Health Utilities in Patients with HIV/AIDS in Thailand

Objectives:  We measured health utility (HU) in Thai HIV/AIDS patients using visual analog scale (VAS), EuroQOL (EQ-5D), and standard gamble (SG), determine the relationships between these HU measures and health-related quality of life (HRQOL) measures of HIV and patient characteristics, and assess the feasibility of the HU methods.
Methods:  A sample of 120 HIV/AIDS patients was identified at Bamrasnaradura Infectious Disease Institute, Thailand, during September to December, 2004. Face-to-face interviews included VAS, SG, and EQ-5D, HRQOL assessment using the Thai abbreviated version of the World Health Organization quality of life (WHOQOL-BREF THAI) and HIV-related symptom instruments, questions about ease of understanding HU approaches and sociodemographic items. Data were analyzed with repeated-measures ANOVA, followed by Dunn–Bonferroni t -test, intraclass coefficients (ICC), Spearman's rank correlation, and multiple linear regressions.
Results:  The mean (95% confidence interval) HUs were as follows: VAS, 0.79 (0.76–0.82); EQ-5D, 0.80 (0.77–0.84); and SG, 0.65 (0.60–0.70). A significant difference in HU by method was found ( P  < 0.001). Agreement by ICC was 0.71 for VAS versus EQ-5D, 0.41 for VAS versus SG, and 0.38 for EQ-5D and SG. The regression models showed that WHOQOL-BREF THAI, frequency of HIV symptoms, and patient characteristics could explain approximately 50% of the variation in the VAS and the EQ-5D and 20% in the SG². Among these three HU methods, the SG was the most difficult task.
Conclusion:  VAS, EQ-5D and SG yielded different HUs for this sample. VAS and EQ-5D showed stronger construct validity with other health measures than SG. From a feasibility perspective, the SG was the least satisfactory of the three approaches.     

A comparison of EQ-5D index scores using the UK,US, and Japan preference weights in a Thai sample with type 2 diabetes

Background  

Data are scarce on the comparison of EQ-5D index scores using the UK, US, and Japan preference weights in other populations. This study was aimed to examine the differences and agreements between these three weights, psychometric properties including test-retest reliability, convergent and known-groups validity, and the impact of differences in the EQ-5D scores on the outcome of cost-utility analysis in Thai people.     

Social Constructivist Learning Environment in an Online Professional Practice Course

Objective

To assess the online social constructivist learning environment (SCLE) and student perceptions of the outcomes of the online introductory module of pharmacy professional practice that was designed based on social constructivism theory.

Design

The online introductory module of pharmacy professional practice in pharmaceutical marketing and business was carefully designed by organizing various activities, which were intended to encourage social interaction among students. The Constructivist Online Learning Environment Survey (COLLES) was applied to assess the SCLE. Course evaluation questionnaires were administered to assess student perceptions of this online module.

Assessment

The result from the COLLES illustrated the development of SCLE in the course. The students reported positive perceptions of the course.

Conclusion

An online introductory module of pharmacy professional practice in pharmaceutical marketing and business was effective in promoting SCLE.     

Factors affecting decision making of low-income young women with unplanned pregnancies in Bangkok, Thailand

Unplanned pregnancy is one of the most difficult life experiences for young women. Women are often confused and seek help and support. When the problem occurs, a woman has three choices: parenting the baby, planning for adoption, or terminating the pregnancy. Choosing one of these three options is often difficult. This study aimed to identify the factors (variables) influencing women's decision making when choosing the options available to them. The study was conducted in five shelters and low-income communities in the Bangkok area. Data were collected for five months, November 2003 to March 2004. Young women, age 13-24, who experienced an unplanned pregnancy at least once, or currently experiencing an unplanned pregnancy, were recruited into the study. One hundred and twenty volunteer cases were recruited. Discriminant analysis was used to determine the factors that affecting the choices of young women with unplanned pregnancies. There were 6 potential influencing variables, in three broad categories of factors that influenced their choices. In this study, the influencing factors from the personal history variables were, age of the most recent unplanned pregnancy. The individual psychosocial variables were: attitude towards unplanned pregnancy, attitude towards contraception, and making a decision without consultation. The relationship variables were: relationship with partner, and consulting partner when having a problem. The results from discriminant analysis yielded 68.3% predictive accuracy. This result was satisfactory compared with a 33% chance of accuracy (classified as chance alone would yield a 33% accuracy). Knowing the influencing factors for the choices of young women with unplanned pregnancies allows us to understand the women's decisions and their utilization of services with some degree of confidence. The program managers or implementers should do as much as possible to support the decision making process in these young women in order to provide better information and services to reduce the impact, both physical and mental, of the selected choice.