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Chronic kidney disease (CKD) is a significant threat to the quality of life of the global population. Thus, slowing kidney disease progression is considered vital in the treatment of CKD patients. The study aimed to evaluate the effectiveness of a program designed to slow the progression of CKD among Type 2 diabetes mellitus patients with HT with stage 3 CKD (CKD 3) in Thailand by adopting the information-motivation-behavioral skills (IMB) model and applying technology. This study was conducted as a cluster randomized controlled trial. The program activities comprised: (i) providing disease information and teaching behaviors to slow the progression of kidney disease to patients and family members via a 2-h session; (ii) teaching practical behavioral skills for appropriate diet and exercise to patients and family members via a 2-h session; (iii) enhancing personal motivation via the Line application and motivational interviewing via telephone calls; (iv) enhancing social motivation with the support of a family member; (v) employing technology to monitor behaviors and increase patient motivation; and (vi) assessing behaviors that were not practical, exploring barriers to behavior modification, and teaching further practical behavioral skills via the Line application. The data were analyzed using percentages, means, standard deviations, chi-square tests, t -tests, and a 2-way repeated-measures analysis of variance. The results showed that after the experiment, the experimental group had significantly higher mean scores in terms of knowledge, perceived benefits, perceived severity, self-efficacy, and behaviors to slow the progression of kidney disease than the control group (P <.05). Further, the experimental group had significantly better clinical outcomes (SBP, DBP, eGFR, BUN, creatinine, albuminuria, FBS, and HbA1c) than the control group (P <.05). In summary, the findings indicate that the program improved clinical outcomes, especially kidney function, effectively slowing the progression of kidney disease. [ABSTRACT FROM AUTHOR]

Background: The prevalence of uncontrolled type 2 diabetes has been increasing, and the nurse is a primary healthcare provider to patients when health professionals are scarce in the community setting. A feasible intervention delivered by nurses is necessary to fulfill patients' needs to help them achieve glycemic control. Aim: To investigate whether Thai adults with uncontrolled diabetes in community hospitals lack self-care competency and whether a nurse-led supportive education program can enhance their self-care skills, change behavior, and control HbA1C levels. Methods: We employed a multi-community hospital cluster randomized controlled trial design. Participants were randomly selected in the experimental group (2 hospitals) and control group (2 hospitals), with 30 patients from each hospital. One hundred twenty adults with HbA1c 7—10% treated by oral glycemic medication were recruited. Using Orem's Theory as a framework, nurses implemented self-care deficit assessments and supportive-educative nursing programs into their work. Participants in the control group received usual care, and those in the experimental group underwent a nurse assessment and supportive education measures. Data were collected at baseline, with 4-week and 12-week follow-ups. Data analysis were a repeated measures ANOVA with post hoc analysis, and Independent t -test. Results: One hundred three patients completed the trial (51 in the experimental group and 52 in the control group). At 12 weeks, there were statistically significant improvements in HbA1c (P <.001), fasting plasma glucose (P =.03), knowledge (P <.001), diabetes self-care agency (P <.001), diet consumption (P <.001), physical activity (P <.001), and medical adherence (P =.03) in the experimental group significantly greater than those in the control group. Also, the between-group effect sizes were 0.49 or greater. Conclusion: The self-care deficit assessment and supportive education program were essential to the nursing intervention that effectively improved knowledge, changed behavior, and HbA1c levels among adults with uncontrolled blood glucose. [ABSTRACT FROM AUTHOR]

INTRODUCTION This systematic review and meta-analysis aimed to explore the existing tobacco interventions and synthesize whether those interventions affected tobacco use among university students. METHODS We searched and found 1799 studies in PubMed, ClinicalKey for Nursing, Embase, and SCOPUS between 2009 and 2022. The risk of bias was assessed using similar criteria for RCT and non-randomized studies guided by the Cochrane Handbook for Systematic Reviews. The heterogeneity of studies was evaluated using Cochran's Q and I2 index. The GRADE system was used to distinguish the quality of evidence, and Egger's linear regression test was performed to assess publication bias. RESULTS Eighteen studies used data extraction and analyses, and only eleven were meta-analyzed, which found that the estimate obtained via the fixedeffects model was statistically significant. Technology-based and motivational interview interventions found pooled ORs of statical significance, while reinforcer interventions showed the smallest effect size. The level of heterogeneity was considered substantial. The assessment for quality of evidence showed low overall certainty of evidence due to imprecision of outcome and suspicion of publication bias. Egger's test showed no publication bias among included studies (p=0.38). CONCLUSIONS There were numerous tobacco cessation interventions for university students, but the most effective intervention to change tobacco consumption behavior was still inconclusive and uncertain. [ABSTRACT FROM AUTHOR]

Adults with type 2 diabetes need to master illness self-management to meaningfully sustain behavior change and mindfulness practice may facilitate this process. This study investigated the effectiveness of the Mindfulness-Based Diabetes Self- and Family Management Support Program to improve glycated hemoglobin among Thai adults with uncontrolled diabetes. This program was developed from a literature review, and in-depth interviews with 15 participants who had poorly controlled diabetes and their family members. The Information-Motivation-Behavioral Skills Model and mindfulness approach was used as a framework to develop study intervention. We conducted a randomized controlled trial from September 2018 to March 2019. Eighty adults with uncontrolled type 2 diabetes were randomized to 12 weeks of either the control group who received only usual care (n = 40) or the experimental group (n = 40) who received an intervention in addition to usual care. Glycated hemoglobin, fasting blood glucose, mindful-eating, self-efficacy, dietary consumption, physical activity, and medication adherence were assessed at baseline, week 12 and week 16. Data were analyzed using descriptive statistics, ANCOVA, Repeated Measures ANOVA, and Independent t-test. The findings showed that participants receiving the intervention improved more between baseline and both weeks 12 and 16 in fasting blood glucose and HbA1c, appropriate dietary consumption, amount of physical activity, medication adherence, mindful eating, and self-efficacy than those in the control group. Nurses can be trained to implement this intervention program in adults with uncontrolled diabetes. However, more studies with a larger number of community participants are recommended with the application of advanced technology such as mobile health. [ABSTRACT FROM AUTHOR]

Background: Cluster symptoms are a common occurrence in breast cancer patients undergoing chemotherapy. The telephone is a well-recognized, convenient device for reaching out to patients for monitoring and managing their symptoms in an efficient, prompt, and appropriate manner. Objective: To investigate the efficacy of telephone-based intervention to achieve energy conservation among breast cancer patients with the aim of alleviating fatigue, pain, sleep disturbance, and depression. Materials and Methods: The present study was a two-armed, randomized control trial conducted in the university hospital between March and September 2019. Seventy-four breast cancer patients, receiving four courses of adjuvant chemotherapy, were randomly recruited and assigned into the experimental group and the control group. One face-to-face intervention interview for energy conservation was conducted, followed by 20-minutes telephone brief counselling and assessment sessions, scheduled on day 1, 2, 7, and 14. Results: The scores for symptoms of median fatigue and pain in the experimental group were shown to be significantly reduced at the end of the study as compared to those scores within the control group (p<0.05). Similarly, scores for median sleep time and depression were greater at the end of cycle 1 and highest in cycle 2 (p<0.05, 0.001, respectively). Physical activity levels were also higher in the experimental group than in the control group in every cycle, with a statistical significance (p<0.001). Conclusion: The present study intervention demonstrated an effectiveness for the reduction of cluster symptoms. Further studies would be needed in a larger population scale in the customary, randomized controlled trial manner. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effectiveness of a program that utilizes community involvement to improve the self-management strategies among people living with hypertension., Material and Method: Forty-four subjects, aged 35 to 59-year-old, with hypertension in Nakhon Pathom Province, Thailand, were randomly allocated to either an experimental group (n = 22) or a control group (n = 20). The experimental group attended a program to improve self-management methods based on social cognitive theory (SCT). The program lasted 12 weeks, consisted of 1 1/2 hours meeting once a week, including group meetings and home visit monitoring. Mann-Whitney U test and Friedman test were employed to analyze the program's effectiveness., Results: After the program, the mean rank of the perceived self-efficacy for the self-management strategies was statistically different between the two groups (p = 0.023). In the experimental group, after the twelve week, the mean rank of perceived self-efficacy and outcome expectancy increased and diastolic blood pressure decreased after the eight week., Conclusion: The program applied social cognitive theory (SCT) to promote self-management techniques, increased the health promoting behavior among hypertensive people.

Objective: To investigate an effectiveness of walking exercise program applying the Theory of Planned Behavior in people at risk of hypertension in Samut Sakorn province., Material and Method: The present study is a quasi-experimental research. The inclusion criteria were people aged 35-59 years old, systolic blood pressure 120-139 mmHg, and diastolic blood pressure 80-89 mmHg. Participants were randomly selected into the experimental group (n = 34) and the comparison group (n = 34). The experimental group received activities including health information, benefits of walking exercise, group discussion in exercise barriers, modeling and experience exchange, walking exercise practice, and practice on using walking monitoring booklet at the baseline and the 2nd week, whereas the comparison group received only health information and the booklet practice at the beginning of the intervention. Data were collected by self-administered questionnaires at the baseline, 2nd week, and 6th week. Statistical analysis was performed using Chi-square, Independent t-test, and repeated measures ANOVA., Results: The experimental group made significant improvements in attitude towards walking exercise, perceived behavior control, subjective norm, walking exercise intention, and walking exercise over time (p < 0.05). However, no statistically significant differences between the experimental and the comparison groups were found in subjective norm, systolic and diastolic blood pressure from baseline to the 6th week. The experimental group had a significant higher mean difference score of attitude towards walking exercise, perceived behavior control, walking exercise intention, walking exercise, weight, and BMI compared to those in the comparison group (p < 0.05). Subjective norm scores in the experimental group were more likely to increase from baseline to the 6th week, but not a significant difference., Conclusion: Walking exercise programs applying the Theory of Planned Behavior should be recommended in people at risk of hypertension. Health professionals should also be motivated to practice with this program.

Objective: To investigate an effect of a personal health record booklet (PHRB) to knowledge, self-efficacy and healthy behaviors among Thai population at risk of CVD., Material and Method: The present study was a quasi-experimental study conducted in a primary care unit during November 2008 and January 2009. A random sample of 204 CVD risk population were recruited as a comparison group (n = 102), who received a regular follow-up and recorded routine blood pressure using booklet and an experimental group (n = 102), who received the regular follow-up and the intervention consisting of health education for CVD information and self-monitoring practice. Data were collected by using self-administered questionnaires at the baseline, the 4th week and the 8th week. These data were analyzed by descriptive statistics, Chi-square test and GLM repeated measures., Results: Knowledge score was significantly decreased although self-efficacy was increased over a time in the experimental group. However except the figure of sweet/cookies consumption, the mean score of healthy behaviors were not improved in the experimental group when compared to the comparison group., Conclusion: CVD information, activity illustrations with caption, health record section and daily self-monitoring tables in desired behaviors should be considered for inclusion in the booklet.