Journal of Nursing Science Chulalongkorn University

Selected Factors Related to Febrile Neutropenia of Lymphoma Patients Undergoing Chemotherapy.

2024-03-05T23:24:30+07:00

Purpose: To examine the occurrence of febrile neutropenia and to study the relationship between Age, Gender, Albumin, type of lymphoma, stage of cancer, number of chemotherapy sessions, comorbidities, Self-care Behavior, Physical activity and Febrile neutropenia in lymphoma patients who received chemotherapy.

Design: Descriptive Research

Methods: The study sample consisted of 114 individuals with lymphoma who received services at the Hematology outpatient department, King Chulalongkorn Memorial Hospital. The research tools used included personal data questionnaires, self-care behavior, and physical activity questionnaires. The content validity was checked to be equal to 1.0 and the reliability was checked and Cronbach's alpha coefficients were 0.76 and 0.72, respectively. Data were analyzed using descriptive statistics. and logistic regression analysis. Data were analyzed using descriptive statistics and logistic regression analysis.

Results: The research findings revealed that 34.2% of individuals with lymphoma receiving chemotherapy experienced Febrile neutropenia (FN), with the majority occurring during the first round of chemotherapy (48.7%) and febrile neutropenia occurring only once, accounting for 84.6%. Factors associated with the occurrence of febrile neutropenia included being female, age 60 or older, low levels of blood albumin (< 3.5 g/dL), advanced stage of cancer, the number of chemotherapy cycles, and the presence of comorbidities (OR=5.43, 1.68, 4.76, 1.62, 1.83, 2.33 respectively, p<.05). On the other hand, factors associated with a decreased risk of Febrile neutropenia included physical activity (OR= 0.58, p<.05). Factors unrelated to febrile neutropenia included self-care behavior and cancer type (OR=0.62, 1.15 respectively, p>.05).

Predictive Factors of Delirium in Older Persons at Emergency Department.

2024-03-01T20:20:50+07:00

Purpose: to study predictive factors related to delirium in older persons at emergency department

Design: Prospective descriptive predictive research

Methods: Data were collected from 220 older persons. Who were according to the specified qualifications. Research instruments were demographic questionnaires, 4 A’s Test for Delirium Screening: 4AT, Informant Questionnaire on Cognitive Decline in the Elderly, IQCODE, Numeric rating scale: NRS. And Pain assessment in advanced dementia, PAINAD. Which were tested for reliability. Cronbach’s alpha coefficient was .83, .79 respectively. test-retest procedure reliability was .77, .97 respectively. Data were analyzed using binary logistic regression.

Results: The finding revealed that 1) delirium in older persons at emergency department are 34 people from the total sample size of 220 people. Representing 15.45 percent 2) Cognitive impairment, history of stroke, emergency department length of stay, pain, intracranial hemorrhage, and depression were significantly positive correlated with delirium in older persons at emergency department at level of .05 (x²= 9.277, 10.020, r_pb= .216, x²= 9.000, 9.568, 3.874 respectively) 3) Cognitive impairment (AOR=7.25, 95% CI : 1.681-31.276), History of stroke (AOR=4.74, 95% CI : 1.540-14.579), emergency department Length of stay (AOR=6.67, 95% CI : 2.300-19.337), intracranial hemorrhage (AOR=14.72, 95% CI : 2.637-82.151), and depression (AOR=6.96, 95% CI : 1.274-37.998) were significantly factors predicting delirium in older persons at emergency department at the level of .05 and accounted for 37 percent (Nagelkerke R2 = .370, p < .05).

Conclusion: result finding can serve as guidelines for developing programs for nursing care, monitoring, and prevention of the risk of acute confusion in the elderly who receive services in emergency departments.

Selected Factors Related to Living will in Persons with Cancer.

2024-01-22T23:18:06+07:00

Purpose: Aimed to examine the living will in persons with cancer and the relationships between age, stage of disease, symptom severity, knowledge on living will, death anxiety, social support, and the living will in persons with cancer.

Design: Descriptive correlational research

Methods: The sample group consisted of 180 individuals who have been diagnosed with cancer and received services at the cancer outpatient department of tertiary hospitals in the Bangkok metropolitan area. The research tools including the personal information questionnaire, Questionnaire for making a living will, the knowledge assessment form about making a living will have had a KR-20 value of .81. The severity of symptoms Questionnaire, Death Anxiety Questionnaire and social support questionnaire have had Cronbach’s alpha coefficients were .88, .90, and .89, respectively. Data were analyzed using descriptive statistics, and logistic regression.

Results: The research results found that the sample group was 180 people with cancer who made a living will 67 people with accounting for 37.2 percent, and people with cancer who did not make a living will 113 people with accounting for 62.8 percent. The majority doing it by means of notification 49.2 percent. Factors that cause more people with cancer to make living wills include people aged 60 years and over with advanced stage cancer, severity of symptoms, and knowledge about making a living will (OR= 2.63, 7.59, 1.05, 1.79 respectively, p<.05) and factors that cause people with cancer to make a living will to decrease was anxiety about death (OR= 0.87, p<.05).

The Effects of Caregiver Empowerment Program Combined with Web Application on Social Skills of Preschool Children with Autism.

2024-02-07T14:10:19+07:00

Purpose: To study the effects of caregivers empowerment program combined with web application on social skills of preschool children with autism

Design: Quasi-experimental research pretest-posttest control group

Methods: Research sample consisted of fifty autistic children, aged 3-6 and caregivers receiving services in the inpatient ward of Rajanukul Institute, selected by inclusion criteria, were matched pair then, equally randomly assigned to an experimental group and a control group with 25 subjects in each group. The experimental group received the caregivers empowerment program for 4 weeks. The control group received usual nursing care. The experimental instruments included the caregivers empowerment program. Data were collected using the social skills of preschool children with autism assessment scale and the caregivers empowerment assessment scale. Its CVI were .89 and .90, respectively. Their Cronbach’s alpha coefficients were .97 and .90, respectively. The t-test was used in data analysis.

Findings: The mean score of social skills of preschool children with autism after using the caregivers empowerment program was significantly higher than those before, and the mean score of social skills of preschool children with autism who received the caregivers empowerment program was significantly increased more than such mean score of autistic children who received usual nursing care, at the .05 level.

Conclusion: The result of this study supports that caregivers empowerment program can increase social skills of preschool children with autism.

Keywords: Caregivers Empowerment/Web Application/Social Skills/Preschool Children with Autism

Lived Experiences of Primary Caregivers in Violent Schizophrenic Persons.

2024-03-01T22:06:57+07:00

Objective: This research aims to study the lived experiences of primary caregivers in schizophrenic persons having violent behaviors.

Designs: The qualitative hermeneutic phenomenological method (Heidegger, 1962) was used in this study.

Methods: The Participants were selected according to purposive sampling. The data were collected through observation, field notes, tape recording, and in-depth interview until data saturation in 16 primary caregivers of schizophrenic persons who had been violently recorded at least three times/year. Then, the data were transcribed verbatim and analyzed by a Hermeneutic circle (Van Manen, 1990).

Results: The results of this study could lead understanding of this objective study through 4 main themes: 1) Lived with endurance. 2) The impacts of schizophrenic persons’ violent behaviors on primary care givers’ lives. 3) Adjusting for living together. 4) Schizophrenic persons’ violent behaviors managements.

Conclusion: The results guide nurses and multidisciplinary teams understanding by care givers’ experiences deeply and providing care to primary caregivers of violent schizophrenic persons to raise from their abilities of care in Thai community efficiently.

The role of nurses in caring for older adults with sepsis in the intensive care unit.

2024-02-18T00:08:48+07:00

Sepsis is a life-threatening condition that requires care in the intensive care unit, especially in older adults who tend to have serious complications, a prolonged length of hospital stay, and a high mortality rate compared to younger patients. Along with factors related to the aging process, including the immune system weakening and the body’s systems deteriorating, and important characteristics of older adults with sepsis include atypical presentations such as hypothermia, acute confusion state, loss of appetite, and malaise, resulting in complex and serious health problems. Screening sepsis to ensure older adults receive proper and timely treatment can reduce multiple organ dysfunction and mortality rates. Therefore, nurses must have the knowledge, understanding, and ability to care for older adults with sepsis while being admitted to the intensive care unit, which requires expert nursing care to achieve rapid screening, accurate diagnosis, and standard treatment to ensure patient safety without serious complications.