Background: Breast cancer is a major health problem among women around the world. Recent developments in screening and treatment have greatly improved the prognosis of patients with breast cancer in developed countries. However, in developing countries breast cancer mortality remains high.Breast cancer awareness is a first and important step in reducing breast cancer mortality. The development of a validated instrument to measure breast cancer awareness is crucial for the understanding and implementation of suitable health education programs to facilitate early deletion and minimize mortality. Objective: The objective of this study was to develop an instrument for the assessment of breast cancer awareness in Thai women. Materials and Methods: This methodological study was conducted in two stages: (1) literature searches and semi-structured interviews were conducted to generate items of the breast cancer awareness scale (B-CAS) which were subsequently examined for content and face validity, and (2) an exploration of the factor structure of the resulting instrument and an examination of its reliability. Data were collected using a self-administered questionnaire in Thai women aged 20-64 in August, 2015. Results: A total of 219 women (response rate 97.4 %) participated in this validation study. The B-CAS contains five domains with 53 items on breast cancer awareness: 1) knowledge of risk factors, 2) knowledge of signs and symptoms, 3) attitude to breast cancer prevention, 4) barriers of breast screening, and 5) health behavior related to breast cancer awareness. Items with a content validity index < 0.80 were excluded, and factor structure for the remaining items reflected the hypothesized five factor model. The scales based on all retained items was shown to have strongly internal consistency reliability (Cronbach's α=0.86). Conclusions: The B-CAS provides good psychometric properties to assess breast cancer awareness in women. It can be used to examine breast cancer awareness in Thai women and it could lead to the development and evaluation of suitable educational interventions for raising breast cancer awareness. Future research should focus on further validating the B-CAS including an assessment of construct and criterion-based validity.

We investigate the relationship of diabetes knowledge, diabetes management self-efficacy and diabetes self-management with blood glucose control among people with Thai type 2 diabetes mellitus (T2D). Seven hundred outpatients from diabetes clinics from large university and small community hospitals in two provinces of Thailand (Khon Kaen and Bangkok) were interviewed to evaluate their diabetes knowledge (DK), diabetes management self-efficacy (DMSE) and diabetes self-management (DSM). In addition, patient medical records were accessed to obtain other patient characteristics including patients’ HbA1c levels. Bivariate and multivariable logistic regression modelling was conducted and unadjusted and adjusted odds ratios obtained, respectively. Over half (52.4%) of the patients in our sample failed to control their blood glucose (HbA1c > 7%). All three psychometric measures (DK, DMSE and DSM) were identified as associated with blood glucose control in the bivariate analysis (ORDK(unadj) = 0.89, 95%CI: 0.82, 0.96; ORDSM(unadj) = 1.64, 95%CI: 1.46, 1.82; ORDMSE(unadj) = 2.84; 95%CI: 2.43, 3.32). However, after mutual adjustment and adjustment for other patient characteristics, of the three psychometric measures, only diabetes management self-efficacy remained associated with blood glucose control (ORDMSE(adj) = 2.67; 95%CI: 2.20, 3.25). Diabetes management self-efficacy is shown to be strongly associated with blood glucose control in the Thai Type 2 diabetes population. Current early diabetes interventions in Thailand tend to focus on disease knowledge. A stronger emphasis on enhancing patients’ disease management self-efficacy in these interventions is likely to lead to substantial improvement in both diabetes self-management and blood glucose control, thereafter reducing the risk, or prolonging the development, of chronic diabetes complications.

Background: Breast cancer is the most common cancer in women worldwide. In south-east Asia, both the incidence and mortality rates of breast cancer are on the rise, and the latter is likely due to the limited access to large-scale community screening program in these resource-limited countries. Breast cancer awareness is an important tool which may, through increasing breast self-examination and the seeking of clinical examination, reduce breast cancer mortality. Investigating factors associated with breast cancer awareness of women is likely to help identify those at risk, and provide insights into developing effective health promotion interventions. Objective: To investigate factors associated with breast cancer awareness in Thai women. Methods: A cross-sectional sample of Thai women aged 20-64 years was collected during August to October, 2015 from two provinces of southern Thailand (Surat Thani and Songkla). A questionnaire including the Breast Cancer Awareness Scale along with demographic characteristics was administered and Proportional Odds Logistic regression was then used to investigate factors associated with breast cancer awareness. Results: In total, 660 Thai women participated in this study. Factors most often associated with the various breast cancer awareness domains were age and rurality. While rural women had poorer knowledge of breast cancer signs and symptoms, they also had lower levels of perceived barriers and considerably better breast cancer awareness behaviors. Conclusion: Despite lower knowledge of breast cancer risk factors and no evidence of better knowledge of signs and symptoms, we found rural Thai women had considerably better breast cancer awareness behavior. This may be due to these women's lower levels of perceived barriers to breast cancer screening services. Indeed this suggests, at least in Thai women, that interventions aimed at lowering perceived barriers rather than enhancing disease knowledge may be more successful in engaging women with breast cancer screening services and increasing breast self-examination.

Background: HIV/AIDS is s ll a problem in the health care system of developing countries. Migrant workers are considered a vulnerable popula on for HIV infec on. The current informa on on HIV/AIDS and migrant workers is useful to provide suitable effec ve health interven ons for the preven on of HIV/AIDS. This study aims to describe knowledge, a tudes and HIV/AIDS risk behaviors among Myanmar male migrant workers in Thailand. Methods: A cross-sec onal study was conducted in Myanmar male migrant workers aged 18-60 years collected from February to May 2018. A total of 400 migrant workers who live in Patumthani provinces were selected by a convenience sampling method. Descrip ve sta s cs were used to explore knowledge, a tudes and HIV/AIDS risk behaviors of par cipants. Results: The mean age of the par cipants was 33 years, ages ranged from 18 to 60 years old, achieved pri- mary school (40.40%), and married (54.30%). An average living in Thailand was 3.25 years and monthly income was 9,166 baht (∼286 USD), respec vely. A majority of par cipants had a poor level of HIV/AIDS knowledge (55.25%) and a fair level of an a tude about HIV/AIDS disease and preven on (61.25%). Risk behaviors related to HIV/AIDS of par cipants who had sex with non-partners were 40.58%. Conclusion: Most par cipants had poor knowledge and a fair a tude of HIV/AIDS. Risk behaviors related to HIV/AIDS of the par cipants were rela vely high. Moreover, most of par cipants had less access to health care services. This results confirmed that an urgent need to provide health interven on to increase knowledge on HIV/AIDS of Myanmar migrant workers in Thailand.

Background Type 2 diabetes (T2D) is one of the most common chronic diseases in the world. In recent decades the prevalence of this disease has increased alarmingly in lower to middle income countries, where their resource-limited health care systems have struggled to meet this increased burden. Improving patient self-care by improving diabetes knowledge and diabetes management self-efficacy represents a feasible way of ameliorating the impact of T2D on the patient, and the health care system. Unfortunately, the relationships between self-efficacy, diabetes self-management, and thereafter, patient outcomes, are still far from well understood. Although a domain-specific measure of diabetes management self-efficacy, the Diabetes Management Self-Efficacy Scale (DMSES), has been validated in the Thai T2D population, more general measures of self-efficacy, such as the General Self-Efficacy scale (GSE) have not been validated in this population. In this paper we translate and examine the psychometric properties of the GSE in Thais living with T2D. Methods In this nation-wide study we examined the psychometric properties of the GSE in 749 Thais diagnosed with T2D within the last five years, and evaluated its relationship with the DMSES along with other patient characteristics. Reliability of GSE was assessed using Cronbach’s alpha, and the construct validity was examined using confirmatory factor analysis, along with GSE’s convergence and discrimination from DMSES. Results The Thai version of the GSE was shown to have good psychometric properties in Thais living with T2D. Cronbach’s alpha was shown to be 0.87 (95% CI [0.86, 0.88]). We also demonstrated the structural validity of the GSE (Tucker-Lewis Index = 0.994, Cumulative Fit Index = 0.995, Adjusted Goodness of Fit Index = 0.998, Root Mean Square Error of Approximations = 0.025, 95% CI [0.06–0.039]), and that this instrument has a similar structure in Thais as in other populations. GSE was also shown to have some overlap with the DMSES with correlations among GSE and the DMSES domains ranging from 0.18 to 0.26, but also the GSE has substantial discrimination from DMSES (Disattenuated correlation coefficient = 0.283, 95% CI [0.214–0.352], p < 0.001). This suggests that while general and diabetes management self-efficacy are somewhat associated, there are aspects of diabetes management self-efficacy not captured by the more stable general self-efficacy. Conclusions We demonstrate that the Thai GSE is a reliable and valid measure. We believe the GSE may represent a useful tool to examine the efficacy of proposed and existing diabetes self-management, and management self-efficacy interventions.

Background: Chronic kidney disease (CKD) has directly affected the quality of life (QOL) of patients. Objective: The objective of this study was to explore the QOL and its associated factors among CKD patients in Thailand. Methodology: A cross-sectional study was conducted with 258 CKD patients from the CKD clinics between January to December 2017. A validated and reliable tool, KDQOL-SF™ 1.3, consisting of 19 domains categorized into three components: physical component summary (PCS), mental component summary (MCS), and kidney disease component summary (KDCS), was adopted to assess QOL through trained data collectors. Ordinal Logistic regression was used to detect the associations between variables at the significance level of 0.05. Results: Among two hundred and fifty-eight patients, 53.9% were females, 67.4% were more than 60 years old, and 73.6% were employed. Employed CKD patients had a better PCS compared to unemployed ones (odds ratio (OR)= 2.87, 95% confidence interval (CI) = 1.52-5.42) and patients who had education lower than primary school (OR = 2.41; 95% CI = 1.02-5.69) tended to have a better PCS compared to those who had secondary and higher school education. CKD patients who had no income tended to have a poorer PCS (OR = 0.40; 95% CI = 0.18-0.91) and MCS (OR = 0.39; 95% CI = 0.18-0.83) than those patients who had an income of more than 10,000 baht. 3a CKD stage patients (OR = 2.62; 95% CI = 1.19-5.77) were more likely to have a good MCS compared to 5 CKD stage patients. ESRD patients who had primary school level education (OR = 0.25; 95% CI = 0.07-0.89) tended to have a poorer KDCS than those patients who had secondary and higher school level education. Conclusion: The study concludes that QOL among CKD patients in CKD clinics needs to improve. Public health should reform and implement the appropriate policy of CKD clinic and intervention to improve QOL among CKD patients by focusing on CKD patients’ occupation, income, education, and the stage of CKD.