Journal of Nursing Science Chulalongkorn University

Evaluation of the efficacy of Search out Severity Score and National Early Warning Score for urgent Endotracheal intubations or unanticipated intensive care unit (ICU) admission for an elderly patient in general medical wards

Sunee Suwanpasu, Werapattra Praparpak, Sukanya Poonsap — Thu, 27 Jan 2022 00:00:00 +0700

Purpose: To investigate the efficacy of Search out Severity Score (SOS) and National Early Warning Score (NEWS) score in predicting urgent endotracheal intubations or unanticipated intensive care unit admission

Design: Prospective analytical study

Method: The sample was patient’s ages 60 years and over admitted to general medical wards at King Chulalongkorn Memorial Hospital between November 1, 2019, to July 31, 2020. Purposive sampling was selected based on criteria. A sample of 85 was obtained. Data were collected using a questionnaire about personal information and observation form composed of respiratory rate, heart rate, systolic blood pressure, body temperature, urine output, and conscious level for the calculation of NEWS and SOS. The data were analyzed for sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve (AUC)

Finding: The NEWS and SOS systems at 4 hours before the event were the most effective, with the cut-off values of NEWS> 7 and SOS> 4 giving the best accuracy (sensitivity 71.4%, 64.3% specificity 98.2%, 98.2%. Respectively). The area under the ROC curve [AUC]) was 0.90 (95% CI 0.81-0.99) and 0.86 (95% CI 0.75-0.97), respectively. The prediction efficiency decreased over time before the event. However, at 8, 12, 24 hours before the incident, it was still accurate at a good-fair level (AUC 0.82, 0.82, 0.74, and 0.77, 0.79, 0.72, respectively).

Conclusion: The NEWS system provides excellent accuracy, while the SOS system gives a good accuracy level. Therefore, the NEWS system should be used for the early detection of abnormalities and as a guideline for the rapid response to changes in the vulnerable elderly. It keeps patients out of the crisis and is safe and able to predict worsening patients.

End-of-life care knowledge of Fourth Year Nursing Students, Faculty of Nursing, Thammasat University

Itsari Srisupha-olarn, Yaowarat Matchim, Borwarnluck Thongthawee — Thu, 27 Jan 2022 00:00:00 +0700

Purpose: To study the end-of-life care knowledge of fourth-year nursing students, Faculty of Nursing, Thammasat University.

Design: Descriptive research.

Methods: The participants included 81 fourth-year nursing students of the academic year of 2017. These students completed all learning courses and preparing for graduation. Instruments used for collecting data included: 1) a demographic data form, and 2) the Palliative Care Quiz for Nursing [PCQN]. The PCQN was tested for reliability with the KR-20 method among 30 fourth-year nursing students, faculty of nursing, Suan Dusit University and yielded 0.81. Descriptive statistics was used to analyze the data.

Results: The results showed that the fourth-year nursing students, Faculty of Nursing, Thammasat University had the average score of end-of-life care knowledge in a low level ( = 11.26, SD = 2.36). Based on the components of end-of-life care knowledge, the average score of general knowledge and the average score of symptom management were in low level ( = 2.38, SD = 1.14; = 6.62, SD = 1.87). The average score of the component of psychosocial and spiritual care was in a moderate level ( = 2.26, SD = 0.49).

Conclusion: The results of this study can be used for teaching and learning development as well as for creating training programs to improve end-of-life care knowledge for nursing students.

The Effect of Coaching Family Member Caring Behavior On Autistic Symptoms Among Autistic Preschoolers

Nattira Tiwato, Jintana Yunibhan, Sunisa Suktrakul — Thu, 27 Jan 2022 00:00:00 +0700

Purpose: 1) to compare autistic symptoms among autistic preschoolers before and after using coaching family member caring behavior, and 2) and to compare autistic symptoms among autistic preschoolers using coaching family member caring behavior and those who received usual nursing care.

Design: Quasi-experimental research

Methods: The research sample consisted of 40 autistic children aged from 3 to 6 years and families receiving services inpatient care service of Rajanukul Institue selected by inclusion criteria, were matched pair by sex and age of autistic preschoolers and education of family member, then, equally randomly assigned to an experimental group and a control group with 20 subjects in each group. The experimental group received coaching family member caring behavior for 6 weeks. The control group received usual nursing care. The experimental instruments included a Nurse handbook for coaching family member caring behavior; Family members handbook for autism care. Data were collected using The Autistic symptoms assessment scale and Autism caring manual for family member’s practical skills questionnaires. Their CVI were .87 and .88, respectively. Their Cronbach’s alpha coefficients were .92 and .89, respectively. The t-test was used in data analysis

Results: 1) The mean score of autistic symptoms after using Coaching family member caring behavior were significantly lower than those before, at the .00 level. 2) The mean score of autistic symptoms who received Coaching family member caring behavior was lower than autistic preschoolers after receiving usual nursing care but no significant differences of Autistic symptoms were found between autistic preschoolers after receiving coaching family member caring behavior and usual nursing care.

Conclusion: The result of this study support that coaching family member caring behavior can reduce autistic symptom among autistic preschoolers.

The Effect of Milieu Therapy on Aggressive Behaviors Of Severe Autistic Children

Prajak Puksupa, Jintana Yunibhand — Thu, 27 Jan 2022 00:00:00 +0700

Purpose: 1) to compare aggressive behaviors of severely autistic children before and after using the milieu therapy program, and 2) to compare aggressive behaviors of severely autistic children using the milieu therapy program and those who received usual nursing care.

Design: Quasi-experimental research

Methods: The research sample consisted of thirty-six severe autistic children, aged 6-12 and caregivers receiving services in the inpatient department of Rajanukul Institute selected by inclusion criteria, were matched pair by sex and age of severely autistic children, then, equally randomly assigned to an experimental group and a control group with 18 subjects in each group. The experimental group received the 4 weeks milieu therapy program. The control group received usual nursing care. Research instruments were: 1) A personal data questionnaire, 2) An aggressive behaviors assessment scale, 3) A clinical nursing practice guideline of the milieu therapy for severely autistic children, 4) A nurses teaching manual for parents on aggressive behavior management, 5) A checklist of caregivers’ ability to manage children’s aggressive behavior at home. All instruments were content validated by a panel of 5 experts. The reliability of the aggressive behavior scale was 0.87. Data analysis was done by t-test.

Results: 1) Aggressive behaviors of severely autistic children after using the milieu therapy program was significantly lower than those before, at the .05 level; and 2) Aggressive behaviors of severely autistic children who received the milieu therapy program was significantly lower than those who received usual nursing care, at the .05 level.

Conclusion: The result of this study support that the milieu therapy program can reduce the aggressive behaviors of severe autistic children.

The Effect of Internalized Stigma Management Program on Depressive Symptoms among Patient with Opioid use Disorder

Pimchompoo Srithanom, Penpaktr Uthis, สุขตระกูล Suktrakul — Thu, 27 Jan 2022 00:00:00 +0700

Purpose: 1) To compare depressive symptoms of patients with opioid use disorder who received internalized stigma management program measured at pre-intervention, the end of the intervention, and at one-month post-intervention. 2) To compare depressive symptoms of patients with opioid use disorder who received internalized stigma management programs and those who received regular nursing care.

Design: Quasi-experimental research

Methods: Thirty-eight opioid use disorder patients who have depressive symptoms and received services at the Methadone Clinic in Princess Mother National Institute on Drug Abuse Treatment were enrolled. Questionnaires were composed of Internalized stigma management program, Demographic data, The 9 Questions Depression Rating Scale revised for Thai Central Dialect, and The brief opioid stigma scale. The questionnaires were tested for content validities and the reliabilities were .77 and .79, respectively. Data were analyzed using descriptive statistics, repeated measure ANOVA and Least Significant Difference.

Findings: 1) The depressive symptoms in the experimental group compared between pre-post and one-month post-intervention are not significant. 2) The depressive symptoms among patients with opioid use disorder in the experimental group at post-intervention and one-month post-intervention were significantly better than the control group.

Conclusion: This program can be used for reduced depressive symptoms among patients with opioid use disorder in a short time.