Jiraporn Suwanteerangkul

Hopelessness and Loneliness Among Suicide Attempters in School-Based Samples of Taiwanese, Philippine and Thai Adolescents

The aim of this study was to assess the level of suicide attempts in three school-based samples of Southeast Asian adolescents (Taipei, Taiwan; the Philippines; Chiang Mai, Thailand) and determine whether adolescent suicide attempters score higher on measures of hopelessness and loneliness relative to nonattempters. It was hypothesized that hopelessness and loneliness would be related to suicide attempts, and that hopelessness would continue to be associated with suicide attempts when controlling for loneliness. The prevalence of suicide attempts across the three samples of Asian youth were not consistent with Taiwanese girls and boys as the most likely to have ever attempted suicide. As expected, results showed that suicide attempters (in past 12 months and ever) scored higher on hopelessness and loneliness than nonattempters across all three samples and for both genders. However, the statistical control of loneliness demonstrably weakened the association between suicide attempt behaviour and hopelessness across the samples and for both genders, and resulted in nonsignificant ANCOVA tests for some of the sample-gender groups. These results attest to the need for more research investigating connections between youth suicide attempts, hopelessness and loneliness in adolescent populations. Loneliness should be included as a potential determinant of youth suicidal behaviour in future research.

Cigarette smoking and indicators of psychosocial distress in Southeast Asian and Central-Eastern European adolescents.

The purpose of this study was to examine the association of cigarette smoking and 2 indicators of psychosocial distress (hopelessness and loneliness) among adolescents from 2 distinctly different regions of the world: Central-Eastern Europe (Hungary, Ukraine, Slovakia, Czech Republic, Romania, Poland) and Southeast Asia (Thailand, Taiwan, and the Philippines). Among Southeast Asian boys and girls, smokers had elevated hopelessness in comparison to nonsmokers but among Central-Eastern European students, this relationship was true only for girls and there was no relationship for boys. Across the country samples, there was only association of smoking with loneliness among Southeast Asian girls and Central-Eastern European girls. While Southeast Asian girls who smoked scored higher on loneliness than nonsmokers, the opposite was true among Central-Eastern European girls, with smokers scoring lower on loneliness.

Stigma, Social Support, and Treatment Adherence Among HIV-Positive Patients in Chiang Mai, Thailand

Our study assessed the influence of HIV-related stigma on treatment adherence among people living with HIV in Chiang Mai, Thailand, and whether social support had a moderating effect on this relationship. We recruited 128 patients living with HIV from Sansai Hospital, a community hospital in Chiang Mai, Thailand, and collected data through structured interviews. All forms of HIV-related stigma considered in this study (personalized experience, disclosure, negative self-image, and public attitudes) were negatively correlated with adherence to anti-retroviral regimens. Multiple linear regression indicated that total HIV-related stigma was more predictive of treatment adherence than any individual stigma type, after adjusting for socio-demographic and health characteristics. Tests of interaction showed that social support did not appear to moderate the association between HIV stigma and treatment adherence. Our findings suggest that community and government efforts to improve public perceptions about people living with HIV might promote treatment adherence behaviors among HIV-positive patients.

Dieting among Thai adolescents: Having friends who diet and pressure to diet

The purpose of this study was to assess dieting behavior, the number of friends who diet, and number of friends who pressure to go on a diet among a sample of 2,519 Thai adolescents. More than half of the girls (52.2%) and over one-fourth of boys (28.0%) reported going on a diet in the past 30 days. Dieting among friends was very common with only 14.2% of girls and 34.3% of boys saying none of their friends dieted. Results also showed significant associations between 1) number of friends who diet and 2) number of friends who pressure to diet with dieting behavior, body mass index (BMI), weight satisfaction, perceived body fatness, effort to look like people in the media, and frequency of thinking about wanting to be thinner in girls. In addition, several of these associations for boys were significant. The role of BMI in these relationships was also explored.

Perception, concern and acceptability of neonatal male circumcision among postpartum mothers in Thailand.

Introduction: Three randomized controlled trials involving over 11,000 men have demonstrated that male circumcision reduces female to male transmission of HIV. It is recommended by the World Health Organization as part of a HIV prevention program. Adult male circumcision is associated with significant complications while neonatal male circumcision (NMC) has few risks and may be a preferred prevention strategy. Internationally, NMC is seldom performed except as a religious ritual. So, introducing NMC in Thailand needs to determine its acceptability among mothers. Therefore a study was conducted among postpartum Thai mothers to determine their perceptions of, concerns about and acceptability of NMC. Methods: A survey was conducted of 593 postpartum mothers from 16 hospitals in 4 provinces in Thailand. Data were analyzed using descriptive statistics, univariate analysis and binary logistic regression. Results: 70 % of the participants reported that they knew or have heard about MC. Safety and pain were the major concerns of the mothers towards NMC. One-third would chose to have their infants circumcised after receiving the information about NMC, an additional third were undecided and 34.5% would not allow their sons to undergo NMC. Mothers (44.0 %) were the most influential person when it comes to the decision on NMC followed by fathers (37.9 %). In a multiple regression, having 9 years or greater of formal education (OR 1.64; 95% CI 1.01-2.66), having a circumcised husband (OR 2.88; 95% CI 1.11-7.50), and knowing of at least one circumcised child (OR 1.97; 95% CI 1.22-3.18) were independent predictors of acceptability to NMC among postpartum mothers. Conclusions: The results suggest that NMC may be culturally neutral with evidence that even modest educational efforts can impact mothers’ decisions in favor of NMC. However, this study and a previous study suggest that both parents and health professionals need to be educated about the benefits of NMC.

Self-Perception of Body Weight among Secondary Students in Chiang Mai, Thailand

Self-perception of body weight and other weight-related factors were assessed among 2,519 Chiang Mai Province, Thailand high school students. A high percentage of the girls (57.6%) and boys (29.0%) reported that they were too fat and these percentages were higher than those reported by U.S. students in a recent Youth Risk Behavior Survey. Yet, in comparison to U.S. students, the Thai students were less likely than their U.S. counterparts to engage in weight management practices (e.g., dieting, eating less food, using diet pills). Thai students with a self-perception of being too fat were more likely than those with perceptions of being just right or too thin to engage in weight management practices, to be dissatisfied with their weight, feel that they were unattractive, estimate that their same-sex peers were trying to lose weight, and have a higher body mass index. The findings showed a relationship between self-perception of body size and engaging in weight control behaviors consistent with other research. It suggested that self-perception of body weight, more so than objective weight status, was predictive of weight loss behavior and also negative psychological outcomes associated with poor body weight image. As a result, self-perception of weight may be an important point of focus for the design and implementation of clinical and public health initiatives and health education interventions targeted at this adolescent population.

Physicians’ and nurses’ thoughts and concerns about introducing neonatal male circumcision in Thailand: a qualitative study

BackgroundNeonatal male circumcision (NMC) is an alternative approach to adult male circumcision for HIV prevention. Recent studies found that NMC was rarely performed in Thailand and that most Thai health professionals did not recognize that NMC could reduce the risk of HIV infection and would not want NMC services in their hospitals. This study explored the thoughts and concerns of Thai government health staff regarding the introduction of NMC in government health facilities as a public health measure.MethodsIn-depth interviews with physicians, nurses and physician administrators from four different levels of government hospitals in four provinces representing 4 regions of Thailand were conducted after provision of education regarding the benefits and risks of NMC. Interviews were audio recorded and analyzed using Atlas.ti software to develop themes.ResultsSix themes emerged from the data of 42 respondents: understanding of the benefits of NMC; risks of NMC; need for a pilot project; need for staff training and hospital readiness; need for parental/family education; and need for public awareness educational campaign. Major concerns included possible medical complications of NMC, infringement of child rights, and lack of understanding from staff and parents. The respondents emphasized the need for a clear policy, proper training of staff, financial and equipment support, and piloting NMC rollout before this measure could be fully implemented.ConclusionsThai health professionals who took part in this study expressed several concerns if NMC had to be performed in their health care facilities. There is significant preparation that needs to be done before NMC can be introduced in the country.

Meanings of Smoking among Adolescents in Chiang Mai, Thailand

The Meanings of Smoking Index-2 (MSI-2) was administered to 2516 Thai adolescents in an urban, suburban, rural, and vocational high school. Factor analysis identified six meanings of smoking factor domains: coping, social image, stimulation, weight, independence, and difficulty refusing smoking. Logistic regression analyses determined that the strongest positive association with smoking behavior and ever smoking was the coping domain, and coping was also positively associated with susceptibility to smoking. The individual meaning item which most differentiated current smokers from nonsmokers was “keeps from being bored” and the dimension of stimulation (gives more energy, helps to concentrate, helps to study, gives something to do) was positively associated with current smoking. Findings suggest that meanings of smoking is important because it can provide guidance to health educators and other health professionals in tailoring smoking prevention and cessation interventions by identifying and targeting meanings that are salient within specific adolescent populations.