Charoensiwarak Kulchayada, Kitreerawutiwong Nithra
Faculty of Public Health, Naresuan University, Phitsanulok Province, 65000, Thailand.
BMC Public Health. 2025 Apr 1;25(1):1236. doi: 10.1186/s12889-025-22351-w.
Hand, foot, and mouth disease (HFMD) is a contagious disease associated with several outbreaks in Thailand, especially among children under five years old, particularly those in childcare centers. This cross-sectional study aimed to investigate the knowledge, attitudes, and practices related to the prevention and control of HFMD and to identify the factors associated with the practices among teachers and child caregivers in childcare centres in Phitsanulok Province.
The sample included 270 teachers and child caregivers in childcare centres under the local governments in the 9 districts of Phitsanulok Province, Thailand, through stratified random sampling. A validated and reliable self-administered questionnaire was used to collect data. The data were analysed using descriptive statistics and multiple logistic regression to identify associated variables at the α = 0.05 significance level.
In total, 156 participants (57.78%) had inadequate knowledge (score < 10), 192 participants (71.11%) had a negative attitude (score < 60), 202 participants (74.81%) reported insufficient support for information and equipment (score < 54), and 196 participants (72.59%) displayed low levels of preventive practice (score < 95). Multivariate analysis revealed that participants who had experience caring for children with HFMD (AOR = 2.57, 95% CI = 1.29-5.13, p = 0.007), those with positive attitudes towards HFMD (AOR = 2.69, 95% CI = 1.41-5.15, p = 0.003), and those who received adequate information and equipment support from the local government and healthcare sector (AOR = 6.26, 95% CI = 3.26-12.02, p < 0.001) were more likely to engage in the prevention and control of HFMD practices.
These findings emphasize the need for training programs designed using experiential-based learning (EBL) to increase positive attitudes and practices. Furthermore, local governments and healthcare sector should increase support for providing information and equipment consistent with the Ministry of Public Health guidelines in Thailand.
手足口病（HFMD）是一种传染病，在泰国多次爆发，尤其是在五岁以下儿童中，特别是在托儿所的儿童。这项横断面研究旨在调查与手足口病预防和控制相关的知识、态度和做法，并确定泰国彭世洛府托儿所教师和儿童保育员中与这些做法相关的因素。
通过分层随机抽样，样本包括泰国彭世洛府9个区地方政府管辖下托儿所的270名教师和儿童保育员。使用经过验证且可靠的自填式问卷收集数据。采用描述性统计和多元逻辑回归分析数据，以在α = 0.05显著性水平下确定相关变量。
总共156名参与者（57.78%）知识不足（得分<10），192名参与者（71.11%）态度消极（得分<60），202名参与者（74.81%）报告在信息和设备方面支持不足（得分<54），196名参与者（72.59%）预防措施水平较低（得分<95）。多变量分析显示，有照顾手足口病患儿经验的参与者（比值比[AOR]=2.57，95%置信区间[CI]=1.29 - 5.13，p = 0.007）、对手足口病态度积极的参与者（AOR = 2.69，95% CI = 1.41 - 5.15，p = 0.003）以及从地方政府和医疗部门获得充足信息和设备支持的参与者（AOR = 6.26，95% CI = 3.26 - 12.02，p < 0.001）更有可能参与手足口病的预防和控制工作。
这些发现强调需要设计基于体验式学习（EBL）的培训项目，以增强积极态度和做法。此外，地方政府和医疗部门应加大支持力度，按照泰国公共卫生部的指南提供信息和设备。
