Medicine and Health Sciences Commons^™

A Study Of Innovation In Model Project Design: Addressing Mental Health Symptoms Among Co-Occurring Substance Use And Mentally Ill Clients Who Are Homeless In A Local Community Clinic Setting, Isis Dian Martel

Graduate Theses and Dissertations

Homeless persons with co-occurring substance use combined with mental illness constitute a particularly vulnerable subgroup with complex service needs. Unfortunately, the capacity to deliver critical treatment services has been extremely limited causing many from this population to remain untreated. Untreated co-occurring disorders can lead to a host of difficulties for both the individual and the community (Bouchery, Harwood, Sacks, Simon, & Brewer, 2011). Developing community based intervention services in Arkansas is a key activity necessary in strategically addressing this problem (Barbee, Gonzales, & Shelor, 2016). In partnership with the Arkansas Division of Behavioral Health Services, a local community treatment provider …

Acceptability Of The Md Anderson Symptom Inventory And Qualitative Analysis Of Barriers To Palliative Care Services For Rural And Non-Rural Populations, Daniel M. W. Johnson

Doctoral Projects

The United States health system strives to improve the care patients receive while reducing healthcare expenditures. A significant portion of the nation’s healthcare expenditure is spent on end of life care. Palliative care provides one solution to reducing healthcare expenditures while improving the patient experience. Reducing symptom intensity is one example of palliative care’s success. A midwest palliative care program was tasked to gather quality data on the service’s ability to manage patient symptoms.

The program selected the MD Anderson Symptom Inventory to improve symptom assessment and provide quality metrics for the organization. Additionally, research suggests rural populations have poorer …

Tuberculosis And Risk Of Acute Myocardial Infarction: A Propensity Score-Matched Analysis, Moises A. Huaman, Richard J. Kryscio, Carl J. Fichtenbaum, David Henson, Elizabeth G. Salt, Timothy R. Sterling, Beth A. Garvy

Biostatistics Faculty Publications

Several pathogens have been associated with increased cardiovascular disease (CVD) risk. Whether this occurs with Mycobacterium tuberculosis infection is unclear. We assessed if tuberculosis disease increased the risk of acute myocardial infarction (AMI). We identified patients with tuberculosis index claims from a large de-identified database of ~15 million adults enrolled in a U.S. commercial insurance policy between 2008 and 2010. Tuberculosis patients were 1:1 matched to patients without tuberculosis claims using propensity scores. We compared the occurrence of index AMI claims between the tuberculosis and non-tuberculosis cohorts using Kaplan–Meier curves and Cox Proportional Hazard models. Data on 2026 patients with …

A Pilot Investigation Of Acute Inhibitory Control Training In Cocaine Users, Joseph L. Alcorn, Erika Pike, William W. Stoops, Joshua A. Lile, Craig R. Rush

Behavioral Science Faculty Publications

Background—Disrupted response inhibition and presence of drug-cue attentional bias in cocaine-using individuals have predicted poor treatment outcomes. Inhibitory control training could help improve treatment outcomes by strengthening cognitive control. This pilot study assessed the effects of acute inhibitory control training to drug- and non-drug-related cues on response inhibition performance and cocaine-cue attentional bias in cocaine-using individuals.

Methods—Participants who met criteria for a cocaine-use disorder underwent five sessions of inhibitory control training to either non-drug-related cues (i.e., rectangles) or cocaine cues (n=10/condition) in a single day. Response inhibition and attentional bias were assessed prior to and following training using …

Spinal Cord Injury Induced Cardiac Decline And The Limitations Of Exercise., Kathryn Michele Deveau

Electronic Theses and Dissertations

There is a general consensus that the level and the severity of spinal cord injury (SCI) impacts chronic cardiac abnormalities such that high thoracic and cervical SCI are the most severely affected. Furthermore, the extreme degree of immobility/inactivity experienced by the persons with SCI has implications on cardiac decline. Yet it has been difficult to separate the relative contributions of the decentralized autonomic nervous system (ANS) and the immediate and profound inactivity to chronic cardiac abnormalities. As such, this body of work sought to characterize a contusion SCI that results in persistent CV dysfunction. Echocardiography, Dobutamine stress echocardiography and pressure …

Expression Of Zeb Factors In Oral Squamous Cell Carcinoma., Saira Ahmed

Electronic Theses and Dissertations

Objectives: The ZEB family of transcription factors (ZEB1 and ZEB2) have been demonstrated to play a role in metastatic progression of several cancers, and may also influence the initial transformation and generation of cancer stem cells. However, the expression pattern of ZEB proteins in the development of oral squamous cell carcinoma has not been investigated. The purpose of this study was to define changes in expression and subcellular localization of the ZEB family in both precancerous lesions and different grades of OSCC. Materials and Methods: Seventy-nine tongue biopsies were subjected to immunohistochemistry and immunofluorescence to determine the expression and subcellular …

Characterization Of A Mutant Oncolytic Adenovirus And The Role Of Jnk In Enhancing Virotherapy., Stephen L. Wechman

Electronic Theses and Dissertations

Oncolytic adenoviruses (Ads) have great therapeutic potential for lung cancer treatment. Cancer selective E1b-deleted Ads are safe; however, their clinical cancer therapeutic efficacy remains limited. The limited efficacy of Ad virotherapy is due to many factors including inefficient cancer cell lysis, Ad release and spread. Progress in overcoming these barriers to Ad virotherapy are hampered by limited knowledge of the genes associated with enhanced Ad release and spread and the dearth of understanding of the mechanisms by which E1b-deleted Ads cause cancer cell lysis. The role of c-JNK n- terminal kinase (JNK) phosphorylation in this process remains unknown. …

The Interaction Of Homoserine Lactones And Paraoxonase 2 Modulates Cell Death Signaling And Cell Proliferation., Aaron Mackallan Neely

Electronic Theses and Dissertations

Pseudomonas aeruginosa produces N-(3-oxododecanoyl)-homoserine lactone (C12) as a quorum-sensing molecule that functions to facilitate bacteria-bacteria communication. C12 has also been reported to affect many aspects of human host cell physiology, including evoking cell death in various types of cells. However, the signaling pathway(s) leading to C12-triggerred cell death remains unclear. To clarify cell death signaling induced by C12, we examined mouse embryonic fibroblasts (MEFs) deficient in one or more caspases. Our data indicate that, unlike most apoptotic inducers, C12 evokes a novel form of apoptosis in cells, probably through the direct induction of mitochondrial membrane permeabilization. Importantly, C12 induces apoptosis …

Using An Audience Response System To Calibrate Dental Faculty Assessing Student Clinical Competence., Sean A. Aiken

Electronic Theses and Dissertations

In order to best prepare students to become competent and confident practitioners in a clinical environment upon graduating dental school, it is imperative for them to receive consistent and productive feedback from the supervising faculty. Through academic engagement, and more specifically faculty calibration, it may be possible to eliminate the disconnect that sometimes exists between faculty expectations and terminology, and those of the students. In terms of definitions, academic engagement reflects faculty scholarly development activities that support integration of relevant, current theory of best practices consistent with the school's mission, expected learner outcomes, and supporting strategies.1-6, 32 The difficulty lies …

Exploring A Novel Nf-ĸb- Inhibiting Nanoparticle For Periodontitis Therapy., Kameswara Satya Srikanth Upadhyayula

Electronic Theses and Dissertations

Periodontitis is an infection-driven inflammatory disease characterized by gingival inflammation and bone loss. The NF-ĸB signaling pathway is pivotal in osteoclastogenesis and infection-induced pro-inflammatory responses. The use of nanoparticles as a vehicle to deliver drug increases stability, loading capacity, and facilitates transmembrane transportation. The hypothesis was that a novel nanoparticle carrying therapeutic NBD inhibitory peptides (NBD-nanoparticles) will inhibit measures of periodontal disease. In this project, we tested the nanoparticles for their ability to directly inhibit osteoclastogenesis and inflammation as an original strategy for periodontitis therapy. We also tested the capability of the nanoparticles to inhibit gingival inflammation and alveolar bone …

The Effects Of Moderate Alcohol Consumption And Inflammation On The Hepatic Matrisome And The Renal Cortex Proteome., Christine E. Dolin

Electronic Theses and Dissertations

Background. The association of chronic ethanol (EtOH) consumption with extracellular matrix (ECM) changes in alcoholic liver disease (ALD) is well established in the context of hepatic fibrosis. However, it is becoming increasingly understood that the hepatic ECM responds dynamically to stress well before fibrosis. The term “transitional tissue remodeling” describes qualitative and quantitative ECM changes in response to injury that do not alter the overall architecture of the organ; these ECM changes may contribute to early disease initiation and/or progression. The nature and magnitude of these changes to the ECM are currently poorly understood. In contrast to the liver, EtOH …

Neural Coding Of Natural And Synthetic Speech., Allison Brown

Electronic Theses and Dissertations

The present study examined whether natural and synthetic speech are differentially encoded in the auditory cortex. Auditory event-related potential (ERP) waveforms were elicited by natural and synthetic fricative-vowel stimuli (/sɑ/ and /ʃɑ/) in a passive listening paradigm in adult listeners with normal hearing. ERP response components were compared across conditions. The results indicated that peak latencies to natural speech were significantly earlier than those to synthetic speech. Natural speech also produced significant electrode hemisphere site effects, whereas synthetic speech activated left, midline, and right electrode hemisphere sites equally. Overall, the results suggest that cortical processing of natural and synthetic speech …

Evaluating The Impact Of Statewide Policy Implementation On Interorganizational Collaboration At The Regional Level : An Application Of Network Analysis., Nida Moez Ali

Electronic Theses and Dissertations

One challenge to improving population health in the United States is that the systems tasked with the responsibility of providing services across the continuum of care often operate in silos, missing opportunities to provide quality, coordinated care. In 2011, Texas received approval from the Centers for Medicare and Medicaid Services (CMS) for a five-year 1115(a) Medicaid Waiver Demonstration Project. This dissertation focuses on one element of the Waiver, the Delivery System Reform Incentive Payment (DSRIP) Program, which was designed to incentivize activities that support organizations’ collaborative efforts with other organizations in addressing the Triple Aim strategies. DSRIP was implemented through …

Withaferin A Synergistically Enhances The Effects Of Paclitaxel Against Lung Cancer., Al Hassan Kyakulaga

Electronic Theses and Dissertations

Lung cancer is the leading cause of cancer-related deaths among both men and women in the U.S and worldwide. Today, paclitaxel (PAC) or taxol alongside platinum-based drugs is the most widely used agent as the first-line regimen for advanced NSCLC. However, due to toxicity, drug resistance, solubility and efficacy issues, efficacy has plateaued. In the present study, the potential of a novel plant-derived steroidal-lactone, withaferin A (WFA), for clinical use alongside PAC to improve efficacy against NSCLC was explored. The anticancer effects of PAC and WFA alone, and in combination against the in vitro cell proliferation, cell adhesion, migration and …

Diffusion-Weighted Magnetic Resonance Imaging In Diagnosing Graft Dysfunction : A Non-Invasive Alternative To Renal Biopsy., Elizabeth Marie Hollis

Electronic Theses and Dissertations

The thesis is divided into three parts. The first part focuses on background information including how the kidney functions, diseases, and available kidney disease treatment strategies. In addition, the thesis provides information on imaging instruments and how they can be used to diagnose renal graft dysfunction. The second part focuses on elucidating the parameters linked with highly accurate diagnosis of rejection. Four parameters categories were tested: clinical biomarkers alone, individual mean apparent diffusion coefficient (ADC) at 11-different b- values, mean ADCs of certain groups of b-value, and fusion of clinical biomarkers and all b-values. The most accurate model was found …

The Association Between Motor Proficiency, Cognitive Tempo, Academic Skills, Balance And Visual Efficiency In Elementary School Aged Children., Franklin R. Muntis

Electronic Theses and Dissertations

The purpose of this study was to investigate the association between motor proficiency, cognitive tempo, academic skills, balance and visual efficiency in elementary school aged children at a local Spanish immersion school. Forty-nine students and their parents provided consent to participate in the study. Motor proficiency was measured using the Bruininks-Oseretsky Test of Motor Proficiency Second Edition (BOT-2), cognitive tempo and academic skills were assessed using the Child and Adolescent Behavior Inventory, Visual Efficiency was measured using Visual Efficiency Rating (VERA) and Balance was measured using a Neurocom^® platform function for stability evaluation test to determine limits of stability. …

Targeting The Glucose Metabolism Of Myeloid-Derived Suppressor Cells (Mdscs) To Stimulate Cancer Immunity., Jaspreet Grewal

Electronic Theses and Dissertations

Myeloid derived suppressor cells (MDSCs) are a heterogeneous group of immature myeloid cells that are significantly increased in cancer patients and correlate with higher stage and poor prognosis. MDSCs negatively modulate anti-tumor immunity, suppress T cell activity, promote angiogenesis and increase the risk of metastasis. In this study, we report that monocytic-MDSCs (M-MDSCs) but polymorphonuclear-MDSCs (PMN-MDSCs) over-express 6-phosphofructo-2-kinase/fructose-2, 6-bisphosphatases 3 (PFKFB3), an important regulator of glycolysis. Furthermore in the melanoma model, M-MDSCs but not PMN-MDSCs suppressed T cell function which correlated with PFKFB3 over-expression and increased rate of glycolysis. PFKFB3 inhibition with the first-in-class small molecule inhibitor, PFK-158 reversed M-MDSC …

Treg Regulation In Periodontal Disease During Pregnancy., Aislinn Leah Hays

Electronic Theses and Dissertations

Background: Although pregnancy is prone to induce more severe periodontal inflammation and tissue damage, its mechanism remains elusive. Periodontal diseases during pregnancy are associated with adverse pregnancy outcomes including preterm birth or low birth weight. Animal models are ideal for investigating immunological mechanisms in periodontal disease. With a newly modified ligature-induced disease model, we managed to develop periodontal disease in pregnant mice and investigate the immunological mechanism of more severe symptoms during pregnancy. Hypothesis: We hypothesis that P. gingivalis infection during pregnancy will lead to a down-regulation of Treg cells, therefore causing increased inflammation and disease severity. Methods: A ligature-induced …

Enhancing Cell Therapy For Ischemic Cardiomyopathy., Michael J. Book

Electronic Theses and Dissertations

Cardiac cell therapy using cardiac mesenchymal cells (CMC) significantly reduces ventricular dysfunction in patients with ischemic cardiomyopathy. Despite the improvement in function, a modest number of CMCs survive in the heart post-transplantation. In this study, we sought to improve the survival and retention of transplanted CMCs to prolong the therapeutic benefits afforded by cardiac cell therapy. To do this, we targeted the enzyme telomerase (TERT), known to be active in some highly proliferating cells (e.g. germ, stem). TERT is responsible for preventing telomere attrition, thereby allowing continued proliferation. TERT has also been shown to be protective, improve cell migration and …

The Effect Of Caffeine On Fecundability : Differences In Coffee, Tea, And Cola Consumption., Emily Kathleen Steinmetz

Electronic Theses and Dissertations

This study examined whether intake of caffeinated beverages (coffee, tea, and cola) was associated with fecundability (time to pregnancy) in a prospective cohort study. Data from 470 women from the Mount Sinai Study of Women Office Workers (1990-1994) were analyzed. Intake of coffee, tea, cola, and other variables were recorded in daily diaries and calculated as menstrual cycle level means for up to 20 cycles. Pregnancy was assayed using hCG and confirmed by physician diagnosis. The associations of caffeinated beverages with the probability of becoming pregnant during a given cycle were determined using discrete survival analysis, adjusted for potential confounders. …

Colorectal Cancer Fit Screening In The Hope Vi Population Of Jefferson County, Kentucky., Jeffrey D. Stone

Electronic Theses and Dissertations

Using pre-post survey data collected from 209 randomly selected African American people from the population of former residents of Clarksdale and Sheppard Square public housing areas, this study explores the relationship between individual characteristics and colorectal cancer screening behavior, measured by the uptake of the Fecal Immunochemical Test (FIT) and by prior colorectal screening, while controlling for neighborhood factors and geographic proximity to healthcare facilities. This particular public housing population is of interest because of their relocation from the downtown area, where healthcare facilities are within walking distances, to other public housing units either in large apartment complexes or scattered …

Pediatric Anxiety And/Or Depression Problems : Associations With Pm10, Fly Ash, And Metal Exposure., Abby Nicole Burns Hagemeyer

Electronic Theses and Dissertations

Background: In the last several decades, the use of coal has become more prevalent in turn increasing the amount of coal ash being produced. Coal ash, the by-product of coal combustion, is composed of small particles that contain essential elements, hazardous metals, polycyclic aromatic hydrocarbons, and radioactive material. While a small proportion of coal ash is reused, the majority gets discarded in open-air landfills and ash ponds. Fly ash, the major component of coal ash, can become emitted into the air and potentially contribute to the air pollution and metal exposure in the surrounding community. Few studies, particularly in the …

Phenomenological Study Of The Lived Experiences Of Appalachian Spouses Of Combat Veterans With Post Traumatic Stress Disorder, Janice E. Greene

Electronic Theses and Dissertations

This study was conducted to identify gaps in existing knowledge regarding impacts of combat-related PTSD on the spouse and to gain an understanding of the lived experience of Appalachian Spouses of combat veterans with PTSD. A systematic literature review was conducted to identify research and findings on the impacts of combat-related PTSD on spouses of veterans and a qualitative study was conducted to gain an understanding of the lives of Appalachian spouses of combat veterans with PTSD.

The systematic review identified 16 qualitative studies conducted between 1988 and 2016 in five countries spanning five wars. Regardless of the country of …

Health Professions At Carolina: Promoting The University Of South Carolina Galen Health Fellows And Health Sciences Initiatives Using Social Media Marketing, Sarah Adair Roof

Senior Theses

This project sought to bring awareness to the newly developed Galen Health Fellows and health sciences programs at the University of South Carolina. In collaboration with the University of South Carolina Office of Admissions, investigators created and promoted a trackable social media marketing campaign for prospective program participants composed of online profiles of current USC health science students. These profiles aimed to promote the beyond-the-classroom experiences and advantages gained from pursuing a health sciences career at the University of South Carolina, particularly as a Galen Health Fellow. Student profiles were posted on the USC Admissions account of the blog site …

ศาสตราจารย์ นายแพทย์ทองจันทร์ หงศ์ลดารมภ์: คุณูปการต่อแพทยศาสตร์ศึกษา, สิทธิศักดิ์ หรรษาเวก

Chulalongkorn Medical Journal

ถ้าย้อนกลับไปราว 50 ปีก่อน ผู้บุกเบิกและให้ แนวคิดรวมทั้งก่อตั้งหน่วยแพทยศาสตรศึกษาของคณะแพทยศาสตร์ จุฬาลงกรณ์มหาวิทยาลัย ที่สำคัญยิ่งคือ ศาสตราจารย์ นายแพทย์ทองจันทร์ หงศ์ลดารมภ์ ท่านเป็นผู้ริเริ่มศึกษาและสนใจอย่างจริงจัง ตั้งแต่ พ.ศ. 2515 โดยได้ศึกษาที่ประเทศสหราชอาณาจักร ท่านมีส่วนสำคัญยิ่งในการจัดประชุมปฏิบัติการทาง แพทยศาสตรศึกษา สำหรับการประชุมการศึกษาแห่งชาติ

Prevalence And Characteristics Of Congenital Hand And Foot Anomalies Requiring Surgery In Remote Areas Of Thailand, Pobe Luangjarmekorn, Pravit Kitidumrongsook, Sittisak Honsawek, Usa Boonplian, Pichit Siriwan

Chulalongkorn Medical Journal

Background : To identify patients in remote regions of Thailand who suffer from congenital anomalies, including cleft lip, cleft palate, and various types of congenital anomalies, in November 1998, the Relief and Community Health Bureau, Thai Red Cross Society, under the HRH Princess Maha Chakri Sirindhorn initiated the “cosmetic surgery project for cleft lips and cleft palates and other deformities” to solve this problem. The surgery mission had been a successful charity project for the last 18 years. Most of the patients are cleft lip and cleft palate patients along with all anomalies of hand and foot.Objective : The purpose …

Cross-Cultural Adaptation And Reliability Of Positive And Negative Affect Schedule (Panas) On Thai Smokers, Thaniya Klinsophon, Premtip Thaveeratitham, Prawit Janwantanakul

Chulalongkorn Medical Journal

Background : Positive and Negative Affect Schedule (PANAS) is a questionnaire for evaluating the affect which is one of the factors associated with smoking relapse and is widely used in clinics and in research. The originalversion of PANAS is in English and has been translated into many languages. However, there has been no translation available into the Thai language.Objectives : To translate PANAS into the Thai language by using the standard method according to the cross-cultural adaptation process and to evaluate the test-retest reliability and internal consistency of PANAS in Thai smokers.Methods : PANAS was translated into Thai. Participants – …

Impact Of Caregiving On Various Aspects Of The Lives Of Caregivers, Babar Irfan, Omar Irfan, Ahmed Ansari, Waris Qidwai, Kashmira Nanji

Department of Family Medicine

Objective: This study was designed to assess the impact of caregiving on the lives of the caregivers.

Methods: A cross-sectional study was conducted between July and September 2015 at a teaching hospital in Karachi, Pakistan. Participants who were more than 18 years old and were involved in caregiving (former or current) of a family member were invited to participate in the study. The participants were recruited through consecutive sampling technique. A total of 400 caregivers were interviewed. Written informed consent was obtained from all the participants. A pretest structured questionnaire was used for data collection and included sections …

ผลการนวดกดจุดสะท้อนเท้าบริเวณที่เชื่อมโยงกับสมองต่อเวลาปฏิกิริยาอย่างง่ายในผู้ใหญ่ที่มีสุขภาพดี, กนกวรรณ ศรีสุภรกรกุล, จีรวรินทร์ทิพย์ ปัญญาพฤกษ์, ทรรศนีย์ อินปรางค์, เกวลี นาคดี, อรอุมา บุณยารมย์, สมภิยา สมถวิล

Chulalongkorn Medical Journal

เหตุผลของการทำวิจัย : เท้ามีตำแหน่งการสะท้อนที่สามารถเชื่อมโยงกับส่วนต่าง ๆ ของร่างกาย เมื่อกระตุ้นตามตำแหน่งต่าง ๆ ของเท้าจะเกิดการสะท้อนไปยังอวัยวะต่าง ๆ ทำให้เกิดการเปลี่ยนแปลงการทำงานของอวัยวะนั้น ๆวัตถุประสงค์ : เพื่อศึกษาผลการนวดกดจุดสะท้อนเท้าบริเวณที่เชื่อมโยงกับสมองต่อเวลาปฏิกิริยาอย่างง่ายในผู้ใหญ่ที่มีสุขภาพดีตัวอย่างและวิธีการศึกษา : ผู้ใหญ่ที่มีสุขภาพดี เพศหญิง จำนวน 24 คน อายุระหว่าง 21 - 30 ปีแบ่งออกเป็น 2 กลุ่ม ด้วยการสุ่ม คือ กลุ่มทดลอง (นวดกดจุดสะท้อนเท้าบริเวณที่เชื่อมโยงกับสมอง, n = 12) และกลุ่มควบคุม(แตะจุดสะท้อนเท้าบริเวณที่เชื่อมโยงกับสมอง, n = 12) โดยทำการวัดเวลาปฏิกิริยาอย่างง่ายของมือขวาและมือซ้ายผลการศึกษา : พบว่าหลังการนวดกดจุดและแตะเบา ๆ ที่จุดสะท้อนเท้าบริเวณที่เชื่อมโยงกับสมอง เวลาปฏิกิริยาอย่างง่ายมีค่าลดลงอย่างมีนัยสำคัญทางสถิติ (P <0.05) แต่ค่าเวลาปฏิกิริยาอย่างง่ายที่ทดสอบด้วยมือขวาและมือซ้ายหลังการนวดกดจุดและแตะเบา ๆ ไม่มีความแตกต่างกันทั้งการนวดกดจุดเท้าขวาและเท้าซ้าย และค่าเวลาปฏิกิริยาอย่างง่ายทั้งกลุ่มทดลองและกลุ่มควบคุมไม่มีความแตกต่างกันสรุป : การนวดกดจุดและแตะเบา ๆ ที่จุดสะท้อนเท้าบริเวณที่เชื่อมโยงกับสมองมีผลต่อการลดลงของเวลาปฏิกิริยาอย่างง่าย.

คุณภาพชีวิตและปัจจัยที่เกี่ยวข้องของผู้ป่วยมะเร็งลำไส้ใหญ่ที่มีทวารเทียมในโรงพยาบาลจุฬาลงกรณ์ สภากาชาดไทย, ชลยา อัตถาภินันท์, พีรพนธ์ ลือบุญธวัชชัย

Chulalongkorn Medical Journal

เหตุผลของการทำวิจัย : การผ่าตัดเปิดลำไส้ใหญ่ออกทางหน้าท้อง (colostomy) มีส่วนทำให้เกิดการเปลี่ยนแปลงภาพลักษณ์แก่ผู้ป่วย อาจมีปัญหาทั้งทางด้านร่างกายจิตใจ อารมณ์ การเข้าสังคม และการดำเนินชีวิตประจำวัน แต่การศึกษาเกี่ยวกับคุณภาพชีวิต ปัจจัยที่เกี่ยวข้องของผู้ป่วยมะเร็งลำไส้ใหญ่ที่มีทวารเทียมในประเทศไทยยังมีข้อมูลจำกัดวัตถุประสงค์ : เพื่อศึกษาคุณภาพชีวิตและปัจจัยที่เกี่ยวข้องกับคุณภาพชีวิตของผู้ป่วยมะเร็งลำไส้ใหญ่ที่มีทวารเทียมในโรงพยาบาลจุฬาลงกรณ์ สภากาชาดไทยวิธีการศึกษา : ทำการศึกษาผู้ป่วยมะเร็งลำไส้ใหญ่ที่มีทวารเทียมที่มารับบริการตรวจรักษาที่ตึก ภปร. ชั้น 6 แผนกผู้ป่วยนอก ฝ่ายศัลยกรรม โรงพยาบาลจุฬาลงกรณ์ สภากาชาดไทย ตั้งแต่เดือน มกราคม - มีนาคม ปี พ.ศ.2559 จำนวน 90 ราย โดยการตอบแบบสอบถามทั้งหมด 8 ชุด ได้แก่1) แบบสอบถามเกี่ยวกับข้อมูลทั่วไปของผู้ป่วย 2) แบบสอบถามข้อมูลสุขภาพ 3) แบบประเมินความรู้ความเข้าใจเกี่ยวกับทวารเทียม 4) แบบประเมินทัศนคติของผู้ที่มีทวารเทียมต่อการมีเพศสัมพันธ์ 5) แบบประเมินคุณภาพชีวิตขององค์การอนามัยโลกฉบับย่อภาษาไทย 6) แบบประเมินการสนับสนุนทางสังคม 7) แบบประเมินอาการวิตกกังวลและอาการซึมเศร้าในโรงพยาบาลฉบับภาษาไทย 8) แบบประเมินปัญหาสัมพันธภาพระหว่างบุคคล วิเคราะห์ปัจจัยที่เกี่ยวข้องกับคุณภาพชีวิตของผู้ป่วยโดยใช้การทดสอบไคสแควร์ และวิเคราะห์ปัจจัยทำนายคุณภาพชีวิตระดับปานกลางถึงดีแบบการถดถอยลอจิสติกผลการศึกษา : คุณภาพชีวิตของผู้ป่วยมะเร็งลำไส้ใหญ่ที่มีทวารเทียมในโรงพยาบาลจุฬาลงกรณ์ สภากาชาดไทย ส่วนใหญ่ (ร้อยละ 67.8) อยู่ในระดับปานกลาง ปัจจัยที่มีเกี่ยวข้องกับระดับคุณภาพชีวิตระดับปานกลางถึงดีได้แก่ สถานภาพสมรส ระดับการศึกษา สิทธิการรักษา การสูบบุหรี่การดื่มเครื่องดื่มแอลกอฮอล์ สัมพันธภาพระหว่างบุคคล ภาวะวิตกกังวลภาวะซึมเศร้า ผลการวิเคราะห์ความถดถอยลอจิสติก พบว่าปัจจัยที่เกี่ยวข้องกับคุณภาพชีวิตระดับปานกลางถึงดี ได้แก่ ปัญหาสัมพันธภาพระหว่างบุคคลระดับไม่มีปัญหาถึงมีปัญหาปานกลาง การไม่สูบบุหรี่มีการศึกษาระดับปริญญาตรีขึ้นไป และมีสิทธิในการรักษาสรุป : คุณภาพชีวิตของผู้ป่วยมะเร็งลำไส้ใหญ่ที่มีทวารเทียมในโรงพยาบาลจุฬาลงกรณ์ สภากาชาดไทย ส่วนใหญ่อยู่ในระดับปานกลาง ปัญหาสัมพันธภาพระหว่างบุคคลระดับไม่มีปัญหาถึงมีปัญหาปานกลางการไม่สูบบุหรี่ สถานภาพสมรสคู่ มีการศึกษาระดับปริญญาตรีขึ้นไปและมีสิทธิในการรักษาจะส่งผลให้คุณภาพชีวิตของผู้ป่วยมะเร็งลำไส้ใหญ่ที่มีทวารเทียมดีขึ้น.