Kuakarun Journal of Nursing

Effect of the Supportive-Educative Nursing Program on Phlebitis Occurrence among Cancer Patients Receiving Chemotherapy

Tulyakhorn Vorakitticharoon — 2024-06-26

This quasi-experimental research, with a two-group posttest design, aimed to investigate the effect of the Supportive-Educative Nursing (SEN) program on the occurrence of phlebitis among thirty-eight cancer patients receiving chemotherapy at a university hospital. The participants were divided equally into a control group (n = 19) receiving routine care and an experimental group (n = 19) receiving routine care and participating in the SEN program. The research instruments comprised 1) the SEN program based on Orem's concept, 2) a chemotherapy-induced phlebitis severity scale, and 3) a chemotherapy-induced phlebitis occurrence record form with an inter-rater reliability of .88. Data were analyzed using descriptive statistics, the chi-square test, and the Fisher’s exact test.

The results revealed that the percentage of chemotherapy-induced phlebitis occurrence and the grade of chemotherapy-induced phlebitis severity at 24 hours, 48 hours, and 72 hours after receiving chemotherapy for the experimental group was significantly lower than that of the control group, at a p-value of .01 and .05 respectively. These findings support that the SEN program can enhance self-care for preventing phlebitis and reducing its severity among cancer patients receiving chemotherapy. Therefore, this SEN program can be integrated with routine care to prevent phlebitis among cancer patients receiving chemotherapy.

Factors Predicting Postoperative Complication in Patients with Ruptured Cerebral Aneurysms

Atchara Srinukul — 2024-06-26

This cross-sectional descriptive research aimed to determine the factors predicting intraoperative status, comorbidity, and leukocytosis in postoperative complications in the 72 hours after surgery among adults with ruptured cerebral aneurysms at an intensive care unit in tertiary care. The samples in this study were 112 patients. The pathological physiology framework was used. Research instruments included demographic data, history of treatment, Surgical Apgar Score, The Charlson co - morbidity index, and complications in postoperative 72 hours record form with Person separation reliability .80 were collected from the patient’s medical record. Data were analyzed using descriptive statistics and binary logistic regression.

The findings found that patients with moderate to severe comorbidities were 13.73 (OR = 13.73, 95%CI [1.378, 136.698], p-value = .026) times more likely to have complications within 72 hours of surgery than those without comorbidities (χ² = 6.70, p-value = .01, sensitivity = 2.60%, specificity = 45.90%, positive predictive value = 100%, negative predictive value = 75.60%). These results can be integrated to develop guidelines for screening the risks of postoperative complications. In addition, the management and correction of comorbidities before surgery in patients with ruptured cerebral aneurysms are needed to reduce the incidence of complications after surgery.

The Prevalence and Factors Influencing the Occurrence of Anemia among Pregnant Women Attending Prenatal Care for the First Time at Mae Sot Hospital in Tak Province

Wilai Prangthong — 2024-06-26

This cross-sectional descriptive research aimed to investigate the prevalence and factors associated with anemia in pregnant women who received prenatal care services for the first time at Mae Sot Hospital, Tak Province. A sample group of 508 women was selected from medical records and hospital databases using data recording forms. General obstetrics and outcome data were included. Content validity was verified at .90 Data were collected between October 1, 2021, to September 30, 2022. Descriptive statistics were employed for data analysis, and relationships between factors were compared using the Chi-square test. Predictive factors were identified through Multiple Logistic Regression analysis.

The study’s results revealed that an anemia prevalence was 26.18% (133 out of the total pregnant women). The normal body mass index was a factor that reduced the risk of anemia. (OR = .49; 95%CI .31 - .78, p-value = .002). Factors that increased the risk of anemia including prenatal care for more than 12 weeks of pregnancy (OR = 3.63; 95%CI 2.33 - 5.64, p-value < .001) and being a carrier of thalassemia (OR = 3.02; 95%CI 1.96 - 4.65, p-value < .001). Recommendations from the results were that nurses in an antenatal care department should develop strategies to encourage pregnant women to avail antenatal services before the 12th week of pregnancy. Simultaneously, they should focus on promoting nutritional status that aligns with the specified criteria to decrease the likelihood of anemia during pregnancy.

Factors Predicting Subjective Career Success among Nurses in Hospitals under the Medical Service Department, Bangkok Metropolitan Administration

Natthawat Wongchan — 2024-06-26

This predictive research aimed to study the level of subjective career success and factors predicting subjective career success among nurses in hospitals under the Medical Service Department, Bangkok Metropolitan Administration. The study sample consisted of 265 nurses working in hospitals under the Medical Services Department of the Bangkok Metropolitan Administration. The research instruments consisted of the Perceived Career Success Scale, the Big Five Inventory, and the Survey of Perceived Organizational Support, of which the Cronbach’s alpha coefficients were .94, .89, and .83, respectively. Data were analyzed using descriptive statistics and inferential statistics with stepwise regression analyses.

The results revealed that nurses perceived a high level of overall subjective career success. The perceived organizational support (β = .537, p-value < .001), open-to-experience personality (β = .165, p-value = .001), and extraversion personality (β = .125, p-value = .012) together predicted the subjective career success of the sample at 40.20%. The perceived organizational support was the best predictor. Nursing administrators can use the study findings to promote nurses' subjective career success by providing support from the organization and developing the open-minded and extrovert personalities of nurses.

Development Practice Guideline of Hypertension Patients for Chronic Kidney Disease Prevention

Suchat Dumdol — 2024-06-28

This participatory action research aimed to develop a guideline for hypertension care approaches following the concept of expanded chronic care. The study was organized into three phases: 1) situational analysis to inform planning, 2) implementation of the plan with observation, and 3) reflection on the outcomes. The study sample consisted of 10 public health personnel and 218 patients with stage 2 and 3 chronic kidney disease-caused hypertension. Research tools included a health behavior questionnaire (index of item objective congruence: IOC ranged .63 - 1.00, Alpha coefficient = .87) and focus group interviews (IOC ranged .63 - 1.00). Data were analyzed using qualitative content analysis and quantitative methods, including the t-test and Repeated Measurement ANCOVA.

The findings revealed that the care approach improved kidney filtration rates by 43.60% in some patients, while 49.50% maintained their baseline levels. This approach incorporated three key elements: 1) community engagement, 2) integrated healthcare services with a patient-centered focus, and 3) monitoring treatment outcomes through a database tracking health behavior and kidney filtration rates. Effective patient care strategies should involve data integration to inform all stakeholders enabling individualized health management. Continuous monitoring and care by specialized healthcare teams are recommended to sustain patient health.

Factors Predicting Health Behaviors of Adults after Coronavirus 2019 Infection

Angkana Kamrak — 2024-06-28

This predictive correlation research design aimed to examine factors predicting the health behaviors of adults after the Coronavirus 2019 infection. The sample group was adults aged 18 - 59, diagnosed with Coronavirus 2019 for over a year. 131 patients received services at King Chulalongkorn Memorial Hospital, The Thai Red Cross Society. Instruments comprised a Personal Data Record Form, an Illness Record Form, a Health Behavior Questionnaire, and a Health Perception Questionnaire. The content validity index of Health Behavior Questionnaire and Health Perception Questionnaire were at .99, and the Cronbach's alpha coefficient were at .82 and .81, respectively. Data were analyzed using Pearson’s product - moment correlation coefficient and stepwise multiple regression analysis.

The research results were as follows: Adults after the Coronavirus 2019 infection had high - level health behaviors. The score of health behaviors ranged from 128 - 167 (Mean = 153.32, SD = 6.71). Perceived benefits and perceived self - efficacy could predict health behaviors of adults after the Coronavirus 2019 infection at 16.30 percent (R² = .163, p-value < .05). These results suggest that nurses should have guidelines for promoting health behaviors to adults who had been infected with the 2019 coronavirus, this is in order to maintain good health behaviors continuously.

Factors Predicting Nurses’ Compliance with Early Warning Sign Guideline

Putthachat Jaigad — 2024-06-29

This predictive correlational research aimed to examine predicting factors of nurses’ compliance with the early warning sign (EWS) guideline. The sample consisted of 290 professional nurses who were purposively selected. Data were collected using a questionnaire that consisted of 6 sections: 1) personal information, 2) characteristics of the EWS guideline, 3) knowledge of deteriorating patient assessment, 4) attitude towards the EWS guideline, 5) organizational support, and 6) nurses’ compliance with the EWS guideline. Content validity indexes of 6 sections were .80 - 1.00. The Cronbach’s alpha coefficient of 2 - 6 sections were .90, .18, .80, .90, and .90, respectively. Data were analyzed using descriptive statistics, Spearman’s rank correlation, and multiple regression analysis.

The results showed that all five predictive factors could explain nurses’ compliance with the EWS guideline 12.70% with statistical significance (R² = .127, p-value < .05). The factors that significantly predicted nurses’ compliance with the EWS guideline were characteristics of the EWS guideline (b = .172, p-value < .05), and organizational support (b = .126, p-value < .05). It is suggested that nurse administrators should train and support the use of the EWS guideline for nurses, as well as assess nurses’ attitudes towards implementing the EWS guideline in patient care.

Effects of Simulation-Based Learning to Clinical Judgement Abilities among Nursing Students in Child and Adolescent Nursing Practicum Course

Witchuta Muksing — 2024-06-29

This quasi-experimental research, with a one-group pretest and posttest design, aimed to compare the clinical judgment abilities of nursing students using virtual simulations in the child and adolescent nursing practicum course. The sample comprised 64 third-year nursing students who studied in the child and adolescent nursing practicum course and were purposively selected. The participants received teaching the simulation-based learning with 3 scenarios. Data were collected by the Thai version of the Lasater clinical judgment rubric (LCJR). The reliability of the Cronbach’s alpha coefficient was at .92. Data were analyzed by descriptive statistics and paired t-test statistics.

The result showed that after teaching the simulation-based learning, most nursing students' clinical judgment were the proficiency levels, which were higher than before received teaching, in particular that were the developing levels. The clinical decision-making among nursing students was statistically and significantly higher than before teaching with simulation-based learning (Mean difference: 8.19, 95%CI: -6.62, p-value < .01). The average score of the student ability in the clinical judgment passed the criteria of 70.00 percent was 71.88 percent. These findings indicated that the simulation-based learning could increase nursing student’s abilities and clinical judgment in nursing practice; therefore, it should be applied to other contents and courses to enhance clinical nursing skills effectively.

A Study of Occupational Health and Safety Hazards among Stretcher Personnel at Vajira Hospital

Chotirot Thonotue — 2024-06-29

This descriptive research aimed to identify occupational health and safety hazards, to study the association between occupational health and safety hazards and work-related injuries and to recommend preventative and control measures among stretcher personnel at Vajira Hospital. The sample consisted of 60 participants with purposive sampling. Data were collected using 2 parts of the interview form developed by the researchers: part 1: the personal information form and part 2: the occupational health and safety risk information form. The content validation with the index of item object congruence (IOC) was .99, and the reliability was tested using Cronbach’s alpha coefficient, which was .96. Data were analyzed using descriptive statistics and the chi-square statistic.

The results revealed that stretcher personnel had the highest ergonomics hazard. The main reason for injuries or pain was over-exertion in lifting the patients 83.30%. In the association test, it was found that for those who over-exertion to lift the patients, the number of people moving with inappropriate and working with the same posture repeatedly were statistically and significantly associated with injuries or pain in the lower back (p-value < .05). Therefore, risk assessments should be conducted to evaluate the risk level of occupational health and safety hazards. Additionally, the occupational health and safety guidelines should be created to ensure that stretcher personnel will work in safe and healthy environments.

The Evaluation of the Life Quality Development Project “Well - Being Center” Boromarajonani College of Nursing Chiang Mai

Somporn Sitthisongkram — 2024-06-29

The aim of this study was to evaluate the efficacy of the “Well - Being Center” project in improving the students’ quality of life. The sample was selected through a purposive sampling method. Interviews were conducted with 24 people, including both personnel and students. The quantitative data collected from 24 students who utilized the services and students who enrolled in academic years 2020 and 2021 was 609 and 595, respectively. The instruments utilized include project interview question guidelines, service satisfaction surveys, client satisfaction surveys, and mental health questionnaires sourced from the Department of Mental Health. The project interview questions have a content validity coefficient of .85. The reliability coefficients for the service and client satisfaction questionnaires were .87 and .82, respectively. The qualitative data was examined using content analysis. The quantitative data was analyzed using descriptive statistics.

The results revealed that: 1) context evaluation: the project structure was aligned with both stakeholder needs and the institution’s policy. 2) input evaluation: the institution provided assistance in facilitating the project’s implementation. The project implementers possessed the requisite knowledge and proficiency to execute a wide range of operations. 3) process evaluation: the planning process was explicit and aligned with the project objectives, resulting in effective implementation. 4) product evaluation: students reported a significant improvement in their quality of life and were extremely satisfied with the services provided. Staff members demonstrated increased confidence in their ability to provide counseling services to students. Based on the study's findings, it is advised that the project be structured consistently.

The Needs of Patients with Chronic Kidney Disease Undergoing Continuous Ambulatory Peritoneal Dialysis

Sukrutai Chimchat — 2024-06-30

The purposes of survey research were to assess and prioritize the needs of patients with chronic kidney disease undergoing continuous ambulatory peritoneal dialysis. The sample was 109 patients who received services at King Narai Hospital, and simple random sampling was used. The research instrument was a questionnaire on the needs of patients with chronic kidney disease undergoing continuous ambulatory peritoneal dialysis with a 5-level rating scale. Content validity was 1.00 (IOC = 1.00), and Cronbach’s alpha coefficient was .84 ( = .84). Data were analyzed using mean, percentage, and modified priority needs index.

The results showed that the overall needs of patients with chronic kidney disease receiving continuous ambulatory peritoneal dialysis were at the highest level. The top three needs were 1) psychosocial and economic dimension (PNI_modified = .08) 2) spiritual dimension (PNI_modified = .05) and 3) physiology dimension (PNI_modified = .04). The top three item needs were 1) home visits from a healthcare provider (PNI_modified = .18) 2) adequate assistance with wound dressing equipment and medical masks (PNI_modified = .15) and 3) performing the same patient’s roles for their family before receiving continuous ambulatory peritoneal dialysis (PNI_modified = .14). These results recommended that healthcare providers should be encouraged to make more home visits, increase the allocation of adequate peritoneal dialysis equipment, and promote self-efficacy in performing the patient’s role before receiving continuous ambulatory peritoneal dialysis.

Effects of the Empowerment Program on Knowledge and Skills for Caregivers of Stroke Patients

Supalak Jaiboon — 2024-06-30

This study was a quasi-experimental research, single-group pretest-posttest design, aimed at comparing the knowledge and skills of caregivers before and after receiving an empowerment program. It also tracked the occurrence of complications in caregivers of discharged stroke patients. The sample comprised 27 caregivers of a newly admitted stroke patient at Fang Hospital, Chiang Mai Province, who were selected through purposive criteria. Data collection tools included caregiver knowledge assessment, caregiver skills assessment, and post-discharge complication incidence recording. The content validity index was 1, and the reliability coefficients for knowledge and skills assessments were .72 and .74, respectively. Descriptive statistics, Repeated Measures ANOVA, and Bonferroni post hoc tests were used for analysis.

The results found that the mean knowledge score and skill score of caregivers after receiving the program on discharge day and 14 days post-discharge were significantly higher than before, with a p-value < .001 No complications were observed in any of the stroke patients after discharge, including pressure sores, pneumonia, and urinary tract infections. Therefore, this program can enhance caregiver performance in caring for stroke patients and prevent post-discharge complications.

Quality of life among Palliative Care Patients and Caregiver Burden of Cancer and Non-Cancer Patients in Laksi District, Bangkok

Pirin Nichachotesalid — 2024-06-30

This cross-sectional descriptive study aimed to compare the quality of life (QOL) of palliative care patients with cancer and non-cancer, consisting of 53 patients and caregiver burden (CGB) with 53 caregivers in Laksi district, Bangkok. The sample was recruited by purposive sampling. Research instruments were a socio-demographic form, the WHOQOL-BREF-THAI, and the Zarit-Caregiver Burden Scale in Thai. The reliability was assessed by calculating Chronbach’s alpha coefficient, which resulted in .94 and .77, respectively. Data were analyzed using descriptive statistics and the Mann-Whitney U-test.

The findings found that a total of fifty-three palliative care patients had an overall QOL at a moderate level (Median = 75.00, IQR = 26 and Median = 87.50, IQR = 44, p-value < .05). When analyzing each dimension, it showed that the physical dimension of the QOL with cancer and non-cancer patients had a statistically significant difference (p-value < .05). Additionally, the CGB of cancer and non-cancer patients was at a moderate to high level (Median = 45.00, IQR = 17 and Median = 54.00, IQR = 21) and had a statistically significant difference (p-value < .05). The findings of this study can be essential information for healthcare providers to promote quality of life and mitigate CGB for both cancer and non-cancer patients, comprehensively.

The Roles of Community Nurses in Prevention Health of Population from Particulate Matter with Diameter of Less Than 2.5 Micron (PM 2.5)

Puttaporn Onkhamsee — 2024-06-30

This academic article aimed to provide essential knowledge about particulate matter with a diameter of less than 2.5 micrometers (PM 2.5) causing irritation of the eyes, nose, and respiratory tract, and leading to cardiovascular diseases. It is a significant public health issue and impacts the economy both domestically and globally.

The roles of community nurses in preventing PM 2.5 exposure and offering preventive measures to the public and at - risk groups. PM 2.5 affects several adverse respiratory, cardiovascular, and dermatological health outcomes. This phenomenon particularly affects vulnerable groups, including infants, young children, pregnant women, older persons, and individuals with pre - existing medical conditions. Thus, by enhancing awareness and prevention among the general population and at-risk groups, individuals will gain the necessary knowledge and understanding to avoid issues caused by PM 2.5, empowering them to prevent potential illnesses. However, the prevention of PM 2.5 should start at the primary level, which requires the involvement of community nurses working in primary healthcare facilities and being closely connected to the community. Their roles include being healthcare providers, educators, patient advocates, managers, coordinators, researchers, change agents, and health promoters, with the goals of equipping the public with the knowledge and understanding needed to prevent issues related to PM 2.5 and enabling them to use this knowledge to foster self-care practices and adapt their health behaviors accordingly.

Role of Nurses in Managing Sepsis Survivors

Napat Rattanahongsa — 2024-06-30

Nowadays, the number of post-sepsis survivors after sepsis has increased; as a result, many survivors suffer complications due to physical and psychological effects and social limitations from surviving crises, hospitalization, and the length of recovery affecting disability, dependence, and long-term care following hospital discharge. These affect health-related quality of life. Nurses play the crucial role in managing complications with physical, mental, and social function assessments, such as assessment of health and physical performance, mental health assessment, and the ability to return to social activities and daily life. Educating post-sepsis survivors on appropriate physical practices and rehabilitation, including promoting nutritional status since hospitalization, can prevent the potential occurrence of impacts.

Therefore, this article aimed to provide nurses with an understanding of various aspects of post-sepsis impact and to promote the roles of nurses in caring, assisting, rehabilitating, and managing side effects in post-sepsis survivors from crisis in the survival stage and hospital stay, which is the rehabilitation phase before discharge, as well as appropriate and effective discharge planning guidelines.