Perception of illness and the use of health care givers among cervical cancer patients at Songkla Nagarind Hospital. A study in southern Thailand.

Cervical cancer is one of the leading causes of death among women in Thailand. It also has been observed that women who suffered from the illness seek care from various types of care givers including doctors, herbalists, and spiritual mediums. This article has two major aims. The first aim is to describe the types of healers from whom women seek care. The second aim is to explain women's perception of the illness regarding etiology, time and onset of symptoms, pathophysiology, course of illness, and treatment. One hundred and twenty women who sought treatment at Songkla Nagarind Hospital, a teaching hospital in southern Thailand, were interviewed. An interview schedule that consisted of both open-ended and close-ended questions was designed and used in the in-depth interview. Results showed that most women who suffered from cervical cancer illness at the hospital were from low socioeconomic levels. Approximately 50% of the women received care from both western-trained care givers and other types of care givers such as those who were traditionally trained and themselves. The number of care givers ranged from one to eight persons. The average number of care givers was four per woman. The initial symptom for the women in the study was abnormal vaginal discharge. The cervical cancer caused physical and psychological problems. Seventy percent of the women recognized they would die if the illness was not treated. Most women had a positive attitude about the illness if they were treated. About 80% perceived that they would be cured regardless of the method of treatment used.(ABSTRACT TRUNCATED AT 250 WORDS)

Minor burn management: an Australian regional perspective.

Minor burns are commonly treated in hospital emergency departments. This study aimed to identify the nursing management of minor burns in hospitals in the Queensland region of Australia. A total of 200 questionnaires were distributed to hospitals with emergency departments in this region. The semi-structured questionnaire enquired about the respondents' initial and ongoing management of minor burns. Fifty completed questionnaires were returned, a response rate of 25%. Most respondents (80%) were registered nurses and the rest enrolled nurses. The respondents' practice was compared with that recommended in the literature. Their practice reflected the variations found in the literature, suggesting that some may not be as effective or efficient as others. The authors conclude that further research is required on the efficacy of products used in minor burn management.

Types of antenatal care and other related factors associated with low birth weight in southern Thailand.

This study investigates the relationship between low birth weight (LBW) and antenatal care (ANC) when provided by different categories of care givers in Thailand. Two types of care providers are distinguished: western trained and traditionally trained. The socioeconomic, biological, and obstetric characteristics of 602 cases and 705 controls were compared based on standardized interviews with postpartum women. The results of the study show that women who receive care from different types of care providers have differing levels of risk of LBW delivery. Women who receive no ANC and those who receive care only from traditionally trained care providers have about twice the level of risk of LBW as women who are attended either by western trained care providers or by a combination of western trained and traditionally trained care providers. Even when major potential confounders, such as maternal age or mother's level of education are controlled, this relationship is still maintained.

Temporary overseas migration of rural Thai men: perception of changes in health and social interactions after returning to their communities.

A cross-sectional study was conducted to assess the perceived health effects of temporary overseas migration on rural Thai men and to evaluate the effects of financial gain on their social interactions with others. Houses in five villages in Khonkaen, northeastern Thailand were systematically visited and one returned overseas migrant per household was interviewed. One hundred and sixty one men participated in the study. Half of the respondents (50%) were manual workers. While overseas, 32% reported adverse effects of migration on their psychological health. Only 19% reported one or more physically ill while overseas. Their contribution to their communities increased. Inability to improve their financial status from overseas work is likely to have negative effects on the migrants' interaction with friends rather than their wives, families or relatives. The effects of migration on health are unlikely to persist after migrants return to their home communities. Overseas migration provides indirect health benefits through improvement of community facilities.

Health beliefs and Pap smears among Thai women in Brisbane, Australia.

Although a number of studies have assessed the use of Pap smear among Thai women in Thailand, little is known about factors influencing the use of this cervical cancer screening among potentially high risk Thai migrant women. We related health belief model (HBM) factors and sociodemographic variables to the use of Pap smears among migrant Thai women in Brisbane, Australia. A cross-sectional study was conducted in Brisbane, Queensland, Australia. A snowball sampling method was used to recruit 145 women. Thirty-nine percent reported regular Pap smears. Summary HBM index and self-efficacy index were positively associated with Pap smears. Barriers to screening were negatively associated. The HBM appears to be a useful framework for planning cervical cancer prevention. Strategies that reduce barriers to the screening and increase the confidence of women and their self-efficacy are likely to increase their participation.

Beliefs and behaviors about Pap and breast self-examination among Thai immigrant women in Brisbane, Australia.

Regular screening is an important preventive method in reducing morbidity and mortality from cervical and breast cancer. In 1998, a cross-sectional study was conducted in Brisbane, Australia, among 145 Thai immigrant women, to explore cultural and social factors related to their use of Pap smear tests and breast self-examination (BSE). The study aimed at describing women's beliefs and perceptions about the body, breast and cervical cancer, and their perceptions of the causes of the diseases. It explored the women's perception of the severity and the effects of both cancers on aspects of patients' lives, and their chance of developing both cancers. The Thai immigrant women explained the causes of breast and cervical cancer using both traditional beliefs and medical knowledge. They perceived that both cancers affect a patient's health and her daily activities. Some women believed that they would develop cervical cancer if their perineum or vulva was "dirty." Some believed that they would have breast cancer because they had a history of benign tumor or cyst of a breast. Forty-four percent of the women had biennial Pap smears in the past five years and only 25% conducted BSE monthly in the past two years. Information relating to perceived barriers to undertake regular cervical cancer and breast cancer screenings and other health beliefs can be applied by health care personnel to increase Thai immigrant women's preventive health behaviors.

Social support and antenatal clinic attendance among Thai pregnant women in Hatyai, a city in southern Thailand.

Many studies in western countries have shown that persons who have a high level of social support are likely to have better health behaviours, including use of preventive health services, than those who have low support. The present study aims to investigate the impact of level of social support among Thai pregnant women on their attendance at antenatal care (ANC) clinics. The study was conducted in Hatyai, a city in Southern Thailand, between 1990 and 1991. Relationships between various measures of the women's social support and their use of antenatal clinics were assessed. Open ended and closed ended questions were used to gather information relating to these women's level of social support, including the number of supporters and their age, the percentage of females among the supporters, the sources of support (spouse, kin, friend and health professionals), the frequency of contact, the types of support and the sufficiency of support. Social support indices were constructed: sources of support indices, a social network index, a subjective support index, and a social support index. One hundred and seventy-seven postpartum women were interviewed at their homes. Spouses, relatives and friends were important sources of the four principle types of support, namely emotional, instrumental, information and appraisal supports. Less than 10% of the women studied identified health personnel as providing support. The majority of supporters were women who had daily, face-to-face communication with the women studied. Approximately 76% of the women studied had sufficient support. The majority of supporters, except health personnel, provided all four types of support. Only 47% of the women studied made four or more antenatal clinic visits as recommended by the Thai government. No significant relationship between the indices of social support and the use of ANC clinics was identified. The Thai extended family by its nature generates large numbers of supporters. Little variation in support levels among all the women therefore occurred. Support to the women could have positive and/or negative effects on the women's use of ANC clinics. It was concluded that in Thai communities, social support is not an important determinant of the use of ANC clinics and the indices of social support were not the most appropriate techniques to use in the communities.

The development and evaluation of a health education programme for pregnant women in a regional hospital, southern Thailand.

The maternal mortality rate (MMR) in Thailand is higher than neighbouring developing countries including Malaysia and Singapore. The 1993 MMR of Thailand was 249 per 100 000 livebirths which was four times higher than the rates in Malaysia and Singapore (World Health Organization 1995). The major causes of these deaths were haemorrhage, toxaemia of pregnancy and sepsis which were likely to be prevented by adequate prenatal care (Thailand Ministry of Public Health 1996). A large proportion of Thai pregnant women have poor health. Between 1994 and 1995, a national study conducted by Thailand Ministry of Health showed that 39% of pregnant women were anaemic, defined as haemoglobin concentration lower than 33% (Supamethaporn 1997). Another study conducted in the southern region also indicated that 13.8% of pregnant women were anaemic caused by iron deficiency (Phatthanapreechakul et al. 1997). Other behaviours which increased risks associated with child birth included non-antenatal care (ANC) attendance, undertaking physically demanding tasks and failure to increase nutritional intake during their pregnancy period (N. Phiriyanuphong et al. 1992, unpublished report). These factors emphasize the importance of a health education programme which could facilitate women to, for example, increase protein and iron intake during pregnancy which would reduce complications from their poor health status. This study was conducted in a regional hospital in Thailand where there was no systematic and well-planned health education programme for pregnant women. The initial aim was to design a health education programme using input from the hospital health care professionals including obstetricians, nurses, nutritionists, health educators and health promoters. An active involvement of these personnel assisted to sustain the provision of the programme provided for pregnant women after the cessation of the study project. Another aim of the study was to evaluate the outcomes of the programme using a pre-test-post-test method among selected pregnant women who participated in the newly designed health education programme.