Kuakarun Journal of Nursing

Factors Associated with Survivals in 24 Hours of Trauma Patients at a Tertiary Care Hospital in Lower Northern Thailand

Montree Phira — 2024-11-05

This study aimed to explore factors influencing the survival of trauma patients within the first 24 hours after injury. Our participants were trauma patients over 20 years old receiving medical treatment at a tertiary care hospital in lower northern Thailand from January 2021 to December 2022. The researcher collected data from electronic medical records of trauma patients using predetermined ICD-10 to identify patients who met the study inclusion criteria. Simple randomization was conducted among the eligible patients to obtain a sample of 220 patients. The data were analyzed using descriptive analysis, Chi-square, Fisher’s exact, and Mann-Whitney U tests.

The study found that out of 220 patients, 182 (82.73%) survived, whereas 38 (17.27%) died. The results indicated several significant factors p-value < .05 associated with the participants’ survivorship. These factors included age, Charlson Comorbidity Index, Glasgow coma score, Injury severity score, Revise trauma score, Body temperature, Blood lactate, Base deficit, Partial thromboplastin time, Prothrombin time, International normalized ratio, Platelet count, Hematocrit, Blood transfusion, and receiving total intravenous resuscitation. Our findings suggest nurses providing care for trauma patients within the first 24 hours after injury should monitor for changes in body temperature control, correction of acid-base status, coagulopathy management, blood transfusion, and intravenous resuscitation, as these factors could indicate the patient's survivorship. The findings from this study also highlight the importance of healthcare system policy to improve the guidelines and education for first responders who are at the frontline taking care of trauma patients regarding factors associated with their first 24-hour survivorship.

Factors Associated with Clinical Sequelae of COVID-19 Survivors at a Secondary-Level Hospital in Central Thailand

Pimchanok Niamhom — 2024-11-05

Long COVID is one of the biggest challenges for healthcare professionals caring for COVID-19 survivors. However, research studies regarding this issue in Thailand are limited. Therefore, this study aimed to explore factors associated with the clinical sequelae of COVID-19 survivors. A total of 268 COVID-19 survivors aged over 20 who received service at a secondary-level hospital in central Thailand were recruited into the study. Data were obtained from medical records and using three questionnaires to measure the feelings of loneliness, stigma, and clinical sequelae that persisted after COVID-19 infection. To determine the associations between reported clinical sequelae and selected factors, Chi-square and Fisher’s exact test was used.

The result shown among the 268 COVID-19 survivors, 167 (62.31%) reported having Long COVID. Symptoms often reported were fatigue (44.78%), memory loss (26.12%), tachypnea after activity (23.88%), joint pain (22.39%), and sleep disorder (22.39%). Factors significantly associated with long COVID (p-value < .05) were 1) male gender, 2) BMI ≥ 25 kg/m², 3) Charlson Comorbidity Index (CCI) > 4, 4) having severe disease of COVID-19, 5) receiving antiviral drugs, 6) requiring oxygen with cannula support 6) having loneliness and 7) having stigma. Nurses and healthcare professionals taking care of this group of patients should be aware of these factors and use them to determine whether an individual is at risk of long-term COVID-19 symptoms. Nursing practice guidelines for long-term COVID-19 symptoms often reported should be developed as well.

A Study of Desirable Competency of New Graduate Nurses, Government Hospitals

Primpiriya Jindawan — 2024-11-14

This descriptive research aimed to study the desirable competency of new graduate nurses in government hospitals using the Ethnographic Delphi Future Research (EDFR) technique. The study subjects were 20 experts. The EDFR consisted of three rounds: 1) interviewing all experts about the desirable competency of new graduate nurses in government hospitals, 2) developing a questionnaire from interview data by using content analysis, and 3) the data from the questionnaire were analyzed by the median and interquartile range and then a new version of the questionnaire was developed for confirmation by prior experts.

The results showed that the desirable competencies of new graduate nurses in government hospitals consisted of 10 components as follows: 1) digital technology literacy, 2) ethics, code of conduct, professional law and digital technology laws, 3) theoretical knowledge and nursing and midwifery practice, 4) diversified communication, 5) personal and agency development, 6) nursing research and innovation, 7) leadership and nursing team management, 8) adapting to diversity, 9) management and problem-solving, and 10) cost and resource management. The desirable competencies of new graduate nurses in government hospitals had high to the highest level of significance (Mdn = 4.10 - 4.72, IQR = .28 - 1.08).

Nurses’ Communication Skills in Providing Care for Patients at the End of Life and Their Families in Bangkok

Siwaporn Charoenpoln — 2024-11-27

This descriptive research aimed to describe the nurse’s communication skills in caring for terminally ill patients and their families. Participants consisted of 165 nurses who had experience of providing care for terminally ill patients and their families. Instruments used for collecting data included: 1) the demographic data form and 2) the Skill Assessment Form of Nurses in Communicating with Terminally Ill Patients and Their Families (SCT-Nurse). The SCT-Nurse was assessed for validity by five experts, yielded CVI of .97 and the SCT-nurse was evaluated for internal reliability among thirty nurses, yielding Cronbach’s alpha coefficient of .96. Data were analyzed by descriptive statistics.

The results of the study found that the overall nurses’ communication skills for caring of terminally ill patients was at a moderate level (Mean = 93.29, SD = 21.79). When classified based on each component of communication skills, nurses’ communication skills in families with interaction problems and communication skills of empathy were at a high level, whereas nurses’ communication skills regarding end-of-life care and advance care planning was at a moderate level (Mean = 39.21, SD = 8.82; Mean = 28.80, SD = 5.42; Mean = 25.28, SD = 10.14, respectively). The results of this study can be used as information for developing nurses’ communication skills to enhance care outcomes among patients at the end of life and their families.

Factors Influencing Syphilis Infection in Pregnant Women

Manitra Mensin — 2024-11-27

This case-control study aimed to determine predictive powers of age, substance abuse, number of sexual partners, knowledge about syphilis, social support, depressive symptoms, and intimate partner violence on syphilis infection in pregnant women. The sample consisted of 196 pregnant women who received antenatal care at hospitals in Bangkok districts and divided into the case group (n = 50) with syphilis infection and the control group (n = 146) without syphilis infection. Data were collected by using: 1) the Personal Data Questionnaire, 2) the Knowledge about Syphilis Questionnaire, 3) the Medical Outcomes Study: Social Support Survey (MOS-SSS), 4) the Center for Epidemiologic Studies-Depression Scale (CES-D), and 5) the Abuse Assessment Screen (AAS). The reliabilities of the second-fifth questionnaire were .78, .94, .92, and .82, respectively. Data were analyzed using descriptive statistics, chi-square tests, and multiple logistic regression analysis.

The findings revealed that age, substance abuse, number of sexual partners, knowledge about syphilis, social support, depressive symptoms, and intimate partner violence could significantly predict 50.50% (R² = .505) of syphilis infection in pregnant women. The findings of this study suggested that midwives should assess risk factors among pregnant women aged 18 - 24 years who had multiple sexual partners, used substances, or were abused by intimate partners to reduce adverse outcomes from syphilis infection during pregnancy.

Development of a Participatory Care Model for Hospitalized Older Adults with Delirium

Chulaluk Jaipang — 2024-12-20

This research aimed to study the situational problems and develop a participatory care model for older adults with delirium. The study sample consisted of 19 older adults for quantitative data and 30 healthcare team members and caregivers for qualitative data. The study was divided into two phases. Phase 1: exploring problems; the tools used included the Confusional Assessment Method (CAM), a questionnaire on need assessment in older adults when admitted to the ward, interview guides, and data recording forms. Quantitative data were analyzed using descriptive statistics, while qualitative data were analyzed through content analysis. Phase 2: developing a care model; this phase was collaboration between researchers and the healthcare team.

Research findings revealed that the prevalence rate of delirium in older adult patients at the female medical ward was 31.58%. They all need health information, self-care advice, communication with staff, sleep promotion, physical activity and accident prevention, and mental support. Identified issues included unclear clinical practice guidelines for care and management of delirium. The care model developed comprises four components: 1) Identification and segmentation focus on assessment to identify problems or risks, 2) Management and prevention, 3) Diagnostic accuracy, and 4) Disposition.

The Effects of an Enhancing Self-Efficacy Program and Mobile Application in Rehabilitation on Physical Fitness and Anxiety among Coronary Artery Bypass Graft Surgery Patients

Jannipa Srimuang — 2024-12-23

This quasi - experimental research aimed to investigate the effect of the self-efficacy program with mobile applications in rehabilitation programs on physical fitness and anxiety among patients with coronary bypass graft surgery. The sample was 52 participants divided equally into experimental and control groups of 26 patients each. This program consisted of educational activities, lesson plans, and video demonstration models to promote competency combined with mobile applications. The research tools comprised a personal data record form, a physical fitness assessment form measuring walking distance on a level surface in 6 minutes, and an anxiety assessment form. The content validity was tested at 1.00, and the alpha Cronbach coefficient was determined at .91. Data were analyzed using descriptive statistics, independent t-test and repeated measure ANOVA. Data were analyzed using descriptive statistics, independent t-test, and repeated - measures ANOVA.

The results revealed that the physical fitness of the experimental group in the 6 weeks after discharge was significantly higher than the control group (t-test = 5.168, p-value < .001), and it was found that the anxiety of the experimental group was significantly lower than the control group (F = 2059.59, p-value < .001). These results demonstrate that the application can improve physical fitness and reduce patient anxiety. Therefore, nurses should apply this application to patient care to be effective continuously.