Background: The global aging trend has accelerated. This study tried to identify the factors related to different patterns of physical and cognitive leisure activities among Chinese middle-aged and older adults. Method: Latent Profile Analysis was conducted to classify 12,480 participants aged 45 and above, followed by logistic regression to understand associations between activity profiles and related factors. Results: Physical activity (n = 2,269) and cognitive leisure activity groups (n = 10,211) were identified according to their different levels of physical activity and cognitive leisure activity engagement. Middle-aged individuals (aOR = 1.42, 95% CI: 1.29–1.56), rural residents (aOR = 1.38, 95% CI: 1.23–1.55), and individuals without formal education (aOR = 1.79, 95% CI: 1.53–2.10) were more likely to belong to the physical activity group. Depression (aOR = 1.23, 95% CI: 1.06–1.42) and without BADL limitations (aOR = 2.11, 95% CI: 1.21–3.67) were also significantly associated with membership in this group. Conclusion: Physical and cognitive leisure activity groups were identified, with age, residence, education, depression, and BADL associated with group membership. Digital and community-based interventions could support both physical and cognitive engagement. Keywords: Activity pattern, Healthy aging, Health behavior, Latent profile analysis, Well-being, China
Background: Organizational readiness is essential for AI-enabled digital transformation as healthcare organizations increasingly integrate artificial intelligence (AI). However, empirical evidence regarding the relationship between AI readiness and organizational change, the mediating role of digital maturity, remains limited in healthcare settings. This study investigated the mediating role of digital maturity in the relationship between AI readiness and organizational change. Methods: This cross-sectional study involved 300 healthcare professionals from two Indonesian hospitals: Persahabatan Hospital (n = 165) and St. Carolus Hospital (n = 135). Data were collected using a questionnaire and analyzed through Partial Least Squares Structural Equation Modeling (PLS-SEM) to assess the measurement and structural models. Results: AI readiness had significant positive associations with digital maturity and organizational change. Digital maturity was positively associated with organizational change and partially mediated the relationship between AI readiness and organizational change. Although respondents reported high digital maturity, their AI readiness remained moderate, indicating a gap between digital capabilities and preparedness for advanced AI implementation. Conclusion: This study provides empirical evidence of the mediating role of digital maturity in the relationship between AI readiness and organizational change in hospitals within a developing-country context. Organizational change was positively associated with AI readiness through direct and indirect pathways, with digital maturity serving as a partial mediator. Strengthening AI readiness alongside digital infrastructure, organizational processes, leadership support, and workforce competencies may facilitate AI-enabled organizational transformation, helping hospitals translate their digital capabilities into effective and sustainable AI implementation. Keywords: AI readiness, digital maturity, organizational change, hospitals
Background: Health literacy (HL) is crucial for delaying chronic kidney disease (CKD) progression, yet evidence on HL promotion among older adults with early-stage CKD is limited. This study examines HL level and explores the situation of HL promotion for delaying kidney progression among older adults with CKD. Methods: A convergent parallel mixed-methods design was employed. The quantitative phase, 297 older adults with CKD complete a questionnaire. The qualitative phase, 50 participants then took part in interviews to explore their experiences. Quantitative data were analyzed using descriptive statistics, and qualitative data through content analysis. Findings were integrated to identify patterns across data sources. Results: Most participants demonstrated high HL for delaying kidney progression (61.28%; mean = 228.31, SD = 36.90). The lowest-scoring dimensions were access to health information and media literacy. Qualitative findings identified five key aspects: 1) Limited awareness and understanding of CKD, 2) Barriers to accessing and screening for accurate health information, 3) Challenges in modifying health behaviors and self-management, 4) Critical roles of family members, village health volunteers, and proactive community-based services, 5) Constraints in resources, policies, and systems supporting health literacy development. Conclusion: Older adults with CKD generally exhibited high HL for delaying kidney progression. However, gaps in CKD awareness and understanding, information access and screening, self-management, along with system-level constraints, highlight the need for health literacy-responsive, community-based support to slow disease progression. Keywords: Health literacy, Chronic kidney disease, Kidney disease progression, Older adults
Background: Exclusive breastfeeding (EBF) is a critical determinant of infant health and survival, yet its prevalence remains suboptimal in low-income communities globally. Barriers such as limited access to lactation support and misinformation continue to challenge EBF promotion efforts in these settings. This review maps and evaluates mHealth interventions that promote exclusive breastfeeding in low-income populations. Methods: This scoping review was conducted following the JBI methodology and reported in accordance with the PRISMA-ScR guidelines. A systematic search of PubMed, Scopus, and Web of Science was conducted for articles published up to July 2025. Eligible studies involved any mHealth-based breastfeeding intervention targeted at low-income mothers, and data were charted using a structured PICO framework. Results: Twenty-four studies met the inclusion criteria, with the majority employing SMS-based interventions, mobile applications, and telelactation support. Most studies reported positive outcomes, including increased EBF rates at 6 weeks to 6 months, improved maternal knowledge, and high app usability and acceptability among users. Interventions involving personalized counseling or peer support through mobile platforms appeared particularly effective. A few studies showed limited impact due to digital literacy, infrastructure barriers, or low engagement levels. The heterogeneity in intervention design and outcome measures limits comparability across studies. Conclusion: mHealth interventions demonstrate promising potential in enhancing exclusive breastfeeding practices among low-income communities. Tailored, culturally sensitive, and user-friendly digital tools, particularly those that include peer or health worker support, can help close the breastfeeding equity gap if scaled and sustained effectively. Keywords: Breastfeeding, Health promotion, Mobile applications, Poverty areas, Telemedicine
Background: Poor sleep is common among older adults and negatively affects physical and mental health. This study evaluated the effects of jasmine and champaca essential oil aromatherapy combined with acupressure on sleep quality and cardiovascular parameters among older adults. Methods: A quasi-experimental study was conducted in rural Phayao, Thailand. Older adults aged ≥60 years with non-communicable diseases and poor sleep quality (Pittsburgh Sleep Quality Index [PSQI] > 5) were assigned to either an intervention group (n = 54), receiving aromatherapy and acupressure for 6 weeks, or a control group (n = 54), receiving usual care. Sleep quality, blood pressure (BP), and pulse rate (PR) were assessed at baseline, post-intervention, and 3 months after intervention completion. Results: Repeated-measures ANOVA showed significant time and group-by-time effects for PSQI, SBP, DBP, and PR (all p < 0.05). ANCOVA confirmed greater improvements in the intervention group, with significant reductions in PSQI, SBP, DBP, and PR at both post-intervention and 3-month follow-up (all p < 0.001). Conclusions: Jasmine and champaca aromatherapy combined with acupressure significantly improved sleep quality and cardiovascular parameters, supporting its use as a complementary intervention for older adults in rural communities. Keywords: Jasmine and Champaca; Aromatherapy; Acupressure; Sleep Quality; Older Adults; Non-Communicable Diseases
Background: Asymptomatic microscopic haematuria (AMH) is frequently detected in outpatient settings. However, its long-term outcomes and association with serious urological conditions; such as genitourinary cancer, urolithiasis, and glomerular disease, remain underexplored. Understanding these associations is essential for improving the diagnostic and management strategies within public health settings. Methods: This study aimed to determine the underlying causes of AMH in an outpatient department after long-term follow-up. It is a descriptive longitudinal study on outpatients with AMH. Medical records from January 1, 2012., were reviewed: in total of 410 patients were included and followed up until 31 December 2022; or until a definitive diagnosis was established. Results:Among the 410 patients (mean age, 57 years), geometric mean of follow-up time, 2 years 9 months, was used due to skewed follow-up times (95%CI=2.4 to 3.2). The long-term outcome of serious disease (Genitourinary malignancy, urolithiasis, Glomerular disease) in patients with AMHwas 19.0%. Specifically, 61 patients (14.9%) were diagnosed with urolithiasis, 3 (0.7%) with genitourinary malignancy, and 14 (3.4%) with glomerular disease. Male and a high blood cell count on urinalysis were significantly associated with major disease (p < 0.01 and p < 0.05, respectively) Conclusion: Serious disease was identified in 19.0% of patients with AMH. Although a small number of red blood cells in the urine may initially appear clinically insignificant, it could be associated with underlying serious pathology, particularly among male patients. Keywords: Hematuria, Outpatient, Urological disease, Longitudinal study, Thailand
Background: Increased concerns over the potential health impacts on consumers from widespread pyrethroid use in agriculture have necessitated the implementation of maximum residue limits (MRLs) on food products. In Thailand, while such regulations exist, their enforcement remains incomplete. The study aims to monitor pyrethroid contamination in Khon Kaen market vegetables and evaluate the risks posed to human health. Method: A total of 100 samples representing ten different fresh vegetable types were collected from May to July 2024. Pyrethroid residues in vegetables collected from both structured and unstructured markets in Khon Kaen, Thailand, were analyzed using gas chromatography (GC) with a micro electron capture detector (μECD). Health risks for both short-term and long-term exposure were calculated by combining the detected pyrethroid residue levels with estimated dietary intake data, utilizing a relevant database. Results: Samples of Chinese kale contained the highest levels of lambda-cyhalothrin detected at 0.71 mg/kg and bifenthrin at 0.70 mg/kg. The structured markets within Muang District had a high prevalence of detectable residues from pyrethroid groups. An evaluation of the short-term (sHI) and long-term (cHQ) health risks associated with the consumption of these vegetables indicates potential health risks exceeding acceptable thresholds, particularly among children. Conclusion: This investigation reveals pyrethroid contamination in vegetables from the Khon Kaen province markets in Thailand. It is vital to reduce contamination to ensure food security as well as educate consumers about this contamination to increase their food safety. Keywords: Pyrethroids, Pesticides, Maximum Residue Limits, Vegetables, Insecticide residues, Health risk assessment
Background: Individuals newly diagnosed with type 2 diabetes often have limited knowledge and self-management skills, leading to poor glycemic control and increased complications. This study evaluated the effectiveness of the Smart ME-DE Digital Program in improving health literacy and glycated hemoglobin levels among newly diagnosed individuals with type 2 diabetes. Methods: A quasi-experimental study was conducted with seventy participants recruited from diabetes clinics at three hospitals in a central province of Thailand. They were selected using simple random sampling and matched by gender, age, and baseline HbA1c levels, and allocated to an experimental or comparison group. The experimental group received the Smart ME-DE digital program for 16 weeks, while the comparison group received standard care. Data were collected at Baseline, Week 8, and Week 16. Repeated-measures ANOVA examined changes in health literacy and HbA1c levels over time and between groups. Results: Health literacy in the experimental group improved significantly at Weeks 8 and 16 compared with baseline and the comparison group (p < 0.001). HbA1c decreased significantly in both groups at Week 16; however, the reduction was greater in the experimental group, with a significant group–time interaction (p < 0.001). Conclusion: The Smart ME-DE Digital Program significantly improved health literacy and glycemic outcomes among individuals newly diagnosed with type 2 diabetes. Integration into routine diabetes care may support early self-management. Further studies with larger samples and longer follow-up are recommended. Keywords: Digital health, Glycated hemoglobin, Health literacy, Type 2 diabetes mellitus
Background: Middle-aged women (aged 40-60) in Malaysia face health concerns due to psychological changes, sociocultural impacts, and hormonal shifts as they age. This study aimed to uncover which aspects of strength training programs enable middle-aged women to better manage their health concerns in Malaysia. Methods: Following the PRISMA guidelines, we utilized the health belief model (HBM) framework to understand how training programs affect the health of middle-aged women worldwide. We focused on women in Malaysia and the unique cultural barriers they experience. Sources were selected from 2010 to 2025. Results: We selected 22 studies within Malaysia to highlight the impacts of strength training on middle-aged women’s health. We found that enhancing self-efficacy led to better management of health concerns for women. The training program also improved women’s psychological well-being. While Western women were motivated by improving their physical appearance, Malaysian women were more interested in exercise to maintain their personal health and their ability to work and care for family. Some Malaysian women found that lack of perceived modesty, as well as difficulty finding women-only exercise spaces and enough free time were significant barriers to exercise. Conclusion: Overall, the health development training programs were beneficial; the programs effectively helped middle-aged women develop their physical and psychological health. Programs in Malaysia should integrate the Health Belief Model (HBM) and address cultural-specific barriers to help women maintain a positive body image with proper exercise structure. Keywords: strength training, body image, Health Belief Model, middle-aged women, Malaysia
Background: The growing burden of NCDs in Thailand highlights the need for effective community management by Village Health Volunteers (VHVs). This study investigated factors associated with health literacy and chronic disease service performance among VHVs in Chiang Rai Province, Thailand. Methods: A cross-sectional survey was conducted among 325 VHVs via two-stage cluster sampling between June and July 2023. Data were collected using a validated five-part questionnaire (Cronbach’s alpha = 0.93–0.98). Data analysis included descriptive statistics, content analysis, Chi-square tests, and Spearman's rank correlation coefficient. Results:VHVs demonstrated good health literacy (41.8%) and a high level of chronic disease service performance (65.5%). Health literacy was significantly associated with education level, occupation, and prior NCD training (p < 0.05). It was positively correlated with work motivation (r = 0.587, p < 0.001) and social support (r = 0.497, p < 0.001). Service performance was significantly associated with education level, residence in health-behavior modification villages, and specialized training (p< 0.05). Performance showed positive correlations with work motivation (r ¼ 0.464), social support (r ¼ 0.484), and health literacy (r ¼ 0.701, p < 0.001). Key barriers include patient non-cooperation, elderly abandonment by families, and insufficient medical equipment. Conclusion: Work motivation and health literacy are critical determinants of VHV performance. Public health agencies should prioritize competency-based training and strengthen social support systems. Addressing systemic barriers through equipment provision and family-community linkages is essential for sustainable health outcomes. Keyword: Health literacy, Chronic disease services, Village Health Volunteers, Work motivation, Social support
Background: Tuberculosis remains a major global public health challenge. This study determined the prevalence of latent tuberculosis infection (LTBI) using the Interferon-Gamma Release Assay (IGRA) and identified associated risk factors among household contacts of pulmonary tuberculosis patients in Roi Et Province. Method: This cross-sectional analytic study included 334 pulmonary tuberculosis patients (index cases) and their 359 household contacts in Roi Et Province. The data was collected using screening and follow-up tools for TB patients and household contacts between October 1, 2024, and September 30, 2025. Data were analyzed using descriptive and inferential statistics. Categorical variables were compared using Chi-square or Fisher’s exact tests, while continuous variables were analyzed using independent t-test or Mann–Whitney U test, as appropriate. Multiple logistic regression analysis was used to determine factors independently associated with latent tuberculosis infection (LTBI). Results: Out of the 359 household contacts, 99 (27.6%) were found to have latent tuberculosis infection (LTBI) or positive IGRA results. Significant risk factors for LTBI consisted of sharing a living space with the patient for more than 8 hours per day (Adjusted OR = 2.44; 95%CI: 1.47–4.07) and the presence of pulmonary cavitation in the index patient (Adjusted OR = 5.11; 95%CI: 2.95–8.86). Conclusion: The Prevalence of LTBI among household contacts in Roi Et was 27.6%. Prolonged daily exposure of more than 8 hours and pulmonary cavitation in index cases were independently associated with latent tuberculosis infection (LTBI). Keywords: Latent tuberculosis infection, Interferon-Gamma Release Assay, Household contacts, Risk factors
Background: Depressive symptoms have been associated with activities of daily living (ADL) disability; however, evidence among Thai older adults remains limited and inconsistent. This study investigates the association between depressive symptoms and ADL disability in older Thai adults. Methods: A cross-sectional analytic study was conducted among 312 older adults in Nakhon Ratchasima, Thailand, who were selected using a multistage sampling method. Data were collected between April and July 2023 using structured questionnaires covering demographic and environmental variables. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale. ADL disability was measured using the Barthel and Chula ADL Indices. Multiple logistic regression was performed to estimate adjusted odds ratios (adjusted ORs) with 95% confidence intervals (CIs). Results: Among participants, 52.6% were female, with a mean age of 69.4 years (SD = 8.6). The prevalence of depressive symptoms was 17.3% (95% CI, 13.3–22.0). The prevalence of basic ADL disability and instrumental ADL (IADL) disability was 4.2% (95% CI, 2.2–7.0) and 21.5% (95% CI, 17.0–26.6), respectively. Depressive symptoms were significantly associated with IADL disability. Participants with depressive symptoms had approximately threefold higher odds of IADL disability than those without depressive symptoms (adjusted OR, 3.05; 95% CI, 1.35–6.87; p = 0.007). Conclusions: These findings highlight the importance of integrated community-based interventions targeting depression among older adults. Strengthening primary care and mental health services may reduce functional disability and support healthy aging. Keywords: Activities of daily living, Depressive symptoms, Geriatric Depression Scale, Older adults
Background: This paper aims to present practical experiences and lessons learned from applying an integrated worker health approach among informal workers in Thailand. The approach draws on the concept of Total Worker Health (TWH) and is implemented through Primary Care Units (PCUs). Methods: This is an invited commentary. Results: Key steps included: (1) identification of occupational health (OH) services provided by PCUs; (2) development and refinement of an integrated worker health assessment tool based on TWH principles; (3) assessment and problem identification among informal workers, highlighting combined occupational and lifestyle-related risks; (4) design and implementation of integrated interventions; and (5) stakeholder engagement and reflection on implementation challenges. Conclusion: Lessons learned highlight the value of integrated approaches, multidisciplinary collaboration, and stakeholder engagement. Capacity building of frontline staff and the development of simple, practical models may support broader implementation of integrated worker health programs among informal workers. Keywords: Informal workers, integrated worker health, occupational health, lifestyle factors, lessons learned, primary care
Background: This paper aims to examine the determinants of health and pesticide exposure among villagers in durian-growing communities in Nakhon Si Thammarat Province, southern Thailand, and Sisaket Province, northeastern Thailand, where pesticide-related health impacts have been identified by local stakeholders as a major public health concern. Methods: This study is presented as an invited commentary and was informed by input from local stakeholders, including district-level leaders and community representatives, who identified the health impacts of pesticide use as a critical public health concern in their communities. Field observations, interviews and focus group discussions with local leaders, villagers and farmers were conducted to better understand community practices and exposure patterns. Results: Key determinants shaping pesticide exposure in rural communities include: (1) occupational and behavioral factors, (2) environmental conditions, (3) technological changes, (4) chemical use, (5) social and economic factors, (6) health system capacity, and (7) policy and structural contexts. Conclusion: Pesticide exposure in rural communities is influenced by multiple interconnected determinants, including occupational practices, environmental conditions, technological changes, and system-level gaps. Addressing these risks requires integrated approaches combining effective policy implementation, risk communication, and community-based interventions to reduce exposure and protect public health. Keywords: Pesticide exposure; Environmental and occupational health; Determinants; Rural communities; Lessons learned.
Background: In early adolescence, psychological well-being represents an important developmental outcome. This period is marked by significant physical, emotional, and psychosocial transitions. Widely recognized as protective factors, executive function and resilience contribute to positive adolescent adjustment and mental health. However, investigations on the roles of these constructs among early adolescents in Northern Thailand in research remains limited. Method: This study employed a cross-sectional correlational design, using secondary data from 210 lower secondary school students aged 11 to 13 years in Northern Thailand. Validated self-report questionnaires were used to collect data by assessing executive function, resilience, and psychological well-being. Direct associations between study variables were examined using descriptive statistics, correlation analysis, multivariable regression, and mediation analysis. Results: Executive function was positively associated with resilience and resilience was positively associated with psychological well-being. After resilience was included in the model, however, the direct association between executive function and personal well-being was not statistically significant (β = −.03, p = .71). Executive function’s significant indirect effect on personal well-being through resilience was demonstrated by bootstrap mediation analysis (β = .22, p < .001), supporting a full mediation model. The findings suggest executive function may indirectly contribute to psychological well-being through resilience-related processes. Conclusion: Resilience played an essential mediating role in the relationship between executive function and psychological well-being among early adolescents. Mental health promotion at schools should have strengthened executive function, and resilience mainly enhanced psychological well-being by influencing adaptive psychosocial functioning. Keywords: Early adolescents, Executive function, Resilience, Psychological well-being
Background: Non-communicable diseases (NCDs) pose a major public health challenge in Sing Buri Province, Thailand. This action research examined the effectiveness of digital health communication innovations delivered through Village Health Volunteers (VHVs) to support NCDs management among at-risk populations. Methods: Employing the Plan-Act-Observe-Reflect cycle (PAOR), the study engaged 8 VHVs, 40 at-risk individuals, and 6 public health officers at Pikhun Thong Health Promotion Hospital, Sing Buri Province from February to September 2024. Digital interventions included pedometer apps, LINE-based dietary tracking, and peer learning groups with competitions and rewards. Quantitative data were analyzed using z-tests and Wilcoxon signed-rank tests, while qualitative data underwent thematic analysis. Results: Digital tools and group-based competition strategies effectively promoted positive health behavior change among at-risk individuals. Quantitative results showed significant improvements in exercise (z = 6.293, p < 0.001) and dietary behaviors (z = 6.563, p < 0.001), as well as significant reductions in systolic and diastolic blood pressure (p = 0.048 and p = 0.035). However, no significant changes were observed in BMI or fasting blood sugar, suggesting that a longer intervention period may be required. Conclusion: Integrating digital technology into community-based health promotion enables, with VHVs to function as effective behavioral change agents. Sustained system support and broader community implementation are essential for long-term program sustainability of digital health interventions to prevent and manage NCDs Keywords: Village Health Volunteers, Non-Communicable Diseases, Digital Health Technology, Health literacy, Community Health Promotion, Thailand
Background: Monkeypox (Mpox) is a global health threat, particularly among men who have sex with men (MSM). Despite the predominance of urban cases in Thailand, rural–urban disparities in Mpox-related attitudes and behaviors remain underinvestigated. This study aimed to compare Mpox-related attitudes and preventive behaviors among urban (Chonburi) and rural (Nakhon Nayok) MSM and identify their influencing factors. Method: This cross-sectional study was conducted between March and April 2025. A total of 842 MSM (421 urban; 421 rural) were recruited via convenience sampling. Data were collected using paper-based, self-administered Health Belief Model (HBM) questionnaires and analyzed using descriptive statistics and multivariable logistic regression. Results: Rural MSM demonstrated more positive attitudes (p < 0.001), whereas urban MSM demonstrated superior preventive behaviors (p = 0.016). Rural residency(odds ratio [OR] = 1.83), income ≥20,000 THB (OR = 1.81), prior information (aOR = 2.22), high perceived severity (aOR = 2.21), and low perceived barriers (aOR = 1.76) were independently associated with positive attitudes. A lower number of sexual partners was associated with increased preventive practices (1-2 partners: aOR = 0.39, ≥3 partners: aOR = 0.14).In addition, high perceived severity (aOR = 3.62), urban residency (aOR = 1.97), and low perceived benefits (aOR = 1.89) were drivers of positive preventive behaviors. Conclusion: Residential area was associated with preventive behaviors. Although rural MSM reported more positive attitudes, urban MSM demonstrated higher engagement in preventive practices. These findings emphasize the importance of contextual factors and health beliefs in influencing Mpox preventive behaviors. Keywords: Men Who Have Sex with Men, Monkeypox, Rural–Urban Disparities
Background: Indoor residential environments influence physical and mental health, but evidence linking perceived Indoor Environmental Quality (IEQ) to Satisfaction With Life (SWL) in Saudi Arabia is limited. This study explored residents’ perceptions of IEQ and its association with SWL. Methods: A cross-sectional online survey (March–April 2025) was conducted among adults (≥18 years) in Saudi Arabia using convenience sampling. A total of 451 participants completed a structured questionnaire. Data were analysed using descriptive statistics, Pearson correlations, one-way ANOVA, and multivariable logistic regression to identify IEQ predictors of low SWL (≤20), adjusting for age, sex, and BMI. Results: The mean SWL score was 24.81 ± 6.90, with 26.8% (n = 121) classified as having low SWL. Most IEQ dimensions were positively associated with SWL, particularly room size, window size, ventilation, and daytime noise comfort (r = 0.24–0.27, all p < 0.001), unpleasant odours, excess humidity, and excess dryness showed negative associations (r = –0.14 to –0.21, all p ≤ 0.004). In adjusted logistic regression, daytime noise comfort, room-size satisfaction, daytime temperature comfort, daytime lighting comfort, and ventilation satisfaction were independently associated with lower odds of low SWL (OR = 0.64–0.76, all p ≤ 0.008), unpleasant odour frequency predicted higher odds (OR = 1.30, 95% CI 1.08–1.57, p = 0.006). Conclusion: Perceived residential IEQ is significantly associated with SWL among Saudi adults, highlighting the importance of indoor environmental conditions in promoting well-being.
Background: Childhood epilepsy requires long-term management and places substantial responsibilities on caregivers. In Thailand, limited public awareness and persistent stigma surrounding epilepsy may intensify caregivers’ psychosocial and practical burdens. This study aimed to explore the lived experiences of caregivers of children with epilepsy in Thailand. Methods: A qualitative study using two semi-structured focus group discussions (FGDs; 5 participants per group) and 15 in-depth interviews (IDIs) was conducted with primary caregivers of children with epilepsy receiving care at a neurological referral institute in Thailand. Participants were purposively selected to capture a diverse range of caregiving experiences. Data were audio-recorded, transcribed verbatim, and analyzed using thematic analysis to identify recurring patterns and key themes related to caregiving experiences and challenges. Results: Caregivers described complex caregiving demands encompassing medical management, emotional strain, social stigma, and financial burden. Major themes included persistent anxiety related to seizure unpredictability, inadequate knowledge and confidence in epilepsy management, experiences of stigma in school and community settings, and reliance on adaptive coping strategies and informal support networks. Despite these challenges, caregivers demonstrated resilience and commitment to their caregiving role. Conclusion: Caring for children with epilepsy in Thailand involves multifaceted challenges that extend beyond clinical care. The findings underscore the importance of family-centered healthcare approaches, comprehensive caregiver education, school-based initiatives aimed at reducing stigma, and accessible health information resources. Addressing these needs may improve caregiver well-being and contribute to better health and quality-of-life outcomes for children with epilepsy. Keywords: Caregivers; Children; Epilepsy; Qualitative research; Thailand
Background: Oral cancer is a major cause of premature mortality in Thailand. This study examines survival and prognostic factors in a northeastern tertiary-care setting. Methods: A hospital-based retrospective cohort study was conducted using the Cancer Registry and medical records in a tertiary care hospital in Northeastern, Thailand. Patients diagnosed with oral cancer between January 2005 and December 2015 and followed until death or February 2020. Overall survival was estimated using the Kaplan–Meier method. Cox proportional hazards models were used to assess factors associated with mortality Results: The median survival time was 18.67 months (95% confidence interval [CI]: 15.70–22.83). It revealed that older age (51–69: adjusted Hazard Ratio [AHR] = 1.34, 95%CI: 1.06-1.69; ≥70: AHR = 1.85, 95%CI: 1.42-2.41), advanced stage (III–IV: AHR = 1.99, 95%CI: 1.47-2.69) or unknown stage (AHR = 1.53, 95%CI: 1.04-2.26), distant metastases (AHR = 1.64, 95%CI: 1.21-2.22), several primary tumor sites (e.g., tongue AHR = 1.82, 95%CI: 1.30-2.55; oropharynx AHR = 1.89, 95%CI: 1.26-2.84), and surgery (AHR = 1.88, 95%CI: 1.49-2.39) were associated with mortality. In contrast, subjects who were female sex (AHR = 0.77, 95%CI: 0.64-0.94) and had supplement therapy (AHR = 0.71, 95%CI: 0.57-0.87) were associated with lower mortality. Conclusion: Survival among oral cancer patients in this tertiary hospital was poor. Older age and advanced disease at diagnosis were key drivers of mortality, highlighting the need for earlier detection, complete staging, and strengthened supportive care. Keywords: Oral cancer, Survival analysis, Advanced stage, Distant metastases, Age, Sex differences, Thailand
