Mahidol University's Institutional Repository
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Recent Submissions
Factors related to the needs for home care of patients with essential hypertension
(Mahidol University. Mahidol University Library and Knowledge Center, 2000) Nongnuch Petchroung; Chounchom Charoenyooth; Jariyawat Kompayak; Rutja Phuphaibul
Essential hypertension is an important public health problem in Thailand. Patients have to confront hypertension all of their lives. Home care should apply an appropriate strategy for essential hypertensive patients. The Neuman System Model (Neuman, 1995) was employed in this study as a guideline. This descriptive study of factors related to the needs for home care of patients with essential hypertension aims to identify the needs for home care and factors related to the needs for home care of patients. Data were gathered from three hundred subjects among essential hypertensive patients who were followed up at the hypertension clinic, Siriraj Hospital, Faculty of Medicine Siriraj Hospital, Mahidol University, using an interview questionnaire
constructed according to the Neuman System Model. Pearson's product moment correlation coefficient and a Chi-square test were used to test the significance of the relationships. The results of the study revealed that the subjects have a high level of overall needs. When considering specific needs, it revealed that the subjects have a high level of physiological, psychological and spiritual needs, and a moderate level of socio-cultural and developmental
needs. The physiological needs of subjects included the need to be instructed about the action and side effects of antihypertensive drugs. The psychological needs were mainly the need to be instructed about the danger of stress affecting hypertension. Socio-cultural needs comprised the need to receive attention from caregivers. The need to be instructed about rehabilitation made up the developmental needs. Spiritual needs were the needs to be helped to maintain hope and willpower in their lives. Factors related to the needs for home care found that internal environmental factors such as gender were statistically associated with developmental needs for home care at the .05 level of significance. Age was negatively associated with socio-cultural needs for home care at the .05 level of significance. The ability to perform activities of daily living was positively associated with socio-cultural needs for home care at the .05 level of statistical significance. It was negatively associated with developmental needs for home care at the .05 level of statistical significance. External environmental factors such as family income were negatively associated with socio-cultural needs for home care at the .01 level of statistical significance. Health insurance was statistically associated with socio-cultural needs for home care at the .05 level of significance. Overall needs for home care were not related to internal and external environmental factors. This study suggests that home care service to patients should focus on informing patients about the action and side effects of antihypertensive drugs, information about the harmful effects of stress on hypertension and education about how to practice skills to manage stress should be included. Counseling patients when they experience stress, learning about community resources, and arranging teaching programs in order to rehabilitate patients and help them maintain hope and willpower in their lives should also be included. These home care services should focus on the patients who are young adults, females, who have a low ability to perform the activities of daily
living, a low family income and no health insurance.
The relationships among life events, social support, and self-esteem of adolescents in a Charity Boarding School
(Mahidol University. Mahidol University Library and Knowledge Center, 2000) Jaroonrat Rodniam; Poolsook Sriyaporn; Panwadee Putwatana; Pairoa Pongchoke
The purposes of this survey study are to explore negative and positive life events, level of social support and self-esteem, the difference between self-
esteem scores of males and females, the relationships among age, feelings toward negative and positive life events, social support and self-esteem in adolescents. The influence of these variables on self-esteem was also explored. The sample for this study comprised 445 school children of grades 7th - 12th in the 19th Rachaprachanukroa (under Royal patronage) School, Thungsong District, Nakhon Sri Thammarat province. The data were collected between February 2 and March 10, 2000 using the Adolescent Self-Assessment and Report Questionnaire (ASARQ). Statistics used for data analysis were percentages, means, standard deviation, independent t-test, Pearson's Product Moment Correlation and Stepwise multiple regression. The results showed that the largest portion of the studied samples reported death of influential relative (43.60%) and having a warm family (22.22%) as a negative and a positive life event, respectively. Most of them had moderate to high self-esteem (52.1%) and had moderate social support (66.1%). There was no significant difference between males' and females' self-esteem scores. The findings revealed a positive correlation between feelings toward positive life events and social support to self-esteem with the correlation coefficient (r) =. 122 (p <. 05) and .486 (p <. 01), respectively. Age and feelings toward positive life events were significantly associated with social support, the correlation coefficient (r) = .216 (p <. 01) and .196 (p <. 01), respectively. Social support was the only one factor among all studied variables found to be influential adolescents' self-esteem scores (R2 =. 237, p <. 001). Overall results from this study provide more understanding of life events in adolescents and the importance of social support to enhancing self-esteem thus leading to the development of appropriate measures in schools to foster self-esteem in adolescents particularly with reference to school nursing services.
The effectiveness of real-time telelactation intervention on breastfeeding outcomes among employed mothers: a systematic review and meta-analysis
(2025-12-01) Iamchareon T.; Maneesriwongul W.; Iamchareon T.; Mahidol University
Background: The global exclusive breastfeeding (EBF) rate during the first six months is < 50%. This rate is particularly low among employed mothers, who may face obstacles in accessing in-person lactation services. Given that telelactation services can increase EBF rates, we conducted this study to assess the effects of real-time telelactation services (vs. usual lactation services) on breastfeeding outcomes among employed mothers. Methods: The Preferred Reporting Items for Systematic Reviews Meta-Analyses guidelines were followed. Studies published between 2012 and 2023 were identified from the Academic Search Ultimate, Cochrane, CINAHL Complete, Embase, ProQuest, SAGE journals, ScienceDirect, Scopus, Springer Link, Google Scholar, and Thai Journal Online databases. Randomized controlled trials and quasi-experimental studies that met the inclusion criteria were included. The JBI critical appraisal tool was used to assess the studies selected for the systematic review. Categorical data were analyzed using relative risk (RR) with 95% confidence intervals (CIs) and a random-effects model. Results: Of the 18 studies selected for the review, 13 were included in the meta-analysis with a total of 4,564 participants. Of these, 3,582 were employed mothers. We identified three types of real-time telelactation services based on the activities of the provider and client: proactive, reactive, and mixed services. The results showed that real-time telelactation services had a statistically significant positive effect on the EBF rate during the first six months compared to usual care (Relative risk (RR): 1.31, 95% Confidence interval (CI) [1.10, 1.54]; p = 0.002). Proactive and mixed services significantly enhanced the rate of EBF (RR: 1.59, 95% CI [1.23, 2.05]; p = 0.0004 and RR: 1.38, 95% CI [1.01, 1.87]; p = 0.04, respectively). Reactive services did not significantly affect the EBF rate during the first six months compared to usual care (RR: 0.98, 95% CI [0.93, 1.04]; p = 0.54). Conclusions: Real-time telelactation services delivered by lactation/trained professionals in a proactive or combined proactive/reactive manner (i.e., via scheduled appointments and on demand) were the most effective. These service models should be considered by lactation service providers and healthcare policymakers seeking to increase EBF among the majority of participants who were employed mothers. Review registration: This review has been registered in the International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42023429900).
The Moderating Role of Genetic and Environmental Risk Factors for Schizophrenia on the Relationship between Autistic Traits and Psychosis Expression in the General Population
(2025-01-01) Karacam Dogan M.; Prachason T.; Lin B.; Pries L.K.; Arias-Magnasco A.; Bortoletto R.; Menne-Lothmann C.; Decoster J.; Van Winkel R.; Collip D.; Delespaul P.; De Hert M.; Derom C.; Thiery E.; Jacobs N.; Van Os J.; Rutten B.; Brondino N.; Colizzi M.; Luykx J.; Fusar-Poli L.; Guloksuz S.; Karacam Dogan M.; Mahidol University
Background: Psychosis-related environmental risks in autism, along with genetic overlaps between autism and psychosis, have been well-established. However, their moderating roles in the relationship between autistic traits (ATs) and psychotic experiences (PEs) remain underexplored. Methods: First-wave data from 792 twins and siblings (mean age: 17.47±3.6, 60.23% female) in the TwinssCan Project were analyzed. PEs and ATs were assessed using the Community Assessment of Psychic Experiences and the Autism-Spectrum Quotient, respectively. Polygenic risk scores for schizophrenia and psychosis-Associated environmental factors (ie, childhood trauma (CT), bullying, negative life events, obstetric complications, cannabis use, winter birth, and hearing impairment) were tested for their independent effects on PEs and their interaction effects with ATs in moderating the relationship between ATs and PEs using separate multilevel linear regression models with Bonferroni's correction. Results: ATs, all CT subtypes, bullying, and negative life events were positively associated with PEs (all P<.004). Moderation analyses revealed that the association between ATs and PEs was amplified by emotional abuse (B:0.08, 95% CI, 0.05-0.11, P<.001), physical abuse (B:0.11, P=.001), sexual abuse (B:0.09, 95% CI, 0.03-0.15, P=.002), and physical neglect (B:0.06, 95% CI, 0.03-0.10, P=.001), emotional neglect (B:0.04, 95% CI, 0.01-0.07, P=.007), and negative life events (B:0.007, 95% CI, 0.0005-0.014, P=.04), although the latter 2 risks did not survive Bonferroni's correction. No significant main or interacting effects of genetic and other risk factors were found. Conclusions: People with high ATs were more likely to have PEs when exposed to CT. Trauma screening and early interventions might be warranted in this at-risk population.
Exploring testate amoebae as taxonomic and functional bioindicators to inform peatland habitat status and blanket bog restoration
(2025-07-01) Liu B.; Heinemeyer A.; Marchant R.; Mills R.T.E.; Liu B.; Mahidol University
Many UK blanket bog peatlands are degraded due to historical management including drainage, leading to reduced biodiversity, carbon sequestration and water storage. Currently, much restoration efforts including rewetting and revegetation strategies are being deployed aiming to restore habitats towards intact and ecohydrologically functioning ecosystems. However, it remains unclear how these efforts affect the key microbial consumers, testate amoebae (TA), especially their functional traits, and whether TA can be used as a generic tool to monitor the long-term hydrological restoration success. This study compared TA communities and their key functional traits at one intact and three near-intact sites versus three modified blanket bog sites with different habitat conditions (i.e., least modified, post-restoration, and degraded) to assess their environmental responses, bioindicator potential and explore their possible functional contribution to ecosystems in the process of recovery. The results showed: 1) TA community composition gradually changes from degraded to intact sites in both Sphagnum and surface peat, with distinct dominant TA species in each; 2) soil moisture, Sphagnum cover, and phosphorus content strongly relate to TA composition; 3) Hyalosphenia subflava and Corythion dubium indicate dry conditions, while Archerella flavum and Amphitrema wrightianum are indicators of wet conditions; 4) significantly higher community-weighted mean values of TA traits (biovolume, aperture width, siliceous tests) in surface peat at the least modified areas suggest TA's strong role in carbon and silica cycling following rewetting. Our findings support TA as bioindicators for tracking habitat hydrological conditions and restoration progress in blanket bogs, effectively linking community composition to ecosystem functions.