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Objective: To examine the effectiveness of a family-based program for post-stroke patients and their families. Methods: A cluster randomized controlled trial design was used. Participants were randomly selected in the experimental group (3 districts) and the comparison group (3 districts), with 62 families recruited. Sixty-two persons with new stroke and families (family caregivers and family members) who met the inclusion criteria were assigned to two groups, 31 in each group. Using the Neuman System Model as a framework, we implemented the stressors assessment and family-based intervention into the program. Participants in the comparison group received usual care, and those in the experimental group underwent a stressors assessment and received the family-based program. Measurement of functional status, depression, and complications in post-stroke patients and family function in family caregivers and family members, as well as caregiver burden and caregiver stress in family caregivers, were assessed at baseline, 4 weeks, and 12 weeks after enrollment. Data analysis included descriptive statistics, the chi-square test, Bonferroni test, and repeated measures analysis of variance. Results: After participating in a 12-week family-based program, post-stroke patients in the experimental group showed statistically significant improvements in their functional status and decreased depression compared to the comparison group (P

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

Introduction Smoking inside the home affects the health of both the smoker and family members via secondhand exposure. This research examined the impact of a community participation program on creating smoke-free homes in a suburban community in Thanyaburi district, Pathumthani province in Thailand. Methods The study involved families, with a smoker in the home, that were randomly assigned to intervention and control groups each containing 27 families. The intervention group was administered with the community participation program for smoke-free homes for 5 sessions during the 6-month period of study. The program included providing information on secondhand smoking and harms, knowledge about quitting smoking and healthcare support, practice skills, campaigns in the community, visiting and encouraging, and reflecting and evaluation. The control group was normally treated by the community committee and health volunteers. Data collection was undertaken at baseline and at 6 months after implementation by an interview with questionnaires. Results Our results show that after the implementation, the intervention group reported significantly higher mean score on skills in negotiating with smokers for a smoking-ban inside home and mean score on emotional support for nonsmoking inside the home than those at baseline and those of the control group. The proportion having smoking ban home rules in the intervention group was significantly higher than at baseline and that of the control group (92.6% vs 18.5%). The proportion of smoke-free homes was higher in the intervention than in the control group (75% vs 0%). Conclusions These findings suggest that community participation programs for smoke-free home may be effective in raising awareness on the impact of secondhand smoke among family members and in working together to manage smoke-free home environments. The program may be applicable for further development within communities to achieve smoke-free homes.

Background: Diabetes mellitus is increasing and a shortage exists of nurses to care for patients. Community health volunteers (CHVs) pose potential supportive networks in assisting patients to perform healthy behaviors. Aim: The study aimed to develop and investigate the effects of a CHV involvement program on reducing glycated hemoglobin (HbA 1c ) levels among Thai patients with uncontrolled type 2 diabetes. Methods: This sequential mixed-method study was conducted from January to June 2019. Sixty patients with HbA 1c exceeding 7% were recruited from 2 communities assigned as the intervention and comparison groups. Using King’s General Systems Framework as a basis to develop the program, the study initially explored the perceptions of diabetes and its management among patients, family members, and CHVs. Then, a quasi-experimental study with 2 groups pretest-posttest design was conducted and compared with usual care. The intervention included educational sessions, home visits, and activities created by CHVs including a campaign, broadcasting, and health food shops. Quantitative data were collected at baseline and 20-week follow-up and analyzed by descriptive statistics, Independent t -test, and paired t -test. Results: The intervention group exhibited a lower mean HbA 1c ( p 1.0, effect size large). Conclusion: Applying this framework to develop the program could benefit glycemic control among patients with uncontrolled diabetes residing in communities. Further studies should be conducted on a large sample to demonstrate the efficacy of the program.

Objective: To determine the effects of goal attainment in nursing programs among hypertensive patients who are at high-risk to cardiovascular disease. Methods: A quasi-experimental study was conducted in a primary care unit setting. Eligible participants included hypertensive patients aged 35 years and above with poorly controlled blood pressure and accompanying risk factors for cardiovascular disease. Seventy-eight participants were divided evenly into two groups via simple random sampling. The experimental group participated in a 10-week program consisting of small group education/demonstration sessions focused on goal setting and self-management behavior. These participants also received a follow-up phone call and text messages that served as reminders/reinforcements. The control group received routine care only, which included appropriately consultation with health care providers. Results: The proportion of participants who achieved optimal blood pressure control (SBP < 140 mmHg) in the experimental group (80.6%) was greater than the control group (44.1%) (p-value < 0.05). In addition, the systolic blood pressure of the experimental group ( 131.33 mmHg, S.D. 12.09) was significantly lower than that of the control group ( 142.96 mmHg, S.D. 15.77) (p-value < 0.05). The mean scores for self-management behavior were significantly higher in the experimental group ( 106.14, S.D. 14.43) than the control group ( 83.21, S.D. 8.17) (p-value < 0.05). Conclusion: The goal attainment nursing program targeting behavior modification through empowerment was effective in improving self-management behavior among hypertensive patients at high risk for cardiovascular disease. Thus, this program can be applied to patients with uncontrolled chronic diseases.

Smoking inside home affects the health of a direct smoker and family members with second-hand exposure. The current research examined the effects of community participation program on smoke-free home in semi-urban community in Thanyaburi district of Pathumthani province in Thailand. Population included members of families with smokers, in respective area of the local administration organization of Thanyaburi municipality, including Lum Pak Kut and Rangsit sub-districts. The sample was randomly assigned for intervention and comparison groups, each containing 27 families. The intervention group was administered with the program for 5 sessions during the 6 month-period of study. The program contained the following components: community committee’s participation in decision making to solve the problem of smoking inside home; formulating smoke-free home policy; making action plans; smoke-free home campaign and public relations in community; educating family members about dangers of smoke and secondhand smoke and establishing smoking ban home rule; participation with the research team to practice skills in negotiating with smokers for smoking-ban inside home; giving emotional support for non-smoking inside home; posting smoke-free home stickers; giving advice about sources of help in need of smoking cessation. The comparison group was normally treated by community committee and health volunteers. Data collection was undertaken before implementation and 6 months after implementation by means of response to structured interview form. Skills in negotiating with smokers for no smoking inside home were evaluated. Emotional support was provided for non-smoking inside home. Comparisons were made on proportion of having smoking-ban home rule, and proportion of having smoke-free homes between the intervention and comparison groups. Data analyses were performed using descriptive statistics and test of hypotheses with Chi-Square test, paired t-test, independence t-test, and Fisher’s Exact test. Research results suggest that after the implementation, the intervention group reported significantly higher mean score of skills in negotiating with smokers for smoking-ban inside home and mean score of emotional support for non-smoking inside home than those before implementation and those of comparison group (p < 0.05). The proportion of having smoking ban home rules in intervention group was significantly higher (p < 0.05) than that before implementation and that of comparison group (92.6% versus 18.5%). The proportion of smoke-free home was higher in intervention than comparison group (75% versus 0%) which was significantly higher than that before implementation and that of the comparison group (p < 0.05). The current research suggests that community participation program for smoke-free home was effective in raising awareness on the impact of secondhand smoke on family members and in working together to manage for smoke-free home environment. The program was thus applicable for further development of community to achieve smoke-free homes.

Purpose: The purpose of this quasi experimental study was to evaluate the effects of Culturally Sensitive Sex Education Skill Development, a teacher-led sex education program in secondary schools in Thailand. Methods: Two public secondary schools in the suburban areas of Bangkok were randomly selected. One was designated as the experimental school and the other as the comparison school. Ninety grade seven and eight teachers, 45 from each school, were selected to participate in the study. Self efficacy theory and culturally appropriate basis were applied to develop the program which included 4 weeks of intervention and 2 weeks of follow up. Primary outcomes were attitudes toward sex education, perceived self efficacy, and sex education skills. Statistical analysis included independent and paired t test, and repeated one-way analysis of variance. Results: At the end of the intervention and during the follow-up period, the intervention group had significantly higher mean scores of attitudes toward sex education, perceived self efficacy, and sex education skills than their scores before (p

Nurses are crucial in providing comprehensive care across age groups and healthcare dimensions in primary care services. In Thailand, there are primary care units with no physicians in most primary healthcare units. Thus, nurses' roles and practices in primary health are different from those of nurses in hospitals. In addition, workload, time spent on non-nursing tasks, unsafe working environment, limited opportunities for professional development, and living in rural areas may contribute to job discouragement. Measuring job satisfaction among these nurses may need a scale other than the scale based on nurses working in hospitals. This study aimed to develop and assess the psychometric properties of the Job Satisfaction Scale among 420 Thai nurses working in primary care units. The scale's items were formulated by a literature review on nurse satisfaction, satisfaction measurement tools, conducting focus group discussions, and undergoing expert reviews. A two-round Delphi approach was employed to validate the content of the scales with three domains and 30 items. The initial scale exhibited acceptable content validity and reliability. Subsequently, a psychometric evaluation was conducted using exploratory factor analysis to determine the construct validity of the scale along with its internal consistency and reliability. The results revealed five domains with 30 items comprising the working environment, the value of work, success and progress, work abilities, and work support and welfare. Finally, the commonalities of the 30 items were adequately explained by the instrument's domains, with an acceptable internal consistency reliability of the entire scale and for the five domains. Therefore, the scale is suitable for assessing the job satisfaction of nurses in primary care units. However, further evaluation of the construct validity by other methods is needed in studies. [ABSTRACT FROM AUTHOR]

Nurses are a cornerstone in providing care for people at primary care units, so the evaluation of the nurses' work performance is important to improve service quality. Nurses' performance has been assessed in many counties, including the United States of America, Canada, England, New Zealand, South Africa, and South Korea. Currently, there is a scarcity of tools for assessing all aspects of the work performance of nurses in Thai primary care units, so we undertook this study to develop and test the work performance scale of nurses. The study design was instrument development and psychometric testing. Qualitative methods using focus group discussions and expert reviews were applied for the items' construction. Quantitatively we examined the psychometric properties of this scale with 662 nurses working at primary care units in Thailand. Only the quantitative data and results are presented here. Exploratory factor analysis revealed 71 items comprising ten factors: Basic treatment for common health problems and continuing care, School health care, Self-development, Research and innovation, Women and child care, Health resource management, Planning and budget management, Standard of care and assurance, Health data management, Disease prevention and environmental health care, and Disaster management. The Cronbach's alpha coefficient of the total 71 items and for each domain are in acceptable ranges. The Work Performance Scale for Nurses at Primary Care Units achieved good validity and reliability scores and can be used to evaluate the work performance of nurse to improve their practices. However, it requires further confirmatory testing with nurses in Thailand at a range of primary care units. [ABSTRACT FROM AUTHOR]

The onset of multiple risk behaviors, such as smoking, alcohol consumption and unprotected sexual intercourse, cluster in adolescence. Previously, many studies on adolescent risk factors have highlighted only a single risk behavior without considering the importance of the mutual relationships among them. Adolescents who engage in any one risk behavior are likely to engage in others. This quasi-experimental study aimed to examine the effects of a School-based Participation Program to prevent multiple risk behaviors in male students. Two secondary schools in suburban areas of Bangkok were randomly selected for this study, one designated the experimental and the other the comparison school. The sample included 64 male students (32 from each school). Additionally, 17 parents participated in the study. Data were collected by a self-administered questionnaire that included the following instruments: Demographic data, Knowledge of Risk Behaviors Prevention, Attitude towards Multiple Risk Behaviors, Self-efficacy to Avoid Multiple Risk Behaviors, Emotional Intelligence, and Time Management, Parental Monitoring and Multiple Risk Behaviors. The independent t-test and repeated one-way analysis of variance were used to analyze the data. Results revealed that most of the experimental and comparison groups smoked cigarettes. The experimental group had significantly higher mean scores of knowledge, attitude, self-efficacy, emotional intelligence, time management, and parental monitoring at baseline, immediately following, and nine weeks after intervention, all better than those in the comparison group across all time points of measurements. Compared to the comparison group, the experimental group did better regarding not having multiple risk behaviors across time. Nurses could apply this program to train adolescents to prevent multiple risk behaviors and the involvement of parents could strengthen the sustainability of risk behavior prevention in adolescents. However, the program requires further research with different populations. [ABSTRACT FROM AUTHOR]

A smoke-free home is defined as one where people are not allowed to smoke anywhere inside the home. Smoking inside the home leads to second-hand smoke for all household members, a health hazard that needs to be addressed. This study explored the perspectives of community members toward a smoke-free home in a suburb of Bangkok metropolitan area, Thailand. This paper describes the qualitative descriptive phase of a sequential mixed method study which employed four focus groups interviews with 29 key informants, including community committee members, smokers' family members, and current smokers. Focus group guidelines centred on understanding second-hand smoke and its effects on family health, how to ban smoking inside homes, and how communities get involved in promoting smoke-free homes. Content analysis was applied for data analysis and the findings on community perspectives on smoke-free home had three categories: 1) negative attitudes toward second-hand smoke inside homes; 2) effect of second-hand smoke on health problems; and 3) feasibility of smoke-free homes. Participants believed it was possible to develop a smoke-free home by setting a community agenda that required participation and coordination among community members, family members, and current smokers. This should entail strengthening family negotiations, setting smoking ban rules, and providing smoking areas outside homes, as well as supporting current smokers to quit. Public health nurses have a role to play in promoting smoke-free homes by their advocating, encouraging, and empowering smokers in reducing or quitting their smoking, as well as providing guidance to their families. In turn this helps to strengthen community action to prevent second-hand smoking and smoking reduction. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this research was to investigate whether the Stress Scale can predict depression after delivery in adolescent pregnancy. Methods: this cross-sectional research design was conducted during the third trimester of pregnancy and the samples being randomly selected from five regions of Thailand (n = 200). Data were collected by self-administered questionnaire at the baseline with the Stress Scale for depression in third trimester and at the 4th week after childbirth. ROC Curve and Logistic regression analysis were used to analyze the data. Results: this study revealed that the prevalence rate of depression in adolescent mothers was 16.5% (33 out of 200), and the Stress Scale had cut point score at ≥ 5.5 with sensitivity of 76% and specificity of 79%, and the area under curve was .84 (p < 0.001). The Stress Scale gained scores for cut point at ≥ 5.5; only 5 items showed capability to predict depression after delivery. Conclusion: This Stress Scale shows potential advantage for health personnel in early detection of depression in adolescent mothers at cut point scores of only 5.5 from 15. [ABSTRACT FROM AUTHOR]

Pregnancy among teenagers is a major public health problem worldwide. Traditionally, they have been considered a risk group, individuals having both physical health and psychological problems, with fewer social connections, low learning and educational achievement, and a poor quality of life. The goal of this cross-sectional study was to test a predictive model of quality of life among pregnant teens. This predictive model of quality of life included 449 Thai pregnant teenagers who received pre-natal care in four provincial hospitals and four community hospitals in northeast Thailand. Data were collected using the Social Support Measure, the Social Readjustment Rating Scale, the Abuse Assessment Screen, the Center for epidemiologic Studies Depression Scale, the Health Literacy Measure, and the Thai version of World Health Organization Quality of Life questionnaire. A structural equation model was used to analyze all factors' relationships in the model and how they affect to quality of life. Results indicated that the modified Model of Quality of Life among Thai Pregnant Teenagers fitted the data well and could explain 68% of variance of quality of life. In addition, social support, depression, and health literacy had a direct effect on quality of life. Meanwhile, social support had an indirect effect on quality of life, mediated through depression and health literacy of the pregnant teenager. Thus, nursing interventions should aim to reduce depression and to improve social support and health literacy for a better quality of life for these teenagers. [ABSTRACT FROM AUTHOR]

This participative action research sought to develop, for early adolescent female Thais, a school-based pregnancy prevention model that included the perspectives of adolescents, family members, school system members, and community members (i.e., health personnel and community leaders) in a province in northern Thailand. A participative action research design was implemented, using quantitative and qualitative data gathering approaches, via a three-phase plan (i.e., situational analysis, model development, and model reflection). In the first phase, 154 female students in secondary-school grades seven and eight, and 115 mothers/female guardians were assessed, using Problem Behavior Theory as a guide, about factors that influence sexual risk behavior. Data were obtained via self-administered questionnaires. During the second phase of the study, 14 focus groups and 15 in-depth interviews were conducted, with 20 of the adolescent subjects, 13 of the adoles­cents' mothers/guardians, and 69 key stakeholders for the purposes of obtaining additional data and developing a provisional teenage-pregnancy prevention model. The third and final phase involved model reflection, with 34 participants, selected from the first two phases of the study (i.e., seven female adolescent subjects, six male adolescent peers, eight mothers/guardians, two teachers, two health personnel, and nine community leaders), to ensure the model was designed to address the pregnancy prevention needs of early adolescent female Thais. Qualitative data were assessed via content analysis, while descriptive statistics, Pearson's correlation coefficient and stepwise multiple regression were used to analyze the quantitative data. The final version of the School-based Teenage Pregnancy Prevention Model was composed of four main parts (i.e., individual, family, school, and community) with nine essential components, including: promote family relationships; promote family communication; promote family roles; establish peer leaders; provide sex education; encourage moral principles; promote recreational interests; create school-family-community networks; and, provide sexual reproductive health services. Actions among and between the four main parts consisted of: sharing information; supporting and involving; sharing environment; supporting and promoting; and collaboration. The key concepts of the model demonstrate the need for ownership and involvement of the family, school, individual, and community in dealing with development of programs that address teenage pregnancy. In addition, the findings provide an increased understanding of sexual risk behavior of early adolescent female Thais. [ABSTRACT FROM AUTHOR]