Nursing perspectives on women, health and work in the socio-cultural context of poor communities in Northeast Thailand.

Women from poor communities in Northeast Thailand can be considered as a disadvantaged group who have struggled against several problems in their daily living and who have worked hard to sustain their lives through unskilled labour. In such a strong Buddhist culture these women have vital roles within the household and in earning money. The combination of which it is suggested, has had an impact on their physical and psychological health. In Thailand, there is limited data available about such women's health, life experience and work. A better understanding of their situation is required in order to inform and redesign effective health intervention programmes to promote the health and well-being of women from these communities. An holistic nursing perspective was used to inform the design of this research. Only by understanding the context, the living experiences and the understandings of the women themselves is it possible to construct effective health intervention programmes. Thus the purpose of the study was to understand women's health and work in the sociocultural context of poverty in Northeast Thailand. A combination of quantitative and qualitative techniques were used in the overall data collection process. The study was conducted in two distinct phases. Phase 1 provided an overall of baseline account of the socio-cultural context of six communities and the health of a sample of women who live therein. It involved focus group interviews (N=102) with residents and a survey (N=209) of households. Phase 2 was a more focused case study (N=49) of women's life experiences, their health and work in one selected community. Phase 1 of the study found that the majority of women had a substantial role in household economics. Coping strategies that women frequently used were `Tam Chai' (accept and not think too much about it). The majority of women in the communities were primary breadwinners and were self-employed as vendors. Regarding women's health, the findings showed a high level of musculoskeletal and psychological complaints. The study showed that nearly all of the women were optimists and felt happy. In the second phase of the study. Buddhism and the Thai way of living emerged as the major factors which influenced women's views on health and well being. The data illustrated that women struggled to survive in the community and that they had to work hard to make ends meet. Women used networks in the community as resources for coping. They saw `health in terms of being strong enough to work and earn a living'. Health per se is the lowest priority in their life. To work and earn money to support their families is the highest. Indeed, the Buddhist teaching of `self-reliance' has a great impact on them. The conclusions reached suggest that nursing interventions and health campaigns could be used to promote and maintain the optimum health of women and their families. Finally recommendations are made with regard to further research; development of services; development of nurse-education and health promotion for women in low-income communities

Exploring the Quality of Life of People in North Eastern and Southern Thailand.

The assumption that development brings not only material prosperity but also a better overall quality of life lies at the heart of the development project. Against this, critics assert that development can undermine social cohesion and threaten cultural integrity. Rarely, however, is the impact of development on wellbeing rigourously analysed using empirical data. This is what the Wellbeing in Developing Countries Group at the University of Bath aims to do drawing on fieldwork carried out in four developing countries, which addresses the themes of resources, needs, agency and structure, and subjective Quality of life (QoL). The first phase of the QoL research in Thailand aimed to explore the categories and components of quality of life for people from different backgrounds and locations with the aim of developing methods for QoL assessment in the third phase of the WeD QoL research. The study presents data obtained from rural and peri-urban sites in Southern and Northeastern Thailand (two villages in Songkhla and three in Khon Kaen, Mukdaharn, and Roi-et). Participants were divided into six groups by gender and age, and were divided again by religion (Buddhist and Muslim) and wealth status in the South. Data collection was conducted between October and December 2004 using focus group discussions, semi-structured interviews, and the Person Generated Index. Content analysis was used for data analysis. The use of a qualitative approach enabled the gathering of empirical data that reflects the sources of difficulty and happiness in the lives of participants. Respondents identified 26 aspects to their quality of life, including family relations, health and longevity, income and having money, jobs, housing, education, debt, and so on. The results reveal clear similarities and differences in the role of traditions, religious beliefs, and values in the lives of people living in remote rural or peri-urban areas in Northeastern and Southern Thailand. These results, together with the findings from Peru, Ethiopia, and Bangladesh, will inform the rest of the WeD research and be used to develop measures to assess the quality of life of people living in developing countries

Identifying diabetes risks among Indonesians: A cross-sectional study in a community setting

Background: There is an upward surge in diabetes patients worldwide, including in Indonesia, annually. Diabetes can lead to new diseases that burden patients’ lives further. Nurses can reduce this problem by identifying people at risk of developing diabetes and educating them on how to prevent diabetes. Objective: The study aimed to determine the risk of diabetes in the Indonesian population. Methods: The descriptive research involved a sample of 1216 Indonesians living in North Sumatra Province. Participants were nondiabetic individuals selected using the convenience method from May to October 2020. This study utilized the Indonesian version of the Finnish Diabetes Risk Score (FINDRISC) tool and employed various statistical analyses, including frequencies, percentages, chi-square test, and Fisher’s exact test. Results: Of the total samples, 372 were males (30.6%), and 844 were females (69.4%). The risk of developing diabetes was classified as low (57.1%), slightly elevated (36.4%), moderate (5.3%), high (1.0%), and very high (0.2%). Only one of the eight risk factors that differed significantly between men and women was a history of elevated blood glucose levels, with a p-value of 0.02. Conclusion: The study identified a portrait of the number and percentage of diabetes risk factors in a community setting in Indonesia. Nurses must provide education on diabetes prevention to not only members of the local community at the research site but also the general public, nationally and globally

My child you must have patience and Kreng Jai : Thai parents and child pain

Purpose: To elicit the experiences of parents in providing care for their hospitalized child’s acute pain needs. Design: Phenomenology, using in-depth interviews with 45 parents whose children were being cared for in five hospitals in Northeastern (Isan) Thailand. Findings: The findings address Thai cultural beliefs regarding the experience of pain and the role societal expectations have on parental behavior in trying to meet their child’s acute pain needs. Two themes emerged– “Understanding my child’s pain: it’s karma” and “Maintaining Kreng Jai”– which identify parent beliefs toward pain and pain treatment, as well as perceived barriers in securing pain management for their children. Together these two themes describe the essence of this study as parents experienced an “inner struggle in providing pain care.” Pain was perceived as an inescapable part of life, and participants identified a preference for traditional remedies. Parents experienced a tension as they wanted to provide and secure pain care for their child but at the same time were reticent to approach staff with concerns about their child’s care. Conclusions: Thai parents viewed pain as a normal consequence of life, and one had to use traditional remedies in addition to medicine to successfully treat pain. Societal behavioral expectations required children to have patience. Nevertheless, parents wanted professionals to show more empathy and provide more effective pain care. Clinical Relevance: Improvements in pediatric pain care must formally include parents. Culturally sensitive approaches that do not stereotype parents and children are needed to ensure that evidence-informed pain care is available for all children

Children's pain assessment in Northeastern Thailand : perspectives of health professionals

Deficiencies in pain care within the developing world are starting to be realized. Children, in particular, are vulnerable, as preliminary studies suggest that these children receive less pain treatment because of health professionals’ attitudes and beliefs. This article reports on some of the findings of the first study in a larger program of research aimed at improving pediatric pain care in Thailand. Improvements in practice are not simply the result of providing evidenced-based knowledge, but a complex process that includes the context of care. Given that little is known about the pain management experiences of Thai health professionals, including the challenges they face, we used focus groups to capture their stories. Data revealed a need for both updating pain knowledge and for supporting an increased use of appropriate practices. In this article, we focus on the issues concerning the assessment of pain resulting from underrecognizing children’s pain and complex issues in communicating findings of children’s pain