DOI:http://dx.doi.org/10.7314/APJCP.2016.17.3.1097 Nurses and Television as Information Sources for Behavioral Improvement Regarding Liver Flukes in Nakhon Ratchasima RESEARCH ARTICLE Nurses and Television as Sources of Information Effecting Behavioral Improvement Regarding Liver Flukes in Nakhon Ratchasima Province, Thailand Soraya J Kaewpitoon1,2,3*, Natthawut Kaewpitoon1,3,4, Ratana Rujirakul1, Parichart Wakkuwattapong1, Likit Matrakul3, Taweesak Tongtawee3, Ryan A Loyd1,2,3, Jun Norkaew4, Jirawoot Kujapun4, Wasugree Chavengkun4, Sukanya Ponphimai4, Poowadol Polsripradist5, Thawatchai Eksanti6, Tanida Phatisena6 Abstract Background: Liver fluke infection with Opisthorchis viverrini and its associated cholangiocarcinoma constitute a serious problem in Thailand. Healthy behavior can decrease infection, therefore, the investigation of knowledge, attitude, and practice is need required in high risk areas. Objective: This study aimed to investigate the behavior and perceptions regarding liver fluke.Materials and Methods: A cross-sectional descriptive study was conducted in Chum Phuang district of Nakhon Ratchasima province, Thailand during July to November 2015. A total 80 participants who had screened with verbal screening test, stool examination, and ultrasonography, were purposive selected and completed a pre-designed questionnaire (Kruder-Richardon-20=0.80, Cronbach’s alpha coefficient=0.82 and 0.79). T-test, ANOVA, and Pearson correlation test were used for analyzed data. Results: The results reveal that O. viverrini infection was 1.25%, and 3 patients had a dilated bile ducts. The participants had a high knowledge, attitude, and practice regarding liver fluke. The education, occupation, and income, were statistical significant to attitude regarding liver fluke. Nurses and television were the main sources of information regarding liver fluke, with statistical significance(p-value <0.05). Knowledge was significantly associated with attitude and practice (p-value<0.05). Conclusions: Participants had good behavior regarding liver fluke. Improvement of knowledge and attitude is influenced to practical change regarding this carcinogenic fluke. In addition, nurse and television are the main information resources for key success in increasing people perception for disease prevention and control in this area. Keywords: Nurses - television - health behavior - liver fluke - Thailand Asian Pac J Cancer Prev, 17 (3), 1097-1102 Introduction strongly indicated that O. viverrini infection is the etiology of cholangiocarcinoma (CCA) (Thamavit et Liver fluke caused by Opisthorchis viverrini, is a al., 1978; IARC, 1994; Sripa et al., 2007), and CCA has serious problem in Thailand particularly in the northeast been reported that Thailand is the highest incident of the and north region (Kaewpitoon et al., 2008b; Sitthithaworn world (Green et al., 1991; Sripa, et al., 2007; Kaewpitoon et al., 2012; Sripa et al., 2012; Wongsaroj et al., 2014; et al., 2008a; Shin, et al., 2010). CCA was the caused of Kaewpitoon et al., 2015). Recently, the current status death in Thai population and found that CCA was ranked of liver fluke infection in Thailand was reported, a 4 in male and 5 in female (Sripa and Pairojkul, 2008). nationwide survey prevalent was 5.1%. The highest of Mortality rate of CCA in Thailand was approximately prevalent was found in the northeast (9.2%) and followed 36.48% (Sripa et al., 2012). The mortality rate of CCA by the north region (5.2%). A total of 1,168 stool samples in Nakhon Ratchasima province, Thailand was ranked were obtained from 516 males and 652 females. Stool between 13.67-16.2 (Sripa et al., 2010). examination showed that 2.48% were infected with O. Behavior on prevention and control of liver fluke viverrini (Kaewpitoon et al., 2012c). infection are essential for decreasing the liver fluke The experimental and epidemiological evidences infection. Previously studied indicated that knowledge, 1Parasitic Disease Research Unit, 2School of Family Medicine and Community Medicine, 4Faculty of Public Health, Vongchavalitkul University, 3Suranaree University of Technology Hospital, Nakhon Ratchasima, 5Provincial Public Health Office of Nakhon Ratchasima, 6Faculty of Public Health, Nakhon Ratchasima Rajabhat University, Thailand *For correspondence: [email protected] Asian Pacific Journal of Cancer Prevention, Vol 17, 2016 1097 Soraya J Kaewpitoon et al 1098 pre-designed questionnaires. The questionnaire was ultrasonography), were participated and completed the Parasep SF concentration technique and abdomen 80 participants (who had stool examination with Mini- people, (7) agriculture, and (8) alcohol consumption. family with cholangiocarcinoma, (6) naïve northeastern relative (5) officers, related or doctor medical by diagnosed doctor or related officers, (4) cholecystitis; definitive consumption, (3) praziquantel used; given by medical medical doctor or related officers, (2) under-cooked fish history with (1) opisthorchiasis; definitive diagnosed by using mini-verbal screening questionnaire contained the ≥30 years old. Populations were screened for CCA by 82,311 populations was selected with criteria of aged in this totalstudied. ofBriefly, 29,385 populations from populations. 82,161 has and mi), sq (208.7 km2 540.6 areas coverage into 9 sub-districts, and 130 villages. This district is of Nakhon Ratchasima again. The district is subdivided Phimai and Thalaeng Huai and province, Buriram of Mat Thamenchai of Nakhon Ratchasima Province, Lam Plai the north clockwise) Prathai, Mueang Yang and Lam Ratchasima province, neighboring districts are (from Chum Phuang is a district in the eastern part of Nakhon province, Thailand during July to November 2015. Ratchasima Nakhon district, Phuang Chum in conducted was study The (EC58-48). 2015 Technology, of University by the human research ethics committees of Suranaree Materials andMethods fluke preventionandcontrol. result may useful for further study and planning of liver The including theinformationresourcesfor this disease. fluke, liver regarding practice and attitude, knowledge, the investigate to aimed study This required. need is resources the current status of health behavior and information rural communities (Kaewpitoon et al., Therefore, 2007). attitude, and practice related to liver fluke infection in 36-45 points, moderate level; 27-35 points, poor level; negative question=1,2,3, and interpreted to good level; sometimes, (frequently, never): positive question=3,2,1, was analyzed according to Best (1977) with 3 choice and low level; 0-35 points. Evaluation of practical level points, 36-47 level; moderate points, 48-60 level; good to interpreted and question=1,2,3, negative question=3,2,1, with 3 choice (agree, not sure, dis-agree): positive attitude level was analyzed according to Likert (1932) level; 6-10 points, 0-5 points; low level. Evaluation of and interpreted to high level; 11-15 points, moderate to Bloom (1971), answer correct=1, incorrect=0, alpha coefficient)=0.82and0.79,respectively. Richardon-20) = 0.80, attitude and practice (Cronbach’s of questionnaire was analyzed, knowledge (Kruder- and (5) practice; 15 questions. Reliability and validity knowledge; 15 questions, (3) attitude; 20 questions, gender, age, education, agriculture, and income, (2) comprised 5 domain included (1) demographic data; Evaluation of knowledge level was analyzed according analyzed was level knowledge of Evaluation participants the select to used was sampling Multi-stage A cross-sectional descriptive study was approved Table 1. Demographic data and Knowledge, Attitude and Practice regarding liver fluke Knowledge Attitude Practice Variables N T, F p-value T, F p-value T, F p-value Mean S.D. Mean S.D. Mean S.D. Male 49 12.47 1.67 T=0.971 0.898 54.9 4.62 T=-1.474 0.145 39.1 3.66 T=-2.448 0.017 Gender Female 31 12.42 1.73 56.35 3.75 41.26 4.11 31-40 years 11 13.09 1.81 F=1.635 0.188 57 3.07 F=1.390 0.252 41.91 3.05 F=1.655 0.184 41-50 years 22 12.68 1.73 55.41 4.38 39.95 3.17 Age 51-60 years 31 12.42 1.54 55.84 4.54 39.97 3.56 >60 years 16 11.75 1.69 53.75 4.43 38.5 5.63 Primary school 55 12.05 1.64 T=3.307 0.001 54.44 4.49 T=-3.858 0 39.36 4.24 T=-1.958 0.054 Education Secondary School and Higher 25 13.32 1.46 57.72 2.99 41.2 2.96 Not Agriculture 7 12.86 1.57 T=0.668 0.506 59.71 0.49 T=8.646 0 41.29 3.09 T=0.943 0.349 Occupation Agriculture 73 12.41 1.7 55.05 4.33 39.81 4.02 < THB 5,000 38 12.08 1.85 F=2.127 0.126 54.13 5.03 F=4.163 0.019 38.82 4.4 F=3.075 0.052 Income THB 5,000 - 10,000 20 13 1.41 56 3.54 40.85 2.85 > THB 10,000 22 12.59 1.5 57.27 2.83 41.05 3.62 Asian Pacific Journal of Cancer Prevention, Vol 17, 2016 DOI:http://dx.doi.org/10.7314/APJCP.2016.17.3.1097 Nurses and Television as Information Sources for Behavioral Improvement Regarding Liver Flukes in Nakhon Ratchasima Table 2. A comparison between perceive and information resources regarding liver fluke, classified by human Perceive Knowledge Attitude Practice n resources mean S.D. T p-value mean S.D. T p-value mean S.D. T p-value Head village yes 14 12.93 1.86 1.174 0.244 55.57 4.29 0.103 0.918 39.71 4.76 -0.231 0.818 no 66 12.35 1.64 55.44 4.38 39.98 3.8 Village health volunteer yes 48 12.67 1.6 1.419 0.16 55.9 4.35 1.095 0.277 40.23 3.53 0.806 0.423 no 32 12.13 1.77 54.81 4.31 39.5 4.54 Public health officer yes 17 12.82 1.67 1.032 0.305 56 4.47 0.573 0.568 41.29 2.39 2.189 0.034 no 63 12.35 1.69 55.32 4.33 39.57 4.22 Neighbor yes 4 13.25 2.06 0.975 0.333 58.25 2.22 1.324 0.189 37.75 6.75 -1.137 0.259 no 76 12.41 1.67 55.32 4.38 40.05 3.79 Member of sub-distric administrative organization yes 2 14 1.41 1.325 0.189 57 1.41 0.505 0.615 43.5 3.54 1.295 0.199 no 78 12.41 1.68 55.42 4.39 39.85 3.94 Nurse yes 13 13.54 1.39 2.643 0.01 57.54 2.47 2.817 0.008 42.46 1.9 4.161 0.000 no 67 12.24 1.66 55.06 4.52 39.45 4.07 Medical doctor yes 10 12.9 1.85 0.903 0.369 57.2 3.36 1.361 0.178 40 2.83 0.053 0.958 no 70 12.39 1.66 55.21 4.43 39.93 4.11 0-26 points.