A Study of Creating Nurses’ Working Culture in Health Promotion, Tertiary Hospitals

Main Article Content

Patcharin Choksawat
Yupin Aungsuroch


          The purpose of this research was to study a creating nurses’ working culture in health promotion in tertiary hospitals. The Delphi technique was used in this study. Participants were 21 experts, including 6 experts with research or working experience related to health promotion, 6 nursing administrators of tertiary hospitals, 4 nursing instructors, and 5 heads of health promotion agency in tertiary hospitals. The Delphi technique consisted of 3 steps. Step 1: Experts were interviewed about creating nurses’ working culture in health promotion, tertiary hospitals. Step 2: Data from step 1 were analyzed using content analysis. Then, the rating scale questionnaire on sub-elements in each item were created. All items in the questionnaire were rated by all 21 experts. Step 3: Data were analyzed using median and interquartile range. Then, the questionnaire with the median and interquartile range of each item was sent to the same experts for their confirmation. Data were analyzed again using median and interquartile range to summarize a creating nurses’ working culture in health promotion, tertiary hospitals.
            According to research, the study of creating nurses’ working culture in health promotion, tertiary hospitals, had 6 main components with a total of 47 items: 1) Determination of health promotion values (7 items), 2) Supporting health promotion from multidisciplinary (4 items), 3) Communication of health promotion values (10 items), 4) Determination of working behavior in health promotion (12 items), 5) Strengthening working behavior in health promotion (7 items), and 6) Creating continuity of working in health promotion (7 items).


Download data is not yet available.

Article Details

Research Article
Author Biographies

Patcharin Choksawat, Faculty of Nursing, Chulalongkorn University

Student in Master of Nursing Science Program, Faculty of Nursing, Chulalongkorn University, Bangkok

Yupin Aungsuroch, Faculty of Nursing, Chulalongkorn University

Faculty of Nursing, Chulalongkorn University, Bangkok


1. Strategy and Planning Division Office of the Permanent Secretary. Twenty-year national strategic plan for public health 2018. [Internet]. [cited 2019 July 3]. Available from: (in Thai).

2. National Health Development Plan Committee Ministry of Public Health. National health development plan no. 12 2017. [Internet]. [cited 2019 July 3]. Available from: http://bps.moph.go.th/new_bps/sites/default/files/HealthPlan12_2560_2564.pdf. (in Thai).

3. Wongkongkam K, Nakagasien P. Factors associated with health promotion competencies of professional nurses in the Central Region of Thailand. Journal of Nursing Science 2016;34(2):102-16. (in Thai).

4. Thiangchanya P, Petpichetchian W. Health promotion nursing guideline in health facilities, Primary level, Secondary level, and Tertiary level. Nonthaburi: Mata printing; 2017. (in Thai).

5. Nursing Division Ministry of Public Health. Nursing standards in hospitals. 3rd ed. Bangkok: Affairs Office Printing War Veterans; 2008. (in Thai).

6. Ekasilp N, Prasomsuk S, Mattavangkul C, Seemanee S. Course documents for teaching 170-344, Community Health Nursing, Faculty of Nursing, Siam University, Chapter 1: Public Health Service System. [Internet]. [cited 2018 May 9]. Available from: https://goo.gl/.hzSFSe. (in Thai).

7. Nantsupawat A, Sathapornpat P. Competency and roles of health promotion among nurses in tertiary hospitals. Journal of The Royal Thai Army Nurses 2017;18(1):222-9. (in Thai).

8. Thampanichawat W, Klayklongji S, Wongwuttisaroj N. Role performance of professional nurses in health promotion in Central Region. Journal of The Royal Thai Army Nurses 2016;17(1):54-62. (in Thai).

9. Graham R, Boyko JA, Sibbald SL. Health promoting hospitals in Canada: a proud past, an uncertain future. Clin Health Promot 2014;4(2):71-5.

10. Thai Health Promotion Foundation. Develop a learning center - nursing innovation to promote health. [Internet]. [cited 2018 May 9]. Available from: http://www.thaihealth.or.th/. Content/37000-พัฒนาศูนย์เรียนรู้-นวัตกรรมพยาบาล%20เพื่อสร้างเสริมสุขภาพ%20.html. (in Thai).

11. Chatthong N. Context Thailand government to step into an innovative organization. Journal of Information 2018;17(1):25-36. (in Thai).

12. Kemppainen V, Tossavainen K, Turunen H. Nurses' roles in health promotion practice: an integrative review. Health Promotion International 2013;28(4):490-501.

13. Sriyanalak N. Nursing administration. Bangkok: Tana Press; 2014. (in Thai).

14. Kurepan O, Tridech P, Puntdee W. Organizational commitment of professional nurses in a private hospital. Journal of Boromarajonani College of Nursing, Bangkok 2013; 29(2):10-9. (in Thai).

15. His-Chi H, Jen-Chia C, Ya-Ling T. The influence of hospital organizational culture on organizational commitment among nursing executives. Afr J Bus Manage 2012;6(44):10888-95.

16. Towne SD, Anderson KE, Smith ML, Dahlke DV, Kellstedt D, Purcell NP, et al. Changing organizational culture: using the CEO cancer gold standard policy initiatives to promote health and wellness at a school of public health. BMC Public Health 2015;15(1):853.

17. Sotthibandhu A. Strategic transformation to practice. [Internet]. [cited 2018 April 30]. Available from: http://uto.moph.go.th/strategy/source/planing/data/11-12_sep_49/ dr.aran/yutasart.pdf. (in Thai).

18. Nantanawijit S. Creating culture to excellence. Productivity World 2008;13(74):18-24. (in Thai).

19. Meechat W. Public organization behavior. 3rd ed. Bangkok: Chulalongkorn University Printing House; 2013. (in Thai).

20. Robbins SP, Judge TA. Essentials of organization behavior. 13th ed. England: Pearson Education; 2016.

21. Phunlapthawee K. Statistics for research. Bangkok: Physicscenter; 1996. (in Thai).

22. Witthaya-anumas K. Delphi research: techniques and problems found in research. Bangkok: Rung Rueang San Printing; 1987. (in Thai).

23. Linstone HA, Turoff M. The Delphi method: techniques and application. Massachusetts: Addison-Wesky Publishing; 1975.

24. Sngounsiritham U. Management for creating safety culture in nursing service. Nursing Journal 2011;38(3):168-77. (in Thai).

25. Ratanasuwan W, Eamsamai S. The development of the knowledge management culture promotion model for nursing colleges under the Jurisdiction of Praboromarajchanok Institute, Ministry of Public Health, Thailand. Nursing Journal of the Ministry of Public Health 2013;23(2):65-78. (in Thai).

26. Nakagasien P. Ottawa charter: the role of the nurses in health promotion. Journal of Nursing Science 2015;33(4):6-14. (in Thai).

27. Sukaram S, Nimit-arnun N, Roojanavech S. The effects of multidisciplinary collaborative care program on depressive prevention amongst diabetic mellitus type 2 patients at a secondary level hospital in Phetchaburi Province. Journal of The Royal Thai Army Nurses 2018;19:251-61. (in Thai).

28. Attamana S. Behavior: applied theory. Bangkok: Thammasat University Press; 1998.
(in Thai).

29. Luo Y, Shenkar O. The multinational corporation as a multilingual community: language and organization in a global context. Journal of International Business Studies 2006;37(3):321-39.

30. Sukglun A, Suttapong K, Yuangyai N. Corporate communications strategy to create a strong organizational culture. Modern Management Journal 2018;16(1):75-82. (in Thai).

31. Feng X, Bobay K, Weiss M. Patient safety culture in nursing: a dimensional concept analysis. J Adv Nurs 2008;63(3):310-9.

32. Irvine D, Leatt P, Evans MG, Baker RG. Measurement of staff empowerment within health service organizations. Journal of Nursing Measurement 1999;7(1):79-96.

33. Inkoom J, Saleewan N, Phakkaew N, Junpha M, Prommine A, Gludkaew A, et al. Factors relating to job satisfaction of nurses working at the HRH Princess Maha Chakri Sirindhorn Medical Center. Thai Pharmaceutical and Health Science Journal 2009;4(4):517-23. (in Thai).

34. Panjinda W, Choocherd P. Achieving a holistic approach in stroke rehabilitation. APHEIT Journals 2016;5(2):70-8. (in Thai).

35. Pilalai T. Searching and decoding best practice 2018. [Internet]. [cited 2019 July 3]. Available from: http://www.med.nu.ac.th/fom/th/nuhoffice/file_document/555_นพ.ทรนง%20พิราลัย%20. (in Thai).

36. Rienrungrote S. Emergency nurses' cultural diversity nursing practice in Southern Thailand and its related factors. [Master’s Thesis, Faculty of Nursing]. Prince of Songkla University; 2016. (in Thai).

37. Pookboonmee R. Role of nursing in Thailand 4.0 era 2017. [Internet]. [cited 2019 July 4]. Available from: https://med.mahidol.ac.th/ramachannel/home/article/บทบาทหน้าที่ของพยาบาล. (in Thai).

38. Bhumisirikul P, Anumas P, Jarusinchai C, Phanpradit O. Effect of implementing computerized perioperative nursing record program on quality of nursing records in surgical operating unit. Ramathibodi Medical Journal 2013;19(2):249-63. (in Thai).

39. Skinner BF. About behaviorism. New York: Vintage books; 1974.

40. Lamkar U, Kasatpibal N, Chitreecheur J. Effect of prevention of infection reinforcement among healthcare: personnel on incidence of surgical site infection in caesarean section. Nursing Journal 2012;39(4):85-96. (in Thai).

41. Bureau of Information office of the Permanent Secretary of MOPH. Family doctor clinic, community health center 2017. [Internet]. [cited 2019 July 5]. Available from: https://www.thaihealth.or.th/Content/38391. (in Thai).

42. Sammer CE, Lykens K, Singh KP, Mains DA, Lackan NA. What is patient safety culture? a review of the literature. J Nurs Scholarsh 2010;42(2):156-65.