Journal of Public Health Nursing

Effectiveness of an Intensive Lifestyle Modification Program among Patients with Type 2 Diabetes at Thasae Hospital

Bhumtapat Mayusiri — 2025-12-29

This quasi-experimental research aimed to evaluate the effectiveness of an intensive lifestyle modification program on glycemic control, medication reduction, and medication discontinuation among patients with type 2 diabetes. Additionally, the study compared patient satisfaction between the intensive program and routine care. The sample consisted of 80 patients with type 2 diabetes, equally divided into an experimental group (n = 40) and a comparison group (n = 40). Research instruments included the intensive lifestyle modification protocol, health record forms, and questionnaires assessing self-care behaviors and patient satisfaction. Health outcomes were evaluated through physical measurements and laboratory blood tests. Data were analyzed using descriptive statistics, Chi-square test, Independent t-test and Paired sample t-test.

The results revealed that after completion of the intensive program, the experimental group demonstrated significant improvements in self-care behaviors (p-value < 0.05). Body Mass Index (BMI), waist circumference, and glycated hemoglobin (HbA1c) were significantly decreased compared to pre-intervention levels (p-value < 0.05). Furthermore, the experimental group shows significantly greater improvements than the control group across all clinical variables. Notably, 55.0% of participants in the experimental group achieved optimal glycemic control, while 15.0% reduced diabetes medication use and 10.0% discontinued medication, proportions substantially higher than those observed in the routine care group. Participants in the experimental group also reported significantly higher satisfaction levels than those receiving routine care (p = 0.021). These findings suggest that integrating an intensive lifestyle modification program into standard clinical practice and health policy may enhance the quality of diabetes care.

Factors Associated with Blood Glucose Control among Employees of the Metropolitan Electricity Authority, Samsen Hospital, Bangkok

THITIRAT JUHONG — 2025-12-29

Diabetes mellitus is continuously increasing. Patients who cannot control their blood glucose are at risk of complications. This cross-sectional study aims to evaluate blood glucose control and determine its associated factors. The samples comprise 260 Metropolitan Electricity Authority employees with type 2 diabetes mellitus receiving treatment at the Metropolitan Electricity Authority Hospital, Samsen, Bangkok, randomly selected using a systematic sampling method. Data was collected through interviews adhering to research ethics. Data were analyzed using percentages, means, standard deviations, and Chi-square tests.

The results revealed that the respondents had an uncontrolled blood glucose level (HbA1C>7) at 75.4%, with an average duration of diabetes of 8.0 years, an average body mass index (BMI) of 27.7 kg/m2, 44.6% exceeding the normal waist circumference criteria, 39.6% had blood pressure ≥140/90 mmHg, 86.5% had comorbidities, 25.8% experienced complications, 58.5% used 3-4 drug groups combination therapy for diabetes, 52.3% faced occupational hazards, and 60.4% experienced work-related stress. 62.7% of the respondents demonstrated a low to moderate level of overall self-management regarding blood sugar control, while 93.8% of them held an overall perception of diabetes patient care services at a good level.

Factors significantly associated with blood glucose control (P<0.05) included diabetes-related complications, medication usage for diabetes treatment, and self-management practices in goal-setting. Therefore, promoting the establishment of specific and clear health goals is essential, as both clinical and behavioral factors significantly influence health outcomes among state enterprise employees with type 2 diabetes.

E-cigarette Use Prevention Model for University Students at Kamphaeng Phet Rajabhat University

Ketkal Thipthimeong — 2025-12-29

The prevalence of e-cigarette use among university students is increasing, posing both short- and long-term health risks. This mixed-methods research aimed to examine the current situation and factors associated with e-cigarette use among students at Kamphaeng Phet Rajabhat University, as well as to develop and evaluate a model for preventing e-cigarette use. The population consisted of students from all academic years across 5 faculties, totaling 4,618 people. The qualitative sample included 16 participants selected using snowball sampling, while the quantitative sample consisted of 355 students determined using the Krejcie and Morgan formula and selected through stratified random sampling. Research instruments included semi-structured interview guides and questionnaires that were validated for content validity and reliability by three experts. Qualitative data were analyzed using thematic analysis, whereas quantitative data were analyzed using descriptive statistics, logistic regression, and paired t-tests.

The research findings revealed that most students perceived e-cigarettes as harmless, were easily accessible through online channels, were influenced by peers, and lacked adequate knowledge regarding health consequences. Significant factors associated with e-cigarette use included peer invitation (OR = 5.12), having friends who use e-cigarettes (OR = 1.21), a history of conventional cigarette smoking (OR = 2.19), positive attitudes toward e-cigarette use (OR = 2.12), and easy accessibility to e-cigarettes (OR = 1.89). Based on these findings, a preventive model comprising five core components was developed: 1) Knowledge Empowerment, 2) Peer Group Engagement, 3) Risk Reduction & Regulation, 4) University Policy & Participation, and 5) Lesson Learned. This model was symbolically named the KPRUL Model. Expert evaluation rated the model at the highest level of appropriateness (mean = 4.51, SD = 0.61). Furthermore, implementation with 156 students demonstrated significant increase in mean knowledge and attitude scores after participation (p < 0.05). These results suggest that the KPRUL Model is effective in preventing e-cigarette use among university students and should be promoted for broader implementation in other educational institutions.

The Development of a Post Anesthetic Continuous Care Model in Post-Operative Neurosurgical Patients

kanjana Tainil — 2025-12-29

Post-anesthesia complications represent a critical patient safety concern in neurosurgical care, and nurses play an essential role in ensuring safe postoperative outcomes for neurosurgical patients. When patients receive appropriate and continuous nursing care, the risk of adverse events and postoperative complications can be significantly reduced. This research and development study aimed to develop a post-anesthesia continuous care model for postoperative neurosurgical patients. The study was conducted in three phases. Phase 1: a situational analysis of post-anesthesia care for neurosurgical patients through in-depth interviews with six multidisciplinary team members. Phase 2: the development of a post-anesthesia continuous care model using focus group discussions with nine multidisciplinary team members. Phase 3: evaluation of the effectiveness and appropriateness of the model through implementation by 15 professional nurses caring for 451 postoperative neurosurgical patients. The research instruments, developed by the researchers, included guiding questions for in-depth interviews and focus group discussions. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument was used to assess the appropriateness of the model. Data were analyzed using descriptive statistics and content analysis.

The results showed that Phase 1 identified four key components of continuous post-anesthesia care for neurosurgical patients: 1) the experience of multidisciplinary team members; 2) preparation of nurse anesthetists prior to patient handover; 3) monitoring and supervision processes to ensure complete and accurate transfer of patient care information among healthcare teams; and 4) effective communication between nurse anesthetists transferring patients and professional nurses receiving patients. Phase 2 revealed that the developed post-anesthesia continuous care model involved both nurse anesthetists and professional nurses across three stages: pre-transfer, during transfer, and post-transfer. Phase 3 demonstrated that following implementation of the model with 451 patients, no adverse events were reported. Nurses evaluated the model as having a high level of appropriateness. Nursing practices guided by the developed model enhanced the efficiency of care delivery and improved patient safety in postoperative neurosurgical care.

Effects of Home Visit Guidelines for Postpartum Mothers with Substance Use and Their Infants on Nursing Service Efficiency and Satisfaction of Registered Nurses in Primary Care Units

Thanyaporn samantarat — 2025-12-29

The number of postpartum mothers with substance use has continued to increase annually. However, a specific and standardized care guideline remains lacking, resulting in discontinuity of care when patients are discharged from hospitals back into the community. This research was a quasi-experimental, one-group pretest–posttest design. The objectives were to compare the mean scores of nursing service efficiency in primary care units before and after the implementation of home visit guidelines for postpartum mothers with substance use and their infants, and to assess the satisfaction of registered nurses in primary care units regarding the use of these guidelines. The sample consisted of 20 professional nurses working in primary care units who were responsible for postpartum mothers and infants in the community. The research instruments included: 1) Intervention tools, comprising 1.1) Home visit guideline for postpartum mothers with substance use and their infants, consisting of a mother and an infant section; 1.2) Postpartum home visit feedback form. 2) Data collection instruments, consisting of 2.1) a demographic questionnaire for professional nurses; 2.2) a nursing service effectiveness assessment tool; and 2.3) a nurse satisfaction questionnaire regarding the guideline. Data were collected over a six-month period (January 1 to July 1, 2025) across 12 subdistricts in Mueang Satun District, Thailand. Data analysis was conducted using descriptive statistics and t-tests to compare pre- and post-intervention mean scores.

The findings revealed that the mean score of nursing service effeciency in primary care settings after implementation of the home visit guideline for postpartum visits to substance use mothers and infants was significantly higher than before implementation (p < .05). Furthermore, professional nurses reported a high level of satisfaction with the use of the guideline.

The Effects of a Home Visit and Telephone Follow-up Program on Blood Pressure, Health Behaviors, and Health Beliefs among Community-Dwelling Patients with Hypertension

Paradee Chaonarin — 2025-12-29

The quasi-experimental study with a one-group pretest-posttest design aimed to evaluate the effects of a home visit program combined with telephone follow-up on blood pressure levels, health behaviors, and health beliefs among patients with hypertension in a community in Thawi Watthana district, Bangkok. The study included 30 participants diagnosed with hypertension and receiving pharmacological treatment. The intervention was implemented over a 12-week period. Research instruments included the home visit and telephone follow-up program, blood pressure monitoring device, health belief questionnaire, and health behavior questionnaire developed based on the Health Belief Model concept. The instruments demonstrated content validity of 0.95 and 0.93, with Cronbach's alpha coefficients of 0.71 and 0.72, respectively. Data were analyzed using descriptive statistics, and t-test.

The results showed that mean systolic and diastolic blood pressure significantly decreased after the intervention, from 138.60 to 134.47 mmHg (p < .001) and from 83.5 to 80.4 mmHg (p = .007), respectively. Mean scores of health belief and health behaviors significantly increased after the intervention, from 79.87 to 84.73 scores, and from 44.53 to 48.73 scores, respectively (p < .001). These findings indicate that home visit programs combined with telephone follow-up are effective in enhancing health beliefs and health behaviors, thereby improving blood pressure control among patients with hypertension. Such interventions may play an important role in reducing the risk of stroke, a major complication of hypertension, in community settings.