Interventions to promote medication adherence among children with epilepsy: An integrative review.

PROBLEM: Many children with epilepsy face challenges in adhering to their medication, leading to inadequate seizure control. However, the most effective intervention is still unclear. This integrative review's main goal was to examine and synthesize the existing literature on interventions for promoting medication adherence in children with epilepsy. ELIGIBILITY CRITERIA: This integrative review followed Whittemore and Knafl's five-stage framework. Four electronic databases (PubMed, ScienceDirect, Scopus, and CINAHL Complete) were systematically searched from 2013 until 2024 to identify eligible studies published in the English language. The key search terms included "Children with epilepsy" AND "medication adherence" AND "intervention." Studies reporting on the implementation and evaluation of medication adherence interventions in children with epilepsy were eligible. Quality assessment and narrative synthesis were subsequently undertaken. SAMPLE: A total of 17 studies were included in the review. RESULTS: Five interventions were found, including educational, behavioral, and mixed intervention types, using technology and family involvement. Promoting medication adherence is crucial, but tailored interventions for different age groups and sustained support are needed. CONCLUSIONS: Promoting medication adherence is of utmost importance to enhance the knowledge of children who have epilepsy and their families, and to increase medication adherence. However, there is still a need to develop interventions that are appropriate for children of different ages and their families, which should be suitable and sustainable during treatment. IMPLICATIONS: Pediatric nurses should consider socioeconomic factors, ethnicity, family functioning, and parental distress. Strategies include monitoring adherence, continuous communication, and technology support for children with epilepsy during treatment.

Nonpharmacological interventions to improve the cognitive function among persons with traumatic brain injury: A systematic review.

PURPOSE: The systematic review aimed to evaluate the effectiveness of nonpharmacological interventions (NPIs) for improving cognitive function among persons with traumatic brain injury. DESIGN: A systematic review. METHODS: This systematic review was registered in PROSPERO and followed the PRISMA guideline. PubMed, ScienceDirect, Scopus, SpringerLink, Wiley Online Library, JSTOR, and Taylor & Francis were systematically searched for relevant articles of peer-reviewed studies published between 2008 and 2022. Two independent researchers conducted study selection, data extraction, and data quality assessment. FINDINGS: Twenty-one studies met inclusion criteria, numbering a total of 757 participants. Six groups of NPIs were effective in improving cognitive functioning among persons with traumatic brain injury, including multimodal cognitive training, technology innovation, memory training, executive function training, physical activity, and sensory stimulation programs. Pooled evidence revealed that NPIs had a large effect on memory (d = 0.80, p < 0.05 to d = 2.03, p < 0.000), processing speed (d = 1.58, p < 0.05), and cognitive behavior (d = 1.63, p < 0.001 to d = 8.91, p 0.003). There was a medium effect on executive function (d = 0.5, p < 0.01 to d = 0.62, p < 0.05), attention (d = 0.5, p < 0.01), and intelligence (d = 0.57 to d = 0.59, p = 0.000). For visuospatial function and language, there was a significant increase post-intervention. CONCLUSION: Evidence from this systematic review indicates that NPIs, specifically the use of multimodal cognitive training and sensory stimulation programs, were effective in improving cognitive function outcomes among persons with traumatic brain injury, with medium to large effect sizes. CLINICAL RELEVANCE: Nonpharmacological interventions (NPIs) can enhance cognitive function in individuals with traumatic brain injury. These findings can guide healthcare professionals in clinical settings and support the development of technology applications for cognitive rehabilitation using NPIs.

Translation and validation of the East Asian Acculturation Measure (EAAM) among Myanmar migrants in Thailand.

Background: Acculturation provides a framework for exploring the health behaviors of ethnic minority or cultural groups. Research on the acculturation level and patterns of Myanmar migrants is crucial since there is ample evidence that acculturation promotes health-promoting behaviors. However, no Myanmar version has undergone cross-cultural validation. Objective: This study aimed to translate the original East Asian Acculturation Measure (EAAM) into the Myanmar version (EAAM-M) and investigate its psychometric properties. Methods: The validation study was conducted on a sample of 200 Myanmar migrants in three factories in Bangkok, Thailand, by a multistage random sampling method from August to September 2023. Brislin's back translation technique was applied to convert the original EAAM into its modified version, EAAM-M. The reliability, content validity, and construct validity of the EAAM-M were examined, and confirmatory factor analysis (CFA) was employed to test the appropriateness of the model that underpins the EAAM-M structure. Results: The average age of the participants was 38.39 years (SD = 5.56), and 68% of participants reported they earned less than 9000 baht. In terms of how long they stayed in Thailand, slightly over half (52.5%) did so for 1-5 years. Nearly half of them (46%) cannot communicate at all regarding their proficiency in speaking Thai. The score regarding the comparability of language and similarity of interpretability between the original EAAM and the EAAM-M was satisfactory. The overall alpha reliability of the EAAM-M was 0.76. Based on the CFA, the measurement model was well fit, with acceptable goodness-of-fit values (Chi-square test of model fit (p = 0.05), CMIN/df = 1.70 (χ2 = 624.931, df = 366), RMSEA = 0.02, CFI = 0.98, and SRMR = 0.06). The validity and reliability of the factors were affirmed through appropriate factor loadings and satisfactory levels of composite reliability (0.942) and average variance extracted (0.538). Conclusion: The EAAM-M is a reliable and valid instrument to measure the acculturation patterns of Myanmar migrants. It is beneficial for scholars across various disciplines, including health professionals and nurses, to deliver culturally tailored care for migrants.

Effectiveness of Family-Based Diabetes Management Intervention on Glycated Haemoglobin Among Adults With Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Glycated hemoglobin (HbA1c) control is a crucial goal in the management of type 2 diabetes mellitus (T2DM), requiring lifelong commitment and family support. This study aimed to assess the effectiveness of family-based diabetes management intervention on HbA1c among adults with T2DM. METHODS: From inception up to 2022, a comprehensive literature search was conducted across PubMed, ProQuest, Scopus, CORE, and the Cochrane Library. The quality of studies was evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal tools. Effect sizes were calculated using standard deviations (SD), while the degree of heterogeneity was evaluated using the Higgins I2 test. Subgroup analyses were performed to explore factors contributing to sources of heterogeneity among trials. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed, and the protocol was registered with PROSPERO CRD42022384034. RESULTS: A total of 18 randomized controlled trials (RCTs) involving 2815 participants indicated that family-based diabetes management intervention had a statistically significant impact on improving HbA1c (Mean Difference [MD] = -.47; 95% Confidence Interval [CI]: -.64 to -.30, p < .001) with a moderate level of heterogeneity (I2 = 59%). Subgroup analysis indicated that family-based diabetes management intervention among adults with T2DM in developing regions was more effective in improving HbA1c levels compared to developed countries. CONCLUSION: Family-based diabetes management interventions improved HbA1c. Further research is required to develop diabetes management strategies with a family focus that clearly defines the family's involvement.

Predicting Factors of Health-Related Quality of Life Among Adults With Type 2 Diabetes: A Systematic Review.

Introduction: One of the most important outcomes of diabetes care and treatment is an improvement in patients' health-related quality of life (HRQoL). Objective: This study aimed to review the empirical evidence regarding the predictors of HRQoL among adults with type 2 diabetes mellitus (T2DM). Methods: To find all English-language articles published between 2012 and 2022, a comprehensive literature search was conducted using ProQuest, Scopus, PubMed, Science Direct, and CORE. Cross-sectional studies were the focus of this analysis. Search terms included "type 2 diabetes" OR "T2DM" AND "health-related quality of life" OR "HRQoL" AND ("predicting factors" OR "influencing factors" OR "associated factors"). The original search yielded a total of 1,089 studies, from which 35 met the review's inclusion criteria. The systematic review protocol was registered with PROSPERO CRD42023431229. Results: The final analysis comprised 24,346 people with type 2 diabetes and used data from 35 cross-sectional studies conducted during the preceding decade. Socio-demographic factors (age, marital status, gender, monthly income, education, area of residence, and religiosity), patient-centered factors (diabetes knowledge and self-efficacy), disease characteristics (comorbidities, duration of diabetes, and insulin treatment), self-management behaviors (physical activity, medication adherence, and frequent glucose checks), and family support were found to be predictors of HRQoL. Conclusion: A diabetes program to enhance the HRQoL among people with T2DM is highly encouraged to address these factors, which can be focused on promoting self-management behaviors, diabetes distress management, and encourage family support.

Physical Activity and Its Synergistic Interaction With Low Platelet-Lymphocyte Ratio Levels Increasing the Sleep Quality in Type 2 Diabetes Mellitus.

PURPOSE: The purpose of the study was to explore the effect of synergistic interaction and the independence of physical activity and inflammatory markers, including platelet-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR), on sleep quality in persons with type 2 diabetes mellitus (T2DM). METHODS: This descriptive cross-sectional study included 294 persons with T2DM in East Java, Indonesia. Fasting blood was analyzed for inflammation markers, including NLR and PLR. Physical activity and sleep quality were assessed using Metabolic Equivalent of Task and Pittsburgh Sleep Quality Index, respectively. Multivariate logistic regression, chi-square test, and independent t test were performed. RESULTS: There was an independently significant relationship between physical activity, NLR, and PLR with sleep quality. Persons with both active physical activity and low PLRs were 12.52 times more likely to have high sleep quality scores than those with low physical activity and high PLRs. A positive additive interaction of active physical activity and low PLRs for high sleep quality scores was identified. CONCLUSION: Physical activity, NLR, and PLR revealed an independently significant relationship with sleep quality. Persons with both active physical activity levels and low PLR were the most substantial synergistic effect of high sleep quality. Further studies are necessary to examine the problems and solutions for sleep quality in this population.

Synergistic Interactions of Insufficient Physical Activity and a High Systemic Immune-Inflammation Index on Psychological Problems in Indonesians With Type 2 Diabetes Mellitus.

BACKGROUND: High-grade inflammation represents a critical contribution to the onset of depression and might be manageable by physical activity (PA). Nevertheless, no study has examined synergistic interactions of insufficient PA and high values of the systemic immune-inflammation index (SII) on psychological problems. OBJECTIVE: We investigated independent and synergistic interactions of insufficient PA and high SII levels on stress, anxiety, and depression in T2DM patients. METHODS: A cross-sectional research design with 294 T2DM patients was conducted. An XP-100 automated hematology analyzer was used to evaluate inflammatory biomarkers. Depression, Anxiety, and Stress Scale-21 items and a standardized questionnaire about PA were respectively used to measure psychological problems and metabolic equivalent of task (MET)-h/week. RESULTS: A multiple linear regression demonstrated that patients with insufficient PA were significantly more likely to have higher stress (ß = 1.84, 95% confidence interval (CI) = 1.03-2.65), anxiety (ß = 1.88, 95% CI = 1.81-2.96), and depression (ß = 2.53, 95% CI = 0.82-4.24) than those with active PA. A high SII level was a key predictor and was most strongly associated with stress (ß = 2.61, 95% CI = 2.02-3.20), anxiety (ß = 3.16, 95% CI = 2.37-3.94), and depression (ß = 3.72, 95% CI = 2.49-4.96) compared to those who had low SII levels. Notably, additive interaction results showed that combining insufficient PA and a high SII level had a significantly escalated 1.71-fold risk of stress, 1.82-fold risk of anxiety, and 2.69-fold risk of depression. CONCLUSIONS: Active PA and a low SII had a positive synergistic effect of decreasing psychological problems.

The Effect of Uncertainty Management Program on Quality of Life Among Vietnamese Women at 3 Weeks Postmastectomy.

BACKGROUND: In Vietnam, breast cancer is a top contributor to cancer-related deaths in women. Evidence shows that, after mastectomy, women in Vietnam have a lower quality of life than women in other countries. In addition, high uncertainty is a predictor of low quality of life postmastectomy. Therefore, if nurses can manage uncertainty, the quality of life postmastectomy can improve. OBJECTIVE: This study examined the effect of the Uncertainty Management Program (UMP) on quality of life at 3 weeks postmastectomy in Vietnamese women. METHODS: This research was a quasi-experimental study using a "posttest only with control group" design. There were 115 subjects assigned to either the experimental group (n = 57), who participated in the UMP and routine care, or the control group (n = 58), who received only routine care. Participants were assessed 2 times postmastectomy using the modified Quality of Life Index Scale-Vietnamese version. RESULTS: The experimental group exhibited low uncertainty before discharge and significantly higher quality of life than the control group at 1 and 3 weeks postmastectomy, respectively (P < .05). Women's physical well-being, psychological well-being, body image concerns, and social concerns were significantly increased with UMP. CONCLUSION: The UMP was considered as a promising program that might benefit the QoL of women with breast cancer 3 weeks postmastectomy. IMPLICATIONS FOR PRACTICE: The UMP appears feasible to apply for women with breast cancer to improve their QoL postmastectomy in various settings. Nurses can flexibility instruct women in their holistic care attention both in the hospital and at home.

The Effect of a Brief HIV Prevention Program on Risk Reduction Behaviors Among Thai Men Diagnosed With Sexually Transmitted Infections.

PURPOSE: Men diagnosed with sexually transmitted infections (STIs) are at greater risk for Human Immunodeficiency Virus (HIV) infection and STIs reinfection. This study aimed to test the effectiveness of a brief human immunodeficiency virus (B-HIV) prevention program on HIV and sexually transmitted infection (STI) knowledge, perceived benefits of condom use, risk reduction self-efficacy, risk reduction behaviors, and reinfection rate among Thai men with STIs. METHODS: A quasi-experimental design was conducted. Participants were selected from men with STI symptoms. They were randomly assigned to a B-HIV prevention program or usual care, 100 each. The program consisted of 3 modules. Key messages for HIV prevention were sent weekly through Line. Outcomes were HIV and STI knowledge, perceived benefits of condom use, risk reduction self-efficacy, risk reduction behaviors (condom use, the number of sexual partners, and condomless sex), and STI reinfection rate. Independent t-test and binary logistic regression were performed. RESULTS: The B-HIV prevention program significantly increased HIV and STI knowledge and resulted in perception of greater benefits from condoms and greater risk reduction self-efficacy. Program participants used condoms more frequently with many types of partners, especially with casual partners and sex workers. The intervention group practiced condomless sex less frequently than the control group. The program did not improve participants' condom use with lovers/steady partners and did not decrease the number of sexual partners and STI reinfection rate at 3-month follow-up. CONCLUSIONS: A B-HIV prevention program could reduce the risk of HIV infection among male clients with current STIs by enhancing their condom use with casual partners and sex workers. Strategies to improve condom use with lovers/steady partners among this high-risk population is needed.

Determinants of Behavior Change Intention Among Heterosexual Thai Males Diagnosed with Sexually Transmitted Diseases.

This study sought to identify factors associated with intention to change sexual practices among heterosexual Thai males diagnosed with sexually transmitted infections (STIs). STI clinic patients (n = 247) reported their sexual behaviors and condom use during the previous 3 months. STI and HIV knowledge, motivation to change sexual practices, and behavioral skills were assessed. Then, self-reported behavior change intention, including consistent condom use, reducing number of sexual partners, not using drugs and alcohol when having sex, and refusal of condomless sex, was examined. Consistent condom use in the past 3 months by Thai males diagnosed with STIs was low across all types of sexual partners (lover 13.8%, casual partner 14.9%, and sex worker 2.5%). Risk reduction self-efficacy (p < 0.001), perceived benefits from condom use (p < 0.001), perceived barriers to condom use (p < 0.001), perceived risk for HIV (p < 0.05), and STI and HIV knowledge (p < 0.05) were significantly correlated with behavior change intention. Significant predictors of behavior change intention were risk reduction self-efficacy (p < 0.001), perceived benefits of condom use (p = 0.016), and perceived risk for HIV (p = 0.033). They explained 36% of behavior change intention variance. Intervention aimed at enhancing motivation and behavioral skills to adopt preventive behaviors should be developed to prevent recurrent STIs, including HIV infection, among heterosexual Thai males diagnosed with STIs.

A causal model for fatigue in lung cancer patients receiving chemotherapy.

PURPOSE: This study explored a causal model explaining fatigue in lung cancer patients currently undertaking Chemotherapy. METHOD: In this cross-sectional study, a convenience sample of 246 lung cancer patients were recruited from six Oncology centers throughout the north of Vietnam. The hypothesized model, consisting of insomnia, dyspnea, cough, anxiety, stage of disease, physical activity, nutritional status, and number of completed chemotherapy cycles, was constructed based on Piper's Integrated Fatigue Model and a review of the literature. RESULTS: All factors, except the number of completed chemotherapy cycles significantly affected fatigue. The hypothesized model explained 42.9% of fatigue variance. Dyspnea had the largest total effect on fatigue (ß = 0.397, p < 0.01), followed by cough (ß = 0.343, p < 0.01), insomnia (ß = 0.318 (p < 0.01), and anxiety (ß = 0.115, p < 0.05). However, insomnia had the greatest direct effect on fatigue. There was also interplay among those four factors in determining fatigue. Physical activity and nutrition status had small effects on fatigue (ß = - 0.148, p < 0.01 and ß = - 0.156, p < 0.01). CONCLUSION: The model fits well to explain fatigue. Having the largest direct effect on fatigue, insomnia appeared as a factor of choice for future fatigue control programs. Due to its higher direct effect on fatigue, dyspnea was recommended over cough for fatigue management. Additionally, the interactions among fatigue, dyspnea, and cough suggested that comprehensive programs, which simultaneously address these three symptoms, would be a promising approach for practitioners to consider.

A brief, peer-led HIV prevention program for college students in Bangkok, Thailand.

STUDY OBJECTIVE: To test the effectiveness of a brief theory-based HIV prevention program led by peers among college students. DESIGN: A quasi-experimental research using a pretest-posttest nonequivalent control group design with 2-mo follow-up. SETTING: A university in Bangkok. PARTICIPANTS: For peer leaders, 70 undergrad students taking health sexuality course were invited to participate in the study. Then, a convenience sample of undergraduate students was recruited through peer leaders, 226 for experimental group and 209 for control group. MAIN OUTCOME MEASURES: Information, motivation, behavioral skills, and AIDS/STIs preventive behaviors. RESULTS: The study revealed that a Brief, Peer-Led HIV Prevention Program significantly increased knowledge of preventive behaviors (ß = 2.67, P < .000), motivated participants to have a better attitude toward preventive behaviors (ß = -5.26, P < .000), better subjective norms (ß = -1.54, P < .000), and greater intentions to practice preventive behavior (ß = -1.38, P < .000). The program also significantly decreased perceived difficulty of AIDS/STIs preventive behaviors (ß = 2.38, P < .000) and increased perceived effectiveness at AIDS/STIs preventive behavior (ß = -3.03, P < .000). However, it did not significantly increase AIDS/STIs preventive behaviors (ß = 2.13, P > .05). CONCLUSION: Findings of this study provide initial evidence as to how theoretical variables were operated to effectively increase knowledge, change motivation, and behavioral skills of AIDS/STIs preventive behavior among Thai college students. More research is needed to further test the effectiveness of the program on AIDS/STIs preventive behaviors among college students.

Obstetric and perinatal outcomes of teenage pregnancies in Thailand.

STUDY OBJECTIVE: To determine whether, when controlling for confounding factors, there was still an association of adolescence with adverse outcomes. DESIGN: Retrospective case control study. SETTING: Seven Bangkok Metropolitan Administration General Hospitals. PARTICIPANTS: Charts of all women aged 19 and younger (n = 1,354) having singleton live births in 2004, 2005, and 2006 were retrieved. For the adult group, 1,389 charts of mothers between the ages of 20 and 34 delivering singleton babies were selected using proportionate systematic random sampling. Maternal age was divided into 3 groups: 11-15, 16-19, and 20-34. MAIN OUTCOME MEASURES: Obstetric and perinatal outcomes. RESULTS: After statistically controlling for known confounding factors, teenage pregnancy was associated with increased risks of anemia (11-15: AOR = 1.81, P < 0.001; 16-19: AOR = 1.48, P < 0.01), very preterm deliveries (11-15: AOR = 2.18, P < 0.05), very low birth weight babies (11-15: AOR = 6.98, P < 0.05; 16-19: AOR = 9.86, P < 0.01), newborn admission to Intensive Care Unit (11-15: AOR = 1.93, P < 0.01; 16-19: AOR = 2.10, P < 0.01), and postpartum complications (11-15: AOR = 3.33, P < 0.01). The rates of cesarean delivery (11-15: AOR 0.58, P < 0.01; 16-19: AOR = 0.57, P < 0.01), operative delivery (11-15: AOR = 0.49, P < 0.01), and oxytocin augmentation (16-19: AOR = 0.66, P < 0.01) were less frequent in younger mothers. CONCLUSION: Independent of known confounding factors, teenage pregnancy was associated with increased risks of adverse maternal and neonatal outcomes requiring clinical and outreach interventions from health care providers.