Yale school of nursing's first doctoral graduate will return to Thailand where she'll work to prevent HIV spread

Connecticut Nursing News, Jun-Aug 1998

New Haven, Conn.-Working as a medical/ surgical nurse in a Thai hospital, Wantana Limkulpong knew that she wanted to change direction. Many of her patients were men who had become infected with HIV through their relations with commercial sex workers. Even more heartbreaking were the expectant mothers whose husbands had brought the virus home to them from visits to brothels. Limkulpong decided to pursue public health nursing so that she could fight the spread of AIDS in Thailand through education.

Later this month, Limkulpong will receive her Doctor of Nursing Science degree from the Yale School of Nursing. Limkulpong, Kerry Ann Milner and Carl Sheih comprise the first doctoral class of the 75-year old nursing institution. Each completed an extensive dissertation as part of the degree requirements. Limkulpong's doctoral dissertation focused on factors that encourage or discourage safe sex practices among commercial sex workers in southern Thailand. Milner studied how gender relates to the symptoms that cardiac patients present in the emergency room. Sheih's work looked at fetal attachment in drug abusing mothers. All three studies will advance nursing research and practice, commented Associate Dean for Research and Doctoral Studies, Margaret Grey.

"Yale School of Nursing began this doctoral program four years ago as a logical extension of its tradition of practice-based scholarship," said Grey. "Our first group of doctoral students truly represents what is best in that tradition. They have advanced science while laying the groundwork for interventions that will have real benefits for patients, particularly for patients often underserved by the traditional health care system. These young scholars are a credit to this institution and to the discipline of nursing."

Limkulpong, who defended her dissertation first and is therefore technically the first student to earn a doctorate at YSN, laughs at the idea of being the school's first DNSc. When she first came to Yale, she remembers timidly entering Grey's office to ask a few questions and seeing a wooden chair with a Yale seal on it.

"If I graduate, I'm going to buy one of those chairs," Limkulpong said.

"What do you mean if?' Grey demanded. "You can do it?.

"I could feel the energy flow from her to myself, and from that time I felt I could do it,' Limkulpong said.

She came to Yale because her undergraduate mentor, Poolsook Sriyaporn, YSN '73, told her that the school offered an excellent education within the context of a supportive family atmosphere. Tve found that to be true," Limkulpong said. Her Yale education gives her the analytical skills she needs to devise effective interventions as well as the prestige that will allow her to get funding for her research and to influence health policy, she said.

While studying at Yale, Limkulpong returned home each summer to interview commercial sex workers in Thailand. She felt a great deal of sympathy for the women she talked with, many of whom felt deep shame over the work they did but felt obligated to support their families through the only opportunity open to them. Limkulpong was particularly moved by the story of a woman who put her son through college, without ever telling him where she got the money. When he graduated, got a good job and sent for his mother to join him, the woman had already tested positive for AIDS.

"Some days I went out and did interviews, and came home feeling very sad for them. I felt I was so fortunate to be born into a good family, where I could get an education and had opportunities," Limkulpong said.

Limkulpong's study examined how various factors influenced whether or not commercial sex workers employed safe sex practices. She found that self efficacy, or the belief that the woman could successfully negotiate practices with her partner to lower her risk, was an important factor. Now Limkulpong will return home to design educational programs that will address the issue of self efficacy as well as other points raised by her research. She will be a member of the faculty at the Ramavbodi School of Nursing at Mahidol University in Bangkok.