BCNNON Health Science Research Journal

Development of Nursing Continuous Care Model for Older Adult Sepsis in a Tertiary Hospital

Warintorn Romsai — 2025-08-30

Background: Developing a high-quality nursing care model plays a critical role in reducing complications and mortality among older adults with sepsis. This life-threatening condition requires comprehensive and continuous care.

Objectives: To develop and evaluate the effectiveness of a continuous nursing care model for older adults with sepsis.

Methods: This research and development (R&D) study was conducted in two phases: (1) development of the model through problem analysis from focus group discussions and data review, and (2) implementation and evaluation of the model. The participants included 30 registered nurses and 66 older adults diagnosed with sepsis. Research instruments consisted of a nursing knowledge test, a nursing practice skill assessment, satisfaction questionnaires for both nurses and patients, and clinical outcome recording forms. Data were analyzed using descriptive statistics and content analysis.

Results: The developed nursing care model consisted of four key components: (1) screening guidelines, (2) care guidelines, (3) transfer guidelines, and (4) a nursing practice manual (7 Aspects of Care). The results demonstrated high satisfaction among nurses (mean =4.57, SD=0.54) and patients (mean=4.06, SD=0.33). Nurses’ post-intervention knowledge scores were significantly higher than pre-intervention scores (p=0.001), and all clinical outcome indicators showed improvement after implementing the model.

Conclusions: The developed nursing care model provides a comprehensive and practical approach for managing sepsis in older adults. It has the potential to reduce mortality and complications while enhancing the satisfaction of both healthcare personnel and patients receiving care.

Maternal Age, Pregnancy-Related Anxiety, Sleep Hygiene Practices, and Sleep Quality Among Pregnant Women

panida pootrakoon — 2025-08-30

Background: Pregnancy affects both physical and psychological aspects and may impact the sleep quality of pregnant women.

Objectives: To examine the relationships among maternal age, pregnancy-related anxiety, sleep hygiene practices, and sleep quality in pregnant women.

Methods: This study employed a descriptive correlational research design. The sample consisted of 129 pregnant women aged 20 years or older who attended antenatal care at a hospital in Pathum Thani Province. The research instruments included a personal information record form, the Pittsburgh Sleep Quality Index (PSQI), a pregnancy-related anxiety questionnaire, and a sleep hygiene practice scale. Data were analyzed using descriptive statistics and Spearman’s rank correlation.

Results: Most participants (72.09%) were aged between 20–30 years, and age showed no significant correlation with sleep quality (r=0.07, p=0.469). Participants had a moderate level of pregnancy-related anxiety (mean = 22.81, SD=5.44), which had a low positive correlation with sleep quality (r=0.24, p=0.006). Sleep hygiene practices were at a low level (mean = 76.93, SD=18.75) but showed a moderate positive correlation with sleep quality (r=0.45, p<0.001). Additionally, 50.39% of the pregnant women had poor sleep quality.

Conclusion: The findings highlight the importance of promoting sleep hygiene and managing pregnancy-related anxiety to improve sleep quality and overall health among pregnant women.

Intention of COVID-19 Vaccination Among Unvaccinated Older Adults in Roi-Et Province: Insights After the Pandemic

Sirima Panadorn — 2025-08-30

Background: COVID-19 vaccination in older adults is effective in reducing the risk of severe illness and mortality from COVID-19 infection.

Objectives: This study aimed 1) to examine the intention to receive COVID-19 vaccination among older adults who had never received the vaccine, and 2) to investigate the predictive factors of vaccination intention in Roi-Et province.

Methods: This predictive correlational study was conducted among older adults aged 60 years who had never received a COVID-19 vaccine in Roi Et Province, Thailand. The samples were selected using simple random sampling. Data were collected after the major COVID-19 outbreak had subsided. Research instruments included personal information and general health questionnaires, a COVID-19 vaccination intention questionnaire, a health belief questionnaire related to COVID-19, and the fear of COVID-19 scale. Data were analyzed using descriptive statistics, the Mann-Whitney U Test, and logistic regression analysis.

Results: The mean score of intention to receive the COVID-19 vaccine among the samples was 2.71 (S.D.=2.12). Perceived benefits of COVID-19 vaccination significantly predicted vaccination intention (OR=1.54, 95% CI=1.14–2.08).

Conclusions: These findings suggest that older adults who perceived benefits of the COVID-19 vaccine reported higher intentions to get vaccinated.

Effects of a Case Management Application on Complication Prevention Behavior in Older Adults After Cataract Surgery

Change Preeprem — 2025-08-30

Background: Cataract is a common health issue in older people. The primary treatment is cataract surgery, which can lead to postoperative complications if appropriate care is not provided. Case management through an application can effectively promote self-care behaviors, ensure continuous support, and reduce the risk of complications following cataract surgery.

Objectives: To examine the effects of a case management application on complication prevention behaviors in elderly patients undergoing cataract surgery.

Methods: A quasi-experimental research study using a two-group pretest-posttest design was conducted. The sample consisted of 90 patients aged 60 and older who underwent cataract surgery at a university hospital in the central region of Thailand. The sample was allocated to the experimental and control groups, 45 each. Data were collected using a personal information questionnaire and a postoperative complication prevention behavior questionnaire. Data analysis included frequency, percentage, chi-square test, and t-test statistics.

Results: Elderly patients using the case management application had significantly higher postoperative complication prevention behavior scores than the control group (P<0.001) and showed a significant improvement compared to their pre-intervention scores (P<0.001).

Conclusions: Nurses can utilize the case management application to promote complication prevention behaviors in elderly patients after cataract surgery to enhance the continuity and effectiveness of care.

The Relationship Between Illness Perception and Behaviors to Slow Kidney Deterioration in Patients with Stage 3 Chronic Kidney Disease in the Southern Border Provinces, Thailand

Waeroslinda Mahama — 2025-08-30

Background: Appropriate illness perception in patients with stage 3 chronic kidney disease (CKD) plays a crucial role in promoting self-management behaviors, which can help delay disease progression.

Objectives: This study aimed to examine the relationship between illness perception and kidney-deterioration-slowing behaviors among patients with stage 3 CKD in the southern border provinces of Thailand.

Methods: A descriptive correlational research design was used. The sample consisted of 84 patients with stage 3 CKD, selected through multistage sampling. The research instruments included a chronic kidney disease illness perception questionnaire and a questionnaire on behavior designed to delay kidney deterioration. Data were analyzed using descriptive statistics and Pearson’s correlation coefficient.

Results: The findings revealed a statistically significant positive correlation between illness perception and kidney deterioration-slowing behaviors (r=.42, p<.01).

Conclusions: The results suggest that a more accurate understanding of their illness helps patients adopt long-term health behaviors that can prevent further kidney decline. Therefore, promoting a more accurate illness perception should be integrated into CKD patient education to enhance disease management and delay progression to more severe stages.

Discharge Planning Model for Preterm Infants with Birth Weight Less Than 1,500 Grams Development in a Hospital in Pathum Thani Province

Kuntima Kaoloung — 2025-08-30

Background: Developing a discharge planning model for preterm infants is crucial for multidisciplinary teams and families, as it helps reduce hospital readmission rates, medical costs, and the length of hospital stay.

Objective: To analyze problems, develop a discharge planning model, and evaluate the outcomes of the model for preterm infants weighing less than 1,500 grams.

Methods: The study was conducted in three phases: 1) drafting the discharge planning model through problem analysis, team collaboration, and literature review; 2) pilot testing the model with 17 nurses and 60 mothers of preterm infants using manuals, knowledge and skill assessment tools; and 3) evaluating the outcomes using descriptive statistics and Independent t-test for quantitative analysis, and content analysis for qualitative data.

Results: The discharge planning model comprised a manual, nursing practice guidelines, and outcome recording forms. Mothers in the experimental group demonstrated significantly higher knowledge and caregiving skills compared to the control group (p<0.001) and reported high levels of satisfaction. After implementing the model, readmission rates decreased by 20%, average treatment costs were reduced by 171,529.60 THB per case, and average hospital stays decreased by 21.5 days per case.

Conclusions: The discharge planning model for preterm infants weighing less than 1,500 grams is an effective tool for ensuring continuity of care through collaborative communication between multidisciplinary teams and families, thereby enhancing mothers' capabilities to care for their infants at home.

Effects of SDU Brain Training Applications on Knowledge of Dementia Prevention in Elderly At-risk People

Renu Kwanyuen — 2025-08-30

Background: Thailand has officially entered an aging society, with an increasing number of elderly people at risk of developing dementia. Concurrently, the use of technology and innovation in healthcare has grown significantly. Therefore, mobile applications are considered a promising option for preventing dementia among elderly people at risk.

Objectives: This study aimed to investigate the effects of the “SDU Brain Training” application on dementia prevention knowledge and to evaluate user satisfaction of at-risk elderly people.

Methods: A quasi-experimental study with a two-group pretest-posttest design was conducted. The sample consisted of 60 elderly people from Suphanburi Province, selected through a multistage random sampling. Research instruments included the SDU Brain Training application, a satisfaction questionnaire, a dementia prevention knowledge assessment form, an application effectiveness evaluation form, and the Abbreviated Mental Test (AMT), all of which were validated for validity and reliability. Data were analyzed using descriptive statistics and t-tests.

Results: The findings showed that the experimental group had a significantly higher knowledge mean score than that of the control group after using the application (M=14.23, SD=0.82 vs. M=11.93, SD=1.41, p<.05). User satisfaction was at the highest level (M=4.90, SD=0.40), and application effectiveness also received the highest mean score (M=4.66, SD=0.42). The application was found to provide helpful information, enhance cognitive function, and be suitable for preventing dementia in elderly people, with the highest effectiveness score (M=4.83, SD=0.38).

Conclusions: In conclusion, the “SDU Brain Training” application can effectively support dementia prevention in at-risk elderly people.

The Policy Recommendations to Develop the Role of Academic Centers in Supporting the Operation of Sub-district Health Promoting Hospitals under the Provincial Administrative Organization

Chiraporn Worawong — 2025-08-30

Background: The transfer of Sub-district Health Promoting Hospitals (SHPHs) to the jurisdiction of Provincial Administrative Organizations (PAOs) has marked a significant shift in Thailand’s primary healthcare system. The Ministry of Public Health plays a crucial role in supporting the operations of these SHPHs to enhance the quality of primary health services.

Objective: To formulate policy recommendations to develop the role of academic centers in supporting the operations of SHPHs under the provincial administrative organization.

Methods: This study employed a qualitative research design. The study areas were selected using stratified purposive sampling, choosing one province from each of the five health regions where academic centers are located. A total of 151 key informants were recruited, comprising personnel from both the Ministry of Public Health and the Ministry of Interior. Data were collected through semi-structured interviews, focus group discussions, and public hearings. The content validity of the interview tools ranged from 0.6 to 1.00. Qualitative data were analyzed using data categorization and content analysis.

Results: The findings suggest three key policy recommendations: (1) Academic centers should provide technical support to SHPHs to help them achieve performance indicators and deliver quality, contextually relevant primary healthcare services that meet the need of the local population; (2) Inter-departmental academic collaboration should be integrated before coordinating with PAOs and local health boards to reduce redundancy in technical support; and (3) The role of academic centers in working with PAOs should be clarified by establishing joint performance indicators for monitoring and evaluating SHPH operations toward the goal of achieving quality SHPHs.

Conclusion: Academic centers play a vital role in the stewardship of the healthcare system by providing technical support in collaboration with healthcare service units at all levels.

The Relationship Between Health Literacy in Rational Drug Use and the Medication Use Behaviors of Hospitalized Patients

Saranit Boonprasop — 2025-08-30

Background: Irrational drug use is a global public health concern. Rational drug use literacy empowers patients to appropriately manage their health during illness, while safe medication use behaviors can reduce healthcare costs.

Objectives: This descriptive study aimed to examine the relationship between rational drug use literacy and medication use behaviors among inpatients at Pranangklao and Pathum Thani hospitals.

Methods: The sample consisted of 155 inpatients admitted to general medical and surgical wards. Data were collected using a rational drug use literacy assessment and a medication use behavior questionnaire. The content validity indices were 0.96 and 0.93, respectively, with a KR-20 reliability of 0.85 and a Cronbach’s alpha of 0.76. Data were analyzed using descriptive statistics and Pearson’s correlation coefficient.

Results: The findings revealed that participants had an inadequate level of rational drug use literacy ( =29.19, SD=6.77), while their medication use behaviors were at a good level ( =2.18, SD=0.41). Rational drug use literacy showed a statistically significant positive correlation with medication use behaviors (r=0.47, p<.01).

Conclusions: The results indicate that inpatients place importance on taking medications and self-care in line with physicians’ recommendations. However, improving rational drug use literacy, particularly in understanding drug and health information, is essential to enhance the appropriate and safe use of medications.

The Effects of a Learning Module on Neonatal Intramuscular Injection on Confidence, Injection Skills, and Satisfaction of Nursing Students

Netsumol Jatulajanyalate — 2025-08-30

Background: Intramuscular injection in neonates is a critical nursing skill that requires adequate knowledge, confidence, and precise technique.

Objectives: This study aimed to examine the effects of a learning package on nursing students’ confidence, intramuscular injection skills in neonates, and learning satisfaction.

Methods: A quasi-experimental one-group pretest-posttest design was employed. The sample consisted of 205 third-year nursing students. The research instruments consisted of a personal data questionnaire, an intramuscular injection confidence rating scale, a learning package satisfaction questionnaire, a skill assessment checklist, and the neonatal intramuscular injection learning package. Data were analyzed using descriptive statistics, a dependent t-test to compare confidence levels before and after the intervention, and Spearman’s rank correlation coefficient to examine the relationship between confidence and skills.

Results: The results showed that the mean confidence score after using the learning package (M=20.13, SD=3.03) was significantly higher than that before (M=12.29, SD=2.94), with a statistical significance of p<.001. Post-intervention confidence was positively correlated with intramuscular injection skill scores (r_s=.636, p<.001).

Conclusions: The learning package significantly enhanced students’ confidence and improved their neonatal intramuscular injection skills, supporting its integration into nursing education to develop essential clinical competencies.

The Development of Line-base Supplementary Lessons in the Pediatric and Adolescent Nursing Course for Nursing Students

Supreeda Manipantee — 2025-08-30

Background: In the digital era, the development of educational technology media plays a crucial role in enhancing students’ learning. Developing lessons through the LINE application is a practical approach to promoting self-directed learning of students.

Objectives: This research aimed to develop online supplementary lessons via the LINE application, compare pre-learning and post-learning scores, and explore students’ opinions and satisfaction with the online supplementary lessons.

Methods: This study employed a research and development design. The sample consisted of three nursing instructors and 31 nursing students. Research instruments included semi-structured interviews, a knowledge test on pediatric and adolescent nursing, and questionnaires assessing the quality and satisfaction with the LINE-based supplementary lessons. Data were analyzed using content analysis, descriptive statistics, and one-way repeated measures ANOVA.

Results: The results showed that the mean scores before learning, immediately after learning, and two weeks post-learning were significantly different (F=23.19, p<.001). The quality of the LINE-based supplementary lessons was rated at the highest level (Mean =4.76, SD=0.37). Students’ satisfaction was also rated at the highest level (Mean =4.69, SD=0.39).

Conclusions: The LINE-based supplementary lessons were of high quality and easy to use. They effectively support students’ self-directed learning and improve their academic performance. Therefore, this innovation can be effectively utilized to enhance learning in pediatric and adolescent nursing courses.

Physical Literacy and Physical Activities Among Social-Bound Older Persons

Tairat Changchana — 2025-08-30

Background: Physical literacy is a crucial factor in promoting physical activity among socially engaged older adults.

Objectives: To examine the level of physical literacy and physical activities among socially active older adults, and to study the correlation between physical literacy and physical activities among socially active older adults.

Methods: This descriptive study was conducted. The sample consisted of 84 socially active older adults receiving services at sub-district health promotion hospitals across four districts selected using a multi-stage sampling technique. Research instruments included a personal information questionnaire, a physical literacy questionnaire, and a physical activity questionnaire for socially active older adults. Data was analyzed using descriptive statistics. Pearson’s correlation was used to assess the relationships between physical literacy and physical activities.

Results: The findings revealed that socially active older adults had a moderate level of physical literacy and a high level of physical activity. Physical literacy was significantly positively correlated with moderate-intensity physical activity of socially active older adults (r=0.377, p<0.01).

Conclusion: The results of this study can serve as a baseline for supporting the development of physical literacy programs aimed at increasing physical activity among socially active older adults.