The need for integration nursing theories into pressure ulcer care in the community.

Pressure ulcers are injuries to the skin requiring integrated care, particularly when patients are at home. Pressure ulcers have been a nursing concern for years, and several strategies have been proposed for its prevention and management. Nursing theory, which is essential for nursing practice, recommends plausible approaches to health problems. However, literature describing steps to integrate nursing theory into pressure ulcer care has not yet been explored. For this reason, this article discusses the six steps on how to apply nursing theory in community practice. A case study is also discussed to help gain a better understanding of these steps.

Improving clinical outcomes of diabetic foot ulcers by the 3-month self- and family management support programs in Indonesia: A randomized controlled trial study.

BACKGROUND AND AIMS: Diabetic foot ulcers are the leading cause of lower extremity amputations, which require more effective prevention. Even though previous nursing studies on diabetic foot ulcers have been well performed, programs implementing self- and family management are limited and even underexplored. Therefore, the purpose of the study was to investigate the effect of 3-month self- and family management support programs on clinical outcomes among Indonesians with diabetic foot ulcers. METHOD: The randomized controlled trial design was used to answer the research question of the study. A total of 56 eligible participants were enrolled, with 27 in the experimental group and 29 in the control group. The experimental group received self- and family management support programs for three months. Meanwhile, the control group received usual care. Descriptive statistics, multivariate analysis of variance, and Generalized Estimating Equations were used to analyze the data. The significance level was considered at .05 for hypothesis testing. RESULTS: The study showed that there were statistically significant improvements in self-management, family supports, hemoglobin A1c, and wound size after implemented the programs for three months (p < .05). CONCLUSIONS: With regard to the result of the study, implementing the 3-month self- and family management support programs improves the patients' and families' abilities to perform diabetic foot ulcer care at home.

Associations Between Quality of Life, Psychosocial Well-being and Health-Related Behaviors Among Adolescents in Chinese, Japanese, Taiwanese, Thai and the Filipino Populations: A Cross-Sectional Survey.

Health-related behaviors during adolescence have lifelong impacts. However, there are unclear areas regarding the associations between health-related quality of life and demographic characteristics, as well as physical and psychosocial indicators. The aim of this study was to examine the associations between quality of life and body weight, sleep outcome, social support by age, and cohabitants, given that income, self-esteem, lifestyle, emotional, social and behavioral problems were taken into account among adolescents in East and Southeast Asia. A cross-sectional survey was conducted in Zhengzhou of China, Hong Kong, Kansai region of Japan, Taipei of Taiwan, Bangkok of Thailand and Manila of the Philippines between 2016 and 2017 among 21,359 urban adolescents aged between 9 and 16. The results showed that adolescents who had better self-esteem and control of emotions and behaviors had much higher level of perceived quality of life. Those who were overweight or obese, sleepy in the daytime, and not living with parents had worse quality of life compared with those who were not. In conclusion, psychosocial well-being should have a higher priority in the promotion of quality of life among Asian adolescents. Nevertheless, further studies are required to explore the differences in perceived quality of life between genders and countries.

ADIE - Nursing Interventions of Diabetic Foot Ulcer: An Integrative Review of the Literature.

BACKGROUND AND AIMS: Diabetic foot ulcer is recognized as a consequence of peripheral neuropathy and peripheral arterial disease amid individuals with diabetes. As is well known, this situation still remains a crucial problem in nursing practice. Available studies describing an algorithm of inter- related nursing interventions concerned with diabetic foot ulcers are limited. Therefore, this integrative review was aimed to present evidence-based practice for overcoming the complications of diabetic foot ulcer as well as preventing lower extremity amputation. METHODS: This integrative review retrieved scientific literature from PubMed, CINAHL, ProQuest, SAGE Publishing and ScienceDirect databases as published from 2008 to 2017. Thirty-seven studies that met the inclusion criteria were included in this study. RESULTS: Our findings present that neurologic and circulatory assessments were considered as primary steps prior to conducting interventions. Formulating a diagnosis based upon the assessment results is a principal part to determine appropriate interventions. Multiple experimental studies displayed the effectiveness of certain interventions consist of applying wound cleansing, advanced modern wound dressing, topical therapy, offloading, intensive diabetes education and advanced treatment modalities. Hemoglobin A1c, high-density lipoprotein, procalcitonin, the potential of hydrogen of wound fluid, wound size, neurological and circulatory status were determined as the outcomes measurement which must be correctly evaluated. CONCLUSION: This review contributes an algorithm for intervening diabetic foot ulcer thereby generating the given name: ADIE (Assessment, Diagnosis, Interventions, and Evaluation). A collaborative care amid multidisciplinary diabetes team is needed for implementing along with evaluating the feasibility of the study findings. Moreover, active family participation also plays a crucial role to achieve successful management of diabetic foot ulcer at home.

A nursing metaparadigm perspective of diabetic foot ulcer care.

Diabetic foot ulcers (DFUs) are a serious complication of diabetes that impact on the patient, their social environment, overall health, and on nursing practice. Nursing scholars have integrated theories on practice to overcome these problems, but a lack of agreement in the available literature acts as a barrier to implementing these in practice. For that reason, using a nursing metaparadigm as a theoretical framework would assist nurses in managing care purposefully and proactively, thus possibly improving outcomes. There has been little discussion about the nursing metaparadigm in relation to DFU care. This article aims to identify why Fawcett's theory of the nursing metaparadigm is important as a fundamental part of DFU care. Understanding this will help to elucidate the phenomenon of DFUs. Moreover, identifying the elements of the DFU care framework is essential to improve reflective practice and intervention. This article discusses the concept of the nursing metaparadigm and its implications for practice in the care of patients with DFUs.

Diabetic foot ulcer care: a concept analysis of the term integrated into nursing practice.

BACKGROUND: Diabetic foot ulcer care demonstrates a beneficial approach to overcoming problems in patients with diabetes. This approach is frequently given but is not always successfully implemented due to its fragmentation amid healthcare providers. What's more, there are a number of different understandings, interchangeable languages and an absence of uniformity overlapping terminologies of meaning for diabetic foot ulcer care. Therefore, analysing the concept of diabetic foot ulcer care is important to provide a wider nursing knowledge, synthesise a greater theoretical model and drive more effective care of diabetic foot ulcer. OBJECTIVE: This article aimed to analyse how the concept of diabetic foot ulcer care is clearly defined in the relevant evidence as it has several implications in nursing practice. METHOD: Walker and Avant's (1995) method of concept analysis was systematically used in this study. FINDINGS: Three critical attributes of diabetic foot ulcer care were determined consisting of assessment, intervention and evaluation. Constructed cases are also presented to differentiate the concept of diabetic foot ulcer care from other concepts. This concept analysis results in the critical attributes of diabetic foot ulcer care, defines an operational definition and describes common goals that improve clarity, consistency and understanding of the concept amid healthcare professionals along with researchers. CONCLUSION: Effective implementation of the concept of DFU care into clinical nursing practice may undoubtedly improve patient outcomes and prevent the complexities of DFU in the years to come. Future research needs to be developed for evaluating the current use of this concept.

"Sufficient health" as perceived by Thai villagers: A qualitative study.

Globalization has led to the rapid modernization of Thai villagers' traditional lifestyle, with significant consequential changes in health. The integration of the sufficiency economy philosophy with health - a concept known as "sufficient health" - can improve health and wellbeing; however, little is known of the actual meaning of "sufficient health." This qualitative study explored the meaning of sufficient health as perceived by Thai villagers. Data were collected from 122 villagers living in a rural Thai community and analyzed using content analysis. The findings revealed five themes reflecting the meaning of sufficient health: being healthy and not having an illness, having regular health check-ups, performing self-care, living sufficiently, and avoiding risks. Understanding the meaning attributed to sufficient health can help nurses provide appropriate health care for villagers while retaining concern and respect for their cultural backgrounds. Importantly, providing opportunities to villagers to participate in health activities could help them recognize and sustain sufficient health.

Can a community-based multidisciplinary intervention effectively restore renal function? A non-randomized clinical trial.

There is insufficient evidence in the literature to indicate whether the promotion of lifestyle changes to prevent renal dysfunction and activate regeneration is effective. We examined the effectiveness of a community-based intervention program on renal restoration using a non-randomized clinical trial design with a follow-up period of six months. The training focused on lifestyle changes, including health education and personal consultation with a multidisciplinary health team. Our study included 120 patients with fractional excretion of magnesium levels of > 2%, who were assigned to experimental or control groups. Fractional excretion of magnesium levels were significantly decreased within six months in the experimental group; however, changes in the estimated glomerular filtration rate were not identified in either of the groups. These results suggest that screening of the fractional excretion of magnesium level and the "Healthy Kidney Program" had an effect in preventing chronic kidney disease or restoring kidney function.

Socioeconomic determinants of infant growth: The Perspective Cohort Study of Thai Children.

AIM: The present study is based on the Prospective Cohort Study of Thai Children (PCTC), and focuses on socioeconomic factors including maternal age, maternal education, living with parents, family size, family income, locality, and sex that affect the growth outcomes of infants at 1 year of age. METHODS: Data was collected among 3679 pairs of mothers and infants in the PCTC cohort in rural and urban locations during 2001-2002. Data collection was performed by interviewing mothers in their 7th to 8th month of pregnancy using family profile questionnaires. The anthropometric measures including weight, length, and head circumference of the infants were later collected at 1 year of age at home. RESULTS: The results show the effects of family socioeconomic status maternal education, living with parents, family size, family income, locality, and sex on their weight (R(2) = 14.2%, P < 0.001) and length (R(2) = 8.7%, P < 0.001) at 1 year of age. The findings suggest that maternal age, maternal education, living with parents, family size, family income, locality, and sex predict infant head circumference (R(2) = 16.8%, P < 0.001) at 1 year of age. CONCLUSION: Infants' growth, including weight, height, and head circumference, are affected by family socioeconomic status factors. It is recommended that the effect of maternal age on growth and development of children among those in the PCTC cohort is examined in the future.

Consistency analysis of parenting styles in Thailand during children's first year.

This descriptive study identifies and examines the consistency of parenting styles during the first year of their children's lives. The data were collected from interviewing 4088 parents or primary care takers of the 6 month old infants during the third wave of data collection of The Prospective Cohort of Thai Children project. The instrument used was the Infant Parenting Styles Questionnaire, developed by the researchers, which reflected parental responses to infant care in five different situations. After the answers were categorized into controlling, reasoning, overprotection, and neglectful parenting styles, the weighted kappa was used for the consistency analysis. The findings revealed that during the first 6 months of life, the overprotection style was the most common, followed by the reasoning style. The controlling and neglectful styles were very seldom used. The consistency of the parental styles in the same care givers using the kappa values showed that agreement between each of the styles was very low (-0.0419 to 0.0688). This suggests that parenting styles during the first year of life seem to occur in random patterns.

Early language delay and predictive factors in children aged 2 years.

OBJECTIVE: To investigate the predictive factors for early language delay (ELD) at age 2 years based on the Prospective Cohort Study of Thai children (PCTC). STUDY DESIGN: A prospective cohort study: secondary data retrieving. SUBJECTS: Three thousand nine hundred five children were recruited from four communities and one hospital in five areas of Thailand. MATERIAL AND METHOD: The Language Development Survey (LDS) was performed to identify children with early language delay (ELD) at age 2 years. Logistic regression analysis was used to investigate the association between possible factors (both biological and environment factors) and ELD. MAIN OUTCOME MEASURE: Number of children with ELD at age of 2 years. RESULTS: The incidence of ELD at age 2 years was 11.68%. Risk factors for ELD were birth weight (Odds Ratio: OR = 2.38, 95% Confidence interval: CI 1.65-3.42), male gender (OR = 2.12, 95% Confidence interval: CI 1.67-2.69), 3rd-4th and 5th child born or more (OR = 1.42, 95% CI = 1.02-1.96; OR = 1.88, 95% CI = 1.08-3.27, respectively), birth weight <2500 grams (OR = 2.38, 95% CI = 1.65-3.42), no first word within 1 year (OR = 2.25, 95% CI = 1.79-2.84), no walking within 1 year (OR = 1.34, 95% CI = 1.05-1.72), and maternal occupation (laborer or none) (OR = 1.36, 95% CI = 1.01-1.82). District living was a protective factor for ELD (OR = 0.42, 95% CI = 0.32- 0.54). There was no clear evidence for a link between breastfeeding and ELD. CONCLUSION: Significant factors identified here raise strong concerns that should be addressed clinically when counseling families and planning treatment. Further study using a longer longitudinal design and more detailed information is recommended to better determine predictive factors for ELD or specific language impairment (SLI).

Nursing data set development in Thailand.

The survey on nursing minimum data set was performed. Questionnaires were sent to 500 randomly selected hospitals, 378 returned questionnaires were analyzed. The top 10 minimum nursing data set were identified. They were patient's hospital number, name, personal ID number, medical diagnosis, referral, admission date, patient/family history, address and phone, gender, birth, religion, education, laboratory tests, discharge/expiration date, condition before discharge, nursing outcome, nursing problem, nursing intervention, admission number, health insurance, discharge plan and home visit.

The impacts of the "Immune of Life" for teens module application on the coping behaviors and mental health of early adolescents.

This quasi-experimental research is the subsequent part of the Health Promotion for Early Adolescents Project, which focuses on the training of schoolteachers in using the module Immune of Life for Teens, which was developed in 1999, for evaluating its impact. The module consists of a manual and a VDO cassette display of a story of a teenager who has difficulty adjusting to life changes. The program aimed at improving the coping skills and psychological health or mental health of junior high school students. Schoolteachers from 13 schools participated nationwide as part of an experimental group and received training in the use of the module in their schools with students in Grades 7-9. The control group was composed of 3 schools that did not apply the module. Each school performed the pretest and posttest 1 month after the module's application. The total number of the students in the study was 1,580. There were 445 students in the control group, 474 in the experimental I group (intensive training) group, and 661 in the experimental II group (nonintensive group). The instruments used to evaluate impact were the following: (1) Young Adult Coping Orientation for Problem Experiences, which was developed by Patterson, McCubbin, and Grochowski in 1983, and the (2) Thai Mental Health Questionnaire, a 70-item self-administered questionnaire developed by Pattrayuwat in 1999 to assess mental health status. The findings reveal that both experimental groups had better coping behaviors than the control group when using pretest scores as covariates (experimental I group: F = 9.425, p < .01; experimental II group: F = 22.446, p < .001) 1 month after the module was implemented. They also show that both experimental groups had better mental health than the control group when using pretest scores as covariates (experimental I group: F = 6.034, p < .05; experimental II group: F = 6.596, p < .001) 1 month after the module was implemented. The study confirmed the impact of the Immune of Life for Teens module on better coping behaviors and better mental health status among the subjects after it was implemented by their teachers. Thus, for further use of the module, intensive training for schoolteachers is recommended for the health promotion of early adolescents.

Nursing Minimum Data Set development and implementation in Thailand.

BACKGROUND: In 1997, the Thai Ministry of Public Health began planning to implement a national health information system. Development of the nursing component of this system is an ongoing process. The first step in developing a nursing information system is to identify an essential Nursing Minimum Data Set (NMDS). AIM: To describe the development of a NMDS in Thailand and explore the challenges of implementing it, including the issue of the comparability with data sets in other countries, primarily the United States of America. METHODS: The process of developing a NMDS specific to Thailand is reviewed. Strategies for implementing this data set and important issues related to it are then discussed. FINDINGS: Although a preliminary Thai NMDS has been identified, challenges associated with its development and implementation within the Thai National health information system remain. CONCLUSION: A Thai NMDS and its elements have been identified. The International Classification of Nursing Practice was translated and is to be used to implement the data set describing the nursing care of patients and their families. However, many issues, such as the need for conceptual translation and increasing nurses' involvement in the process, still need to be addressed in order to implement the data set successfully.