{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T06:45:56Z","timestamp":1792565156389,"version":"4.5.0"},"reference-count":21,"publisher":"Belitung Raya Foundation","issue":"5","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Faculty of Nursing,\nKhon Kaen University","award":[""],"award-info":[{"award-number":[""]}]}],"content-domain":{"domain":["belitungraya.org"],"crossmark-restriction":true},"short-container-title":["Belitung Nurs J"],"abstract":"<jats:p>Background: Chronic non-communicable diseases (NCDs) are increasing among the Tai Saek ethnic minority in Thailand, yet little is known about how this community culturally interprets and manages NCDs in daily life.\nObjective: To develop a substantive theory explaining how the Tai Saek ethnic group perceives NCDs and manages them within changing lifestyles.\nMethods: A grounded theory design based on Strauss and Corbin was used. Eighteen Tai Saek adults (10 with NCDs, 8 without) were theoretically sampled from two villages in Nakhon Phanom province, Thailand. Data were collected from August 2024 to April 2025 through in\u2011depth interviews, field notes, and theoretical memos, and analyzed with ATLAS.ti using constant comparative analysis.\nResults: The core category, Cultural Perceptions and Risk Management of NCDs, describes a non-linear process where Tai Saek people balance traditional lifeways, modern influences, and spiritual beliefs. This paradigm model consists of interrelated components: (1) Contextual Conditions, characterized by a dual lifestyle involving modernized agriculture, dietary shifts, generational negotiations, and traditional \u201cSum Saew\u201d gatherings; (2) Causal Conditions, where individuals construct meanings of NCDs (behavioral vs. genetic) and respond emotionally and behaviorally; (3) Action\/Interaction Strategies, which selectively integrate indigenous practices (ancestor worship) with biomedical care; and (4) Consequences, which include both positive adaptation (cultural empowerment) and negative outcomes (delayed biomedical care due to reliance on rituals).\nConclusion: The study demonstrates that Tai Saek people do not simply adopt biomedical advice but actively filter it through ancestral beliefs and modern constraints. Nursing care should assess cultural transitions, acknowledge spiritual rituals, and co\u2011design NCD management plans respecting local wisdom.<\/jats:p>","DOI":"10.33546\/bnj.4761","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T05:52:22Z","timestamp":1792561942000},"page":"653-663","update-policy":"https:\/\/doi.org\/10.33546\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Balancing tradition, modernity, and spirituality: A grounded theory of non-communicable disease management in the Tai Saek Ethnic Group of Thailand"],"prefix":"10.33546","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2467-956X","authenticated-orcid":false,"given":"Amornrat","family":"Sangsaikaew","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4636-5270","authenticated-orcid":false,"given":"Wasana","family":"Ruaisungnoen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"19163","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"key":"163480","doi-asserted-by":"crossref","unstructured":"Andersen, M. M., & Nielsen, M. E. (2016). Personal responsibility and lifestyle diseases. Journal of Medicine and Philosophy, 41(5), 480\u2013499. https:\/\/doi.org\/10.1093\/jmp\/jhw015","DOI":"10.1093\/jmp\/jhw015"},{"key":"163481","unstructured":"At Samat Health Promoting Hospital. (2023). Epidemiological data of non-communicable disease [in Thai]. Nakhon Phanom: At Samat Health Promoting Hospital."},{"key":"163482","doi-asserted-by":"crossref","unstructured":"Bandura, A. (1978). Self-efficacy: Toward a unifying theory of behavioral change. Advances in Behaviour Research and Therapy, 1(4), 139\u2013161. https:\/\/doi.org\/10.1016\/0146-6402(78)90002-4","DOI":"10.1016\/0146-6402(78)90002-4"},{"key":"163483","doi-asserted-by":"crossref","unstructured":"Becker, M. H. (1974). The health belief model and personal health behavior. 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Accepting and adjusting to chronicity of hypertension: A grounded theory study in Thai people [Doctoral dissertation, University of Washington]."},{"key":"163487","doi-asserted-by":"crossref","unstructured":"Kohori-Segawa, H., Dorji, C., Dorji, K., Wangdi, U., Dema, C., Dorji, Y., Musumari, P. M., Techasrivichien, T., Watanabe, S. P. S., Sakamoto, R., Ono-Kihara, M., Kihara, M., & Imanaka, Y. (2020). A qualitative study on knowledge, perception, and practice related to non-communicable diseases in relation to happiness among rural and urban residents in Bhutan. PloS One, 15(6), e0234257. https:\/\/doi.org\/10.1371\/journal.pone.0234257","DOI":"10.1371\/journal.pone.0234257"},{"key":"163488","doi-asserted-by":"crossref","unstructured":"Leininger, M. (2002). Culture care theory: A major contribution to advance transcultural nursing knowledge and practices. 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K., Ramaswamy, B., & Taylor, C. A. (2024). Cultural perceptions of health in Asian Indian Adults. Journal of Nutrition Education and Behavior, 56(11), 775\u2013782. https:\/\/doi.org\/10.1016\/j.jneb.2024.07.005","DOI":"10.1016\/j.jneb.2024.07.005"},{"key":"163493","doi-asserted-by":"crossref","unstructured":"Sangsaikaew, A., Junsevg, K., Thong-On, R., & Pilayon, B. (2022). Perceived factors contributing to the care provided by informal (family) and formal caregivers of older adults with noncommunicable diseases in rural communities: A qualitative focus group study. Journal of Education and Health Promotion, 11, 228. https:\/\/doi.org\/10.4103\/jehp.jehp_1104_21","DOI":"10.4103\/jehp.jehp_1104_21"},{"key":"163494","unstructured":"Strauss, A., & Corbin, J. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory (2nd ed.). Thousand Oaks, CA, US: Sage Publications, Inc."},{"key":"163495","unstructured":"Strauss, A., & Corbin, J. M. (1990). 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