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

This research aimed to develop a model of promoting knowledge and behavioral adjustment of hypertensive patients. MATERIALS AND METHODS: This action research was based on the concept of Kemmis and Mc Taggart (1988). The sample of 34 people consisted of 24 hypertensive patients and 10 community health volunteers. The research instruments were divided into the following two parts: 1) a general information questionnaire for older adults; 2) a qualitative data collection instrument consisting of semi-structured interviews, focus group discussions, and observations. The study was conducted between 30 November 2021-10 March 2022. Quantitative data were statistically analyzed by using frequency, percentage, mean and standard deviation. Qualitative data analysis used thematic analysis. RESULTS: A model of promoting knowledge and behavior adjustment was developed for hypertensive patients through community participation. Both cycles found that there were 4 development activities: 1) educating knowledge to hypertensive patients; 2) education about behavior modification; 3) providing models to transfer knowledge; 4) exchanging knowledge and using learning materials. Knowledge increased considerably, averaging from 14.87 ± 5.21 to 17.37 ± 4.65 (t = -2.882, p = 0.010, 95%CI -4.368 to -0.685). Hypertension complications prevention behavior of hypertensive patients was a high score, with diet control of 87.50 %, exercise at 91.70%. After the second round, hypertension patients were satisfied to develop a model of promoting knowledge and behavioral adjustment, at an higher number and percentage after developing a model from 18 (75.00%) to 21 (87.50%). After developing a model, and having completed the second round, community health volunteers classified the satisfaction of hypertension patients. This showed an increased satisfaction to develop a model of promoting knowledge and behavioral adjustment of hypertensive patients from 8 (80.00%) to 10 (100%). CONCLUSION: Nurses and healthcare workers should focus on educating and promoting the participation of patients and community health volunteers in encouraging hypertension patients to engage in self-care.

T hailand is a country that enjoys a stable fertility rate. Moreover, advanced technology in medicine has led to improved human longevity. The number of elderly people in Thailand has continued to rise therefore, from 7.2 million in 2010 and is estimated to reach 11 million by 2020. 2,3 The growth rate of the older population in Thailand is predicted to be high, at a rate of increase of more than 3% each year. With the increasing rate of the number of elderly people in Thailand of around 3-3.6% per year, the total number of elderly people will double within the next 17 to 23 years. Thailand is going to be an elderly society within the next 10 years. Overall, only 15% of persons aged 60 and above admitted that they needed some assistance with their daily living activities. 2,3 Therefore, informal caregivers currently take on important roles to care for the elderly. In the giving of care, caregivers reported problems in physical, psychological or emotional and financial overload, affecting the quality of care for elderly people. 4 The issue of the burden experienced by caregivers is not new and most of caregivers need to manage their emotions for an effective outcome of caring. 5,6 Most caregivers are relatives who care for elderly parents or someone who cares for elderly people. 7 As a result, caregivers are prepared themselves for caring, which means they were aware of the physical, psychological and environmental factors that they were facing.The management of the emotions of caregivers is a major issue that health staff should be concerned with. If caregivers could manage their emotions effectively, this would be an important step to help develop a more positive outcome in caring. The risk indicators specified here, such as limited resources, giving care to a close loved one, and giving emotional support, could help to prevent informal caregivers from a heightened risk of emotional disorders. Therefore, the study of emotional management of caregivers working with the elderly is important. Whittemore and Knafl's 2005 1 technical procedure was developed for AbstractThe purpose of this study is to summarize the management of emotions of caregivers who take care of elderly people in line with nursing literature using a technical procedure that meets the five stages developed by Whittemore and Knafl 1 and published in 2005. MATERIALS AND METHODS:A qualitiative literature review of nursing literature of many source publications on the emotional state of caregivers working with elderly people including, Cumulative Index to Nursing and Allied Health (CINAHL), PubMed, SienceDirect and PsycINFO. From the literature available, the four core themes identified were: 1) atmosphere of caring; 2) coping; 3) the potential to care; and 4) understanding. This integrative review is designed to provide a good understanding of the underlying issues of managing the emotions of caregivers so they are appropriate when caring for elderly people. From the core themes, this integrative review led to an evidence-based practice to support c...

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.

Background: A secure attachment style of informal caregivers is important for the care of older adults at home. Informal caregivers who have secure attachment style to care for older adults, can effectively provide care for older adults. Objective: A sequential explanatory mixed-method design was introduced to study the factors predicting secure attachment and explain informal caregivers’ perceptions. Materials and Methods: 140 informal caregivers were selected from sub-district health-promoting hospitals from provinces in the northeastern Thailand by using the multi-stage random sampling method. The parameters included were caregivers’ personal information, satisfaction, empathy, health status, and caregivers’ attachment. Five experts in the field considered the content validity of all the measurements. The reliability of the four measurements was verified by applying Cronbach’s alpha coefficient, yielding 0.83, 0.70, 0.82 and 0.74. The researchers analyzed the data obtained from descriptive statistics and hierarchical regression analysis. A qualitative descriptive study was performed using semi-structured interviews, and data were analyzed using thematic analysis. Results: The results of quantitative data (a cross-sectional design) revealed that caregivers’ health status was considered the strongest predictor (β = .362, t = 5.208, p <.001) of secure attachment, followed by satisfaction, gender (female) and empathy. The qualitative data results revealed that four factors, i.e., caregivers’ healthy status, caregivers’ satisfaction, caregivers’ empathy, and female gender, could help the caregivers provide better care. Conclusion: Informal caregivers with good health status exhibited secure attachment. Healthcare teams and nurses should implement a program promoting good health status for informal caregivers who care for older adults at home.

The purpose of a concept analysis of caregivers' burden is to identify this in formal and informal caregivers to provide improved care to elderly adults with Alzheimer's disease (AD) and to reduce the burden of caregiving. The concept analysis proposed was conducted by Walker and Avant's eight-step method. The search was performed in December 2016. Four databases were included: CINAHL, EBSCO Host, Google Scholar, and Science Direct. The outcome of the search was five areas found overall: nursing, gerontology, medical, public health, and psychological. Exclusion criteria included editorials, and duplication in each database. Finally, 24 papers were used for analysis in the concept of "caregiver burden in caregivers of elderly adults with AD". The result of the concept analysis has three attributes including: physical and psychological problems, family function, and social support.