Sunida Preechawong

RELATIONSHIPS OF FAMILY FUNCTIONING, SELF-ESTEEM, AND RESOURCEFUL COPING OF THAI ADOLESCENTS WITH ASTHMA

Within the context of Rosenbaums theory of learned resourcefulness, this correlational study examined the relationships among family functioning, self-esteem, and resourceful coping in Thai adolescents with asthma. A convenience sample of 132 Thai adolescents (aged 12–17 years) with asthma was recruited from the outpatient asthma clinics of four hospitals in Bangkok. Self-administered questionnaires included an assessment of demographic information and asthma status, the revised Family APGAR, the Rosenberg Self-Esteem Scale, and the Childrens Self-Control Scale. Hierarchical multiple regression analysis was used to examine the relationships among variables. Effective family functioning had a significant positive effect on self-esteem (β = .27, p < .01) and resourceful coping (β = .30, p < .01), controlling for gender and age. However, self-esteem was not significantly correlated with resourceful coping (β = .15, p = .08). The findings suggest that nursing interventions should take into account the role of family functioning in promoting self-esteem and resourceful coping in Thai adolescents with asthma. Recommendations for future research include replication of the study with a larger sample of adolescents with asthma and with adolescents with other chronic illnesses.

Focused Reflection Reminiscence Group for Elders: Implementation and Evaluation

The majority of elders have at least one or more chronic conditions. Functional decline coupled with increased dependence can make elders more vulnerable to negative emotions. Reminiscence can be useful in maintaining a healthy psychological adaptation in the later years of life. This study examined the effectiveness of a specific type of reminiscence in reducing negative emotions in 32 elders residing in retirement communities. This type of reminiscence, called focused reflection, was organized into six weekly, 2-hour group sessions, each with a specific theme. Paired t tests suggested that the focused reflection program reduced symptoms of depression and anxiety but not those reflecting agitation. Overall, the participants gave high ratings to the program. Health care providers should develop focused reflection reminiscence programs to enhance the psychological well-being of elders. Further testing of the focused reflection in larger groups of elders is recommended.

Success Counteracting Tobacco Company Interference in Thailand: An Example of FCTC Implementation for Low- and Middle-income Countries

Transnational tobacco companies (TTCs) interfere regularly in policymaking in low- and middle-income countries (LMICs). The WHO Framework Convention for Tobacco Control provides mechanisms and guidance for dealing with TTC interference, but many countries still face ‘how to’ challenges of implementation. For more than two decades, Thailand’s public health community has been developing a system for identifying and counteracting strategies TTCs use to derail, delay and undermine tobacco control policymaking. Consequently, Thailand has already implemented most of the FCTC guidelines for counteracting TTC interference. In this study, our aims are to describe strategies TTCs have used in Thailand to interfere in policymaking, and to examine how the public health community in Thailand has counteracted TTC interference. We analyzed information reported by three groups with a stake in tobacco control policies: Thai tobacco control advocates, TTCs, and international tobacco control experts. To identify TTC viewpoints and strategies, we also extracted information from internal tobacco industry documents. We synthesized these data and identified six core strategies TTCs use to interfere in tobacco control policymaking: (1) doing business with ‘two faces’, (2) seeking to influence people in high places, (3) ‘buying’ advocates in grassroots organizations, (4) putting up a deceptive front, (5) intimidation, and (6) undermining controls on tobacco advertising, promotion and sponsorship. We present three case examples showing where TTCs have employed multiple interference strategies simultaneously, and showing how Thai tobacco control advocates have successfully counteracted those strategies by: (1) conducting vigilant surveillance, (2) excluding tobacco companies from policymaking, (3) restricting tobacco company sales, (4) sustaining pressure, and (5) dedicating resources to the effective enforcement of regulations. Policy implications from this study are that tobacco control advocates in LMICs may be able to develop countermeasures similar to those we identified in Thailand based on FCTC guidelines to limit TTC interference.

The influence of symptoms, social support, uncertainty, and coping on health-related quality of life among cholangiocarcinoma patients in northeast Thailand.

Background: Health-related quality of life (HRQOL) is an important outcome for evaluating the effectiveness of cancer care. Cholangiocarcinoma (CCA) is a major public health problem in northeast Thailand. There is little information regarding factors influencing HRQOL in CCA patients. Understanding the factors affecting HRQOL in CCA patients is necessary to develop nursing interventions to improve the HRQOL. Objective: The purpose of this study was to develop and test a model that explained the influence of symptoms, social support, uncertainty, and coping on the HRQOL in CCA patients. Methods: Using a cross-sectional descriptive design, a convenience sample of 260 CCA patients were consecutively recruited from a regional hospital and a university hospital in northeast Thailand. All participants responded to a set of 6 questionnaires in structured interview format. A linear structural relationship was used to test the hypothesized model. Results: Findings revealed the hypothesized model fit the empirical data and explained 69.4% of the variance of HRQOL. Symptoms were the most influential factor affecting HRQOL directly and indirectly through uncertainty. Social support had a direct effect on HRQOL and an indirect effect on HRQOL through uncertainty. Uncertainty had a direct effect on coping and HRQOL. Coping had a nonsignificant direct effect on HRQOL. Conclusion: Symptoms, social support, and uncertainty were important factors influencing HRQOL in CCA patients. Implications for Practice: Cholangiocarcinoma is a unique yet understudied condition. Further work in developing CCA-specific HRQOL interventions is warranted.

Randomized controlled trial of a self-efficacy enhancement program for the cardiac rehabilitation of Thai patients with myocardial infarction.

This study examined the effects of a self-efficacy enhancement program for the cardiac rehabilitation of Thai patients who had a myocardial infarction. Sixty-six hospitalized patients of various ages and both genders were randomly assigned to either an experimental or a control group. Participants in the experimental group took part in three individualized in-hospital education sessions and three weekly sessions of telephone counseling. The control group primarily engaged in a supervised exercise and activities of a daily living performance regimen, and received education in this regard. Self-efficacy and functional status were measured via questionnaire. Four weeks after discharge, the experimental group was found to have significantly higher total self-efficacy and functional status scores than the control group. In addition, the experimental group exhibited significantly higher subscale scores on social activity, household tasks, occupation, and exercise self-efficacy than the control group. These results indicate that the program is effective in improving the self-efficacy and functional status of Thai patients who have had a myocardial infarction.

Validation of the Thai version of the Duke Activity Status Index in patients with a previous myocardial infarction

Abstract Background: The Duke Activity Status Index is a widely used instrument for measuring functional status in patients with cardiovascular disease. However, items and subscales on this instrument have not been validated for Thai patients with a previous myocardial infarction (MI). Objective: To test the reliability and validity of the Thai version of the Duke Activity Status Index (DASI-T) in Thai patients with a previous MI using a cross-sectional study design. Methods: The DASI-T was translated using forward and backward translation methods and administered to 100 MI patients from outpatient departments of two general hospitals in Thailand. Internal consistency was determined to test reliability. Two criterion measures (i.e. Canadian Cardiovascular Society (CCS) classification, SF-36 physical functioning subscale) were used to test the concurrent validity of the DASI-T. Age group and CCS classification were used to determine known-groups validity of the DASI-T. Results: Cronbach’s α for the DASI-T total score was 0.76. No ceiling or floor effect was detected for the DASI-T total score. DASI-T total score was significantly correlated with the CCS classification (r = -0.68, P < 0.01) and SF-36 physical functioning subscale (r = 0.79, P < 0.01). DASI-T total scores could differentiate MI patients based on age (P = 0.040) or CCS classification (P = 0.000). Conclusion: The DASI-T is a potentially reliable and valid instrument with which to assess functional status in MI patients and is also useful to evaluate a treatment effect and be a guideline for clinical purposes (i.e. exercise prescription, risk stratification).

Translation and Validation of the Thai Version of a Modified Brief Pain Inventory: A Concise Instrument for Pain Assessment in Postoperative Cardiac Surgery

Acute pain after cardiac surgery can be assessed using validated instruments such as the modified interference subscale of the Brief Pain Inventory (mod‐BPI). Despite the available knowledge, the Thai version of a mod‐BPI has not yet been presented.