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

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, crosssectional 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 selfreport 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 selfharm (b = À0.139, b = À0.266, b = 0.163, and b = À0.671, 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.

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 < .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.

No abstract

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.]