The Development of a Nursing Program for Emergency Care and Reducing Patient Stress in the Emergency Room at Thong Pha Phum Hospital, Kanchanaburi Province, through the Integration of Nursing Team and Family Participation

Abstract

Emergency room patients often face severe illnesses, long waits, and a stressful environment, all of which cause stress and can impact their treatment. Integrating the involvement of nursing teams and families is therefore a key approach to communication and psychological support in order to promote holistic care. This research and development aimed to develop and evaluate a nursing program to reduce the stress of emergency room patients at Thong Pha Phum Hospital, Kanchanaburi Province. The study involved three groups: 7 nurses and medical personnel, 323 patients and relatives, and an experimental group of  30 patients. The research consisted of 5 phases: R1-studying the situation and identifying essential needs, D1-developing the program, R2-trial implementation, D2-program adjustment, and R3-evaluation of the actual results. The research tools demonstrated appropriate reliability (IOC = 0.66–1.00, α = 0.80–0.85). Qualitative data were analyzed using content analysis, and quantitative data using descriptive statistics, the Priority Needs Index (PNI), and the one sample t-test.

Results: It was found that the main sources of stress included delays and congestion, lack of information, and psychological and economic burdens. PNI analysis identified key needs such as effective communication, emotional relaxation, family integration, and mental support systems. The developed program consisted of four steps: assessment, planning, activity implementation, and follow-up. It was evaluated as highly appropriate and feasible (Mean = 4.34, 4.40). After the trial implementation, stress and anxiety levels were found to have decreased significantly (t = 2.46, p = .045), dropping to a low level (Mean = 2.15). When practically applied, the program notably increased family participation, enhanced the efficiency of the nursing team, and concretely reduced patient stress. In conclusion, this program is effective and can be applied in other community hospitals to elevate the quality of holistic emergency patient care.