Kuakarun Journal of Nursing

Health Literacy among Older Adults of Cerebrovascular Risk Group in Community

Wanida Sripromsa — 2023-12-07

This explanatory sequential mixed-method study aimed to identify the level of health literacy, the factors influencing a high level of health literacy, and the guidelines for improving health literacy among older adults of the cerebrovascular risk group in the community. For the quantitative study, the samples of 128 older adults with Diabetes Mellitus and hypertension in the Mueang district, Udon Thani Province were purposively selected and 10 older adults were selected for the qualitative study. The instrument was a health literacy questionnaire and the content validation with the Index of Item Object Congruence (IOC) was .87. The reliability was tested by using Cronbach’s alpha coefficient, which was .80. In-depth interviews were conducted for content validity of the IOC, which was .70. Quantitative data were analyzed by descriptive statistics. Qualitative data were analyzed by using content analysis.

The findings revealed that the mean score of health literacy was moderate (Mean = 30.86, SD = 6.72). The key 4 factors influencing the high level of health literacy consisted of 1) personal competence to support the understanding of health information 2) personal motivation 3) family-cousin support and 4) proactive services of health care personnel and village health volunteers. The guidelines for improving health literacy knowledge were as follows: 1) creating opportunities and access to health information 2) improving technology capabilities 3) capacity building 4) support from the organization and 5) creating learning in health literacy. The results can be used as basic information to develop guidelines for health literacy among older adults of cerebrovascular risk groups in the community.

The Prediction of Locomotive Syndrome based on Health-Promoting Lifestyle in Older Adults Living in Urban Areas

Jintana Rittharomya — 2023-12-11

This case-control study aimed to examine the predictive factors, including personal factors and health-promoting lifestyles, which affected the locomotive syndrome among older adults living in urban areas in Bangkok. The sample consisted of 200 older adult patients in the Orthopedic Outpatient Unit, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, and they were equally divided into experimental and control groups. Research instruments were a personal data record form and a lifestyle assessment form for health promotion - II in the Thai version. The reliability analyzed by using Cronbach’s alpha coefficient was .93. Data were analyzed using Descriptive Statistics and Binary Logistic Regression.

The results revealed that age, body mass index, educational background, smoking habit, high blood pressure, diabetes mellitus, knee osteoarthritis, and low to moderate levels of health-promoting lifestyle were able to predict the locomotive syndrome in older adults. Recommendations from the results were that medical personnel, especially geriatric care nurses, should recommend health promotion to older adults for improving healthy lifestyle behaviors in accordance with their daily habits. Furthermore, this health promotion is crucial for older adults with chronic diseases in preventing the effects of Locomotive syndrome and maintaining functional capacity and a good quality of life.

Self-Care Behaviors and Self-Perceived Health Status among Older Adults in Muang Chiang Rai District, Chiang Rai Province

Thitima Thasuwanain — 2023-12-12

This descriptive research aimed to examine self-care behaviors, perceived health status, and the relationship between self-care behaviors and perceived health status among older adults in Muang District, Chiang Rai Province. Data were collected using a Personal Data Record Form, a self-care behaviors questionnaire, and a perceived health status questionnaire. The validity of the questionnaires was tested by five experts with a content validity index ranging from .66 to 1.00. The reliability was assessed by calculating Cronbach's alpha coefficient, which resulted in .77 and .87, respectively. Data were analyzed by descriptive statistics and the Spearman correlation coefficient.

The results revealed that the majority of the sample had moderate self-care behaviors (Mean = 2.09, SD = .85). When considering each aspect, the highest developmental self-care requisites were moderate and the level of perceived health status was high (Mean = 3.32, SD = .68). Likewise, the level of the highest perception of present health status was high (Mean = 3.67, SD = .52). Self-care behaviors had statistically significant correlations with perceived health status (p-value < .01, r = .669). The results of this study can be used to guide health promotion that focuses on the perception of health status for older adults to appropriately develop self-care behaviors and improve their quality of life.

The Effects of a Pressure Ulcer Prevention Program in Patients with Spine Surgery

Waranya Paksa — 2023-12-13

This is a two-group pretest-posttest quasi-experimental research that aimed to compare the incidences of pressure ulcers in patients undergoing spinal surgery in the group who received a pressure ulcer prevention program and the group who received regular nursing care. The sample consisted of patients aged 18 years and over. The researcher purposively selected 58 people, divided into equal numbers of control and experimental groups. The experimental group received a pressure ulcer prevention program. The control group received regular nursing care. The incidences of pressure ulcers were measured by using the Bates-Jensen wound assessment tool (BWAT), with
the content validity at 1.00 and reliability at .98. Data were analyzed using descriptive statistics, Chi-square statistics, Fisher statistics and Man-Whitney U statistics

The results of the study found that the experimental group had significantly lower pressure ulcers than the control group both immediately after surgery and within 2 hours after surgery. A pressure ulcer prevention program in patients with spine surgery can reduce the occurrence of pressure ulcers. These results indicated that the program can be applied to preventing pressure ulcers in patients undergoing spinal surgery who do not have a cervical spine injury and there was no use of intraoperative skull fixation tools.

Effectiveness of the Mindfulness-Based Diabetes Self-Management Program among Adults with Uncontrolled Diabetes

Nittaya Sukchaisong — 2023-12-24

This two-group, pretest-posttest and follow-up, quasi-experimental research aimed to examine the effectiveness of the mindfulness-based diabetes self-management program among adults with uncontrolled diabetes. The sample was 52 adult people aged 35 - 60 years old. The participants were equally assigned into experimental and comparison groups, 26 each. The experimental group received the mindfulness-based diabetes self-management program. Data were collected by a questionnaire with the following components: demographic data questionnaire, mindful eating questionnaire, dietary consumption questionnaire, and exercise questionnaire. The Cronbach’s alpha coefficient ranged from .8.-91. Data were analyzed by descriptive statistics, independent t-test, and repeated measure one-way ANOVA.

The results revealed that the mean scores of mindful eating, dietary consumption, and exercise in the experimental group were statistically significantly higher than those before the intervention, follow-up, and in the comparison group (p-value < .05). Compared with the comparison group, the experimental group had a significantly lower mean score of fasting blood sugar than the comparison group and before intervention (p-value < .05). Therefore, this mindfulness-based diabetes self-management program can change behaviors to prevent disease complications and help patients with diabetes improve self-management and blood sugar.

Effects of a Self-Management Support Program on Self-Management Behavior to Slowing Progressive in Patients with Chronic Kidney Disease at Stages 1 - 2

Kamonwan Suwan — 2023-12-24

This research was a one-group pretest-posttest design that aimed to examine the effects of a self-management support program on self-management behaviors among patients with chronic kidney disease at Stages 1 - 2 at Nibongbaru Subdistrict Health Promoting Hospital. The sample of 27 participants was recruited by random sampling with proportional allocation. The research instrument for intervention was a self-management support program on self-management behaviors to slow progression in patients with chronic kidney disease at stages 1 - 2. The data-collection instruments were 1) manual, 2) interview forms of chronic kidney disease knowledge, and 3) interview forms of self-management behaviors. The item-objective congruences of the instruments were 1.00, 1.00, and .75, respectively. The reliability measured by Kuder-Richardson formula 20 (KR-20) was .83 and the Coefficient Alpha was .86. Data were analyzed by percentages, mean, standard deviation, and paired t-test statistics.

The results revealed that the average scores of knowledge, self-management behavior, and glomerular filtration rate after receiving the program were statistically higher than before receiving the program, with a significant difference at .05 (t = 5.25, 4.51, and 2.56). Therefore, healthcare providers should apply this program to care for patients with stages 1-2 of chronic kidney disease to slow the deterioration, prevent complications, and improve quality of life

Effectiveness of the VDO Interactive CPR Game on Retention of Knowledge and Skills in Cardiopulmonary Resuscitation of Public Health Volunteers

Pornsawan Khitka — 2023-12-26

The objectives of this study were to evaluate the effectiveness of interactive video CPR games and examine the effects on the retention of cardiopulmonary resuscitation (CPR) knowledge and skills among public health volunteers. The sample was 50 public health volunteers who were selected and equally divided into the experimental group (25 cases) and the control group (25 cases). The experimental group received basic life support (BLS) training, a BLS manual, and interactive video CPR games. The control group received BLS training along with additional self-study resources. Instruments were 1) interactive video CPR games, 2) a BLS manual, 3) an assessment questionnaire on BLS knowledge and skills, and 4) a satisfaction assessment of interactive video CPR game usage form. The content validity of the interactive video CPR games was .88. The video performance assessed by the expert was 3.36 and the video efficiency criteria was 80/80. Data were analyzed using descriptive statistics, Mann-Whitey U test and Wilcoxon signed ranks test.

The results revealed that the interactive video CPR games were highly effective. The highest level of satisfaction was 60% of the video viewers. After one month of training, the group of public health volunteers who played the interactive video CPR games achieved a significantly higher score of CPR knowledge and skill than the control group (p-value < .05). Research results indicated that the interactive video CPR games were highly effective, delivered user satisfaction, and impacted the retention of cardiopulmonary resuscitation (CPR) knowledge and abilities among public health volunteers.

Factors Influencing Recurrent Stroke Preventive Behaviors among Stroke Patients during COVID-19 Pandemic, Bangkok

Hathairat Sangkaew — 2023-12-28

This predictive descriptive research aimed to study the recurrent stroke preventive behaviors and the factors influencing recurrent stroke preventive behaviors among stroke patients during the COVID-19 pandemic in Bangkok. A PRECEDE-PROCEED framework was applied for the research framework. This study included 148 patients, multi-stage randomly selected from the stroke patients in the community of Bangkok. Data were collected by using interviewing forms consisting of 1) general information, 2) ability to perform the activities of daily living scale, 3) health literacy scale, 4) recurrence risk perception scale, 5) access to health services scale, 6) social support scale and 7) recurrence stroke preventive behavior scale. The content validity index of instruments part 3 - 7 had values of .80, 1.00, .80, .80, and .92, respectively, and Cronbach’s alpha coefficients of .96, .78, .76, .73, and .73, respectively. Data were analyzed by descriptive statistics, Pearson’s product-moment correlation coefficient, and stepwise multiple regression analysis.

The results revealed that around two-thirds of stroke patients (68.20%) had a high-level recurrent stroke preventive behavior (Mean 73.62 ± 8.46). Age (β = .328), perceived risk of recurrence (β = .312), health literacy (β = .290), access to health services (β = .257), and social support from health volunteers (β = -.184) were factors that predicted recurrent stroke preventive behaviors in a stroke patient at 45.20% (adj R2 = .452). According to the results of this study, community nurses should promote health literacy, perception of risk of recurrence, appropriate recurrence stroke preventive behaviors, and support access to health services with consideration of patient’s age, and capacity building of health care volunteers.

Coping with Loss and Grief of Postpartum Women with Death Fetal in Utero

Maliwan Rattaya — 2023-12-28

This qualitative, hermeneutic phenomenological study aimed to explore the experiences of coping with loss and grief among postnatal women with death fetal in utero when they labored at Phatthalung Hospital from April 2022 to September 2022. Purposeful sampling was used for the recruitment of 15 participants. Semi-structured interviews were conducted to gather information through individual in-depth interviews with members checked for verification. Data were analyzed by content analysis.

The results revealed that the encounters with loss and grief for the death fetal in utero were: 1) Responses to loss and grief upon learning of the death fetal which included: 1.1) awareness of the potential impact on oneself and family, 1.2) the amount of time to overcome loss and grief, and 1.3) acceptance of the truth leading to appropriate encounters with loss and grief; 2) Coping with loss and grief consisted of two sub-themes, namely: 2.1) coping with loss and grief by oneself and 2.2) receiving support from others or the environment. The results of this study could make healthcare providers understand the loss and grief of women with death fetal in utero. The results can be used as basic information to develop nursing guidelines for postpartum women with death fetal in utero to deal effectively with the loss and grief and be able to continue living in the appropriate way.

Effects of Health Promotion Program on Dietary Behavior, Exercise Behavior, and Blood Sugar Levels among Pregnant Women with False Positive Glucose Challenge Test

Angsuma Chuprakong — 2023-12-28

This quasi-experimental research aimed to examine the effects of a health promotion program on dietary behavior, exercise behavior, and blood sugar levels among pregnant women with a false-positive glucose challenge test. The samples were pregnant women with false-positive glucose challenge tests and selected by convenience sampling. The samples were divided into the control group and the experimental group. Each group consisted of 28 participants. Data were collected using a personal information questionnaire, an online dietary behavior record, and an online exercise behavior record. The quality of the research instrument was evaluated by the Content Validity Index (CVI ≥ .80). Data analysis was performed with descriptive statistics, Chi-Square, and Mann-Whitney U test.

The results revealed that the ratio of participants in the experimental group who could control dietary behavior and exercise behavior was significantly greater than those in the control group ( = 31.540, p-value < .001; = 29.167, p-value < .001 respectively). Besides, the mean score of blood sugar levels in the experimental group was significantly lower than that in the control group (Z = -2.230, p-value < .05). It could be summarized that the health promotion program could influence the modification of health behavior and effectively control the normal glycemic level in pregnant women with a false-positive glucose challenge test. Therefore, the LINE application should be further developed to modify health behavior in pregnant women.

Effect of a Nutritional Promoting Program using Social Media on Gestational Weight Gain and Recover from Anemia in Adolescent Pregnant Women with Iron Deficiency Anemia

Poramapon Vachiravanichkij — 2023-12-28

This quasi-experimental research aimed to examine the effect of a nutritional promoting program using social media on gestational weight gain and recovery from anemia in adolescent pregnant women with iron deficiency anemia. The sample comprised adolescent pregnant women aged between 16 and 19 years old with a gestational age of 20 and 24 weeks who received antenatal care at Vajira Hospital. The participants of the study were 51 women who were recruited by purposive sampling, and they were assigned to the experimental group (n = 25) and the control group (n = 26). The experimental group received a nutritional promoting program using social media, whereas the control group received usual care. The research instruments consisted of 1) personal and pregnancy data questionnaires (Content Validity Index = 1.00) and 2) nutritional promoting programs using social media. Descriptive statistics and Chi-square statistics were used to analyze data.

The findings revealed that the ratio of the sample with gestational weight gain, according to the criteria, and the sample with recovered from iron deficiency anemia in
the experimental group, was statistically and significantly higher than that of the control group (x² = 7.069, p-value = .008, x² = 4.581 p-value =.032). Thus, programs can be applied to nursing practice for teenage pregnant women with iron deficiency anemia, especially pregnant women in urban areas.

Effects of Using Simulation and Video Teaching Techniques on Beta - Thalassemia Knowledge in Pregnant Women among Junior Nursing Students, Kasem Bundit University

Somboon Boonyakiat — 2023-12-28

This one-group pretest-posttest quasi-experimental study aimed to examine the effects of simulation and video teaching techniques on beta-thalassemia knowledge in pregnant women among junior nursing students at Kasem Bundit University. The sample group was 3rd year nursing students, Faculty of Nursing, Kasem Bundit University, who enrolled in the course of Maternal and Newborn Nursing and Midwifery Practicum 2, academic year 2022. Fifty - four 3rd year of nursing students were selected by purposive sampling. Research instruments included simulation and knowledge videos about a high-risk couple of Hb E- and beta-thalassemia traits. Data collection instruments were a personal information data form and a beta - halassemia knowledge test with content validity and reliability at .86 and .80, respectively. Data were analyzed by using descriptive statistics and the paired sample t-test.

The results revealed that the mean score of beta - thalassemia knowledge among participants after the experiment significantly increased before the experiment (p-value < .001). This result indicated that using simulation and video teaching techniques based on the principles of Bloom’s Taxonomy resulted in improving nursing students’ learning and knowledge. Simulations and video teaching techniques can be applied to other courses to effectively improve nursing clinical skills.

Development of a Health Assessment Model, Health Perception and Health Behavior Assessment from Lanna Folk Wisdom in the Next Normal Era

Mujjalin Pangsiri — 2023-12-28

The advanced mixed method studies employed a sequential and dominant approach in mixed methods research to explore factors influencing health-enhancing behaviors and health perceptions. This study focused on health perceptions and behaviors derived from Lanna folk wisdom, employed by a model’s expert assessment. The research targeted a sample with data collected from 295 participants through questionnaires and group discussions with an empowerment approach. Data analysis utilized descriptive statistics and stepwise multiple regression analysis.

The findings indicated that health-enhancing behaviors derived from Lanna folk wisdom were moderate (Mean = 2.59, SD = .16). Self-efficacy, health perceptions, perception of practice benefits, education, and income could collectively be predicted for 46.80% (R² = .468). These insights informed the development of a health assessment tool comprising 4 components, namely a health screening system, enhancement of health perceptions, network partners, and promoting Lanna folk wisdom. The model underwent expert evaluation to confirm its suitability, emphasizing its potential utilization and feasibility for implementation.

Resilience and the Process of Building Resilience of Nursing Students Private University in Bangkok

Narudee Chonlachatbodee — 2023-12-28

This mixed methods research aimed to study resilience and the process of building resilience in the lives of first-year nursing students at a private university in Bangkok. 85 nursing students were selected for quantitative data, and 20 nursing students for qualitative data. Research instruments included an assessment of resilience, with Cronbach’s alpha coefficient for reliability at .85, and semi-structured interviews, with content validity at .73. Quantitative data were analyzed by statistics and qualitative data were analyzed by content analysis.

The results revealed that the overall resilience score of nursing students was at a high level, with a mean score of 123.81 (SD = 11.51). The highest score was ‘I am’ and its mean score was 45.20 (SD = 3.74), followed by the mean score of ‘I have’ which was 39.52 (SD = 3.98), and the mean score of ‘I can’ was 39.14 (SD = 3.84). Moreover, the process of building resilience was made from the resilience components of “I am” including love for others, knowing your worth, having hopes for success, having a good job, and supporting your family, together with building resilience for “I have” meaning people inside and outside the family who supported, helped, encouraged, advised, corrected, warned, and forgave me when I made mistakes, and “I can” showing the ability to solve problems, deal with emotions, and remain tactful in waiting for the right moment to solve the problems. This study indicated that there should be programs or activities to develop resilience for nursing students.

Prototype Development for Fixation and Protection of Endotracheal Tube

Pornsawan Khitka — 2023-12-28

This research aimed to develop and evaluate the quality of a prototype for endotracheal tube fixation and protection. The samples of 36 registered nurses were selected for the study. Research instruments consisted of a semi-structured interview form, a time recording form, a quality evaluation questionnaire, the fixation and protection endotracheal tube devices, and a manikin. These instruments were tested by using the item objective congruence, which was .50 - 1.00. The reliability was tested by using Cronbach's alpha coefficient, which was .82. Data were analyzed using descriptive statistics and a one-way repeated-measures ANOVA.

The study’s findings revealed that applying a twill or plaster to fix the endotracheal tube was inconvenient and increased the risk of irritation or pressure ulcers. Also, applying an oropharyngeal airway raised the risk of aspiration. Consequently, the researchers developed a prototype device made from plastic materials that is convenient and safe. This prototype was tested and evaluated for quality. The overall quality was good. The items with the highest average scores were convenience of mouth care (Mean = 3.20, SD = .62, suitability for the oral cavity (Mean = 3.10, SD = .55), and simplicity of use (Mean = 3.10, SD = .62). Furthermore, time for device replacement process was significantly faster than using twill and plaster. (F = 217.386, p-value = .000) This study concluded that the prototype can be used for fixing and protecting the endotracheal tube.