Self-esteem is a key feature in a person's perception of their own worth. This report is of a study of the reported self-esteem levels of two groups of student nurses: one in Thailand and one in the UK. Purposive samples of 120 Thai students and 101 UK undergraduate nursing students were given the Culture-Free Self-Esteem Inventory (CFSEI-2). The CFSEI-2 is a self-reported inventory, which measures an individual's perception of self. The findings of the study indicate that the perceptions of own self-esteem in undergraduate student nurses in the UK and in Thailand were comparable to the normal ranges of self-esteem as assessed by the instrument. An independent sample t-test revealed that there were no significant differences in mean overall and subscale self-esteem scores between UK and Thai nursing students. There were no indications of differences in levels of self-esteem for UK and Thai nursing students experiencing different parts of their training.
Thailand is a Buddhist country located on the mainland of southeast Asia, where 3-generation homes are still common. Care of older adults is primarily a family responsibility. Recent policy changes mean that all Thais are now eligible for services through the national health care system. Almost half the population has no retirement pension, leaving responsibility for support of older adults largely to extended family. Long-term care is becoming a serious concern as the population ages, women move into the workforce, and family size decreases. Thai researchers have focused on issues related to health and nutrition, income security, housing, general population aging, local and community care and services, information and education, and quality of life. There is currently no formal long-term care system.
ProblemDemand for long-term care services for older people is increasing rapidly in low- and middle-income countries. Countries need to establish national long-term care systems that are sustainable and equitable.ApproachThe Governments of Costa Rica and Thailand have implemented broadly comparable interventions to deploy volunteers in long-term home care. Both countries trained older volunteers from local communities to make home visits to impoverished and vulnerable older people and to facilitate access to health services and other social services.Local settingCosta Rica and Thailand are upper-middle-income countries with strong traditions of community-based health services that they are now extending into long-term care for older people.Relevant changesBetween 2003 and 2013 Thailand’s programme trained over 51 000 volunteers, reaching almost 800 000 older people. Between 2010 and 2016 Costa Rica established 50 community care networks, serving around 10 000 people and involving over 5000 volunteers. Despite some evidence of benefits to the physical and mental health of older people and greater uptake of other services, a large burden of unmet care needs and signs of a growth of unregulated private services still exist.Lessons learntThere is scope for low- and middle-income countries to develop large-scale networks of community-based long-term care volunteers. The capacity of volunteers to enhance the quality of life of clients is affected by the local availability of care services. Volunteer care networks should be complemented by other initiatives, including training about health in later life for volunteers, and investment in community long-term care services.
Objective: This study aimed to develop and validate protein energy malnutrition (PEM) screening tool for older adults in public residential homes, and test its practicality. Design: This cross-sectional study consisted of two phases: tool development/validation and tool practicality evaluation. In Phase 1, the questionnaire was developed based on literature review and tested for content validity. Older residents were interviewed using this questionnaire to identify potential PEM risk factors. A 24-hour recall was used to collect dietary data, and body composition and serum albumin were measured. In Phase 2, practicality of new PEM screening tool was evaluated by intended users. Data were analyzed by Chi-square test, Fisher’s exact test, t-test, Mann-Whitney U test, and multiple logistic regression. Akaike Information Criterion (AIC) was used to estimate the best fit model. Setting: Four public residential homes in central region, Thailand. Participants: 249 older residents residing in public residential homes and eight intended users. Results: 26∙9% had PEM (serum albumin <3∙5 g/dl). According to multiple logistic regression and AIC values, PEM predictors were having pressure ulcer, experiencing significant weight loss and taking ≥9 types of medicine daily. These predictors were included in PEM screening tool. Regarding tool performance test, area under the ROC curve was 0∙8 (P<0∙001) with sensitivity and specificity of 83∙9 and 45∙5%, respectively. For its practicality, eight intended users reported that it was useful and easy to use. Conclusions: New screening tool may be capable of identifying PEM in older residents, and further testing is required before being recommended for use.
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