Tiraporn Junda

Background: Former homeless older adults represent a highly vulnerable population facing substantial community health challenges, including an elevated risk of sarcopenia due to compounded health and social disadvantages. Developing a context-specific management system is crucial for enhancing early detection, prevention, and care within supportive housing settings. Objective: This study aimed to develop and evaluate the feasibility of a sarcopenia management system for former homeless older adults in Thailand. Methods: mixed methods design was used, consisting of three phases: (1) development, (2) implementation, and (3) preliminary evaluation testing. The development phase engaged 18 stakeholders and 32 focus group participants (former homeless older adults and staff) through 2 rounds of consultation. The system was subsequently implemented and preliminarily evaluated for feasibility, perceived quality, perceived benefits, and user satisfaction. Results: Through qualitative methods and a systematic review, a context-specific sarcopenia management system was developed for former homeless older adults. The system comprised five core components screening, classification, management, follow-up, evaluation and was integrated into routine care processes involving multidisciplinary staff and homeless volunteers within a supportive housing setting. The system was subsequently implemented and preliminarily tested among 116 former homeless older adults living in a supportive housing facility in Thailand. Preliminary findings indicated good feasibility and acceptability of the system. The perceived quality of the system achieved a mean score of 2.6 (SD 0.48), while perceived benefits were rated at 3.8 (SD 0.40). Overall satisfaction with system use and implementation processes achieved mean scores of 2.8 (SD 0.41) and 2.72 (SD 0.79), respectively, indicating high user satisfaction. Conclusions: This study presents the first context-sensitive sarcopenia management system specifically developed for former homeless older adults in supportive housing in Thailand. The system was well accepted and shows promise for strengthening early detection, prevention, and management of sarcopenia in community-based housing settings.

Aim: This study sought to elucidate the conditions associated with sarcopenia among older, formerly homeless people residing in supportive housing in Thailand. Design: This study employed a qualitative design. Methods: Eight comprehensive interviews ( n = 8) and four focus group discussions ( n = 20) were conducted. The data collection spanned from March 2024 to June 2024 and was subsequently analysed utilising content analysis methodologies. Results: All participants (age range: 31–83 years, female participants: 52.38%) were selected from a shelter for the economically disadvantaged in Nonthaburi. The analysis revealed two overarching themes: (1) insufficiency, encompassing five subthemes: deficient knowledge, limited dietary intake, poor oral health, insufficient physical activity and substandard sarcopenia care system and (2) the price of plenty, which includes four subthemes: carbohydrate consumption, poorly prepared food (characterised by hard, undercooked, or burnt items and excessive salt and spice usage), comorbid health conditions and excessive periods of inactivity. Implications for the Profession: Absence of nursing roles in supportive housing limits the delivery of people‐centred care for formerly homeless older adults. Integrating nurses into these settings is essential to meet complex health needs and improve care quality. Patient or Public Contribution: This represents the inaugural Thai research conducted within a shelter for the impoverished, underserved and marginalised population. The rich insights from this study provided a foundation for understanding and guiding the management, local policy formulation and prevention strategies related to sarcopenia for this population.

The World Health Organization approximates that around 56.8 million individuals require palliative care annually, with 25.7 million of them being in the final stage of life. Ensuring high-quality care, particularly towards the end of life, can significantly enhance the quality of dying and death (QODD) for terminally ill patients. This, in turn, may alleviate grief among their loved ones following their passing. This descriptive study seeks to explore the correlation between the quality of end-of-life care (EOLC), QODD, and the experience of grief among bereaved family caregivers. A total of 318 participants, the primary family caregivers of patients who died within 3–12 months, were recruited for this study by the purposive sampling method. The instruments used for collecting data included (1) the participant demographic data form, (2) the family APGAR questionnaire, (3) The Family Satisfaction with the End-of-Life Care (4) the quality of dying and death questionnaire (QODD), and (5) the inventory of complicated grief. The data were analyzed by using descriptive statistics, and Spearman rank-order correlation coefficient. The results showed that bereaved family caregivers had satisfaction with the quality of care and their perceptions of QODD at a moderate level. Bereaved family caregivers had 74.8% of normal grief. The quality of EOLC and QODD had a significant negative correlation with grief in bereaved family caregivers. The quality of EOLC also had a significant positive correlation with the QODD. Improving the quality of EOLC, can improve the QODD and help bereaved family caregivers cope with grief.

Background/Objectives: Sexual activity (SA) in heart failure (HF) is frequently impaired by physiological, psychological, and relational factors, often overlooked despite its impact on sexual life. This study identified predictors of SA in HF patients, specifically metabolic equivalents (METs), age, mental health, and partner communication. Methods: A cross-sectional study involved 144 married Thai patients with congestive HF from two tertiary hospitals. Participants completed questionnaires on demographics, METs (Duke Activity Status Index), mental health (DASS-21), and partner communication (Dyadic Sexual Communication Scale). Binary logistic regression analyzed the predictive value of these variables on SA. Results: Most participants reported some SA, but often with de-creased frequency and duration, and a lack of professional guidance. Significant predictors of SA included lower METs (OR = 0.362), depression (OR = 0.002), and effective partner communication (OR = 1.156). Age, anxiety, and stress were not significant predictors. Conclusions: The study concludes that lower METs and depression and enhanced partner communication are associated with reduced SA in HF patients. These findings emphasize integrating physical, psychological, and relational assessments into HF care. Routine evaluation of METs, depression, and partner communication should be incorporated into clinical protocols to facilitate targeted interventions and educational support for patients' sexual well-being.

Patients with advanced-stage cancer undergoing chemotherapy are highly susceptible to infections due to immunosuppression. Inappropriate behaviors further increase their risk of infection and severe complications such as not washing hands, consuming unsafe food, or exposure to contaminated environments. Consequently, nursing interventions are essential in promoting preventive behaviors and reducing infection risks. This study, therefore, examined the predictive power of infection prevention knowledge, distress, perceived self-efficacy, and social support on infection prevention behaviors in patients with advanced-stage cancer receiving chemotherapy. Bandura's Self-efficacy Theory was also integrated into the study's framework. This predictive study used a cross-sectional design that included 100 patients with advanced solid malignancy receiving outpatient chemotherapy at the King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Thailand. Participants were selected through purposive sampling. Data were collected using the Knowledge of Infection Prevention in Cancer Patients Receiving Chemotherapy Questionnaire, the Thai version of the Distress Thermometer, the Thai Version of the General Self-Efficacy Questionnaire, the Social Support Questionnaire, and the Infection Prevention Behaviors in Cancer Patients Receiving Chemotherapy Questionnaire. Descriptive and multiple regression statistics with the Enter method were used for data analysis. Notably, this study received Institutional Review Board approval from two university hospitals in Bangkok, Thailand. The participants showed a high mean infection prevention knowledge score of 17.09 (SD=2.49), low distress (M=3.17, SD=2.78), moderate self-efficacy (M=30.40, SD=6.99), high social support (M=56.24, SD=6.71), and high infection prevention behaviors (M=105.85, SD=7.89). Regression analysis indicated that self-efficacy (β=0.244, p<0.05), distress (β=-0.233, p<0.05), knowledge (β=0.212, p<0.05), and social support (β=0.192, p<0.05) significantly predicted infection prevention behaviors, explaining 30.6% of the variance (p<0.05). These findings underscore that infection prevention behaviors are influenced by self-efficacy, distress, knowledge, and social support. Specifically, higher self-efficacy improves adherence to prevention and greater knowledge equips patients for effective infection control. Additionally, strong social support reinforces healthy behaviors. Conversely, high distress negatively impacts compliance with preventive behaviors. These insights can guide nurses in promoting effective infection prevention strategies for reducing infection risks. Keywords: Advanced-stage cancer, cancer care, chemotherapy, infection prevention behaviors, nursing care

Background: Non-communicable diseases have become a leading global health challenge, with mortality rates steadily rising. Insufficient patient care can worsen chronic illness, often placing significant caregiving responsibilities on the patient’s spouse. In some cases, spouses may need to leave their jobs to provide full-time care, especially during the end-of-life stage. Spousal caregivers often face emotionally distressing circumstances while caring for their loved ones, which can lead to elevated stress levels. However, research indicates that adequate social support can improve caregivers’ quality of life, reducing some of the burdens associated with end-of-life care. Objectives: This study aimed to assess and analyze the relationships between stress, social support, and quality of life experienced by spousal caregivers in Thailand, guided by Lazarus and Folkman’s (1984) Stress and Coping Theory. Methods: A correlational descriptive study design was used. The study was conducted with 84 spouses of patients in the end-of-life stage at a university hospital between October 2021 and March 2022. Data were collected using a questionnaire covering stress, social support, and quality of life and analyzed using Pearson’s Product Moment and Spearman Rank Correlation Coefficients. Results: The majority of spouses were women aged between 31 and 83 years (Mean = 61.24, SD = 10.42). The mean stress level was 6.40 (SD = 1.62), the mean social support was 55.07 (SD = 9.06), and the mean quality of life was 94.69 (SD = 10.04). There was no significant correlation between social support and stress (r = -0.098, p = 0.373). However, stress was negatively correlated with quality of life (r = -0.299, p = 0.006), and social support was positively related to quality of life (r = 0.219, p = 0.045). Conclusion: Spousal caregivers of patients at the end-of-life stage experienced varying levels of stress, social support, and quality of life. While no significant relationship was found between social support and stress, stress negatively impacted quality of life, while higher social support was associated with improved quality of life. Healthcare providers, especially nurses, should assess and address the stress, social support, and overall well-being of spousal caregivers to enhance their quality of life.

Patients with advanced cancer often experience numerous distressing symptoms that can significantly affect their quality of life. In addition to standard therapies, many patients use herbal remedies to manage symptoms, alleviate pain, or enhance their overall well-being. However, studies examining the use of herbal treatments in this population are limited in the literature. Therefore, the present study aims to understand the factors influencing herbal use among patients with advanced cancer. The World Health Organization (WHO) model of medication adherence was also incorporated into this study. This observational study utilized secondary data collected from hospitals in West Java. The study started from September to November 2016. The study employed a demographic questionnaire, the Memorial Symptom Assessment Scale, and the Palliative Management Questionnaire to gather comprehensive data from participants. Descriptive statistics were utilized to effectively summarize and present the characteristics of the study participants. Binomial logistic regression analysis was performed to identify significant predictor variables by modeling the logit function, which represents the natural logarithm of the odds ratio. The study reported that pain, fatigue, decreased appetite, vomiting, and nausea were identified as the five most prevalent symptoms experienced by patients during their care. Soursop leaves emerged as the most commonly preferred herbal treatment among participants in this study. Key factors influencing the use of herbal remedies included female gender, low-income levels, distress-related symptoms, perceived effectiveness of herbal treatments, and specific cancer types—most notably head and neck cancers. These findings highlight the critical need to integrate herbal remedies into conventional cancer care practices while encouraging further research focused on evaluating their efficacy and safety profiles. Keywords: Cancer care, chronic illness, community nursing, herbal, symptom management

Background: Sexual satisfaction is vital for the sexual health and well-being of both cervical cancer patients and their spouses. Sexual dissatisfaction can arise from negative treatment, making it important to examine the factors that influence sexual satisfaction. Objective: The purpose of this study was to explore the factors affecting the sexual satisfaction of Thai women with cervical cancer after complete treatment and their spouses. Materials and Methods: A predictive correlational study was conducted with 100 couples using convenience sampling. The study was based on the ecological theory framework. Data were collected from April 2023 to January 2024 in two tertiary hospitals through five questionnaires: a demographic questionnaire, the Thai Hospital Anxiety and Depression Scale, the Charlson Comorbidity Index, the Couple Relationship Scale, Natsal 2000, and the New Sexual Satisfaction Scale. Data analysis was performed using multiple linear regression. Results: The multiple regression analysis showed that sexual difficulties and duration of marriage predicted 25.6% of the variance in sexual satisfaction among women with cervical cancer. The duration of marriage (b = −0.48, p = 0.012) had a stronger impact than sexual difficulties (b = −2.82, p = 0.005). Sexual difficulties and couple relationships accounted for 34.9% of the variance in sexual satisfaction for spouses. Sexual difficulties (b = −3.13, p = 0.004) had a greater effect than couple relationships (b = 0.30, p = 0.003). Conclusions: Healthcare providers should promote constructive communication between couples through open, respectful, and supportive dialogue to strengthen their relationship, improve mutual understanding, address sexual difficulties, and enhance sexual satisfaction for women with cervical cancer after treatment and their spouses. The findings results can inform future intervention research aimed at improving sexual satisfaction in this population one-year post treatment.

Nurses are essential in coordinating palliative care among healthcare teams, yet nursing education still lacks explicit focus on this area. This study aims to explore nursing students’ competencies including palliative care knowledge (PCKN), attitudes toward death and end-of-life care (ADEoLC), perceived self-efficacy in EOL care (PSEC), ethical understanding in palliative care (EUPC), and fear and stress related to providing EOL care (FSEC), as well as the relationships among these variables. A cross-sectional descriptive correlational design was employed to examine the relationships among those variables. The sample consisted of 355 fourth-year undergraduate nursing students. Data were collected using six questionnaires: Personal Information Questionnaire (PIQ), PCKN Questionnaire, ADEoLC Questionnaire, PSEC Questionnaire, EUPC Questionnaire, and FSEC Scale. The study found that nearly half of the students (51%) exhibited low PCKN, with a mean score of 19.59/32. The average score for ADEoLC was 94.75/125, with 64.2% demonstrating a positive attitude. The mean score for PSEC was 69.90/100, while the mean score for EUPC was 3.30/5. Fear and stress related to providing end-of-life care scored 3.78 and 5.11 out of 10, respectively. PCKN was positively correlated with ADEoLC and EUPC but not with PSEC. ADEoLC was positively correlated with both PSEC and EUPC. PSEC was positively correlated with EUPC. Fear was correlated with stress related to end-of-life care, but neither was associated with other variables. The results provide the basic information for appropriate planning to enhance nursing student competencies to provide quality palliative and end-of-life care.