Journal of Health and Nursing Research (Journal of Boromarajonani College of Nursing, Bangkok)

Factors Associated with Successful Resuscitation in Out-of-Hospital Cardiac Arrest Patients within 30 Minutes

2025-05-02T22:51:09+07:00

Introduction: The survival rates of out-of-hospital cardiac arrest (OHCA) depend not only on rapid access to emergency medical services (EMS) but also critically on the ability and actions of bystanders.

Research objectives: This study aimed to examine factors associated with the return of spontaneous circulation (ROSC) in patients experiencing OHCA within 30 minutes prior to hospital arrival.

Research methodology: This retrospective study used data from medical records identified by the ICD-10 code for OHCA. The data came from a community hospital that provided outpatient and emergency services 24 hours a day. There were 90 cases included in the analysis. The research instrument was a structured data collection form for OHCA patients. It consisted of two parts: 1) general patient information and 2) variables derived from the conceptual framework. Content validity was assessed using the Index of Item-Objective Congruence. Values ranged from 0.60 to 1.00 for all items. Descriptive statistics, Chi-square tests,
and independent t-tests were used for statistical analysis.

Results: Age and comorbidities did not differ significantly between ROSC and non-ROSC groups (p > .05). In contrast, the suspected cause of cardiac arrest was the only covariate with a statistically significant difference between groups (p < .05). These three variables were analyzed for survival outcomes without covariate adjustment. EMS transport was significantly associated with ROSC (p < .05). No significant associations were found between the presence of a witness and ROSC, or between bystander CPR before hospital arrival and ROSC (p > .05).

Conclusions: The time from the emergency call to hospital arrival via EMS does not affect survival rates. Chest compressions performed by bystanders before EMS arrival do not significantly increase survival chances.

Implications: Efforts should focus on enhancing the quality of CPR delivered by community bystanders and optimizing EMS performance. Furthermore, the deployment of advanced life support teams is essential to provide timely and effective resuscitation.

Effects of Motivation Enhancing Program on Females’ Screening Cervical Cancer of Ban Lan Laem Health Promoting Hospital in Nakhon Pathom Province

2025-06-05T07:38:42+07:00

Introduction: Cervical cancer remains a significant health challenge for Thai women. Cervical cancer screening and HPV vaccination are essential to lower the incidence of this disease.

Research objectives: This study aimed to evaluate the effects of motivational enhancement program on cervical cancer screening participation among sexually active women in the target area.

Research methodology: This study applied a quasi-experimental design with a two-group pretest-posttest design. The sample consisted of 80 women aged 30 – 60 years, divided into experimental and control groups. The experimental group (n = 40) was selected from Ban Lan Laem Health Center’s service area, and the control group (n = 40) from Bang Phra Health Center. There were no significant differences in baseline characteristics between groups. The experimental group received a motivational enhancement program based on Rogers’ Protection Motivation Theory, including educational sessions, media aids, group discussions, and other activities to enhance motivation. Data were collected from using service records and Motivation in Cervical Cancer Screening Participation Questionnaire. Data were analyzed using paired t-tests and independent t-tests.

Results: The experimental group demonstrated significantly higher motivation and perception for cervical cancer screening participation compared with the control group (p < .05). The number of women in the experimental group who underwent cervical cancer screening increased following participation in the motivational enhancement program compared with the pre-intervention period.

Conclusions: The motivational enhancement program effectively improves health behaviors among sexually active women by increasing their perception of the severity of disease and encouraging proactive protection against cervical cancer.

Implications: The motivational enhancement program should beimplemented in clinical practice to encourage women to adoptpreventive behaviors against cervical cancer and to participate regularly and consistently in cervical cancer screening.

Incidence and Associated Factors of Postoperative Nausea and Vomiting (PONV) after Anesthesia at Pakthongchai Hospital in Nakhonratchasima Province: A Retrorespective Descriptive Study

2025-06-10T09:22:38+07:00

Introduction: Postoperative nausea and vomiting (PONV) following cesarean delivery is a common health issue in postpartum mothers. The incidence rate can be as high as 30 - 50%, affecting comfort, recovery, and the ability to care for the newborn. The causes of these symptoms may stem from various factors, such as anesthetics, analgesics, or post-surgical stress.

Research objectives: This research aimed to determine the incidence of postoperative nausea and vomiting (PONV) and to identify its associated factors among patients who underwent a spinal block for cesarean section at Pakthongchai Hospital in Nakhon Ratchasima province.

Research methodology: This research employed a retrospective descriptive study design. Data were collected from medical records at Pakthongchai Hospital, Nakhon Ratchasima from January 2021 to December 2023. A total of 429 patients who underwent a spinal block for cesarean section were selected using purposive sampling. The data were analyzed using descriptive statistics and the Chi-square test.

Results: Forty point eight percent (40.80%) of patients experienced PONV within 24 hours of surgery. Age was a significant factor, with patients aged 15 - 44 years having a significantly higher likelihood of nausea compared to other age groups (p < .05). Furthermore, the administration of preventive drugs significantly reduced the incidence of nausea and vomiting (p < .05).

Conclusions: Patients undergoing spinal block for cesarean section are likely to experience PONV.

Implications: Close monitoring and observation may help manage and reduce the incidence of PONV in these patients, ensuring patient comfort, preventing complications, and promoting continuous quality improvement in anesthesia practices.

The Development of a Home-Based Continuous Nursing Care Model for Stroke Patients with Family Participation in Udon Thani Province

2025-07-21T23:18:45+07:00

Introduction: Stroke is a leading cause of disability and dependency worldwide. Effective home-based continuous care is essential to prevent complications, enhance recovery, and improve quality of life for stroke survivors.

Research objectives: 1) To study the situation and problems of caring for stroke patients at home 2) To develop and evaluate the effectiveness of the continuous care model for stroke patients at home with family involvement in Udon Thani.

Research methodology: This action research was conducted in 3 phases: 1) assessing current conditions, 2) developing a continuous care model for stroke patients, and 3) monitoring and evaluating outcomes using the Health Belief Model (HBM) and family participation as a conceptual framework. Participants included 60 stroke patients, 60 primary caregivers, and 25 multidisciplinary personnel, purposively selected from five network hospitals. Research instruments comprised questionnaires on knowledge, beliefs, attitudes, and caregiving behaviors; an ADL assessment form; interview guidelines; and a satisfaction survey. Content validity was verified using the Index of Item Objective Congruence (0.67 - 1.00). The reliability was .79 (Cronbach's Alpha), and the knowledge test reliability was .80 (KR-20). Quantitative data were analyzed using descriptive statistics and paired t-tests, while qualitative data was analyzed using content analysis.

Results: The continuous nursing care model for stroke patients at home, implemented with family participation through activities that enhanced self-efficacy and reflection via a nursing care diary, significantly improved primary caregivers’ knowledge, understanding, health perceptions, and caregiving behaviors (p < .001).

Conclusions: The model strengthened caregiver capacity based on the Health Belief Model (HBM) and family participation concepts by enhancing perceived benefits and self-efficacy, while reducing perceived barriers to care. As a result, patients tended to achieve greater independence in performing daily activities.

Implications: The model should be expanded to other healthcare settings with contextual adaptations and supported by ongoing practical training for caregivers in the community.

A Synthesis of Studies on Palliative Care for Cancer Patients Integrating The Wisdom of Thai Traditional Medicine

2025-07-21T22:33:06+07:00

Introduction: Palliative care for cancer patients, incorporating Thai traditional medicine, aims to improve their quality of life. Understanding the integration of Thai traditional wisdom in this care is critical.

Research objectives: To review the characteristics of research and the body of knowledge on palliative care for cancer patients using Thai traditional medicine and to evaluate the outcomes of its application.

Research methodology: This descriptive research employed a research synthesis approach. Relevant literature was identified using the keywords: palliative care, cancer patients, and Thai traditional medicine. Reviewing 20 studies that met the quality criteria.

Results: Most of the studies were quantitative, 13 studies and seven were qualitative. The findings were synthesized into three categories: care models, procedures, and methods. Outcomes were classified as physical (Kayanamaya), mental (Cittanamaya), and social and environmental well-being (Jivitanamaya). Patients experienced enhanced quality of life, increased security, and alleviated suffering, facilitating a more peaceful end-of-life.

Conclusions: Thai traditional medicine-based palliative care significantly improves the holistic quality of life of patients with cancer.

Implications: Holistic integrative palliative care, which incorporates Thai traditional wisdom and is supported by multidisciplinary as well as community-based approaches, should be promoted to ensure dignified end-of-life care.

Effectiveness of Debriefing for Meaningful Learning in High-fidelity Simulation-Based Learning on Clinical Reasoning and Clinical Decision Making of Nursing Students: A Mixed-Methods Research

2025-07-30T23:28:40+07:00

Introduction: Debriefing for meaningful learning is a reflective model that helps nursing students develop clinical reasoning and learn to think like nurses.

Research objectives: To determine the effect of debriefing for meaningful learning in high-fidelity simulation-based learning on clinical reasoning and clinical decision making of nursing students

Research methodology: Mixed-methods research was conducted among 75 third-year nursing students at Boromarajonani College of Nursing, Saraburi. The control and experimental groups were selected using simple random sampling with 38 and 37 participants, respectively. The research instrument had two parts: 1) The Nurse Clinical Reasoning Scale and 2) the clinical decision-making ability tests, with reliability indices of .81 and .82, respectively. Quantitative data were analyzed using descriptive statistics and independent t-tests. Qualitative data were analyzed using content analysis.

Results: 1) the mean scores of clinical reasoning and clinical decision making in the experimental group were significantly higher after the intervention than before the intervention (p < .001) and were significantly higher than those of the control group after the intervention (p < .05 and p < .001) respectively, and 2) focus group analysis showed four major themes: 1) recognition through visual cues, 2) the value of clinical reasoning, 3) confidence in decision-making, and 4) learning from errors.

Conclusions: Debriefing for meaningful learning is an effective strategy for enhancing nursing students’ clinical reasoning and decision-making skills.

Implications: The concept of debriefing for meaningful learning should be effectively integrated into simulation-based learning.

Self-care in Individuals with Noncommunicable Diseases and Its Associated with E-health Factors

2025-09-03T10:14:56+07:00

Introduction: Currently, healthcare systems are using eHealth to improve service efficiency and patient outcomes. Studying factors related to eHealth will provide information to promote self-care among individuals with noncommunicable diseases.

Research objectives: This study aimed to examine the relationships between eHealth literacy, attitudes towards eHealth use, social support for eHealth use, and self-care among individuals with noncommunicable diseases.

Research methodology: This research adopted a descriptive correlational research design. A purposive sampling was employed to recruit 135 participants with noncommunicable diseases from a medical outpatient department at a tertiary hospital in Bangkok. Data were collected using the personal information questionnaire, the eHealth literacy questionnaire, the attitudes towards eHealth use questionnaire, the social support in eHealth use questionnaire, and the Self-Care of Chronic Illness Inventory. Data were analyzed using descriptive statistics and Spearman's rank correlation coefficient.

Results: The results showed that eHealth literacy (r = .36, p < .001) and attitudes toward eHealth use (r = .38, p < .001) had a significantly low positive correlation with self-care, while social support in eHealth use had a significantly very low positive correlation with self-care (r = .18, p < .05).

Conclusions: eHealth literacy, attitudes toward eHealth use, and social support in eHealth use are positively associated with self-care among individuals with noncommunicable diseases.

Implications: Healthcare providers should recommend the use of eHealth and facilitate patients' access to reliable and accurate online health information.

The Effect of Online Health Education for Anemia Prevention on Knowledges and Food & Drugs Consuming Behaviors among Pregnant Women in Antenatal Care Clinic at Songdao Hospital

2025-07-08T11:54:58+07:00

Introduction: Anemia during pregnancy is a significant public health concem that affects both mothers and fetuses. The primary factors contributing to anemia include poor dietary habits and inadequate intake of iron supplements, which may result from a lack of understanding about their importance.

Research objectives: This study aimed to evaluate the effects of an online health education program on the knowledge, dietary habits and supplement intake behaviors among pregnant women.

Research methodology: A quasi-experimental study was conducted at the antenatal care clinic of Songdao Hospital. Thirty-four pregnant women who met the inclusion criteria were consecutively sampled and equally assigned to an experimental group (n = 17) and a control group (n = 17). The intervention, developed based on Bandura's Theory, was delivered via the LINE application in addition to routine nursing care, while the control group received only routine care. Data were collected using a knowledge assessment on anemia (Cronbach's alpha .70, Content Validity Index 1) and a behavior questionnaire on dietary and supplement intake (Cronbach's alpha .92, Content Validity Index 1). Data were analyzed using descriptive statistics, paired t-test, Wilcoxon matched-pair signed-rank test, McNemar Chi-square, and Chi-square tests.

Results: The experimental group had significantly higher knowledge scores and improved dietary and supplement intake behaviors compared to their pre-test scores and the control group (p < .05).

Conclusions: The online health education program is effective in enhancing knowledge and promoting healthier dietary and supplement intake behaviors among pregnant women.

Implications: Integrating online health education programs into antenatal care services can enhance maternal health promotion.

Prevalence and Factors Associated with Preterm Birth in Ang Thong Hospital

2025-05-02T23:09:21+07:00

Introduction: Preterm birth is a major cause that leads neonatal mortality and morbidity, including serious health complications. The causes of pretem birth are varied and may depend on regional contexts.

Research objectives: To examine the prevalence and factors associated with preterm birth at Ang Thong Hospital.

Research methodology: This study employed a case-control retrospective design. Data were collected from medical records and electronic databases at Ang Thong Hospital between January 1, 2022, and December 31, 2023. A total of 2,733 pregnant cases were identified, comprising 247 women who experienced preterm birth and 2,486 women who delivered at term. A sample of 145 cases was randomly selected from the preterm birth group, while all women in the term birth group were as control group. Factors associated with preterm birth were analyzed using multiple logistic regression.

Results: The prevalence of preterm birth was 9.03%. The factors associated with preterm birth included a history of preterm birth (adjusted odds ratio (Adj OR) = 2.20, 95% confidence interval (CI): 1.22 - 3.60, p < .001), medical complications (Adj OR = 4.54, 95% CI: 1.40 - 13.47, p < .001), and infections during pregnancy (Adj OR = 13.92, 95% CI: 2.16 - 88.12, p < .001).

Conclusions: Preterm birth accounted for 9.03% of birth cases at Ang Thong Hospital. The factors related to preterm births were a history of preterm birth, medical complications, and infections during pregnancy.

Implications: The findings of this study could be useful in developing prevention strategies by promoting maternal health during pregnancy and addressing identified risk factors.

The Development of a Nursing Service System for Emergency Accident Patients Requiring Abdominal Surgery under General Anesthesia at Udon Thani Hospital

2025-07-31T17:00:15+07:00

Introduction: Emergency accident patients with abdominal injuries requiring surgery under general anesthesia often experience prolonged preoperative preparation times, leading to high postoperative complication rates. Therefore, developing an efficient nursing service system is essential for improving patient survival.

Research objectives: To examine the current situation, develop a nursing service system, and evaluate the outcomes of emergency accident patients requiring abdominal surgery under general anesthesia.

Research methodology: This research and development study consisted of three phases. The sample included: 1) 35 nurse anesthetists and 25 emergency room nurses, and 2) 70 patients with abdominal trauma (35 in the control group and 35 in the experimental group). The intervention tool was a nursing service system for emergency accident patients requiring abdominal surgery under general anesthesia. Four data collection instruments were used: 1) demographic information form, 2) nursing knowledge assessment, 3) clinical outcome assessment form, and 4) satisfaction questionnaire. Content validity was verified by five experts, yielding CVI values of .89, .91, .99, .97, and 1, respectively. Data were analyzed using descriptive statistics, paired sample t-test, and independent t-test.

Results: Situational analysis revealed delays in preoperative patient preparation, inconsistent nursing standards, and ineffective communication. Following the implementation of the developed nursing service system, the experimental group showed significantly fewer postoperative complications within the first 24 hours and a shorter average time from the emergency room to the operating room than the control group. However, the length of hospital stay did not differ significantly between the groups. Nurse satisfaction with the system was at the highest level (M = 4.30, SD = .52).

Conclusions: The nursing service system reduced preoperative preparation time and postoperative complications, resulting in improved clinical outcomes and increased survival.

Implications: The developed nursing service system can be adapted for use in other hospitals with similar contexts. Further research should investigate long-term outcomes.

Development of a Fall-Alert Innovation for Older Adults

2025-07-21T22:13:12+07:00

Introduction: Falls are a primary cause of morbidity and mortality among older adults. Therefore, development of innovations to prevent falls in this population is essential to improve their quality of life.

Research objectives: This study aimed to develop an innovative fall alert system for older adults.

Research methodology: This developmental research comprised three phases: knowledge synthesis, device design and development, performance testing and user satisfaction assessment. The sample included 30 older adults aged 60 years and above from Sam Phrao Subdistrict, Mueang District, Udon Thani Province. Participants were selected through purposive sampling based on a Thai Falls Risk Assessment Test (Thai-FRAT) score of ≥4. The data were collected using the Belt Fall Alert (fall-warning belt) device, a form for recording the performance of the innovation, and a user satisfaction questionnaire. Data were analyzed using descriptive statistics, including frequency, percentage, mean, and standard deviation.

Results: The Belt Fall Alert accurately detected changes in body tilt angles in all instances (100%) and successfully triggered alerts in every test. Overall user satisfaction was at a high level (M = 3.99, SD = .56).

Conclusions: The developed innovation serves as an effective fall prevention alert system for older adults. Users also reported high satisfaction with its use.

Implications: Further studies should examine the impact of this innovation on reducing fall incidence, consider developing a smaller and more convenient device, explore the integration of AI for deeper analysis of older adults’ behavior, and evaluate cost-effectiveness to reduce production costs and support commercial production.

The Effect of a Self-Efficacy Promotion Program for Exercise on Balance and Fear of Falling among Older Adults at Ban Dong Man Sub-district Health Promoting Hospital, Singkhok Sub-district, Kaset Wisai District, Roi Et Province

2025-07-30T23:45:44+07:00

Introduction: Falls among older adults are a major cause of injury, disability, and death. Enhancing exercise self-efficacy helps older adults build confidence in their abilities to successfully engage in physical activities.

Research objectives: This research aimed to examine the effects of the exercise self-efficacy promotion program on balance and fear of falling in older adults.

Research methodology: This study employed a quasi-experimental, two-group, pre-test and post-test. The sample consisted of older adults aged 60 years and over residing in Singkhok Sub-district, Kaset Wisai District, Roi Et Province. Participants were identified as being at risk of falling (scoring 4 points or higher on the fall risk assessment) and were able to complete a balance test. Participants were assigned to either an experimental group or a control group, with 37 individuals in each group. The experimental group participated in the program for 45 minutes per session, three times a week for 12 weeks while the control group received routine care. Data were collected using the balance test and the fear of falling assessment scale. Descriptive statistics and t-test were used to analyze the data.

Results: The results showed that the mean balance time and the mean fear of falling score of the experimental group were significantly lower than those of the control group (p < .001).

Conclusions: The exercise self-efficacy promotion program effectively improved balance performance and reduced fear of falling among older adults.

Implications: The exercise self-efficacy promotion program should be implemented in community and healthcare settings to enhance balance and reduce fear of falling among older adults. Additionally, appropriate and well-maintained equipment should be provided, and caregivers should closely supervised older adults to ensure their safety during exercise activities.

Effectiveness of Oral Health Care Program for Children Aged 6 Months - 2 Years Using Digital Media "21 for FUN" for Caregivers in Songkhla Province

2025-05-22T11:51:01+07:00

Introduction: Dental caries is a significant oral health problem in young children, particularly in Southern Thailand, where the incidence of dental caries is higher than the national average. Tooth brushing is an effective preventive method, but appropriate approaches for promoting such behavior are still lacking.

Research objectives: To compare oral hygiene behavior and microbial plaque levels in children aged 6 months to 2 years between groups receiving tooth brushing training using real children (hands-on practice) with posters and groups receiving tooth brushing training using simulation dolls with "21 for FUN" media.

Research methodology: This was a quasi-experimental study with a two-group pretest-posttest design. The sample consisted of 1,156 pairs of children aged 6 months - 2 years and their primary caregivers in Songkhla Province, divided into 532 pairs for the group trained in tooth brushing on real children with posters and 624 pairs for the group trained in tooth brushing on dolls with "21 for FUN" media using simple random sampling. Tooth brushing behavior, caregivers' knowledge levels, and microbial plaque levels in children were assessed before and after the intervention. Data were analyzed using descriptive statistics and analytical statistics by T-test, Paired t-test and Chi-square.

Results: After the intervention, both groups showed significant increases in knowledge levels, tooth brushing behavior and microbial plaque levels decreased significantly (p < .001). However, it was found that the knowledge levels, tooth brushing behavior, and microbial plaque levels after the experiment between the experimental and control groups were not significantly different (p = .698).

Conclusions: Both methods were effective in promoting tooth brushing behavior among caregivers and reducing microbial plaque levels in children.

Implications: Training in tooth brushing on dolls with "21 for FUN" media can be an effective alternative when there are limitations in personnel and time.