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Manaboriboon B, In-Iw S, Bongsebandhu-Phubhakdi C, Arunakul J, Kamol N, Areekul W, Thunyapipat C, Leelathipkul L, Areemit R. Feeding and eating disorders among hospitalized children and adolescents in Thailand: A 5-year secondary national database analysis. Int J Nurs Pract 2024; 30:e13189. [PMID: 37591310 DOI: 10.1111/ijn.13189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 06/26/2023] [Accepted: 07/28/2023] [Indexed: 08/19/2023]
Abstract
AIMS This study aimed to present national data for children and adolescents requiring hospitalization in Thailand. BACKGROUND Feeding and eating disorders can cause life-threatening and negative health impacts. In Asia, the prevalence is rising. Data from children and adolescents in Thailand are limited. DESIGN This study is a retrospective study of the national database. METHODS Data from the National Health Security Office database on Universal Health Insurance Coverage (2015-2019) of 0-17-year-olds were analysed by diagnosis (anorexia nervosa, bulimia nervosa, vomiting associated with psychological disturbances, other eating disorders and unspecified eating disorders). Descriptive statistics, chi-square test and multinomial logistic regression were used. RESULTS There were 163 patients, averaging 9.4 ± 5.2 years old, requiring 205 admissions. Most diagnoses showed stable trends, except for a slight decrease in anorexia and unspecified eating disorders. Most admissions were due to unspecified eating disorders and psychogenic vomiting, followed by anorexia nervosa. The overall prevalence was 3.86 per 100 000 admissions. Anorexia had the highest hospital costs and re-admission rates. Anorexia nervosa was most prevalent in early adolescence and females, while bulimia nervosa was most prominent in middle adolescence and had a male predominance. CONCLUSION Early recognition in clinical practice could increase early detection and improve outcomes.
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Affiliation(s)
| | - Supinya In-Iw
- Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chansuda Bongsebandhu-Phubhakdi
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Jiraporn Arunakul
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Napapailin Kamol
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wirote Areekul
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand
| | | | - Lalit Leelathipkul
- Department of Pediatrics, Faculty of Medicine, Thammasat Hospital, Thammasat University, Khlong Nueng, Thailand
| | - Rosawan Areemit
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Jamneankal T, Kiatrungrit K, Arunakul J, Korpaisarn S, Auapisithwong S. Validity and reliability of the Thai version of the Utrecht Gender Dysphoria Scale-Gender Spectrum (UGDS-GS) in Thai youths and young adults with gender dysphoria. Gen Psychiatr 2023; 36:e100980. [PMID: 37529558 PMCID: PMC10387638 DOI: 10.1136/gpsych-2022-100980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 07/03/2023] [Indexed: 08/03/2023] Open
Abstract
Background Many people who are gender variant have undiagnosed gender dysphoria, resulting in delayed receipt of gender-affirming support and prolonged distress in living with their gender-non-conforming sex. The Utrecht Gender Dysphoria Scale-Gender Spectrum (UGDS-GS) is a newly developed tool that measures dissatisfaction with gender identity and expression. However, there is no translated version of this tool in Thai. Moreover, the sensitivity, specificity and cut-off point of the UGDS-GS to detect gender dysphoria in people who are transgender remain unknown. Aims This study translated the UGDS-GS into Thai and then examined the validity and reliability of the Thai UGDS-GS. Methods 185 participants with and without gender dysphoria were selected from the Gender Variation Clinic in Ramathibodi Hospital and from social media platforms. The UGDS-GS was translated into Thai according to the World Health Organization (WHO) guidelines on translation. The medical records of patients with gender dysphoria and semi-structured interviews were used to confirm the diagnosis of gender dysphoria. Subsequently, the validity and reliability of the instrument were analysed. Results The mean age of participants was 30.43 (7.98) years among the 51 assigned males (27.6%) and 134 assigned females (72.4%) at birth. The Thai UGDS-GS average score was 77.82 (9.71) for those with gender dysphoria (n=95) and 46.03 (10.71) for those without gender dysphoria (n=90). Cronbach's alpha coefficient was 0.962, showing excellent internal consistency. In addition, exploratory factor analysis showed compatibility with the original version's metrics. The value of the area under the curve was 0.976 (95% confidence interval: 0.954 to 0.998), indicating outstanding concordance. At the cut-off point of '60', sensitivity and specificity were good (96.84% and 91.11%, respectively). Conclusions The Thai UGDS-GS is an excellent, psychometrically reliable and valid tool for screening gender dysphoria in clinical and community settings in Thailand. The cut-off point of '60' scores suggests a positive indicator or a high chance of gender dysphoria.
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Affiliation(s)
- Tanawis Jamneankal
- Department of Psychiatry, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
- Department of Psychiatry, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Komsan Kiatrungrit
- Department of Psychiatry, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Jiraporn Arunakul
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sira Korpaisarn
- Department of Internal Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suthra Auapisithwong
- Department of Mental Health, Ministry of Public Health, Child and Adolescent Mental Health Rajanagarindra Institute (CAMRI), Bangkok, Thailand
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Rutnin S, Suchonwanit P, Kositkuljorn C, Pomsoong C, Korpaisarn S, Arunakul J, Rattananukrom T. Characterizing Dermatological Conditions in the Transgender Population: A Cross-Sectional Study. Transgend Health 2023; 8:89-99. [PMID: 36824384 PMCID: PMC9942180 DOI: 10.1089/trgh.2021.0105] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose This study aimed to demonstrate the effects of gender-affirming hormone therapy (GAHT) and gender-affirming procedures on the skin in transgender individuals. Methods We conducted a cross-sectional study among transgender people. Skin conditions related to GAHT were assessed, including acne (using the Investigator's Global Assessment, IGA), postacne sequelae, melasma, hypertrichosis in androgen-sensitive areas (HAAs) in transgender men (TM) and hirsutism in transgender women (TW) (using the modified Ferriman-Gallwey score, mFG score), and hair loss (using the Hamilton-Norwood and Ludwig scale) at baseline, 6 months after GAHT, and the day on which the questionnaire was completed. Dermatological problems after gender-affirming procedures were evaluated. Results A total of 159 patients, including 134 TM and 25 TW, were eligible to participate. The median duration of GAHT was 23 and 36 months in TM and TW, respectively. In TM, the median IGA score of facial acne increased from 1 at baseline to 3 after 6 months and decreased to 2 after 2 years of GAHT. The mFG score indicated HAA in all TMs after testosterone treatment. A total of 88.1% of TM had no hair loss before hormone therapy. However, after 2 years of GAHT, 76.1% of TM developed male pattern hair loss (MPHL), and 26.1% of them had moderate-to-severe MPHL. In TW, the median IGA and mFG scores decreased after 3 years of hormone therapy, and the proportion of female pattern hair loss (FPHL) in TW increased to 16% after GAHT. In both groups, the most common skin complication after gender-affirming surgery was hypertrophic scarring. Conclusions GAHT in TM resulted in acne and MPHL, whereas GAHT in TW caused melasma and FPHL.
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Affiliation(s)
- Suthinee Rutnin
- Divisions of Dermatology and Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Divisions of Dermatology and Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chaninan Kositkuljorn
- Divisions of Dermatology and Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Cherrin Pomsoong
- Divisions of Dermatology and Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sira Korpaisarn
- Divisions of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Jiraporn Arunakul
- Division of Child and Adolescent Health, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Teerapong Rattananukrom
- Divisions of Dermatology and Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.,Address correspondence to: Teerapong Rattananukrom, MD, MSc, Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand,
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Areemit RS, Manaboriboon B, In-Iw S, Arunakul J, Bongsebandhu-Phubhakdi C, Kamol N, Thunyapipat C, Leelathipkul L, Areekul W. Five-Year Trend of Adolescent Hospitalizations and Deaths in Thailand: A Secondary National Data Health Situation Analysis. J Prev (2022) 2023; 44:127-142. [PMID: 36512185 DOI: 10.1007/s10935-022-00716-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 12/15/2022]
Abstract
Adolescence is a critical phase for achieving human potential, serving as the foundation for later health. In 2010, the major causes of hospital admissions and deaths in Thai adolescents were related to preventable causes, specifically engagement in high-risk behaviors such as unprotected sexual intercourse, substance use and unsafe driving. We retrieved data from 1,761,667 adolescent (10-17 years) hospital admissions and 6362 deaths between 2015 and 2019 from the National Health Security Office database. Trends of hospital admissions and deaths, length of stay and medical expenses by sex, age: early (10-13 years) and middle adolescents (14-17 years), and geographical regions were analyzed by ICD-10 disease group and single diagnosis. Hospital admissions increased in relation to the same age population from 2015 to 2019. Trends of the top 3 diagnoses shifted between disease groups from 2015 to 2019. Pregnancy retreated from the first (17.8%) to the third rank (12.2%), and arthropod-borne viral fevers advanced from the third (13.1%) to the first rank (17.1%). Injury and poisoning remained at the second rank (14.5-14.4%). Females were admitted more than males, but males had significantly longer hospital stays. Early adolescents were admitted less than middle adolescents and their hospital stay was significantly shorter. Trends of the top 3 diagnoses for deaths by disease groups remained stable: injury and poisoning (41.2%), neoplasms (10.2%), and respiratory infections (9.5%). The average direct health care cost utilized on adolescent health care was 3813 million Baht (115.54 million US Dollars) per year. Considering the top 3 disease groups, injury and poisoning had the highest average cost per hospital admission and net cost per year consuming 26.4% of the total cost. Our study highlights the cause of hospital admissions and deaths in Thai adolescents, which are mainly preventable. Adolescent health care will improve with more investment in prevention through policy, service, and education reform.
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Affiliation(s)
- Rosawan S Areemit
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, 123 Mittraphap Road Muang Khon Kaen, Khon Kaen, 40002, Thailand
| | - Boonying Manaboriboon
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, 2, Wanglang Road, Siriraj, Bangkoknoi, Bangkok, 10700, Thailand.
| | - Supinya In-Iw
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, 2, Wanglang Road, Siriraj, Bangkoknoi, Bangkok, 10700, Thailand
| | - Jiraporn Arunakul
- Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchatewi, Bangkok, 10400, Thailand
| | - Chansuda Bongsebandhu-Phubhakdi
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873, Rama 4 Road, Pathumwan Sub-district, Pathumwan District, Bangkok, 10330, Thailand
| | - Napapailin Kamol
- Chakri Naruebodindra Medical Institute, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thepharak, Mueang Samut Prakan District, Samut Prakan, 10540, Thailand
| | - Chaloempong Thunyapipat
- Department of Pediatrics, Maharat Nakhon Ratchasima Hospital, 49 Changphuak Rd, Mueang Nakhon Ratchasima District, Nakhon Ratchasima, 30000, Thailand
| | - Lalit Leelathipkul
- Department of Pediatrics, Faculty of Medicine, Thammasat Hospital, Thammasat University, 95/8, Khlongluang District, Pathumthani, 12120, Thailand
| | - Wirote Areekul
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, 317 Ratchawithi Rd, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand
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Korpaisarn S, Chiewchalermsri D, Arunakul J, Chinthakanan O, Poomthavorn P, Sriphrapradang C. Effects of testosterone treatment on transgender males: A single-institution study. SAGE Open Med 2021; 9:20503121211051546. [PMID: 34659767 PMCID: PMC8511909 DOI: 10.1177/20503121211051546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/16/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives: Data regarding gender-affirming hormone therapy in the Asian population are
sparse. We aimed to evaluate the efficacy and safety of testosterone therapy
in transgender men. Methods: A retrospective study chart review was conducted in a single university-based
transgender clinic. Transgender men aged >18 years who newly started
testosterone therapy during January 2015 to October 2019 were recruited.
Physical changes, laboratory results, and adverse events, including cancer,
thromboembolism, cardiovascular events, and death after masculinizing
hormone therapy, were evaluated. Results: A total of 39 transgender men (mean age: 27.8 ± 6.0 years) were included. All
individuals were treated with intramuscular testosterone injection with a
mean follow-up of 25.2 ± 12.9 months. The most common maintenance regimen
was testosterone enanthate 250 mg every 4 weeks. Masculinizing effects
developed in all transgender men. There were no changes in body weight, and
systolic and diastolic blood pressure. Hematocrit levels were 12%
significantly increased from 39.9 ± 3.3% to 48.9 ± 2% (p < 0.001). Ten
individuals (25.6%) had hematocrit >50%. Significant changes were found
in decreased fasting plasma glucose, increased creatinine, and increased
uric acid levels. A non-significantly increased alanine aminotransferase,
increased low-density lipoprotein cholesterol, and decreased high-density
lipoprotein cholesterol were observed. No thromboembolism, cancer, stroke,
or coronary artery disease occurred. Conclusions: Gender-affirming hormone therapy is an effective and safe short-term
treatment in Thai transgender men. Apart from the standard recommendation,
uric acid, plasma glucose, and creatinine level evaluation before and during
masculinizing hormone therapy are rational practices. An intramuscular
testosterone enanthate 250 mg every 4 weeks is an alternative masculinizing
regimen with decent efficacy and safety profile.
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Affiliation(s)
- Sira Korpaisarn
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Dararat Chiewchalermsri
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Jiraporn Arunakul
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Orawee Chinthakanan
- Department of Obstetrics and Gynecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Preamrudee Poomthavorn
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chutintorn Sriphrapradang
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Sukrat B, Okascharoen C, Rattanasiri S, Aekplakorn W, Arunakul J, Saejeng K, Böhning D, Thakkinstian A. Estimation of the adolescent pregnancy rate in Thailand 2008-2013: an application of capture-recapture method. BMC Pregnancy Childbirth 2020; 20:120. [PMID: 32075596 PMCID: PMC7031918 DOI: 10.1186/s12884-020-2808-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 02/12/2020] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Adolescent pregnancy is an important health and social issue that affects both individual and social well-being. However, deriving a national estimate is challenging in a country with multiple incomplete national databases especially the abortion statistics. The objective of this study was to estimate the adolescent pregnancy rates in Thailand using capture-recapture method. METHODS An application of capture-recapture method was conducted using two cross-sectional databases (i.e., the national birth registration and the Ministry of Public Health standard health databases) and one hospital-based data source from medical record reviews. A 3-sources capture-recapture with log-linear model was applied to estimate adolescent pregnancy rates. RESULTS A total number of 741,084, 290,922 and 25,478 records were respectively identified from the birth registrations, standard health databases and hospital-based survey data during 2008 to 2013. The estimated adolescent pregnancy rates /1000 adolescent women (95% confidence intervals (CI)) ranged from 56.3 (49.4, 66.9) to 70.3 (60.3, 76.6). The estimated rates were about 12-31% higher than adolescent birth rates reported by the Thailand Public Health Statistics. CONCLUSIONS With the capture-recapture method, more accurate adolescent pregnancy rates were estimated. This method should be able to apply to any setting with similar context.
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Affiliation(s)
- Bunyarit Sukrat
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chusak Okascharoen
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 RAMA VI Road. Rachathevi, Bangkok, 10400, Thailand.
| | - Sasivimol Rattanasiri
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wichai Aekplakorn
- Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Jiraporn Arunakul
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 RAMA VI Road. Rachathevi, Bangkok, 10400, Thailand
| | - Kittipong Saejeng
- Bureau of Reproductive Health, Department of Health, Ministry of Public Health, Nonthaburi, Thailand
| | - Dankmar Böhning
- Southampton Statistical Sciences Research Institute, University of Southampton, Southampton, UK
| | - Ammarin Thakkinstian
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Suwannachat S, Wattanasirichaigoon D, Arunakul J, Chirdkiatgumchai V, Tim-Aroon T. Correction to: Perspectives of adults with Klinefelter syndrome, unaffected adolescent males, and parents of affected children toward diagnosis disclosure: a Thai experience. J Community Genet 2019; 11:239. [PMID: 31745761 PMCID: PMC7062945 DOI: 10.1007/s12687-019-00445-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Sukrit Suwannachat
- Division of Medical Genetics, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Bangkok, 10400, Thailand
| | - Duangrurdee Wattanasirichaigoon
- Division of Medical Genetics, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Bangkok, 10400, Thailand.
| | - Jiraporn Arunakul
- Division of Child and Adolescent Health, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - Vilawan Chirdkiatgumchai
- Division of Child Development, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - Thipwimol Tim-Aroon
- Division of Medical Genetics, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Bangkok, 10400, Thailand
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Suwannachat S, Wattanasirichaigoon D, Arunakul J, Chirdkiatgumchai V, Tim-Aroon T. Perspectives of adults with Klinefelter syndrome, unaffected adolescent males, and parents of affected children toward diagnosis disclosure: a Thai experience. J Community Genet 2019; 11:171-181. [PMID: 31485954 PMCID: PMC7062947 DOI: 10.1007/s12687-019-00435-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 08/28/2019] [Indexed: 01/15/2023] Open
Abstract
Little is known about disclosure of diagnosis to males with Klinefelter syndrome (KS) diagnosed before birth or during childhood, especially in Asian context. Insufficient preparation for disclosure communication could lead to the child's depression, anxiety, or disrupted self-esteem. This is an interventional and qualitative interview study with a brief self-reported survey. The study consists of three phases. In phase I, adults with KS were asked about their experiences and viewpoints toward KS disclosure and diagnosis through individual interviews. In phase II, unaffected adolescent males were given information about KS and then asked to give hypothetical answers to a questionnaire followed by a group interview, as if they had KS. In phase III, parents of children with KS were asked to complete a questionnaire followed by a group interview which included a discussion about their disclosure plans and their concerns. The parents were provided information obtained from adults with KS and unaffected adolescent males, and were then interviewed again as a group. We found that the most hurtful issues were discovering their infertility from KS and late disclosure. From the perspective of unaffected adolescent males, early disclosure in early or mid-teens in a neutral, supportive, and relaxed manner, along with information on benefits of hormonal treatment, the assurance of biological sex as "male," and avoidance of some sensitive words are strongly recommended, as a way to promote self-confidence and positive coping with the diagnosis. After intervention, the parents reported more confidence and less anxiety about disclosing the diagnosis to their children, and indicated that they would disclose KS at an earlier age. For unaffected adolescent males, though it is a hypothetical scenario and their reaction may differ from affected adolescents, unaffected adolescent males' viewpoints on how they might react are more or less representative of cultural changes for the new generation, especially in the Asian context. In addition, their viewpoints influenced parents' decision and genetic counseling plans for the diagnosis disclosure of KS to their children. We propose a preliminary guideline for KS diagnosis disclosure.
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Affiliation(s)
- Sukrit Suwannachat
- Division of Medical Genetics, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Bangkok, 10400, Thailand
| | - Duangrurdee Wattanasirichaigoon
- Division of Medical Genetics, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Bangkok, 10400, Thailand.
| | - Jiraporn Arunakul
- Division of Child and Adolescent Health, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - Vilawan Chirdkiatgumchai
- Division of Child Development, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - Thipwimol Tim-Aroon
- Division of Medical Genetics, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Bangkok, 10400, Thailand
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9
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Leelathipkul L, Ruangkanchanasetr S, Arunakul J. Risk behaviors screening in Thai adolescents with acute and chronic illnesses. Int J Adolesc Med Health 2018; 33:/j/ijamh.ahead-of-print/ijamh-2018-0047/ijamh-2018-0047.xml. [PMID: 30375347 DOI: 10.1515/ijamh-2018-0047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 08/28/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND Adolescence is considered as a transition period from childhood to adulthood. This transition leads to various types of risk behaviors. Ten percent of adolescents suffer from a chronic illness that can limit their daily activities and which may exhibit higher rates of risk behaviors than those without chronic illnesses. OBJECTIVE To evaluate the prevalence of risk behaviors in chronically ill adolescents compared to adolescents without chronic illnesses and their associated risk factors. METHODS We enrolled 312 patients aged 10-20 years who visited Ramathibodi Hospital from January 2015 to December 2017. There were 161 adolescents with chronic illnesses and 151 without a chronic illness. We used a computer-based program for the Youth Risk Behaviors Survey as well as a confidentiality interview. Statistical analyses included the chi-squared (χ2) and Student's t-tests as appropriate. RESULTS The risk behaviors in chronically ill adolescents were the following: learning problems, 86.3%; excessive screen time, 62.3%; unintentional injuries, 60.2%; depression, 38.5%; low self-esteem, 18.1%; substance abuse, 13% and sexual behavior, 6.2%. Youths with a chronic illness were more likely to report significantly higher risk of excessive screen time (62.3% vs. 48%, p = 0.01), depression (38.5% vs. 15.9%, p < 0.01) and, also low self-esteem (18.1% vs. 8.6%, p = 0.01) compared to those without chronic illness. CONCLUSIONS These results indicated that adolescents with chronic illnesses engage more in health risk behaviors and are prone to mental health and learning problems. These data emphasize the importance of health risk behavior screening and preventive counseling for young patients with chronic illnesses where these risks might worsen their disease.
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Affiliation(s)
- Lalit Leelathipkul
- Mahidol University Faculty of Medicine Ramathibodi Hospital, Department of Pediatrics, Bangkok, Thailand
| | - Suwanna Ruangkanchanasetr
- Mahidol University Faculty of Medicine Ramathibodi Hospital, Department of Pediatrics, Bangkok, Thailand
| | - Jiraporn Arunakul
- Mahidol University Faculty of Medicine Ramathibodi Hospital, Department of Pediatrics, Bangkok, Thailand
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Areemit RS, Manaboriboon B, In-Iw S, Arunakul J, Areekul W. HEEADSSS up: pediatric residents' confidence and practice in adolescent health care before and after mandatory adolescent medicine rotations in Thailand. Int J Adolesc Med Health 2017; 32:ijamh-2017-0149. [PMID: 29168974 DOI: 10.1515/ijamh-2017-0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 09/25/2017] [Indexed: 11/15/2022]
Abstract
Background The field of adolescent medicine is an emerging area of specialization in Thailand. Adolescent medicine was made a mandatory rotation in general pediatric residency training programs for the class of 2013. Objective This study aims to explore the difference in pediatric residents' confidence and the frequency in providing aspects of care to adolescents. Subjects Participants included two groups of pediatric residents; the former curriculum group (FCG) in 2012 and the mandatory curriculum group (MCG) in 2015. Methods Participants in this cross-sectional study answered a 41-item self-administered questionnaire and results were analyzed by descriptive statistics. Results There were 91 participants, 50.05% were in the MCG. The FCG reported a higher percentage of feeling "more confident" on physical examination (p = 0.031, V = 0.23) and growth assessment (p = 0.040, V = 0.22). The MCG reported a higher percentage of "more frequently" carrying out the psychosocial assessment (p = 0.035, V = 0.22). Conclusion The FCG reported higher levels of confidence than the MCG in most of the items, while the MCG reported higher levels of frequency in providing care. The psychosocial (HEEADSSS) assessment, a key aspect of the adolescent clinical visit, was the item that the MCG reported doing more frequently than the FCG which remained significant when only the postgraduate year of training (PGY) 4s were compared.
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Affiliation(s)
- Rosawan S Areemit
- Division of Ambulatory Pediatrics, Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Boonying Manaboriboon
- Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Supinya In-Iw
- Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jiraporn Arunakul
- Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wirote Areekul
- Phramongkutklao College of Medicine, Department of Military and Community Medicine, Bangkok, Thailand
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