Self-efficacy as mediators of the association between dyadic coping and quality of life among spousal caregiver of patients with cervical cancer.

Objective: This study aims to explore the influence of dyadic coping (DC) on the quality of life (QoL) of spousal caregivers for patients with cervical cancer and to investigate the mediating role of self-efficacy in this relationship. Methods: A convenience sample of 206 spouses of cervical cancer patients from five hospitals in Jiangsu Province, China, was included in the study. The participants completed three instruments: the 12-item Short-Form Health Survey, the General Self-Efficacy Scale, and the Dyadic Coping Inventory. Structural Equation Modeling (SEM) was used to analyze the mediating effect of self-efficacy in the DC and QoL relationship. Results: The study found a positive correlation between self-efficacy and DC. Self-efficacy partially mediated the impact of DC on QoL, accounting for 16% of the total effect. Self-efficacy played a mediating role in facilitating the indirect positive effects of DC on QoL. Conclusions: Spousal caregivers of cervical cancer patients frequently experience a relatively low QoL. The results suggest that interventions aimed at enhancing DC among spousal caregivers should incorporate strategies to improve self-efficacy, given its mediating role in the positive relationship between DC and QoL.

Predictors of changes in resilience among spousal caregivers of patients with advanced cancer within the first 6 months after initial treatment.

BACKGROUND: While previous research has established that resilience is affected by various factors, these studies have primarily focussed on individual variables associated with resilience, without providing insights into how to influence the rate of change in resilience. AIM: To examine the trajectory of resilience and identify the factors associated with changes in resilience among spousal caregivers of patients with newly diagnosed advanced cancer receiving treatment during the first 6 months. DESIGN: An observational longitudinal study. METHODS: A total of 312 spousal caregivers of patients with newly diagnosed advanced cancer were recruited from January 2022 to December 2022 in Yancheng, China. Three data collection points were established, spanning from the first month to 6 months after initial cancer treatment. A latent growth model was employed to depict the resilience trajectory at various time points. A latent growth model with time-invariant covariates was adopted to determine the factors influencing resilience trajectory. The study adhered to the STROBE checklist for proper reporting. RESULTS: Throughout the follow-up period, the participants experienced a significant increase in resilience. Gender, family income, the patient's health status, spirituality and belief in familism were significantly associated with the baseline resilience level. Moreover, family income, the patient's health status, spirituality, caregiver burden and belief in familism were significantly associated with the rate of resilience change over time. CONCLUSIONS: Spousal caregivers demonstrated a linear increase in resilience during the first 6 months after initial treatment. Meanwhile, changes in resilience were influenced by multiple factors during the early phase of cancer treatment. Thus, more attention should be paid to early identification and implementation of targeted interventions. RELEVANCE TO CLINICAL PRACTICE: Healthcare professionals should understand the change in resilience among spousal caregivers and conduct timely mental health interventions to enhance the resilience of families affected by cancer. PATIENT OR PUBLIC CONTRIBUTION: The Guidance for Reporting Involvement of Patients and the Public-Short Form reporting checklists were used to improve patient and public involvement.

The role of academic procrastination on Internet addiction among Thai university students: A cross-sectional study.

Background: The internet has become an inevitable tool for information-seeking and communication in today's modern era. However, ironically it has driven humankind to become more dependent, leading to addiction. Internet addiction has increased exponentially at all levels of society, especially university students, impeding their physical, psychological, and social well-being. Objective: This study aimed to examine the relationship between academic procrastination and internet addiction and determine the influence of academic procrastination on internet addiction among Thai university students. Methods: A cross-sectional study was conducted involving 470 participants selected through multi-stage cluster random sampling from a university in eastern Thailand. The data collection was conducted between 29 November 2022 and 27 January 2023. The data were gathered using a demographic data form, an internet addiction test, and a procrastination assessment scale for the students' questionnaire. Descriptive statistics, Pearson correlation coefficient, and simple linear regression were employed for data analysis. Results: The results revealed that academic procrastination (M = 49.68, SD = 12.61) and internet addiction (M = 65.26, SD = 5.60) were at a moderate level. A positive correlation was identified between academic procrastination and internet addiction (r = 0.33, p <0.01), indicating a low relationship. Academic procrastination also had a significant predictive power on internet addiction, accounting for 11.3% of the variance (R2 adjusted = 0.113, F (1, 468) = 59.583, p <0.001). Conclusion: The findings indicated the significant role of academic procrastination on internet addiction. Therefore, it is crucial that nurses should formulate interventions by considering this factor and emphasize self-regulatory and time-management skills and practical ways to limit internet dependence. Furthermore, the findings suggest that nurses could assess the procrastination level among students, devise prevention strategies, and organize awareness campaigns to instill information about rational internet use that aids in mitigating the risks and preventing them from getting addicted.

Factors associated with feeding behaviors among mothers of obese infants: a cross-sectional study.

Background: Infant obesity is a risk factor for diseases in childhood and even in adulthood. Maternal feeding behaviors are strongly associated with infant obesity, hence factors relevant to mother's perception, socioeconomic status, and social support that influence the feeding behaviors need to be explored. Therefore, this study aimed to examine associated factors of feeding behaviors among mothers with obese infants. Methods: This cross-sectional study was conducted at the pediatric wards of a tertiary hospital in Wenzhou, Zhejiang Province, China. Participants (n=134) were mothers of infant with obesity aged 6-12 months. Data were collected by structured questionnaires. Maternal feeding characteristics and the relationship between mothers' age, monthly personal income, parental self-efficacy, social support, benefits of maternal feeding behaviors, barriers to maternal feeding behaviors and feeding behaviors were examined. The Data was analyzed by descriptive statistics and multiple regression analysis. Results: Most of the infants (84.3%) was in the 98th-100th percentile. Nearly half of the mothers were 30-39 years old and unemployed (46.3%). One-third (61.40%) were multiparous mothers and 73.1% cared for their infants for more than 6 hours per day. Monthly personal income, parenting self-efficacy and social support together explained 28% of variance on feeding behaviors (P<0.05). Parenting self-efficacy (ß=0.309, P<0.05) and social support (ß=0.224, P<0.05) had significantly positive influence on feeding behaviors. Maternal personal income (ß=-0.196, P<0.05) had a significantly negative influence on feeding behaviors among mothers having infants with obesity. Conclusions: Nursing interventions should be focused on enhancing parenting self-efficacy and promoting social support for the feeding behaviors of mothers.

Change in resilience among spousal caregivers of patients with newly-diagnosed advanced cancer over the first six months posttreatment in China.

OBJECTIVE: A longitudinal observational study was conducted and aimed to examine the change in resilience among spousal caregivers of newly-diagnosed advanced cancer patients over the first six months after initial treatment. METHODS: In total, 312 Chinese spousal caregivers who were taking care of their patients with newly-diagnosed advanced cancer were recruited. The level of resilience was measured using the Connor-Davidson Resilience Scale at the first month post-initial treatment (T1), three-month post-initial treatment (T2), and six-month post-initial treatment (T3). Latent growth modeling analyses were performed to examine changes in resilience using Mplus 8.3. RESULTS: The mean scores of resilience in spousal caregivers were 54.01 ± 7.68 at T1, 56.20 ± 6.38 at T2, and 57.97 ± 6.70 at T3, respectively. Results of latent growth modeling indicated that spousal caregivers showed a significant increase in their resilience scores over the first six months post-treatment (Mean slope = 1.98, p < 0.001). Furthermore, a significant individual variation in the rate of changes in resilience scores allowed spouses to be categorized into two groups: 42.9% participants with fast growth and 57.1% participants with slight growth. CONCLUSION: Our findings highlight the importance that new knowledge about change patterns of resilience in the nursing field is beneficial to reveal different psychosomatic health. Acknowledging that resilience is a dynamic process that changes over time, it is crucial for healthcare providers to monitor the psychological adjustment and focus of vulnerable caregivers, particularly spouses.

Factors influencing exclusive breastfeeding for 6 months postpartum: A systematic review.

PURPOSE: This systematic review aims to identify factors influencing exclusive breastfeeding (EBF) up to 6 months. METHODS: The databases including PubMed, MEDLINE, CINAHL, Scopus, EMBASE, CNKI, and WANFANG were searched to retrieve studies. Quantitative research were extracted and the preferred reporting items for systematic reviews were followed. Critical appraisal checklists of Joanna Briggs Institute were used to evaluate the quality of the included studies. FINDINGS: A total of 16 papers were eligible for this systematic review, comprising five cohort studies and 11 cross-sectional studies. Moderate to strong evidence supported that 6-month exclusive breastfeeding is affected by maternal working status, breastfeeding knowledge, delivery mode, parity, perception of insufficient human milk, mothers' infant feeding attitude, breastfeeding self-efficacy, and intention. CONCLUSIONS: Factors influencing EBF up to 6 months postpartum play a key role in promoting mothers' health and reducing diseases in their infants. IMPLICATIONS FOR NURSING PRACTICE: Interventions based on related factors should be developed and taken into practice to assist mothers in exclusive breastfeeding for up to 6 months. Additional studies from different countries in different populations with high quality are needed to provide more reliable and richer findings.

Interventions for the prevention of postpartum depression in adolescent mothers: a systematic review.

Postpartum depression (PPD) is a major public health problem affecting 10-57% of adolescent mothers which can affect not only adolescent mothers but also their infants. Thus, there is a need for interventions to prevent PPD in adolescent mothers. However, recent systematic reviews have been focused on effective interventions to prevent PPD in adult mothers. These interventions may not necessarily be applicable for adolescent mothers. Therefore, the purpose of this review was to examine the effectiveness of the existing interventions to prevent PPD in adolescent mothers. A systematic search was performed in MEDLINE, CINAHL, and SCOPUS databases between January 2000 and March 2017 with English language and studies involving human subjects. Studies reporting on the outcomes of intervention to prevent PPD particularly in adolescent mothers were selected. Non-comparative studies were excluded. From 2002 identified records, 13 studies were included, reporting on 2236 adolescent pregnant women. The evidence from this systematic review suggests that 6 of 13 studies from both psychological and psychosocial interventions including (1) home-visiting intervention, (2) prenatal antenatal and postnatal educational program, (3) CBT psycho-educational, (4) the REACH program based on interpersonal therapy, and (5) infant massage training is successful in reducing rates of PPD symptoms in adolescent mothers in the intervention group than those mothers in the control group. These interventions might be considered for incorporation in antenatal care interventions for adolescent pregnant women. However, this review did not find evidence identifying the most effective intervention for preventing postpartum depression symptoms in adolescent mothers.

A family empowerment program for families having children with thalassemia, Thailand.

The purpose of this quasi-experimental design study was to examine the effectiveness of a family empowerment program (FEP) on family functioning and empowerment among 56 families having children with thalassemia. The 26 families in the experimental group received the FEP and usual care, while 30 families in the control group received usual care. Data collection occurred through family functioning and empowerment questionnaires. Between-group differences were tested with t-tests and analysis of variance. The result revealed that family caregivers who participated in the FEP had significantly increased family functioning and empowerment scores over time. The FEP can be used as a powerful intervention for assisting families and children with thalassemia and the education of health professionals.

Examining the usefulness of a Family Empowerment Program guided by the Illness Beliefs Model for families caring for a child with thalassemia.

The purpose of this pilot study was to design, implement, and evaluate a Family Empowerment Program (FEP), guided by the Illness Beliefs Model. Participants included 25 Thai family members who were the primary caregivers of a child with thalassemia. In Phase I, data were collected from participants using individual in-depth interviews and focus groups before involvement in the FEP. In Phase II, 12 hr of FEP sessions were offered to groups of participants. Content analysis of the audiotaped FEP sessions is reported in this article. Family caregivers reported that the FEP helped them share beliefs and experiences related to caring for their child with thalassemia, make decisions related to families' problems/needs and beliefs, provide each other mutual social support, and develop increased ability to manage care for their chronically ill child through sharing information and learning from other family caregivers about family functioning, family management, and family relationships. Future research is needed to examine the FEP intervention under more controlled conditions with measures that include family functioning and child health outcomes.

Characteristics and predictors of home injury hazards among toddlers in Wenzhou, China: a community-based cross-sectional study.

BACKGROUND: Home hazards are associated with toddlers receiving unintentional home injuries (UHI). These result in not only physical and psychological difficulties for children, but also economic losses and additional stress for their families. Few researchers pay attention to predictors of home hazards among toddlers in a systematic way. The purpose of this study is firstly to describe the characteristics of homes with hazards and secondly to explore the predicted relationship of children, parents and family factors to home hazards among toddlers aged 24-47 months in Wenzhou, China. METHODS: A random cluster sampling was employed to select 366 parents having children aged 24 - 47 months from 13 kindergartens between March and April of 2012. Four instruments assessed home hazards, demographics, parent's awareness of UHI, as well as family functioning. RESULTS: Descriptive statistics showed that the mean of home hazards was 12.29 (SD = 6.39). The nine kinds of home hazards that were identified in over 50% of households were: plastic bags (74.3%), coin buttons (69.1%), and toys with small components (66.7%) etc. Multivariate linear regression revealed that the predictors of home hazards were the child's age, the child's residential status and family functioning (b = .19, 2.02, -.07, p < .01, < .05 and < .01, respectively). CONCLUSIONS: The results showed that a higher number of home hazards were significantly attributed to older toddlers, migrant toddlers and poorer family functioning. This result suggested that heath care providers should focus on the vulnerable family and help the parents assess home hazards. Further study is needed to find interventions on how to manage home hazards for toddlers in China.

Factors influencing Thai parent-child interaction in a rapidly changing industrial environment.

This paper explores factors influencing parent-child interaction of parents with children age 13-36 months old and working in the industrial setting in the eastern region of Thailand. An ethnographic study was conducted with 22 families. Data were collected through in-depth interviews, participant observation, audiotape/videotape recording and field notes from October 2008 to September 2009. The data were analyzed by means of (i) quantitative data using frequency and percentage and (ii) qualitative data using Roper and Shapira's strategies of content analysis. The factors influencing parent-child interaction include the parental knowledge about child development, their intention and time availability. Other influences noted were economic burdens and support from parents, the factory and the community. These findings provide a greater understanding of the factors influencing parent-child interaction among Thai families with young children. Also, the findings may be useful in the development of effective interventions and/or guidelines that improve the quality of parent-child interaction.

Families suffering with HIV/AIDS: what family nursing interventions are useful to promote healing?

The purpose of this clinical research project was to examine the usefulness of a family nursing intervention program offered to families experiencing illness suffering related to HIV/AIDS. The interventions were based on the Family Caregiving Model and the Illness Beliefs Model. Sixteen Thai families with one or more family members living with HIV/AIDS were offered three to four family clinical sessions by an advanced practice family nurse. The audiotaped family clinical sessions and field notes were analyzed using thematic analysis. The outcomes reported by families included a competence to manage illness care of family members experiencing HIV/AIDS, new meaning and purpose, improved family interaction, embraced facilitating beliefs and changed constraining beliefs, and a recognition of the family's strengths.

A cross cultural study of vaginal practices and sexuality: implications for sexual health.

Between 2005 and 2006, we investigated vaginal practices in Yogyakarta, Indonesia; Tete, Mozambique; KwaZulu-Natal, South Africa; and Bangkok and Chonburi, Thailand. We sought to understand women's practices, their motivations for use and the role vaginal practices play in women's health, sexuality and sense of wellbeing. The study was carried out among adult women and men who were identified as using, having knowledge or being involved in trade in products. Further contacts were made using snowball sampling. Across the sites, individual interviews were conducted with 229 people and 265 others participated in focus group discussions. We found that women in all four countries have a variety of reasons for carrying out vaginal practices whose aim is to not simply 'dry' the vagina but rather decrease moisture that may have other associated meanings, and that they are exclusively "intravaginal" in operation. Practices, products and frequency vary. Motivations generally relate to personal hygiene, genital health or sexuality. Hygiene practices involve external washing and intravaginal cleansing or douching and ingestion of substances. Health practices include intravaginal cleansing, traditional cutting, insertion of herbal preparations, and application of substances to soothe irritated vaginal tissue. Practices related to sexuality can involve any of these practices with specific products that warm, dry, and/or tighten the vagina to increase pleasure for the man and sometimes for the woman. Hygiene and health are expressions of femininity connected to sexuality even if not always explicitly expressed as such. We found their effects may have unexpected and even undesired consequences. This study demonstrates that women in the four countries actively use a variety of practices to achieve a desired vaginal state. The results provide the basis for a classification framework that can be used for future study of this complex topic.

Uncovering a family caregiving model: insights from research to benefit HIV-infected patients, their caregivers, and health professionals.

The purpose of this study was to understand family caregiving practices for HIV-infected patients, including problems and needs based on experiences of primary family caregivers and persons living with HIV (PLWH) in Rayong province, Thailand. The participants were 48 PLWH and 48 primary family caregivers. Data collection consisted of individual in-depth interviews of PLWH and family caregivers, plus focus groups with the primary family caregivers and observations. Content analysis was performed to analyze the qualitative data. Results indicated that there was a transformation in family caregivers from the time of initial diagnosis to their offering of loving, caregiving practices. The most unexpected result was that primary family caregivers evolved their own model for caregiving practices; the most concerning result was their fear of stigmatization. Caregiving practices included seeking treatment and help, providing support and care, keeping the closure of diagnosis, coping with stress, requesting the truth about diagnosis, and maintaining family values and dignity.

Family nursing practice, education, and research: what is happening in Thailand?

This article highlights 20 years of family nursing development and evolution in Thailand in the areas of education, practice, and research. The progress of family nursing in Thailand has been impressive and steady despite the challenges of nursing policy, conceptualization controversies, and knowledge transfer. One of the most unique and hopeful developments has been the establishment of health centers that have a designated family nurse responsible for approximately 300 households. Future dreams for family nursing in Thailand are also offered.