Effectiveness of a phone-based support program on self-care self-efficacy, psychological distress, and quality of life among women newly diagnosed with breast cancer: A randomized controlled trial.

PURPOSE: This study aimed to determine the effectiveness of a Phone-Based Support Program (PBSP) for newly diagnosed women with breast cancer. METHODS: A two-group repeated measures randomized controlled trial was designed. Participants included 94 patients aged 18-60 years who were newly diagnosed with breast cancer and undergoing chemotherapy in a tertiary hospital in China. They were randomly assigned to the intervention and the control groups. Participants in the intervention group were enrolled in a four-session PBSP, consisting of four interactive sections: learning, discussion, ask-the-expert, and personal stories, plus the routine care. Outcomes included patients' self-care self-efficacy, psychological distress (including symptom distress, anxiety, and depression), and quality of life. These were assessed at three time points: pre-intervention (T1), post-intervention (T2), and follow-up (T3) by using the self-care self-efficacy scale, the M.D. Anderson Symptom Inventory, the hospital anxiety and depression scale, and the global health status scale. RESULTS: After completion of the intervention, participants in the intervention group had significantly (p < .001) higher self-care self-efficacy (T2: Mdiff = 11.49, T3: Mdiff = 22.33), better quality of life (T2: Mdiff = 8.18, T3: Mdiff = 17.19), lower symptom distress (T2: Mdiff = -26.68, T3: Mdiff = -54.76), less anxiety (T2: Mdiff = -2.52, T3: Mdiff = -5.11), and less depression (T2: Mdiff = -3.61, T3: Mdiff = -6.71) than those in the control group. CONCLUSION: These findings indicate that the PBSP is effective. Healthcare professionals, especially nurses, could utilize it to enhance self-care self-efficacy and quality of life, as well as decrease psychological distress among women newly diagnosed breast cancer. REGISTRATION: The Thai Clinical Trial Registry #TCTR20230321010.

Effects of the mindfulness program for male substance abusers in Thailand on stress, deliberate self-harm, and drug abstinence intention: A repeated-measure design.

Background: Substance abuse is prevalent among males, and mindfulness could serve as a means of helping individuals suffering from the adverse effects of substance abuse find relief. Objective: This study employed a one-group repeated-measure design and aimed to evaluate the effects of the mindfulness program on stress, deliberate self-harm, and drug abstinence intention among male substance abusers. Methods: The mindfulness program was implemented for Thai males with a history of narcotic drug use. Five participants were recruited from a rehabilitation institute in Thailand using convenience sampling. The program consisted of eight sessions over four weeks. The study outcomes were measured at three time points: pre-intervention (Time 1, Week 1), post-intervention (Time 2, Week 4), and follow-up (Time 3, Week 6). Research instruments included the Deliberate Self-Harm Inventory, the Perceived Stress Scale, and the Drug Abstinence Intention Questionnaire, all of which had Cronbach's alpha values above 0.80. Data analysis was carried out using the Friedman test and Dunn-Bonferroni post-hoc test. Results: The eight-session program was implemented as intended, with a retention rate of 100%. The mean scores of deliberate self-harm and drug abstinence intention were significantly different across the three time points (χ2 = 10.000 and χ2 = 9.579, p <0.01, respectively). After conducting pairwise comparisons, the mean scores of deliberate self-harm at Time 2 and Time 3 were significantly lower than those at Time 1. Additionally, the mean scores of drug abstinence intention at Time 2 and Time 3 were higher than those at Time 1. However, the mean score of stress did not have a significant difference. Conclusion: This program was both acceptable and effective in reducing deliberate self-harm and improving drug abstinence intention. These findings suggest that nurses and healthcare teams involved in caring for individuals with substance abuse issues could utilize this intervention alongside other therapies or hospital treatments. Consequently, relapse prevention among substance abusers could be achieved.Thai Clinical Trials Registry Number: TCTR20230404001.

A Pilot Study of a Family Management Program for Parents of Children with Acute Lymphoblastic Leukemia.

OBJECTIVES: The aim of this completed pilot study was to evaluate the feasibility of implementing a family management program (FMP) for parents of children with acute lymphoblastic leukemia (ALL). DATA SOURCES: A convenience sample of 11 parents of preschool-aged children with ALL were recruited from an ambulatory chemotherapy-care clinic at a tertiary hospital in Thailand. Participants received three FMP sessions over 3 weeks. The FMP is based on two established family programs (ie, FMP-style framework and building on family strengths) and reviewed literature. The following measures were used to evaluate parents' responses at baseline, postintervention, and follow-up: Family Management Measure, Beach-Center Family Quality-of-Life Scale, and Pediatric Quality of Life Inventory. Data were analyzed using one-way repeated-measures analysis of variance. CONCLUSION: The study results provide promising evidence that the FMP is feasible and improves family management and quality of life for parents of enrolled children with ALL. IMPLICATIONS FOR NURSING PRACTICE: Educating pediatric oncology nurses and other healthcare professionals to replicate the FMP may help to provide better family management, and child quality of life support to future parents and other family members of young children diagnosed with ALL. This support should focus on educating parents about the potential effects of caring for a child with ALL on the family and fostering positive relationships within the family and offering guidance on effective family communications and decision-making processes.

Effects of a Phone-Based Support Program for Women With Breast Cancer Undergoing Chemotherapy: A Pilot Study.

Introduction: The increasing number of women with breast cancer undergoing chemotherapy may result in long-lasting, adverse physical side effects and reduced quality of life. Objective: This study aimed to develop and assess the feasibility and preliminary effects of the Phone-Based Support Program for women with breast cancer undergoing chemotherapy. The primary outcome was self-care self-efficacy; secondary outcomes were symptom distress and quality of life. Methods: This pilot study was conducted at a tertiary hospital in Jiangsu province, China, from February to March 2023. The Phone-Based Support Program was delivered to 20 participants through the smartphone application WeChat, consisting of learning, discussion, ask-the-expert, and personal stories components. Outcome measures were assessed at three time points: preintervention, postintervention, and follow-up. Results: The Phone-Based Support Program was feasible and could improve self-care self-efficacy, decrease symptom distress, and promote quality of life. The program was well-accepted, and participants engaged actively in the online discussion and sought expert advice. Conclusions: The Phone-Based Support Program showed feasibility and effectiveness in improving self-care self-efficacy, reducing symptom distress, and enhancing quality of life.

Integrative Stress Reduction Program for Family Caregivers of Persons With Advanced Dementia: A Randomized-Controlled Trial.

BACKGROUND: Older adults with advanced dementia require significant care, leading to high stress levels in caregivers. OBJECTIVES: The current study aimed to evaluate the effects of an Integrative Stress Reduction Program on Thai caregiver's outcomes of stress, sleep quality, and caregiver-assessed neuropsychiatric symptoms of persons with dementia. METHODS: A single-blind randomized-controlled trial was conducted. A sample of family caregivers of people with dementia was recruited from memory clinics at outpatient community health centers in Thailand and randomly assigned to the experimental and control groups. Participants in the experimental group were enrolled in 5 intervention sessions over 4 weeks, while the control group received usual care. Outcome variables were collected at baseline, 4 weeks postintervention, and 8 weeks of follow-up. RESULTS: Compared with the control group, caregivers in the experimental group (n = 27) had significantly decreased stress (p < .01) and better sleep quality (p < .01), and caregivers reported that their family members with dementia (n = 27) had decreased neuropsychiatric symptoms (p < .01) after the intervention (week 4) and at the 8-week follow-up. CONCLUSIONS: The Integrative Stress Reduction Program improved outcomes for caregivers and decreased neuropsychiatric symptoms in people with dementia.

Effectiveness of neurobic exercise program on memory performance in community-dwelling older adults with mild cognitive impairment: A randomized controlled crossover trial.

Background: Mild cognitive impairment (MCI) is an early stage of cognitive decline in individuals who are still able to perform their activities of daily living. They are at increased risk of developing dementia. Improving and maintaining cognitive functions are essential goals for older people with MCI to delay or prevent the transition to dementia. Objective: This study investigated the effect of the neurobic exercise program on memory performance among community-dwelling older adults with MCI. Methods: A single-blind, randomized, controlled, two-period crossover design was used. Thirty-two older adults who met the study criteria were randomly assigned to one of two sequence groups, A (n =16) and B (n = 16). Group A received three weeks of neurobic exercise, followed by a three-week washout period, and then three weeks of the traditional brain exercise program. Group B received the treatments in the reverse order but otherwise in a similar manner. Two aspects of memory performance were evaluated: subjective memory and objective memory. Blinded evaluators measured the outcomes four times at baseline, post-intervention (week 3), follow-up stage (week 7), and the end of the study (week 9). Descriptive statistics, independent t-tests, and repeated measures ANOVA were employed for data analyses. Results: For subjective memory, rmANOVA revealed a significant difference of within-subject (F1.437, 43.113 = 9.324, p <0.05) and interaction effect (time*group) (F1.437, 43.113 = 12.313, p <0.05) and also showed significant differences of within-subject (F1.794,53.811 = 28.931, p < .05) and interaction effect (time*group) (F1.794, 53.811 = 31.190, p <0.05) for objective memory. The study results revealed that the participants in both groups had significantly lower mean scores on the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), indicating better or improved subjective memory. They also had significantly higher mean scores on the Common Objects Memory Test (COMT) after receiving the neurobic exercise program, indicating improvement in cognitive performance. Conclusion: The neurobic exercise intervention could improve subjective and objective memory among community-dwelling older adults with MCI more than those who received the traditional brain exercise program. Therefore, the neurobic exercise program can be used by nurses and multidisciplinary teams to enhance memory performance among older adults with MCI. Trial registration: Thai Clinical Trials Registry (TCTR) 20210326003.

Effectiveness of a School-Based Pregnancy Prevention Intervention for Female Teenagers and Their Boyfriends: A Randomized Controlled Trial.

PURPOSE: This study examined the effectiveness of a school-based pregnancy prevention intervention. METHODS: 73 female and male teenagers were recruited from an urban secondary school and randomly assigned to the intervention and control groups. The females were aged 13-15 years, and the boyfriends were aged 13-18 years. The intervention was implemented in six sessions over six weeks. Sessions 1-4 were conducted at the school, and sessions 5-6 were delivered via a smartphone messaging application. The outcomes included sexual health literacy, pregnancy prevention behaviors, and sexual risk behaviors. They were measured three times: at baseline (week 0, T1), immediately post-intervention (week 6, T2), and follow-up (week 10, T3). Two-way mixed repeated measure ANOVA was used to determine the differences of the outcomes. RESULTS: After completion of the intervention, participants in the intervention group had significantly higher sexual health literacy both at T2 and T3 and better pregnancy prevention behavior. They had lower sexual risk behaviors at T3 than the control group. DISCUSSION: The results indicate that the school-based pregnancy prevention intervention is effective. It improved the outcomes in female teenagers and their boyfriends at six weeks and 10 weeks post-intervention.

An Integrative Stress Reduction Program for Family Caregivers of Persons With Advanced Dementia: A Pilot Study.

The current study sought to pilot test and examine the effects of an integrative stress reduction program (ISRP) on caregiver stress and sleep quality and behavioral and psychological symptoms of dementia (BPSD) of care recipients. Family caregivers (N = 12) of persons with moderate to severe dementia were recruited from memory clinics in Thailand. Twelve caregivers participated in five educational sessions on dementia care, stress, and BPSD management over 4 weeks. The Relative Stress Scale and Pittsburgh Sleep Quality Index were used to measure caregiver outcomes. The Neuropsychiatric Inventory was used to measure BPSD of care recipients. Outcome variables were collected at baseline, postintervention, and follow up. Data were analyzed using one-way repeated measures analysis of variance. Participants reported statistically decreased stress, improved sleep quality, and decreased BPSD among care recipients postintervention and at follow up (all p < 0.001). The ISRP was feasible and shows promise in reducing stress and improving sleep quality in caregivers and lessening BPSD in care recipients. [Journal of Gerontological Nursing, 48(10), 26-32.].

Relationships between caregiving stress and sleep quality among family caregivers of older adults with dementia in Thailand.

Background: Providing care for older people with memory loss is a significantly stressful task. The caregiver experienced deterioration of the care recipients regarding their cognitive and functioning abilities, often resulting in the caregiver's feelings of distress, stress, and unsatisfactory sleep quality. Objective: This cross-sectional study aimed to examine the relationships between caregiving stress and sleep quality among family caregivers of older adults with dementia. Methods: A simple random sampling method was used to recruit participants of seventy-two family caregivers who received care from a community long-term care facility at two primary hospitals in Thailand. Research instruments included the Relative Stress Scale and the Pittsburgh Sleep Quality Index. The data were analyzed using descriptive statistics, means, standard deviation, and simple linear regression. Results: The study revealed that caregivers had a high level of caregiving stress (M = 49.68, SD = 4.71), and poor sleep quality (M = 12.44, SD = 3.60). Caregiving stress was positively correlated with poor sleep quality (r = 0.54, p < 0.01) with a large relationship. Conclusion: Thai family caregivers of people with dementia reported high stress level and had poor sleep quality. The findings suggest that nurses in primary health care should focus on assessing stress levels and sleep quality as well as improving sleep quality for family caregivers by developing interventions.

Deliberate self-harm among adolescents: A structural equation modelling analysis.

Deliberate self-harm is an intentional behaviour involving direct destruction of body tissues that causes non-fatal physical trauma to the extent that bleeding or bruising occurs without conscious suicidal intent. Adolescents' self-harm is an important issue in mental health work due to its high prevalence in Thailand. This study aims to test a causal model of deliberate self-harm and identify how sex, family relationship, school connectedness, stress, resilience, and self-control influenced deliberate self-harm behaviour in Thai adolescents. A model-testing, cross-sectional study was conducted to test a causal model of deliberate self-harm in Thai adolescents. Multi-stage random sampling was used to recruit 360 adolescents. Adolescents completed six self-report instruments: the family relationship questionnaire, student-school connectedness scale, resilience factors scale for Thai adolescents, self-control questionnaire, Perceived Stress Scale-10 (Thai version), and Deliberate Self-Harm Inventory. Internal consistencies ranged from 0.81 to 0.89. Data were analysed by using descriptive statistics and structural equation modelling. The findings found sex, resilience, stress, and school connectedness had direct effects on deliberate self-harm (ß = -0.139, ß = -0.266, ß = 0.163, and ß = -0.671, respectively). Resilience and stress also mediated the links between sex (female), family relationship, school connectedness, and deliberate self-harm. The variables accounted for 65.2% of the variance in the prediction of deliberate self-harm behaviour in Thai adolescents. These findings suggest the causal model of deliberate self-harm fit the empirical data. Interventions to reduce stress and strengthen school connectedness, family relationship, and resilience among Thai adolescents should be implemented, particularly for boys, to prevent deliberate self-harm.

Simulation With Standardized Patients Designed as Interventions to Develop Nursing Students' Cultural Competence: A Systematic Review.

INTRODUCTION: Nursing education is challenged to improve students' cultural competence. Clinical simulation using standardized patients (SPs) may be an effective learning intervention. This systematic review was to identify current evidence on the use of simulations with SPs as learning interventions that have been developed to improve nursing students' cultural competence and on the effectiveness of those interventions. METHOD: Using published guidelines, we conducted a systematic review of studies on simulation using SPs to teach cultural competence. RESULTS: Ten studies met the inclusion criteria. Outcomes of simulation with SPs increased levels of nursing students' cultural competence. Simulations with SPs were used in theoretical and practicum courses of nursing students' cultural competence, often combined with case-study and video presentations. Other forms of cultural education also improved cultural competence. DISCUSSION: This study supports that a combination of lecture, case-based learning, and simulation with SPs can increase nursing students' cultural competence.

A self-management support intervention on knee functional status and health-related quality of life among middle-age women: A randomized controlled trial.

AIM: To determine the effectiveness of a self-management support intervention on knee functional status and health-related quality of life among middle-age women with knee osteoarthritis. DESIGN: Randomized controlled trial. METHODS: The participants were 40 middle-aged women who had been clinically diagnosed with knee osteoarthritis for more than 3 months and randomly assigned into intervention and control groups equally. After IRB approval code 02-05-2562 was obtained, data collection was carried out from July - November 2019 at the Outpatient Department of Orthorpedics, Thasala Hospital, Thailand. The modified Thai version of the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and the Short Form Survey (SF-36) were used to measure knee functional status and health-related quality of life at baseline (T1), immediately after completing the intervention (T2) and 4 weeks after the intervention (T3). The participants in the intervention group received a self-management support program developed by the researcher based on the Individual and Family Self-Management Theory and a review of related literature plus routine care. The implementation consisted of eight sessions over 4 weeks. The control group received only routine care from the hospital. Two-way repeated measure ANOVAs were used to analyze the data. RESULTS: The findings revealed that the participants in the intervention group had better knee functional status and HRQOL than those in the control group at follow-up. Additionally, in the intervention group, both knee functional status and HRQOL significantly improved from pre- to post-intervention and follow-up. CONCLUSIONS: The findings indicate that this self-management support intervention is effective. IMPACT: For women, the prevalence rate of knee OA rises dramatically post-menopause due to lower oestrogen levels. Policy makers and healthcare providers could obtain and promote this intervention as part of standard practice. This should lead to improved knee functional status and HRQOL among middle-aged women. Thai Trial Registration number: TCTR20191223003. on February 5th, 2019.

Prevalence of depression and its associated factors among persons with chronic medical illness in Bhutan.

This study aimed to determine the prevalence of depression and factors associated with the depression among persons with chronic medical illness. A total of 120 adult patients visited at a medicine OPD hospital in Bhutan were recruited and asked to complete self-report questionnaires. Descriptive statistics and binary logistic regression were employed to analyze the data. Results revealed 41% of the prevalence rate of depression in persons with chronic medical illness in Bhutan. Patients' age ≤ 40 years, being a female, and those with low level of physical activity and low social support were significantly associated with depression. Nurses and related health care providers could utilize these findings to develop an intervention to prevent depression in persons with medical chronic illness by promoting social support and physical activity focusing on females, and young adults.

Maternal sensitivity and attachment security in Thailand: cross-cultural validation of Western measures.

The purpose of this study was to examine the psychometric properties of Thai versions of the Maternal Behavior Q-Sort (MBQS), Caldwell's HOME, and the Attachment Q-set (AQS). A sample of 110 Thai mother-infant dyads were studied. The Content Validity Index (CVIs) of the Thai MBQS, HOME and AQS were between 91% and 99%. Internal consistency of the HOME was .71. Interobserver reliability of the MBQS, HOME, and AQS were .95, .87, and .87, respectively. Convergent validity was supported by finding a positive correlation between the MBQS and the HOME (r = .29, p < .001). A positive correlation of .45 (p < .001) between the scores of the MBQS and the AQS indicated concurrent validity of these scales. Study findings indicate the Thai MBQS, HOME, and AQS are reliable and valid in this Thai sample and suggest that the Thai versions reflect concepts similar to those in the original English versions.