The Roles of Spirituality in People Living with HIV/AIDS: A Qualitative Meta-synthesis T he spread of HIV/AIDS continues to be a major problem for public health around the world. People living with HIV/AIDS (PLWHA) steadily climbed from 35.6 to 36.9 million between 2015 and 2017, with 940,000 people dying from HIV/AIDS during the aforementioned period. 1 Similarly, the number of PLWHA in Thailand increased from 445,000 to 450,000 with approximately 15,000 people dying from HIV/ AIDS during the abovementioned period. 2 Due to the increasing numbers of people receiving antiretroviral therapy (ART), HIV-related deaths have dropped by 38%, 1 and AIDS has changed into a chronic disease drawing new challenges for health care providers. 3 PLWHA are faced with stressful life events related to the illness including physical health problems resulting from declining immune status, psychological distress related to stress, anxiety and depression, social isolation due to social stigma, fear and uncertainty about death, loss of self-control, self-blame, internalized conflict, and hopelessness. 3-9 The aforementioned problems might lead PLWHA to become spiritually distressed and commit suicide. 4,6,9 Spirituality is a broad concept consisting of several key features and it is the source of human beings that can help people to accept themselves and their illness, find meaning and purpose in life, create inner strength, maintain hope, improve the sense of selftrancendence, create relationships and connect with other people as well as a higher power, divine or God. 3,8,9-11 Moreover, spirituality can play a vital role in supporting PLWHA. According to the studies of Ironson et al (2006), 12 Ironson et al (2016), 13 and Black and Slavice (2016) 14 it was found that spirituality/religiousness significantly correlated with better CD4 cell count and controlling of viral load. Consequently, spirituality has a significant effect on controlling disease symptoms and slowing the progression of disease, 5,15 while ensuring life-satisfaction, quality of life, well-being, 5,16 and long-term survival. 13 According to the literature review, limited research studies have been conducted in Thailand about the role of spirituality among PLWHA. Most research studies were quantitative research studies and focused on the

Thai Nurses' Perceptions of a Good Death: An Integrative Review I n Thailand, there was a total population of approximately 66.4 million at the end of 2018, 1 with an increase of total death from 456,391 to 473,541 cases (from 2015 to 2018). 2 The five major causes of death in Thailand are aging, heart failure, sepsis, primary hypertension, and diabetes mellitus. 3 The place of death occurs mainly at hospitals and homes. Thus, health care providers, especially nurses, have an opportunity to prepare to care for people who are confronted with death and dying. 4,5 Death is a natural phenomena that everyone has to experience and there is no escape from this. 5,6 According to the Thai cultural context, death has been perceived as taboo by Thai people. Consequently, they do not talk about death and there is a lack of preparation for death. 6 Those nearing death may also face emotional turmoil, including fear of death. 4 It causes people to fight for prolonging life, increasingly dependent on medical care services including medicinal use, invasive medical instruments, and cardiopulmonary resuscitation. 7 Although these treatments can extend life, these treatments can cause patients physiological, psychosocial, and spiritual suffering. 4,6,8 A good death is an important goal of caring for patients with end of life conditions or receiving palliative care. 4-10 A good death has not been universally defined because of the differences in individual perception, belief, and sociocultural context. Moreover, the meaning of a good death is different depending on patient's views, families, and health care providers. This may affect the patients' care in promoting a good death. [4][5][6][8][9][10][11] Thailand is different from western countries, particularly when it comes to spiritual and religious beliefs that are integral to the Thai way of life from the beginning of life to the end of life. The majority of Thai people are Buddhist accounting for more than 90%, Muslims accounting for 4% of the population, and others. 9,11,13 The difference in sociocultural context and belief have influenced the perception of good death among patients, families, and health care providers, which may be different in their views. Nurses have played important roles to promote a good death for patients nearing death. [4][5][6] Deep understanding of a good death from a nurse's perception is crucial for providing care to promote a peaceful death.

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To synthesize the meaning of self-care regarding peritoneal dialysis (PD) for end-stage renal disease (ESRD) patients. A systematic review and thematic analysis of qualitative studies were conducted regarding the perspectives of self-care by adults, and PD.MED-LINE, PsycINFO, and CINAHL databases were searched from January 1st, 2008 until April 1 st , 2017. Seven studies involving 107 participants were included and three themes: self-control (adherence and confidence in managing PD), self-monitoring and self-management (lifestyle adaptation, managing dialysis, managing medicine and managing environment). The PD impacts on patients' behaviors and lifestyle were identified. Self-care refers to individual actions that are associated and interact with everyday life activities for good living. Self-care involves self-monitoring, management and control of personal activities that affect health. Healthcare providers must support and educate PD patients to develop their own self-care abilities.