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Diabetic erectile dysfunction (DED) is one of the most frequently occurring complications of diabetes mellitus (DM) in men, and past studies have usually overlooked the effect DED has on quality of life (QoL). The objectives of this study are to determine the prevalence of DED and to investigate QoL, and the factors that influence QoL, in Thai men who are living with DED. Five hundred and eighty-two Thai men living with diabetes who enrolled in the diabetic and general medical outpatient clinic at a tertiary hospital in the northern part of Thailand were surveyed to determine the prevalence of DED, as well as QoL and its influencing factors, for men living with DED. The average age of the men was 58.2 years old (±SD = 10.1, range = 34.3 - 80 years old). DED was found in 417 out of the 582 men (71.5 %). The International Index of Erectile Function (IIEF-5) mean score was 17.03 (±SD = 3.47). The QoL was found to be at a moderate level (= 95.42 ±SD = 11.39). The QoL domains found to be at a good level were the psychological (= 23.84 ±SD = 3.42) and environmental domains (= 31.4 ±SD = 3.98), while domains found to be at a moderate level were the social relationships (= 10.77 ±SD = 1.93) and physical domains (= 24.9 ±SD = 3.13). The mean score of the QoL of men living with DED was lower than that of men without DED. The most important factor associated with poor QoL was severity of DED, while men who have a good QoL tend to have a higher education level and more frequent sexual intercourse (p < 0.05). The study showed that the prevalence of erectile dysfunction in Thai men living with DED was high. DED has a moderate impact on QoL, especially on the social relationship domain. The results suggest the importance of screening for DED in clinical settings for early detection of, and creating supportive strategies for treating men with, diabetes mellitus.

Objective To critically review and summarize the results of published articles on fathers' perspectives regarding breastfeeding support for their partners. Data Sources We searched the following databases for articles published between January 2010 and May 2019: CINAHL, MEDLINE, PubMed, Scopus, Web of Science, ThaiJo, and ThaiLis. We included articles published in English and Thai. Study Selection After duplicates were removed, our initial search yielded 3,927 articles. We excluded articles in accordance with pre-established criteria. We performed a quality appraisal of the selected full-text articles and ultimately included 27 in this review. Data Extraction We analyzed studies that met inclusion criteria and extracted and organized data related to fathers' perspectives on breastfeeding support into a structured table. Data Synthesis The data were synthesized into three themes: Attitude Toward Breastfeeding, Knowledge of Breastfeeding, and Fathers' Perceptions of the Breastfeeding Support They Provided. Conclusion Our results showed that fathers' perspectives on breastfeeding support were shaped by their knowledge of breastfeeding and participation in the breastfeeding process. To promote breastfeeding, further research is required to design and implement appropriate interventions to help fathers effectively support their breastfeeding partners.

There has a growing trend of health spa services in Thailand over the past decade. However, little information is available about the effectiveness of a Lanna-styled spa for health. The propose of this qualitative study was to explore the Lanna Spa Model for health in Thailand. A qualitative method was used with six focus groups and in-depth, semi-structured interviews were held with a purposive selected staff who specialized in spa treatments in Northern Thailand between February and April 2017. Guided interviews focused on spa experiences, the main components of Lanna-style spa services, and suggestions for implementing the Lanna spa model for health. Data were analyzed using content analysis with the principles of trustworthiness. The health and wellness spa model consisted of four categories: 1) Identity of Lanna spa; 2) Lanna spa services (hydrotherapy, massage, and products); 3) Lanna culture; and 4) Lanna health wisdom. Lanna spa is beneficial for people as it can help promote their health and well-being. Training program and service delivery of Lanna-style spa for health should be integrated with Lanna culture and wisdom. Keywords: Lanna spa Model, Qualitative research, Thailand

Background For older men with hypertension living in rural areas, non-adherence to treatment is a common phenomenon. The experience on risk perception of individuals with their condition is recognized as playing a critical role in promoting treatment adherence. However, the experience on risk perception in a cohort of older men with hypertension seems unclear. Aim To develop a theory concerning risk perception experience in a cohort of older men with hypertension from a rural area of Thailand. Methods A grounded theory approach was used. Semi-structured, face-to-face interviews with 29 hypertensive older men were conducted in Thailand using purposive and theoretical sampling methods. The grounded theory analytical method that included initial and focused coding, and constant comparison was used to analyse the data. Findings 'Developing a personal sense of risk' emerged as a core category, which incorporated the related four subprocesses: comparing healthcare provider information with stories of people with hypertension, comparing one's own situation with stories of people with hypertension, changing personal sense of risk and changing risk-related behaviour. Older men selected to focus on one particular outcome, using the selected outcome to monitor their risk. Conclusion This investigation provides a theory for healthcare providers to understand older men's perceptions of personal risk for complications of hypertension. A personal sense of risk influences risk-related behaviour change. Implications for nursing and health policy The findings can be used in assessing a personal sense of risk and promoting treatment adherence in older men with hypertension. Effective storytelling intervention, a standard tool for assessment personal sense of risk in older men with hypertension, should be developed. Hypertension care policy needs to be developed for individualized approaches.

To determine associations between Thai fathers' self-efficacy to support exclusive breastfeeding and exclusive breastfeeding duration.A descriptive quantitative design was used.The study sample consisted of 205 father-mother couples (410 participants) with an infant who was 6 months old. Data were conducted from well-baby clinics of two hospitals in Thailand's Chiang Mai province from January to March 2020.Each participant completed a sociodemographic questionnaire and Breastfeeding Self-Efficacy Scale (Short-Form). Father participants also completed the Father's Attitude toward Exclusive Breastfeeding questionnaire.Bivariate correlation analyses of survey data showed that paternal and maternal breastfeeding self-efficacy scores were positively associated with longer duration of exclusive breastfeeding (ρ=0.19 and ρ=0.54, respectively). Paternal self-efficacy scores were also positively correlated with maternal self-efficacy scores (ρ=0.30, p=.01). However, the results of Tobit regression analyses indicated that paternal self-efficacy scores did not moderate the relationship between maternal self-efficacy scores and exclusive breastfeeding duration. Only maternal self-efficacy scores were significantly associated with duration of exclusive breastfeeding (B=.16, p.01).This is the first Thai study to assess the relationship between fathers' breastfeeding support self-efficacy and exclusive breastfeeding duration. The results increase our understanding of paternal factors that impact exclusive breastfeeding duration. Although paternal self-efficacy did not moderate the effects of maternal self-efficacy on exclusive breastfeeding duration in this study, paternal self-efficacy positively related to maternal self-efficacy and breastfeeding duration.Paternal breastfeeding support self-efficacy should be promoted in co-parenting breastfeeding interventions both antenatal care clinics and postpartum units to promote exclusive breastfeeding and increase Thailand's overall exclusive breastfeeding rate.

Background Becoming an adolescent father is a significant and critical life event. Expectant fathers are faced with a concurrent dual developmental crisis: being an adolescent and becoming a father. This transition has a tremendous impact on these adolescents, their families and society. The impact on these individuals and society does not, at this point, seem to be clearly understood. Purpose To explore the process of Thai adolescents becoming first-time fathers with an unplanned pregnancy during their girlfriend's pregnancy. Methods A grounded theory approach was used, drawing upon semi-structured interviews with 16 expectant fathers in Chiang Mai, Thailand. Findings 'Growing into teen fatherhood' was the basic social process that emerged as the core category. These fathers used this process for developing themselves to fatherhood. This process was further divided into three phases: enduring the conflict of future role, accepting impending fatherhood and developing a sense of being teen expectant father. Throughout this process, the participants encountered many conflicts and challenges. They employed various strategies to manage the emotional, financial and interpersonal challenges they faced during the transition to fatherhood. Conclusion This study provides data as well as anecdotal evidence for healthcare professionals to better understand adolescent fathers and their unique challenges during their girlfriend's pregnancy. A better understanding of these rich findings will enable healthcare professionals to assist young men and boys in their struggle to transition to fatherhood. Implications for nursing policy Our data may guide policymakers in developing support groups, effective mentoring programs and national follow-up services as standard services in hospitals' care for first-time adolescent fathers in Thailand.

The objective of this study was to explore the process of transition into fatherhood for Thai men from childbirth to the postpartum period. Forty-one first-time Thai fathers were voluntarily recruited from two hospitals in Chiang Mai, Thailand, from December 2012 to June 2013. In-depth interviews were used to collect the data, which were analyzed based on grounded theory methodology. The basic social process that emerged as the core category was termed: "the journey into fatherhood." This process was divided into three phases: labor, delivery, and family beginning. Within this process, there were various situations, challenges, and pressures, which caused many changes of mood and feelings for the first-time fathers. Throughout this process, they applied various strategies to manage their concerns and needs, in order to develop into masterly fathers. Identifying the process of the journey into fatherhood provides nurses and midwives insight into the new fathers' experiences, which will enable them to be more sensitive, respectful, and effective caregivers.

The purpose of this study was to understand the process of Thai men becoming a first-time father. Twenty expectant fathers were voluntarily recruited from the antenatal clinics of three hospitals in Chiang Mai, northern Thailand. The data were collected by in-depth interviews and analyzed on the basis of grounded theory methodology. The findings demonstrated that "protecting the unborn baby" was the basic social process that emerged as the core category. This process was divided into three phases: confirming and accepting, perceiving the unborn baby as a human being, and ensuring the health of the mother and baby. Throughout this process, the Thai expectant fathers applied many strategies to manage their concerns, needs, and emotions and to develop themselves into fathers. The process of protecting the unborn baby provides insight into the expectant fathers' experiences, which will enable nurses and midwives to assist and care for men as they become fathers.

Summary Objective to examine women's embodied knowledge of pregnancy and birth, women's explanations of precautions during pregnancy and birth and preparations for easy birth and the role of a traditional midwife in a Thai birthing care. Design in-depth interviews relating to traditional and changed beliefs and practices of pregnancy and childbirth with Thai women in Northern Thailand. Setting Chiang Mai city and Mae On sub-district in Chiang Mai province, Northern Thailand. Participants 30 Thai women living in Chiang Mai in Thailand. Findings the social meaning of childbirth in Thai culture is part of the larger social system, which involves the woman, her family, the community, society and the supernatural world. Traditional beliefs and practices in Thai culture clearly aim to preserve the life and well-being of a new mother and her baby. It seems that traditional childbirth practices have not totally disappeared in northern Thailand, but have gradually diminished. Women's social backgrounds influence traditional beliefs and practices. The traditions are followed by most rural and some urban poor women in Chiang Mai. Implications for practice the findings of this study may assist health professionals to better understand women from different cultures. It is important to recognise many factors discussed in this paper within the context of Thai lives and traditions. This will prevent misunderstanding and, consequently, encourage more sensitive pregnancy and birthing care for pregnant women.

The purpose of this study was to understand the process of Thai men becoming a first-time father. Twenty expectant fathers were voluntarily recruited from the antenatal clinics of three hospitals in Chiang Mai, northern Thailand. The data were collected by in-depth interviews and analyzed on the basis of grounded theory methodology. The findings demonstrated that "protecting the unborn baby" was the basic social process that emerged as the core category. This process was divided into three phases: confirming and accepting, perceiving the unborn baby as a human being, and ensuring the health of the mother and baby. Throughout this process, the Thai expectant fathers applied many strategies to manage their concerns, needs, and emotions and to develop themselves into fathers. The process of protecting the unborn baby provides insight into the expectant fathers' experiences, which will enable nurses and midwives to assist and care for men as they become fathers.