he illness of a family member is recognized as a stressful life event that affects caregivers, spouses or other relatives. Furthermore, illness causes physical health problems for both patients and caregivers. 1,2 It also increases perceived stress, strain and depression. 1,3 Moreover, chronic illness with a high level of dependency is correlated with a sense of burden on family caregivers that significantly increases the sense of fatigue and burnout experienced by caregivers. 1 These above factors have an impact on the equilibrium of family systems and accelerate family adaptation. Family adaptation is a process in which families engage in direct responses to the extensive demands of a stressor, and realize that systemic changes are needed within the family unit, to restore functional stability and improve family satisfaction and well-being. 4,5 It means if the family has more function, that family can provide adaptation. Family functioning is defined as the extent to which a family operates as a unit to cope with stressors. The model of marital and family systems holds that family functioning is composed of three dimensions: cohesion, adaptability, and communication. Family cohesion refers to the emotional bonding among family members. Family adaptability represents the ability of a family to change its rules, the role of relationships, and power structure in response to developmental changes or situational stressors. Communication is a facilitating factor in cohesion and adaptability. 6 Families who exert tremendous effort toward coping with the daunting challenge of providing care for a family member during illness are actively engaged in the process of coping or adaptation. These families are well-aware of the requirement for a complete overhaul within the family in the transition from crisis back to sustainable family functionality with
In developing countries, agrochemicals are frequently used, resulting in direct and indirect chemical exposure as well as a variety of health concerns. Although agrochemical safety education is essential to promoting protective behavior among agricultural workers, there is a gap in the body of evidence concerning experience with agrochemical use and practice, which is critical for developing and improving educational interventions, so they are more effective and acceptable to the workers' culture and lifestyle. This phenomenology study included twenty agricultural workers with high serum cholinesterase levels in two Thai rural communities. Data from semi-structured interviews were transcribed verbatim and analyzed by using Colaizzi's 7-step data analysis, which is mentioned in the data analysis part. Five themes and three subthemes emerged in relation to agrochemical use and health: (i) long-term chemical exposure; (ii) no need to be concerned about health after chemical exposure; (iii) insufficient chemical protection knowledge and practices; (iv) difficulties in adhering to the agrochemical exposure prevention regimen; and (v) government policy and the growth of the organic products market are important components of chemical use reduction. Based on the findings, the workers lacked awareness regarding protective behaviors, because they did not notice any abnormal changes in their health. We, therefore, recommend that they undergo annual checkups for monitoring their SChE levels, which should be provided by the local government. In addition, agrochemical use is influenced by socioeconomic and political factors. Thus, a health education program for agricultural workers should involve a multidimensional and community-engaged training program that would promote the safe handling of chemicals through contextually appropriate interventions.
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