NU Journal of Nursing and Health Sciences

Analysis and Evaluation of Nursing Theories: Processes and Application

wongduan suwannakeeree — 2025-02-03

Nursing theory analysis and evaluation are the processes of systematically examining a theory and identifying a theory’s degree of usefulness to guide practice, research, education, and administration. Additionally, these processes allow the reviewer to determine the strengths and weaknesses of a theory and assist in identifying the need for additional theory development or refinement. The ultimate goal of nursing theory analysis and evaluation is to determine the potential contribution of the theory to new insights and new formulations that will add to the nursing body of knowledge. Nurses play an important role in developing nursing discipline and determining the nursing theory value. Therefore, they should have knowledge and understanding about nursing theory analysis and evaluation regarding significant issues; nursing theory characteristics, types, and the processes to analyze and evaluate a nursing theory. In addition, the example of nursing theory analysis and evaluation may help to clear understanding and feasible for applying correctly.

Role of Nurses: Dietary Promotion Based on The Dietary Approaches to Stop Hypertension in Person with Hypertension

Preeya Leesagul — 2025-02-03

Hypertension is a major global health problem and a leading cause of premature death worldwide. Lifestyle modification is one of the standard treatments for managing hypertension. The Dietary Approaches to Stop Hypertension (DASH) diet has been proven effective in reducing blood pressure in hypertensive patients. The DASH diet emphasizes reducing sodium intake while increasing the consumption of foods rich in potassium, magnesium, calcium, and healthy sources of protein, such as vegetables, fruits, whole grains, low-fat dairy products, and legumes. Additionally, the DASH diet promotes the reduction of saturated fats, trans fats, and added sugars, helping to balance nutrients that benefit cardiovascular health. Essential minerals like potassium help expel excess sodium from the body, while magnesium and calcium play roles in regulating the contraction and relaxation of blood vessels. These outcomes contribute to lowering blood pressure and reducing the long-term risk of cardiovascular diseases. The promotion of this dietary approach is a crucial role for nurses in educating, counseling, monitoring, and evaluating person with hypertension. Nurses also play a key role in motivating patients, supporting their families and caregivers, and collaborating with interdisciplinary teams to ensure that hypertensive individuals can sustainably modify their dietary behaviors.

The The Effect of Resilience Reinforcement among the Elderly People in Amphoe Mueang, Nakhonsawan Province

Eakaluk Dekyong — 2025-02-03

This study was a quasi - experimental research using a one-group, pre-test/post-test design. The objective was to examine the effect of resilience reinforcement among the elderly people in Amphoe Mueang, Nakhonsawan Province. The sample consisted of 33 elderly people from Wat sai Subdistrict, Nakhonsawan Province, who passed the intellectual screening (Mini-Cog). The tools used in the study consisted of 2 parts: 1) the resilience reinforcement program, consisting of three dimensions withten activites for three times, one week apart and 2) data collection tools, including a general information form and a resilience reinforcement form for the elderly , developed by the Department of Mental Health, Ministry of Public Health, with a reliability coefficient of .90. the general information datawere analyzed by descriptive statistics and the hypothesis was tested by paired t-test.The results showed that a statistically significant increase in the overall mean score of resilience of the elderly after resilience reinforcement in the program (x̅ = 66.55, S.D. = 5.98) compared to before the intervention (x̅ = 60.33, S.D. = 5.98), with a p-value of < .001. Furthermore, by dimensions demonstrated significant improvements in emotional endurance (x̅ = 32.30, S.D. = 3.16, p = .001), motivation (x̅ = 17.82, S.D. = 2.36, p = .003), and problem-solving skills (x̅ = 16.42, S.D. = 2.77, p = .016) post-intervention.The results of this study showed that resilience reinforcement programs can increase resilience, or mental health strength, and can be used to further promote the abilities of the elderly.

Factors Predicting Stress among Pregnant Women with Preterm Labor

Piengtawan Pantuyotee — 2025-02-03

This predictive research aimed to study stress and factors predicting stress among pregnant women with preterm labor. Participants consisted of 101 pregnant women with 22 to less than 37 weeks of gestation who were diagnosed by an obstetrician as having preterm labor and were admitted to the hospital for no less than 24 hours during August – December 2022. They were selected by the study inclusion criteria. Research instruments included 1) demographic record form 2) perceived severity of illness questionnaire 3) nurse social support questionnaire 4) family social support questionnaire and 5) stress assessment form created by Department of Mental Health, Ministry of Public Health. Content validity values of developed questionnaires were .84, .80 and .93 respectively. Reliability of questionnaires were .84, .91, .93 and .80 respectively. Descriptive statistics and standard multiple regression were conducted for data analysis.Results revealed that according to the stress criteria of mental health department, ministry of public health; stress mean score was at a moderate level ( X^- = 7.46, S.D. = 2.29). Items of stress assessment having highest average score were sleep problems ( X^- = 2.02, S.D. = .82). Factors regarding social support provided by nurses (β = -.27, p = .007), pregnancy complications (β = .23, p = .01) and perceived severity of the illness (β = .20, p = .04) significantly predicted 12.9% of the variance in stress among pregnant women with preterm labor (R²= .129, F_(3,97)= 4.77, p = .004). Social support provided by nurses has the most negative influence on stress among pregnant women with preterm labor. The findings will be used as basic information to develop a stress reduction program for pregnant women with preterm labor.

Effects of a Health Literacy Enhancement Program and Health Behavior on Health Behavior and Blood Glucose Level among High Risk Pregnant Women of Gestational Diabetes Mellitus

Pennapa Dumminsek — 2025-02-03

This study was quasi-experimental research. The purpose of this research is to investigate the effects of a health literacy enhancement program and health behavior on health behavior and blood glucose level among high risk pregnant women of gestational diabetes mellitus. The participants were people aged of 18 or more at risk of gestational diabetes mellitus, who received antenatal care at the Buddhachinaraj Phitsanulok Hospital, Phitsanulok. The sample of 60 person were assigned into the control group and the experimental group with 30 in each group. The experimental group received the Health Literacy Enhancement Program and Health Behavior Praboromarajchanok Model and control group received routine care. The study duration was between July to September 2023. Research instrument were conducted as questionnaires divided into three parts: Personal information record form, Health Behavior Praboromarajchanok Model Questionnaire and blood glucose record form. Cronbach's alpha coefficient was used to test reliability of Health Behavior Praboromarajchanok Model questionnaire and a value of .84. Data were analyzed using descriptive statistics and inferential statistics. (paired t-test , independent t-test). Analysis of average health behavior and blood glucose level The results showed that after receiving in the program, the experimental group had significantly higher mean scores of health behavior than before receiving the program and their scores were also higher than the control group (t = 9.01 , p<.05). The experimental group had significantly a lower blood glucose level than the control group (t = -3.98 p<.05). The findings suggest that health literacy development should be provided for high risk pregnant women of gestational diabetes mellitus. This results in more appropriate changes in health behavior, which may affect normal blood glucose level and good health outcome.

Development of Clinical Practice Guidelines for Pain Management Among Patients Undergoing Open Heart Surgery

Tanutporn Junsiri — 2025-02-03

Pain after open heart surgery impacts patients physically and mentally, necessitating effective management. This developmental research aimed to develop clinical practice guidelines (CPGs) for pain management among patients undergoing open heart surgery. The study framework was based on the development of CPGs recommended by the Australian National Health and Medical Research Council (NHMRC, 1999). The participants consisted of 1) 3 nurses using the CPGs, and 2) 3 patients undergoing open heart surgery. Data collection instruments included: 1) a demographic data record form, 2)a pain assessment form on postoperative cardiac surgery with reliability index of 0.84, 3) a questionnaire on patient satisfaction with pain management with reliability index of 0.83 and 4) a questionnaire on feasibility of CPGs. Data were analyzed using descriptive statistics include frequency, percentage, mean, and standard deviation.The results revealed that the CPGs for pain management among patients undergoing open heart surgery consisted of 1) preoperative patient assessment and pain management education; 2) pain severity assessment, cause of pain and postoperative pain management; 3) evaluation after pain management; 4) dosage adjustment according to treatment plan or change of pain management method according to pain severity; 5) managing pain medication side effects; and 6) monitoring of pain management and documentation of pain score. The feasibility for implementation was at a high level. Patients have lower incidence of mild chest wound pain and pain interference was reported less frequently. Additionally, satisfaction with pain management was high level. The findings of this study indicate that these CPGs are practical and effective for individuals undergoing open heart surgery. Therefore, further studies should consider the outcome of implementation.

Development of the Hybrid Evaluation Model to Evaluate Comprehensive Knowledge and Skill in Pediatric Nursing

Wansiri Nilnate — 2025-02-03

This research and development study aimed to develop the hybrid evaluation model to evaluate comprehensive knowledge and skill in pediatric nursing during COVID-19 pandemic. The sample consisted of 55 senior nursing students and 9 nursing lecturers. The research instruments comprised the hybrid evaluation model to evaluate comprehensive knowledge and skill in pediatric nursing, the manual set of the hybrid evaluation model to evaluate comprehensive knowledge and skill in pediatric nursing, the satisfaction questionnaire, and semi-structured interview form. The content validity index of the questionnaire was 1 and Cronbach's alpha coefficient was .96. Data were analyzed using descriptive statistics and content analysis.The results indicated that the hybrid evaluation model to evaluate comprehensive knowledge and skill in pediatric nursing during COVID-19 pandemic consisted of 1) Online pediatric nursing knowledge test and 2) Face-to-face pediatric nursing skills exam with no more than 15 students and lecturers in room together. Student satisfaction with the hybrid evaluation model to evaluate comprehensive knowledge and skill in pediatric nursing revealed that the sample was overall satisfied at a high level (X^- = 4.23, S.D. = .59) and the focus group activity found that the hybrid evaluation model to evaluate comprehensive knowledge and skill in pediatric nursing was feasible to replace traditional face-to-face clinical practice assessments in the event of an outbreak of COVID-19 is severe, or there are other special circumstances such as unable to organize clinical teaching and face-to-face learning in large groups.

The Causal Relationship Model among Leadership Styles, Decision Making Behaviors on Performance in Long Term Care Management of the Elderly of First-line Nurse Managers in Community Hospitals

Panisara Kasemsuk — 2025-02-03

The purpose of Descriptive Research was to examine the relationship model among leadership style of first-line managers, decision making behaviors and performance in long term care management of the elderly. The samples were 312 first-line nurse managers from community hospitals. The research instruments comprised of leadership style of first-line managers, decision making behaviors and performance questionnaires. The content validity index were 0.93, 0.89 and 1.00. The reliability of research questionnaire with Cronbach’s alpha coefficient were 0.83, 0.90 and 0.82, respectively. Data were analyzed using descriptive statistics ( , S.D.) and Structural Equation Model (SEM). The LISREL was used to analyze the linear structural equation model.

The findings of this study revealed that the structural equation model of performance in long term care management of the elderly was congruent with the empirical data (CMIN/DF = 0.66, GFI = .98, AGFI = .96, CFI = 1, RMR = .00, RMSEA = .00). The performance, leadership style, and decision making behaviors had high level (X^- = 3.98, S.D. = .34, = 3.86, S.D. = .41; X^- = 3.92, S.D. = .31), respectively. Leadership style of first-line managers had positive direct effects on performance (β = .032, p<.01). Likewise, However, leadership style had an indirect effects on performance through decision making behaviors (β = .002, p<.01). Leadership style explained 35 percent of the variability in decision making behavior, while the combination of leadership style and decision-making behavior able to jointly predict 38 percent of the performance in long term care management of the elderly. The results of this research show a new finding in the context of long-term care management for the elderly. It is to expand the knowledge of community hospital leadership model that affects decision-making behavior and can be further study the causal model in different contexts.

Problem Condition and Needs for Patient Triage at the Emergency Department in the New Normal Age, Tertiary Care Center, Health Region 2

Supaporn Chanuwat — 2025-02-03

The purpose of this qualitative research was to study problem condition and needs of Triage at the emergency department of a tertiary care center in Health Region 2. Informer 12 professional nurses who had ability to triage patients and worked in the emergency department for at least 6 months. The in-depth interview was used for data gathering.Data were analyzed by descriptive and content analysis.The research found problems in 4 areas divided into 9 issues as follows. 1. Area of patients and information givers had 2 issues 1) complexity of the symptoms and signs of patients 2) readiness of relatives or caregivers to provide information. 2. Area of the screeners had 3 issues 1) lack of triage nurses during late night shifts 2) lack of additional support team and 3) insufficient competency of triage nurses 3. Area of screening tools and information technology had 2 issues 1) complexity to use the screening tools 2) complexity of technology usage 4. Area of location and equipment had 2 issues 1) unclear of access and room signs 2) inadequate equipment at certain times.The research found that the needs for patient triage in the Emergency Department consisted of 3 areas divided into 7 issues as follows. 1. Area of screener had 3 issues 1) regularly increase nurses’ patient triage competency 2) increase the number of nurses appropriate for each shift 3) increase support team according to work demand. 2. Area of tool and technology had the demand to ease data entry both in data complexity and data entry process. 3. Area of triage had 3 issues 1) specific place for triage which is convenient for access 2) appropriate furniture and equipment for triage 3) proper and clear signs for patients and relatives.

The Effects of Symptom Management Program on Abdominal Distention in Colorectal Cancer Patients After Abdominal Surgery

Pulyada Mookdagarnthong — 2025-02-03

This study was quasi-experimental research design. The purpose of this research was to investigate the effects of symptom management program on abdominal distention in colorectal cancer patients after abdominal surgery. The participants were patients diagnosed with colorectal cancer and are receiving treatment by abdominal surgery in a hospital in Health Region 2 of Thailand. There were selected by purposive sampling and separated. 52 participants were divided into an experimental group and a control group, 26 for each group. The experimental group received the symptom management program, adapted from symptom management concept of Dodd et al., (2001) comprised of 3 steps: 1) symptom experience of abdominal distension, 2) symptom management strategies for abdominal distension, and 3) symptom outcome of abdominal distension. The control group received routine nursing care. Data were collected between November 2022 and August 2023. The research collection tools were 1) personal information record and 2) abdominal distension form was used to test reliability (Cronbach's alpha coefficient 0.97). Data were analyzed using descriptive statistics, chi-square test, Fisher’s exact test, independent samples t-test, and Mann-Whitney U test.The results revealed that the experimental group receiving the symptom management program had a lower mean abdominal distention score than the control group receiving routine nursing care statistical significance (p<.001). The results of this study suggest that the nurse should apply the symptom management program to help reduce abdominal distention after abdominal surgery.

Effectiveness of Sexual Education Literacy Program on Life Skills due to Preventive Risk Behaviors among Adolescents at Vocational Institutes, Chiang Rai Province

Kridsana Pingwong — 2025-02-03

This research is a quasi-experimental study using a two-group pretest-posttest design. It was aimed to examine the effects of sexuality education literacy programs on life skills for preventing adolescent risk behaviors of vocational institutes in Chiang Rai province. The sample group consists of students aged 15-19 years in vocational institutes in Chiang Rai province. The total participant 54 people, divided into 27 people for the experimental group and 27 people for the comparison group. The research tools included the sexuality education literacy program and a life skills questionnaire to prevent adolescent sexual risk behavior. The quality of the questionnaire was assessed using Cronbach’s alpha coefficient, which yielded a reliability value of 0.82. Analyzed by descriptive statistics, Chi-square test statistic, independent t-test statistic, and Paired t-test.The research findings indicate that the experimental group’s average life skills scores increased significantly in all aspects compared to before the intervention (t=-3.698, p<.01). The mean scores for each aspect of life skills, problem solving skills, creative thinking skills, effective communication skills, self-awareness skills, empathy skills and stress management skills were significantly higher (p< .05), compared to before the intervention, as well as decision-making skills, critical thinking skills, interpersonal relationship skills and coping with emotional skill (p< .01). These results demonstrate that the program effectively enhances life skills in preventing adolescent sexual risk behavior.

The Influence of Job Characteristic and Happiness on Quality of Working Life of Professional Nurses in a University Hospital

Nittaya Niemhom — 2025-02-03

The predictive research aimed to explore the level of job characteristics, happiness, and quality of work life among professional nurses in a university hospital. Additionally, it also attempted to investigate the influence of job characteristics and happiness that affect the quality of work life of professional nurses. This study employed quantitative research design. Questionnaires were used for data collection. Stratified Sampling was applied in selecting the samples. This research recruited 145 professional nurses who had worked at a university hospital and have working experiences at least 6 months. The questionnaire was divided into four sections, which were 1) demographic data 2) the Job Characteristic level of profession nurses 3) the Happiness of profession nurses and 4) the Quality of Working Life. The questionnaire was tested for validity and reliability. The content validity of the questionnaire was 0.50 – 1.00, respectively. The Cronbach’s Alpha reliability coefficients of questionnaires were 0.89, 0.88, and 0.96, respectively. Data were analyzed using descriptive statistics (percentage, mean, standard deviation), Pearson’s product moment correlation and multiple regression analysis.The results revealed that the Job Characteristics of the professional nurses in a university hospital was at high level (X^- =4.41 SD =.46). The Happiness and the Quality of Work Life of professional nurses in the university hospital were at medium level (X^- = 3.32, S.D. = .32) and (X^- = 3.42, S.D. =.61), respectively. Resulted in the Happiness and Job Characteristics can predict quality of working life of professional nurses in the university hospital which accounted for 41.8 (R²= .418, p < .01)Recommendation from this study : Nurse organization should have the policy that improved the level of quality in working life among professional nurses such as creating the professional nurses happiness, balanced between a work time and privacy time, planning appropriated workforce and workload, and enhancing the autonomy and freedom in nurses, which helped professional nurses had a good quality of working life.

Adaptation Experiences among Older Persons with Successful Treatment of Pulmonary Tuberculosis

Nawapon Janjamsri — 2025-02-03

The descriptive qualitative study was aimed to explore the adaptation experiences among older persons with successful treatment of pulmonary tuberculosis. The research also aims to identify the factors that promote or hinder the adaptation process in these patients. The study selected 15 specifically targeted older pulmonary TB patients who had been successfully treated. Data were collected from February 2022 to September 2023 using various research tools including researcher, in-depth question, general data record form, and recording devices. Data was analyzed by Giorgi’s method.The study revealed that the adaptation experiences of older pulmonary TB patients who had undergone successful treatment can be categorized into the following key themes 1) Symptom management and treatment which included seeking treatment for pulmonary TB, using patience to medication side effects, attending scheduled medical appointments and being cautious about the spread of infection. 2) Physical strengthening which included modifying their diet, increasing rest, and cessation of smoking and alcohol consumption. 3) Psychological well-being which included patients engaged in relaxation activities, sought emotional support to maintain psychological well-being and confidence in the medical treatment. Factors facilitating adaptation included family support and health care worker support. Factors hindering adaptation included being communicable disease of pulmonary TB and declining memory abilities. Recommendations based on the study findings suggest that the results of this study can be used as a foundation for promoting adaptive strategies for older pulmonary tuberculosis patients, aiming for successful future treatments.

Development of a Breast Compress using Mung Beans and Herbs to Stimulate the First Lactation in First Time Mothers after Cesarean Section

Naraporn Khunkumhaeng — 2025-02-03

This quasi-experimental study aimed to develop and examine the effects of a breast compress using mung beans and herbs on the time to first lactation in first-time mothers after cesarean section. The sample consisted of 60 first-time mothers after cesarean section, who were recovering in the postpartum obstetrics department at Sukhothai Hospital. Participants were purposively selected based on inclusion criteria and divided into two groups: 30 in the experimental group and 30 in the control group. The experimental group received breast compresses with mung beans and herbs created by the researcher based on a review of related literature, documents, and textbooks, in addition to routine nursing care. The control group received routine nursing care only. Data collection took place from January 2024 to July 2024. The research instruments included: a breast compress pad with mung beans and herbs and a manual for using the breast compress pad with mung beans and herbs. The data collection tools included: a data collection form, a lactation onset form and a user manual. The content validity of both the user manual and data collection tool was rigorously assessed, resulting in a CVI 1.00. The reliability of the lactation onset form was evaluated using the ICC 0.98. Data were analyzed using descriptive statistics, independent t-test, chi-square test, and Mann-Whitney U test.The results showed that the experimental group, which received the breast compress with mung beans and herbs, had a significantly shorter average time to first milk ejection than the control group, which received routine nursing care (U = 36.00, p < .001). Therefore, nurses should consider using the breast compress pad with mung beans and herbs to reduce the time to first milk ejection in first-time mothers after cesarean delivery.

A Development of Community Participation Model in Road Traffic AccidePrevention Management at Raikhing Sub-district Sampran District Nakhon Pathom Province

Kannikar Chatdokmaiprai — 2025-02-03

This action research aimed to analyze the situation of road traffic accidents, develop, trial use, and evaluate the road traffic accident management model in Rai Khing Subdistrict, Nakhon Pathom Province. The sample groups were 1) the community leader group and stakeholder consisting of 10 persons, and 2) the student group, consisting of 60 students. The research instrument used were five tools that drive the mechanism of the Road Safety Center to the outcomes, and a questionnaire of knowledge, perceived sensitivity, perceived severity, perceived benefits, perceived barriers, and behavior in preventing road traffic accident. Qualitative data was analyzed by content analysis. The mean differences of the score of knowledge, perceptions in each area, and behavior in preventing road traffic accidents between the experimental group and the control group were compared using the independent t-test.The research results found that: 1) The most common traffic accidents in Raikhing sub-district were caused by motorcycles, at 65.7%. Majority (35.5%), were aged 36-60 years and found in adolescents aged 15-18 years at 8.4%. Most of the accident (32.3%) occurred during, 6.00-9.59 pm. 2) The community participation model has 3 aspects: 2.1) Developing the potential of youth in terms of knowledge, perceived sensitivity, perceived severity, perceived benefits, perceived barriers, and behavior in preventing road traffic accident. 2.2) Preventing accidents at risk points, and 2.3) Creating a traffic accident prevention mechanism by the community leader team organizing a rescue team that can reach victims in a timely manner. 3) In the evaluation of the model development phase, it was found that after the training, the experimental group of students had average scores in knowledge, perceived sensitivity, perceived severity, perceived benefits, perceived barriers and behavior in preventing road traffic accident significantly higher than the ones of control group at the .05 level.This study suggests that this community participation model should be further developed in other sub-districts.This study suggests that community leaders, and stakeholders should create a concrete working model, and this community participation model should be further developed in other sub-districts.

The Effect of a Self-Management Program on Dietary Behavior and Glomerular Filtration Rate in Patients with Chronic Kidney Disease at Chaophrayayommarat Hospital, Suphanburi Province

Sureewan Sawangha — 2025-02-03

Research Objective: This study aimed to examine the effects of a self-management program on dietary behavior and kidney filtration rates in patients with chronic kidney disease (CKD) at Chaophrayayommarat Hospital, Suphanburi Province.
Research Instruments: The research instruments included 1) a self-management program which tailored based on concept by Kanfer and 2) data collection tools included a general information questionnaire, a health information questionnaire, and a dietary behavior questionnaire. The dietary behavior questionnaire’s content validity was evaluated by three experts, yielding an Index of Item-Objective Congruence:IOC of 0.90 Its reliability was confirmed with a Cronbach’s alpha coefficient of 0.87
Data Collection and Analysis: The sample consisted of 30 participants each in the experimental and control groups, selected purposively and randomized to ensure comparable baseline characteristics. Data were collected at the hospital’s kidney clinic between March and June 2024, at weeks 1 and 12. Descriptive statistics were used for general data analysis. To test the equality of dietary behavior and kidney filtration rate, a paired samples t-test was used within groups, and an independent t-test was used between groups.
Results:1) Dietary behavior and kidney filtration rates significantly improved in the experimental group after the intervention (p < .01). 2) Post-intervention, the experimental group had significantly higher dietary behavior scores and kidney filtration rates compared to the control group (p < .01).
Conclusion: Continuous promotion of self-management in CKD patients is recommended to support appropriate dietary behavior and delay kidney deterioration, preventing progression to end-stage renal disease.