Factors influencing self-management behaviors in persons with lupus nephritis: A cross-sectional study.

Background: Patients with lupus nephritis experience disease symptoms and side effects from treatment. Although self-management behaviors are important in patients with this disease, there is limited research on the factors influencing these behaviors. Objective: This study aimed to examine the factors influencing self-management behaviors in patients with lupus nephritis. Methods: This cross-sectional study was conducted in 240 patients with lupus nephritis at a university hospital in Thailand between August 2019 and December 2020 using a random sampling method. Data were collected using a demographic and clinical characteristic questionnaire, Self-Management Behavior Questionnaire, Self-efficacy for Managing Chronic Disease: A 6-item Scale, Knowledge about Lupus Nephritis Questionnaire, Family Support Scale, Social Networks in Adult Life Questionnaire, and Memorial Symptom Assessment Scale for Lupus Nephritis. Descriptive statistics and multiple linear regression analyses were employed. Results: The participants reported a moderate level of self-management behaviors. Multiple regression analyses revealed that disease duration, income, symptoms, self-efficacy, knowledge, family support, social networks, and classes of lupus nephritis significantly explained 21% of the variance in self-management behaviors (R2 = 0.21; F(8,231) = 7.73; p <0.001). Family support (ß = 0.32, p <0.001) and symptoms (ß = -0.23, p <0.001) were significant determinants of self-management behaviors in patients with lupus nephritis. Conclusion: The findings provide valuable insight for nurses to better understand the factors influencing self-management behaviors in patients with lupus nephritis. Patients with low family support and high symptom severity may face difficulty in performing self-management behaviors. Nurses should pay more attention to these patients and provide family-based interventions to optimize self-management behaviors in this population.

Civil Society Involvement in Managing the COVID-19 Pandemic: A Case Study of a Large and Congested Urban Community in Bangkok, Thailand.

Introduction: The COVID-19 pandemic has significantly impacted Thailand, including urban centers like Bangkok and surrounding areas, highlighting a critical need for effective management within densely populated communities to mitigate its effects. Methods: This qualitative study sought to explore community management strategies developed in Khlong Toei, a large, congested urban community in Bangkok, Thailand. Seven in-depth interviews (n=7), six focus groups (n=23), and two brainstorming sessions (n=12) were conducted for this study. Data were collected using Zoom, an online communication platform, and through on-site interviews between August 2021 and March 2022 in the congested urban community of Bangkok, Thailand. The data were analyzed using content analysis. Results: All informants (age range: 20-66 years, female respondents: 73.33%) were recruited by a community leader and the abbot of Saphan Temple, the community waiting area in Khlong Toei. The findings revealed two main themes: (1) Caring people, including two subthemes, and (2) Caring community, including two subthemes. Discussion: The study's findings provide guiding inputs for management of public fear to prevent emerging or re-emerging infectious pandemics within congested urban communities.

The prevalence and factors associated with sarcopenia in Thai older adults: A systematic review and meta-analysis.

Objective: This systematic review and meta-analysis aimed to assess the prevalence and identify factors associated with sarcopenia in older Thais. Methods: Research studies were searched in online databases, including PubMed, Embase, Scopus, and Thai-Journal Citation Index. The articles included in this review were limited to being published between January 1, 2013 and January 31, 2023 and observational study designs. The research quality was evaluated using the Joanna Briggs Institute (JBI) critical appraisal tool for prevalence studies. A meta-analysis was performed using the JBI SUMARI software. The review protocol has been registered on PROSPERO with the assigned ID CRD42023420514. Results: A total of 265 research articles were initially identified, out of which 17 articles were included in this study, including a total of 4,668 participants aged 60 years and over, consisting of 1,380 (29.6%) men and 3,288 (70.4%) women. The overall prevalence of sarcopenia in Thai older adults was 20.7% (95% CI 14.4%-27.8%). Subgroup analysis of the sarcopenia prevalence based on the study areas revealed that the prevalence was 33.4% (95% CI 28.7%-38.3%) in hospitalized individuals, 23.2% (95% CI 12.5%-35.9%) in outpatient clinic settings, and 17.3% (95% CI 9.4%-26.8%) in community-living older adults. Advanced age (OR = 4.60, 95% CI 3.07-6.91), being male (OR = 2.30, 95% CI 1.37-3.85), low body mass index (BMI) (OR = 8.95, 95% CI 6.05-13.25), and malnutrition (OR = 2.78, 95% CI 2.09-3.70) are strong predictors of sarcopenia in older adults in Thailand. Conclusions: This systematic review represents the first assessment of the overall prevalence and factors associated with sarcopenia in Thai older adults, indicating its significant concern within this population. These findings are of importance for public health management aimed at preventing and managing sarcopenia in the country.

The effectiveness of protein supplementation combined with resistance exercise programs among community-dwelling older adults with sarcopenia: a systematic review and meta-analysis.

OBJECTIVES: The combination of protein supplementation and resistance exercise shows promise for improving and maintaining muscle mass, strength, and performance in older adults with sarcopenia. This systematic review aimed to evaluate the effects of this combination on muscle mass, muscle strength, and physical performance in community-dwelling older adults with sarcopenia. METHODS: We conducted a comprehensive search of 4 electronic databases: PubMed, Scopus, Embase, and the MEDLINE Library. The search covered literature from January 2013 to January 2023 and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two independent reviewers assessed the methodological quality of each study using the standard critical appraisal tool from the Joanna Briggs Institute (JBI). Meta-analysis was performed with the JBI Sumari program. RESULTS: The review included 7 randomized controlled trials and 1 quasi-experimental study, encompassing a total of 854 participants aged 60 years and above. The study durations ranged from 10 weeks to 24 weeks. An analysis of standardized mean differences (SMDs) showed that protein supplementation combined with resistance exercise significantly increased muscle mass (SMD, 0.95; 95% confidence interval [CI], 0.13 to 1.78; p<0.05) and muscle strength (SMD, 0.32; 95% CI, 0.08 to 0.56; p<0.05). CONCLUSIONS: Although the limited number of randomized controlled trials restricts the robustness of our conclusions, the evidence suggests that protein supplementation combined with resistance exercise is effective in enhancing muscle mass and strength in community-dwelling older adults with sarcopenia.

Effects of a Comprehensive Dietary Intervention Program, Promoting Nutrition Literacy, Eating Behavior, Dietary Quality, and Gestational Weight Gain in Chinese Urban Women with Normal Body Mass Index during Pregnancy.

In urban Chinese women with normal body weight during pregnancy, we implemented a comprehensive dietary intervention program aimed at enhancing nutrition literacy, dietary quality, and gestational weight gain. The methods included both online and offline health education on prenatal nutrition, weekly weight monitoring, family back education practices, and real-time dietary guidance. The intervention was delivered to randomly assigned control and intervention group participants from gestational week 12 to week 24. The intervention group (n = 44; 100% complete data) showed significant differences (mean (SD)) compared to the control group (n = 42; 95.5% complete data) in nutrition literacy (53.39 ± 6.60 vs. 43.55 ± 9.58, p < 0.001), restrained eating (31.61 ± 7.28 vs. 28.79 ± 7.96, p < 0.001), Diet Quality Distance (29.11 ± 8.52 vs. 40.71 ± 7.39, p < 0.001), and weight gain within the first 12 weeks of intervention (4.97 ± 1.33 vs. 5.98 ± 2.78, p = 0.029). However, there was no significant difference in the incidence of gestational diabetes (2 (4.5%) vs. 4 (9.5%), p = 0.629). Participants in the intervention group reported an overall satisfaction score of 4.70 ± 0.46 for the intervention strategy. These results emphasize the positive role of comprehensive dietary intervention in promoting a healthy diet during pregnancy.

The Effects of Nursing Case Management on Self-Care Behaviors, Clinical Outcomes, and Quality of Life Among Community-Dwelling Older Adults with Poorly Controlled Type 2 Diabetes in Thailand.

This study evaluated the effectiveness of nursing case management on self-care, clinical outcomes, and quality of life in community-dwelling older adults with poorly controlled type 2 diabetes in Thailand. The research employed a quasi-experimental, single-group, pretest - posttest design. Methods: Twenty-three participants participated in a 12-week nursing case management program, which was tailored to the individual's needs and abilities, as well as their family, community, and healthcare context. Self-care behaviors increased significantly (p = .000) after implementation of the case management program, while waist circumference, fasting capillary blood glucose, and hemoglobin A1c decreased significantly (p = .001, p = .000, p = .003, respectively) from pre-intervention values. Quality of life was significantly better after the program (p = .000) than before. Results suggest that implementing tailored nursing case management could increase self-care behaviors and quality of life while decreasing waist circumference, fasting capillary blood glucose, and hemoglobin A1c in community-dwelling older adults with poorly controlled type 2 diabetes. The effectiveness of nursing case management depends on the healthcare context, the training and expertise of case managers, as well as the patient's needs and preferences. Furthermore, the availability of families and communities can influence the nursing case management outcomes.

The Thai version of the COVID-19 Yorkshire Rehabilitation Scale: a valid instrument for the psychometric assessment of the community members in Bangkok, Thailand.

BACKGROUND: Coronavirus disease 2019 (COVID-19) can develop into a long-term COVID in some cases, which can have a major impact on various health systems requiring appropriate treatment involving multi-disciplinary healthcare. The COVID-19 Yorkshire Rehabilitation Scale (C19-YRS) is a standardized tool widely used for screening the symptoms and severity of long-term COVID. Translation of the English version of the C19-YRS into the Thai language and testing it is essential for the psychometric evaluation of the severity of the long-term COVID syndrome prior to providing rehabilitation care for community members. METHODS: Forward-and back-translations including cross-cultural aspects were conducted in order to develop a preliminary Thai version of that tool. Five experts evaluated the content validity of the tool and produced a highly valid index. A cross-sectional study was then conducted on a sample of 337 Thai community members recovering from COVID-19. Assessment of internal consistency and individual item analyses were also performed. RESULTS: The content validity resulted in valid indices. The analyses showed that 14 items had acceptable internal consistency, based on the corrected item correlations. However, five symptom severity items and two functional ability items were deleted. The Cronbach's alpha coefficient of the final C19-YRS was 0.723, indicating acceptable internal consistency and reliability of the survey instrument. CONCLUSIONS: This study indicated that the Thai C19-YRS tool had acceptable validity and reliability for the evaluation and testing of the psychometric variables in a Thai community population. The survey instrument also had acceptable validity and reliability for screening the symptoms and severity of long-term COVID. Further studies are warranted in order to standardize the various applications of this tool.

Flood Preparedness Literacy and Behaviors in Community Dwelling Older Adults.

OBJECTIVES: The purpose of this study was to investigate the factors related to flood preparedness literacy and the relationship between flood preparedness literacy and behaviors. METHODS: A quantitative descriptive correlational study. The sample included 134 people residing in a central Thai province. Descriptive statistics, point-biserial correlation coefficient, and Spearman's rank correlation were used in the data analysis. RESULTS: The results revealed that the factors related to flood preparedness literacy with a statistical significance were marital status (rpb = 0.207; P < 0.01), hearing ability (r = 0.197; P < 0.05), instrumental activities of daily living (r = 0.226; P < 0.01), and social support (r = 0.388; P < 0.01). Flood preparedness literacy was correlated with flood preparedness behaviors (r = 0.281; P < 0.01). CONCLUSION: The factors related to flood preparedness literacy as mentioned above should be assessed to identify vulnerable groups for specific care provision. Furthermore, nurses should promote these factors to contribute to effective responses during flood disasters.

Management of food insecurity in the COVID-19 pandemic: a model of sustainable community development.

The COVID-19 pandemic has a severe and immediate impact on unemployment and reduced household income, resulting in global food insecurity. Women play a major role as household food providers who manage food insecurity in Thai community. In this qualitative study researchers aimed to understand how communities engage in management of food insecurity resulting from COVID-19. Participants included 12 female food providers who were community volunteers, four community leaders, and four health providers. Focus group interviews were conducted. Data were analyzed using content analysis. We explain community engagement to manage food insecurity through strategies including connecting through empathy, community empowerment, and engaging for sustainability. We present findings to illustrate how women's groups may work through a public-private partnership to achieve sustainable food security.

Improving clinical outcomes of diabetic foot ulcers by the 3-month self- and family management support programs in Indonesia: A randomized controlled trial study.

BACKGROUND AND AIMS: Diabetic foot ulcers are the leading cause of lower extremity amputations, which require more effective prevention. Even though previous nursing studies on diabetic foot ulcers have been well performed, programs implementing self- and family management are limited and even underexplored. Therefore, the purpose of the study was to investigate the effect of 3-month self- and family management support programs on clinical outcomes among Indonesians with diabetic foot ulcers. METHOD: The randomized controlled trial design was used to answer the research question of the study. A total of 56 eligible participants were enrolled, with 27 in the experimental group and 29 in the control group. The experimental group received self- and family management support programs for three months. Meanwhile, the control group received usual care. Descriptive statistics, multivariate analysis of variance, and Generalized Estimating Equations were used to analyze the data. The significance level was considered at .05 for hypothesis testing. RESULTS: The study showed that there were statistically significant improvements in self-management, family supports, hemoglobin A1c, and wound size after implemented the programs for three months (p < .05). CONCLUSIONS: With regard to the result of the study, implementing the 3-month self- and family management support programs improves the patients' and families' abilities to perform diabetic foot ulcer care at home.

The effectiveness of a Japanese style health program: comparison between Minowa, Japan and Rayong, Thailand.

AIM: This study aimed to appropriately establish a Japanese style healthcare program under the ISO9001:2008 (ISO: International Organization for Standardization) in Minowa, Japan and Rayong, Thailand to improve problem areas and inspect its effectiveness. Furthermore, we want to make this health promotion through ISO widely available in Asian countries and to make an international contribution. METHOD: We implemented a 6-month health program in the c Rayong city, Thailand, and a 12 month health program in the Minowa town, Japan. This study assessed findings from pedometry, anthropometry and blood pressure measurements, physical fitness, blood chemistry, and brain function tests. RESULTS: The comparisons were made using interaction effects between the participants in Rayong and Minowa. They showed significant differences in the 10-m obstacle walk, the 6-minute walk, HDL, the reverse and reverse differentiation time, the total number of forgets, the total number of mistakes, and the total number of brain function errors. CONCLUSIONS: To improve the brain function in participants from Rayong through this health education program, measures such as increasing the number of steps, adding muscular strength/stretching exercises, and home training every day is suggested.

Prevalence and determinants of sufficient fruit and vegetable consumption among primary school children in Nakhon Pathom, Thailand.

BACKGROUND/OBJECTIVES: Low consumption of fruit and vegetable is frequently viewed as an important contributor to obesity risk. With increasing childhood obesity and relatively low fruit and vegetable consumption among Thai children, there is a need to identify the determinants of the intake to promote fruit and vegetable consumption effectively. SUBJECTS/METHODS: This cross-sectional study was conducted at two conveniently selected primary schools in Nakhon Pathom. A total of 609 students (grade 4-6) completed questionnaires on personal and environmental factors. Adequate fruit and vegetable intakes were defined as a minimum of three servings of fruit or vegetable daily, and adequate total intake as at least 6 serves of fruit and vegetable daily. Data were analyzed using descriptive statistics, the chi-square test, and multiple logistic regression. RESULTS: The proportion of children with a sufficient fruit and/or vegetable intakes was low. Covariates of child's personal and environmental factors showed significant associations with sufficient intakes of fruit and/or vegetable (P < 0.05). Logistic regression analyses showed that the following factors were positively related to sufficient intake of vegetable; lower grade, a positive attitude toward vegetable, and fruit availability at home; and that greater maternal education, a positive child's attitude toward vegetable, and fruit availability at home were significantly associated with sufficient consumption of fruits and total fruit and vegetable intake. CONCLUSIONS: The present study showed that personal factors like attitude toward vegetables and socio-environmental factors, such as, greater availability of fruits were significantly associated with sufficient fruit and vegetable consumption. The importance of environmental and personal factors to successful nutrition highlights the importance of involving parents and schools.

Development of a Food Insecurity Screening Instrument.

BACKGROUND: Food insecurity is a dynamic, global issue requiring our constant attention today, and practical assessment instruments are needed to detect food insecurity in various populations and countries. A screening tool for food insecurity was developed and tested its psychometric properties. MATERIAL AND METHOD: The Food Insecurity Screening Instrument (FISI) was developed based on literature review and qualitative data from a sample of 30 female who were family food providers in crowded urban communities in Bangkok. RESULTS: Content validity was determined by five experts, resulting in a good content validity index. It was tested with another 350 food providers, resulting in high reliability Item analysis revealed good internal consistency of items to total scale, except for two items which were deleted. Construct validity was determined using exploratoiy factor analysis, and revealed four factors, consisting of 33 items, food quantity, food quality, food safety, and anxiety about food These factors together explained 74.9% of total variance of the new tool. CONCLUSION: This new tool provides a valid and reliable means of screening for food insecurity in families and communities. Policy makers in Thailand have supported the usefulness of the instrument which has already been used across the country for the National Survey, and after the 2011 Thai floods.

Understanding food insecurity among Thai older women in an urban community.

In this qualitative study we aimed to describe how older women in a crowded urban community perceive the food insecurity experience and deal with it. In-depth interviews were conducted among 30 Thai older women. Results revealed that older women perceived their food insecurity experience as a negative effect of the current economic downturn globally. They felt that they were confronting a crisis. Problems they dealt with included six issues. The women employed management strategies around food, health, money, and family. Our results suggest a need for welfare reform that facilitates management strategies aimed to meet food security.

Association of circulating leptin with bone mineral density in males and females.

Leptin, a hormone produced by fat cells, possesses several physiological functions not limited to energy balance. Recently, leptin has been shown to inhibit bone formation through its action at the hypothalamus. In the present study, the authors explored the association of leptin with bone mineral density (BMD) in men and women according to menopausal status. Subjects consisted of 75 men, 51 premenopausal women and 63 postmenopausal women aged 20-80 years. All were healthy and did not take medication which may affect bone metabolism. BMD was measured at L2-4 and femoral neck by DEXA. Serum leptin concentrations were measured by radioimmunoassay. Serum leptin in males was independently related to BMD at L2-4 (r = -0.36, p < 0.05) and the femoral neck (r = -0.32, p < 0.05) in a multiple linear regression model with age, body mass index (BMI), serum free testosterone, estradiol and leptin as independent variables. In premenopausal women, serum leptin correlated negatively to L2-4 (r = -0.29, p < 0.01) and femoral neck BMD (r = -0.29, p < 0.05) independently of age and BMI. However, in postmenopausal women, no association of leptin with BMD was found after controlling for age and BMI. The authors concluded that circulating leptin is negatively associated with BMD in men and premenopausal women, but not in postmenopausal women. The negative associations found in both premenopausal women and men in the present study strengthen the notion that leptin may inhibit bone formation during the accumulation of bone mass early in life

Less money less food: voices from women in urban poor families in Thailand.

Food insecurity is a public health problem. Information on how cultures perceive the experience of a financial crisis and resultant food insecurity is limited. Our purpose in this study was to understand how poor families residing in urban slums in Thailand perceive their food situation. Interviews were conducted with 30 women aged 20-65 years who were household food providers. Content analysis revealed three themes: experiencing changes, being vulnerable to not having enough food, and getting support. Policy changes to address access to social and health services and development of additional welfare programs must be made to achieve food security.

Household food insecurity among urban poor in Thailand.

PURPOSE: To assess perceptions of food insecurity (FI), socioeconomic change, and health among urban poor households in Thailand. Research questions were: (a) what are the experiences of food insecurity among households living in slum areas? and (b) what are the socioeconomic conditions, basic needs, food-related behaviors, and perceptions of health that have changed in this group since the 1997 economic recession? METHODS: A cross-sectional descriptive survey was conducted to identify experiences of FI and perceptions of health in households living in slum areas. Questionnaires on food security, health, and nutritional assessment, including 3-day dietary records, and anthropometric measurements, were collected from 199 female food providers of households. FINDINGS: Only 44.2% of the households reported food security, and 39.2%, 13.6%, and 3% reported FI without hunger, FI with moderate hunger, and FI with severe hunger, respectively. Overall, households reported lower income and worse health and life satisfaction as a result of the economic recession. In addition, a decrease in income led to difficulty meeting their basic needs, such as access to health service and food provision. CONCLUSIONS: FI was prevalent and the reported experiences of those with FI indicate areas for improvement of health policy for urban poor families. The results of the study are constructive for developing health programs to empower the urban poor and contribute to health promotion of food security in Thailand.

Influence of normal ageing on mechanism of bone loss in women and men in Bangkok.

UNLABELLED: Age and sex related changes in bone metabolism are of interest in the pathogenesis of osteoporosis. However, most data in the literature were studied in Western countries. In a tropical country, such as Thailand, little is known of vitamin D status and bone remodeling. Thus, the aim of this study was to determine the changes of vitamin D levels and biochemical markers of bone turnover in healthy women and men of various age groups between 20-80 years who were living in Bangkok. From the results, vitamin D levels of various age groups did not alter significantly between men and women except in the sixth decade of women. However, men had higher levels of vitamin D than women. In women, all biochemical markers of bone turnover increased with age, with a sharp increase at the onset of menopause. In contrast, biochemical markers of bone turnover in men gradually declined with advancing age. CONCLUSION: There was no evidence of vitamin D deficiency in the Bangkok population. Women and men showed different age-related changes in bone metabolism.

Causal analysis of exercise and calcium intake behaviors for osteoporosis prevention among young women in Thailand.

The goal of health education is to provide information to affect attitudes, beliefs, and intentions for behavior change. However, little is known about the effects of changes in knowledge on behaviors for osteoporosis prevention. Our objective is to develop and test theoretical models of the effects of knowledge, attitude, and self-efficacy on exercise and calcium intake among young women before and after an intervention program. First, we hypothesized that knowledge would positively predict attitude, self-efficacy, calcium intake, and exercise. Second, attitude would positively predict self-efficacy, calcium intake, and exercise. Third, self-efficacy would positively predict calcium intake and exercise. Fourth, attitude and self-efficacy would mediate the effect of knowledge on calcium intake and exercise. At the beginning and end of the study, participants in the control group and intervention group completed the osteoporosis knowledge test, the osteoporosis health belief scale, the osteoporosis self-efficacy scale, a self-report for food records, and exercise. The causal model was examined as a result of our study. After the intervention program, calcium intake and exercise were predicted by knowledge when mediated by attitudes and self-efficacy. The final model accounted for 30% and 45% of the variance in calcium intake and exercise, respectively. We conclude that interventions to enhance young women's knowledge and self-efficacy may result in increased calcium intake and exercise.