Influencing factors of good quality of life among chronic obstructive pulmonary disease patients living in Zhejiang Province, China.

Chronic obstructive pulmonary disease (COPD) is a chronic, progressive and debilitating disease that affects quality of life (QOL), especially among patients living in poor environments. This study aimed to determine the influencing factors of good QOL among COPD patients living in Zhejiang, China. A cross-sectional study was conducted to collect data from participants in six tertiary hospitals in Zhejiang Province by a simple random sampling method. A validated questionnaire was used to collect general information, environmental factors, and COPD stage. The standardized St. George's Respiratory Questionnaire (SGRQ) was used to assess QOL. Logistic regression was used to determine influencing factors of good QOL among COPD patients at a significance level of α = 0.05. A total of 420 participants were recruited for analysis. The overall prevalence of patients with good QOL was 25.7%. Six variables were found to be associated with good QOL in the multivariable analysis. Patients who were employed had 2.35 times (95% CI 1.03-5.34) greater odds of having good QOL than those who were unemployed. Those whose family income was higher than 100,000 CNY had 2.49 times (95% CI 1.15-5.39) greater odds of having good QOL than those whose family income was lower than 100,000 CNY. Those who had treatment expenses less than 5,000 CNY had 4.57 (95% CI 1.57-13.30) times greater odds of having good QOL than those who had treatment expenses of 5,000 CNY or higher. Those who had mild or moderate airflow limitation were 5.27 times (95% CI 1.61-17.26) more likely to have good QOL than those who were in a severe or very severe stage of COPD. Those who had a duration of illness less than 60 months had 5.57 times (95% CI 1.40-22.12) greater odds of having good QOL than those who had a duration of illness of 120 months or more. Those who were not hospitalized within the past 3 months had 9.39 times (95% CI 1.62-54.43) greater odds of having good QOL than those who were hospitalized more than twice over the past 3 months. Socioeconomic status, disease stage and accessibility were associated with good QOL among COPD patients in Zhejiang Province, China. Increasing family income and implementing measures to improve the accessibility of medical care, including developing a proper system to decrease the cost of treatment for COPD patients, can improve patients' QOL.

Knowledge attitude and practice regarding prevention of needle stick injuries among nursing students in Henan province, China.

Nursing students are more vulnerable to needle stick injuries (NSIs) among all the nurses due to lack of work experience and poor awareness of occupational protection. A cross-sectional study of 400 nursing students was carried out to assess the participants' knowledge, attitudes, and practices regarding prevention of NSIs. The results indicated that 67% of nursing students suffered at least one NSI during their internship. The most common causes of injury were the injection process, venous catheter management process, and the process of disposal of all kinds of needle waste. Intentionally breaking the needle after injection, capping needles, and separating the needle from the syringe by hand are the risk factors for NSIs among nursing students. It is necessary to develop and increase occupational safety protection courses and establish regulations for the prevention of NSIs.

Using Action Research to prevent work-related illness among rubber farmers in Northeastern Thailand.

OBJECTIVES: This research aimed to enhance self-care among rubber farmers for preventing work-related illness. DESIGN AND SAMPLE: The project used Action Research's four phase iterative process: fact-finding to understand the problems, action planning, action plan implementation, and evaluation and reflection on action plan impacts. Sixty-six participants (46 rubber farmers and 20 community stakeholders) were purposively recruited from two villages in the top 10 rubber producing provinces in Northeastern Thailand. MEASURES: Demographic and work-related illness data were collected in face-to-face structured interviews, Focus group interviews and participant observations were used to collect data in each project phase. Night group meetings were held throughout the research phases. The intervention included training workshops and establishing a community health education team for ongoing farmer support. RESULTS: Results showed improved farmer self-care behaviors and establishment of a community health education team to encourage farmers to care for themselves properly. CONCLUSION: Community nurses, other health personnel, and the Thai government can build on initiatives like this to strengthen occupational health and safety practices and services policy for rubber farmers.

Development and validation of a work-related low back pain risk-assessment tool for sugarcane farmers.

This cross sectional study developed and validated a LBP risk-factor screening scale for use with sugarcane farmers. The scale was developed from a synthesis of LBP risk factors, pretested with 30 sugarcane farmers and administered to five hundred and forty sugarcane farmers to test its psychometric properties. Results indicated construct validity for three factors; physical factors (19 items) with factor loadings of 0.406 to 0.881 and communalities between 0.471 and 0.991; psychological factors (7 items) with factor loadings of 0.635 to 0.821 and communalities between 0.444 and 0.714, and third, working environment factors (2 items), with factor loadings between 0.345 and 0.347 and communalities between 0.946 and 0.953. The content validity index was 0.90 with reliability index of 0.87. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 82.02%, 30.49%, 62.65% and 54.40% respectively. The area under the receiver operating characteristic was 0.56. The scale's high specificity and sensitivity and comprehensive three risk-factor dimensions should make it a very useful screening tool in primary health care for early detection of LBP and for LBP risk-reduction and prevention advice. Future studies could focus on confirming content and predictive validity in other settings to assess generality of its usage.

Work-related musculoskeletal disorders among sugarcane farmers in north-eastern Thailand.

This cross-sectional analytical study aimed to identify prevalence and factors associated with work-related musculoskeletal disorders (WMSDs) among sugarcane farmers. Cluster random sampling was used to select 540 sugarcane farmers from 3 provinces in North-Eastern Thailand. Three related questionnaires, plus assessments by 2 expert physiotherapists, were used to check for factors associated with WMSDs and prevalence of WMSDs. Data were analyzed using descriptive statistics and multiple logistic regressions. The results indicated the prevalence of WMSDs among sugarcane farmers in the 7 days before the interview and looking back over the previous 12 months were 82.96% and 88.70%, respectively. Factors significantly associated with reporting WMSDs (P value < .05) during past 12 months were (a) repetitive motions (adjusted odds ratio [OR] = 1.90; 95% confidence interval [CI] = 1.05-3.43), (b) working in awkward postures (adjusted OR = 1.95; 95% CI = 1.01-3.77), (c) forceful exertions (adjusted OR = 2.78; 95% CI = 1.54-5.02), and (d) stress about future income (adjusted OR = 1.80; 95% CI = 1.02-3.16). Recommendations are made for risk prevention strategies.

Action research to strengthen women weavers' self-care in North-East Thailand.

OBJECTIVE: The objective of this research was to improve self-care and work safety practices among women weavers in North-East Thailand. DESIGN AND SAMPLE: Action research was used with a sample of 107 weavers and 15 community and local government stakeholders from six rural villages. Formative and summative evaluation was carried out over 10 months following initial implementation of five action plans, and after 5 years. MEASURES: Qualitative data were collected via focus groups, formal and informal interviews and research field notes. Women's self-care issues and safety problems, and weaving-related environmental pollution emerged from the content analyses. Five action plans were created. RESULTS: Results showed that through action research the women were empowered to identify personal and work-related health issues, environmental contamination concerns, and lack of social and community support systems. Over time they developed capacity for working collectively to address these. Five year follow-up revealed many of the changes made were ongoing, and well-integrated into community life. CONCLUSIONS: The study reaffirmed the potential for public health or community nurses and other health personnel for enhancing community health status via action research with vulnerable populations; in this case, rural village women weavers in North-East Thailand.

A cross-sectional study of pre-travel health-seeking practices among travelers departing Sydney and Bangkok airports.

BACKGROUND: Pre-travel health assessments aim to promote risk reduction through preventive measures and safe behavior, including ensuring travelers are up-to-date with their immunizations. However, studies assessing pre-travel health-seeking practices from a variety of medical and non-medical sources and vaccine uptake prior to travel to both developing and developed countries within the Asia-Pacific region are scarce. METHODS: Cross-sectional surveys were conducted between July and December 2007 to assess pre-travel health seeking practices, including advice from health professionals, health information from other sources and vaccine uptake, in a sample of travelers departing Sydney and Bangkok airports. A two-stage cluster sampling technique was used to ensure representativeness of travelers and travel destinations. Pre-travel health seeking practices were assessed using a self-administered questionnaire distributed at the check-in queues of departing flights. Logistic regression models were used to identify significant factors associated with seeking pre-travel health advice from a health professional, reported separately for Australian residents, residents of other Western countries and residents of countries in Asia. RESULTS: A total of 843 surveys were included in the final sample (Sydney 729, response rate 56%; Bangkok 114, response rate 60%). Overall, pre-travel health information from any source was sought by 415 (49%) respondents with 298 (35%) seeking pre-travel advice from a health professional, the majority through general practice. Receipt of a pre-travel vaccine was reported by 100 (12%) respondents. Significant factors associated with seeking pre-travel health advice from a health professional differed by region of residence. Asian travelers were less likely to report seeking pre-travel health advice and uptake of pre-travel vaccines than Australian or other Western travelers. Migrant Australians were less likely to report seeking pre-travel health advice than Australian-born travelers. CONCLUSIONS: This study highlights differences in health-seeking practices including the uptake of pre-travel health advice by region of residence and country of birth. There is a public health need to identify strategies targeting these travel groups. This includes the promotion of affordable and accessible travel clinics in low resource countries as traveler numbers increase and travel health promotion targeting migrant groups in high resource countries. General practitioners should play a central role. Determining the most appropriate strategies for increasing pre-travel health preparation, particularly for vaccine preventable diseases in travelers is the next stage in advancing travel medicine research.

Enhancing a health-related quality-of-life model for Laotian migrant workers in Thailand.

We undertook this action research study to enhance the health-related quality of life (HRQOL) of Laotian migrant workers, and to conceptualize a practical model for workers for use in similar situations. Seventy Laotian migrant workers, 3 researchers, and 18 stakeholders took part in the study. Several data collection methods were utilized, including in-depth interviews, focus groups, participant observations, and field notes. Content analysis was employed to analyze qualitative data. Findings suggest that because of their participation in the study, the workers improved certain aspects of their HRQOL through participation, consciousness raising, and empowerment, which enabled them to become more self-reliant, confident, and competent, and have greater strength to overcome their difficulties. The Enhancing Laotian Workers' HRQOL Model was conceived as a practical model that could be used by community health nurses working with migrant workers in various contexts.

Self-reported symptoms of infection among travelers departing from Sydney and Bangkok airports.

BACKGROUND: Data on the burden of illness in travelers departing from both developing and developed countries within the Asia-Pacific region is scarce. We conducted a survey to assess symptoms of infection among travelers within the region. METHODS: A self-administered questionnaire was distributed to travelers departing Sydney airport, Australia, for destinations in Asia and departing Bangkok Airport, Thailand, for Australian destinations during the respective winter months of 2007. A two-stage cluster sampling technique was developed to ensure representativeness and a weighting was applied to the Sydney sample. Travelers were assessed for symptoms of infection (fever, sore throat, diarrhea, rash, and myalgia), travel activities, and social contact in the 2 weeks prior to departure. RESULTS: A total of 843 surveys was included in the final sample (Sydney 729, response rate 56%; Bangkok 114, response rate 60%). Overall, 45.6% of respondents were Australian residents and 26.7% were residents of countries in Asia. At least one symptom of infection was reported by 23.8% of respondents and 5.4% reported two or more symptoms of infection in the 2 weeks prior to departure. The proportion reporting symptoms was higher in those departing Bangkok compared to Sydney. Significant risk factors for the reporting of symptoms differed between residents and visitors departing each study site. Activities resulting in high rates of social contact prior to travel, particularly contact with febrile persons, were found to be independent predictors of reported symptoms. CONCLUSIONS: Self-reported symptoms of infection were common in our sample of travelers. Infectious diseases in travelers can result in spread across international borders and may be associated with the frequency of social contacts and reported illness among travelers.

Perception of stress in Laotian migrant workers in Thailand.

Globalization and the movement of workers across borders in search of a better life or employment are presenting healthcare systems and researchers with problems of increasing complexity. This study focused on how migrant workers in Thailand from the Lao People's Democratic Republic conceptualized their stress and stressing factors. Participant observation, in-depth interviews, and field notes were employed in the study, which analyzed data from seventy subjects through qualitative content analysis. The migrant workers in this sample perceived stress as a state of being unable to fulfill their preferences or expectations revolving around issues of: living with poverty, employment, loneliness, poor relationships, competition in the workplace combined with job uncertainty, and invisibility. To provide care for the minority migrant workers, nurses need to focus on identifying how these users perceive stress, and urgent action and further research are needed.

The surveillance system in health centers in northeastern Thailand.

In this study we assessed the existing communicable disease surveillance system in health centers of a province in northeastern Thailand. The first part of the study was an examination of medical records from 11 local health centers: 649 were examined for sensitivity, positive predictive value, and representativeness; and 433 were examined for timeliness and data quality. The second part of the study looked at 50 local officers from 11 local health centers, 1 district health office, 1 community hospital, and 8 sub-district administrative organizations. Quantitative data was collected through a review of medical records. Qualitative data was collected by focus groups and in-depth interviews. The reporting of suspected cases was 50.8%. Sensitivity was low for common diseases. Positive predictive value was lowest for fever of unknown origin (0%). Data quality for the date of onset and diagnosis was low. Case reporting was considered timely in only 45% of cases. Health officers perceived the surveillance system as not being up-to-date. They only collected data in a district without data analysis; the information provided by the system is not representative of the true epidemiological situation countrywide and cannot be used to help monitor disease patterns and trends. In conclusion, health officers should report diseases according to symptoms and analyze data continuously to identify urgent problem and elicit prompt responses.

Strengthening the self-care of women working in the informal sector: local fabric weaving in Khon Kaen, Thailand (Phase I).

The first phase of this study was undertaken using Participatory Action Research (PAR) to identify the factual situations of fabric-weaving women working in the informal sector in Thailand. The aims were to enhance the mutual understanding of the women and researchers concerning the problems faced by these women and to establish an action plan to address these problems. The participant group consisted of 107 women working in the informal sector from three local villages who voluntarily took part in the study. Data were collected using quantitative and qualitative methods through structured questionnaires, focus groups, in-depth interviews, participant observations, and field notes. The results of the study revealed that the women learned their health problems were related to work and their labor potentially placed them at a risk for illness. When the women realized the gravity of their situation, they attained a sense of empowerment and took the initiative in establishing action plans to address their problems.