Testing the nicotine dependence measure mFTQ for adolescent smokers: A multinational investigation.

BACKGROUND AND OBJECTIVES: As a measure of nicotine dependence among adolescent smokers, the modified Fagerström Tolerance Questionnaire (mFTQ; seven items), has been successfully used in the United States (USA). Nonetheless, the validity and reliability of mFTQ at the international level is still needed. The current study is the first to test the validity and reliability of mFTQ in four countries: Thailand, Spain, the USA, and Russia. METHODS: In a cross-sectional survey, mFTQ, risk factors of nicotine dependence, and sociodemographic characteristics were assessed. Risk factors included age of first cigarette, frequency of alcohol use, frequency of marijuana use, and number of cigarettes smoked yesterday. Salivary cotinine was also obtained in Thailand and Spain. RESULTS: For all four countries, mFTQ exhibited a single factor structure, as supported by previous work in the USA. For all studied countries except Thailand, mFTQ presented acceptable internal reliability. Overall, risk factors of nicotine dependence have predicted mFTQ scores across countries. Frequency of alcohol use in the USA and frequency of marijuana use in Thailand and Spain were not associated with mFTQ scores. DISCUSSION AND CONCLUSIONS: mFTQ is a single-factor measure of nicotine dependence that shows acceptable internal consistency and validity across countries. Further work can advance the scale and tailor it to different cultures. SCIENTIFIC SIGNIFICANCE: mFTQ can be a clinically practical international measure of nicotine dependence. This study provides initial support for the utility of the mFTQ among Thai, Spanish, American, and Russian adolescents. Further research is needed to test and advance mFTQ across cultures. (Am J Addict 2017;26:689-696).

Validation of the parenting sense of competence scale in fathers: Thai version.

The role of the parent is a significant family factor that can impact the child cognitively, emotionally, and socially. Strengthening parents' competence improves their performance as parents. This study is the development and validation of the Thai Parenting Sense of Competence scale (Thai PSOC scale) for assessing the parenting competence of Thai fathers. The Thai PSOC scale was revised from the PSOC scale developed by Gibaud-Wallston and Wandersman (1978). The scale consists of 17 items with 2 subscales: skill/knowledge (8 items) and valuing/comfort (9 items). The scale was tested with 195 Thai fathers-to-be/ fathers. The results showed high internal consistency: 0.78 for the total scale and 0.73 and 0.80 for the skill/knowledge and valuing/comfort subscales, respectively. Confirmatory factor analysis (CFA) led to a revision of the Thai PSOC scale with better goodness of fit indices for the sample. In the revised scale with Item 17 was omitted, several goodness of fit indices improved significantly with a more acceptable, good fit (Chi(2)/df = 1.63; RMSEA = 0.06; GFI = 0.91; AGFI = 0.88; NFI = 0.80; TLI = 0.90; CFI = 0.91). With revision, the Thai PSOC scale is a potential instrument to measure parenting competence in Thai fathers.

Implementation of Self-Care Deficits Assessment and a Nurse-Led Supportive Education Program in Community Hospitals for Behavior Change and HbA1c Reduction: A Cluster Randomized Controlled Trial.

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.

The effectiveness of tobacco cessation programs for university students: A systematic review and meta-analysis.

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 fixed-effects 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. TRIAL REGISTRATION: This systematic review was registered with PROSPERO. The registration number is CRD42019142491.

Effectiveness of a model of risky sexual behavior prevention among adolescent boys in Thailand.

The objectives of this study were to identify predictable factors affecting risky sexual behavior and to evaluate the effectiveness of a risky sexual behavior prevention program among boys one and two months after the program. The Information-Motivation-Behavioral skills (IMB) model program was carried out among 74 adolescent boys aged 10-13 years and 74 of their parents in Phitsanulok Province, Thailand. Repeated analysis was employed to analyze the program's effectiveness. After the program, mean scores for comfort in talking about sex, self-efficacy, and skills in condom use increased significantly (p<0.05), and mean scores regarding knowledge about sexually transmitted infections and skills in decision making decreased significantly (p<0.05) compared to baseline. Boys participating in this program improved their condom use skills and comfort talking about sex at two months follow-up (t=3.82, p<0.001; t=3.10, p=0.003, respectively). These results provided evidence for applicability of a prevailing theory-based intervention within the local cultural context.

Development of a model for parent-adolescent daughter communication about sexuality.

This study aimed to develop a model for parent-adolescent daughter communication about sexuality (PDCS). The subjects were 18 mother-doughter pairs. The females were 12-13 years old studying in the 7th grade of a secondary school in Bangkok. The model had 3 parts: (1) the process of PDCS development, (2) the essential components, characteristics and patterns of PDCS and (3) the impact of the program. The model was examined using both quantitative (paired t-test) and qualitative (content analysis) methods. The inputs, assessing the guardian and adolescent female factors, included sexuality knowledge, understanding of the daughter's sexual development, attitudes regarding talking about sexuality, perceptions regarding communication and the maternal-daughter relationship, and uncomfortable feelings and confidence in ability to talk about sexuality. The processes included: (1) raising awareness and enhancing positive attitudes about PDCS, (2) establishing sexual knowledge and development, (3) establishing a maternal-daughter relationship and (4) training in reciprocal PDCS skills. The output was modification of maternal and daughter communication skills that occurred during the shared discussion and reflection process. The outcomes reflected 4 aspects: feelings toward PDCS, characteristics of PDCS, sexual knowledge, and maternal-daughter relationship. The model was successful in guardian implementation and networking were established on their own with the cooperation of both subjects in accordance with their likenesses, abilities, and competencies. There was little assistance needed from the researcher or teacher to support self reliance with the PDCS.

Academic Stress among High School Students in a Rural Area of Nepal: A Descriptive Cross-sectional Study.

INTRODUCTION: The period of adolescence undergoes many physical and mental changes. Changing emotional and physical status along with increasing social, family, and academic pressure lead to various impairments in the mental health of adolescents. Academic failure leads to the suicide rate in adolescents, predominantly high during the declaration of exam results which is significantly high in a rural area in comparison with urban. The study examined the prevalence of academic stress among high school students in a rural area of Rolpa, Nepal. METHODS: A descriptive cross-sectional study was conducted in 6 schools in Rolpa from July to October 2019. The sample size calculated was 521. A convenient sampling technique was used for this study. The target population was adolescents enrolled in high schools of Rolpa. Ethical approval was taken before data collection. The scale for assessing academic stress was used to find out the prevalence. A questionnaire was translated in local language and pre-testing was done in Nepal Police School,Sanga among 10% of the calculated sample size. Data entry was done in Statistical Package for the Social Sciences version 18. Descriptive statistical analysis was done for prevalence calculation. RESULTS: Out of a total of 521 students, the prevalence of academic stress was seen among 138 (26.5%)students at a 95% confidence interval (22.72-30.28). CONCLUSIONS: The prevalence of academic stress in our study was high and was consistent with other South Asian studies. Understanding academic stress and providing help and support to the students would help ease the burden for them.

Prevalence and risk factors of low back pain among nurses in a Thai public hospital.

OBJECTIVE: To determine the prevalence and risk factors causing low back pain in Thai nurses working in a public hospital. MATERIAL AND METHOD: A cross-sectional study was conducted among 265 Thai Hospital nurses between July and August 2008. A self-reported questionnaire was used to collect the data onsite. Risk factors including personal factors, working factors, job stress, health behavior, and work environment were measured. Data were analyzed by frequency distribution, mean, standard deviation, and logistic regression. RESULTS: The prevalent rate of low back pain based upon the nurses' report in the previous 12 months was 61.5%. Logistic regression analysis indicated that moving patients in bed without assistance and a lack of back muscle exercise were the significant risk factors causing low back pain among nurses (p < 0.05). CONCLUSION: The prevalence of low back pain among Thai Hospital nurses was high. Further steps should be taken to prevent LBP by designing and implementing preventive factor-based interventions.

Three-month effects of Project EX: A smoking intervention pilot program with Thai adolescents.

Adolescent smoking is a major public health problem around the world, including Thailand. The current study provides a three-month follow-up evaluation of the Project EX tobacco use cessation program among Thai adolescents. The intervention was tested involving a quasi-experimental trial with 185 smokers, with two program and two control condition schools (within each condition, one school in Bangkok Province and one school in Nakhon Pathom Province). At 3-month follow-up, the intent-to-treat (ITT) quit rate was 23% in the program group and 11% in the standard care control group (p<0.02). The intervention also lowered the level of last 30-day smoking at follow-up among persons who did not quit in the program condition, while no change in level of smoking was reported in the control condition. These results are promising for teen tobacco use cessation programming in Thailand.