Journal of Nursing Research, Innovation, and Health

The challenges in making a living will in a person with cancer.

Athipong Muneeno — 2024-12-17

During the final stages of life, the patient may lose the ability to communicate, leaving important care decisions in the hands of others. However, these decisions may not align with the patient’s wishes. It is crucial for the patient to have a plan and to establish care directives for the end of life in advance. For individuals with cancer, creating a living will can be particularly challenging compared to other disease groups. This article presents a comprehensive review of the literature, aiming to describe the various challenges faced by individuals with cancer. It discusses the obstacles that hinder the preparation of advance directives and elucidates the role of healthcare providers, including nurses, in supporting the decision-making process for people with cancer to choose advanced self-care strategies. Armed with a solid understanding of the illness and the correct knowledge, I intend to create an advance directive to guide and facilitate my treatment, nursing care, and family care in line with my intentions. This endeavor seeks to promote the development and widespread acceptance of advance directives for end-of-life care within society, ultimately benefitting many lives.

Ethical Decision-Making in End-of-Life care for Gender-Diverse Individuals: Challenges in Professional Nursing Management

Nawapat Kongdee — 2024-12-17

Ethical decision-making is one of the critical challenges faced by professional nurses, particularly in providing end-of-life care for gender-diverse individuals. These patients often encounter barriers related to legal, cultural, and social acceptance. This article aims to analyze the complexities of ethical decision-making for nurses caring for gender-diverse individuals at the end of life, focusing on the application of ethical theories and frameworks, such as deontological ethics, moral development theory, and the ethical tree framework. The process involves five steps: information gathering, identifying ethical dilemmas, evaluating alternatives, decision-making, and outcome assessment.

The study highlights the importance of respecting patients’ gender identity, recognizing their unique needs, and aligning nursing practices with contemporary contexts. Practical recommendations include promoting advance directives, educating nurses about the legal rights and end-of-life care considerations for gender-diverse individuals, and establishing support systems to facilitate appropriate ethical decision-making.

In summary, addressing the challenges of ethical decision-making in caring for gender-diverse individuals at the end of life is a significant responsibility for professional nurses. It requires both knowledge and skills to deliver personalized care, reduce disparities, and enhance patients’ quality of life. This approach ensures dignity, the safe expression of gender identity, autonomy in decision-making alongside families, and effective responses to the rapidly evolving societal context surrounding end-of-life care

Factors predicting quality of life among family caregivers Of stroke survivors

Niphaphon Thiangnu — 2024-12-17

This predictive research aims to study quality of life of family caregivers of stroke survivors and determine the quality of life of family caregivers of stroke survivors.The samples were family caregivers of stroke survivors attending the outpatient departments of the Neurological Institute of Thailand and King Chulalongkorn Memorial Hospital, the Thai Red Cross Society. The research tools consisted of questionnairesto collect personal data, quality of life, activities of daily living (ADLs), care burden, depression, family relationship, and social support. The data was analyzed using descriptive statistics, Pearson’s coefficients, and stepwise analysis of multiple regression.

The results of the research were as follows. Family caregivers of stroke survivors had a moderate quality of life with the mean scores of 95.89 (S.D. = 11.48). The factors predicting the quality of life of caregivers in survivors’ families with statistical significance at .05 levels were social support (Beta = .37), depression (Beta = -.24), and ADLs of survivors (Beta = .22). Predictive factors accounted for 33 percent of quality of life.

Conclusions: The findings are useful for the further development of nursing intervention programs to prepare family caregivers of stroke survivors appropriately in order to enhance good quality of life among these caregivers.

Selected Factors Related to Patient Activation Among Older Buddhist Monks with Hypertension

Chanoknunt Kuntayunt — 2024-12-17

Objectives: To examine patient activation among older Buddhist monks with hypertension and explore the relationships between depression, self-efficacy, illness perception, social support, secular education level, Dharma education level, and body mass index with patient activation.

Research Design: A descriptive correlational study.

Method: The sample included 84 hypertensive Buddhist monks aged 60 years and older who attended the medical outpatient department of a priest hospital in Bangkok, Thailand. The research instruments included a personal information form, the Thai Geriatric Depression Assessment Scale, a Self-Efficacy Perception Questionnaire, a Brief Illness Perception Questionnaire, a Social Support Questionnaire, and a Patient Activation Measure (PAM) Questionnaire. The Cronbach’s alpha coefficients for these instruments were .84, .81, .86, .87, and .88, respectively. Data were analyzed using means, standard deviations, Pearson’s correlation coefficients, and point-biserial correlation.

Results: Approximately one-third (38.1%) of the monks exhibited a high level of patient activation (level 4), characterized by successful behavior modification and maintenance even under pressure. Factors positively associated with patient activation were self-efficacy perception (r = .736), illness perception (r = .659), social support (r = .386), and secular education level (r = .295). Depression was negatively associated with patient activation (r = -.765), with all findings statistically significant at the .05 level.

Conclusion: Promoting patient activation among older Buddhist monks may benefit from addressing the identified factors. These findings can inform the development of programs aimed at enhancing patient activation among older Buddhist hypertensive monks.

Development and Pilot Testing of a Thai Herbal Cold Compression Abdominal Binder for Abdominal Pain Relief in Open Abdominal Surgery Patients: Feasibility Study

Nattapong Chanmala — 2024-12-17

Purpose: To develop and assess the feasibility of an innovative Thai herbal cold compression abdominal binder for relieving pain in post-abdominal surgery patients.

Design: This research involved developing a prototype innovation as part of a broader study investigating the effects of the Thai herbal cold compression abdominal binder on pain in postoperative abdominal surgery patients.

Methods: The innovation development process consisted of three phases: 1) Studying the issues faced by postoperative patients, combined with a literature review; 2) Designing and producing the innovation based on the Gate Control Theory and insights from the literature review; 3) Testing the feasibility of the innovation with postoperative patients. The innovation was evaluated for suitability by five experts. The sample included five patients who had undergone abdominal surgery, selected through purposive sampling. Instruments used included the innovation prototype, a satisfaction questionnaire, and a pain assessment form. Data were analyzed using percentages, means, and standard deviations.

Results: The innovation received an average usability score of 4.6 (± 0.54), a practicality score of 4.80 (± 0.44), a safety score of 5.00 (± 0.00), and a satisfaction score of 4.80 (± 0.44). A comparison of pain scores before and after using the innovation showed effective pain reduction, with the average pain score decreasing from 8.2 before using the innovation to 5.0 afterward. The innovation is deemed suitable for further study in a larger sample of postoperative abdominal surgery patients.

Development of a Model for Caring for Osteoarthritis in the Community by Nurse Practitioners, Thai Traditional Medicine Practitioners, and Thai Community Masseuses

Ravinun Nuchasilp — 2024-12-17

Purpose: To develop and study the effects of a model for caring for osteoarthritis in the community involving nurse practitioners, Thai traditional medicine practitioners, and Thai community masseuses.

Design: Research & Development

Methods: The research surveyed the proportion and severity of osteoarthritis. The sample group was divided into: 1) 136 individuals aged 50 years and over to study problems and needs for care, 2) Practical nurses, Thai traditional medicine practitioners, and community Thai masseuses (18 people in total) to develop a care model, and 3) Forty individuals with knee osteoarthritis who were purposively selected to implement and evaluate the osteoarthritis care model in the community. Tools used included: 1) An osteoarthritis screening assessment form, 2) An osteoarthritis severity assessment form, and 3) An evaluation form for osteoarthritis care in the community, with content validity indices of 0.85, 0.87, and 0.81, respectively. Interrater reliability coefficients were 0.82, 0.84, and 0.79, respectively. Data were analyzed using content analysis and the t-test.

Results: The self-management behavior of individuals with knee osteoarthritis significantly improved (p < 0.05). Pain levels and severity of osteoarthritis significantly decreased (p < 0.05).

Conclusion: The results of this study demonstrate that a care model for osteoarthritis in the community, collaboratively developed by practical nurses, Thai traditional medicine practitioners, and community Thai masseuses through a health partnership process, can lead to improved self-management behavior and reduced pain levels and osteoarthritis severity.

Factors Related to Burnout of Spouses of Schizophrenic Patients

Apiwart Srikasi — 2024-12-17

Purpose: To study burnout of spouses of schizophrenic patients, and to investigate relationship between gender, duration of care, stress, social support, marital relationship, spouse burden, affiliate stigma, positive syndrome, and negative syndrome, and burnout of spouses of schizophrenic patients.

Design: Descriptive correlation research study

Method: The sampling consisted of 180 spouses of schizophrenic patients who received follow up in Psychiatric Hospital, and Psychiatric Outpatient Department at the hospital, Bangkok area. The research instruments were demographic questionnaires, Maslach Burnout Inventory, Stress Questionnaires, Social support questionnaires, Marital Adjustment Test, Spouse burden scale, Affiliate stigma scale, Positive Syndrome scale, and Negative Syndrome scale. Data were analyzed by using descriptive statistics and Pearson product-moment correlation coefficient.

Results: Burnout in spouses of schizophrenic patients was assessed in three dimensions. Emotional exhaustion was at a low level ( = 11.02, SD = 10.83), depersonalization was at a moderate level ( = 6.36, SD = 8.06), and perceived personal accomplishment was at a high level ( = 13.45, SD = 9.64). Factors significantly related to burnout at the p < .05 level were as follows: marital relationship and social support had a significant negative correlation (r = -.378, r = -.154, respectively). Negative syndrome (r = .305), positive syndrome (r = .509), spouse burden (r = .779), affiliate stigma (r = .711), and stress (r = .819) had significant positive correlations. Gender and duration of care had no correlation with burnout in spouses of schizophrenic patients.

Conclusion: The results of this research can inform the planning of activities to mitigate the factors related to burnout in spouses of schizophrenic patients.

Selected Factors Associated with Supportive Care Needs in Newly Diagnosed Breast Cancer Persons

Uthumporn Siringam — 2024-12-17

Purpose: To study the supportive care needs and the relationships between selected factors, including age, marital status, education level, type of treatment, anxiety, symptom distress, and social support, with the supportive care needs of newly diagnosed individuals with breast cancer.

Design: Descriptive correlational research.

Methods: The sample consisted of 133 individuals newly diagnosed with breast cancer and receiving treatment at two tertiary hospitals in Bangkok. Multi-stage random sampling was conducted between November 2023 and April 2024. The instruments used included a personal information form, the Supportive Care Needs Survey-Short Form 34, the State-Trait Anxiety Inventory, the Symptom Distress Scale, and a Social Support Questionnaire. The content validity indices of the instruments were as follows: the Supportive Care Needs Survey had a validity of 0.88, the Symptom Distress Scale had a validity of 0.80, and the Social Support Questionnaire had a validity of 0.90. Cronbach's alpha coefficients were 0.957, 0.953, 0.850, and 0.824, respectively. Data were analyzed using Pearson's correlation, point-biserial correlation, and Spearman's rank correlation statistics.

Results: The participants had an average age of 55 years, were predominantly married, and held a bachelor's degree. They reported a low level of supportive care needs, with an average score of 2.39 (SD = 0.78). In the domain of health systems and information, participants reported a moderate level of need, with an average score of 3.09 (SD = 0.91), followed by patient care and support, with an average score of 2.80 (SD = 1.22). Anxiety and symptom distress showed a moderate positive correlation with supportive care needs (state anxiety: r=0.40r = 0.40, trait anxiety: r=0.41r = 0.41, and symptom distress: r=0.45r = 0.45, p<0.001p < 0.001). Social support demonstrated a low negative correlation with supportive care needs (r=−0.18r = -0.18, p<0.05p < 0.05). No significant correlations were found between supportive care needs and age, marital status, educational level, or type of treatment.

Conclusion: The findings of this study can inform the development of nursing guidelines for newly diagnosed breast cancer patients, with particular focus on addressing needs related to the health system and information to better meet their requirements.