Consumers Protection Performance of Health Personnel in Sub-district Health Promoting Hospitals, Khon Kaen Province

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1 Available online at GlobalIlluminators FULL PAPER PROCEEDING Multidisciplinary Studies Full Paper Proceeding GTAR-2014, Vol. 1, ISBN: GTAR-14 Consumers Protection Performance of Health Personnel in Sub-district Health Promoting Hospitals, Khon Kaen Province SumaleeLarangsitand 1* and Prachak Bouphan 2 1, Research Student, 1,2, Public Health Administration, Graduate School, Khon Kaen University Abstract This is a cross-sectional descriptiv e research. The objective was to study consumer s protection performance of health personnel in sub-district health promoting hospitals Khon Kaen province. Motivation and organizational supports that effect consumers protection performance of health personnel in sub-district health promoting hospitals Khon Kaen province of 162 and by using 248 subjects (n=162), randomly selected by systematic sampling and were additionally collected by group discussion of 12 subjects. To data were collected by the developed questionnaire and which was verified by three experts. Its validity was tested and gained coefficient cronbach s alpha=0.97. Data collection was carried out from January 15, 2014 to February 13, 2014.The collected data were then analyzed by statistical value, percentage, mean, standard deviation, median, minimum, maximum and Inferential Statistics were Pearson product moment correlation coefficient and Stepwise multiple regression analysis. The finding revealed that the motivation had high level =3.67 (S.D.=0.45), and organizational supports had high level =3.54 (S.D.=0.59)and consumers protection performance had high level =3.74 (S.D.=0.54). The motivation and organizational supports had moderately positive influence on the consumers protection performance of health personnel in sub-district health promoting hospitals Khon Kaen province relation at statistical significance of (r=0.675, p-value <0.001,r=0.638,p-value<0.001)and the factors influenced the performance of consumers protection performance of health personnel in sub-district health promoting hospitals Khon Kaen province were Material (p-value<0.001), Achievement(p-value=0.020), Man (p-value<0.001), Recognition (p-value=0.002), Salary(p-value<0.001), and Advancement(p-value=0.018). These six factors could together predict the performance of consumer s protection performance of health personnel in sub-district health promoting hospitals Khon Kaen province at a level of 62.5 %. Problem and obstacles arising from the study were practices, consumer protection, and personnel developments 71.1% The Authors. Published by Global Illuminators. This is an open access article under the CC BY-NC-ND license ( Peer-review under responsibility of the Scientific & Review committee of GTAR Keywords Consumers Protection Performance, Health Promoting. Introduction Consumer protection performance is a key burden of sub-district health promoting hospitals in Thailand. There is responsible for consumer drug and health product safety for *All correspondence related to this article should be directed to SumaleeLarangsitand, Research Student, Public Health Administration, Graduate School, Khon Kaen University. sumalee_sit@yahoo.com 2015 The Authors. Published by Global Illuminators. This is an open access article under the CC BY-NC-ND license ( Peer-review under responsibility of the Scientific & Review committee of GTAR-2015.

2 all people in community. The consumer protection is undertaken to enhance the immunity that is affected from deceived products and unsuitable services.due to sub-district health promoting hospital is primary health care center closely in community. There is available for the effective health consumer protection performance.the practice guidelines of the consumer protection performance of sub-district health promoting hospital are 1) database development, 2) capacity development, and 3) surveillance and risk management (Public Health, 2010). However, for achieving the consumer protection performance, there would be required towards motivation which is a variable for contributing health personnel more satisfied with work completely.as the motivation theory of Herzberg therefore includes motivation factors such as achievement, recognition, work itself, responsibility and advancement and another of maintenance factors (hygiene factors) such as salary, relationship with supervisor and subordinates, policy, work conditions, status, security and personnel life(herzberg, Mausner and Snyderman, 1993). Moreover, there also involved with organizational support factors that are a crucial factor in the management administration of organization for achieving the goal, including man support, money support, material support and technology support (Dedthai, 2007). In the year of 2010 to 2013, Khon Kaen province has had the strategic policy of health development consisted of five issues such as 1) development of health service system and patient referral quality, 2) development of diseases and health hazards surveillance, prevention and control, 3) health consumer protection, 4) healthy buildings, and5) organization development. The above mentions illustrated that health consumer protection is one of important aspect directing the performance of being surveillance, control and monitor for manufacturing in place, health care service and health products. The capacity development of strengthening consumer protection network and legislation enforcement are focused on benefits of consumers for getting health product and service safety importantly (Health Provincial Office, 2012).Therefore, however, Khon Kaen Provincial Health Office has determined the responsibility of the consumer protection in community that is an indicator of the district-network performance evaluation (Contacting Unit for Primary care: CUP). According to the consumer protection performance as the required criteria of the office of Food and Drug Administration is passed about 60% showed that estimated 79.4% of all sub-district health promoting hospitals are met. There also provided the project of the consumer protection system development in sub-district health promoting hospitals by focusing on the participation and its capacity and knowledge improvement in community found that only 7.7% of sub-district health promoting hospitals was participated(health Provincial Office, 2011). Despite it has been met the criteria of a previous implementation, the capacity and knowledge development for the practitioners on consumer protection performance needs to build the strengthening consumer network and emphasizes the performance. Researchers therefore interested to study health consumer protection performance through its motivations and organizational supports in health personnel of sub-district health promoting hospitals, Khon Kaen province, Thailand. Findings of the study could be benefits for development planning in this field as well as promoting consumer protection performance for the practitioners in sub-district health promoting hospitals further. 537

3 Objectives 1. To study consumer protection performance and level of motivations and organizational supports of health personnel in sub-district health promoting hospitals. 2. To study what factors, including motivations and organizational supports, affected to consumer protection performance of health personnel in sub-district health promoting hospitals. 3. To study obstacles and suggestions on consumer protection performance of health personnel in sub-district health promoting hospitals. Design Materials and Methods This research was a cross-sectional analytical study undertaking in Khon Kaen province, Thailand. Population and sample Out of 248 health personnel, who was responsible on consumer protection performance working at sub-district health promoting hospitalsof Khon Kaen province, was randomly recruited into this study. The desired total sample of 162 participants was supposed to calculate based on using the required sample size for mean estimation in the case of known population size with the 95% of confidence interval ( = 0.05) as the following formula. n e 2 NZ 2 / N 1 Z / 2 Where N = 248 is the known population of health personnel who had the responsibility of consumer protection performance in sub-district health promoting hospitalsof Khon Kaen province (Health Provincial Office, 2013), Z α/2 = 1.96 is the critical value of the standard normal distribution corresponding to 1-α = 0.95, e = 0.05 is the value of acceptable tolerance allowing to occur in this study and σ = 0.55 is the standard deviation a preliminary studyin a group of similar sample in Udon Thani province. The desired sample size of this study then was given by [248(1.962) (0.552)]/ [(0.052) (248-1) + (1.962) (0.552)] = ( 162 participants). To ensure the sample of this study to be balanced, the total participants were randomly selected by systematic random sampling and twelve key informants of them were purposive selection to be volunteers for a group interview from each zone consisted of four pharmacists, four directors of sub-district health promoting hospitals and four public health officers. Tool and data collection Self-administered questionnaire and structured interview were used for data collection regarding motivations and organizational supports on consumer protection performance. The 538

4 questionnaire included 96 items that classified into 5-point score of Likert-type scale (Likert, 1967). The respondents indicated the degree of the perception ranging from very low to very high by choosing only one response. The perception scores were given including very low referred the score to be 1.00 to 1.49, low referred the score to be 1.50 to 2.49, moderate referred the score to be 2.50 to 3.49, high referred the score to be 3.50 to 4.49 and very high referred the score to be 4.50 to 5.00 (Chantrasuwan and Buatuan,2008). The structured interview included 4 question items for instances, what are obstacles affecting your motivation at work and how can you suggest to solve them?(considering towards work achievement, its recognition, work itself, responsibility and work advancement for majority of consumer protection performance), etc. Both of tools were examined by three experts in the fields of pharmaceutical science, community health development and public health administration for checking the content validity. The reliability was assessed by a test-retest study in a group of thirty health personals in Udon Thani province and the Cronbach s alpha coefficient was to be 0.97 for the questionnaire. The data collection was conducted in between January and February 2014.This study protocol was approved by the human research ethic committee of Khon Kaen University, Thailand. The number of the approval was HE Data analysis Data analysis used the program of SPSS for windows. Descriptive statistics including frequency, mean, standard deviation and percentage were used to describe characteristics, motivations and organizational supports of the sample. Inferential statistics including Pearson s correlation coefficient and stepwise multiple regression analysis were used to identify the association of between motivation and organizational support factors and consumer protection performance. Evaluation criteriafor level of correlation coefficient (r) was defined by the values ranging from -1 to +1, which was given by no correlation referred r to be 0, weak correlation referred r to be to , moderate correlation referred r to be to , strong correlation referred r to be to and perfect correlation referred r to be (Elifson, Runyon and Haber, 1990). Characteristics of the study participants Results The study participants mostly were female (65.4%). Estimated 35.7% of them were aged between years (mean=38.3, SD=9.27, min=22 and max=60). Most participants were public health officer (30.9%) and bachelor degree graduates (79.6%). Overall 41.2% of all participants had monthly income ranged 20,001-30,000 baht (mean= , SD=9,731.97,min=9,600 and max=50,000). Almost 83.4% of participants had the period of time on consumer protection performance ranged 1-10 years (mean=6.69, SD=5.81, min=1 and max=30). Most of study participants had the training experience (93.2%) and approximately 68.2% of all participants had the training experience ranged 1-5 times (mean=5.08, SD=3.63, min=2 and max=19). 539

5 Motivation level on the consumer protection performance The results (in Table 1), revealed that the overall motivation was a high level (mean score=3.6, SD=0.45), additionally revealed that both motivation factor and maintenance factor also were a high level (mean score=3.73, SD=0.48 and mean score=3.60, SD=0.49, respectively). When considering from each of the factors found that, the highest mean score of being a high level was the work itself (mean score=4.04, SD=0.57) and the second was the work status (mean score=3.87, SD=0.63), and the lowest mean score of being a moderate level was the salary (mean score=3.03, SD=0.87) and the second was the work conditions (mean score=3.18, SD=0.73). From a group discussion, the key informants mentioned that other compensations over the salary should be allocated to worker as similar as the other side for enhancing motivation on the performance. Organizational support level on the consumer protection performance The finding results (in Table 2) revealed that the overall organizational support factor was a high level (mean score=3.53, SD=0.59). When considering from each of the factor found that, the highest mean score of being a high level was the human support (mean score=3.62, SD=0.59) and the second was the information technology support (mean score=3.58, SD=0.79), and the lowest mean score of being a moderate level was the material support (mean score=3.43, SD=0.68) and the second was the budget support (mean score=3.51, SD=0.71). From a group discussion, the key informants mentioned that the material support in term of the management policy should be explored the needs and allocated the enough material for the utilization of different areas properly. Because of individual health personnel in sub-district health promoting hospitalshad more responsibilities on their working position. Besides, consumer protection performance is actually undertaken as a team work. The allocation of budget support also is depended on the CUP and other networks in the local area that supports for both budget and materials. Performance level on the consumer protection performance The findings (in Table 3) revealed that the overall performance was a high level (mean score=3.74, SD=0.54). When considering from each of the factor found that, the highest mean score of being a high level was the database system development (mean score=3.85, SD=0.60) and the second was the surveillance and risk management (mean score=3.72, SD=0.56), and the lowest mean score of being a high level was the capacity development (mean score=3.65, SD=0.64). From a group discussion, the key informants mentioned that consumer protection performance of practitioners is only focused on knowledge and advices to consumers while currently induced advertising of media has been claimed a bad quality product through different multi-channel media. It affects the practitioners in the local area cannot be controlled the exaggerated product that may results to the public belief. Required from health personnel is important and necessary. Correlation of motivation and organizational support with the consumer protection performance 540

6 Findings of the analysis (in Table 4) revealed that the variables of overall motivation, overall motivation factor overall maintenance factor and overall organizational support were significantly positively correlated with consumer protection performance of the study participants in a moderate level (r=0.675, p-value<0.001; r=0.675, p-value<0.001, r=0.564, p-value<0.001 and r=0.638, p-value<0.001, respectively). Motivation and organizational support affecting the consumer protection performance The finding results of stepwise multiple regression analysis (in Table 5) revealed that the variables influencing consumer protection performance of the study participants were the organizational support factor of material support (p-value<0.001), the motivation factor of work achievement (p-value=0.020), the organizational support factor of human support (pvalue<0.001), the motivation factor of recognition (p-value=0.002), the maintenance factor of salary (p-value<0.001) and the motivation factor of work advancement (p-value=0.018). Therefore, all six factors could together predict consumer protection performance of the participants to be 62.5% as the following equation of mean scores. Y = (the constant value) (the material support) (the work achievement) (the human support) (the recognition) (the salary) (the work advancement) Where Y is consumer protection performance of the participants and is the constant value. This equation supposed that if the above factors level, including the material support, the work achievement, the human support, the recognition, the salary and the work advancement, is equal to zero. The level of consumer protection performance of the participants (Y) then is Therefore, for examples, when coefficient value of the material support is 0.205, it means that level of the consumer protection performance will be increased about units where level of that factor is inflated for 1 unit and other remaining variables are constant; when coefficient value of the work achievement is 0.165, it also means that level of the consumer protection performance will be increased about units where level of that factor is inflated for 1 unit and other remaining variables are constant; when coefficient value of the human support is 0.278, it also means that level of the consumer protection performance will be increased about units where level of that factor is inflated for 1 unit and other remaining variables are constant; when coefficient value of the recognition is 0.209, it also means that level of the consumer protection performance will be increased about units where level of that factor is inflated for 1 unit and other remaining variables are constant; when coefficient value of the salary is 0.154, it also means that level of the consumer protection performance will be increased about units where level of that factor is inflated for 1 unit and other remaining variables are constant; and when coefficient value of the work advancement is 0.135, it also means that level of the consumer protection performance will be increased about units where level of that factor is inflated for 1 unit and other remaining variables are constant. Obstacles and suggestions on the consumer protection performance 541

7 A total 162 of completed questionnaires of the study revealed that only 46.9% of the respondents addressed obstacles and suggestions on the performance. The obstacles mostly were the capacity development on the consumer protection performance (71.1%) and the motivation of maintenance factor (47.3%), respectively. A small of the obstacle was the organizational support factor of information technology (6.5%). The suggestions mostly were the capacity development on the consumer protection performance (59.2%) and the motivation of maintenance factor (46.0%), respectively. Conclusionand Discussion As the study results showed that the study participants had overall motivation (mean score=3.67, SD=0.45), overall of both motivation factor and maintenance factor (mean score=3.73, SD=0.48 and mean score=3.60, SD=0.49, respectively), overall organizational support (mean score=3.53, SD=0.59) and the consumer protection performance (mean score=3.74, SD=0.54) in a high level. These are consistent with the study of Khunsri and Bouphun,(2013) found that overall motivation factor was a high level (mean score=3.55, SD=0.38) and the study of Laowittawas and Bouphun, (2013) found that overall motivation factor was a high level (mean score=3.92, SD= 0.41). In the qualitative data found that the motivation factors of work achievement, recognition and work advancement were less. The authority led the consumer protection performance in a small of proportion on considering the higher position of work compared to other workloads. The authority thus should pay more attentions to health personnel who worked on the responsibility as well as the motivation of compensation over the salary should be equal with a performance of other responsibilities. Variables of overall motivation, overall motivation factor overall maintenance factor and overall organizational support were significantly positively correlated with consumer protection performance of the study participants in a moderate level (r=0.675, p-value<0.001; r=0.675, p-value<0.001 and r=0.564, p-value<0.001, respectively). These are consistent with the study of Laowittawas and Bouphun, (2013) found that overall motivation was significantly positively correlated with the performance of general nursing practice in subdistrict health promoting hospitals of Khon Kaen province (r=0.628, p-value<0.001) and the study of Srilamart and Bouphan, (2013) found that overall motivation was significantly positively correlated with the performance of medical product administration in sub-district health promoting hospitals of Khon Kaen province (r=0.643, p-value<0.001). Additionally, results of the present study showed that overall organizational support was significantly positively correlated with the consumer protection performance of the study participants (r=0.638, p-value<0.001) and variable factors that affected the consumer protection performance of the study participants included the organizational support factor of material support (p-value<0.001), the motivation factor of work achievement (p-value=0.020), the organizational support factor of human support (p-value<0.001), the motivation factor of recognition (p-value=0.002), the maintenance factor of salary (p-value<0.001) and the motivation factor of work advancement (p-value=0.018). These variable factors could predict the consumer protection performance of the study participants to be 62.5%. These also are consistent with several studies including the study of Khunsri and Bouphun,(2013) found that motivation factor of work advancement (p-value<0.001) and organizational support factors of human support and material support (r=0.640, p-value<0.00 and r=0.681, p-value<0.001, respectively) were the variable factors that could together predict the role performance of public health academic officers in sub-district health promoting hospitals of Udon Thani province, the study of Laowittawas and Bouphun, (2013) found that motivation factor of 542

8 work achievement (p-value<0.001) was the variable factor that predicted the performance of general nursing practice in sub-district health promoting hospitals of Khon Kaen province, the study of Assiri and Bouphan, (2009) found that motivation factor of work advancement (p-value<0.001) and maintenance factor of salary (p-value<0.001) were variable factors that could together predict the medical service standard performance of health officers in primary health centers of Nong Khai province, the study of Meprom and Bouphan, (2008) found that motivation factor of recognition (p-value<0.001) and maintenance factor of salary (pvalue<0.001) also could together predict the good governance administration of the heads of health centers in Sakon Nakhon Province and the study of Boonmak and Bouphan, (2008) found that organizational support factor of material support (p-value<0.001) was the variable factor that could predict the performance of public sector management quality development of public health officers in in primary health centers of Nongbualumphu province. However, the study found that the problems and obstacles mostly were the capacity development on the consumer protection performance and the maintenance factor of salary as that is require for adjusting the compensation as equal as other responsibilities. Recommendations of the study Recommendations and Suggestions 1. Materials should be sufficiently allocated to the target needs in each area. 2. Consumer protection responsibility should be clearly identified and assigned for health personnel. 3. Personnel skill development on responsible for consumer protection should be more promoted in health personnel of sub-district health promoting hospital. 4. Consumer protection performance in sub-district health promoting hospital should be used in performance evaluation for salary increment appropriately for the workload in community. 5. Work achievement and recognition motivation on consumer protection performance of health personnel in sub-district health promoting hospital should be facilitated by supervisor for providing opportunities on its presentation. 6. Consumer protection performance should be encouraged for motivation of advancement and its responsibility in health personnel of sub-district health promoting hospital. Suggestions for further study 1. We should have to study a guideline for consumer protection performance development in health personnel of sub-district health promoting hospital. 2. We should have to study toward factors that influence to advancement of consumer protection performance in health personnel of sub-district health promoting hospital. References Assiri C, Bouphan P.(2009) Motivation Affecting the Performance on Thai Traditional Medicine Standard of Health Personnel at Primary Care Units in Nongkhai Province. J office DPC 6 Khon Kaen 16(4): Thai. 543

9 Boonmak R, Bouphan P.(2008) Quality of Diabetes Mellitus Patient s Care by Sub-District Health Promotion Hospitals in the North East of Thailand. J KKU Graduate Studies, 8(3), Thai. Chantrasuwan S, Buatuan S. Social Sciences Research Methodology. Khon Kaen: Department of Sociology and Anthropology, Faculty of Humanities and Social Sciences, Khon Kaen University; Thai. Chirawatkul A. Biostatistics. 4th ED. Khon Kaen: Klang Nana Wittaya; Thai. Dedthai T. Principle of Public Health Administration. 4thED. Bangkok: Faculty of Public Health, Mahidol University; Thai. Elifson WK, Runyon RP, Haber A. Fundamentals of Social Statistics. 2ndED. New York: McGraw-Hill; Herzberg F, Mausner B, Snyderman BB. The Motivation to Work. New Brunswick, NJ: Transaction Publishers; Khon Kaen Health Provincial Office. Annual Review Fiscal Year 2011 [Photocopied]. Khon Kaen: The Consumer Protection and Public Health Pharmacy Group, Khon Kaen Health Provincial Office; Thai. Khon Kaen Health Provincial Office. Summary Report of Major Public Health Khon Kaen Fiscal Year 2013 Presented to the 1st Cycle of Inspector of Ministry of Public Health, District 12 and the Board [Photocopied]. Khon Kaen: Health Strategy Division, Khon Kaen Health Provincial Office; Thai. Khunsri A, Bouphun P.(2013) Factors Affecting the Performance of Public Health Technical Officers in Sub-District Health Promoting Hospital in Udon Thani Province. Res Dev Health Syst J, 6(1), Thai. Laowittawas W, Bouphun P. (2013)The Performance of Nurse Practitioners in Sub-District Health Promoting Hospitals in Khon Kaen Province. KKU J Graduate Studies, 13(2), Thai. Likert R. The Human Organization: Its Management and Value. New York: McGraw-Hill; Meprom P, Bouphan P.(2008) The Motivation Affecting the Good Governance of the Chiefs Administration at Health Centers in Sakonnakon Province. J Khon Kaen Office DPC 6, 15(3), Thai. Srilamart S, Bouphan P.(2013) Drug Management of Health Personnel at Sub-district Health Promoting Hospitals in Khon Kaen Province. KKU J Graduate Studies, 13(2), Thai. The Preparation of Guidelines for Consumer Protection for Hospital Health District Working Group. 2nd ED. Nontaburi: Bureau of Primary Care Development Coordination, Ministry of Public Health; Thai. Table 1:Mean and standard deviation of motivation scores of the study participants (n=162) Motivations Mean SD Motivation level Motivation factor * High Work achievement High Recognition High 544

10 Work itself High Work responsibility High Work advancement Moderate Maintenance factor ** High Salary Moderate Relationship with subordinates High Relationship with supervisor High Policy and administration High Work conditions Moderate Work status High Work security High Personal life High Overall motivation High *Full score = 5 Table 2:Mean and standard deviation of organizational support scores of the study participants (n=162) Organizational supports * Mean SD Support level Human support High Budget support High Material support Moderate Information technology support High Overall organizational support High * Full score = 5 Table 3:Mean and standard deviation of the performance scores of the study participants (n=162) Performance aspects * Mean SD Performance level Database development High 545

11 Capacity development High Surveillance and risk management High Overall performance High * Full score = 5 Table 4: Correlation coefficient analysis of variable factors and the consumer protection performance Variables Consumer protection performance Coefficient (r) P-value Correlation level Motivation ** <0.001 Moderate Motivation factors ** <0.001 Moderate Work achievement ** <0.001 Moderate Recognition ** <0.001 Moderate Work itself ** <0.001 Moderate Work responsibility ** <0.001 Moderate Work advancement ** <0.001 Moderate Maintenance factors ** <0.001 Moderate Salary ** Low Relationship with subordinates ** <0.001 Moderate Relationship with supervisor ** <0.001 Moderate Policy and administration ** <0.001 Moderate Work conditions ** <0.001 Moderate Work status ** <0.001 Moderate Work security ** <0.001 Moderate Personal life ** <0.001 Moderate Organizational supports ** <0.001 Moderate Human support ** <0.001 Moderate Budget support ** <0.001 Moderate 546

12 Material support ** <0.001 Moderate Information technology support ** <0.001 Moderate * at level of significance <0.05, ** at level of significance <0.01 Table 5:Stepwise multiple regression analysis of variable factors and the consumer protection performance Variables B Beta T P-value Organizational support factor of material support <0.001 Motivation factor of work achievement Organizational support factor of human support <0.001 Motivation factor of recognition Maintenance factor of salary <0.001 Motivation factor of work advancement Constant value=0.648, F=43.12, P-value<0.001, R=0.791, R²=