒


°“√æ—≤π“À≈—° Ÿµ√°“√„Àâ°“√ª√÷°…“‡°’ˬ«°—∫‡Õ™‰Õ«’„π§Ÿà “¡’¿√√¬“∑’Ë¡“Ω“°§√√¿å

2. Ko, N.Y., Lee, H.C., Hsu, S.T., Wang, W.L., Huang, M.C., Ko, W.C. Differences in HIV disclosure by modes of transmission in Taiwanese families. AIDS Care. 2007; 19(6):791-8. 3. Sawatphanit, W., Ross, R., & Suwansujarid, T. Development of self-esteem among HIV positive pregnant women in Thailand. Action research. Journal of Science,Technology, and Humanities. 2004; 2(2), 55-69. 4. Ross, R., Sawatphanit, W., Suwansujarid, T., & Draucker,C.B. Life Story of and depression in an HIVPositive Pregnant Thai Woman who was a Former Sex Worker: Case Study. Archives of Psychiatric Nursing. (2007); 21(1), 32-39. 5. Ross, R., Sawatphanit, W., Drauker, C., & Suwansujarid, T. The lived experiences of HIV-positive pregnant women in Thailand. Health Care for Women International. 2007; 28(8),731-744. 6. Sawatphanit, W. HIV Infected women caring model for Self-esteem promotion :A new vision and implication for practitioner. Journal of Faculty of Nursing Burapha University.2005; 13(3),1-9. 7. Friedman, M.M., Bowden, V.R., & Jones, E.G. Family nursing: Research, Theory, and Practice. 5th ed.. New Jersey : Upper Saddle River; 2003. 8. Wright, L.M., & Leahey, M. Nurses and Families: A guide to family assessment and intervention.3rd ed. Philadelphia : FA. Davis; 2000. 9. Wright, L.M., & Leahey, M. Nurings and Families: A guide to family assessment and intervention.5th ed. Philadelphia : FA. Davis; 2009. 10. Kemmis & Mc Taggart. The Action research planner.3rd ed. Victoria : Deakin University; 1990. 11. «‘‰≈æ√√≥ «— ¥‘Ïæ“≥‘™¬å. °“√欓∫“≈¡“√¥“µ‘¥‡™◊ÈÕ‡Õ™‰Õ«’. ™≈∫ÿ√’ : »√’»‘≈ª; 2549. 12. √ÿ®“ ¿Ÿà‰æ∫Ÿ≈¬å. °“√欓∫“≈§√Õ∫§√—« : ·π«§‘¥ ∑ƒ…Æ’ ·≈–°“√𔉪„™â. æ‘¡æå§√—Èß∑’Ë 3. °√ÿ߇∑æœ : «’ ‡® æ√‘Èπµ‘Èß; 2541. 13.  ÿæ√ ‡°‘¥ «à“ß. °“√„Àâ°“√ª√÷°…“. æ‘¡æå§√—Èß∑’Ë 2. °√ÿ߇∑æœ : ∫√‘…—∑ “¡‡®√‘≠æ“≥‘™¬å; 2546. 14. Õÿ¡“æ√ µ√—ߧ ¡∫—µ‘. ®‘µ«‘∑¬“™’«‘µ§Ÿà·≈–°“√∫”∫—¥§Ÿà ¡√ . °√ÿ߇∑æœ : ´—πµâ“°“√æ‘¡æå;2545. 15. ∫√√æµ  ÿ«√√≥ª√–‡ √‘∞. °“√æ—≤π“À≈—° Ÿµ√‚¥¬‡πâπºŸ‡â √’¬π‡ªì𠔧—≠. ‡™’¬ß„À¡à : The Knowledge Center; 2544. 16. »‘√‘æ√ ®‘√«—≤πå°ÿ≈. °“√«‘®—¬‡™‘ߧÿ≥¿“æ„π«‘™“™’æ°“√欓∫“≈. ¢Õπ·°àπ : »‘√‘¿—≥±å ÕÕø‡´Á∑; 2548. 17.  ÿ¿“ß§å ®—π∑«“π‘™. °“√«‘ ‡ §√“–Àå ¢â Õ ¡Ÿ ≈ „π°“√«‘ ®— ¬ ‡™‘ ß §ÿ ≥ ¿“æ .æ‘¡æå§√—Èß∑’Ë 2. °√ÿ߇∑æœ: ”π—°æ‘¡æå·Ààß ®ÿÓ≈ß°√≥å¡À“«‘∑¬“≈—¬; 2542. HEALTH

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH

July - September 2012

89

การพัฒนาหลักสูตรการให้คำปรึกษาเกี่ยวกับ เอช ไอ วี ในคู่สามีภรรยาที่มาฝากครรภ์  

วารสารการส่งเสริมสุขภาพและอนามัยสิ่งแวดล้อม ปีที่ 35 ฉบับที่ 3 กค.-กย.55

Read more
Read more
Similar to
Popular now
Just for you