1
|
Teli M, Thato R, Hasan F, Rias YA. Effectiveness of Family-Based Diabetes Management Intervention on Glycated Haemoglobin Among Adults With Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Biol Res Nurs 2024; 26:315-333. [PMID: 38063030 DOI: 10.1177/10998004231218887] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2024]
Abstract
BACKGROUND Glycated hemoglobin (HbA1c) control is a crucial goal in the management of type 2 diabetes mellitus (T2DM), requiring lifelong commitment and family support. This study aimed to assess the effectiveness of family-based diabetes management intervention on HbA1c among adults with T2DM. METHODS From inception up to 2022, a comprehensive literature search was conducted across PubMed, ProQuest, Scopus, CORE, and the Cochrane Library. The quality of studies was evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal tools. Effect sizes were calculated using standard deviations (SD), while the degree of heterogeneity was evaluated using the Higgins I2 test. Subgroup analyses were performed to explore factors contributing to sources of heterogeneity among trials. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed, and the protocol was registered with PROSPERO CRD42022384034. RESULTS A total of 18 randomized controlled trials (RCTs) involving 2815 participants indicated that family-based diabetes management intervention had a statistically significant impact on improving HbA1c (Mean Difference [MD] = -.47; 95% Confidence Interval [CI]: -.64 to -.30, p < .001) with a moderate level of heterogeneity (I2 = 59%). Subgroup analysis indicated that family-based diabetes management intervention among adults with T2DM in developing regions was more effective in improving HbA1c levels compared to developed countries. CONCLUSION Family-based diabetes management interventions improved HbA1c. Further research is required to develop diabetes management strategies with a family focus that clearly defines the family's involvement.
Collapse
Affiliation(s)
- Margareta Teli
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
- Nursing School, Polytechnic of Health Ministry of Health Kupang, Kupang, Indonesia
| | - Ratsiri Thato
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
| | - Faizul Hasan
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
| | - Yohanes Andy Rias
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
- Faculty of Health, College of Nursing, Institut Ilmu Kesehatan Bhakti Wiyata, Kediri, Indonesia
| |
Collapse
|
2
|
Oo HSW, Thato R, Phyo NW. Translation and validation of the East Asian Acculturation Measure (EAAM) among Myanmar migrants in Thailand. Belitung Nurs J 2024; 10:114-121. [PMID: 38425685 PMCID: PMC10900054 DOI: 10.33546/bnj.3109] [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] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/11/2023] [Accepted: 12/28/2023] [Indexed: 03/02/2024] Open
Abstract
Background Acculturation provides a framework for exploring the health behaviors of ethnic minority or cultural groups. Research on the acculturation level and patterns of Myanmar migrants is crucial since there is ample evidence that acculturation promotes health-promoting behaviors. However, no Myanmar version has undergone cross-cultural validation. Objective This study aimed to translate the original East Asian Acculturation Measure (EAAM) into the Myanmar version (EAAM-M) and investigate its psychometric properties. Methods The validation study was conducted on a sample of 200 Myanmar migrants in three factories in Bangkok, Thailand, by a multistage random sampling method from August to September 2023. Brislin's back translation technique was applied to convert the original EAAM into its modified version, EAAM-M. The reliability, content validity, and construct validity of the EAAM-M were examined, and confirmatory factor analysis (CFA) was employed to test the appropriateness of the model that underpins the EAAM-M structure. Results The average age of the participants was 38.39 years (SD = 5.56), and 68% of participants reported they earned less than 9000 baht. In terms of how long they stayed in Thailand, slightly over half (52.5%) did so for 1-5 years. Nearly half of them (46%) cannot communicate at all regarding their proficiency in speaking Thai. The score regarding the comparability of language and similarity of interpretability between the original EAAM and the EAAM-M was satisfactory. The overall alpha reliability of the EAAM-M was 0.76. Based on the CFA, the measurement model was well fit, with acceptable goodness-of-fit values (Chi-square test of model fit (p = 0.05), CMIN/df = 1.70 (χ2 = 624.931, df = 366), RMSEA = 0.02, CFI = 0.98, and SRMR = 0.06). The validity and reliability of the factors were affirmed through appropriate factor loadings and satisfactory levels of composite reliability (0.942) and average variance extracted (0.538). Conclusion The EAAM-M is a reliable and valid instrument to measure the acculturation patterns of Myanmar migrants. It is beneficial for scholars across various disciplines, including health professionals and nurses, to deliver culturally tailored care for migrants.
Collapse
Affiliation(s)
- Htet Shwe Wah Oo
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
- University of Nursing, Yangon, Myanmar
| | - Ratsiri Thato
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
| | - Nyan Win Phyo
- World Vision Foundation of Thailand, Bangkok, Thailand
| |
Collapse
|
3
|
Rias YA, Tsai HT, Thato R, Apriyanto BS, Chou KR, Ho SC, Sun CH. Synergistic Interactions of Insufficient Physical Activity and a High Systemic Immune-Inflammation Index on Psychological Problems in Indonesians With Type 2 Diabetes Mellitus. Biol Res Nurs 2023; 25:516-526. [PMID: 36891960 DOI: 10.1177/10998004231162050] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
BACKGROUND High-grade inflammation represents a critical contribution to the onset of depression and might be manageable by physical activity (PA). Nevertheless, no study has examined synergistic interactions of insufficient PA and high values of the systemic immune-inflammation index (SII) on psychological problems. OBJECTIVE We investigated independent and synergistic interactions of insufficient PA and high SII levels on stress, anxiety, and depression in T2DM patients. METHODS A cross-sectional research design with 294 T2DM patients was conducted. An XP-100 automated hematology analyzer was used to evaluate inflammatory biomarkers. Depression, Anxiety, and Stress Scale-21 items and a standardized questionnaire about PA were respectively used to measure psychological problems and metabolic equivalent of task (MET)-h/week. RESULTS A multiple linear regression demonstrated that patients with insufficient PA were significantly more likely to have higher stress (β = 1.84, 95% confidence interval (CI) = 1.03-2.65), anxiety (β = 1.88, 95% CI = 1.81-2.96), and depression (β = 2.53, 95% CI = 0.82-4.24) than those with active PA. A high SII level was a key predictor and was most strongly associated with stress (β = 2.61, 95% CI = 2.02-3.20), anxiety (β = 3.16, 95% CI = 2.37-3.94), and depression (β = 3.72, 95% CI = 2.49-4.96) compared to those who had low SII levels. Notably, additive interaction results showed that combining insufficient PA and a high SII level had a significantly escalated 1.71-fold risk of stress, 1.82-fold risk of anxiety, and 2.69-fold risk of depression. CONCLUSIONS Active PA and a low SII had a positive synergistic effect of decreasing psychological problems.
Collapse
Affiliation(s)
- Yohanes Andy Rias
- Faculty of Health and Medicine, College of Nursing, Institut Ilmu Kesehatan Bhakti Wiyata, Kediri, Indonesia
- Graduate School of Chulalongkorn University, Bangkok, Thailand
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, ROC
| | - Hsiu Ting Tsai
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, ROC
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, ROC
| | - Ratsiri Thato
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
| | - Bagus Sholeh Apriyanto
- Faculty of Health and Medicine, College of Nursing, Institut Ilmu Kesehatan Bhakti Wiyata, Kediri, Indonesia
| | - Kuei Ru Chou
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, ROC
| | - Shu Chuan Ho
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, ROC
| | - Chia Hsuan Sun
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, ROC
| |
Collapse
|
4
|
Rias YA, Thato R, Tsai HT. Physical Activity and Its Synergistic Interaction With Low Platelet-Lymphocyte Ratio Levels Increasing the Sleep Quality in Type 2 Diabetes Mellitus. Sci Diabetes Self Manag Care 2023:26350106231173675. [PMID: 37166083 DOI: 10.1177/26350106231173675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
PURPOSE The purpose of the study was to explore the effect of synergistic interaction and the independence of physical activity and inflammatory markers, including platelet-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR), on sleep quality in persons with type 2 diabetes mellitus (T2DM). METHODS This descriptive cross-sectional study included 294 persons with T2DM in East Java, Indonesia. Fasting blood was analyzed for inflammation markers, including NLR and PLR. Physical activity and sleep quality were assessed using Metabolic Equivalent of Task and Pittsburgh Sleep Quality Index, respectively. Multivariate logistic regression, chi-square test, and independent t test were performed. RESULTS There was an independently significant relationship between physical activity, NLR, and PLR with sleep quality. Persons with both active physical activity and low PLRs were 12.52 times more likely to have high sleep quality scores than those with low physical activity and high PLRs. A positive additive interaction of active physical activity and low PLRs for high sleep quality scores was identified. CONCLUSION Physical activity, NLR, and PLR revealed an independently significant relationship with sleep quality. Persons with both active physical activity levels and low PLR were the most substantial synergistic effect of high sleep quality. Further studies are necessary to examine the problems and solutions for sleep quality in this population.
Collapse
Affiliation(s)
- Yohanes Andy Rias
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
- Faculty of Health and Medicine, College of Nursing, Institut Ilmu Kesehatan Bhakti Wiyata, Kediri, Indonesia
| | - Ratsiri Thato
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
| | - Hsiu Ting Tsai
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- School of Nursing, College of Nursing, Taipei Medical University, Taipei Taiwan
| |
Collapse
|
5
|
Teli M, Thato R, Rias YA. Predicting Factors of Health-Related Quality of Life Among Adults With Type 2 Diabetes: A Systematic Review. SAGE Open Nurs 2023; 9:23779608231185921. [PMID: 37448972 PMCID: PMC10336768 DOI: 10.1177/23779608231185921] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 05/10/2023] [Accepted: 06/15/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction One of the most important outcomes of diabetes care and treatment is an improvement in patients' health-related quality of life (HRQoL). Objective This study aimed to review the empirical evidence regarding the predictors of HRQoL among adults with type 2 diabetes mellitus (T2DM). Methods To find all English-language articles published between 2012 and 2022, a comprehensive literature search was conducted using ProQuest, Scopus, PubMed, Science Direct, and CORE. Cross-sectional studies were the focus of this analysis. Search terms included "type 2 diabetes" OR "T2DM" AND "health-related quality of life" OR "HRQoL" AND ("predicting factors" OR "influencing factors" OR "associated factors"). The original search yielded a total of 1,089 studies, from which 35 met the review's inclusion criteria. The systematic review protocol was registered with PROSPERO CRD42023431229. Results The final analysis comprised 24,346 people with type 2 diabetes and used data from 35 cross-sectional studies conducted during the preceding decade. Socio-demographic factors (age, marital status, gender, monthly income, education, area of residence, and religiosity), patient-centered factors (diabetes knowledge and self-efficacy), disease characteristics (comorbidities, duration of diabetes, and insulin treatment), self-management behaviors (physical activity, medication adherence, and frequent glucose checks), and family support were found to be predictors of HRQoL. Conclusion A diabetes program to enhance the HRQoL among people with T2DM is highly encouraged to address these factors, which can be focused on promoting self-management behaviors, diabetes distress management, and encourage family support.
Collapse
Affiliation(s)
- Margareta Teli
- Faculty of Nursing, Chulalongkorn University Bangkok, Bangkok, Thailand
- Nursing School, Polytechnic of Ministry of Health-Kupang, East Nusa Tenggara, Indonesia
| | - Ratsiri Thato
- Faculty of Nursing, Chulalongkorn University Bangkok, Bangkok, Thailand
| | - Yohane Andy Rias
- Faculty of Nursing, Chulalongkorn University Bangkok, Bangkok, Thailand
- Institut Ilmu Kesehatan Bhakti Wiyata Kediri, Kediri, Jawa Timur, Indonesia
| |
Collapse
|
6
|
Thato R, Daengsaard E, Sukrak N. The Effect of a Brief HIV Prevention Program on Risk Reduction Behaviors Among Thai Men Diagnosed With Sexually Transmitted Infections. Asian Nurs Res (Korean Soc Nurs Sci) 2018; 12:265-272. [PMID: 30342223 DOI: 10.1016/j.anr.2018.10.003] [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: 03/30/2018] [Revised: 10/05/2018] [Accepted: 10/08/2018] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Men diagnosed with sexually transmitted infections (STIs) are at greater risk for Human Immunodeficiency Virus (HIV) infection and STIs reinfection. This study aimed to test the effectiveness of a brief human immunodeficiency virus (B-HIV) prevention program on HIV and sexually transmitted infection (STI) knowledge, perceived benefits of condom use, risk reduction self-efficacy, risk reduction behaviors, and reinfection rate among Thai men with STIs. METHODS A quasi-experimental design was conducted. Participants were selected from men with STI symptoms. They were randomly assigned to a B-HIV prevention program or usual care, 100 each. The program consisted of 3 modules. Key messages for HIV prevention were sent weekly through Line. Outcomes were HIV and STI knowledge, perceived benefits of condom use, risk reduction self-efficacy, risk reduction behaviors (condom use, the number of sexual partners, and condomless sex), and STI reinfection rate. Independent t-test and binary logistic regression were performed. RESULTS The B-HIV prevention program significantly increased HIV and STI knowledge and resulted in perception of greater benefits from condoms and greater risk reduction self-efficacy. Program participants used condoms more frequently with many types of partners, especially with casual partners and sex workers. The intervention group practiced condomless sex less frequently than the control group. The program did not improve participants' condom use with lovers/steady partners and did not decrease the number of sexual partners and STI reinfection rate at 3-month follow-up. CONCLUSIONS A B-HIV prevention program could reduce the risk of HIV infection among male clients with current STIs by enhancing their condom use with casual partners and sex workers. Strategies to improve condom use with lovers/steady partners among this high-risk population is needed.
Collapse
Affiliation(s)
- Ratsiri Thato
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand.
| | - Ekkachai Daengsaard
- General Male Clinic, Bangrak STIs Cluster, Bureau of AIDS, TB, and STIs, Ministry of Public Health, Bangkok, Thailand
| | - Nutthavit Sukrak
- General Male Clinic, Bangrak STIs Cluster, Bureau of AIDS, TB, and STIs, Ministry of Public Health, Bangkok, Thailand
| |
Collapse
|
7
|
Thato R, Daengsaard E. Determinants of Behavior Change Intention Among Heterosexual Thai Males Diagnosed with Sexually Transmitted Diseases. AIDS Patient Care STDS 2016; 30:512-518. [PMID: 27849371 DOI: 10.1089/apc.2016.0127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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
This study sought to identify factors associated with intention to change sexual practices among heterosexual Thai males diagnosed with sexually transmitted infections (STIs). STI clinic patients (n = 247) reported their sexual behaviors and condom use during the previous 3 months. STI and HIV knowledge, motivation to change sexual practices, and behavioral skills were assessed. Then, self-reported behavior change intention, including consistent condom use, reducing number of sexual partners, not using drugs and alcohol when having sex, and refusal of condomless sex, was examined. Consistent condom use in the past 3 months by Thai males diagnosed with STIs was low across all types of sexual partners (lover 13.8%, casual partner 14.9%, and sex worker 2.5%). Risk reduction self-efficacy (p < 0.001), perceived benefits from condom use (p < 0.001), perceived barriers to condom use (p < 0.001), perceived risk for HIV (p < 0.05), and STI and HIV knowledge (p < 0.05) were significantly correlated with behavior change intention. Significant predictors of behavior change intention were risk reduction self-efficacy (p < 0.001), perceived benefits of condom use (p = 0.016), and perceived risk for HIV (p = 0.033). They explained 36% of behavior change intention variance. Intervention aimed at enhancing motivation and behavioral skills to adopt preventive behaviors should be developed to prevent recurrent STIs, including HIV infection, among heterosexual Thai males diagnosed with STIs.
Collapse
Affiliation(s)
- Ratsiri Thato
- Faculty of Nursing, Chulalongkorn University, Pathumwan, Bangkok, Thailand
| | - Ekkachai Daengsaard
- Bangrak STIs Cluster, Bureau of AIDS, TB, and STIs, Ministry of Public Health, Sathorn, Bangkok, Thailand
| |
Collapse
|
8
|
Thato R, Penrose J. A brief, peer-led HIV prevention program for college students in Bangkok, Thailand. J Pediatr Adolesc Gynecol 2013; 26:58-65. [PMID: 23332197 DOI: 10.1016/j.jpag.2012.09.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Revised: 09/21/2012] [Accepted: 09/29/2012] [Indexed: 10/27/2022]
Abstract
STUDY OBJECTIVE To test the effectiveness of a brief theory-based HIV prevention program led by peers among college students. DESIGN A quasi-experimental research using a pretest-posttest nonequivalent control group design with 2-mo follow-up. SETTING A university in Bangkok. PARTICIPANTS For peer leaders, 70 undergrad students taking health sexuality course were invited to participate in the study. Then, a convenience sample of undergraduate students was recruited through peer leaders, 226 for experimental group and 209 for control group. MAIN OUTCOME MEASURES Information, motivation, behavioral skills, and AIDS/STIs preventive behaviors. RESULTS The study revealed that a Brief, Peer-Led HIV Prevention Program significantly increased knowledge of preventive behaviors (β = 2.67, P < .000), motivated participants to have a better attitude toward preventive behaviors (β = -5.26, P < .000), better subjective norms (β = -1.54, P < .000), and greater intentions to practice preventive behavior (β = -1.38, P < .000). The program also significantly decreased perceived difficulty of AIDS/STIs preventive behaviors (β = 2.38, P < .000) and increased perceived effectiveness at AIDS/STIs preventive behavior (β = -3.03, P < .000). However, it did not significantly increase AIDS/STIs preventive behaviors (β = 2.13, P > .05). CONCLUSION Findings of this study provide initial evidence as to how theoretical variables were operated to effectively increase knowledge, change motivation, and behavioral skills of AIDS/STIs preventive behavior among Thai college students. More research is needed to further test the effectiveness of the program on AIDS/STIs preventive behaviors among college students.
Collapse
Affiliation(s)
- Ratsiri Thato
- Faculty of Nursing Chulalongkorn University, Pathumwan, Bangkok, Thailand.
| | | |
Collapse
|
9
|
Thaithae S, Thato R. Obstetric and perinatal outcomes of teenage pregnancies in Thailand. J Pediatr Adolesc Gynecol 2011; 24:342-6. [PMID: 22099731 DOI: 10.1016/j.jpag.2011.02.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2010] [Revised: 02/08/2011] [Accepted: 02/15/2011] [Indexed: 11/25/2022]
Abstract
STUDY OBJECTIVE To determine whether, when controlling for confounding factors, there was still an association of adolescence with adverse outcomes. DESIGN Retrospective case control study. SETTING Seven Bangkok Metropolitan Administration General Hospitals. PARTICIPANTS Charts of all women aged 19 and younger (n = 1,354) having singleton live births in 2004, 2005, and 2006 were retrieved. For the adult group, 1,389 charts of mothers between the ages of 20 and 34 delivering singleton babies were selected using proportionate systematic random sampling. Maternal age was divided into 3 groups: 11-15, 16-19, and 20-34. MAIN OUTCOME MEASURES Obstetric and perinatal outcomes. RESULTS After statistically controlling for known confounding factors, teenage pregnancy was associated with increased risks of anemia (11-15: AOR = 1.81, P < 0.001; 16-19: AOR = 1.48, P < 0.01), very preterm deliveries (11-15: AOR = 2.18, P < 0.05), very low birth weight babies (11-15: AOR = 6.98, P < 0.05; 16-19: AOR = 9.86, P < 0.01), newborn admission to Intensive Care Unit (11-15: AOR = 1.93, P < 0.01; 16-19: AOR = 2.10, P < 0.01), and postpartum complications (11-15: AOR = 3.33, P < 0.01). The rates of cesarean delivery (11-15: AOR 0.58, P < 0.01; 16-19: AOR = 0.57, P < 0.01), operative delivery (11-15: AOR = 0.49, P < 0.01), and oxytocin augmentation (16-19: AOR = 0.66, P < 0.01) were less frequent in younger mothers. CONCLUSION Independent of known confounding factors, teenage pregnancy was associated with increased risks of adverse maternal and neonatal outcomes requiring clinical and outreach interventions from health care providers.
Collapse
Affiliation(s)
- Suparp Thaithae
- Department of Obstetrics and Gynecology Nursing, Kuakarun College of Nursing, Dusit, Bangkok, Thailand
| | | |
Collapse
|
10
|
Thato R, Jenkins R, Dusitsin N. Effects of the culturally-sensitive comprehensive sex education programme among Thai secondary school students. J Adv Nurs 2008; 62:457-69. [DOI: 10.1111/j.1365-2648.2008.04609.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|