Sang-arun Isaramalai

Productive engagement in older adults: A concept analysis

This study aimed to clarify the concept of productive engagement as it applies to older adults. The concept analysis was based on Walker and Avants eight-step method. A literature review of articles published in English between 1990 and 2011 (n = 37) was conducted, using an electronic search of multiple sources. Results revealed that four defining attributes for productive engagement include continuing to work either paid or unpaid, caring for others, engaging in social activities, and growing spirituality. The antecedents of productive engagement are sociocultural factors as well as individual and institutional capacities. Meanwhile, the consequences are increased feelings of usefulness, improved health and well-being, aged successfully, and enhanced quality of life. Model, borderline, and contrary cases are presented to illustrate the concepts defining attributes. Defining the concept of productive engagement provides a basis for nurses and other health professionals to better understand productive engagement in older adults, thus effective strategic plans or programs for promoting productive roles among older adults can be further developed.

Personal awareness and behavioural choices on having a stoma: a qualitative metasynthesis

AIMS AND OBJECTIVES To answer how personal awareness and behavioural choices on having a stoma have been described and interpreted in previous qualitative studies. BACKGROUND Over the past two decades, there has been an accumulation of the qualitative studies concerning the experiences of individuals living with a stoma. Synthesising the findings of these studies would be able to improve the understanding among health providers. DESIGN Qualitative metasynthesis. METHODS The literature was obtained through searching CINAHL and PubMed databases for papers published in English, and China National Knowledge Infrastructure database for papers published in Chinese from 1990-March 2012. Sixteen articles were selected using the predefined criteria. RESULTS Three themes about personal awareness and behavioural choices on having a stoma were identified: altered self, restricted life and overcoming restrictions. The results showed the impacts of having a stoma through the analysis on connections between personal awareness and behavioural choices. CONCLUSIONS Having a stoma means that the individuals have to learn to be aware of and accustomed to changes and restrictions in their everyday lives. The individuals take behavioural efforts to overcome these restrictions involving: deciding on whether to reveal or conceal their stomas to others based on the possibility of being accepted or rejected, using internal resources, seeking and receiving external supports. RELEVANCE TO CLINICAL PRACTICE The description and interpretation on personal awareness and behavioural choices associated with having a stoma is useful for nurses in providing practical, informational and emotional supports to help the individuals successfully adapt to their lives with a stoma.

Development and psychometric testing of the active aging scale for Thai adults.

Background Active aging is central to enhancing the quality of life for older adults, but its conceptualization is not often made explicit for Asian elderly people. Little is known about active aging in older Thai adults, and there has been no development of scales to measure the expression of active aging attributes. Purpose The aim of this study was to develop a culturally relevant composite scale of active aging for Thai adults (AAS-Thai) and to evaluate its reliability and validity. Methods Eight steps of scale development were followed: 1) using focus groups and in-depth interviews, 2) gathering input from existing studies, 3) developing preliminary quantitative measures, 4) reviewing for content validity by an expert panel, 5) conducting cognitive interviews, 6) pilot testing, 7) performing a nationwide survey, and 8) testing psychometric properties. In a nationwide survey, 500 subjects were randomly recruited using a stratified sampling technique. Statistical analyses included exploratory factor analysis, item analysis, and measures of internal consistency, concurrent validity, and test–retest reliability. Results Principal component factor analysis with varimax rotation resulted in a final 36-item scale consisting of seven factors of active aging: 1) being self-reliant, 2) being actively engaged with society, 3) developing spiritual wisdom, 4) building up financial security, 5) maintaining a healthy lifestyle, 6) engaging in active learning, and 7) strengthening family ties to ensure care in later life. These factors explained 69% of the total variance. Cronbach’s alpha coefficient for the overall AAS-Thai was 0.95 and varied between 0.81 and 0.91 for the seven subscales. Concurrent validity and test–retest reliability were confirmed. Conclusion The AAS-Thai demonstrated acceptable overall validity and reliability for measuring the multidimensional attributes of active aging in a Thai context. This newly developed instrument is ready for use as a screening tool to assess active aging levels among older Thai adults in both community and clinical practice settings.

Weighing Distress: Decision-Making Surrounding Management of the Pregnancy Experience Among HIV-Infected Thai Women

The researchers conducted this grounded theory study in order to describe the decision making surrounding management of the pregnancy experience of 38 pregnant, HIV-infected Thai women. Data were collected using in-depth interviews and an open-ended questionnaire, and they were analyzed using constant comparative analysis. We found that “weighing distress” was the core category of the decision-making process. The supporting categories were being ambivalent about continuing the pregnancy, exploring alternative options, and selecting the appropriate choice. Health care providers should encourage family members to participate and be involved in the womens decision-making processes.

Integrating participatory ergonomic management in non-weight-bearing exercise and progressive resistance exercise on self-care and functional ability in aged farmers with knee osteoarthritis: a clustered randomized controlled trial

Background Ergonomic hazards are the most important cause of knee osteoarthritis (OA) in aged para rubber farmers. Ergonomic management comprising improvement of working conditions and muscle-strengthening exercise has been well documented in terms of workers’ health benefit. However, those interventions were not adequate to sustain the advantage. Few studies have demonstrated the effect of integrating participatory ergonomic management (PEM) in non-weight-bearing exercise (NWE) and progressive resistance exercise (PRE), and none has focused on aged para rubber farmers with knee OA. Purpose This study investigated the effect of PEM-NWE, PEM-PRE, and standard treatment (ST) on self-care and functional ability in the aged population. Materials and methods A single-blinded, clustered randomized controlled trial was carried out. Participants (n=75) from three different communities in southern Thailand were randomly assigned to PEM-NWE, PEM-PRE, and ST. Self-care and functional ability (pain, stiffness, and physical function) were examined at baseline (B), during the intervention at Week 5 (W5), and after its completion at Week 9 (W9). Mean comparison of those outcomes over time was made using Generalized Linear Mixed Models (GLMMs). Results Compared to the standard treatment, the means of both groups, PEM-NWE and PEM-PRE, were significantly increased in self-care and functional ability. However, no significant difference between PEM-NWE and PEM-PRE was found. Conclusion Either or both interventions should be incorporated into nursing practice in order to promote occupational health and enhance quality of work life for Thai aged farmers. Further study on their cost-effectiveness is highly recommended.