Community Health Nurses' Perspective on the Introduced Rational Drug Use Policy in Primary Care Settings in Thailand: A Descriptive Qualitative Study.

BACKGROUND: To address the problems related to drug resistance and medication safety, the rational drug use (RDU) policy has been implemented in Thailand since 2014. Theoretically, the policy was supposed to bring drastic changes to the way clinicians prescribe medications and its impacts on clinical practice, however, it has not yet been investigated. The study aimed to describe the experience of community health nurses with regard to the impact of RDU policy implementation on their practices. METHODS: Focus group interviews and in-depth interviews with community nurses were conducted. Thematic analysis was performed. RESULTS: Five themes emerged from the analysis, namely, (1) a welcome opportunity, (2) RDU as the quality of healthcare, (3) multidisciplinary collaboration, (4) reinventing productive interactions between nurses and patients, and (5) challenges over control of medications prescribed or purchased elsewhere. CONCLUSIONS: Implementing RDU in primary care provides opportunities for protecting individual patients and public health as well as safeguarding against professional prescription error. This can be made possible by adopting a systemic approach to changes. Additional educational and organizational support will optimize health professionals' contribution to the implementation and hence optimal outcomes of this important policy.

Parents' knowledge, attitudes, behaviors, and barriers to promoting condom use among their adolescent sons.

Human immunodeficiency virus (HIV) is increasing in Thai youth. Consequently, a school-based National Condom Strategy program was launched in 2015 to reduce the rate of HIV and sexually transmitted infections. We conducted in-depth interviews of 31 parents/adoptive guardians of high-school age Thai boys to explore parents' knowledge, attitudes, behaviors, and barriers to promoting condom use and its role in preventing HIV/sexually transmitted infections. A descriptive phenomenological approach and thematic analysis was used. Most participants had knowledge and positive attitudes about condom use. Half disagreed with the National Condom Strategy of placing condom vending machines in schools. More than half did not initiate teaching male youth about condom use until the youth had broached the question or only intended to do so when the youths were older. Barriers included parents' lack of condom experience and knowledge, embarrassment/discomfort when talking about condoms, and belief that youth were not sexually active. Parents are a key factor for supporting condom use in Thailand. This study supports the need for education programs for parents.

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.