This phenomenological study used content analysis of interview data to explore factors affecting maternal role attainment in a convenience sample of 39 low-income, Thai, HIV-positive mothers selected for their successful adaptation. All mothers reported feeling comfortable in their maternal roles and achieved greater than 80% of the total score on the Maternal Behavioral Questionnaire. In-depth interviews were conducted regarding the life experience of the mothers. The results revealed the mothers' uses of internal and external resources to attain their maternal roles. Six factors were identified: (a) setting a purpose for life, that is, to raise the infant; (b) keeping secrets from others; (c) a feeling of normalization; (d) having good quality of support from others; (e) having hope for an HIV cure; and (f) receiving accessible, pleasant health services that protect anonymity regarding HIV status. The results suggest that nurses can promote maternal role attainment by supporting the mothers' management style.

The objective of this study was to explore strategies for improving the appropriateness of a health care delivery model to meet HIV-infected mothers' complex needs. A participatory action research paradigm was used as a process for an empowerment program (EP) and to elucidate the essential components of the program identified by these mothers. To test the EP's effectiveness, a nonequivalent control group pretest-posttest, quasi-experimental design was used. The participants included 94 Thai HIV-infected mothers rearing their own infants, with 46 in the 6-week experimental group and 48 in the control group. Study findings showed that the mothers in the EP group significantly increased levels of coping ability, quality of life, and maternal role adaptation when compared to mothers in the control group. In addition, data analysis revealed five components of the EP that were identified by mothers as essential for HIV-infected mothers' psychological well-being and their maternal role adaptation. These interventions included peer group meetings, professional support on infant rearing and maternal self-care, stress management, access to available social support, and alternative medicine. The mothers reported greater autonomy, accountability, collegiality, and more effective communication by the implication process of the EP.

Background: Heart failure is an increasing global health problem which adversely affects all aspects of a patient's health-related quality of life (HRQOL). Purpose: The hypothesized causal model of HRQOL in Thai heart-failure patients was based on Wilson and Cleary's HRQOL conceptual model. We examined causal relationships among bio-physiological status, symptoms, functional status, general health perception (GHP), and HRQOL shown in the model, and added an additional item-social support. Methods: A stratified four-stage random sampling method was used to obtain 422 heartfailure patients 18 years of age and older who visited nine outpatient hospital clinics from five regions of Thailand including metropolitan Bangkok. In addition to the participants' personal medical records, research instruments consisted of a personal information questionnaire, the Enhancing Recovery in Coronary Heart Disease Social Support Instrument, Cardiac Symptom Survey, the New York Heart Association functional classification system, a 100-mm horizontal visual analogue scale of GHP, and the Minnesota Living with Heart Failure Questionnaire. Data were analyzed using SPSS and AMOS computer programs. Results: The model fit well with the empirical data (χ 2 =19.87, df=13, p=0.10, GFI=0.99, and RMSEA=0.04). Symptom status was the most influential factor affecting HRQOL by both direct and indirect effects through functional status and GHP. Social support was the least influential factor affecting HRQOL. Social support had a negative direct effect on HRQOL, but had a positive indirect effect on HRQOL through symptom status and GHP. Conclusions: HRQOL was affected by each variable proposed in our causal model of HRQOL in Thai heart-failure patients. Symptom status had the strongest effect on HRQOL.Clinical Relevance: A comprehensive symptom management and prevention program that includes the described health outcome measures could lead to improved HRQOL for Thai heart-failure patients, and perhaps others.

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Quasi‐experimental research was conducted to investigate the optimum placement time and normative values of temperature measurements from the tympanic membrane, abdominal skin, axilla, and rectum of neonates at a newborn nursery of a university medical center in Thailand. A convenience sample of 52 growing preterm and 57 healthy term neonates was enrolled. Simultaneous temperature measurements were made at the four sites. Temperatures were recorded when they had remained unchanged for 2 min. The axillary temperature was as accurate as the rectal temperature measured with a glass thermometer if the placement times were optimal. The mean placement times in preterm and term neonates were 2.8 and 3.4 min for the rectum, 5.4 and 7.9 min for axilla, and 4.0 and 6.1 min for abdominal skin, respectively. The rectal temperature equalled the abdominal skin temperature plus 0.3°C for preterm and plus 0.2°C for term neonates. However, temperatures obtained with an infrared tympanic thermometer in the rectal‐equivalent mode did not give an accurate reading and are not recommended as a substitute for rectal temperatures in neonates.