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Schizophrenia is a chronic mental illness that affects thought processes, perception, and behavior, and antipsychotic medications are important to control psychotic symptoms. People with schizophrenia who adhere to neuroleptic medication are less likely to relapse than those who do not. This paper reports on a meta-synthesis of qualitative research exploring medication adherence experiences among people with schizophrenia. Published articles written in English from 1999-2019 were searched (January 1999-December 2019), from electronic databases, including CINAHL, PubMed, Science Direct, Scopus, PsycINFO, ProQuest, Dissertations and Theses, and the Thai National Research Repository. Twelve studies were included in the final review. Major components that affect medication adherence in people with schizophrenia positively or negatively were gentle pressure, trust and social support, a positive attitude toward disease and treatment, a sense of understanding of the beneficial and negative impact of medication, and financial constraints. We suggest a gentle medication adherence approach that departs from a joint responsibility between the family network and health providers to push people with schizophrenia towards medication uptake and help them develop coping mechanisms to deal with important side effects. Family members and health care providers should consider the patient's concerns about what is perceived as a normal life and a potential future life, taking into account social stigma and financial barriers. [ABSTRACT FROM AUTHOR]

Owing to multiple roles, including caregiving provision, mothers of children with schizophrenia experience a high level of stress. How these mothers adapt themselves to this caregiving, in addition to their other roles in the family, requires understanding before the development of an intervention. This study explored the process of adaptation among 20 Northeastern Thai mothers caring for children with schizophrenia who had provided such care for more than one year. They were interviewed in-depth, and Strauss and Corbin's grounded theory approach was used for collecting and analyzing. Hopeful endless caring to maintain normal life emerged as the core category, and consisted of three phases. Phase 1, Dealing with immediate care demands, involved mothers responding to their situation with supernatural rituals, combining treatment, finding medical treatment, and taking advice. Phase 2, Adjusting ourselves, involved mothers trying to adjust the caring and strategies, living situation, and their mental state. In Phase 3, Restoring self-balance, they adjusted their mind, tried to heal body and mind, reframed thoughts, and tried to get back to normal. The findings provide a deep understanding of mothers' adaptation process toward their caregiving over time, based on their perspectives. In developing a robust program to improve adaptation competency, mental health care providers, including nurses, need to understand what could be involved in the lives of caregivers, and take steps to realize each person's uniqueness, and that adapting to caregiving is a process. Heath professionals thus need to adjust interventions to be most appropriate for the different phases experienced by mothers. [ABSTRACT FROM AUTHOR]

This study aimed to design a Social Story, based on Gray, that reduces undesirable eating behaviours among individuals with autism and compare their behaviours before and after the intervention. It was conducted in three subjects with autism, using the ABAB reversal single-subject design. Undesirable eating behaviours were observed and then they were used to developed Social Story in line with Gray's three steps. The tools underwent quality testing in both the content validity and the pilot implementation to check the language and understanding in an individual with autism who was similar to the subjects. The data was then analysed using descriptive statistics. The developed Social Story consisted of five pages, containing five images and five sentences. After using the developed Social Story, the reduction of undesirable eating behaviours occured in Case 1, 2 and 3 in all four phases of the study. In Phase 1, in the baseline data was gathered, the average occurrences of the behaviours were 13.50%, 11.83% and 10.00%, respectively. Then, in Phase 2, the first treatment phase (B1), the average occurrences were 10.83%, 8.54% and 7.83% respectively. Then, in Phase 3, the intervention withdrawal, they were 9.42%, 5.92% and 8.33% respectively. In Phase 4, the second treatment phase, the percentages reduced to 7.42, 5.58 and 6.30, respectively. This study proves that the designed Social Story was effective in reducing undesirable eating behaviours in people with autism and should be adapted and applied to others with the same behaviours as appropriate. Further studies can be done on the effectiveness of Social Story in supporting people with autism in other aspects such as enhancing social skills and interaction, reducing other undesirable behaviours or even developing Social Story e-books. [ABSTRACT FROM AUTHOR]

Background: There is limited understanding of the symptoms that older people living with cancer, chronic obstructive pulmonary disease and chronic kidney disease experience during the last year of life in Thailand, in addition to their health service preferences. Aims: To survey the symptom experiences and health service preferences at the end of life of older people with chronic illnesses from the perspective of bereaved carers. Methods: The study used a retrospective post-bereavement approach to collect quantitative data. Purposive sampling was used to select 76 bereaved relatives of older people living with chronic illnesses who had died in the previous 5 to10 months. Telephone interviews and a translated version of the Views of Informal Carers—Evaluation Services (VOICES) questionnaire were conducted. Data were analysed using the statistical package SPSS version 17. Findings: The overall quality of care received by older people living with chronic diseases during the last three months of life was described as 'good' (36%). However, in comparing the quality of care from different settings, most of the subjects (63%) thought that the quality of care at home should be rated as 'poor'. During the last twelve months, 35% of the respondents rated pain and poor appetite as the main symptoms, while 25% described experiencing 'worry' related to being at the end of life. The severity of many symptoms increased during the last three months of life; 21% of carers recommended that pain caused the most suffering to their relatives at 'all times', when compared with other symptoms of end of life. Around 21–35% reported that their relatives 'sometimes' experienced worry, low mood, breathlessness and oedema. During the last three days of life, it was reported by 97% of respondents that their relatives spent all of their time in hospital, and no respondents reported that their relatives had died at home. Conclusion: The study indicates that older people living with chronic diseases in Thailand are less likely to access specialist palliative care and are more likely to have poor symptom control at the end of life. It indicates that health services may not be meeting patients' needs and that there was clearly insufficient healthcare provision at home for older people to help them to manage their symptoms such as pain and breathlessness. [ABSTRACT FROM AUTHOR]

Diabetic foot ulcers are a main cause of morbidity related to type 2 diabetes. Living with a diabetic foot ulcer has a significant impact on health-related quality of life and has a negative impact on daily living among people with the condition. The aim of this study was to explore the experiences of Thai adults living with diabetic foot ulcers using a descriptive qualitative design. Participants were recruited from the outpatient diabetes and foot clinic at a tertiary teaching hospital in Northern Thailand from January to April 2017. In-depth interviews were conducted with 13 participants using a semi-structured interview guide. Thematic analysis was used to identify the participants' experiences and two themes were identified: 1) living with a diabetic foot ulcer and 2) managing a diabetic foot ulcer. The findings enhance the knowledge of healthcare professionals and the public to understand the experience of having diabetic foot ulcers and contribute to understanding how to manage a diabetic foot ulcer based on the participant's experiences in the Thai context. Nurses must provide knowledge and self-care skills as part of routine care to improve health-related quality of life for people with diabetic foot ulcers. [ABSTRACT FROM AUTHOR]

Background: Many people with a mental illness are parents caring for dependent children. These children are at greater risk of developing their own mental health concerns compared to other children. Mental health services are opportune places for healthcare professionals to identify clients' parenting status and address the needs of their children. There is a knowledge gap regarding Thai mental health professionals' family-focused knowledge and practices when working with parents with mental illness and their children and families.Methods: This cross -sectional survey study examined the attitudes, knowledge and practices of a sample (n = 349) of the Thai mental health professional workforce (nurses, social workers, psychologists, psychiatrists) using a translated version of the Family-Focused Mental Health Practice Questionnaire (FFMHPQ).Results: The majority of clinicians reported no training in family (76.8%) or child-focused practice (79.7%). Compared to other professional groups, psychiatric nurses reported lower scores on almost all aspects of family-focused practice except supporting clients in their parenting role within the context of their mental illness. Social workers scored highest overall including having more workplace support for family-focused practice as well as a higher awareness of family-focused policy and procedures than psychiatrists; social workers also scored higher than psychologists on providing support to families and parents. All mental health care professional groups reported a need for training and inter-professional practice when working with families.Conclusions: The findings indicate an important opportunity for the prevention of intergenerational mental illness in whose parents have mental illness by strengthening the professional development of nurses and other health professionals in child and family-focused knowledge and practice. [ABSTRACT FROM AUTHOR]

Aims: With the increase in the number of systematic reviews available, a logical next step to provide decision makers in healthcare with the evidence they require has been the conduct of reviews of existing systematic reviews. Syntheses of existing systematic reviews are referred to by many different names, one of which is an umbrella review. An umbrella review allows the findings of reviews relevant to a review question to be compared and contrasted. An umbrella review's most characteristic feature is that this type of evidence synthesis only considers for inclusion the highest level of evidence, namely other systematic reviews and meta-analyses. A methodology working group was formed by the Joanna Briggs Institute to develop methodological guidance for the conduct of an umbrella review, including diverse types of evidence, both quantitative and qualitative. The aim of this study is to describe the development and guidance for the conduct of an umbrella review. Methods: Discussion and testing of the elements of methods for the conduct of an umbrella review were held over a 6-month period by members of a methodology working group. The working group comprised six participants who corresponded via teleconference, e-mail and face-to-face meeting during this development period. In October 2013, the methodology was presented in a workshop at the Joanna Briggs Institute Convention. Workshop participants, review authors and methodologists provided further testing, critique and feedback on the proposed methodology. Results: This study describes the methodology and methods developed for the conduct of an umbrella review that includes published systematic reviews and meta-analyses as the analytical unit of the review. Details are provided regarding the essential elements of an umbrella review, including presentation of the review question in a Population, Intervention, Comparator, Outcome format, nuances of the inclusion criteria and search strategy. A critical appraisal tool with 10 questions to help assess risk of bias in systematic reviews and meta-analyses was also developed and tested. Relevant details to extract from included reviews and how to best present the findings of both quantitative and qualitative systematic reviews in a reader friendly format are provided. Conclusions: Umbrella reviews provide a ready means for decision makers in healthcare to gain a clear understanding of a broad topic area. The umbrella review methodology described here is the first to consider reviews that report other than quantitative evidence derived from randomized controlled trials. The methodology includes an easy to use and informative summary of evidence table to readily provide decision makers with the available, highest level of evidence relevant to the question posed. [ABSTRACT FROM AUTHOR]