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∫ ∑ «‘ ∑ ¬ “ ° “ √ 78 °√¡Õπ“¡—¬  à߇ √‘¡„Àâ§π‰∑¬  ÿ¢¿“楒 °√°Æ“§¡ - °—𬓬π 2555 °“√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√– ß§å‡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°∑—Èß 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

การพัฒนาหลักสูตรการให้คำปรึกษาเกี่ยวกับ เอช ไอ วี ในคู่สามีภรรยาที่มาฝากครรภ์

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วารสารการส่งเสริมสุขภาพและอนามัยสิ่งแวดล้อม ปีที่ 35 ฉบับที่ 3 กค.-กย.55

Text of การพัฒนาหลักสูตรการให้คำปรึกษาเกี่ยวกับ...

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78 °√¡Õπ“¡—¬ à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒°√°Æ“§¡ - °—𬓬π 2555

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

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√—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 °—∫°≈ÿࡵ—«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∑’ËÀπà«¬Ω“°§√√¿å‰¡àπâÕ¬°«à“ 6 ‡¥◊Õπ ®“°‚√ß欓∫“≈»Ÿπ¬å/∑—Ë«‰ª/™ÿ¡™π„π¿“§µ–«—πÕÕ°∑—Èß 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∑’Ë1-3 (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÷ßæÕ„®À≈—ß°“√Õ∫√¡ ∑”°“√«‘‡§√“–Àå¢âÕ¡Ÿ≈ ‚¥¬„™â ∂‘µ‘‡™‘ßæ√√≥π“ ”À√—∫¢âÕ¡Ÿ≈‡™‘ߪ√‘¡“≥ à«π¢âÕ¡Ÿ≈‡™‘ߧÿ≥¿“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√–¥—∫¥’·≈–¥’¡“° “¡“√∂𔉪„™â„Àâ∫√‘°“√‰¥â®√‘ß à«π°‘®°√√¡°“√æ—≤π“À≈—° Ÿµ√¡’§«“¡‡À¡“– ¡¥’¡“° ·≈–∑ÿ°§π‡ÀÁπ«à“µπ‡Õß∫√√≈ÿ

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THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH 79July - September 2012

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

Development of the training curriculum onHIV couple counseling in antenatal care

Ratana Petcharapun Public Health Officer, Senior Professional level.The Regional Health Promotion Center 3Wilaiphan Sawatphannit Associated Professor.Faculty of Nursing, Burapha UniversityPissamai Homchampa Assistant Professor.Faculty of Public Health, Burapha UniversityChintana Wacharasin Associated Professor.Faculty of Nursing, Burapha University

«—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„Àâ§Ÿà “¡’¿√√¬“‰¥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¬åÕπ“¡—¬‡¢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

This action research was aimed to develop a training curriculum on counseling of HIV positivecouple 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 ofcontents 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 wereapplied to the 1st training group and the 2nd and 3rd training groups, respectively. Finally, the properlyimproved curriculum was applied and evaluated in the 4th to 6th training groups. This research wasconducted between September 2007 to February 2009. The samples were nurses who have been workingmore than 6 months in antenatal care units of regional, general and community hospital of nine easternThailandûs provinces (Chonburi, Rayong, Chantaburi, Trad, Chachoengsao, Prachinburi, Srakaew,Nakornnayok and Smutprakarn). By purposive sampling, two sample groups were selected, one fromtrainees of the 1st to 3nd generation (n=40) and the other from trainees of the 4th to 6th training generation

Abstract

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80 °√¡Õπ“¡—¬ à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒°√°Æ“§¡ - °—𬓬π 2555

‚√ß欓∫“≈ ¡‡¥Á®æ√–∫√¡√“™‡∑«’ ≥ »√’√“™“®—ßÀ«—¥™≈∫ÿ√’ √–À«à“ߪï æ.». 2546-2549 ¡’À≠‘ßµ—Èߧ√√¿å∑’˵‘¥‡™◊ÈÕ‡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—Èߧ√√¿å∑’˵‘¥‡™◊ÈÕ‡Õ™‰Õ«’ ®”π«π 10 §πÕ“¬ÿ√–À«à“ß18-29 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≈°√–∑∫∑“ߥâ“𮑵„®·≈– —ߧ¡¢ÕߺŸâµ‘¥‡™◊ÈÕ·≈–§Ÿà‡æ» —¡æ—π∏å °“√„Àâ°“√ª√÷°…“·∫∫§Ÿà‡°’ˬ«°—∫‡Õ™‰Õ«’„π§Ÿà “¡’¿√√¬“∑’Ë¡“Ω“°§√√¿å πà“®–‡ªìπ«‘∏’°“√∑’˙૬„Àâ§Ÿà “¡’¿√√¬“ ‰¥â√—∫√Ÿâ·≈–‡¢â“„®∂÷ß惵‘°√√¡∑’ˇ ’ˬߵàÕ°“√µ‘¥‡™◊ÈÕ‡Õ™‰Õ«’ æ√âÕ¡∑—È߇ªî¥‚Õ°“ „Àâ “¡’¿√√¬“ ¡’°“√查§ÿ¬ ◊ËÕ “√°—π‰¥â¥’¡“°¬‘Ëߢ÷Èπ™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√ஓ°§π∑’˵‘¥·≈â« ‰ª Ÿà§Ÿà‡æ» —¡æ—π∏剥â 1,2,3,4,5,6,11,12

∫∑π”°“√·æ√à‡™◊ÈÕ‡Õ™‰Õ«’ ¬—ߧ߇ªìπªí≠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√«¡∑—Èßß“πªÑÕß°—π°“√·æ√à‡™◊ÈÕ °“√µ‘¥‡™◊ÈÕ√“¬„À¡à ·≈–°“√≈¥º≈°√–∑∫®“°ªí≠À“‡Õ¥ å∑—Èß„π√–¥—∫∫ÿ§§≈§√Õ∫§√—« ·≈–™ÿ¡™π ®“°º≈°“√µ√«®‡≈◊Õ¥À≠‘ßµ—Èߧ√√¿åæ∫§Ÿà‡æ» —¡æ—π∏å¡’º≈‡≈◊Õ¥µà“ß°—π §◊Õ “¡’À√◊Õ¿√√¬“µ‘¥‡™◊ÈÕ‡Õ™‰Õ«’ ·µàÕ’°ΩÉ“¬Àπ÷Ëßµ√«®‰¡àæ∫°“√µ‘¥‡™◊ÈÕÀ√◊Õ‰¡à¬Õ¡‰ªµ√«®‡≈◊Õ¥ ®“°√“¬ß“π¢Õߧ≈‘π‘°Ω“°§√√¿å ‚√ß欓∫“≈™≈∫ÿ√’®—ßÀ«—¥™≈∫ÿ√’ √–À«à“ߪï æ.». 2541-2547 ®“°À≠‘ßµ—Èߧ√√¿å∑’˵‘¥‡™◊ÈÕ‡Õ™‰Õ«’¡“Ω“°§√√¿å®”π«π430 §π·≈–¡’ “¡’¡“µ√«®‡≈◊Õ¥®”π«π 214 §πæ∫§Ÿà “¡’¿√√¬“∑’Ë¡’º≈‡≈◊Õ¥µà“ß°—π ®”π«π 100 §Ÿà§‘¥‡ªìπ√âÕ¬≈– 46.7 ·≈–¢âÕ¡Ÿ≈∑’˧≈‘π‘°Ω“°§√√¿å

(n=117). Data from the first sample group were collected by means of questionnaires and focus groupdiscussion, while those from the second were collected for learning achievement by knowledge tests andfor overview satisfaction by post training program questionnaires. Quantitative data were analyzed bydescriptive statistics analysis while qualitative data were analyzed by content analysis. The results revealedthat all the 9 lessons plans included modern well-defined contents which were practical and consistent withcurrent situation. The traineesû learning achievement scores were at good and very good level. Applicationof this training program to health care service is practical. Curriculum development activities were wellsuitable. All the trainees agreed that they achieved the curriculum objectives. Information and skills gainedfrom this training program were useful for them, clients and their work units. In addition, the overviewsatisfactory was at very good level as that was stated that çFeeling good on the training curriculum on HIVcouple counseling in antenatal care clinics was helpful to couples in solving problems that leading tounderstand each other and raised awareness in HIV infection risk. The clients received holistic care.éFurthermore, 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 guidelinesto improve performance on HIV couple counseling in antenatal care clinics. For the regional healthpromotion center or other agencies that need to apply the curriculum, it was suggested that contentimprovement of teaching plans in accordance with roles and area of responsibility.Key words : Development of the training curriculum, couple counseling, antenatal care

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THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH 81July - September 2012

°“√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∫§√—«∑’˵‘¥‡™◊ÈÕ‡Õ™‰Õ«’ ‡æ◊ËÕæ—≤π“»—°¬¿“æ∫ÿ§≈“°√¥â“π “∏“√≥ ÿ¢„π°“√„Àâ°“√ª√÷°…“∑’ˇ°’ˬ«¢âÕß°—∫°“√¥Ÿ·≈À≠‘ßµ—Èߧ√√¿å·≈–À≠‘ßÀ≈—ߧ≈Õ¥ ÷Ë߇ªìπÀ≈—° Ÿµ√∑’ˇ°’ˬ«°—∫‡Õ¥ å„π·¡à·≈–‡¥Á°¢Õß°√¡Õπ“¡—¬ ‡™àπÀ≈—° Ÿµ√°“√„Àâ°“√ª√÷°…“¬“µâ“π‰«√— „πÀ≠‘ßÀ≈—ߧ≈Õ¥·≈–§√Õ∫§√—«∑’˵‘¥‡™◊ÈÕ‡Õ™‰Õ«’ À≈—° Ÿµ√°“√„Àâ°“√ª√÷°…“°√≥’‡ªî¥‡º¬º≈‡≈◊Õ¥ (Disclo-sure) 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’Õπ“¡—¬ æ∫«à“ªí≠À“∑’˺à“π¡“ §◊ÕÀ≠‘ßµ—Èߧ√√¿åÀ√◊ÕÀ≠‘ßÀ≈—ߧ≈Õ¥∑’˵‘¥‡™◊ÈÕ‡Õ™‰Õ«’®–‰¡à°≈Ⓡªî¥‡º¬º≈‡≈◊Õ¥¢Õßµπ‡Õß°—∫ “¡’ À√◊ÕºŸâÕ◊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◊ËÕæ—≤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◊ËÕæ—≤π“À≈—° Ÿµ√°“√„Àâ°“√ª√÷°…“

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

«‘∏’°“√»÷°…“·∫à߇ªìπ 5 ¢—ÈπµÕπ §◊Õ1. °“√°”Àπ¥ª√–™“°√·≈–°“√‡≈◊Õ°

°≈ÿࡵ—«Õ¬à“ß §◊Õ æ¬“∫“≈¢Õß‚√ß欓∫“≈„π¿“§µ–«—πÕÕ°‰¥â·°à‚√ß欓∫“≈»Ÿπ¬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°≈ÿࡵ—«Õ¬à“߇ªìπ欓∫“≈∑”ß“πÀπà«¬Ω“°§√√¿å‰¡àπâÕ¬°«à“ 6 ‡¥◊Õ𠇧¬ºà“π°“√Õ∫√¡À≈—° Ÿµ√°“√„Àâ°“√ª√÷°…“‡Õ¥ å„π·¡à·≈–‡¥Á°Õ¬à“ßπâÕ¬ 1À≈—° Ÿµ√ ·≈– “¡“√∂‡¢â“√—∫°“√Õ∫√¡‰¥â§√∫µ“¡‡«≈“°”Àπ¥

2. °“√ÕÕ°·∫∫°“√«‘®—¬ „™â√–‡∫’¬∫«‘∏’°“√«‘®—¬‡™‘ߧÿ≥¿“æ ‚¥¬„™â°√–∫«π°“√«‘∏’°“√«‘®—¬‡™‘ߪؑ∫—µ‘°“√ (Action Research) ´÷Ëß¡’¢—ÈπµÕπ¥—ßπ’È

¢—ÈπµÕπ∑’Ë 1 ‡™‘≠ºŸâ∑√ߧÿ≥«ÿ≤‘ ‰¥â·°à»“ µ√“®“√¬å𓬷æ∑¬å ÿæ√ ‡°‘¥ «à“ß √Õß»“ µ√“®“√¬å«‘‰≈æ√√≥ «— ¥‘Ïæ“≥‘™¬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» °“√ ◊ËÕ “√ °“√æ—≤π“ —¡æ—π∏¿“æ„π§√Õ∫§√—« ∑—°…–°“√ª√÷°…“∑’Ë°àÕ„À⇰‘¥°“√‡ª≈’ˬπ·ª≈ß„π§√Õ∫§√—«·≈–§«“¡ ”§—≠·≈–§«“¡®”‡ªìπ„π°“√®—¥∑”·ºπ°“√ Õπ§Ÿà ¡√ ∑’ËΩ“°§√√¿å ‡æ◊ËÕÀ“·π«∑“ß®—¥∑”À≈—° Ÿµ√ „Àâ¡’·ºπ°“√ Õπ

¢—ÈπµÕπ∑’Ë 2 °“√«“ß·ºπ ‚¥¬ºŸâ∑√ߧÿ≥

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∫ ∑ «‘ ∑ ¬ “ ° “ √

82 °√¡Õπ“¡—¬ à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒°√°Æ“§¡ - °—𬓬π 2555

«ÿ≤‘√à«¡°—∫∑’¡«‘∑¬“°√ ®—¥∑”·ºπ°“√ Õπ √ÿª‰¥â9 ·ºπ

¢—ÈπµÕπ∑’Ë 3 ¡Õ∫À¡“¬ß“π „À⺟â∑√ߧÿ≥«ÿ≤‘·≈–∑’¡«‘∑¬“°√·µà≈–∑à “π‰ª‡¢’¬π·ºπ°“√ Õπµ“¡§«“¡‡™’ˬ«™“≠

¢—ÈπµÕπ∑’Ë 4 °“√®—¥∑”·ºπ°“√ Õπ ‚¥¬¡’«—µ∂ÿª√– ß§å ¥—ßπ’È

- «—µ∂ÿª√– ߧå∑—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√– ߧ凩擖 ‡¡◊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’‡°’ˬ«°—∫ ÿ¢¿“æ§√Õ∫§√—« ÿ¢¿“æ∑“ß‡æ» °“√ ◊ËÕ “√ °“√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‘¥‡™◊ÈÕ‡Õ™‰Õ«’ : °√≥’º≈‡≈◊Õ¥≈∫∑—ÈߧŸà

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

9. –∑âÕ𧫓¡√Ÿâ ÷°·≈–°“√𔉪ª√–¬ÿ°µå„™â (After Affective Refection)

3. °“√„™â·≈–ª√–‡¡‘πº≈À≈—° Ÿµ√ π”À≈—° Ÿµ√‰ª„™â„π°“√Õ∫√¡√ÿàπ∑’Ë 1 ‚¥¬„À⺟⇢â“Õ∫√¡ª√–‡¡‘πº≈À≈—° Ÿµ√æ∫«à“¡’§«“¡´È”´âÕπ¢Õ߇π◊ÈÕÀ“„π·ºπ°“√ Õπ∫“ß·ºπ ®÷߉¥âª√—∫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÷ßæÕ„® ‚¥¬‡™‘≠ºŸâ‡™’ˬ«™“≠ §◊Õ »“ µ√“®“√¬å𓬷æ∑¬å ÿæ√ ‡°‘¥ «à“ß ¡“„À⧫“¡√Ÿâ·≈–¢âÕ‡ πÕ·π–‡æ‘Ë¡‡µ‘¡ ·≈–π”À≈—° Ÿµ√‰ª„™âÕ∫√¡µàÕ„π√ÿàπ∑’Ë4-6 æ√âÕ¡∑—Èß„À⺟âÕ∫√¡ª√–‡¡‘πº≈À≈—° Ÿµ√ ‡æ◊ËÕπ”¢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 ‡§√◊ËÕß¡◊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√–‡¡‘𧫓¡πà“‡™◊ËÕ∂◊Õ¢Õß

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THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH 83July - September 2012

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

¢âÕ¡Ÿ≈‡™‘ߧÿ≥¿“æ10,16,17 §«“¡‡∑’ˬߵ√ß (Valid-ity) §≥–ºŸâ«‘®—¬‰¥â®—¥∑”·π«§”∂“¡‡æ◊ËÕ°“√ 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§§≈∑’˵à“ß°—π‚¥¬°“√ —¡¿“…≥å„π‡√◊ËÕ߇¥’¬«°—π ∑’Ë∑”ß“π„π·ºπ°‡¥’¬«°—π·µàµà“ß‚√ß欓∫“≈ °“√µ√«® Õ∫¢âÕ¡Ÿ≈®“°‡®â“¢ÕߢâÕ¡Ÿ≈ ¬◊π¬—π°“√«‘‡§√“–Àå¢âÕ¡Ÿ≈∑’ˉ¥â®“°æ¬“∫“≈∑’Ë√à«¡°≈ÿà¡«‘®—¬‡™‘ߪؑ∫—µ‘°“√§«“¡‡™◊ËÕ¡—Ëπ¢Õß°“√«‘®—¬ (Reliability) ‰¥â¡“®“°°“√∑’˧≥–ºŸâ«‘®—¬‡ªìπ欓∫“≈«‘™“™’æ ¡’∑—°…–·≈–ª√– ∫°“√≥å„π°“√ªØ‘∫—µ‘ß“π„πÀπâ“∑’Ë欓∫“≈ª√–®”°“√¡“°àÕ𠇪ìπºŸâ∑’ˇ°Á∫√«∫√«¡¢âÕ¡Ÿ≈¥â«¬µπ‡Õß∑—Èß°√–∫«π°“√∑”«‘®—¬ ‡æ◊ËÕ„À≥â¢âÕ¡Ÿ≈¡“«‘‡§√“–Àå ·≈–ª√– ∫°“√≥å„π°“√¥”‡π‘π°‘®°√√¡°≈ÿà¡

5. °“√®—¥°√–∑”·≈–°“√«‘‡§√“–Àå¢âÕ¡Ÿ≈

¢âÕ¡Ÿ≈∑—Ë«‰ª „™â ∂‘µ‘‡™‘ßæ√√≥π“ ¢âÕ¡Ÿ≈‡™‘ߧÿ≥¿“愙Ⱃ√«‘‡§√“–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„À⇰‘¥§«“¡‡¢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’‡°’ˬ«°—∫ ÿ¢¿“æ§√Õ∫§√—« ÿ¢¿“æ∑“ß‡æ» °“√ ◊ËÕ “√ °“√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‘¥‡™◊ÈÕ‡Õ™‰Õ«’ : °√≥’º≈‡≈◊Õ¥≈∫∑—ÈߧŸà(Couple VCT Post-test Counseling Concor-dant Sero-negative) ‡«≈“ 2 ™—Ë«‚¡ß

1.7°“√„Àâ°“√ª√÷°…“§Ÿà ¡√ À≈—ß°“√µ√«®À“°“√µ‘¥‡™◊ÈÕ‡Õ™‰Õ«’ : °√≥’º≈‡≈◊Õ¥∫«°∑—ÈߧŸà(Couple VCT Post-test Counseling Concor-dant Sero-positive ) 2 ™—Ë«‚¡ß

1.8°“√„Àâ°“√ª√÷°…“À≠‘ßµ—Èߧ√√¿å·≈– “¡’ : °√≥’º≈‡≈◊Õ¥µà“ß (Discordant CoupleCounseling) ‡«≈“ 3 ™—Ë«‚¡ß

1.9°“√ –∑âÕ𧫓¡√Ÿâ ÷°·≈–°“√𔉪ª√–¬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√÷°…“

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

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84 °√¡Õπ“¡—¬ à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒°√°Æ“§¡ - °—𬓬π 2555

¢âÕ¥’´÷Ëß∂◊Õ«à“‡ªìπ®ÿ¥·¢ÁߢÕßÀ≈—° Ÿµ√

§◊Õ§«“¡§√Õ∫§≈ÿ¡·≈–§«“¡≈–‡Õ’¬¥ÕàÕπ¢Õ߇π◊ÈÕÀ“ ·≈–ª√–‚¬™πå∑’Ë ‡°‘¥¢÷Èπ®“°°“√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“–∑’ˇ°’ˬ«°—∫°“√„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„Àâ§Ÿà “¡’¿√√¬“¡’º≈‡≈◊Õ¥‡ªìπ≈∫µ≈Õ¥‰ª °“√ªØ‘∫—µ‘µπ‡æ◊ËÕ°“√ªÑÕß°—π‚√§√«¡∑—Èߢ—ÈπµÕπ·≈–‡∑§π‘§°“√„Àâ°“√ª√÷°…“ ‚¥¬‡©æ“–°“√·®âߺ≈°“√µ√«®‡≈◊Õ¥ ∑”„Àâ∑√“∫∂÷ߪí≠À“¢ÕߧŸà “¡’¿√√¬“ ¡Õ߇ÀÁπ·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«“¡‡ ’ˬߵàÕ°“√µ‘¥‡™◊ÈÕ‡Õ™‰Õ«’ ∑”„À≥⥟·≈ºŸâ√—∫∫√‘°“√·∫∫Õߧå√«¡é ·≈–«‘∏’°“√Ωñ°Õ∫√¡„πÀ≈—° Ÿµ√ ‚¥¬‡©æ“–·ºπ°“√ Õπ∑’Ë 6, 7, 8 ∑”„À⇰‘¥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¢âÕ§‘¥‡ÀÁπ‡æ‘Ë¡ ‡µ‘¡«à“ ‡π◊È ÕÀ“„πÀ≈—° Ÿµ√§√Õ∫§≈ÿ¡ ·µà‡ªìπ·∫∫°«â“ßÊ ‰¡à¡’§” ”§—≠À√◊Õ¢âÕ§«“¡ —ÈπÊ ∑’Ë∑”„Àâ®”‰¥âßà“¬¢÷Èπ‡¡◊ËÕ𔉪„™â

”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 ‡°’ˬ«°—∫°“√„™â¬“ °“√ªÑÕß°—π¿“«–·∑√°´âÕπ ·≈–¬“µâ“π‰«√— ‡Õ¥ å ‡æ‘Ë¡°“√Ωñ°∑—°…–°“√„Àâ°“√ª√÷°…“∑’Ë ”§—≠ À√◊Õ®—¥∑”‡ªìπÀ≈—° Ÿµ√‡©æ“–‡°’ˬ«°—∫∑—°…–°“√·®âߺ≈‡≈◊Õ¥µà“ߧ«√¡’µ—«Õ¬à“ß∫∑ π∑π“„π°“√„Àâ°“√ª√÷°…“ °“√‡√’¬π√Ÿâ®“°µ—«·∫∫‚¥¬‡©æ“–®“°«’¥’∑—»πå ·≈–§«√¡’°“√ª√–‡¡‘πº≈®“°·∫∫∫—π∑÷°√“¬°“√(Check list) ·≈–§«√‡æ‘Ë¡°≈«‘∏’°“√‚πâ¡πâ“«∑’ˉ¥âº≈¡“°°«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

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®—¥°“√¢ÕßÀπà«¬ß“π ®“°‚√ß欓∫“≈∑ÿ°√–¥—∫¡’ªí≠À“À≈“¬¥â“π‰¥â·°à

1) ¥â“πºŸâ∫√‘À“√ ºŸâ∫√‘À“√¢ÕßÀπ૬ߓπ‰¡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 ‚¥¬∑’ˬ—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◊ËÕÀ“°“√µ‘¥‡™◊ÈÕ‡Õ™‰Õ«’ „π “¡’ √“§“

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THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH 85July - September 2012

°“√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ìππ‚¬∫“¬°“√„Àâ∫√‘°“√Ω“°§√√¿å·∫∫§Ÿà ‡æ◊ËÕ„À⺟â∫√‘À“√„Àâ°“√ π—∫ πÿπ¥â“π∑√—欓°√

2) Àπ૬ߓπ§«√¡’°“√ª√—∫√–∫∫°“√„Àâ

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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“

§–·ππ‡©≈’ˬ (X) À≈—ß®“°°“√Õ∫√¡ ∑—Èß3 √ÿàπ ‡æ‘Ë¡¢÷Èπ 3.6, 3.8 ·≈– 5.6 µ“¡≈”¥—∫ ¥—ßµ“√“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¬

®”π«π 576 691 664 809 745 1,008

X 18.0 21.6 17.5 21.3 15.9 21.5

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

§–·ππ √ÿàπ∑’Ë 4 √ÿàπ∑’Ë 5 √ÿàπ∑’Ë 6

Pre-test Post-test Pre-test Post-test Pre-test Post-test

≈– 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)

1. ß“π∑’Ë∑à“π∑”ªí®®ÿ∫—π‡°’Ë¬«¢âÕß°—∫°“√Õ∫√¡§√—Èßπ’ȇ撬߄¥ 43.4 37.7 12.9 2.6 3.42. §«“¡√Ÿâ¢Õß∑à“π°àÕπ‡¢â“√—∫°“√Õ∫√¡§√—Èßπ’È 5.4 6.3 46.3 34.1 7.93. §«“¡√Ÿâ¢Õß∑à“πÀ≈—߇¢â“√—∫°“√Õ∫√¡§√—Èßπ’È 24.7 71.9 3.4 0.0 0.04. ∑à“π “¡“√∂𔧫“¡√Ÿâ‰ª„™âª√–‚¬™πå„π°“√æ—≤π“ß“π 34.0 61.5 4.5 0.0 0.05. «‘∑¬“°√„π°“√Õ∫√¡‡À¡“– ¡ 76.3 23.7 0.0 0.0 0.06. ≈—°…≥–°“√∂à“¬∑Õ¥§«“¡√Ÿâ‡À¡“– ¡ 76.3 23.7 0.0 0.0 0.0

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∫ ∑ «‘ ∑ ¬ “ ° “ √

86 °√¡Õπ“¡—¬ à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒°√°Æ“§¡ - °—𬓬π 2555

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°√–¥—∫ ∑—Èß‚√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欓∫“≈™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‡©≈’ˬ 39.5ªï) ‡ªìπ欓∫“≈«‘™“™’懰◊Õ∫∑—ÈßÀ¡¥ à«π„À≠à¡’°“√»÷°…“√–¥—∫ª√‘≠≠“µ√’√âÕ¬≈– 92.5 ·≈–‡ªìπºŸâªØ‘∫—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„πÀπ૬ÀâÕߧ≈Õ¥·≈–ÀÕºŸâªÉ«¬À≈—ߧ≈Õ¥ Àπ૬ߓπ∑’Ë„Àâ∫√‘°“√Ω“°§√√¿å 2 «—πµàÕ —ª¥“Àå√âÕ¬≈– 45.0 ∂÷ß

·¡â«à“ à«π„À≠à√–∫ÿ«à“¡’ª√– ∫°“√≥å„Àâ∫√‘°“√ª√÷°…“„π§≈‘π‘°Ω“°§√√¿å·µà¬—ßæ∫«à“ √âÕ¬≈– 22.5‡ªìπºŸâ∑’ˉ¡à‡§¬„Àâ∫√‘°“√∑’˧≈‘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 §ŸàµàÕ«—π¡“°∑’Ë ÿ¥√âÕ¬≈– 32.0 ¥—ßµ“√“ß∑’Ë 3

2.4 ¥â“πº≈º≈‘µ·≈–º≈≈—æ∏å „™â·∫∫√“¬ß“π°“√‡°Á∫¢âÕ¡Ÿ≈

º≈°“√¥”‡π‘πß“π„Àâ∫√‘°“√ª√÷°…“„π§≈‘π‘°Ω“°§√√¿å ®”π«π 40 ·Ààß ´÷Ëß¡’∑—Èß‚√ß欓∫“≈»Ÿπ¬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·∫∫§Ÿà‰¡àµ√ß°—∫π‚¬∫“¬¢ÕߺŸâ∫√‘À“√ 2 ·Àà߉¡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—Èπæ∫«à“ ¡’§«“¡æ√âÕ¡·≈– “¡“√∂„Àâ∫√‘°“√ª√÷°…“‡°’ˬ«°“√µ‘¥‡™◊ÈÕ‡Õ™‰Õ«’/‡Õ¥ å ”À√—∫À≠‘ßµ—Èߧ√√¿å·≈–§Ÿà ¡√ ®”π«π 3,242 §Ÿà ®“°®”π«π

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

7. ‡π◊ÈÕÀ“„π°“√Õ∫√¡‡À¡“– ¡ 66.9 33.1 0.0 0.0 0.09. ◊ËÕÕÿª°√≥å„π°“√Õ∫√¡‡À¡“– ¡ 31.5 51.8 12.3 4.4 0.010. √–¬–‡«≈“„π°“√Õ∫√¡‡À¡“– ¡ 30.2 52.6 13.5 3.7 0.011. ∑à“π¡’§«“¡æ÷ßæÕ„®µàÕ°“√Õ∫√¡„π¿“æ√«¡ 41.9 54.8 3.3 0.0 0.0

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Page 10: การพัฒนาหลักสูตรการให้คำปรึกษาเกี่ยวกับ เอช ไอ วี ในคู่สามีภรรยาที่มาฝากครรภ์

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH 87July - September 2012

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

‡ªìπ∫ÿ§≈“°√ºŸâ„Àâ∫√‘°“√„π§≈‘π‘°Ω“°§√√¿å 38 95.0

®”π«π«—π∑’Ë„Àâ∫√‘°“√ (§√—ÈßµàÕ —ª¥“Àå)1 «—π 15 37.52 «—π 18 45.03 «—π 2 5.05 «—π 5 12.5√–¬–‡«≈“∑’˪ؑ∫—µ‘ß“π„π§≈‘π‘°Ω“°§√√¿å

‰¡à‡§¬„Àâ∫√‘°“√∑’˧≈‘π‘°Ω“°§√√¿å 9 22.5πâÕ¬°«à“ 1 ªï 3 7.51 - 2 ªï 10 25.03 - 4 ªï 7 17.5¡“°°«à“ 5 ªï 11 27.5

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∫√‘°“√ √–¬–‡«≈“∑’˪ؑ∫—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

∫ÿ§≈“°√∑’Ë¡’ª√– ∫°“√≥å„π°“√„Àâ∫√‘°“√Ω“°§√√¿å·∫∫§Ÿà

‰¡à¡’ª√– ∫°“√≥å 15 37.5¡’ª√– ∫°“√≥å¡“·≈â«πâÕ¬°«à“ 1 ªï 22 55.0¡’ª√– ∫°“√≥å¡“·≈â«¡“°°«à“ 1 ªï 3 7.5∫ÿ§≈“°√∑’ËÕ¬Ÿà„πÀπ૬ߓπ‡ªî¥„Àâ∫√‘°“√Ω“°§√√¿å·∫∫§Ÿà 25 62.5

®”π«πºŸâ¡“√—∫∫√‘°“√Ω“°§√√¿å·∫∫§Ÿà (§ŸàµàÕ«—π) n= 25 √âÕ¬≈– 100.01 - 2 §Ÿà 7 28.03 - 5 §Ÿà 5 20.0¡“°°«à“ 5 §Ÿà 8 32.0„Àâ∫√‘°“√ª√÷°…“Ω“°§√√¿å‡ªìπ√“¬°≈ÿà¡ 5 20.0

À≠‘ßµ—Èߧ√√¿å√“¬„À¡à∑—ÈßÀ¡¥„π™à«ß‡«≈“‡¥’¬«°—π12,765 §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¬≈–

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 ÷Ëß¿√√¬“¡’º≈°“√µ√«®æ∫°“√µ‘¥‡™◊ÈÕ ‡Õ™‰Õ«’„π —¥ à«π∑’Ë¡“°°«à“ “¡’ 1.3 : 1 ¥—ßµ“√“ß∑’Ë 4

º≈°“√«‘®—¬§√—Èßπ’È ‡ªìπª√–‚¬™πå ”À√—∫ºŸâ

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∫ ∑ «‘ ∑ ¬ “ ° “ √

88 °√¡Õπ“¡—¬ à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒°√°Æ“§¡ - °—𬓬π 2555

®”π«πÀ≠‘ßΩ“°§√√¿å√“¬„À¡à∑—ÈßÀ¡¥ 12,765 §π(„π™à«ß‡«≈“‡¥’¬«°—π) 3,242 25.41. ®”π«π§Ÿà “¡’¿√√¬“√“¬„À¡à∑’Ë¡“√—∫∫√‘°“√ª√÷°…“‡ªìπ§Ÿà§√—Èß·√° 3,242 100.02. ®“°¢âÕ 1 ®”π«π “¡’∑’ˉ¡à¬Õ¡µ√«®‡≈◊Õ¥À“ HIV „Àâ¿√√¬“µ√«®§π‡¥’¬« 1,364 42.13. ®“°¢âÕ 1 ®”π«π§Ÿà “¡’¿√√¬“∑’ˬաµ√«®‡≈◊Õ¥À“ HIV æ√âÕ¡°—π∑—ÈߧŸà 1,878 57.9

3.1 ®“°¢âÕ 3 º≈°“√µ√«®‡≈◊Õ¥À“ HIV ≈∫∑—ÈߧŸà 1,816 96.73.2 ®“°¢âÕ 3 º≈°“√µ√«®‡≈◊Õ¥À“ HIV ∫«°∑—ÈߧŸà 18 1.03.3 ®“°¢âÕ 3 º≈°“√µ√«®‡≈◊Õ¥À“ HIV “¡’∫«° ¿√√¬“≈∫ 19 1.03.4 ®“°¢âÕ 3 º≈°“√µ√«®‡≈◊Õ¥À“ HIV ¿√√¬“∫«° “¡’≈∫ 25 1.3

4. ®“°¢âÕ 3 ®”π«π§Ÿà “¡’¿√√¬“∑’ˬաøíߺ≈°“√µ√«®‡≈◊Õ¥ HIV æ√âÕ¡°—π 1,853 98.75. ®“°¢âÕ 3 ®”π«π§Ÿà “¡’¿√√¬“∑’Ëøíߺ≈°“√µ√«®‡≈◊Õ¥ HIV ∑’Ë≈–§π 25 1.3

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

√“¬°“√ ®”π«π (§Ÿà) √âÕ¬≈–

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

¢âÕ‡ πÕ·π–„π°“√π”º≈«‘®—¬‰ª „™â1. 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√◊ÕÀπ૬ߓπÕ◊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√“®“√¬å𓬷æ∑¬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¡ ‘ßÀå ºŸâÕ”π«¬°“√»Ÿπ¬åÕπ“¡—¬∑’Ë 3 ∑’Ë„Àâ°“√ π—∫ πÿπ„π°“√¥”‡π‘π°‘®°√√¡µà“ßÊ ‡ªìπÕ¬à“ߥ’

‡Õ° “√Õâ“ßÕ‘ß1. 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 Self-esteem and HIV Transmission Prevention Behaviors among Seropositive Postpartum ThaiWomen.é Action Research, April 2;2006.

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THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH 89July - September 2012

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

H E A L T H

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3. Sawatphanit, W., Ross, R., & Suwansujarid, T. Development of self-esteem among HIV positivepregnant 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 HIV-Positive Pregnant Thai Woman who was a Former Sex Worker: Case Study. Archives ofPsychiatric Nursing. (2007); 21(1), 32-39.

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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√‚¥¬‡πâπºŸâ‡√’¬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¢âÕ¡Ÿ≈„π°“√«‘®—¬‡™‘ߧÿ≥¿“æ.æ‘¡æå§√—Èß∑’Ë 2. °√ÿ߇∑æœ: ”π—°æ‘¡æå·Ààß

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