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In this study, we aimed to examine the prevalence, associated factors, and management of sexual problems in older people at a primary care unit. We recruited people aged 60 years old and over, who visited the Primary Care Unit of Songklanagarind Hospital, a tertiary-care and referral centre in Southern Thailand, between June and August 2021, and used a self-administered questionnaire on sexuality, sexual problems, help-seeking behaviours, and clinical consultations for sexual problems in older people. There were 190 participants in this study (120 women, 70 men, mean age = 68.3). One hundred and five (55.3%) participants reported having sexual problems. Compared to their female counterparts, males were more likely to have sexual problems (adjusted OR = 3.11; 95% CI = 1.52,6.34; p-value = 0.001). The majority (77.3%) considered non-penetrative sexual activities (outercourse) when discussing sexuality in later life, and they had lower odds of having sexual problems compared to those who relied purely on sexual intercourse (adjusted OR = 0.27 for only outercourse and 0.30 for both intercourse and outercourse; p-value = 0.016). Only 2.1% (4/190) of participants reported that a physician had asked them about sexual problems. Participants reporting sexual problems (N = 105) often consulted their partners (25.7%) and friends (10.5%) or searched information from the internet (18.1%). According to this study, sexual problems in older people are common in primary care settings, but they tend to be poorly managed. Clinical discussions and interventions that are sensitive to gender differences and acknowledge the broadened concepts of sexuality in later life, e.g., encouragement to practice outercourse, may help improve sexual problems and well-being among older people. [ABSTRACT FROM AUTHOR]

To investigate sexuality in older Thai adults during the coronavirus disease (COVID-19) pandemic and the associated factors. This cross-sectional survey was conducted on older adults visiting a primary care unit (PCU) in Thailand. A hundred and ninety older adults were enrolled by convenience sampling. Multiple logistic regression analysis with a backward stepwise algorithm was used to analyze factors associated with sexual desire and activity in older Thai adults. The median age of participants was 67.99 (60.01–88.57) years, and 63.2% were women. Overall, 37.4% of participants had sexual desires, and 54.2% were sexually active during the COVID-19 pandemic; however, more than half reported a decrease in sexual activity, fearing COVID-19 transmission as the most common reason. Men had more sexual desire and activity than women (adjusted OR [95% CI] = 13.92 [4.76, 40.73] and 6.63 [2.59, 16.94], respectively). Older Thai adults in the PCU displayed decreased sexual desire and activity during the COVID-19 pandemic. Sexual health is a lifestyle aspect that required investigation and care during the pandemic. Older Thai adults should be educated in that sexual activities can be broader than sexual intercourse, and sexual health should be cared for during an eventual new pandemic disease. [ABSTRACT FROM AUTHOR]

The aim of this paper was to understand the needs of family caregivers and professionals supporting people living with dementia with eating and drinking difficulties towards the end of life and the strategies they use to overcome them. A total of 41 semi‐structured interviews with family caregivers (n = 21) and professionals (n = 20) were conducted in London and surrounding areas of England. Interviews were audio‐recorded and transcribed verbatim. Four themes were identified: caregivers accessing and seeking help, perceived priorities of care, professionals' supportiveness and educational role, and strategies. Caregivers often struggle as they are not aware of the eating and drinking difficulties associated with dementia's progression. Care can change over time with families prioritising a person's comfort towards the end of life rather than ensuring a particular level of nutrition. Mutual support is required by both professionals and caregivers to enhance the care of the person living with dementia. Cognitive difficulties are often behind initial eating and drinking challenges in dementia, whereas physical challenges take over towards the later stages. Flexibility and creativity are key to adapting to changing needs. There is a need to raise awareness of the eating and drinking challenges associated with the progression of dementia. Professionals can help caregivers embark on the transition towards focussing on comfort and enjoyment of eating and drinking near the end of life rather than nutrition. This is particularly relevant for those caring for a relative living at home. Caregivers' input is needed to tailor professionals' recommendations. [ABSTRACT FROM AUTHOR]

Objective: Investigate the prevalence and the characteristics of mental illness in elderly outpatients at Songklanagarind Hospital, a university hospital in southern Thailand. Material and Method: This was a cross-sectional study. We extracted the medical records of the outpatients aged over 65 years old diagnosed with a category (F) mental disorder in the International Statistical Classification of Diseases and Related Health Problems, tenth revision (ICD-10) over the periods between July 1 and December 31, 2014, from all outpatient medical records. We used R program for analyzing descriptive data. Results: There were 31,329 patients, aged over 65 years, who visited the outpatient clinic. We found that 752 patients in this group had been diagnosed with mental disorders; the prevalence was 2.4%. The most common diagnoses were: mood disorders (0.89%), organic mental disorders (0.85%), and neurotic-somatoform disorders (0.51%). Most patients (85.5%) received some form of medication. For each visit, the average medical fee for these patients was 3,431.30 Baht (96.80 US dollar). Conclusion: The prevalence of geriatric mental disorders, among the outpatients of Songklanagarind Hospital was much lower than the inpatient and community setting. This could be a reflection that some were under-diagnosed for these disorders in the outpatient clinics. One of these factors was the limited time available for each patient. We need some interventions and policies to detect these abnormalities early and thoroughly, so the patients would be receiving appropriate treatments, which in turn would provide them with a better quality of life. [ABSTRACT FROM AUTHOR]

Background: Decisions about eating and drinking for people with severe dementia in acute hospitals are often difficult. Using a codesign process, we developed a decision guide for family carers and hospital professionals to help everyone making these decisions. Method: We conducted a systematic review and qualitative interviews with people with mild dementia, family carers and hospital professionals in the UK. We ran four online workshops with family carers and hospital professionals to codesign the decision guide. In parallel with the codesign workshops, a matrix approach was used to synthesise data from all studies, including the workshop data, and to develop a prototype of the decision guide. We refined the prototype through workshops and discussions among the research team and lay people. User testing evaluated the prototype, which finalised the decision guide. Result: Most participants were aware of the limited benefits of artificial nutrition and hydration for people with severe dementia. However, participants often found conversations and decision‐making processes confusing and fragmented in hospitals. The codesign process highlighted the importance of meeting individuals' needs and preferences. The decision guide aimed not only to help people reach evidence‐based decisions but also to support conversations and decision‐making processes. It was designed to clarify the decision‐making process, provide necessary information about eating and drinking interventions, and elicit the values/preferences of everyone involved. It emphasises person‐centred care, best‐interests decision‐making, and multidisciplinary team approaches. From the user‐testing, family carers and hospital professionals perceived the decision guide to be useful in starting conversations and helping with the decision‐making processes. The final version of the decision guide was widely disseminated and is being used in clinical practice. Conclusion: The codesigned decision guide may facilitate conversations between family carers and hospital professionals and help them reach shared decisions that meet the needs and preferences of people with severe dementia. Further evaluation research of the decision guide is required to test its real‐world impacts. [ABSTRACT FROM AUTHOR]

Background: Depression in elderly usually goes unnoticed in the general population. The aim of this research is to study on the prevalence, and associated factors of elderly depression within Songkhla province. This being a major city with a population of one and a half million, situated in the south of Thailand. Methods: This is a two-stage cluster sampling study. We collected data from members of the elderly population (65-99 years of age) in Songkhla Province from 1st of September – 30th of November 2015. The sample size was calculated by R-program. We used the 15-item Thai Geriatric Depression Scale (TGDS-15) questionnaire to find the prevalence and its association of factors. The associated factors were analyzed by multiple logistic regression using a backward-stepwise method. Results: By using TGDS-15, the prevalence of depression in the elderly population in Songkhla province was 12.0 percent. The association of depression as well as potential, associated factors in this study; sex, age, and residential area, were not found to be significant. We found more prevalence among Muslims, those being alone, and having a lower educational level within this area (p-value < 0.05). Conclusions: The prevalence of depression was quite high among the elderly population of Songkhla province. Many statically, both significant and insignificant, correlations were found. We need an in-depth research, concerning both biological and spiritual aspects to explain the etiology of depression. Then, some policies need to be implemented to intervene those factors, so as to promote better health and quality of life in elderly people. [ABSTRACT FROM AUTHOR]

Introduction: Palliative care is an approach that aims to holistically improve the quality of life, care and death of people living with life-limiting conditions as well as their families. In Thailand, palliative care became one of its national strategies as of 2014. However, the access to as well as the quality of palliative care being delivered still varies across the nation, due to multiple factors spanning multiple levels. Consequently, there is a need to comprehensively understand the current palliative care ecosystem in Thailand. This review aims to explore, map and conceptualise the literature available on the palliative care ecosystem in Thailand, and how the service being delivered influences the quality of life, death and care of people living with life-limiting conditions alongside their families., Methods and Analysis: This review will consist of two stages. First, a scoping review guided by the Joanna Briggs Institute methodology for scoping reviews will be initially conducted. A systematic literature search using Medical Subject Heading and text words related to palliative care will be performed in PubMed, CINAHL and Thai Citation Index from 2013 to 2023. Grey literature will be searched via alternative sources: Google keyword searching and stakeholders consultation. References of included sources will be handsearched to identify further resources.The population, concept and context framework is used to frame the inclusion and exclusion criteria. This will be further refined after the initial search, reflecting the iterative nature of a scoping review. Articles will be independently screened by three reviewers. A Microsoft Excel spreadsheet will be used as the data extraction tool. Data will be extracted and presented using a narrative synthesis approach.Second, included articles from the scoping review will be further analysed and visualised using a bibliometric analysis technique. This stage involves a computational method, including statistical analysis and content analysis of the articles' bibliographic details., Ethics and Dissemination: This paper describes a protocol for a scoping review and bibliographical analysis. As such, ethical approval was not required. Information relating to the review will be stored with Open Science Framework Registries. The findings of this proposed scoping review will be distributed through a peer-reviewed publication, academic seminars, conferences and patients and public involvement groups., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)