Navigating personal recovery: multinomial logistic regression analysis of schizophrenia outcomes in community-dwelling individuals.

Background: Schizophrenia is a chronic mental disorder affecting individuals globally, emphasising the significance of personal recovery in mental healthcare. Understanding the recovery stages and the associated factors can provide essential insights for targeted interventions. Aims: This study aimed to discern the stages of personal recovery in Thai patients with schizophrenia and elucidate the associated factors with each stage. Methods: A multistage sampling technique was employed, selecting 231 patients with schizophrenia from mental health outpatient departments of general and psychiatric hospitals. Data collected from March to May 2023 included screening for psychotic symptoms using the Brief Psychiatric Rating Scale and six self-report questionnaires-Stage of Recovery Scale, Beck Cognitive Insight Scale, Brief Resilience Scale, Family Support, Therapeutic Relationship-Patients Version and Social Support Questionnaire-along with personal data sheets. Pearson correlation and multinomial logistic regression were performed. Results: The predominant personal recovery stage among participants was stage 3, 'living with disabilities', comprising 42.4% of the participants. Key factors contributing to personal recovery, explaining approximately 38.4% of the variance, included resilience, family support, therapeutic alliance, hospitalisations since onset and recovery-oriented nursing service utilisation. Logit equations for stages 3 and 4 are as follows: stage 3 (living with disability): logit=-4.44+0.74×resilience+0.07×therapeutic alliance+0.02×recovery-oriented nursing service utilisation; stage 4 (living beyond disability): logit=-11.57-0.05×hospitalisation since onset+1.96×resilience+0.11×family support+0.06×therapeutic alliance. Conclusion: The findings emphasise the significance of mental health nursing interventions. In conjunction with recovery-oriented nursing services, strengthening resilience, therapeutic alliances and family support may accelerate personal recovery and reduce hospitalisations among individuals with schizophrenia.

Evaluation of nursing process competencies, nursing quality, and patient safety using virtual simulation with debriefing: A quasi-experimental study.

Background: Investing in clinical education is important for adult urgent and emergency surgery and traumatology as it promotes registered nurses' competencies by providing professional development training to respond to urgent or emergency surgeries. Objective: To examine registered nurses' self-assessment of the effects of virtual video simulation with an immediate debriefing approach on nursing process competencies, nursing care quality, incomplete care, and patient safety in surgical units. Methods: This study used a quasi-experimental two-group pre- and post-test design. The study was conducted at two provincial hospitals in Cambodia. Participants included registered nurses employed in surgical units. The experimental group (n = 46) completed a virtual video simulation and immediate debriefing. The control group (n = 35) completed virtual training on the nursing process. Data were collected two months after a successful second-week follow-up using Competency of Nursing Process, Cambodian Nursing Care Quality, Care Left Undone, and Patient Safety scales. Wilcoxon signed-rank test and Mann-Whitney U test were used to evaluate the differences before and after the sessions. Generalized linear model was used to compare the differences between the two groups. Results: The results showed statistically significant improvements in the experimental group on competency, nursing care quality, patient safety, and reducing care left undone after the intervention. However, the control group revealed statistically insignificant differences. In addition, the experimental group provided positive feedback, such as experiencing a real patient scenario, developing critical-thinking, improving communication skills, and having an opportunity to ask questions. Conclusion: Our study showed that VVS and immediate debriefing have the potential to support in-service training of RNs from diverse backgrounds. Particularly, integrating virtual video simulation and immediate debriefing may to promote competency in the nursing process and improve care outcomes.

Strategies and challenges in addressing ethical issues in the hospital context: A phenomenological study of nurse team leaders.

Background: Nurse team leaders encounter considerable ethical challenges that necessitate using effective strategies to overcome them. However, there is a lack of research exploring the experiences of nurse team leaders in Indonesia who face ethical dilemmas in their professional duties. Objective: This study aimed to explore nurse team leaders' experiences regarding strategies and challenges in dealing with ethical problems in hospital settings in Indonesia. Methods: This qualitative study employed a hermeneutic phenomenology design. Online semi-structured interviews were conducted between November 2021 and February 2022 among 14 nurse team leaders selected using a snowball sampling from seven hospitals (three public and four private hospitals). Van Manen's approach was used for data analysis. Results: The strategies for overcoming ethical dilemmas included (i) seeking the facts, (ii) stepping back, (iii) considering support, and (iv) standing by patients. The challenges for the nurse team leaders in resolving ethical problems consisted of (i) seniority, (ii) trust issue, and (iii) lack of reflection and ethics training. Conclusion: Nurse team leaders recognize their specific roles in the midst of ethical challenges and seek strategies to deal with them. However, a negative working environment might impact ethical behavior and compromise the provision of quality care. Therefore, it is imperative for hospital management to take note of these findings and address issues related to seniority by providing regular ethics training and group reflection sessions to maintain nurses' ethical knowledge in hospital practice. Such interventions can support nurse team leaders in resolving ethical dilemmas and provide a conducive environment for ethical decision-making, ultimately improving patient outcomes.

The effect of the multimodal intervention on blood pressure in patients with first ischemic stroke: A randomized controlled trial.

Background: Multimodal intervention is currently promoted to control blood pressure in patients with first ischemic stroke. However, a dearth of studies has examined the influence of the intervention among patients with ischemic stroke, particularly in Thailand. Objective: This study aimed to determine the effect of the multimodal intervention on blood pressure in patients with first ischemic stroke. Methods: A randomized controlled trial was conducted. Sixty participants were randomly selected from two tertiary hospitals in Thailand. Eligible participants were randomly assigned into an experimental group (n = 30) and a control group (n = 30). The experimental group was provided with the multimodal intervention, while the control group was given the usual care. Data were collected from May 2021 to October 2021 at baseline (pre-test), 4th week, 8th week, and 12th week using the demographic data form and sphygmomanometer. The data were analyzed using the Chi-square test, t-test, and repeated measure analysis of variance (ANOVA). Results: The participants' blood pressures after receiving the multimodal intervention were lower than those before receiving the multimodal intervention. Both systolic and diastolic blood pressure were statistically significantly decreased over time, starting from baseline to the 8th week and 12th week (p <0.001). In addition, the participants' mean scores of systolic blood pressure (F (1, 58) = 4.059, p = 0.049) and diastolic blood pressure (F (1, 58) = 4.515, p = 0.038) were lower than the control group. Conclusion: The multimodal intervention is effective in controlling blood pressure. Therefore, nurses should educate patients with ischemic stroke to manage systolic and diastolic blood pressure, facilitate the patient's participation in the exercise program, and monitor the patients via telephone to continue blood pressure control. Trial Registry: Thai Clinical Trials Registry (TCTR) identifier number 20210318001.

Recovery-oriented nursing service for people with schizophrenia in the community: An integrative review.

Background: The recovery-oriented service concept has been recognized for its impact on mental health practices and services. As the largest group of mental healthcare providers, mental health nurses are well-positioned to deliver recovery-oriented services but face challenges due to role ambiguity and identity issues. Therefore, clarifying the role and principles of mental health nursing is essential. Objective: This study aimed to identify essential nursing practices for individuals with schizophrenia in recovery-oriented mental health services. Design: The study utilized a five-step integrative review approach, including problem identification, literature search definition, critical analysis of methodological quality, data analysis, and data presentation. Data Sources: Multiple databases, such as ScienceDirect and Scopus, as well as online libraries and journals/publishers, including Sage journals, APA PsyNet, SpringerLink, PsychiatryOnline, Taylor & Francis Online, and Wiley Online Library, were searched. The search spanned from the inception of the recovery-oriented services concept in 1993 to 2022. Review Methods: Content and thematic analysis were employed to analyze and synthesize the findings from the included studies. Results: Twenty-four articles met the inclusion criteria. Two themes were identified: 1) Direct nursing care, consisting of six sub-themes: therapeutic nurse-patient relationship (TNPR), psychoeducation (PE), coping skill training (CST), cognitive behavioral techniques (CBT), interventions to improve medication adherence (IMA), and social functioning (SF); and 2) Indirect nursing care. Conclusion: This study highlights the crucial role of nursing and nursing practices in recovery-oriented services. Mental health nurses prioritize person-centered care, therapeutic relationships, and collaboration with peer support workers to enhance treatment effectiveness. In addition, they focus on improving medication adherence, providing coping support, and promoting social capabilities, ultimately improving individuals' quality of life. Aligning actions with recovery-oriented principles, mental health nurses emphasize empowerment and holistic care. Further research in this area will enhance the healthcare system and better support individuals on their recovery journey.

Development and psychometric testing of a competency of nursing process questionnaire.

Objectives: This study aimed to develop and evaluate a competency of nursing process questionnaire (CNPQ) for registered nurses in Cambodia. Methods: Guided by the nursing process, an initial questionnaire was generated through focus group discussion, literature review, and the expert consultation. Finally, the validity and reliability of the questionnaire were validated through a questionnaire survey online of 260 registered nurses selected from Complimentary Package Activities 1, 2, 3, and national hospitals from January to February 2022 in five geographic areas of Cambodia. Results: The content validity index was 1.00. The Cronbach's α coefficient for the whole questionnaire was 0.963, and the range for the five dimensions was 0.963-0.964, which shows that the questions were consistent. The test-retest reliability was 0.769. The exploratory factor analysis led to a list of 24 items that were grouped into five dimensions: assessment, diagnosis, planning, implementation, and evaluation. The cumulative variance contribution rate was 70.08%. Conclusions: The CNPQ developed in this study showed good reliability and validity and can be used to assess the competency of registered nurses by themselves and help nursing managers to develop the relevant policies.

Nursing workforce characteristics and effect on life expectancy and under-five mortality in the ASEAN.

AIM: To assess the effects of the nursing workforce and advanced nursing practice on the outcomes of patients and life expectancy, including mortality rates of under-five children in Cambodia, and to develop policy recommendations to increase the influence of the nursing workforce. BACKGROUND: In low-middle-income nations, life expectancy and under-five mortality are important measures of public health. However, there is still a dearth of literature related to the nursing workforce in Southeast Asia. METHOD: The authors retrieved the data from the World Nursing Report produced by the World Health Organization 2020 for 10 member states. The transparent reporting of a multivariable prediction model for individual prognosis or diagnosis checklist has guided this study. The univariate linear regression model was applied to categorize the potential predictors for each outcome assessment. In addition, the Spearman rank correlation test was selected to assess the potential predictors, and a multivariate statistical analysis was carried out for each of the five outcomes. RESULTS: According to the study's findings, nurse density and advanced practice nursing improve both female and male life expectancy. The existence of advanced nursing roles is associated with decreased under-five mortality. CONCLUSIONS: There are great opportunities to improve the nursing workforce within Cambodia and other Association of Southeast Asian Nations member states to increase patient outcomes. Investment in nursing is essential for improved patient outcomes. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Health policy investments in these projects and future initiatives intended to advance nurse density, education, and practice are based on this study's results. Policy initiatives should focus on increasing density because nursing appears to impact life expectancy and other outcomes.

Effectiveness of an integrated smoking cessation service model on smoking status: A preliminary study.

INTRODUCTION: Smoking cessation has been considered a benefit for smokers. This study aimed to investigate the effect of an integrated smoking cessation service model (ISCSM) on enhancing cessation among smokers in a community setting. METHODS: The participants were 144 smokers allocated into two groups, experimental and control with 72 participants each. The ISCSM comprised two sessions: 1) smoking cessation service design and training smoking cessation capacity for the Community Health Workers (CHWs) by nurses; and 2) integrated smoking cessation service delivery. The CHWs offered brief advice for smoking cessation for smokers through home visits under supervision by nurses, then referred to proactive multisession intensive telephone counselling that was behavioral therapy with follow-up. In contrast, the control group received Thai therapy, which was mouthwash. The 7-day point prevalence abstinence (PPA) was assessed 30 days after the quit date. The probability of quitting between the experimental and control groups was calculated by the risk ratio (RR). Propensity score matching was performed to analyze the treatment effect after balancing the covariate factors. RESULTS: The probability of quitting smoking successfully among the participants in the experimental group was 7.5 times higher than the control group (χ2=46.18, RR=7.50, p<0.001). For the treatment effect tested by the PSM, the ISCSM efficiently impacted the 7-day PPA at 30 days among smokers in the experimental group after balancing the covariates (SS=0.281, MS=0.281, df=1, F=13.20, p<0.001). CONCLUSIONS: The findings of this study indicate that the ISCSM is an efficient, powerful intervention for enhancing smoking cessation.

Comparison of 12 and 24-hours shift impacts on ICU nursing care, efficiency, safety, and work-life quality.

BACKGROUND: Nursing care quality is a central concern of health policy, and nurses' shift schedules affect the quality of care and their work-life status internationally. A lack of reliable information on the differences between 24- and 12-h shifts on care quality, nursing care quality, patient safety, and adverse and missed events warranted investigation in Cambodia. AIM: We aimed to examine the impacts of 12-h shifts compared with 24-h shifts. The purpose was to find evidence to support the use of maximum 12-h shifts by registered nurses working in ICU contexts. METHOD: A convergent mixed-method approach was chosen to highlight the issues around the long hours of shift work. We designed a 12-week coaching course during the implementation of 12-h shifts and assigned 30 nurses each to an experimental group and a control group. Data from quantitative surveying of 58 participants were combined with focus group discussions of 20 participants to gather qualitative insights. Pre- and post-test analysis involved descriptive statistics and the Wilcoxon sign rank test for quantitative analysis and then merged with qualitative findings from content analysis. Reporting of this study was steered by the STROBE and COREQ guidelines for quantitative and qualitative findings, respectively. RESULTS: Quantitative results showed the increased quality of nursing work-life, nursing care quality, and patient satisfaction; decreased missed care and adverse events were significantly associated with the 12-h shift. Qualitative data supported nurses preferring 12-h rather than 24-h shift options. DISCUSSION AND CONCLUSIONS: Changing rosters to 12-h shifts in the intervention caused increases in the study variables' scores. Results indicate the benefits of 12-h shifts on the quality of nursing work-life, nursing care quality, missed care, adverse events, and patient safety. IMPLICATIONS FOR NURSING AND NURSING POLICY: We found that 24-h shifts had deleterious impacts on care quality and safety and nurse satisfaction with work. Health and nursing policymakers are urged to provide resources and strategize to implement 12 h shifts as soon as possible since the current 24-h shifts of nurses affect the patient quality of care and their health and safety and that of the nurses.

Nursing Development in Indonesia: Colonialism, After Independence and Nursing act.

INTRODUCTION: Stereotyping of nurses still occurs nowadays in Indonesia. Society and healthcare think nursing is a doctor helper service. The public image of a nurse as a doctor's helper is hard to erase. Thus, the nursing development in Indonesia needs to be explored in describing the stereotyping and the nursing conditions in the current situation. METHODS: The study used a narrative review with 45 sources analyzed and extracted. RESULTS: Nursing education has been developed since colonialism. The first time the Netherland Indies built the hospital and they used Babu or a helper as a nurse. The result showed it had a negative impact, which showed as they started to train nurses. They trained male nurses to be Mantri nurses as hulpgeneesheeren (ancillary doctors). After independence, the project HOPE influenced the development of nursing in Indonesia. Indonesian nurses focused on technical aspects and added the nursing process to the education curricula in 1986. However, nurses' practice culture did not change for a long time because of a lack of research and literature being evaluated during 1990-2010. Indonesia nursing started to increase the education, practice, and research afterward, with specifically the declaration of the Indonesian Nursing Act. It brought nurses into the professionalism of healthcare which the Indonesian government recognized. Then, nurses have faced new problems, including practice and education gaps. CONCLUSION: The development of nurses will increase autonomy and dignity. Increasing education curricula, practice competency, and research impact will change the perspective of society with the support of recognition and education from the nursing organization. In addition, the nursing organization has an essential role in nursing development in each country.

Struggling to live a new normal life among Chinese women after losing an only child: A qualitative study.

OBJECTIVES: Losing an only child is a life-altering event that destroys Chinese women's lives and health in several dimensions. However, there is no unified theory exists to guide nursing practice. This study aimed to discover the substantive theory of how Chinese women live with the loss of their only child. METHODS: This qualitative study used the grounded theory method. Purposive sampling, snowball sampling, and theoretical sampling were used to recruit participants. Saturated data from the in-depth interview, observation, and field notes with 13 Chinese women who have lost an only child in Southwest China were analyzed using the constant comparative method concurrently supplemented by the ATLAS.ti program, memo writing, and diagramming. FINDINGS: Struggling to live a new normal life among Chinese women after losing an only child emerged as the substantive theory. It consists of three phases: living in agony, coming to terms, being alive in a new way. Receiving support motivated them to deal with such a loss. However, it brought them back to the previous phase(s) whenever they encountered adverse triggering situations. Therefore, they moved back and forth between these phases. The findings also illustrated that this process was profoundly affected by Chinese culture and personal beliefs. CONCLUSIONS: This substantive theory may guide nursing practice based on understanding the living process by working through the three phases. It would help develop a professional care plan recognizing individual diversity and incorporating socio-cultural and religious knowledge to effectively support women to deal with the loss of an only child.

"It is really so exhausting": Exploring intensive care nurses' perceptions of 24-hour long shifts.

AIM AND OBJECTIVES: To explore the perceptions and experiences of Cambodian ICU registered nurses regarding their working 24-hr shifts. BACKGROUND: In Europe and the USA, nurses are moving to a 12-hr shift, and numerous studies have revealed the positive and negative effects of these. However, lesser known is the impact of 24-hr nursing shifts on care quality, and health and safety. In Cambodia, 100% of nurses are rostered for these in their shift patterns, but until this study no research had been conducted on such shifts. DESIGN: A qualitative descriptive study. METHOD: Three focus group discussions were conducted with 30 registered nurses in July 2019, ten in each group, from three intensive care units of three hospitals in Cambodia. Data saturation was obtained. Data were analysed using content analysis, and the COREQ was applied for reporting this study. FINDINGS: The ICU nurses' perspectives revealed significant and unacceptable effects of working shifts of ~25-hr length, taking into account staff handover. Two major themes arose: It is so exhausting and Compromised hospital care. Alarmingly, participants worked on average 72 hr per week, were exhausted, and nursed between 6 and 10 critically ill patients per shift. CONCLUSION: To our knowledge this is the first study on nurses working 24-hr shifts, revealing unacceptable, high risks for the health and safety of nurses and patients, with nursing activities left undone, and a lack of quality care. RELEVANCE TO CLINICAL PRACTICE: Improving nurse and patient health and safety, and quality of care requires hospital leaders to work with government and nursing organisations to develop better shift strategies. Resources need to be provided so that: nurses can work a maximum 12-hr shifts; the ratio of nurses to patients is improved; and nurses can have decent break times. This has major implications, for not only practice, but also management, administration, budgets and education.

Registered nurses' perceptions of factors influencing nursing care quality: A structural equation modeling study.

Cambodia, like many other countries, is working to raise nursing care standards, including improving nurse work environments and nurse education. This descriptive, cross-sectional study examined the factors influencing nursing care quality among 375 registered nurses from 12 government hospitals in Cambodia. The conceptual framework was modified from the Nurse Work Environment, Nurse Staffing, and Outcome Model, and five questionnaires were used. The hypothesized model fitted the empirical data and explained 12% of the variance in nursing care quality. Structural equation modeling revealed that nurse work satisfaction negatively affected nursing care quality, while the nurse practice environment and burnout had no effect. Nurse staffing had a positive direct effect on nurse work satisfaction, while nurse work satisfaction did not directly affect burnout. The results indicate that the highest impacting factors influencing nursing care quality were nurse work satisfaction and the indirect effect of nurse staffing on nursing care quality. Therefore, leaders and policymakers in government, health systems, and nursing across the country need to consider these results to enhance nursing care quality.

Relationship between personal, maternal, and familial factors with mental health problems in school-aged children in Aceh province, Indonesia.

Recently, mental health problems (MHP) in school-aged children have become a global phenomenon. Yet, the number of children affected remains unclear in Indonesia, and the effects of mental health problems are of concern. The purpose of this study was to investigate the prevalence of MHP in school-aged children and its relationship to personal, maternal, and familial factors in Aceh province, Indonesia. Participants were 143 school-aged children with MHP and their mothers. They completed the Strengths and Difficulties Questionnaire, Social Competence Questionnaire, Brief Family Relationship Scale, Parental Stress Scale, Parent's Report Questionnaire, and Indonesian Version of the Beck Depression Inventory-II. Mainly, children were rated to have emotional symptoms by their mothers (37.8%). Factors such as academic competence, family relationships, and maternal parenting stress are related to MHP. Given the high prevalence of school-aged children that have emotional symptoms, child psychiatric mental health nurses should give special attention to assist them during their school years. Moreover, nurses should aim to improve family relationships and reduce maternal parenting stress.

An evaluation of usage patterns, effectiveness and cost of the national smoking cessation quitline in Thailand.

BACKGROUND: Telephone-based smoking cessation services (quitlines) offering counselling for smoking cessation without nicotine replacement therapy may be important components of tobacco control efforts in low and middle income countries, but evaluations in such resource-limited settings are lacking. We aimed to evaluate the usage, effectiveness and cost of the Thailand National Quitline (TNQ). METHODS: Analysis of retrospective data for callers to the TNQ between 2009 and 2012 and a follow-up survey in 1161 randomly selected callers. RESULTS: Between 2009 and 2012 there were 116 862 callers to the TNQ; 36 927 received counselling and at least one follow-up call. Compared with smokers in the general population, callers were younger, more highly educated, more likely to be students, and more likely to smoke cigarettes rather than roll-your-own tobacco. Continuous abstinence rates at 1, 3 and 6 months after calling were 49.9%, 38.0% and 33.1%. The predicted rate at 12 months was 19.54% (95% CI 14.55 to 26.24). Average cost per completed counselling was $31 and the average cost per quitter was $253. Assuming all (and two-thirds) TNQ callers who succeed in quitting would have failed to quit without the assistance of the TNQ, cumulative life years saved (LYS) for the 4-year period were 57 238 (36 733) giving a cost per LYS of $32 (50) (about 7.93 LYS per quitter) and an estimated return on investment over 4 years of 9.01 (5.78). CONCLUSIONS: A low-cost quitline without nicotine replacement therapy is a promising model for smoking cessation services and likely to offer good value for money in Thailand.

Parenting: what are the critical attributes?

OBJECTIVE: Identifying the critical attributes of the parenting concept. MATERIAL AND METHOD: The parenting attributes are the process, activity, and interaction regarding to rearing and educating a child, which is undertaken by parent or parental figure. Those aim at developing a child's growth, development, and well-being. CONCLUSION: The specific parenting attributes can be applied to practice, education, and research in the area of pediatric, family and community health care.

Creating a new whole: helping families of people with schizophrenia.

Collaboration between psychiatric nurses and family members is considered an important part of caring for people with schizophrenia either in hospital or at home after discharge. Studies have demonstrated family involvement in terms of caring for patients who have been discharged early from hospital. An extensive review of the literature and related studies regarding nursing interventions have been done, but there have been limited studies on what psychiatric nurses actually do when working with the families of people with schizophrenia in Thailand. The purpose of the present study was to explore relationships between Thai psychiatric nurses and families in terms of administering nursing care to patients. Grounded theory methodology was used to examine the processes through which psychiatric nurses work with families. Data were collected by 16 psychiatric nurses through in-depth interviews, observations, and field notes. Data were analyzed using constant and comparative methods of other studies, which revealed the process by which nurses can create a new whole between families, patients, and Thai psychiatric nurses. The process consists of four major stages: establishing trust, strengthening connections, promoting readiness to care, and supporting family.

Thai Family Health Routines: scale development and psychometric testing.

The aims of the study were to develop and test the psychometric properties of the Thai Family Health Routines (TFHR) scale, a 70-item self-report questionnaire used to measure the health of Thai families through their routine behaviors in daily life. Development of the TFHR was based on the structural domains of Denham's Family Health Model. The TFHR scale was initially composed of 85 items and tested on 1,040 families living in the central region of Thailand. The confirmatory factor analysis, with an acceptable factor structure model, yielded 70 items aligned with six factors: self-care, safety and prevention, mental health behavior, family care, family caregiving, and illness care routines. The preliminary psychometric properties demonstrated that the TFHR scale had satisfactory internal consistency, criterion validity, and construct validity. The test results suggested that the TFHR scale has potential benefits for family and community nurses to assess Thai family health for both research and clinical purposes.

Remolding child: process of nursing practice for sexually abused children.

OBJECTIVE: To explore and understand the nursing practice processes of psychiatric nurses for school-aged sexually abused children admitted to psychiatric wards. MATERIAL AND METHOD: Grounded theory approach. Twelve psychiatric nurses, aged between 35-59 years old, experienced with sexually abused child patients, participated in the present study Data was collected by using in-depth interview that were tape-recorded and transcribed verbatim, line by line. It was then analyzed using grounded theory method. RESULTS: "Remolding child" was the basic social process by which psychiatric nurses provided nursing care for school-aged sexually abused children admitted to psychiatric wards. It was composed of three stages happening continuously in sequence. Each stage consisted of sub-stages that had no sequence in their occurrence and were simultaneous and reciprocal. The first stage started with establishing trust, arranging effective communication, and providing physical care. The second stage was fostering socialization, building will-power; and arranging a safe and supportive environment. The final stage was assisting living in society. Two other important characteristics of this remolding child process were working as a team and self-development. CONCLUSION: The substantive theory derived from the study recommends new understanding in the holistic nursing practice process for school-aged sexually abused children admitted to psychiatric wards in Thailand. It can be used as a guideline to develop interventions to prevent residual effects of chronic psychiatric problems occurring in later years.

Causal model of health: health-related quality of life in people living with HIV/AIDS in the northern region of Thailand.

The purpose of this study was to examine the causal relationships between age, antiretroviral treatment, social support, symptom experience, self-care strategies, and health-related quality of life (HRQOL). The subjects were 422 people living with HIV/AIDS. The data were collected via the Personal Resource Questionnaire 85 part 2, Symptom Experience Questionnaire, Self-care Strategies Questionnaire, and HRQOL Questionnaire. The results revealed that symptom experience had a significant negative direct effect on the HRQOL. Age, social support, antiretroviral treatment, and self-care strategies had a significant positive direct effect on the HRQOL. Moreover, social support and antiretroviral treatment had an indirect effect on the HRQOL via self-care strategies. The findings indicated that the health-care team should promote social support, both in the family and the community, including antiretroviral treatment, for enhanced HRQOL in people living with HIV/AIDS in the future.