Well-being in Thailand: A Culturally Driven Grounded Inquiry Exploration of a Complex Construct

Rodriguez Espinosa P., Pichayayothin N.B., Suavansri P., French J.J., Areekit P., Nilchantuk C., Jones T.S., Mam E., Moore J.B., Heaney C.A.

Qualitative scholars are increasingly engaged in global research where members of the research team are from different countries and cultures and have different primary languages. However, in-depth descriptions of how to work as a transnational team successfully and rigorously are scarce. Using a collaboration between Stanford University in the US and Chulalongkorn University in Thailand as a case example, we present the nuances and challenges experienced in this research collaboration, as well as the strategies employed to optimize the validity and reliability of the study findings. While we started our data analysis following a more typical qualitative analysis path, shortcomings of this approach brought us to explore an alternative, involving data review and coding by transnational coding sub-teams. This approach was better able to illuminate cultural nuances, address coding discrepancies, and bring forward discussions to enhance interpretation and validity of findings. We describe our collaborative and iterative approach, and highlight methodological implications around team composition, language nuances and translation challenges, our coding process involving transnational coding sub-teams, and important considerations for managing team dynamics (e.g., power and hierarchy) and the partnership process and engagement over time. Moreover, we highlight the benefits of integrating insiders and outsiders throughout the research process, from data collection to coding and interpretation. Our process can serve as a model for similar transnational teams seeking ways to fully benefit from cross-cultural research collaborations.

Rodriguez Espinosa P., Chen Y., Sun C., You S., Lin J., Chen K., Hsing A.W., Heaney C.A.

Our aim was to explore the concepts of health and well-being from the point of view of the people experiencing them. Most of the efforts to understand these concepts have focused on disease prevention and treatment. Less is known about how individuals achieve health and well-being, and their roles in the pursuit of a good life. We hoped to identify important components of these concepts that may provide new targets and messages to strengthen existing public health programs. An improved understanding of health and well-being - or what it means to be well - can guide interventions that help people lead healthier, more fulfilling lives. Using a grounded qualitative approach drawing from narrative inquiry, we interviewed 24 Taiwanese adults. Thematic inductive coding was employed to explore the nature of health and well-being. Eight constituent domains emerged regarding well-being and health. While the same domains were found for both constructs, important frequency differences were found when participants discussed health versus well-being. Physical health and lifestyle behaviors emerged as key domains for health. Disease-related comments were the most frequently mentioned sub-category within the physical health domain, along with health care use and aging-related changes. For well-being, family and finances emerged as key domains. Family appears to be a cornerstone element of well-being in this sample, with participants often describing their personal well-being as closely tied to - and often indistinguishable from - their family. Other domains included work-life, sense of self, resilience, and religion/spirituality. Health and well-being are complex and multifaceted constructs, with participants discussing their constituent domains in a very interconnected manner. Programs and policies intended to promote health and well-being may benefit from considering these domains as culturally-appropriate leverage points to bring about change. Additionally, while the domains identified in this study are person-centered (i.e., reflecting the personal experiences of participants), the stories that participants offered provided insights into how well-being and health are influenced by structural, societal and cultural factors. Our findings also offer an opportunity for future refinement and rethinking of existing measurement tools surrounding these constructs.

Ljubotina M.K., Cahill J.F.

Plants regularly encounter patchily distributed soil nutrients. A common foraging response is to proliferate roots within high-quality patches. The influence of the social environment on this behaviour has been given limited attention, despite important fitness consequences of competition for soil resources among plants. Using the common sunflower (Helianthus annuusL.), we compared localized root proliferation in a high-quality patch by plants grown alone to that of plants in two different social environments: with a neighbouring plant sharing equal access to the high-quality patch, and with a neighbouring plant present but farther from the high-quality patch such that the focal individual was in closer proximity to the high-quality patch. Sunflowers grown alone proliferated more roots within high-nutrient patches than lower-nutrient soil. Plants decreased root proliferation within a high-nutrient patch when it was equidistant to a neighbour. Conversely, plants increased root proliferation when they were in closer proximity to the patch relative to a nearby neighbour. Such contingent responses may allow sunflowers to avoid competition in highly contested patches, but to also pre-empt soil resources from neighbours when they have better access to a high-quality patch. We also compared patch occupancy by sunflowers grown alone with two equidistant high-quality patches to occupancy by sunflowers grown with two high-quality patches and a neighbour. Plants grown with a neighbour decreased root length within shared patches but did not increase root length within high-quality patches they were in closer proximity to, perhaps because resource pre-emption may be less important for individuals when resources are more abundant. These results show that nutrient foraging responses in plants can be socially contingent, and that plants may account for the possibility of pre-empting limited resources in their foraging decisions.

Seligman M.

Tosangwarn S., Clissett P., Blake H.

Thai culture traditionally abhors elders living in care homes due to the belief that this represents a dereliction of filial piety by their children, thus care homes are stigmatized as the domain of poor older adults with no family. This may impact negatively on psychological wellbeing of residents, although little is known about the key factors influencing depressive symptoms. Therefore, this study explores factors associated with depressive symptoms, internalised stigma, self-esteem, social support and coping strategies among older adults residing in care homes in Thailand.A cross-sectional questionnaire study was conducted with 128 older residents recruited from two care homes in Northeast Thailand. Data were collected using the 15-Item Thai Geriatric Depression Scale, Internalised Stigma of Living in a Care Home Scale, Thai Version of Rosenberg Self-Esteem Scale, Thai Version of Multidimensional Scale of Perceived Social Support and the Coping Strategies Inventory Short-Form.Depressive symptoms were significantly correlated with internalised stigma, self-esteem and social support (r=0.563, -0.574 and -0.333) (p

Badash I., Kleinman N.P., Barr S., Jang J., Rahman S., Wu B.W.

Althubaiti A.

Otten J.J., Cheng K., Drewnowski A.

Data visualization combines principles from psychology, usability, graphic design, and statistics to highlight important data in accessible and appealing formats. Doing so helps bridge knowledge producers with knowledge users, who are often inundated with information and increasingly pressed for time.

Rukumnuaykit P.

MacPhail C., Khoza N., Abler L., Ranganathan M.

Qualitative interviews are increasingly being utilized within the context of intervention trials. While there is emerging assistance for conducting and reporting qualitative analysis, there are limited practical resources available for researchers engaging in a group coding process and interested in ensuring adequate Intercoder Reliability (ICR); the amount of agreement between two or more coders for the codes applied to qualitative text. Assessing the reliability of the coding helps establish the credibility of qualitative findings. We discuss our experience calculating ICR in the context of a behavioural HIV prevention trial for young women in South Africa which involves multiple rounds of longitudinal qualitative data collection. We document the steps that we took to improve ICR in this study, the challenges to improving ICR, and the value of the process to qualitative data analysis. As a result, we provide guidelines for other researchers to consider as they embark on large qualitative projects.

Le Mare A., Promphaking B., Rigg J.

We personalise the middle-income trap by exploring the experiences of migrants from north-east Thailand, most of whom return to their natal villages as a result of family decisions based on more than achieving higher incomes. Whereas men are largely content, women have to balance a range of roles because of prescribed gender norms. Increased education and migration did not lead to higher value work on their return because of lack of investment and opportunity, but also because of gender norms and relationships that reflect rather than challenge the norms that would allow women (and men) to develop new employment opportunities. Copyright © 2015 John Wiley & Sons, Ltd.

Rittirong J., Prasartkul P., Rindfuss R.R.

This study explores rural elderly preferences for support across a multi-dimensional measure of elderly care needs. Applying a framework developed in the U.S. to Thailand for the first time, five diverse types of support are considered: meal preparation, personal care, transportation, financial support, and emotional support. The emphasis is on preferences for care and not actual care received. The data are from focus group discussions conducted in seven villages in Nang Rong district, northeastern Thailand. Thailand and the study site represent the social and economic conditions faced by many rapidly industrializing places-where there has been a dramatic demographic transition (lowered fertility and substantial out-migration), growing numbers of older persons remaining in rural settings, and limited publically-financed elderly care or market-based elder care available for purchase. For this study, in each village, male and female older persons aged 60 and over participated in the focus group discussions. As part of the discussion, focus group participants were asked to rank their first four preferences by type of support. Male and female older persons' preferences were slightly different for genderized tasks. In addition, social closeness and geographical proximity mattered. Traditional matrilocal residence patterns contributed to the perceptions of the older persons. Neighbors were preferred when kin were not available. Preferences inform strategic choices by older persons given the context of available resources. Understanding preferences and strategic choices among the older persons can help policy makers tailor programs more effectively and efficiently, without jeopardizing elderly well-being.

Ryff C.D.

This article reviews research and interventions that have grown up around a model of psychological well-being generated more than two decades ago to address neglected aspects of positive functioning such as purposeful engagement in life, realization of personal talents and capacities, and enlightened self-knowledge. The conceptual origins of this formulation are revisited and scientific products emerging from 6 thematic areas are examined: (1) how well-being changes across adult development and later life; (2) what are the personality correlates of well-being; (3) how well-being is linked with experiences in family life; (4) how well-being relates to work and other community activities; (5) what are the connections between well-being and health, including biological risk factors, and (6) via clinical and intervention studies, how psychological well-being can be promoted for ever-greater segments of society. Together, these topics illustrate flourishing interest across diverse scientific disciplines in understanding adults as striving, meaning-making, proactive organisms who are actively negotiating the challenges of life. A take-home message is that increasing evidence supports the health protective features of psychological well-being in reducing risk for disease and promoting length of life. A recurrent and increasingly important theme is resilience - the capacity to maintain or regain well-being in the face of adversity. Implications for future research and practice are considered.

Palinkas L.A., Horwitz S.M., Green C.A., Wisdom J.P., Duan N., Hoagwood K.

Purposeful sampling is widely used in qualitative research for the identification and selection of information-rich cases related to the phenomenon of interest. Although there are several different purposeful sampling strategies, criterion sampling appears to be used most commonly in implementation research. However, combining sampling strategies may be more appropriate to the aims of implementation research and more consistent with recent developments in quantitative methods. This paper reviews the principles and practice of purposeful sampling in implementation research, summarizes types and categories of purposeful sampling strategies and provides a set of recommendations for use of single strategy or multistage strategy designs, particularly for state implementation research.

Eklund Karlsson L., Crondahl K., Sunnemark F., Andersson Å.

Phenwan T., Sittiwantana E., Jarusomboon W., Peerawong T.