Journal of Nurses Association of Thailand Northern Office

The Balancing of Student Expectations and Professional Nursing Standards

2026-01-04T00:11:10+07:00

Nursing education in the digital era is characterized by a significant gap between the expectations held by nursing students and the realities encountered in actual professional practice. This academic article aims to examine the expectation-reality discrepancy concerning professional standard compliance as observed within clinical settings, utilizing a multi-theoretical framework comprising Benner's Model of Clinical Competence Development, Kolb's Experiential Learning Theory, Vroom's Expectancy Theory, and the SERVQUAL Model. The analysis reveals that disparities between classroom-based instruction and clinical practicum experiences substantially affect student expectations, giving rise to heightened levels of stress, psychological pressure, and diminished motivation toward learning. In light of these findings, several recommendations are proposed. Incoming nursing students should be provided with accurate and comprehensive information regarding the nursing curriculum in order to cultivate realistic professional perceptions. Curriculum design and instructional management should encompass a diverse range of learning modalities, including didactic theoretical instruction, skills training in nursing laboratories, practice in simulated and virtual clinical environments, and direct clinical practicum, in order to facilitate experiential learning. This should be complemented by evidence-based and transparent assessment and evaluation mechanisms that promote continuous development, systematic preparation of students prior to clinical placement, psychological counseling and support, and ongoing faculty development. Such a comprehensive approach aims to produce graduates of high competence who are genuinely equipped to meet the complex challenges of professional nursing practice.

Body Narrative: A Participatory Learning Tool for Enhancing Primary Care Management Competency: A Case Study of Chun Sub-district, Chun District, Phayao Province

2026-01-22T13:48:16+07:00

This article presents the lessons learned from utilizing Body Narrative as a participatory learning tool to enhance the primary health care management competencies of health network partners in Chun Sub-district, Chun District, Phayao Province, where health network partners used community waste management as a foundational issue for learning. The study utilized Body Paint as a tool within Body Narrative, guided by the 4P’s conceptual framework: Principle, Purpose, Participation, and Process. The implementation was grounded in the concepts of Narrative Medicine and Experiential Learning.

The findings indicated that the tool effectively promoted systems-based learning and was readily understood by users. It addressed a gap in community nursing practice by providing a procedural framework that systematically linked nursing knowledge with the practical experiences of local partners, enabling the translation of academic concepts into concrete community-based actions. Furthermore, the participatory learning process strengthened collaboration among network partners by fostering teamwork, collective reflection, effective communication, and leadership development. This led to tangible outcomes in environmental management and community participation, resulting in the co-design of a waste management system that seamlessly integrated health, environmental, and social dimensions. Furthermore, it established continuous monitoring and increased household waste segregation behaviors to over 90 percent.

Additionally, the process empowered the community, strengthened collaborative relationships, and improved communication among network partners. This led to the development of the “Community-based Participatory Waste Management Model”, which serves as a district-level prototype for primary health care operations. The lessons learned reflect that Body Narrative is a high-potential tool for supporting the roles of community nurses and primary health care teams in driving sustainable community health development.

Factors Associated with Hypothermia in Preterm Infants with Birth Weight Less than 1,500 grams Upon the First Admission to the Neonatal Intensive Care Unit, Maharaj Nakorn Chiang Mai Hospital

2025-08-16T00:44:35+07:00

This retrospective descriptive study aimed to examine factors associated with hypothermia in preterm infants with birth weight less than 1,500 grams upon the first admission to the neonatal intensive care unit (NICU), Maharaj Nakorn Chiang Mai Hospital. The purposive sampling were 237 preterm infants with birth weight less than 1,500 grams who were born at Maharaj Nakorn Chiang Mai Hospital. Data were collected retrospectively from the hospital medical registration department from January 1, 2019 to December 31, 2023. Research instruments consisted of: (1) a data collection form recording four factors associated with hypothermia in preterm infants namely: infant factors, environmental factors, equipment factors, and personnel factors, and (2) a body temperature record body from upon admission. Data were analyzed using descriptive statistics and Chi-square test.

The findings showed that 147 preterm infants (62.03%) with birth weight less than 1,500 grams demonstrated hypothermia upon admission. Eighty of them (54.42%) had mild hypothermia, 67 infants (45.58%) exhibited moderate to severe hypothermia (<36.0°C). It was found that the mode of delivery, birth weight, Apgar scores, and place of birth had statistically significant associated with hypothermia upon admission with p<.001, p<.01, and p<.05, respectively. However, the use of plastic wrap or plastic bag, the equipment used for transportation, and personnel-related factors were not statistically significant associated with hypothermia upon admission.

The results of this study serve as a preliminary information for healthcare professionals to understand factors associated with hypothermia upon admission, leading to the development of Clinical Practice Guidelines for preterm infants in order to reduce in the incidence of hypothermia, and increase the survival rate effectively.

The Clinical Outcomes of Using Cold Atmospheric Plasma for Chronic Wound Treatment: Wound and Ostomy Care Center, Lamphun Hospital

2025-10-18T22:09:30+07:00

This quasi-experimental study aimed to evaluate the clinical outcomes of cold atmospheric plasma (CAP) therapy in the management of chronic wounds. The outcomes included wound size reduction within two months, infection rate, complications related to CAP therapy, and the overall duration from treatment initiation to complete wound healing. Stratified random sampling was performed using a computer program. The sample size was calculated using G*Power version 3.1.9.4, yielding a total of 176 patients with chronic wounds, including diabetic ulcers, pressure ulcers, vascular ulcers, and necrotizing wounds. Participants were equally allocated into a control group and an experimental group. The control group received advanced wound care, while the experimental group received advanced wound care combined with cold atmospheric plasma therapy three times per week. The study was conducted from January 2022 to March 2025. Data were analyzed using mean, percentage, and independent t-test statistics.

The results showed that within two months, the experimental group demonstrated a mean wound size reduction of 6.59 cm, whereas the control group showed a mean reduction of only 0.49 cm with statistically significant difference (p < .001). No infections were observed in either group. The mean total duration from treatment initiation to complete wound healing was 175.92 days in the control group, compared with only 71.89 days in the experimental group, which was statistically significant difference (p < .001). Regarding complications related to cold atmospheric plasma therapy, 18.18% of patients reported a fishy ozone-like odor during treatment. No pain or tissue burns were observed.

The findings of this study suggest that cold atmospheric plasma is an effective adjunctive therapy for promoting wound healing. It accelerates wound size reduction, does not cause wound infection, and is not associated with pain during treatment. Therefore, cold atmospheric plasma should be considered for using in the management of chronic wounds, particularly when applied from the early stage of wound development.

The Development of a Participatory Clinical Supervision Model on Nursing Competency and Clinical Outcomes in Stroke Patients at Chiangmai Neurological Hospital

2025-11-17T11:14:37+07:00

This research and development study aimed to develop a participatory clinical supervision model on nursing competency and clinical outcomes in stroke patients at Chiangmai Neurological Hospital. It consisted of four phases; 1) situation analysis, 2) model development, 3) model implementation, and 4) model evaluation. The participants included 15 nurse supervisors, 15 supervisees, 262 stroke patients before using the model and 248 stroke patients after using the model. The study carried from January 2025 to September 2025. The research instruments comprised demographic questionnaire, focus group discussion guideline, standard clinical supervision knowledge test, self-assessment form for supervisors, evidence-based stroke care knowledge test, five-minutes talk measurement tool, work stress questionnaire, self-efficacy assessment questionnaire, stroke nursing competency assessment, participatory clinical supervision competence assessment, and clinical outcomes record form. All instruments were validated for content validity and reliability by five experts prior to data collection. Data were analyzed using descriptive statistics, paired t-test, and Wilcoxon signed rank test.

The results revealed that the developed participatory clinical supervision model, named the STROKE Model, comprised six key components: S – Systematic and Standardized Approach, T – Technology and Evidence-Based Practice Integration, R – Relationship Building and Supportive Environment, O – Ongoing Support and Continuous Development, K – Knowledge and Skills Enhancement, and E – Engagement and Participatory Approach. After the implementation, the competencies of nurse supervisors significantly improved (p <.001). In addition, the competencies and self-confidence of supervised nurses increased significantly (p <.001), while their stress levels significantly decreased (P=.03). Overall, participants reported a high level of satisfaction with the use of this model. Furthermore, clinical outcomes among patients with stroke demonstrated improvement, including shorter hospital stays, fewer unplanned ICU transfers, and a declining trend in complications.

The STROKE Model was proved to be an effective and contextually appropriate guideline for tertiary hospitals providing care for stroke patients. It helps strengthening nursing competency and increases clinical outcomes in stroke patients.

The Effects of a Home-Based Nursing Case Management Program for Terminally Ill Patients on Suffering Symptoms, Care Outcome, and Caregiver Satisfaction

2026-01-22T14:06:15+07:00

This quasi-experimental research aimed to examine the effects of a home-based nursing case management program for terminally Ill patients on suffering symptoms, care outcome, and caregiver satisfaction. The samples were 25 terminally ill patients who received palliative care at home and their 25 caregivers, selected by purposive sampling. The research instruments consisted of 2 parts: 1) the data collecting instruments were the personal data questionnaire, the Thai Palliative Performance Scale, the Thai version of the Edmonton Symptom Assessment System, the Thai Palliative Care Outcome Assessment Scale, and the Caregiver Satisfaction questionnaire; 2) the experimental instrument was a home-based nursing case management program for terminally Ill patients. Data were analyzed using descriptive statistics and Wilcoxon Sign Rank tests.

The results found that, after receiving a home-based nursing case management program for terminally Ill patients, the mean score of suffering symptoms and palliative care outcomes showed significantly lower than before receiving the program ( p<.001). The caregiver satisfaction’s mean score showed a significantly higher than before receivingthe program ( p<.0 0 1 ) . Therefore, application of the program showed better outcomes of terminally ill the patients and the caregivers.

The recommendations for further studies are: extending the follow-up period; expanding the program to variety context; developing palliative care models, community network, and health volunteers to ensure the patients and caregivers accessing the quality of care and improving their quality of life.

Factors Influencing Health-Related Quality of Life among Patients with End-Stage Renal Disease Receiving Hemodialysis

2025-11-16T16:02:00+07:00

This descriptive research aimed to examine the level of health-related quality of life (HRQoL) and its associated factors among patients with end-stage renal disease undergoing hemodialysis. The sample consisted of 120 patients receiving hemodialysis at a tertiary care hospital in Kamphaeng Phet Province, selected by purposive sampling. Research instruments included a demographic questionnaire and the Kidney Disease Quality of Life (KDQOL-SF version 1.3), Thai version, with a Cronbach’s alpha coefficient of .90. Data were analyzed using descriptive statistics: percentage, mean, and standard deviation, and multiple linear regression analysis.

The results showed that the overall HRQoL of patients was at a moderate level (mean = 61.86, SD = 8.40). The majority of patients had moderate HRQoL (81.66%), followed by low and high levels at equal proportions (9.17%). No patients were classified as having very low HRQoL. Stepwise multiple linear regression analysis revealed that monthly income, duration of hemodialysis, and hemodialysis-related complications were significant predictors of HRQoL (p < .05), accounting for 55.1% of the variance (R² = .551).

These findings suggest that, although the identified predictors are largely non-modifiable, they can be used to identify patients at risk of poor HRQoL and inform the development of appropriate care plans tailored to patients’ conditions.

The Development of Emergency Nurses Competencies in Caring for Patients with Severe Chest Trauma

2025-11-30T00:18:22+07:00

This research and development study aimed to develop and examine the effects of enhancing professional nurses’ competencies in caring for patients with severe thoracic trauma in emergency departments. The study was guided by Soukup’s concept, accident and emergency nursing standards, competency frameworks for emergency nursing, and advanced trauma life support principles (ATLS). The process comprised four phases: 1) situational and problem analysis through focus group discussions with 29 nurses, in-depth interviews with 5 administrators, and medical record/incident reviews by 10 experts; 2) development of competency enhancement tools (such as online lessons, video media, and simulation-based practice) and outcome evaluation instruments; 3) pilot testing of the tools with 29 nurses and 10 patients/relatives in two rounds, followed by refinement; and 4) evaluation of outcomes with 29 nurses and 35 patients/relatives. Data were analyzed using descriptive statistics and paired t-tests.

The results revealed that after the competency development, the mean scores of emergency nurses’ knowledge increased from 78.57% to 85.43%. The nursing role performance increased from 69.39% to 95.07%. The nurses’ satisfaction with the competency development program was very high (95.66%). The service quality outcomes showed that the risk incidents related to triage, communication, and patient referral were reduced, while patient relatives’ satisfaction with services was high (95.33%).

Conclusion and Recommendations: The competency development program effectively helps promoting nurses’ knowledge, strengthening nurses’ competencies in providing safe and efficient cares for patients with severe thoracic trauma in emergency department. Future studies should include a long-term follow-up (6–12 months) to assess sustainability of competencies and continuity of service quality.