Journal of Nursing and Therapeutic Care

The Relationship Between Cyberbullying Behavior and Coping with Stress among Students: A Case Study of a Nursing College in Northeastern Thailand

Wikanda Anusuren — 2025-10-20

Cyberbullying is the use of online media to violate the rights of others, and it is especially common among nursing students. Cyberbullying causes stress and affects students' learning. This descriptive research aimed to study the relationship between cyberbullying behavior and students’ ability to cope with stress at a college of cursing in the northeast of Thailand. The sample consisted of 220 first- to fourth-year nursing students studying in the 2023 academic year who were selected by simple random sampling. Data were collected from November 2023 to January 2024. The research instruments were the cyberbullying behavior questionnaire and the stress coping or coping with stress questionnaire. The content validity of the questionnaires were validated by experts with an index of content validity of 1 and 0.93, respectively, and the reliability testing using Cronbach's alpha coefficients showed an acceptable reliability of 0.92 and 0.95, respectively. The data were analyzed using descriptive analysis, and the relationships of the studied variables was analyzed using Pearson's product moment correlation coefficients.
The research results found that the sample group had a moderate mean score for being bullied online, with being sent harassing or slanderous messages being the most common occurrence. The sample group had a moderate level of coping with stress. When looking for a relationship, it was found that being bullied online had a statistically significant positive relationship with coping with stress among students (r = .539, p <.001). Educational institutions can use the results of the study as supporting information for creating programs for coping with stress to reduce potential cyberbullying.

The Influence of Transformational Leadership by Head Nurses and Work Engagement on the Job Performance of Professional Nurses in a Tertiary Hospital under the Ministry of Public Health in Health Region 2

Punnika Krowtrakool — 2025-10-08

This study was a predictive correlational research. It was a purpose to study The Influence of Transformational Leadership of In-Patient Unit Head Nurses as Perceived by Professional Nurses and Work Engagement on Job Performance of Professional Nurses in tertiary hospital Affiliation Ministry of Public Health, Regional Health 2. The sample group consisted of 174 professional nurses with at least 1 year of experience working in in-patient wards at tertiary hospital under the Ministry of Public Health, Regional Health 2. The sample size was determined using the G*power program and the Multistage Sampling method. The research instruments were five rating scale questionnaires on Transformational leadership, Work engagement and Job performance of professional nurses , with reliability values of Cronbach's alpha coefficients of 0.943, 0.952, and 0.932, respectively. Data were analyzed using statistics such as frequency, percentage, mean, standard deviation and stepwise multiple regression analysis.

The research findings found that the transformational leadership of the in-patient unit head and the work engagement of professional nurses had a statistically significant influence on the job performance of professional nurses at the .001 level with a multiple correlation coefficient (R) of .694 and could predict the job performance of professional nurses by 48.1 percent. It was found that work engagement could predict the job performance the most (β = .564, p < .001), followed by transformational leadership (β = .215, p = .001) with an adjusted prediction coefficient or predictive power of 47.5 percent (Adjusted R Square = .475)

The Effects of a Meditation Program on the Perceived Emotional Intelligence of Charge Nurses in a Private Hospital

Preawploy Wanna — 2025-11-11

The objective of this quasi-experimental research was to compare the mean scores for the perceived emotional intelligence of charge nurses working in a private hospital between an experimental group and a control group. The sample consisted of 60 charge nurses working in inpatient wards, with the sample size calculated based on the power of the test as determined by power analysis who were recruited using purposive sampling and places into an experimental group (n=30) and a control group (n=30). The experimental group participated in a 6-week meditation program, while the control group received standard care. The research instruments included a meditation program and an emotional intelligence perception questionnaire. The content validity index of the instrument was 1.00 and the Cronbach's alpha coefficient was 0.96. Descriptive statistics (means and standard deviations) and inferential statistics, specifically the Paired t-tests and independent t-tests, were used to compare mean scores of the participants’ perceived emotional intelligence.

The research findings showed that the experimental group’s overall emotional intelligence perception scores were at a high level after participating in the meditation program. The highest mean score found was related to good social skills at work, followed by emotional management at work. It was found that the experiment group’s mean scores for perceived emotional intelligence were significantly higher after the intervention compared to before the intervention (p < .05). Additionally, the mean scores for perceived emotional intelligence in the experimental group were significantly higher than in the control group (p < .05). These results provide empirical evidence of the meditation program’s impact on the emotional intelligence of those in in leadership roles. This indicates that having a meditation program in the unit affects the efficiency and effectiveness of nursing administrators’ performances in healthcare organizations. Therefore, it is recommended that administrators of nursing organizations and other institutions recognize the significance of these impacts and consider incorporating meditation curricula as an integral part of emotional intelligence development for nursing leaders and other organizational executives.

Spiritual Practices of Parents Caring for Children and Adolescents with Cancer: A Systematic Review

Wipawee Ponkaew — 2025-10-20

Childhood cancer is a condition that causes significant stress to families, especially to parents who often experience psychological burdens. As a result, spiritual practices are commonly adopted to alleviate emotional distress. Spiritual practices play a crucial role in promoting mental well-being and empowering individuals to cope with challenges. These practices help parents manage emotional suffering, restore hope, and find meaning in difficult experiences. This systematic review aimed to summarize and synthesize current literature on the spiritual practices of parents caring for children and adolescents (from birth to 20 years old) with cancer in any stage of the disease. The review followed the Joanna Briggs Institute (JBI) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The tools used included a research screening form, a critical appraisal checklist, and a data extraction form. Literature was searched across four databases: MEDLINE/PubMed, CINAHL, ProQuest, and PsycINFO, covering the period from January 2017 to February 2025.

A total of 275 studies were identified . After applying the inclusion criteria using the screening and quality appraisal tools, 11 articles met the eligibility criteria. The results of this review identified two main types of spiritual practices among parents of children and adolescents with cancer: 1) religious-related spiritual practices – including prayer, rituals, sermon books, and meditation; and 2) finding social support from various sources, such as other parents, faith communities, and health professionals. This review may enhance the understanding of spiritual practices across different contexts, contributing to more profound spiritual care for parents. It also supports more effective care for children and adolescents with cancer, ultimately improving their quality of life.

Development of a Seamless Integrated Palliative Cancer Care Nursing System within the Maharat Nakhon Ratchasima Hospital Network in Nakhon Ratchasima Province

Pensri Rukwong — 2025-09-26

End-stage cancer care in Thailand faces challenges regarding continuity of care services. This action research aimed to: 1) develop a seamless nursing care system, 2) study the outcomes of the seamless nursing care system, and 3) synthesize policy recommendations. The study was conducted from September 2024 to August 2025 and was divided into three phases: 1) situational analysis, 2) development of the seamless nursing care system, and 3) outcome evaluation with 46 end-stage cancer patients and 46 caregivers, divided into experimental and control groups of 23 participants each. Data was collected through in-depth interviews, focus group discussions, natural conversations, observations, document analysis, a palliative care outcome evaluation form, a quality of life assessment form, a caregiver perception assessment of patients' peaceful end of life, and a caregiver satisfaction questionnaire regarding palliative care. Data was analyzed using descriptive statistics, two-way repeated measures analysis of variance, t-tests, and content analysis.

The research findings revealed that the seamless nursing care system was comprised of three main components: 1) Input factors including patient factors, nursing factors, and service system factors; 2) Process components, consisting of a 5-phase care plan driven by the peaceful end of life theory concept, case management, primary nursing, nursing process, and telenursing; 3) Outcomes of the nursing system implementation demonstrated that the experimental group demonstrated superior palliative care outcomes, quality of life, caregiver perceptions regarding the patients' peaceful end of life experience, and caregiver satisfaction compared to the control group. The research findings led to the following significant policy recommendations: 1) consideration of curriculum revisions for Bachelor of Nursing Science and advanced specialty nursing programs; 2) identification of case manager roles in health service plans; 3) support for telenursing information technology, and 4) adjustment of indicators to reflect good death through peaceful end of life.

Effects of a QR Code-Based Cesarean Section Surgical Instrument Management Program on Operating Room Nurses' Perception of Instrument Preparation at a Tertiary Hospital

Naree Chaisiri — 2025-10-09

The importance of surgical instrument preparation in the operating room requires operating room nurses to have knowledge and expertise in preparing surgical instruments. There should be standardized practice guidelines for surgical instrument preparation so that all nurses follow the same standard procedures for instrument preparation in the operating room to prevent errors caused by inadequate preparation of surgical instruments. As an administrator, the researcher recognizes the importance of developing a knowledge program for cesarean section surgical instrument management through the use of QR codes. This quasi-experimental research with a two-group, pre-post design aimed to compare the perception scores for surgical instrument management among operating room nurses between an experimental group that received the QR code-based cesarean section surgical instrument management program and a control group that received the conventional cesarean section surgical instrument management program. The experimental group received routine teaching through on-the-job supervision. The sample consisted of 66 professional operating room nurses from two hospitals who divided into experimental and control groups of 33 nurses each. The research instruments included a QR code-based cesarean section surgical instrument management program and a questionnaire on the perception of surgical instrument management. The instrument quality showed a content validity of 0.80 and Cronbach's alpha reliability coefficient of 0.96. Data analysis used descriptive statistics, including frequencies, percentages, means, standard deviations, and inferential statistics, including independent t-tests and dependent t-tests.

The research findings showed that, after participating in the program, the experimental group had overall mean scores for perception of surgical instrument management at a very good level, which was significantly higher than the control group at the .05 statistical significance level. Additionally, the experimental group's mean scores after the experiment were at a high level and significantly higher than before the experiment at the .05 statistical significance level. This research indicates that nursing administrators in operating rooms should continuously apply human resource development concepts, particularly for new nurses or nurses rotating between departments. They should implement QR code-based cesarean section surgical instrument management programs in units to improve safety, efficiency, and effectiveness of nursing care.

Effects of a Preparatory Information Program on Reducing Anxiety among Patients Undergoing Uretero – Renoscopic Litholapaxy

Kruamard Katasila — 2025-09-29

This Quasi-experimental research aimed to examine the effects of a preoperative information program on anxiety reduction in patients undergoing Uretero-Renoscopic Litholapaxy at Yasothon Hospita between August and October 2024. The sample consisted of 40 patients undergoing Uretero-Renoscopic Litholapaxy who were divided into a control group and an experimental group with 20 participants in each group. The participants were selected by simple random sampling using the self-regulation theory. The experimental group received 1. A pre-operative information program consisting of 1) procedural information, 2) pensory information, 3) pehavioral Information, and 4) information on coping with problems; and 2. assessment for their anxiety using the State-Trait Anxiety Inventory of Spielberger, which had a Cronbach alpha coefficient of 0.88. The duration of the program was one day. The control group received routine care. Data were analyzed using frequencies, percentages, means, standard deviations, Chi-square tests, Fisher's exact tests, independent t-tests, and Paired t-tests.

The results of the study found that the control group had a mean anxiety score of 62.95 (S.D.= 4.80) before the experiment, which was at a high level, and that their mean anxiety score was 64 (S.D.= 4.76) after the experiment, remaining in the high level. The experimental group had a mean anxiety score of 62.10 (S.D.= 4.72) before the experiment, which was at a high level, but after the experiment, their mean anxiety score fell to 39.10 (S.D.= 2.74), dropping to a low level. The t-test analysis confirmed that the experimental group had a significantly lower mean anxiety score after the experiment than before the experimental (t =0.56, p <.05) and a significantly lower mean anxiety score than the control group after the experiment (t =20.78, p <.05). The results of this study demonstrate the usefulness of the preoperative preparation information program for reducing anxiety in patients undergoing Uretero-Renoscopic Litholapaxy.

Perception and Attitudes Regarding Living Wills Among Older Adults and Family Caregivers in Rural Areas of Thailand’s Central Region

Johnphajong Phengjard — 2025-11-19

Decision-making regarding end-of-life care remains a challenge for patients and their families, as most patients never plan for their care in advance. This qualitative study aimed to describe the perceptions and attitudes toward living wills among older adults and their family caregivers in a community in a central province of Thailand. Participants were purposively selected according to the following criteria: older adults aged 60 years or above who were able to communicate and respond clearly, and family caregivers aged 18 years or above who lived together with them. Both groups voluntarily provided information through audio-recorded interviews. Data saturation was reached at 15 families, consisting of 15 older adults and 15 caregivers. Data were analyzed using content analysis.

Findings revealed that the perceptions and attitudes of older adults and family caregivers influencing the completion of living will consisted of six key themes: 1) lack of awareness regarding the existence of living wills, particularly in rural communities where information is not widely accessible; 2) beliefs about bad omens or fears that completing a living will may hasten death, especially among those already ill, leading to discouragement, hopelessness, and reluctance to proceed; 3) viewing a living will as irrelevant or unnecessary at the present stage of life, with the belief that they are only needed when being older, seriously ill, or without family support; 4) concerns about neglect in medical care, such as fears of not receiving adequate treatment, not being consulted, and being unable to revise the directive later; 5) absence of real-life examples to confirm the benefits of having a living will, resulting in uncertainty and the need for evidence from lived experiences; and (6) approaches to fostering acceptance of living wills, including providing accurate and easy-to-understand information through communication by healthcare professionals and community-wide dissemination. The study highlights that the promotion the acceptance of living wills should focus on providing clear and easily understandable information, along with communication strategies appropriate to the community context, specifically formulated to reach key target groups, including older adults, families, and village health volunteers.

Predictive Factors of Self-Care Behaviors among Patients with Type 2 Diabetes at Nakhon Phanom Hospital

Charoenchai Muenhor — 2025-10-29

This research was a descriptive predictive correlational study aiming to investigate the levels of factors, relationships, and predictors of self-care behaviors among patients with type 2 diabetes (T2DM) at Nakhon Phanom Hospital. The participants consisted of 107 T2DM patients receiving care at Nakhon Phanom Hospital who met the inclusion criteria and were selected using simple random sampling. The research instruments included questionnaires covering: 1) personal information, 2) personal competence, 3) health perception, 4) social support, 5) health literacy related to T2DM, and (6) self-care behaviors of diabetic patients. The Cronbach’s alpha coefficients for the instruments were 0.83, 0.89, 0.97, 0.96, and 0.84, respectively. Data were analyzed using Point-biserial correlations, Eta correlations, Pearson’s correlation coefficients, and stepwise multiple regression analysis.

The results showed that majority of participants had moderate mean levels of personal competence, health perception, health literacy regarding T2DM, and self-care behaviors. The mean score for social support was rated at a high level and showed a low positive correlation with self-care behaviors, whereas personal competence, health perception, and health literacy demonstrated moderate positive correlations with self-care behaviors. Furthermore, two factors, personal competence and health perception, were found to significantly predict self-care behaviors among T2DM patients, accounting for 28.90% of the variance. The findings of this study can be applied to enhance the self-care capacity of patients with diabetes. A model to promote diabetes care could be developed by emphasizing strategies to improve patients’ personal abilities. Additionally, care approaches should be adjusted to focus on stimulating patients’ awareness of their own health conditions and their potential consequences in order to raise awareness and encourage appropriate self-care behaviors.

Effects of the Self-efficacy Enhancement Program for Drinking Refusal on Alcohol Drinking Behaviors among Major Depressive Disorders, Dokkhamtai Hospital, Phayao Province.

Raddarat Gojagang — 2025-10-06

For persons with major depressive disorders drinking alcohol often leads to self-harming behaviors and puts them at a significantly higher risk of completed suicide. This study employed a quasi-experimental, one-group, pre-posttest design to study the effect of a self-efficacy enhancement for drinking refusal program on alcohol drinking behaviors among patients with major depressive disorders who drink alcohol at Dokkhamtai Hospital, Phayao province. The sample consisted of 30 persons with major depressive disorders with alcohol drinking behaviors. Data were collected at four time points: before the intervention, immediately after the intervention, at a 1-month follow-up, and at a 3-month follow-up. The self-efficacy enhancement for drinking refusal program was used as the research’s interventional program. Data collection instruments included: 1) a general information questionnaire and 2) an alcohol drinking behavior screening tool. Data were analyzed using descriptive statistics for general information, the Friedman test to compare differences over time, and Wilcoxon signed-rank tests for pairwise comparisons.

The results revealed that the mean scores of alcohol drinking behavior at all three post-intervention time points were significantly lower than the pre-intervention scores. Actually, when paired for each two time points as shown on the abstract, the findings were statistically significant different except the pair of a 1-month F/U and a 3-month F/U. Therefore, the self-efficacy enhancement program for alcohol refusal demonstrated a reduction in effectiveness within one month after program completion. It is recommended that the program be further developed to include a booster dose beyond the one-month period.

The Effects of a Peer Coaching Supervision Program on the Perception of the Breast Cancer Patient Referral process among Health Personnel in Primary Care Units

Chananpat sukparsert — 2025-11-03

This quasi-experimental research with a two-group, pre-post results approach aimed to compare the perceptions of the breast cancer patient referral process of health personnel in primary care units before and after receiving a peer coaching supervision program. The sample consisted of 48 health personnel in primary care units, divided equally into experimental and a control groups with 24 people in each group. The experimental group received the 13-hours peer coaching supervision program and the control group received conventional teaching. The research instruments were 1) the peer coaching supervision program, and 2) a questionnaire on the perception of the breast cancer patient referral process which had a content validity index (CVI) of 0.98 and a reliability of 0.98. Data were analyzed using descriptive statistics, Chi-square tests, and paired t and independent t tests. Independent t-tests were used to compare the differences in the perception of the breast cancer patient referral process between the experimental and the control groups.

The results revealed that, after participating in the peer coaching supervision program, the experimental group had a significantly higher mean score for overall perception of the breast cancer patient referral process at a high level. Regarding the perceptions of specific aspects of the process, the mean score for the perception of patient assessment and screening was high, followed by the perception of the referral process guidelines, which was also at a high level. The mean score for the perception of the breast cancer patient referral process after the experiment was significantly higher than before the experiment, and higher than the control group (p < .001). This study suggests that managing health services to achieve personnel development goals can benefit from using peer coaching supervision tools, which enhance the knowledge and understanding of health personnel. This ultimately ensures that clients receive services that meet standards.

The Effects of Authentic Learning on Learning Outcomes of Nursing Students in a Pediatric and Adolescent Nursing Practicu at, Vongchavalitkul University

Tasanee Meetian — 2025-09-23

This quasi-experimental study utilized a one-group pretest-posttest design to examine the level of course-level learning outcomes among nursing students before and after implementing authentic learning in the Pediatric and Adolescent Nursing Practicum course. The study also aimed to compare students’ learning outcomes (LOs) prior to and following the intervention. The conceptual framework was based on Newman et al.'s Authentic Learning Model. The sample consisted of 125 third-year undergraduate nursing students enrolled in the Pediatric and Adolescent Nursing Practicum course during the 2024 academic year at the Faculty of Nursing of Vongchavalitkul University. The research instruments included the teaching and learning processes and activities for nursing practice training in real-world situations, based on the authentic learning approach and the LO assessment instrument for the Pediatric and Adolescent Nursing Practicum course, which was comprised of eight Los and was developed according to outcome-based education principles. The Item-Objective Congruence (IOC) index was 0.83. Reliability was assessed using Cronbach's alpha coefficient, yielding a reliability value of 0.91. Descriptive statistics were employed to analyze the overall mean scores of the course-level learning outcomes. Paired t-tests were used to compare pre- and post-intervention scores.

The results revealed that, prior to the implementation of authentic learning, the students’ overall mean scores for course-level learning outcomes were at a high level. After the intervention, the overall mean scores increased to a very high level. The comparison between pre- and post-intervention scores showed a statistically significant improvement in students' learning outcomes at the p < .05 level. These findings indicate that the authentic learning approach can serve as an effective instructional strategy to enhance course-level learning outcomes in nursing practicum settings, particularly in pediatric and adolescent nursing education.

Effects of a Competency Development Program on Knowledge and Competency in Primary Health Caregivers of Older People with Non-complicated Illness in the Community

Natcha Trakarnjan — 2025-10-14

This quasi-experimental research employed a one-group, pretest-posttest design. The objective was to examine the effects of a competency development program on the knowledge and competency of primary health caregivers for elderly individuals with non-complicated illnesses in the community. The sample group consisted of 38 primary caregivers of older people with non-complicated illnesses, with the sample size having been calculated using the G*Power program. The research instruments included: the competency development program for primary health caregivers of elderly individuals with non-complicated illnesses in the community, a personal information questionnaire, a knowledge assessment tool (content validity index [CVI] = 0.95; KR-20 = 0.78) and a competency assessment tool (CVI = 0.97; Cronbach’s coefficient = 0.89). Descriptive statistics were used to analyze general data, while the differences in the mean scores for knowledge and competency before and after the program were analyzed using paired t-tests.

The results showed that, after participating in the program, caregivers had significantly higher mean scores for knowledge and basic health caregiving competency for older adults with uncomplicated illnesses in the community compared to before the program. These findings suggest that the program effectively enhances caregivers’ competencies, contributing to the development of community health services for older people with non-complicated illnesses in the community. It is recommended that long-term programs with ongoing monitoring, including periodic evaluations to ensure sustained effectiveness, to empower volunteer caregivers of elderly patients be developed in collaboration with public health professionals.

Future Leadership for Nursing Administrators in the Era of Transition from VUCA to the BANI World

Jutaporn Pramuang — 2025-11-03

This academic article aims to propose future nursing leadership for nurse administrators in the rapidly shifting global environment from the VUCA to the BANI context. Future nursing leadership must focus on analyzing challenges in the complex health system and nursing services stemming from population structure, technology, and emerging diseases.

This article presents tips for applying strategic leadership, strategic thinking and visionary skills, adoption of technology and innovation, agility and crisis adaptability, and nursing management especially in an agile, data-driven nursing management environment. Such management emphasizes using big data, artificial intelligence (AI), and evidence-based decision making in order to improve workforce planning, workload monitoring, and promotion of sustainable health outcomes. Expected results from applying this conceptual approach includes reducing burnout among nurses, increasing client service satisfaction, and improving the overall quality of health services.