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π‘æπ∏åµâπ©∫—∫

Original Article

∫∑§—¥¬àÕ °“√¥”‡π‘πß“π‡°’Ë¬«°—∫‰¢âÀ«—¥π° µâÕßÕ“»—¬æ≈—ß®“°∑ÿ°¿“§ à«π¡“√à«¡°—πÕ¬à“ß®√‘ß®—ß °“√»÷°…“π’È¡’

«—µ∂ÿª√– ß§å ‡æ◊ËÕ»÷°…“√–¥—∫§«“¡√Ÿâ·≈–°“√¡’ à«π√à«¡‡°’Ë¬«°—∫‰¢âÀ«—¥π°¢ÕßÕ“ “ ¡—§√ “∏“√≥ ÿ¢ ·≈–

™àÕß∑“ß°“√ ◊ËÕ “√∑’Ë‡À¡“– ¡„π°“√‡æ‘Ë¡æŸπ§«“¡√Ÿâ·≈–°“√¡’ à«π√à«¡¥—ß°≈à“« „πæ◊Èπ∑’ËÕ”‡¿Õ·¡à«“ß ®—ßÀ«—¥

‡™’¬ß„À¡à ‚¥¬„™â√Ÿª·∫∫°“√«‘®—¬‡™‘ß ”√«® „π™à«ß‡¥◊Õπ¡‘∂ÿπ“¬π-æƒ»®‘°“¬π 2550 ÿà¡µ—«Õ¬à“ß·∫∫ multistage ®“°µ”∫≈·≈–À¡Ÿà∫â“πµà“ß Ê ·≈–‡°Á∫√«∫√«¡¢âÕ¡Ÿ≈®“°Õ“ “ ¡—§√ “∏“√≥ ÿ¢ ®”π«π 254 §π º≈°“√»÷°…“ æ∫«à“ °≈ÿà¡µ—«Õ¬à“ß¡’§«“¡√Ÿâ‡√◊ËÕß‰¢âÀ«—¥π°„π√–¥—∫ Ÿß (x=6.91, SD 1.58, range=0-9) ·≈–

°“√¡’ à«π√à«¡°ÁÕ¬Ÿà„π√–¥—∫ Ÿß‡™àπ°—π (x=20.71, SD 7.25, range=0-30) °≈ÿà¡µ—«Õ¬à“ß‰¥â√—∫¢âÕ¡Ÿ≈¢à“«

“√‡√◊ËÕß‰¢âÀ«—¥π°®“°‡®â“Àπâ“∑’Ë “∏“√≥ ÿ¢¡“° ÿ¥ (78.3%) √Õß≈ß¡“§◊Õ ‚∑√∑—»πå (66.5%) ·À≈àß

¢âÕ¡Ÿ≈¢à“« “√®“°‚∑√∑—»πå ¡’§«“¡ —¡æ—π∏å°—∫√–¥—∫§«“¡√Ÿâ‡√◊ËÕß‰¢âÀ«—¥π°¢ÕßÕ“ “ ¡—§√ “∏“√≥ ÿ¢Õ¬à“ß

¡’π—¬ ”§—≠∑“ß ∂‘µ‘ (p<0.001) ·≈–·À≈àß¢âÕ¡Ÿ≈¢à“« “√®“°‡®â“Àπâ“∑’Ë “∏“√≥ ÿ¢ ™¡√¡Õ“ “ ¡—§√

“∏“√≥ ÿ¢·≈–ÀÕ°√–®“¬¢à“« ¡’§«“¡ —¡æ—π∏å°—∫√–¥—∫°“√¡’ à«π√à«¡¥”‡π‘πß“π‰¢âÀ«—¥π°¢ÕßÕ“ “ ¡—§√

“∏“√≥ ÿ¢Õ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘µ‘ (p<0.001, p=0.005 ·≈– p=0.010 µ“¡≈”¥—∫) ·µà§«“¡√Ÿâ·≈–°“√¡’

à«π√à«¡‡°’Ë¬«°—∫‰¢âÀ«—¥π° ‰¡à¡’§«“¡ —¡æ—π∏å°—πÕ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘µ‘ ¥—ßπ—Èπ °“√‡ √‘¡ √â“ßæ≈—ßÕ“ “ ¡—§√ “∏“√≥ ÿ¢À√◊Õ™ÿ¡™π ‡æ◊ËÕ°“√¥”‡π‘πß“π‡°’Ë¬«°—∫‰¢âÀ«—¥π° ®÷ß§«√æ‘®“√≥“‡≈◊Õ°™àÕß∑“ß°“√ ◊ËÕ “√

·≈–‡≈◊Õ°„™â°≈‰°∑’Ë‡À¡“– ¡°—∫¿“√°‘®·µà≈–‡√◊ËÕß¥—ß°≈à“«

§” ”§—≠: ‰¢âÀ«—¥π°, ™àÕß∑“ß°“√ ◊ËÕ “√, Õ“ “ ¡—§√ “∏“√≥ ÿ¢, §«“¡√Ÿâ, °“√¡’ à«π√à«¡, °“√ªÑÕß°—π§«∫§ÿ¡

Õ‘∑∏‘æ≈·À≈àß¢âÕ¡Ÿ≈¢à“« “√µàÕ√–¥—∫§«“¡√Ÿâ·≈–

°“√¡’ à«π√à«¡ªÑÕß°—π§«∫§ÿ¡‚√§‰¢âÀ«—¥π°

°√≥’»÷°…“„π°≈ÿà¡Õ“ “ ¡—§√ “∏“√≥ ÿ¢

Õ”‡¿Õ·¡à«“ß ®—ßÀ«—¥‡™’¬ß„À¡à

ÿæ®πå ‡®√‘≠æ√*

¿“§¿Ÿ¡‘ ∏“«ß§å**

« ÿ∏√ µ—π«—≤π°ÿ≈***

* ”π—°ß“π “∏“√≥ ÿ¢Õ”‡¿Õ·¡à«“ß ‡™’¬ß„À¡à

** ”π—°ß“π “∏“√≥ ÿ¢®—ßÀ«—¥‡™’¬ß„À¡à

***§≥– “∏“√≥ ÿ¢»“ µ√å ¡À“«‘∑¬“≈—¬∫Ÿ√æ“ ™≈∫ÿ√’

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Journal of Health Science 2009 Vol. 18 No. 1

106 ∫∑π”

‚√§‰¢âÀ«—¥π°(avian influenza À√◊Õ™◊ËÕ “¡—≠ bird flu) ‡ªìπ‚√§µ‘¥µàÕ®“° —µ«å¡“ Ÿà§π∑’Ë°”≈—ß‡ªìπªí≠À“

§ÿ°§“¡™’«‘µ¡πÿ…¬å ‚¥¬‡ªìπ‚√§∑’Ë‡°‘¥®“°‡™◊ÈÕ‰«√— Influ- enza A ∑’Ë∑”„Àâ‡°‘¥‚√§„π —µ«å ‚¥¬‡©æ“– —µ«åªï°∑’Ë¡’

°“√√–∫“¥„πÀ≈“¬ª√–‡∑»¡“‡ªìπ‡«≈“π“π^(1-5) ·µà

‡™◊ÈÕ‰¢âÀ«—¥π° A (H5N1) ‡ªìπ‡™◊ÈÕ∑’Ë√ÿπ·√ß “¡“√∂

·æ√àµ‘¥µàÕ¡“¬—ß§π‰¥â ´÷Ëß¡’√“¬ß“π§√—Èß·√°„π æ.». 2540

∑’Ëª√–‡∑»ŒàÕß°ß ∑”„Àâ§πµ‘¥‡™◊ÈÕ 18 §π ·≈–‡ ’¬™’«‘µ 6 §π „π æ.». 2542 ¡’°“√√–∫“¥„πŒàÕß°ß “∏“√≥√—∞

ª√–™“™π®’π ·≈–‡π‡∏Õ√å·≈π¥å ·≈–„π æ.». 2547 ‡°‘¥

°“√√–∫“¥„π —µ«åªï°„πÀ≈“¬ª√–‡∑»·∂∫‡Õ‡™’¬^(1,2) ”À√—∫ª√–‡∑»‰∑¬ ¡’°“√√–∫“¥¢Õß‰«√— ‰¢âÀ«—¥- π°‡°‘¥¢÷Èπ‡ªìπ√–¬– Ê §◊Õ„π™à«ß‡¥◊Õπ °ÿ¡¿“æ—π∏å-¡’π“§¡

2547 ¡’ºŸâªÉ«¬ 12 √“¬ ‡ ’¬™’«‘µ 8 √“¬ ™à«ß‡¥◊Õπ

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ºŸâªÉ«¬ 5 √“¬ ‡ ’¬™’«‘µ 2 √“¬ æ.». 2549 æ∫ºŸâªÉ«¬ 3

√“¬ ‡ ’¬™’«‘µ 3 √“¬^(1,2,6,7)

®“°°“√»÷°…“∑“ß√–∫“¥«‘∑¬“¢Õß ”π—°ß“π “∏“√≥ ÿ¢®—ßÀ«—¥‡™’¬ß„À¡à „π æ.». 2547-2549 ‰¡à¡’

√“¬ß“πºŸâªÉ«¬‚√§‰¢âÀ«—¥π° ·µàæ∫°“√ªÉ«¬·≈–µ‘¥‡™◊ÈÕ

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µ√«®æ∫‡™◊ÈÕ„π —µ«åªï°„πæ◊Èπ∑’Ë 2 µ”∫≈ §◊Õ µ”∫≈¥Õπ

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§ « ∫ §ÿ ¡ ‚ √ § Õ ¬à “ ß ‡ ªì π √ – ∫ ∫ √ « ¡ ∂÷ ß ° “ √ °” À π ¥

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Õ“°“√ªÉ«¬¢Õß§π∑’ËªÉ«¬‡ªìπ‚√§‰¢âÀ«—¥π° 182 (71.7) 72 (28.3) 0.72 0.45

“√∑’Ë„™â‚√¬‡æ◊ËÕ¶à“‡™◊ÈÕ‚√§„π°“√Ωíß∑”≈“¬´“° —µ«åªï° 214 (84.3) 40 (15.7) 0.84 0.37

∑’Ëµ“¬¥â«¬‚√§‰¢âÀ«—¥π°

«‘∏’°“√∑”≈“¬ —µ«åªï°∑’ËªÉ«¬À√◊Õµ“¬¥â«¬‚√§‰¢âÀ«—¥π° 251 (98.8) 3 (1.2) 0.99 0.11

ºŸâ∑’Ë§«√¡’∫∑∫“∑‡°’Ë¬«°—∫‰¢âÀ«—¥π° 151 (59.4) 103 (40.6) 0.59 0.49

√ÿª√«¡ ™à«ß§–·ππ 0-9, §–·ππ‡©≈’Ë¬ =6.91, ¡—∏¬∞“π =7.0, ∞“ππ‘¬¡ =8.0, à«π‡∫’Ë¬ß‡∫π¡“µ√∞“π =1.58, §–·ππµË” ÿ¥ =0, §–·ππ Ÿß ÿ¥ =9

*§–·ππ‡©≈’Ë¬¢Õß§«“¡√Ÿâ·µà≈–¢âÕ Àπà«¬‡ªìπ§–·ππ

(4)

108

µ“√“ß∑’Ë 2 °“√¡’ à«π√à«¡‡°’Ë¬«°—∫‚√§‰¢âÀ«—¥π° ·≈–§–·ππ‡©≈’Ë¬°“√¡’ à«π√à«¡ ¢Õß°≈ÿà¡µ—«Õ¬à“ß (n = 254 √“¬)

√–¥—∫°“√¡’ à«π√à«¡ n (%)

°“√¡’ à«π√à«¡ªÑÕß°—π·≈–§«∫§ÿ¡‚√§‰¢âÀ«—¥π° xxxx*x SD

∑ÿ°§√—Èß ‡ªìπ∫“ß§√—Èß ‰¡à‡§¬‡≈¬

°“√¡’ à«π√à«¡§âπÀ“ªí≠À“·≈–°“√µ—¥ ‘π„®

√à«¡ª√–™“§¡ À√◊Õª√–™ÿ¡ª√–®”‡¥◊Õπ ¢ÕßÀ¡Ÿà∫â“π 154 (60.6) 78 (30.7) 22 (8.7) 1.52 0.65

√à«¡æŸ¥§ÿ¬ªí≠À“‚√§‰¢âÀ«—¥π°¢ÕßÀ¡Ÿà∫â“π 109(42.9) 106 (41.7) 39 (15.4) 1.28 0.71

√à«¡§âπÀ“ À√◊Õ ”√«® —µ«åªï°„πÀ¡Ÿà∫â“π 138(54.3) 80 (31.5) 36 (14.2) 1.40 0.73

√à«¡· ¥ß§«“¡§‘¥‡ÀÁπ À√◊Õ„Àâ¢âÕ‡ πÕ·π–«‘∏’°“√ªÑÕß°—π 112(44.1) 102 (40.2) 40 (15.7) 1.28 0.72

·≈–§«∫§ÿ¡‚√§‰¢âÀ«—¥π°¢ÕßÀ¡Ÿà∫â“π

√à«¡µ—¥ ‘π„® °”Àπ¥°Æ¢ÕßÀ¡Ÿà∫â“π ‡æ◊ËÕ°“√ªÑÕß°—π 112(44.1) 91 (35.8) 51 (20.1) 1.24 0.77

·≈–§«∫§ÿ¡‚√§‰¢âÀ«—¥π°

°“√¡’ à«π√à«¡¥”‡π‘π°“√ªÑÕß°—π§«∫§ÿ¡‚√§‰¢âÀ«—¥π°

π—∫ πÿπ„Àâ§«“¡√Ÿâ‡√◊ËÕß‰¢âÀ«—¥π° ∑“ßÀÕ°√–®“¬¢à“« 140(55.1) 75 (29.5) 39 (15.4) 1.40 0.74

„Àâ§«“¡√à«¡¡◊ÕæàππÈ”¬“‡§¡’‡æ◊ËÕ¶à“∑”≈“¬‡™◊ÈÕ‚√§ 141(55.5) 71 (28.0) 42 (16.5) 1.39 0.76

‰¢âÀ«—¥π°„πÀ¡Ÿà∫â“π / µ”∫≈

™—°™«π≠“µ‘æ’ËπâÕß À√◊Õ‡æ◊ËÕπ∫â“π„Àâ√à«¡ ”√«® —µ«åªï° 161(63.4) 74 (29.1) 19 (7.5) 1.56 0.63

„πÀ≈—ß§“‡√◊Õπ¢Õßµπ‡Õß / À¡Ÿà∫â“π

√à«¡√≥√ß§åªÑÕß°—π·≈–§«∫§ÿ¡‚√§‰¢âÀ«—¥π°„πæ◊Èπ∑’Ë 155(61.0) 77 (30.3) 22 (8.7) 1.52 0.65

°“√¡’ à«π√à«¡√—∫ª√–‚¬™πå

∑à“π·≈–§√Õ∫§√—«‰¥âÕ“»—¬Õ¬Ÿà„πÀ¡Ÿà∫â“π∑’Ëª≈Õ¥¿—¬ 182(71.7) 38 (15.0) 34 (13.4) 1.58 0.72

®“°‚√§‰¢âÀ«—¥π°

≠“µ‘æ’ËπâÕß / ≈Ÿ°À≈“π ·≈– ¡“™‘°„π§√Õ∫§√—« 147(57.9) 29 (11.4) 78 (30.7) 1.27 0.90

‰¡àªÉ«¬‡ªìπ‚√§‰¢âÀ«—¥π°

—µ«åªï° / —µ«å‡≈’È¬ß¢Õß∑à“π ‰¡àªÉ«¬À√◊Õµ“¬ 143 (56.3) 29 (11.4) 82 (32.3) 1.24 0.91

®“°°“√‡ªìπ‚√§‰¢âÀ«—¥π°

°“√¡’ à«π√à«¡µ‘¥µ“¡ª√–‡¡‘πº≈

‡§¬‡¢â“√à«¡ª√–‡¡‘πº≈°“√ ”√«® —µ«åªï°„πÀ¡Ÿà∫â“π / 143(56.3) 71 (28.0) 40 (15.7) 1.41 0.75 µ”∫≈À√◊Õ„π‡¢µ√—∫º‘¥™Õ∫

‡§¬√à«¡ª√–‡¡‘πº≈°“√„Àâ§«“¡√Ÿâ‚√§‰¢âÀ«—¥π°∑“ßÀÕ 123(48.4) 74 (29.1) 57 (22.4) 1.26 0.80

°√–®“¬¢à“«„πÀ¡Ÿà∫â“π / µ”∫≈

‡§¬‡¢â“√à«¡ª√–‡¡‘π ∂“π°“√≥å‚√§‰¢âÀ«—¥π° 137(53.9) 72 (28.3) 45 (17.7) 1.36 0.77

¢ÕßÀ¡Ÿà∫â“π

√ÿª√«¡ ™à«ß§–·ππ 0-30, §–·ππ‡©≈’Ë¬=20.71, ¡—∏¬∞“π=21.0, ∞“ππ‘¬¡=30.0, à«π‡∫’Ë¬ß‡∫π¡“µ√∞“π=7.25,

§–·ππµË” ÿ¥=0, §–·ππ Ÿß ÿ¥=30

*§–·ππ‡©≈’Ë¬¢Õß°“√¡’ à«π√à«¡·µà≈–¢âÕ, Àπà«¬‡ªìπ§–·ππ

(5)

µ“√“ß∑’Ë 3 ·À≈àß¢âÕ¡Ÿ≈¢à“« “√∑’Ë°≈ÿà¡µ—«Õ¬à“ß‰¥â√—∫¢âÕ¡Ÿ≈¢à“« “√‡°’Ë¬«°—∫‰¢âÀ«—¥π° ·≈–§«“¡ —¡æ—π∏å√–À«à“ß·À≈àß¢âÕ¡Ÿ≈¢à“« “√

°—∫√–¥—∫§«“¡√Ÿâ‡°’Ë¬«°—∫‰¢âÀ«—¥π° (n=254 √“¬)

√–¥—∫§«“¡√Ÿâ n (%)

·À≈àß¢âÕ¡Ÿ≈¢à“« “√ ®”π«π (√âÕ¬≈–) p-value

µË” Ÿß

‡®â“Àπâ“∑’Ë “∏“√≥ ÿ¢

- ‰¥â√—∫ 199 (78.3) 15 (75.0) 184 (78.6) 0.777^¢

- ‰¡à‰¥â√—∫ 55 (21.7) 5 (25.0) 50 (21.4)

‚∑√∑—»πå

- ‰¥â√—∫ 169 (66.5) 6 (30.0) 163 (69.7) <0.001^°*

- ‰¡à‰¥â√—∫ 85 (33.5) 14 (70.0) 71 (30.3)

™¡√¡Õ“ “ ¡—§√ “∏“√≥ ÿ¢

- ‰¥â√—∫ 122 (48.0) 6 (30.0) 116 (49.6) 0.093^°

- ‰¡à‰¥â√—∫ 132 (52.0) 14 (70.0) 118 (50.4)

Àπ—ß ◊Õ§Ÿà¡◊Õ/«“√ “√ “∏“√≥ ÿ¢

- ‰¥â√—∫ 118 (46.5) 12 (60.0) 106 (45.3) 0.206^°

- ‰¡à‰¥â√—∫ 136 (53.5) 8 (40.0) 128 (54.7)

«‘∑¬ÿ™ÿ¡™π

- ‰¥â√—∫ 93 (36.6) 3 (15.0) 90 (38.5) 0.051^¢

- ‰¡à‰¥â√—∫ 161 (63.4) 17 (85.0) 144 (61.5)

ÀÕ°√–®“¬¢à“«

- ‰¥â√—∫ 84 (33.1) 5 (25.0) 79 (33.8) 0.621^¢

- ‰¡à‰¥â√—∫ 170 (66.9) 15 (75.0) 155 (66.2)

° ∑¥ Õ∫‰§ ·§«√å (chi-square test)

¢ ∑¥ Õ∫¥â«¬«‘∏’øî™‡™Õ√å (Fisherûs exact test)

* ¡’π—¬ ”§—≠∑“ß ∂‘µ‘ (p<0.05)

°≈ÿà¡µ—«Õ¬à“ß¡’§«“¡√Ÿâ‡√◊ËÕß‰¢âÀ«—¥π°Õ¬Ÿà„π√–¥—∫ Ÿß

‚¥¬¡’§–·ππ‡©≈’Ë¬ 6.91 (SD 1.58) ¡—∏¬∞“π 7.0 ·≈–

∞“ππ‘¬¡ 8.0 ®“°§–·ππ 0-9 ´÷Ëß‡√◊ËÕß∑’Ë¡’§–·ππ

‡©≈’Ë¬§«“¡√Ÿâ¡“° ÿ¥ §◊Õ «‘∏’°“√∑”≈“¬ —µ«åªï°∑’ËªÉ«¬

À√◊Õµ“¬¥â«¬‚√§‰¢âÀ«—¥π° (x=0.99, SD 0.11) à«π

‡√◊ËÕß∑’Ë¡’§–·ππ‡©≈’Ë¬§«“¡√ŸâπâÕ¬ ÿ¥ §◊Õ Õ“°“√ªÉ«¬

¢Õß —µ«å∑’ËªÉ«¬‡ªìπ‚√§‰¢âÀ«—¥π° (x=0.50, SD 0.50) ¥—ß µ“√“ß∑’Ë 1

”À√—∫°“√¡’ à«π√à«¡¢Õß°≈ÿà¡µ—«Õ¬à“ß æ∫«à“ °≈ÿà¡

µ—«Õ¬à“ß¡’ à«π√à«¡„π√–¥—∫ Ÿß‡™àπ°—π ‚¥¬¡’§–·ππ‡©≈’Ë¬

20.71 (SD 7.25) ¡—∏¬∞“π 21.0 ·≈–∞“ππ‘¬¡ 30.0

®“°§–·ππ 0-30 ‡√◊ËÕß∑’Ë¡’§–·ππ‡©≈’Ë¬°“√¡’ à«π√à«¡

¡“° ÿ¥ §◊Õ °“√‰¥â√—∫ª√–‚¬™πå∑’Ë‰¥âÕ“»—¬Õ¬Ÿà„πÀ¡Ÿà∫â“π

∑’Ëª≈Õ¥¿—¬®“°‚√§‰¢âÀ«—¥π° (x=1.58, SD 0.72) ”À√—∫

‡√◊ËÕß∑’Ë¡’§–·ππ‡©≈’Ë¬°“√¡’ à«π√à«¡πâÕ¬ §◊Õ °“√√à«¡

µ—¥ ‘π„®°”Àπ¥°Æ¢ÕßÀ¡Ÿà∫â“π‡æ◊ËÕ°“√ªÑÕß°—π§«∫§ÿ¡

‚√§‰¢âÀ«—¥π° (x=1.24, SD 0.77) °“√√à«¡√—∫

ª√–‚¬™πå∑’Ë —µ«åªï°À√◊Õ —µ«å‡≈’È¬ß‰¡àªÉ«¬À√◊Õµ“¬®“°

°“√‡ªìπ‚√§‰¢âÀ«—¥π° (x=1.24, SD 0.91) ·≈–°“√

√à«¡ª√–‡¡‘πº≈°“√„Àâ§«“¡√Ÿâ∑“ßÀÕ°√–®“¬¢à“«

(x=1.26, SD 0.80) ¥—ßµ“√“ß∑’Ë 2

°≈ÿà¡µ—«Õ¬à“ß√—∫¢âÕ¡Ÿ≈¢à“« “√‡°’Ë¬«°—∫‰¢âÀ«—¥

(6)

110

µ“√“ß∑’Ë 4 §«“¡ —¡æ—π∏å√–À«à“ß·À≈àß¢âÕ¡Ÿ≈¢à“« “√∑’Ë°≈ÿà¡µ—«Õ¬à“ß‰¥â√—∫¢âÕ¡Ÿ≈¢à“« “√‡°’Ë¬«°—∫‰¢âÀ«—¥π° °—∫√–¥—∫°“√¡’ à«π√à«¡

‡°’Ë¬«°—∫‰¢âÀ«—¥π° (n= 254 √“¬)

√–¥—∫°“√¡’ à«π√à«¡ n (%)

·À≈àß¢âÕ¡Ÿ≈¢à“« “√ p-value

µË” °≈“ß Ÿß

‡®â“Àπâ“∑’Ë “∏“√≥ ÿ¢

- ‰¥â√—∫ 9 (50.0) 74 (71.2) 116 (87.9) <0.001*

- ‰¡à‰¥â√—∫ 9 (50.0) 30 (28.8) 16 (12.1)

‚∑√∑—»πå

- ‰¥â√—∫ 14 (77.8) 65 (62.5) 90 (68.2) 0.378

- ‰¡à‰¥â√—∫ 4 (22.2) 39 (37.5) 42 (31.8)

™¡√¡Õ“ “ ¡—§√ “∏“√≥ ÿ¢

- ‰¥â√—∫ 4 (22.2) 43 (41.3) 75 (56.8) 0.005*

- ‰¡à‰¥â√—∫ 14 (77.8) 61 (58.7) 57 (43.2)

Àπ—ß ◊Õ§Ÿà¡◊Õ/«“√ “√ “∏“√≥ ÿ¢

- ‰¥â√—∫ 9 (50.0) 46 (44.2) 63 (47.7) 0.825

- ‰¡à‰¥â√—∫ 9 (50.0) 58 (55.8) 69 (52.3)

«‘∑¬ÿ™ÿ¡™π

- ‰¥â√—∫ 7 (38.9) 31 (29.8) 55 (41.7) 0.168

- ‰¡à‰¥â√—∫ 11 (61.1) 73 (70.2) 77 (58.3)

ÀÕ°√–®“¬¢à“«

- ‰¥â√—∫ 4 (22.2) 25 (24.0) 55 (41.7) 0.010*

- ‰¡à‰¥â√—∫ 14 (77.8) 79 (76.0) 77 (58.3)

∑¥ Õ∫‰§ ·§«√å (chi-square test)

*¡’π—¬ ”§—≠∑“ß ∂‘µ‘ (p<0.05)

π°®“°‡®â“Àπâ“∑’Ë “∏“√≥ ÿ¢¡“° ÿ¥ √âÕ¬≈– 78.3 √Õß

≈ß¡“ §◊Õ ‚∑√∑—»πå √âÕ¬≈– 66.5 º≈°“√«‘‡§√“–Àå

§«“¡ —¡æ—π∏å√–À«à“ß·À≈àß¢âÕ¡Ÿ≈¢à“« “√ °—∫√–¥—∫

§«“¡√Ÿâ æ∫«à“ ·À≈àß¢âÕ¡Ÿ≈¢à“« “√®“°‚∑√∑—»πå ¡’

§«“¡ —¡æ—π∏å°—∫√–¥—∫§«“¡√Ÿâ‡√◊ËÕß‰¢âÀ«—¥π°¢ÕßÕ“ “ ¡—§√ “∏“√≥ ÿ¢ Õ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘µ‘ (p<0.001)

¥—ßµ“√“ß∑’Ë 3 ·≈–·À≈àß¢âÕ¡Ÿ≈¢à“« “√®“°‡®â“Àπâ“∑’Ë “∏“√≥ ÿ¢ ™¡√¡Õ“ “ ¡—§√ “∏“√≥ ÿ¢ ·≈–ÀÕ

°√–®“¬¢à“« ¡’§«“¡ —¡æ—π∏å°—∫√–¥—∫°“√¡’ à«π√à«¡„π

°“√¥”‡π‘πß“π‰¢âÀ«—¥π°¢ÕßÕ“ “ ¡—§√ “∏“√≥ ÿ¢

Õ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘µ‘ (p<0.001, p=0.005 ·≈–

p=0.010 µ“¡≈”¥—∫) ¥—ßµ“√“ß∑’Ë 4

”À√—∫º≈°“√«‘‡§√“–Àå§«“¡ —¡æ—π∏å√–À«à“ß

§«“¡√Ÿâ‡°’Ë¬«°—∫‰¢âÀ«—¥π° °—∫°“√¡’ à«π√à«¡‡°’Ë¬«°—∫‰¢â À«—¥π° ‚¥¬„™â°“√∑¥ Õ∫ —¡ª√– ‘∑∏‘Ï À —¡æ—π∏å¢Õß

‡æ’¬√å —π (Pearsonûs correlation coefficient) æ∫«à“

‰¡à¡’§«“¡ —¡æ—π∏å°—πÕ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘µ‘ (p=0.649, r=0.029)

«‘®“√≥å

°“√¥”‡π‘π°“√ªÑÕß°—π§«∫§ÿ¡‚√§‰¢âÀ«—¥π° µâÕß Õ“»—¬§«“¡√à«¡¡◊Õ √à«¡„® ·≈–°“√¡’ à«π√à«¡®“°∑ÿ°

(7)

¿“§ à«π„π —ß§¡ ™ÿ¡™π Õ¬à“ßµàÕ‡π◊ËÕß ®÷ß®–ª√– ∫ º≈ ”‡√Á® ´÷ËßÕß§å°√Õ“ “ ¡—§√ “∏“√≥ ÿ¢ ∂◊Õ«à“

‡ªìπ°≈ÿà¡∑’Ë¡’∫∑∫“∑ ”§—≠„π°“√‡™◊ËÕ¡µàÕ°“√¥”‡π‘π ß“π·∫∫¡’ à«π√à«¡®“°¿“§√—∞ Ÿà¿“§ª√–™“™π·≈–

™ÿ¡™π∑’Ëª√– ∫º≈ ”‡√Á®‡ªìπÕ¬à“ß¥’¡“·≈â«À≈“¬

ª√–°“√⁽¹⁰⁾ ¥—ßπ—Èπ°“√¥”‡π‘πß“π‡°’Ë¬«°—∫ªí≠À“‚√§‰¢â À«—¥π°„π™ÿ¡™π ®÷ß§“¥À«—ß«à“Õß§å°√Õ“ “ ¡—§√

“∏“√≥ ÿ¢®–¡’ à«π ”§—≠„π°“√‡ΩÑ“√–«—ß ªÑÕß°—π

§«∫§ÿ¡ ·≈– àß‡ √‘¡„Àâª√–™“™π‡¢â“¡“¡’ à«π√à«¡„π

°“√¥”‡π‘πß“π‰¥âÕ¬à“ß‡À¡“– ¡·≈–‡°‘¥ª√– ‘∑∏‘¿“æ

‰¥â‡ªìπÕ¬à“ß¥’ Õ¬à“ß‰√°Áµ“¡Àπà«¬ß“π∑’Ë‡°’Ë¬«¢âÕß

®”‡ªìπµâÕß‡ √‘¡»—°¬¿“æ π—∫ πÿπ·≈–°√–µÿâπ°≈ÿà¡

Õ“ “ ¡—§√ “∏“√≥ ÿ¢‡À≈à“π—Èπ‡ªìπ√–¬– Ê Õ¬à“ßµàÕ

‡π◊ËÕß¥â«¬⁽⁴⁾

®“°∑’Ëæ∫«à“ Õ“ “ ¡—§√ “∏“√≥ ÿ¢¡’√–¥—∫§«“¡

√Ÿâ·≈–°“√¡’ à«π√à«¡„π°“√ªÑÕß°—π§«∫§ÿ¡‚√§‰¢âÀ«—¥

π°Õ¬Ÿà„π√–¥—∫ Ÿß^(11,12) π—∫‡ªìπ‡√◊ËÕß∑’Ëπà“¬‘π¥’·≈–§«√

„Àâ‡°‘¥ ∂“π°“√≥å‡™àππ’Èµ≈Õ¥‰ª ‰¡à„™à¡’√–¥—∫ Ÿß·µà

°Áµ“¡§«√‡√àß‡ √‘¡§«“¡√Ÿâ·≈–°“√¡’ à«π√à«¡„πª√–‡¥Áπ ”§—≠∑’Ë¬—ß¡’√–¥—∫µË”Õ¬Ÿà„Àâ¡“°¬‘Ëß¢÷Èπ ‡™àπ §«“¡√Ÿâ‡√◊ËÕß Õ“°“√ªÉ«¬¢Õß —µ«å∑’ËªÉ«¬‡ªìπ‚√§‰¢âÀ«—¥π° À√◊Õ°“√¡’

à«π√à«¡„π°“√§âπÀ“ªí≠À“·≈–°“√µ—¥ ‘π„®‡æ◊ËÕ°“√

ªÑÕß°—π§«∫§ÿ¡‚√§ √«¡∂÷ß°“√µ‘¥µ“¡ª√–‡¡‘πº≈°“√

¥”‡π‘πß“π

”À√—∫·À≈àß¢âÕ¡Ÿ≈¢à“« “√ ‡æ◊ËÕ°“√‡æ‘Ë¡æŸπ§«“¡

√Ÿâ·≈– √â“ß°“√¡’ à«π√à«¡‡√◊ËÕß‰¢âÀ«—¥π°π—Èπ ‡®â“Àπâ“∑’Ë “∏“√≥ ÿ¢·≈–‚∑√∑—»πå®–‡ªìπ ◊ËÕ∑’ËÕ“ “ ¡—§√

“∏“√≥ ÿ¢‰¥â√—∫¢âÕ¡Ÿ≈¢à“« “√¡“° ÿ¥^(11,13) Õ¬à“ß‰√°Áµ“¡

À“°‡ªìπ‡√◊ËÕß°“√‡æ‘Ë¡æŸπ§«“¡√Ÿâπ—Èπ ·À≈àß¢âÕ¡Ÿ≈¢à“«

“√®“°‚∑√∑—»πå¡’º≈µàÕ√–¥—∫§«“¡√ŸâÕ¬à“ß™—¥‡®π „π

¢≥–∑’Ë‡√◊ËÕß°“√ √â“ß°“√¡’ à«π√à«¡π—Èπ ·À≈àß¢âÕ¡Ÿ≈¢à“«

“√®“°‡®â“Àπâ“∑’Ë “∏“√≥ ÿ¢ ™¡√¡Õ“ “ ¡—§√

“∏“√≥ ÿ¢ ·≈–ÀÕ°√–®“¬¢à“« ¡’º≈µàÕ√–¥—∫°“√¡’

à«π√à«¡Õ¬à“ß™—¥‡®π ·µà§«“¡√Ÿâ ‰¡à¡’º≈µàÕ°“√¡’ à«π

√à«¡„π°“√¥”‡π‘πß“πªÑÕß°—π§«∫§ÿ¡‰¢âÀ«—¥π° ¥—ßπ—Èπ

„π°“√¥”‡π‘πß“π‡ΩÑ“√–«—ß ªÑÕß°—π§«∫§ÿ¡‰¢âÀ«—¥π° ‰¡à

§«√§“¥À«—ß«à“§«“¡√Ÿâ°àÕ„Àâ‡°‘¥°“√¡’ à«π√à«¡‡ ¡Õ‰ª

·≈–§«√æ‘®“√≥“„™â™àÕß∑“ß°“√ ◊ËÕ “√„Àâ‡À¡“– ¡°—∫

·µà≈–‡√◊ËÕß∑’ËµâÕß°“√ ◊ËÕ “√∂÷ß°≈ÿà¡‡ªÑ“À¡“¬ ‡æ◊ËÕ„Àâ

‡°‘¥ª√– ‘∑∏‘¿“æ·≈–ª√– ‘∑∏‘º≈„π°“√¥”‡π‘πß“π Ÿß ÿ¥µàÕ‰ª

°‘µµ‘°√√¡ª√–°“»

¢Õ¢Õ∫§ÿ≥ ‡®â“Àπâ“∑’Ë “∏“√≥ ÿ¢·≈–Õ“ “ ¡—§√

“∏“√≥ ÿ¢ „πæ◊Èπ∑’ËÕ”‡¿Õ·¡à«“ß∑ÿ°∑à“π ∑’Ë„Àâ§«“¡√à«¡

¡◊Õ„π°“√‡°Á∫√«∫√«¡¢âÕ¡Ÿ≈‡ªìπÕ¬à“ß¥’ ·≈–¢Õ¢Õ∫§ÿ≥ºŸâ

‡ªìπ°”≈—ß„® ºŸâ„Àâ°“√ π—∫ πÿπ„π°“√»÷°…“«‘®—¬§√—Èßπ’È∑ÿ° Ê

∑à“π¡“ ≥ ‚Õ°“ π’È

‡Õ° “√Õâ“ßÕ‘ß

1. ”π—°‚√§µ‘¥µàÕ∑—Ë«‰ª °√¡§«∫§ÿ¡‚√§ °√–∑√«ß “∏“√≥ ÿ¢.

√Ÿâ∑—π‚√§‰¢âÀ«—¥π°. æ‘¡æå§√—Èß∑’Ë 1. °√ÿß‡∑æ¡À“π§√:

Õß§å°“√ ß‡§√“–Àå∑À“√ºà“π»÷°; 2548.

2. °√¡§«∫§ÿ¡‚√§ °√–∑√«ß “∏“√≥ ÿ¢. ªÑÕß°—π·≈–‡¢â“„® ‚√§

‰¢âÀ«—¥π°. æ‘¡æå§√—Èß∑’Ë 1. °√ÿß‡∑æ¡À“π§√: Õß§å°“√

ß‡§√“–Àå∑À“√ºà“π»÷°; 2550.

3. °Õß ÿ¢»÷°…“ °√¡ π—∫ πÿπ∫√‘°“√ ÿ¢¿“æ °√–∑√«ß “∏“√≥ ÿ¢. ‚√§‰¢âÀ«—¥π° ‘Ëß∑’Ëª√–™“™π§«√√Ÿâ®—°. æ‘¡æå§√—Èß

∑’Ë 1. °√ÿß‡∑æ¡À“π§√: Õß§å°“√ ß‡§√“–Àå∑À“√ºà“π»÷°; 2549.

4. °Õß π—∫ πÿπ ÿ¢¿“æ¿“§ª√–™“™π °√¡ π—∫ πÿπ∫√‘°“√

ÿ¢¿“æ °√–∑√«ß “∏“√≥ ÿ¢. §Ÿà¡◊Õ°“√ªÑÕß°—π·≈–§«∫§ÿ¡

‚√§‰¢âÀ«—¥π° ”À√—∫Õ“ “ ¡—§√ “∏“√≥ ÿ¢. æ‘¡æå§√—Èß∑’Ë 1.

°√ÿß‡∑æ¡À“π§√: ™ÿ¡πÿ¡ À°√≥å°“√‡°…µ√·Ààßª√–‡∑»‰∑¬;

2549.

5. °√¡§«∫§ÿ¡‚√§ °√–∑√«ß “∏“√≥ ÿ¢. §”·π–π” ”À√—∫

°√ÿß‡∑æ¡À“π§√: ™ÿ¡πÿ¡ À°√≥å°“√‡°…µ√·Ààßª√–‡∑»‰∑¬;

2547.

6. ”π—°√–∫“¥«‘∑¬“ °√¡§«∫§ÿ¡‚√§ °√–∑√«ß “∏“√≥ ÿ¢.

√“¬ß“π‡ΩÑ“√–«—ß∑“ß√–∫“¥«‘∑¬“. ππ∑∫ÿ√’: ”π—°√–∫“¥«‘∑¬“

°√¡§«∫§ÿ¡‚√§ °√–∑√«ß “∏“√≥ ÿ¢; 2547.

7. ”π—°√–∫“¥«‘∑¬“ °√¡§«∫§ÿ¡‚√§ °√–∑√«ß “∏“√≥ ÿ¢.

√“¬ß“π‡ΩÑ“√–«—ß∑“ß√–∫“¥«‘∑¬“. ππ∑∫ÿ√’: ”π—°√–∫“¥«‘∑¬“

°√¡§«∫§ÿ¡‚√§ °√–∑√«ß “∏“√≥ ÿ¢; 2548.

8. ”π—°ß“π “∏“√≥ ÿ¢®—ßÀ«—¥‡™’¬ß„À¡à. √“¬ß“π √ÿª¢âÕ¡Ÿ≈

∑“ß√–∫“¥«‘∑¬“ (√ß.506, √ß.507): ‚ª√·°√¡ √ÿª¢âÕ¡Ÿ≈

(8)

112

√“¬ß“π∑“ß√–∫“¥«‘∑¬“. ‡™’¬ß„À¡à: ΩÉ“¬§«∫§ÿ¡‚√§

”π—°ß“π “∏“√≥ ÿ¢®—ßÀ«—¥‡™’¬ß„À¡à; 2547.

9. ”π—°ß“π “∏“√≥ ÿ¢®—ßÀ«—¥‡™’¬ß„À¡à. §Ÿà¡◊Õ°“√®—¥∑”·ºπ

¬ÿ∑∏»“ µ√å√–¬–ª“π°≈“ß ”π—°ß“π “∏“√≥ ÿ¢®—ßÀ«—¥

‡™’¬ß„À¡à. ‡™’¬ß„À¡à: °≈ÿà¡ß“π¬ÿ∑∏»“ µ√å·≈–·ºπß“π “∏“√≥ ÿ¢ ”π—°ß“π “∏“√≥ ÿ¢®—ßÀ«—¥‡™’¬ß„À¡à; 2547.

10. « ÿ∏√ µ—π«—≤π°ÿ≈. ÿ¢¿“æ Õπ“¡—¬™ÿ¡™π ·≈–°√–∫«π°“√

æ—≤π“. ™≈∫ÿ√’: §≥– “∏“√≥ ÿ¢»“ µ√å ¡À“«‘∑¬“≈—¬∫Ÿ√æ“;

2547.

11. °Õß π—∫ πÿπ ÿ¢¿“æ¿“§ª√–™“™π. °“√»÷°…“∫∑∫“∑¢Õß Õ“ “ ¡—§√ “∏“√≥ ÿ¢·≈–‡§√◊Õ¢à“¬ ÿ¢¿“æ√–¥—∫µ”∫≈„π

°“√‡ΩÑ“√–«—ß‚√§‰¢âÀ«—¥π°„π™ÿ¡™π. ππ∑∫ÿ√’: °Õß π—∫ πÿπ

ÿ¢¿“æ¿“§ª√–™“™π °√¡ π—∫ πÿπ∫√‘°“√ ÿ¢¿“æ

°√–∑√«ß “∏“√≥ ÿ¢; 2548.

12. ¡“πÿ™“ ®—π∑√å‡®ä°, π‘µ‘∏√√¡ √—µ° ‘°√, ∏π—™æ‘¡æå ÿ¿“¿√≥å ª√–¥—∫. ªí®®—¬∑’Ë¡’§«“¡ —¡æ—π∏å°—∫æƒµ‘°√√¡°“√ªÑÕß°—π µπ‡Õß®“°‰¢âÀ«—¥π°¢Õßª√–™“™π°≈ÿà¡‡ ’Ë¬ß„π‡¢µ‡∑»∫“≈

®—ßÀ«—¥æ‘…≥ÿ‚≈°. æ‘…≥ÿ‚≈°: ‚√ßæ¬“∫“≈æÿ∑∏™‘π√“™; 2549.

13. ª√“∫¥“ ª√–¿“»‘√‘, Sonja Olsen, §√√™‘µ ≈‘¡ª°“≠®π“√—µπå,

¬ß‡®◊Õ ‡À≈à“»‘√‘∂“«√, »“√‘°“ æ—≤π ‘π. §«“¡√Ÿâ ∑—»π§µ‘ ·≈–

°“√ªØ‘∫—µ‘µ—« °àÕπ·≈–À≈—ß‰¥â¬‘π¢à“«‡°’Ë¬«°—∫‰¢âÀ«—¥π°

®—ßÀ«—¥π§√æπ¡. ππ∑∫ÿ√’: ”π—°√–∫“¥«‘∑¬“ °√¡§«∫§ÿ¡‚√§

°√–∑√«ß “∏“√≥ ÿ¢; 2547.

Abstract Communication Channel Influences on Health Volunteers’ Knowledge and Participation on Bird Flu Prevention and Control in Mae Wang District, Chiang Mai Province, Thai- land

Supoj Charoenpone*, Pakphom Tawong**, Vasuton Tanvatanakul***

*Mae Wang Public Health Office, Chiang Mai, **Chiang Mai Provincial Health Office, ***Faculty of Public Health, Burapha University, Chon Buri

Journal of Health Science 2009; 18:105-12.

Addressing the problems of bird flu needs empowerment of every sector. This study was aimed at identifying appropriate communication channels for increasing the health volunteers’ knowledge and their participation on bird flu prevention and control. A survey research design was used in Mae Wang district, Chiang Mai Province, Thailand between June and November 2007. Multi- stage sampling was used in various sub-districts and villages. In all, 254 respondents were inter- viewed. Results indicated that the knowledge of the respondents about bird flu problems was high (x=6.91, SD 1.58, range=0-9), and also the participation was high (x=20.71, SD 7.25, range=0-30).

Most of bird flu information was from health personnel and television (78.3% and 66.5% respectively). Bird flu information from television was significantly related to knowledge about bird flu problems (p<0.001); while the information from health personnel, health volunteer association and community loudspeakers were significantly related to participation (p<0.001, p=0.005 and p=0.010 respectively). Knowledge and participation about bird flu problems were not statistically related.

Findings lead to recommend empowerment of health volunteers and communities to participate in bird flu implementation via the appropriate communication channels identified by this study.

Key words: bird flu, communication channel, health volunteer, knowledge, participation, prevention and control