Because little is known about elderly Thai immigrants' conceptualization of depression, a qualitative descriptive research study was conducted to explore their perception of depression. Semi-structured individual face-to-face interviews were performed with a purposeful sampling of ten men and ten women aged 60 years and older at participants' homes or Thai Buddhist temples. The results revealed that depression was defined as feeling disappointment and pressure in the mind and included symptoms of isolation, heart pounding, and dissatisfaction. Coping strategies comprised practicing Buddhism and acceptance. Gender differences existed and reflected cultural expectations for men and women. These findings provide a foundation for developing culturally sensitive health care.
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.
Most Thai registered nurses who provide end-of-life care emphasize the physical dimension of care rather than spiritual care. There is a need to explore the experiences of Thai nurses who provide spiritual care. The purpose of the study was to explore the experiences of Thai palliative care nurses providing spiritual care for older adults at the end of life. A descriptive qualitative research design was used. The 8 participants were Thai nurses with experience of palliative care in hospitals in the central, northeastern, northern, and southern regions of Thailand. A focus group discussion was used for data collection. Content analysis was used to analyze data. Five themes were as follows: (1) spiritual care was searching for meaning in patients' lives, (2) spiritual self-preparation of nurses for making sense and connecting to patients' spirituality, (3) caring for patients' spiritual needs by recognizing psychological and religious beliefs, (4) facilitating ways to ease patients' suffering, and (5) assuring confidence of patients and relatives for receiving the best care. These findings that should be included in training registered nurses are honoring the patients' lives, addressing spiritual needs to decrease patients' suffering, and enhancing patients' perceptions of care through spiritual self-preparation and spiritual concern of nurses.
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