ABSTRACT. The assumption that development brings not only material prosperity but also a better overall quality of life lies at the heart of the development project. Against this, critics assert that development can undermine social cohesion and threaten cultural integrity. Rarely, however, is the impact of development on wellbeing rigourously analysed using empirical data. This is what the Wellbeing in Developing Countries Group at the University of Bath aims to do drawing on fieldwork carried out in four developing countries, which addresses the themes of resources, needs, agency and structure, and subjective Quality of life (QoL). The first phase of the QoL research in Thailand aimed to explore the categories and components of quality of life for people from different backgrounds and locations with the aim of developing methods for QoL assessment in the third phase of the WeD QoL research. The study presents data obtained from rural and peri-urban sites in Southern and Northeastern Thailand (two villages in Songkhla and three in Khon Kaen, Mukdaharn, and Roi-et). Participants were divided into six groups by gender and age, and were divided again by religion (Buddhist and Muslim) and wealth status in the South. Data collection was conducted between October and December 2004 using focus group discussions, semi-structured interviews, and the Person Generated Index. Content analysis was used for data analysis. The use of a qualitative approach enabled the gathering of empirical data that reflects the sources of difficulty and happiness in the lives of participants. Respondents identified 26 aspects to their quality of life, including family relations, health and longevity, income and having money, jobs, housing, education, debt, and so on. The results reveal clear similarities and differences in the role of traditions, religious beliefs, and values in the lives of people living in remote rural or peri-urban areas in Northeastern and Southern Thailand. These results, together with the findings from Peru, Ethiopia, and Bangladesh, will inform the rest of the WeD research and be used to develop measures to assess the quality of life of people living in developing countries.
This qualitative paper explores the perception of pain among north-eastern Thai children experiencing illness, aged from 4-18 years. Data was obtained from 17 children living in the community and 32 children admitted to two major hospitals in Isan, totaling 49 children. The qualitative data collection techniques used were observation, drawing, role-playing, story-telling, and "day conferences" (relaxed and informal group discussions). The study was conducted over 1 year and the data were analyzed using Fielding's method of content analysis. The research found that children described their experience of pain as "disheartening", "suffering", and "torturing" and that the expression of pain in Isan families is characterized by avoidance and endurance. The findings suggest a role for a model of pain management in children specific to the sociocultural context of Isan, which focuses on family-centered care and acknowledges cultural diversity.
Deficiencies in pain care within the developing world are starting to be realized. Children, in particular, are vulnerable, as preliminary studies suggest that these children receive less pain treatment because of health professionals' attitudes and beliefs. This article reports on some of the findings of the first study in a larger program of research aimed at improving pediatric pain care in Thailand. Improvements in practice are not simply the result of providing evidenced-based knowledge, but a complex process that includes the context of care. Given that little is known about the pain management experiences of Thai health professionals, including the challenges they face, we used focus groups to capture their stories. Data revealed a need for both updating pain knowledge and for supporting an increased use of appropriate practices. In this article, we focus on the issues concerning the assessment of pain resulting from underrecognizing children's pain and complex issues in communicating findings of children's pain.
Background: Cancer and non-communicable diseases are a major issue not only for the developed but also developing countries. Public health and primary care nursing offer great potential for primary and secondary prevention of these diseases through community and family-based approaches. Within Thailand there are related established educational curricula but less is known about how graduate practitioners enact ideas in practice and how these can influence policy at local levels. Aim: The aim of this inquiry was to develop family nursing practice in primary care settings in the Isaan region or Northeastern Thailand and to distill what worked well into a nursing model to guide practice. Materials and Methods: An appreciative inquiry approach involving analysis of written reports, focus group discussions and individual interviews was used to synthesize what worked well for fourteen family nurses involved in primary care delivery and to build the related model. Results: Three main strategies were seen to offer a basis for optimal care delivery, namely: enacting a participatory action approach mobilizing families' social capital; using family nursing process; and implementing action strategies within communities. These were distilled into a new conceptual model. Conclusions: The model has some features in common with related community partnership models and the World Health Organization Europe Family Health Nurse model, but highlights practical strategies for family nursing enactment. The model offers a basis not only for planning and implementing family care to help prevent cancer and other diseases but also for education of nurses and health care providers working in communities. This articulation of what works in this culture also offers possible transference to different contexts internationally, with related potential to inform health and social care policies, and international development of care models.
Cancer is one of the leading causes of death in Thailand as well as other countries. Evidences from studies in Asia show that alcohol consumption has been linked to an increased risk for various types of cancer. In the qualitative participatory action research presented here, the possibilities of a volunteer women's movement to reduce harmful alcohol consumption by facilitating the creation of emancipatory knowledge in the Thai-Isaan community was explored. During in-depth interviews with 10 female volunteer participants, the following themes emerged: merit making, developing a sense of personal empowerment, and the experience of participating in an action plan that utilized various strategies. The project activities empowered participants to create and share knowledge which was then applied toward action for change. Adoption of this type of program by local health care providers to reduce health problems and risks related to alcohol misuse in similar contexts and cultures is recommended.
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