Thai Families’ Caring Practices for Infants with Congenital Heart Disease prior to Cardiac Surgery

This focused ethnographic study aimed at exploring how the Thai sociocultural context influenced the perceptions and practices of Thai families caring for infants, 3 months to 17 months, with symptomatic, acyanotic or cyanotic, congenital heart disease (CHD), prior to cardiac surgery. Purposive sampling was used to recruit twelve parents and two family members, from eight families, who brought their infant with a CHD, to two university hospitals in Bangkok. Data were collected through in-depth interviews, participant observations and field notes, from September 2006 to October 2007, and analyzed through use of content analysis.Family care practices were characterized by the phrase: “doing our best to get our child ready for surgery.” Families understood their infants may not survive and would be difficult to care for. All the infants required pharmacological management, followed by surgery, and needed weight gain and strength to withstand and recover from surgery. Families prevented their children from getting worse, as well as managed their respective infant’s care under significant constraints.Findings indicated the families’ perceptions and practices were influenced by the socio-cultural contexts, which included Buddhist teachings, cultural beliefs, financial constraints, hospital services, and support from family members and significant others. The results provided health professionals with an understanding of perspectives and practices of Thai families providing care, prior to surgery, for infants with CHD, and highlighted the context-dependent nature of family care and need for new and creative ways to provide culturally congruent professional care.

Living with the Differences: Thai Adolescents' Experiences of Living with Transfusion-dependent Thalassemia

Although transfusion-dependent thalassemia causes physical and psychosocial impacts, little is known about adolescents’ experience in living with the disease. The knowledge of how adolescents live with their illness is expected to benefit patient focused nursing interventions to promote adolescents’ well-being. The purpose of this study was to understand and explain Thai adolescents’ experience of living with transfusion-dependent thalassemia.  Grounded theory methodology was employed to generate a substantive theory to capture that experience. Data were gathered from thirteen Thai adolescents through in-depth interviews and analyzed concurrently through constant comparative analysis to generate a substantive theory. The adolescents were recruited by purposive and theoretical sampling. Theoretical saturation was a criterion to finish data collection. Living with the differences emerged as a core category of the substantive theory, and consists of four related categories: illness understanding; a sense of differences; emotional experiences; and, managing the differences. The findings provide better understanding of the experiences of Thai adolescents attempting to meet social expectations of normalcy in living with transfusion-dependent thalassemia. This understanding adds to prior knowledge of the disease and other chronic illnesses, and contributes to the development of nursing interventions to support adolescents to achieve well-being as they navigate life.

Predictors of Eating Behaviors for Weight Control Among Overweight Early Adolescents

This study aimed to identify predictors of eating behaviors for weight control among 151 overweight early adolescents in the Bangkok Metropolitan based on the Theory of Planned Behavior. Two self-administered questionnaires were used for data collection, including the Eating Behaviors for Weight Control Questionnaire and the Planned Behavior Scales of Eating Behaviors for Weight Control developed by the researcher. The proposed model was tested and modified by path analyses. The final model adequately fit the data and could explain 47.80% of variance in eating behaviors for weight control. The results revealed that past eating behaviors was the best predictor of eating behaviors for weight control. Past eating behaviors and perceived behavioral control had a positive direct effect on eating behaviors for weight control (β = 0.59, p \< .001; β = 0.15, p \< .01, respectively). Control beliefs had an indirect effect on eating behaviors for weight control through perceived behavioral control (β = 0.10, p \< .01). In addition, attitudes, subjective norms, and perceived behavioral control explained up to 41.8% of variance in intentions. The intentions were influenced most by perceived behavioral control and then by attitudes and subjective norms (β = 0.46, p \< .001; β = 0.32, p \< .001, β = 0.22, p \< .01 respectively).Thus, the findings support the Theory of Planned Behavior and provide nurses and health care providers with information to understand predictors of eating behaviors for weight control among overweight early adolescents. Furthermore, the findings provide a knowledge base for developing interventions to promote early adolescents’ healthy eating behaviors, addressing the elements identified in this study as important factors.

Enhancing Nursing Practice in Developmental Care for Preterm Infants

This study aimed to enhance nursing practice in developmental care for preterm infants. A participatory action research (PAR) model was used as a catalyst for changing nursing practice. Participants were 30 neonatal nurses working in a neonatal intensive care unit (NICU) at a university hospital in Bangkok. Data was collected using multiple methods. The findings revealed that enhancing nursing practice in developmental care for preterm infants was an empowering process which covered three components: nurses, administrators and the health care team and hospital policy. The nurses’ component comprised six strategies: 1) the provision of knowledge and practice skills; 2) the provision of opportunities for sharing knowledge and experiences; 3) the encouraging of self-directed learning; 4) the provision of opportunities for creative innovations; 5) motivation; and 6) the encouraging of regular developmental care practice. The outcomes of the process of enhancing nursing practice in developmental care could be categorized into two themes: 1) positive changes of nurses and 2) innovation. The knowledge gained from this study will provide guidance for future nursing research into ways of enhancing nursing practice, and thereby improve developmental care for preterm infants.