"Failure to control blood sugar" experiences of persons with type 2 diabetes mellitus.

Objectives: This study aimed to explore the experiences of persons with type 2 diabetes mellitus having poor glycemic control. Methods: A narrative qualitative study was conducted. Eight participants were recruited at a hospital's primary care unit (PCU) in northeastern Thailand from October to December 2021. The data was collected using in-depth interviews, field notes, and non-participatory observation. It was then analyzed based on the thematic analysis guide of Braun & Clarke (2006). Results: The results revealed four main themes and eight sub-themes: lifestyle practice (inappropriate eating behaviors, taking diabetes drugs irregularly, exercising irregularly); perception of self-care (misperceptions about self-care practices, diabetes was a genetic disease and therefore had to be accepted); awareness regarding complications (not being aware of glycemic control, issues with social gatherings); stress from socioeconomic issues (feeling stressed in daily life). Conclusions: It is the role of healthcare professionals to stress the importance of healthy behaviors to improve glycemic control in terms of diet, exercise, medication use, perception, awareness, culture, and beliefs. The study results could aid healthcare providers in developing innovations in nursing care or interventions to change unhealthy behaviors.

Nephrology nurses' perceptions of discussing sexual health issues with patients who have end-stage kidney disease.

BACKGROUND: Despite sexual dysfunction (SD) being common among, and affecting quality of life in people with end-stage kidney disease (ESKD) receiving dialysis, sexuality is not a subject that patients and nephrology nurses usually discuss. OBJECTIVE: To explore Thai nephrology nurses' perceptions about discussing sexual health issues with patients receiving dialysis. MATERIAL AND METHODS: A phenomenological approach was applied and data were collected using semi-structured individual interviews. Purposive sampling was used to recruit 20 participants from four Southern regional hospitals in Thailand between April and June 2016. Recruitment continued until data saturation was reached. Data were analysed using Colaizzi's method. FINDINGS: Participants were aged between 27 and 53 years: mean 42.95 (±7.62 SD). Nineteen were female and sixteen were married. Five themes emerged: (1) improving knowledge in order to enhance confidence before discussing sexuality with patients; (2) gaining patients' trust before discussing sexuality; (3) finding an appropriate time to discuss sexuality; (4) organising a suitable setting in which to discuss sexuality and (5) feelings of appreciation for helping patients and their partners overcome their sexual health issues. CONCLUSION: These findings provide an understanding of Thai nurses' perceptions about the challenges in communicating with patients experiencing ESKD regarding sexual health problems and concerns. The findings suggest that sexual health education and training would enhance the confidence of Thai nephrology nurses in initiating sexuality-related discussions with their patients.

How do Thai patients receiving haemodialysis cope with pain?

BACKGROUND: Pain affects peoples' well-being and quality of life and is one of the most common symptoms experienced by people receiving haemodialysis (HD). OBJECTIVES: To explore how Thai people receiving HD perceive pain, the effect of pain on their lives, and how they cope with and manage pain. METHODS: Purposive sampling was used to recruit participants from two Thai outpatient haemodialysis facilities in Songkhla province. Face-to-face, in-depth individual interviews using open-ended questions were conducted during January and February 2012. The interviews were audio-recorded and transcribed verbatim. Data were analysed using Ritchie and Spencer's Framework method. FINDINGS: Twenty people receiving HD participated in the study: age range 23-77 years; 10 were females. Three main types of pain emerged: physical pain, which occurred when needles were inserted during HD treatment and vascular access operations; psychological pain due to unfulfilled hopes and dreams and changes in family roles; and social pain. Perception of pain was influenced by the general populations' perceptions of chronic kidney disease. Participants used two main coping styles to manage pain: health-adjustment and health-behaviour styles. These two coping styles encompassed four specific coping strategies: religion, spirituality, accepting pain associated with HD treatment, and social support. Coping styles and strategies were influenced by Thai culture. CONCLUSION: The study elicited information that could help nursing staff understand how Thai people manage pain and the importance of cultural beliefs to their pain experience and coping strategies, which in turn can help nurses plan appropriate pain management.

How do Thai patients with end stage renal disease adapt to being dependent on haemodialysis?: a pilot study.

BACKGROUND: Researchers have explored the experiences of patients on haemodialysis (HD); however, most studies do not include Thai patients. Thus, the way Thai patients experience and adapt to HD is unknown. AIM: To conduct a pilot study to explore how HD affects Thai patients with end stage renal disease (ESRD) and understand HD patients' perspectives about adapting to being dependant on HD. METHODS: Data were collected using semi-structured interviews that focused on problems, feelings, thoughts, attitudes and ways of adapting to HD. Grounded theory (GT) method was selected to guide data collection and analysis. FINDINGS: Five patients (age range 24-66 years; mean 45.40 years; mode = 24) participated in the study. Four main coping processes emerged during data analysis: planning, adjustment and avoidance, belief in religion and superstition and living with hope. In addition, the patients reported a range of adverse effects of HD including fluid restriction, fatigue, effects on sexual activity, altered body image, fear of dying, stress and depression and suicide. CONCLUSION: Thai patients with ESRD felt treatment, including HD, adversely affected their lives and required physical, psychological and social changes to enable them to cope. They reported use of a range of strategies to deal with the adverse effects.

Using a mentorship model to prepare newly graduated nurses for competency.

This research was conducted to study the level of nursing competency of newly graduated nurses after using a mentor-ship model. Nineteen newly graduated nurses worked with a trained mentor. Before the experiment, newly graduated nurses were evaluated regarding their nursing competency by head nurses two times, with a 1-month interval between evaluations. Select experienced nurses were prepared in mentoring roles. The mentors and the newly graduated nurses worked together for 1 month. After that, newly graduated nurses were evaluated for nursing competency by head nurses again. All data were analyzed by median, quartile deviation, and Wilcoxon signed ranks test. The level of nursing competency of newly graduated nurses was higher using the mentor model. This finding showed that the mentor program increased the nursing competency of newly graduated nurses.

Tactful monitoring: how thai caregivers manage their relative with schizophrenia at home.

Approximately 343,680 individuals in Thailand suffering from schizophrenia are cared for at home by relatives, most of whom have a little knowledge of the disease; therefore they're left to develop their own strategies of care. Data were collected by in-depth interviews and observation involving 17 caregivers of relatives diagnosed with schizophrenia. Data were analyzed using the constant-comparative method of grounded theory. Caregivers' chief concern was avoiding psychotic episodes. They do this through a process we call "tactful monitoring," which includes the co-variables "unobtrusive observation" and strategies for calming. Caregivers follow a trajectory that leads them to a state of exhaustion, tired and sad, and fearful about the future care of their loved one. Findings from this study led the authors to conclude that in Thailand, caregivers were able to develop creative ways of tending to their relatives with schizophrenia at home, but not without significant cost to themselves. Limited provision for caregiver education and respite exists. If education and increased respite care were instituted, caregivers could benefit, and patients might avoid expensive inpatient visits.

A study of dissemination of health information via internet.

This study was conducted with two research approaches: First, survey approach by examining credibility of 255 websites, based on study criteria obtained from 1,888 Thai health related websites. Secondly, qualitative approach by interviewing 30 webmasters regarding how to develop health websites. Major findings were: 99.20 % of health websites providing health information have legal/and ethical issues, only 9% were given a disclaimer.