Journal of the Medical Association of Thailand = Chotmaihet thangphaet最新文献

{"title":"Correlation between a Compliance of Using Double-Gloving Bundle during Endotracheal Intubation and the Surgical Site Infection","authors":"","doi":"10.35755/jmedassocthai.2023.03.13804","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.03.13804","url":null,"abstract":"Background: Surgical site infections (SSI) represent severe postoperative adverse events. Contamination of operating room (OR) environment with oral bacteria and bloodborne pathogens poses an additional risk of infection. Studies have demonstrated that anesthesia providers’ use of double-gloving care bundle reduce operating room contamination as intubator wears two sets of gloves, sheaths the laryngoscope blade after use with endotracheal tube packaging and removes the outer glove after intubation.\u0000\u0000Materials and Methods: The authors conducted a prospective, single-center quality improvement project to increase anesthesia provider compliance with a double-gloving care bundle between January and December 2019. The primary measure was the percentage of anesthesia providers’ compliance with the double-gloving care bundle as compared to baseline. The secondary measure was the correlation between compliance with the use of the double-gloving bundle and SSIs.\u0000\u0000Results: The authors assessed 307 surgeries with 280 that had adequate data for analyses. The initial compliance rate was 38% before the quality improvement initiative. There was no change in the median compliance rate following the initiative. There was no difference in demographic data between the compliance and the non-compliance providers. Three patients (1.07%) developed SSIs, one patient in compliance group and two patients in the non-compliance group. There was no correlation between double-glove care bundle compliance and SSIs.\u0000\u0000Conclusion: The present study quality improvement initiative study did not increase anesthesia providers’ compliance with the double-gloving care bundle. There was no correlation between compliance and SSIs due to small sample size. However, double-gloving and laryngoscope sheathing by anesthesia providers do improve the standard of care and reduce contamination in the operating room setting. We will continue efforts to increase compliance.\u0000\u0000Keywords: Double-gloving; Laryngoscope sheathing; Surgical site infection; Anesthesia provider; Operating room contamination","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86748112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Looking at mHealth Digital Application Interventions for youths with Addictive Behavior through the Lens of Beck’s Cognitive Model and Cognitive Behavioral Therapy: A Scoping Review","authors":"","doi":"10.35755/jmedassocthai.2023.03.13800","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.03.13800","url":null,"abstract":"Objective: To explore the scope of the published research studies on mHealth digital application interventions for youths with addictive behaviors, considering both the development and evaluation aspects. The main goal was to identify the concepts and theories underlying such applied technologies, detect any gaps, and provide recommendations. A secondary goal was to identify the components of mHealth digital application interventions that led to cognitive, emotional, and behavioral change among youths with addictive behaviors by drawing on Beck’s cognitive model and cognitive behavioral therapy (CBT).\u0000\u0000Materials and Methods: A scoping review was done based on York’s five-stage framework outlined by Arksey and O’Malley. Four leading databases were searched, PubMed, Science Direct, Web of Science, and Google Scholar.\u0000\u0000Results: There were 16 mHealth digital application interventions being developed to help youth overcome addiction issues. Most of the existing techniques involve dealing with youth’s stimuli, emotions, addictive behaviors, and physiology or physical reactions. These were the components of cross-sectional Beck’s cognitive model and CBT. In addition, most of the cognitive skill components were focused on managing reflective thoughts such as planning to stop addictive behaviors, intention to stop, encouraging more of creating positive thinking, or benefits of stop doing addictive behavior. No application component focused on identifying any implicit thought influenced of specific memories on addiction outcome expectancies such as the substance or self-intermediate belief, substance or self-core belief contained in Beck’s longitudinal cognitive model.\u0000\u0000Conclusion: Findings from the present scoping review suggest new routes for working with implicit thoughts. Some opportunities exist here for the development of CBT mHealth applications to raise awareness in youth concerning the implicit substance or self-concept appearing in Beck’s longitudinal cognitive model.\u0000\u0000Keywords: mHealth applications; CBT; Cognitive model; Beckian; Youth; Addictive behaviour; Substance","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86528992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Treatment of Nasal and Parotid Mycobacterium avium Complex Infection in Adult-Onset Immunodeficiency: A Case Report with Literature Review","authors":"","doi":"10.35755/jmedassocthai.2023.03.13814","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.03.13814","url":null,"abstract":"Non-tuberculous mycobacteria (NTM) infection has increasingly been reported throughout the world, especially in Asia. Autoantibodies to interferon-γ are implicated in the pathogenesis of adult-onset immunodeficiency resulting in multiple opportunistic infections, in particular NTM infection. There are few reports regarding Mycobacterium avium complex infection of the nasal cavity or parotid gland in this condition. The authors reported the first case of nasal and parotid Mycobacterium avium complex presenting with recurrent epistaxis, nasal mass, and parotitis successfully treated with combined systemic and topical anti-mycobacterial agents in Thailand.\u0000\u0000Keywords: Nasal and parotid Mycobacterium avium complex; Nontuberculous mycobacteria; Autoantibody to interferon-γ; Nasal mass; Epistaxis; Parotitis","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77803049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Value of Neutrophil-to-Lymphocyte Ratio at Admission for Chest X-Ray Progression in Hospitalized COVID-19 Patients","authors":"C. Chantharakhit, A. Inkanuwat, K. Nouchpramool","doi":"10.35755/jmedassocthai.2023.03.13815","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.03.13815","url":null,"abstract":"Objective: Previous studies focused on using the neutrophil-to-lymphocyte ratio (NLR) to monitor COVID-19 patients as an early warning signal of severe COVID-19 infection. Results showed that NLR could also be used as a prognostic factor. In the present study, the role of NLR in predicting chest X-ray (CXR) progression in hospitalized COVID-19 patients was investigated.\u0000\u0000Materials and Methods: The present study was an ambispective observational cohort study that included COVID-19 patients admitted to the isolation ward and COVID-19 intensive care unit between July and September 2021 in Buddhasothorn Hospital, Chachoengsao, Thailand. NLR and demographic findings were analyzed.\u0000\u0000Results: Medical details of 564 patients were retrospectively analyzed using 3.24 as the cut-off value of the maximum Youden index to classify a high NLR group and a low NLR group. The estimated cumulative hazard function for CXR progression in the high NLR group was statistically significant, (HR 1.31, 95% CI 1.02 to 1.68, p=0.031). Univariate analysis suggested that high NLR value and three or more clinical risk factors (age 60 years or older, diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, cirrhosis, stroke, obesity, and immunocompromised) were associated with CXR progression, while multivariate analysis determined high NLR as an independent predictive marker for COVID-19 CXR progression (aOR 1.54, 95% CI 1.06 to 2.23, p=0.022). Using NLR along with pre-existing comorbidity risk factors significantly increased the predictive value for COVID-19 CXR progression (area under the ROC curve 0.565, p=0.017).\u0000\u0000Conclusion: High NLR at the time of hospitalization was identified as a simple predictor for COVID-19 CXR progression requiring close monitoring.\u0000\u0000Keywords: Neutrophil-to-lymphocyte ratio (NLR); COVID-19; Disease progression; Predictive factor; Hospitalization","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90298823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Cochlear Implant Outcome and Factors Associated of Pre-Operative among Prelingual Deafness Patients Under 3 Years and 6 Months Old in Rajavithi Hospital: A Single Center Experience","authors":"","doi":"10.35755/jmedassocthai.2023.03.13797","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.03.13797","url":null,"abstract":"Background: The recent government announcement that fees for cochlear implants in prelingual patients will be reimbursed means that this treatment will be more accessible in the near future. The data in the present study would form the baseline for improving the care process in Rajavithi Hospital.\u0000\u0000Objective: To study the outcomes of cochlear implants in prelingual hearing loss patients younger than three years and six months, and to determine preoperative assessment factors that affect the outcomes.\u0000\u0000Materials and Methods: A retrospective review was conducted of the medical records of prelingual deafness patients younger than three years and six months that underwent cochlear implants between 2013 and 2019. Forty patients were enrolled, and their demographic data, preoperative assessment, and Category Auditory Performance (CAP) score outcomes were recorded. The preoperative factors affecting the CAP score at 2 years post-operation were analyzed.\u0000\u0000Results: A CAP score above 5 at two years after cochlear implant, considered to be good habilitation, was reported in 55% (22 cases). After further follow up, the number of patients whose CAP score reached 5 or more was 31 (77.5%). The mean age of diagnosis was 13.28±9.38 months, and the mean age at surgery was 25.73±9.74 months. The preoperative factors associated with poor CAP scores were Goldenhar syndrome, Waardenburg syndrome, Autism, small inner ear canal, and poor eye contact. The differences in preoperative factors between patients with CAP scores of 5 or more and those with scores less than 5 at two years after cochlear implant were not statistically significant.\u0000\u0000Conclusion: The outcomes of cochlear implant operations may be improved by early age at surgery, which will be assessed by the Newborn Hearing Screening policy. Preoperative assessment factors associated with poor outcomes were identified, but they were not statistically significant in the present study.\u0000\u0000Keywords: Cochlear implant; CAP score; Preoperative factors","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90224927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Sleep Quality and Quality of Life Among Medical Students in Chiang Mai University","authors":"","doi":"10.35755/jmedassocthai.2023.03.13808","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.03.13808","url":null,"abstract":"Objective: To explore and compare the sleep quality between pre-clinical and clinical medical students. The present study also assessed the influence of sleep quality on the quality of life in four domains, physical, psychological, social relationships, and environment.\u0000\u0000Materials and Methods: A cross-sectional study was conducted among 261 second-year students and 241 fourth-year students from the Faculty of Medicine, Chiang Mai University as the representatives of preclinical and clinical medical students. Participants completed questionnaires consisting of the Pittsburgh Sleep Quality Index (PSQI) Thai version and WHOQOL-BREF-THAI to assess sleep quality and quality of life. The sleep quality was examined by chi-square test for the comparison between the two groups. Linear regression was used to evaluate the overall influence of sleep quality on each domain of the quality of life after adjusting for other covariates.\u0000\u0000Results: Two hundred sixty-one participants or 46.7% had poor sleep quality with a PSQI of 6.5 or more. The sleep quality compared between the academic years had significantly worse results (p<0.001) in the preclinical students. Sleep latency and sleep disturbance were the two components of sleep quality that were statistically poorer in the preclinical students (p<0.001). Poor sleep was significantly associated with a poor quality of life in all domains (p<0.001). Each score increased in the global PSQI score, 2.924 score of total WHOQOL-BREF-THAI would be diminished, resulting in an impaired quality of life (p<0.001).\u0000\u0000Conclusion: The prevalence of poor sleep quality was significantly higher in the preclinical year. As poorer sleep is statistically associated with the poorer quality of life, the curriculum and schedule should give consideration and provision for good sleep quality, especially in preclinical students for the improvement of medical student’s well-being.\u0000\u0000Keywords: Sleep quality; Quality of life; Medical students","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82462795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between Health Literacy in Disease Prevention and Quality of Life of Older People in the Region Public Health of Thailand","authors":"","doi":"10.35755/jmedassocthai.2023.03.13816","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.03.13816","url":null,"abstract":"Objective: To examine relationship between health literacy (HL) in disease prevention associated with the quality of life (QOL) of the older people.\u0000\u0000Materials and Methods: Three hundred sixty elderly persons aged 60 to 80 years living in the Health District 7 of Thailand were included in this study. The subjects were randomized by the multi-stage sampling technique. The data were collected using the HL in disease prevention and WHOQOL-OLD questionnaire. The data were analyzed by descriptive statistics and multiple logistic regression analysis.\u0000\u0000Results: The results showed that most of the HL in disease prevention was in the sufficient to excellent level at 71.67%, and most of the QOL was in the good level at 85.84%. The factors relating to the QOL in the elderly included HL in disease prevention at a sufficient to excellent level (adjusted OR 2.17, 95% CI 1.18 to 3.99, p=0.013).\u0000\u0000Conclusion: HL in disease prevention is associated with QOL in the older people. Therefore, HL in disease prevention among the older people should be continually strengthened to have a good QOL as long as possible in old age.\u0000\u0000Keywords: Health Literacy; Quality of Life; Older people; Associated factors","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77378010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Preoperative Intravenous Tranexamic Acid Before Cesarean Section in Placenta Previa: A Randomized Double Blind Control Trial","authors":"","doi":"10.35755/jmedassocthai.2023.03.13798","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.03.13798","url":null,"abstract":"Background: Placenta previa is a common cause of postpartum hemorrhage (PPH) that contributes substantively to maternal morbidity and mortality rates. Tranexamic acid is an antifibrinolytic drug that is useful for the treatment of PPH. The recommendation from many guidelines is to start giving tranexamic acid as soon as PPH is diagnosed to reduce postpartum blood loss. Furthermore, some studies report the beneficial use of tranexamic acid given as a prophylactic before Cesarean section to decrease intraoperative blood loss and prevent PPH. To the authors’ knowledge, in high-risk obstetrics case such as placenta previa, there was insufficient data to support recommendations of the use of tranexamic acid for prevent PPH.\u0000\u0000Objective: To evaluate the efficacy of supplementary intravenous tranexamic acid before cesarean section versus prophylactic intravenous oxytocin after placenta delivery alone to decrease intraoperative blood loss and prevent PPH in placenta previa.\u0000\u0000Material and Methods: The present study conducted a double blinded placebo control trial comparing adjunct 1 g tranexamic acid given intravenously before skin incision with prophylactic intravenous oxytocin after placenta delivery alone before cesarean section for placenta previa. The study recruited 60 women who were diagnosed with placenta previa at gestational age (GA) of more than 28 completed weeks undergoing emergency cesarean section due to active bleeding or scheduled for elective cesarean section at 37 completed weeks at Chonburi Hospital between July 2021 and July 2022. The primary outcome was intraoperative blood loss.\u0000\u0000Results: Sixty diagnosed placenta previa women were recruited, with 30 patients per group. Group I patients were given 1 g tranexamic acid and Group II were given a placebo of 100 ml NSS before skin incision. Both groups received intravenous oxytocin 20 units after placenta delivery. The main outcome showed that preoperative tranexamic acid intravenous reduced intraoperative blood loss significantly compared with the placebo at 349.5 ml (range of 168 to 2,200) versus 619 ml (range of 288 to 3,243), p<0.001. The secondary outcome showed a significant decrease in the incidence of PPH at 4 (13.33%) versus 10 (33.33%), p=0.030 and decreased in the incidence of blood transfusion of more than one unit from 5 (16.67%) versus 13 (43.33%), p=0.047.\u0000\u0000Conclusion: Prophylactic supplementary 1 g tranexamic acid intravenously before cesarean section to prophylactic intravenous oxytocin after placental delivery was found to effectively reduce intraoperative blood loss and PPH.\u0000\u0000Keywords: Tranexamic acid; Preoperative; Placenta previa; Intraoperative blood loss; Cesarean section","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87218121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the Efficacy and Success Rate of Radial Artery Approach under Ultrasound Guidance and Palpation Technique for Coronary Intervention at Central Chest Institute of Thailand","authors":"","doi":"10.35755/jmedassocthai.2023.03.13807","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.03.13807","url":null,"abstract":"Background: Previous studies of ultrasound guidance for transradial artery access during coronary angiography or interventional procedures demonstrate improving success rate, number of attempts, and short-time access in radial artery cannulation.\u0000\u0000Objective: To compare the benefit of ultrasound guidance radial artery access during coronary angiography (CAG) or percutaneous coronary intervention (PCI) with palpation technique in experienced and inexperienced operators.\u0000\u0000Materials and Methods: A randomized prospective study was performed between October 2021 and April 2022. One hundred sixty-four patients were randomized into three groups. The first group, group I (55 cases), underwent radial artery puncture with ultrasound guidance by an experienced interventionist. The second group, group II (56 cases), underwent radial artery puncture using the palpation technique by another experienced interventionist. The third group, group III (53 cases), was also assigned to radial artery puncture with the palpation technique, however, performed by three interventional cardiology fellows.\u0000\u0000Results: The success rate of radial cannulation was 55 (100%) in group I, 52 (92.9%) in group II, and 48 (90.6%) in group III (p=0.060). Firstattempt success rates in the three groups were 83.6%, 75%, and 69.8%, respectively (p=0.233). The median number of attempts was not significantly different (p=0.208). Time to access the radial artery in group I was reduced significantly compared to the palpation technique in group II and group III (p<0.001). There were no significant differences in complications such as difficult access, access site crossover, radial spasm, and hematoma/ bleeding complication (p=0.135, 0.367, 0.132, and 0.700, respectively).\u0000\u0000Conclusion: In experienced operators, an ultrasound-guided technique has been shown to have beneficial advantages in reducing the time to access radial artery cannulation compared to experienced and inexperienced operators using the palpation technique.\u0000\u0000Keywords: Transradial catheterization; Ultrasound guide","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90951461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards Integrating Health Economics into Medical Education in Thailand","authors":"","doi":"10.35755/jmedassocthai.2023.03.13812","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.03.13812","url":null,"abstract":"Objective: To describe the attempts to integrate health economics (HE) into medical education in Thailand.\u0000\u0000Materials and Methods: A national survey was launched to all medical education centers in Thailand to discern the situation and gaps in HE teaching. Discussions about improving HE education were held among experienced educators. As a result, the HE working group, comprising experienced medical teachers in HE, was initiated with the aim of recommending the essential contents for HE education. The HE working group also helped preparing a HE curriculum and instructional media assisted general medical educators in HE teaching. Distribution of learning materials developed was planned.\u0000\u0000Results: Results from the survey revealed gaps in HE teaching, including the lack of HE teaching in clinical curricula, inconsistency in teaching standards, and scarcity of teaching materials and resource persons. The HE working group developed a spiral-based HE curriculum for medical training from undergraduate to graduate levels. Moreover, HE study guides were proposed as teaching aids. Additionally, an example to integrate HE into other medical discipline was demonstrated in the undergraduate curriculum of Family Medicine. Workshops “training for the trainers” were successfully arranged twice. All produced materials, including HE essential contents, curriculum, and study guides, as well as teaching experience were shared to the medical teachers in this regard.\u0000\u0000Conclusion: While a number of efforts had been established to integrate HE into medical education, further attempts are still required to continuously improve HE teaching.\u0000\u0000Keywords: Health economics; Study guide; Curriculum; Situation","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87007605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}