Identifying diabetes risks among Indonesians: A cross-sectional study in a community setting.

Background: There is an upward surge in diabetes patients worldwide, including in Indonesia, annually. Diabetes can lead to new diseases that burden patients' lives further. Nurses can reduce this problem by identifying people at risk of developing diabetes and educating them on how to prevent diabetes. Objective: The study aimed to determine the risk of diabetes in the Indonesian population. Methods: The descriptive research involved a sample of 1216 Indonesians living in North Sumatra Province. Participants were nondiabetic individuals selected using the convenience method from May to October 2020. This study utilized the Indonesian version of the Finnish Diabetes Risk Score (FINDRISC) tool and employed various statistical analyses, including frequencies, percentages, chi-square test, and Fisher's exact test. Results: Of the total samples, 372 were males (30.6%), and 844 were females (69.4%). The risk of developing diabetes was classified as low (57.1%), slightly elevated (36.4%), moderate (5.3%), high (1.0%), and very high (0.2%). Only one of the eight risk factors that differed significantly between men and women was a history of elevated blood glucose levels, with a p-value of 0.02. Conclusion: The study identified a portrait of the number and percentage of diabetes risk factors in a community setting in Indonesia. Nurses must provide education on diabetes prevention to not only members of the local community at the research site but also the general public, nationally and globally.

A phenomenological study on older persons as a breadwinner of A skipped-generation family: day by day coping journey in Thai context.

Purpose: Many countries around the world are facing an ageing society in which older persons share the fate of carrying a burden in their families, especially in skipped-generation families. This increasing trend has noted over the past several years in Thailand. This is an interpretive phenomenological study that seeks to explore Thai older grandparents' life experience of raising grandchildren in skipped-generation families.Methods: The participants were purposively selected from older grandparents in skipped-generation families in the Northeast of Thailand in 2019. Data were collected by in-depth interviews with 29 participants. Data were analysed using Diekelmann & Allen method.Results: Three major themes emerged regarding the Thai older persons as a breadwinner of a skipped-generation family were as follows. 1) Sacrifice for the family is a value of life. 2) Day by day coping journey of individuals maintains mental well-being. 3) Being grandparents leads to spiritual pride.Conclusion: The older grandparents suffered from a variety of burden and vulnerability beyond their abilities. Social and governmental supporting systems are limited. Creating supporting system strategy is required to increase well-being of grandparents in skipped-generation families.

A volunteer alcohol consumption reduction campaign: participatory action research among Thai women in the Isaan region.

Cancer is one of the leading causes of death in Thailand as well as other countries. Evidences from studies in Asia show that alcohol consumption has been linked to an increased risk for various types of cancer. In the qualitative participatory action research presented here, the possibilities of a volunteer women's movement to reduce harmful alcohol consumption by facilitating the creation of emancipatory knowledge in the Thai-Isaan community was explored. During in-depth interviews with 10 female volunteer participants, the following themes emerged: merit making, developing a sense of personal empowerment, and the experience of participating in an action plan that utilized various strategies. The project activities empowered participants to create and share knowledge which was then applied toward action for change. Adoption of this type of program by local health care providers to reduce health problems and risks related to alcohol misuse in similar contexts and cultures is recommended.

Development of a family nursing model for prevention of cancer and other noncommunicable diseases through an appreciative inquiry.

BACKGROUND: Cancer and non-communicable diseases are a major issue not only for the developed but also developing countries. Public health and primary care nursing offer great potential for primary and secondary prevention of these diseases through community and family-based approaches. Within Thailand there are related established educational curricula but less is known about how graduate practitioners enact ideas in practice and how these can influence policy at local levels. AIM: The aim of this inquiry was to develop family nursing practice in primary care settings in the Isaan region or Northeastern Thailand and to distill what worked well into a nursing model to guide practice. MATERIALS AND METHODS: An appreciative inquiry approach involving analysis of written reports, focus group discussions and individual interviews was used to synthesize what worked well for fourteen family nurses involved in primary care delivery and to build the related model. RESULTS: Three main strategies were seen to offer a basis for optimal care delivery, namely: enacting a participatory action approach mobilizing families' social capital; using family nursing process; and implementing action strategies within communities. These were distilled into a new conceptual model. CONCLUSIONS: The model has some features in common with related community partnership models and the World Health Organization Europe Family Health Nurse model, but highlights practical strategies for family nursing enactment. The model offers a basis not only for planning and implementing family care to help prevent cancer and other diseases but also for education of nurses and health care providers working in communities. This articulation of what works in this culture also offers possible transference to different contexts internationally, with related potential to inform health and social care policies, and international development of care models.

My child you must have patience and Kreng Jai: Thai parents and child pain.

PURPOSE: To elicit the experiences of parents in providing care for their hospitalized child's acute pain needs. DESIGN: Phenomenology, using in-depth interviews with 45 parents whose children were being cared for in five hospitals in Northeastern (Isan) Thailand. FINDINGS: The findings address Thai cultural beliefs regarding the experience of pain and the role societal expectations have on parental behavior in trying to meet their child's acute pain needs. Two themes emerged-"Understanding my child's pain: it's karma" and "Maintaining Kreng Jai"-which identify parent beliefs toward pain and pain treatment, as well as perceived barriers in securing pain management for their children. Together these two themes describe the essence of this study as parents experienced an "inner struggle in providing pain care." Pain was perceived as an inescapable part of life, and participants identified a preference for traditional remedies. Parents experienced a tension as they wanted to provide and secure pain care for their child but at the same time were reticent to approach staff with concerns about their child's care. CONCLUSIONS: Thai parents viewed pain as a normal consequence of life, and one had to use traditional remedies in addition to medicine to successfully treat pain. Societal behavioral expectations required children to have patience. Nevertheless, parents wanted professionals to show more empathy and provide more effective pain care. CLINICAL RELEVANCE: Improvements in pediatric pain care must formally include parents. Culturally sensitive approaches that do not stereotype parents and children are needed to ensure that evidence-informed pain care is available for all children.

Children's pain assessment in northeastern Thailand: perspectives of health professionals.

Deficiencies in pain care within the developing world are starting to be realized. Children, in particular, are vulnerable, as preliminary studies suggest that these children receive less pain treatment because of health professionals' attitudes and beliefs. This article reports on some of the findings of the first study in a larger program of research aimed at improving pediatric pain care in Thailand. Improvements in practice are not simply the result of providing evidenced-based knowledge, but a complex process that includes the context of care. Given that little is known about the pain management experiences of Thai health professionals, including the challenges they face, we used focus groups to capture their stories. Data revealed a need for both updating pain knowledge and for supporting an increased use of appropriate practices. In this article, we focus on the issues concerning the assessment of pain resulting from underrecognizing children's pain and complex issues in communicating findings of children's pain.

The development and validation of the Khon Kaen University Pediatric Pain Assessment Tool for school-aged Isaan children in Thailand.

This research was aimed at developing a tool for pain assessment specifically for parents to use with children of the Isaan culture of Northeast Thailand. The Khon Kaen University (KKU) Pediatric Pain Assessment Tool was first constructed through the use of a qualitative study and literature reviews. Then, it was modified using the results of a pilot study with 38 stakeholders. Seventeen nurses, 150 postoperative children, and 150 family caregivers participated in a study comparing the tool with the standard Faces Scale and Numeric Rating Scale. Results revealed no difference in children's pain scores, as well as no statistical difference in children's pain score ratings between the three groups, suggesting the new tool is appropriate for Isaan children.

The meanings of pain: A qualitative study of the perspectives of children living with pain in north-eastern Thailand.

This qualitative paper explores the perception of pain among north-eastern Thai children experiencing illness, aged from 4-18 years. Data was obtained from 17 children living in the community and 32 children admitted to two major hospitals in Isan, totaling 49 children. The qualitative data collection techniques used were observation, drawing, role-playing, story-telling, and "day conferences" (relaxed and informal group discussions). The study was conducted over 1 year and the data were analyzed using Fielding's method of content analysis. The research found that children described their experience of pain as "disheartening", "suffering", and "torturing" and that the expression of pain in Isan families is characterized by avoidance and endurance. The findings suggest a role for a model of pain management in children specific to the sociocultural context of Isan, which focuses on family-centered care and acknowledges cultural diversity.

Work life and psychological health: the experiences of Thai women in deprived communities.

I discuss women's work life and the psychological health of women in low-income communities in Northeast Thailand. Previous research has shown that low-income women are part of a disadvantaged group who struggle against several problems in their everyday life, and who work hard to survive. These women worked as either manual laborers in agriculture or factories or as self-employed vendors, and were busy Ha Yoo Ha Kin (working and earning a living). The women's way of life was complex and involved being responsible for their children, husband, extended family, work, and themselves. Understanding women's beliefs and practice relating to work life and health is essential in designing effective intervention programmes to promote the health and well-being of low-income women in Thailand.