JOURNAL OF THE POLICE NURSES AND HEALTH SCIENCE

Editorial Note

Editorial Board Journal of The Police Nurses and Health Science — 2025-12-31

WITHERING RESPIRATION PM2.5: PERCEPTIONS OF HEALTH IMPACTS AND EXPERIENCES OF COPING AMONG OLDER ADULTS LIVING IN MARGINALIZED MEKONG RIVERSIDE COMMUNITIES

Nadhamon Jompaeng — 2025-12-14

This qualitative research study examined the perceptions of health impacts and experiences of coping with PM2.5 dust among older adults living in marginalized communities along the Mekong River. Participants were purposively selected based on specific criteria: aged over 60 years, residing in Nakhon Phanom Municipality for more than one year, and able to speak and communicate in Thai. A total of 28 participants were recruited. Data were collected through in-depth interviews using a semi-structured interview guide and analyzed using thematic analysis.

The study revealed that older adults’s perceptions of health impacts of PM2.5 dust comprised three main themes: 1) Functional health literacy: perception and understanding of PM2.5 hazards through direct experience; 2) Interactive health literacy: self-management and communication amid uncertainty; and 3) Critical health literacy: analytical thinking ability but with gaps in support systems. In terms of coping experiences, elderly participants employed two main management strategies: 1) Proactive adaptation to confront hazardous dust exposure, and 2) Achieving life balance through the power of community networks.

The findings from this study provide foundational data for the development of air pollution management policies that account for the specific contexts of marginalized border communities, particularly areas along the Mekong River facing transboundary pollution.

A STUDY OF THE ROLES OF HEALTH UTILIZATION MANAGEMENT NURSES UNDER THE JURISDICTION OF THE OFFICE OF PERMANENT SECRETARY, MINISTRY OF PUBLIC HEALTH

Rinrada Vannavijit — 2025-12-14

This descriptive research aimed to explore the roles of nurses in health utilization management (UM) within units under the Office of the Permanent Secretary, Ministry of Public Health, using the Delphi technique. The participants consisted of 20 experts, divided into 5 groups: 1) Three policymakers from the Ministry of Public Health and the Bureau of Nursing, 2) Four directors or financial administrators of public hospitals, 3) Five heads of health insurance departments in public hospitals, 4) Three nursing instructors with experience in teaching health utilization management, and 5) Five practicing health UM nurses from the public sector. Data collection was conducted in three rounds: In-depth interviews were conducted with experts regarding the roles and sub-roles of UM nurses in various settings in the first round, including those working in Provincial Public Health Offices, Regional/General Hospitals, and Community Hospitals. Then, in the second round, interview data were analyzed using content analysis to develop a questionnaire, which was then used to assess the perceived importance of each role. Median values and interquartile ranges were calculated. Finally, a revised questionnaire was distributed for expert validation in the third round. Responses were used to recalculate medians and interquartile ranges, leading to a consensus on the defined roles.

The results revealed six major roles of health UM nurses under the jurisdiction of the Office of the Permanent Secretary, Ministry of Public Health: 1) Advocate for patients’ rights and benefits, 2) Health insurance data manager, 3) Coordinator, 4) Health resource utilization auditor, 5) Health resource analyst, and 6) Case manager. Although health UM nurses across all levels shared these six core roles, their responsibilities varied by work setting: 1) At Provincial Public Health Offices, health UM nurses primarily function at the policy level, setting strategic directions, overseeing provincial health resource management, and conducting systems-level data analysis and inter-network coordination. 2) In Regional and General Hospitals, health UM nurses manage hospital-wide service delivery systems, oversee complex case management, act as central coordinators for health insurance data, and facilitate continuity of care across healthcare levels. 3) In Community Hospitals, health UM nurses emphasize direct patient care, ensuring efficient use of health resources, collaborating with local communities, and protecting patients’ rights and benefits at the primary care level.

These findings can inform the development of competency-based curricula and professional role guidelines for health UM nurses within the Office of the Permanent Secretary, Ministry of Public Health. They also provide useful insights for nursing and hospital administrators to better support health UM nurses in performing these designated roles effectively and consistently.

DEVELOPMENT AND IMPLEMENTATION OF A PRACTICE PROTOCOL FOR BEREAVEMENT CARE FOR FAMILIES OF PEDIATRIC PATIENTS RECEIVING PALLIATIVE CARE

Phawinee Piwngam — 2025-12-20

This research and development study aimed to develop and implement a practice guideline for bereavement care for families of pediatric patients who had received palliative care. The sample was selected using purposive sampling, including 43 family members of deceased pediatric patients who had entered the palliative care system at the Pediatric Nursing Department, Faculty of Medicine Ramathibodi Hospital, Mahidol University. The research instruments included the bereavement care practice guideline for families of pediatric patients, the Brief Grief Questionnaire (BGQ), and a satisfaction questionnaire. The reliability of BGQ measured by Cronbach’s alpha was .75. Data were analyzed using descriptive statistics and the Wilcoxon Signed-Rank test.

The findings indicated that: 1) The developed practice guideline for bereavement care of families of pediatric patients receiving palliative care demonstrated a content validity index (CVI) ranging from .87 to 1.00 and was considered both clinically appropriate and feasible, yielding outcomes aligned with its intended objectives; 2) Follow-up assessments of BGQ scores among participating family members showed a significantly decrease over time, with scores at 2 weeks, 6 weeks, and 6 months post-loss demonstrating statistical significance at the .05 level (Mdn_{2nd weeks} = 4.00, Mdn_{6th weeks} = 3.00 and Mdn_{6th months}= 1.00, respectively; p = .000); and 3) Overall satisfaction with the bereavement care received over the 6-month period was reported at the highest level (M = 4.72, SD = .29).

COMPLICATIONS WITHIN THE FIRST 72 HOURS AFTER OPEN-HEART SURGERY AND ASSOCIATED FACTORS: A TWO-YEAR RETROSPECTIVE COHORT STUDY

Teepatad Chintapanyakun — 2025-12-20

The purpose of this retrospective cohort study was to explore the relationship and factors influencing postoperative complications among patients undergoing open-heart surgery within the first 72 hours. The sample consisted of 345 patients who had undergone open-heart surgery and were admitted to the intensive care unit (ICU) at Ramathibodi Hospital, Mahidol University, between January 1, 2019, and December 31, 2020. Participants were selected using simple random sampling. Data collection instruments included record forms comprising 1) demographic information, 2) comorbidities, and 3) postoperative complications occurring within the first 72 hours after surgery. Data were analyzed using descriptive statistics, Pearson’s product-moment correlation, and hierarchical multiple regression analysis.

The results revealed that the three most common complications among patients undergoing open-heart surgery within the first 72 hours were cardiac arrhythmias (90.72%), myocardial damage (75.94%), and acute kidney injury (50.14%, respectively. Age, comorbidities, New York Heart Association (NYHA) functional classification, cardiopulmonary bypass (CPB) times, and aortic cross-clamp time were moderately positively correlated with complications within the first 72 hours (r = .492, r = .472, r = .375, r = .413, and r = .357, respectively; p < .05). In contrast, left ventricular ejection fraction (LVEF) was moderately negatively correlated with complications (r = -.350, p < .05). Additionally, age, comorbidities, NYHA classification, LVEF, CPB time, and aortic cross-clamp time significantly predicted postoperative complications within the first 72 hours, accounting for 41.3% of the variance (R² = .413, p < .05).

These findings suggest that critical care nurses providing postoperative care for cardiac surgery patients can develop nursing care plans based on preoperative and intraoperative clinical data to prevent potential early complications following open-heart surgery in the ICU setting.

THE EFFECTIVENESS OF A DATE-BASED ENERGY GEL ON BLOOD GLUCOSE LEVELS, FATIGUE, AND HEART RATE IN INDIVIDUALS WITH HIGH ENERGY DEMANDS

Chomphunut Singmanee — 2025-12-23

This quasi-experimental study aimed to compare the effectiveness of a date-based energy gel (Date Gel) with that of a commercial energy gel with similar properties (Commercial Gel) on blood glucose levels, perceived fatigue, and heart rate in healthy adults engaging in exercise. A total of 30 healthy individuals who regularly exercised by running participated in this randomized crossover study. Each participant consumed both types of gels in separate sessions, spaced 7 days apart. Outcomes were assessed at baseline, during a 30-minute exercise session, and post-exercise for each gel condition. Data were analyzed using descriptive statistics and repeated-measures ANOVA.

The results showed that during the sessions when participants consumed the Date Gel, their blood glucose levels, fatigue, and heart rates were elevated, similar to the sessions when the Commercial Gel was used. However, there were no statistically significant differences between the two gels in terms of fatigue or heart rate (p > .05). Notably, the Date Gel tended to produce a slightly greater increase in blood glucose levels compared to the Commercial Gel. Both gels were effective in elevating and maintaining blood glucose throughout the 30-minute exercise period until the session ended.

These findings suggest that the Date Gel can help sustain blood glucose levels during exercise comparably to the Commercial Gel, with no significant differences in its effects on fatigue and heart rate. Therefore, the Date Gel may serve as a viable alternative for individuals who engage in prolonged physical activity and require consistent energy support.

THE EFFECT OF JOINT ATTENTION WITH WEB APPLICATION AND FAMILY INVOLVEMENT PROGRAM ON SOCIAL COMMUNICATION SKILLS IN PRESCHOOL-AGE CHILDREN WITH AUTISTIC SPECTRUM DISORDER

Jutamat Thumchaloemchaisakun — 2025-12-29

This study employed a quasi-experimental two-group repeated measures design. The objectives were to compare the social communication skills of experimental group for preschool-aged children with autistic spectrum disorder (ASD) at three time points, before the intervention, after intervention, and two weeks post-intervention, and to compare the social communication skills between the experimental and control groups. The sample consisted of 40 children, aged 3 - 6 years, who had been diagnosed with ASD by physicians according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and were receiving inpatient services at Rajanukul Institute along with their families. The experimental group received a joint attention program integrated with a web application and family involvement, in addition to routine nursing care, while the control group received only routine nursing care. Research instruments included: 1) A joint attention program incorporating a web application and family participation, comprising six activities over three weeks (two sessions per week, each lasting 60 - 90 minutes); 2) The Social Communication Checklist; and 3) The Joint Attention Protocol. Data were analyzed using Repeated Measures ANOVA and planned comparisons, with statistical significance level at .05.

The results indicated that preschool-aged children with ASD in the experimental group had significantly higher social communication skill scores immediately after intervention and two weeks post-intervention compared to their pre-intervention scores (p < .05). Additionally, their scores at both post-intervention time points were significantly higher than those of the control group (p < .05).

The findings of this study indicate that the joint attention program with web application and family involvement can enhance social communication skills in preschool-aged children with ASD.
The program is therefore recommended for implementation in early childhood development centers or specialized service centers for children with special needs.

EFFECTS OF SELF-ESTEEM IMPROVEMENT PROGRAM ON DEPRESSION OF THE ELDERLY WITH CHRONIC DISEASES IN COMMUNITY

Patsara Weerapong — 2025-12-29

This study employed a quasi-experimental research, two group pretest–posttest with follow-up design. The objectives were to compare the mean self-esteem and depression scores before the intervention, immediately after the intervention, and at a 2-week follow-up, among community-dwelling older adults with chronic diseases. Participants were divided into two groups: one received a self-esteem improvement program in addition to routine care, while the other received routine nursing care only. The sample consisted of elderly individuals aged 60 - 69 years in Nakhon Nayok Province, who had been diagnosed with hypertension and/or diabetes mellitus and exhibited mild to moderate depression. Participants were recruited by simple random sampling into 27 participants per group. The research instrument was the self-esteem improvement program, conducted over a six-week period. Data collection tools included: 1) The Thai Geriatric Depression Scale, with a content validity index (CVI) of .83 and a Kuder-Richardson 20 (KR20) reliability coefficient of .83, and 2) The Self-Esteem Scale, with a CVI of .84 and a KR21 of .77. Data were analyzed using the descriptive statistics, t-test, and repeated measures ANOVA. The level of statistical significance was set at .05.

The results showed that the experimental group had significantly higher mean self-esteem scores across all three time points (pretest, posttest, and follow-up) (p < .05), and significantly higher scores than the comparison group (p < .05). Additionally, their mean depression scores decreased significantly across the same time points (p < .05), and were also significantly lower than those of the comparison group (p < .05).

In conclusion, the self-esteem improvement program can be employed as a mental health promotion strategy for community-dwelling older adults among chronic diseases and depression.

THE EFFECTS OF A SELF-EFFICACY ENHANCEMENT PROGRAM ON PERCEIVED SELF-EFFICACY AMONG CAREGIVERS OF OLDER ADULTS WITH MILD TRAUMATIC BRAIN INJURIES

Rattiya Chupanya — 2025-12-23

This quasi-experimental study aimed to 1) compare the mean perceived self-efficacy scores of caregivers in the experimental group before and after participating in a self-efficacy enhancement program, and 2) compare the post-intervention perceived self-efficacy scores between the experimental group and the control group, which received standard nursing care. The sample consisted of 42 caregivers of older adults with mild traumatic brain injury, divided into two groups: 21 in the experimental group and 21 in the control group. The control group received standard nursing care, while the experimental group participated in a two-week caregiver self-efficacy enhancement program. The research instruments included: the caregiver self-efficacy enhancement program, which comprised four components-knowledge provision, vicarious learning, skill practice, and verbal encouragement; and a perceived self-efficacy assessment tool for caregivers of older adults with mild traumatic brain injury demonstrated good overall reliability, with a Cronbach’s alpha coefficient of .86. Data were analyzed using frequency, minimum, maximum, percentage, mean, standard deviation, Paired t-test, and Independent t-test.

The results showed that caregivers in the experimental group who received the self-efficacy enhancement program had significantly higher mean self-efficacy scores post-intervention compared to pre-intervention (M = 140.57, SD = 8.61 and M = 50.52, SD = 20.31; t = -20.74, p = .000). The experimental group's mean self-efficacy score was also significantly higher than the control group who received standard nursing care (M = 140.57, SD = 8.61 and M = 85.09, SD = 12.34; p = .000).

The caregiver self-efficacy enhancement program was effective in improving perceived self-efficacy among caregivers of older adults with mild traumatic brain injury. It is recommended that this program be implemented in healthcare settings that care for older adults with head injuries to enhance caregiving effectiveness and reduce the risk of post-injury complications.

EFFECTS OF NURSING INTERVENTIONS ON VENOUS PAIN LEVELS IN PATIENTS WITH COLORECTAL CANCER RECEIVING OXALIPLATIN

Aungkana Yota — 2025-12-31

This quasi-experimental study with a two-group posttest design aimed to compare venous pain levels in colorectal cancer patients receiving oxaliplatin between an experimental group, who received a researcher-developed nursing intervention, and a control group, who received routine nursing care. The sample consisted of 40 colorectal cancer patients were selected using simple random samplings from individuals who met the predefined inclusion criteria. All participants were undergoing oxaliplatin treatment at the Chemotherapy Unit, Division of Special Medical Services Nursing, Buddhachinaraj Phitsanulok Hospital, Phitsanulok Province. The participants were evenly assigned to the experimental group (n = 20) and the control group (n = 20). Research instruments included: 1) the nursing intervention developed for colorectal cancer patients receiving oxaliplatin, 2) a demographic and treatment data record form, and 3) the Numerical Rating Scale (NRS) for pain assessment. Descriptive statistics were used to analyze participant characteristics, while repeated measures ANOVA and post hoc tests were used to compare mean venous pain scores between the two groups.

The results indicated that during oxaliplatin infusion, no significant differences in mean pain scores were found between the two groups at the 1st and 2nd hours (p = .489 and .071, respectively). However, at the 3rd hour, the experimental group reported significantly lower mean pain scores compared to the control group (p = .003). In the post-infusion phase, the experimental group also had significantly lower mean pain scores on Day 1 (p = .049), while no statistically significant differences were observed on Day 3 and Day 5 (p = .053 and .640, respectively).

The findings of this study demonstrate that the developed nursing intervention can serve as an effective clinical guideline for managing venous pain in colorectal cancer patients receiving oxaliplatin, both during drug administration and in the post-infusion period.

EFFECTS OF A HEALTH PERCEPTION PROMOTING PROGRAM ON KNOWLEDGE, DIETARY AND EXERCISE BEHAVIOR IN PREGNANT WOMEN WITH GESTATIONAL DIABETES MELLITUS TYPE A1

Patcharavadee Chusong — 2025-12-31

This quasi-experimental study aimed to examine the effects of a Health Perception Promotion Program on knowledge, dietary and exercise behaviors among pregnant women diagnosed with gestational diabetes mellitus class A1. Participants were 48 pregnant women with GDM-A1 who attended the antenatal clinic at Police General Hospital, Bangkok. A purposive sampling method, based on inclusion criteria, was used to recruit participants, who were then allocated into an experimental group (n = 24) and a control group (n = 24). The control group received routine antenatal care, while the experimental group received the Health Perception Promotion Program in addition to routine care. The intervention program were verified for content validity by five experts. The intervention was conducted over four weeks. Research instruments included: 1) A knowledge test on gestational diabetes mellitus (Kuder-Richardson: KR-20 = .78), 2) A dietary behavior questionnaire (Cronbach’s alpha coefficient = .86), and 3) An exercise behavior questionnaire (Cronbach’s alpha coefficient = .93). Data were analyzed using chi-square test, Independent t-test, Wilcoxon signed-rank test, Mann–Whitney U test, Fisher’s exact test, and McNemar’s test.

The results indicated that pregnant women with gestational diabetes mellitus class A1 after the intervention, the experimental group demonstrated significantly higher levels of knowledge regarding gestational diabetes mellitus, as well as improved dietary and exercise behaviors, compared to both their baseline scores and the control group (p < .05).

Therefore, antenatal care nurses and other relevant healthcare personnel can apply the health perception promotion program as part of routine care for pregnant women with gestational diabetes mellitus, class A1.

FACTORS ASSOCIATED WITH RENAL FUNCTION IN RECIPIENTS OF DECEASED-DONOR KIDNEY TRANSPLANTS

Tri Hanprasertpong — 2025-12-31

This retrospective study aimed to examine the relationships between age, body mass index, duration of illness, operative time, number of arterial anastomoses, cold ischemia time, warm ischemia time, time to normalized urination post-surgery, postoperative body weight, glomerular filtration rate, and serum creatinine levels in recipients of deceased-donor kidney transplants. Data were collected from the medical records of 106 recipients who underwent kidney transplantation from deceased donors at Sunpasitthiprasong Hospital, Ubon Ratchathani, between January 2017 and May 2025. A structured data collection form was used, and the data were analyzed using descriptive statistics, and Pearson’s correlation coefficient.

The results revealed that the serum creatinine levels of these recipients were significantly correlated with the following factors: cold ischemia time (r = –.216, p = .027), time to normalized urination after surgery (r = .382, p = .000), postoperative body weight (r = –.302, p = .002), and glomerular filtration rate (r = –.680, p = .000). However, age, body mass index, duration of illness, operative time, number of arterial anastomoses, and warm ischemia time showed no significant association with serum creatinine levels in these patients.

Therefore, healthcare professionals involved in the care of recipients of deceased-donor kidney transplants should place emphasis on both the intraoperative and postoperative phases. During surgery, appropriate management of cold ischemia time should be appropriately controlled. In the postoperative period, it is essential to monitor and maintain urine output within normal ranges, control postoperative body weight appropriately, and regularly assess glomerular filtration rate in order to support a good quality of life for transplant recipients.

STRATEGIES FOR EFFECTIVE UTILIZATION MANAGEMENT: EXPERIENCES OF NURSES AT HEALTH INSURANCE DEPARTMENT IN A REGIONAL HOSPITALS

Pachara Peerapadhanapong — 2025-12-31

This qualitative descriptive study aimed to explore strategies employed by nurses in the Health Insurance Department of a regional hospital to ensure efficient health resource utilization. Twelve professional nurses with a minimum of five years’ experience in the Health Insurance Department of a regional hospital, along with formal training in health resource management, were purposively selected as key informants. Data were collected through in-depth interviews, direct observations, and field notes. Data analysis was conducted using Braun and Clarke’s thematic analysis, and the trustworthiness of the data was ensured following Guba and Lincoln’s criteria.

The findings revealed five key strategies for efficient health resource management by nurses in the Health Insurance Department: 1) Cost analysis to reduce financial risks, where nurses evaluate costs and returns to prevent financial losses from health service delivery; 2) Appropriate budgeting and control, involving the establishment of guidelines to align budget utilization efficiently with organizational goals; 3) Ensuring compliance with fund entitlement standards, where nurses verify that services meet fund requirements to secure appropriate reimbursements; 4) Adapting practices to align with reimbursement criteria, which includes making operational adjustments in accordance with fund regulations and procedures; and 5) Active involvement in service planning and development, where nurses participate in designing new services and improving existing ones to address public needs and optimize resource use.

The findings of this study can be applied to promote the proactive role of nurses in the Health Insurance Department in planning, cost analysis, and resource management under the constraints of benefit schemes. In addition, the results may support hospital administrators in developing service systems and practical guidelines to prepare nurses for future roles.

THE OUTCOMES OF MANAGEMENT FOR PATIENTS WITH SEPSIS AND SEPTIC SHOCK IN THE EMERGENCY ACCIDENT AND FORENSIC UNIT AT SAWANGWEERAWONG HOSPITAL: A 12-MONTH RETROSPECTIVE COHORT STUDY

Narknoi Nontawee — 2025-12-31

This retrospective cohort study aimed to examine the outcomes of management for patients with sepsis and septic shock in the Emergency Accident and Forensic Unit at Sawangweerawong Hospital. The sample consisted of 40 patients with sepsis and septic shock who received care in this unit. Participants were selected using purposive selection. The research instrument was a data recording form that included personal information, treatment received, process outcomes, and treatment outcomes. Data were analyzed using descriptive statistics, a one-sample t-test, and the Wilcoxon signed-rank test.

The research findings revealed that: 1) For the process outcomes, the mean time for patient assessment and screening by registered nurses was 17.35 minutes (SD = 5.05), and the mean time to diagnosis by physicians was 41.88 minutes (SD = 25.93). Both durations were significantly longer than the 15-minute standard set by the Ministry of Public Health, with statistical significance at the .05 level (p = .005 and p = .000, respectively). The median time from diagnosis to antibiotic administration was 27.50 minutes (IQR = 10.00 - 53.75), which was significantly shorter than the Ministry’s 60-minute standard, also with statistical significance at the .05 level (p = .016). Additionally, the mean volume of intravenous fluids administered within the first 3 hours for patients without contraindications was 695.75 mL (SD = 468.25), significantly lower than the recommended 1,500 mL, with statistical significance at the .05 level (p = .000). 2) Treatment outcomes showed that 77.50% of patients were admitted to the general ward. The average length of hospital stay was 4.85 days (SD = 3.14), and the average cost of treatment was 10,277.16 bath (SD = 4,891.25).

DEVELOPMENT OF A SERVICES SYSTEM FOR IMPOVERISHED BEDBOUND PATIENTS IN THE BANGKOK AREA

Phitchayuth Kritrattanachot — 2025-12-31

This mixed-methods study aimed to: 1) assess the development level of service systems for impoverished bedridden patients, service innovations, standards of care, service policies, and stakeholder participation; 2) examine the influence of service innovations, standards of care, service policies, and stakeholder participation on the development of these service systems; and 3) propose strategic guidelines for service system improvement. The quantitative phase involved 350 bedridden patients selected through multistage random sampling. Data were analyzed using descriptive statistics, structural equation modeling (SEM), and path analysis. The qualitative phase consisted of in-depth interviews with 15 informants selected through purposive selection, with data analyzed through content analysis.

The results revealed that: 1) The highest mean score was for the development of service systems for impoverished bedridden patients, followed by standards of care, service policy, service innovation, and stakeholder participation, respectively. 2) The SEM model showed good fit with the empirical data (Chi-square = 70.9, df = 44, p = .06, GFI = .99, AGFI = .99, CFI = .99, RMR = .043, RMSEA = .042). Standards of care had the greatest total influence on service system development for impoverished bedridden patients, followed by stakeholder participation, service policy, and service innovation. 3) The proposed development guidelines included: 3.1) expanding service accessibility through mobile health units and centralized data systems; 3.2) applying digital and Internet of Things (IoT) technologies aligned with local community contexts; 3.3) developing and implementing practical, standardized care protocols; 3.4) ensuring sustained policy and budgetary integration; and 3.5) fostering multisectoral and community-wide engagement to build equitable, inclusive, and sustainable care systems.

A STUDY OF COMPETENCY OF NURSES IN A GENERAL INTENSIVE CARE UNIT BASED ON CAREER LADDER, MID-LEVEL REFERRAL HOSPITALS

Sunee Yeesoon — 2025-12-31

This descriptive study aimed to explore the competencies of nurses working in general intensive care units (GICUs) based on the career ladder in M2-level secondary hospitals, using the Delphi technique. A total of 23 experts were selected from six professional groups: three critical care physicians, three GICU management experts, three nursing administration experts, three academic experts, seven critical care nursing specialists, and four advanced practice nurses. Data were collected in three rounds. In Round 1, experts were interviewed regarding the competencies of GICU nurses at three levels: operational, proficient, and expert. In Round 2, the interview data were analyzed to develop a questionnaire used to assess the importance of each competency. Median and interquartile ranges were calculated. In Round 3, experts reviewed and confirmed their opinions using the revised questionnaire, and the median and interquartile ranges were re-analyzed to finalize the findings.

The findings revealed seven core competencies for GICU nurses in M2-level secondary hospitals: 1) critical care nursing, 2) high-alert medication management, 3) communication and coordination for patient care, 4) complication prevention and management, 5) end-of-life care for critically ill patients, 6) utilization of medical devices and health informatics, and 7) quality management and care control. While these core competencies were consistent across all nursing levels, differences were observed in sub-competencies: 1) Operational-level nurses focused on basic care under the supervision of experienced nurses or preceptors; 2) Proficient-level nurses applied in-depth knowledge to manage complex cases and collaborated effectively within multidisciplinary teams; and 3) Expert-level nurses were capable of managing highly complex cases, resolving urgent problems, and advancing nursing practices through evidence-based approaches.

These findings can serve as a conceptual framework for developing competency-based performance assessment tools aligned with career ladder levels. Furthermore, nursing administrators may use these results to guide workforce planning and task allocation based on the competencies of nurses at each professional level.

THE DEVELOPMENT OF AN ENHANCED RECOVERY AFTER SURGERY PROGRAM FOR PATIENTS UNDERGOING HIP INTERNAL FIXATION AT DETUDOM CROWN PRINCE HOSPITAL

Chantip Buawat — 2025-12-31

This research and development study aimed to develop an Enhanced Recovery After Surgery (ERAS) program for patients undergoing hip internal fixation and to compare clinical and hospital outcomes between the experimental and control groups. The sample consisted of 62 patients with hip fractures who underwent internal fixation surgery in the orthopedic ward of Detudom Crown Prince Hospital. Participants were purposively selected and divided into two groups: 31 patients in the experimental group who received the ERAS program and 31 patients in the control group who received standard nursing care. Research instruments included the ERAS program for hip internal fixation surgery, a personal and treatment information questionnaire, a pain assessment form, and a hip range of motion (ROM) recording sheet. Data were analyzed using descriptive statistics and the Mann-Whitney U test.

The findings were as follows: 1) The ERAS program for patients undergoing hip internal fixation surgery demonstrated strong content validity, with a content validity index (CVI) ranging from .90 to 1.00, indicating academic soundness and likely safety for implementation. 2) Regarding clinical outcomes, the median pain score at 72 hours postoperatively was significantly lower in the experimental group than in the control group (p < .05). Although pain scores at 24 and 48 postoperative hours differed between groups, the differences were not statistically significant. The experimental group also showed significantly greater hip ROM-flexion, extension, and abduction-compared to the control group (p < .05). 3) In terms of hospital outcomes, the median length of stay and hospitalization costs were significantly lower in the experimental group compared to the control group (p < .05).

THE INFLUENCE OF SELF-ESTEEM AND SELF-CONTROL ON ELECTRONIC CIGARETTE SMOKING AVOIDANCE BEHAVIOR AMONG LOWER SECONDARY SCHOOL STUDENTS IN SONGKHLA MUNICIPALITY

Kedsirin Phuphet — 2025-12-31

This predictive research aimed to examine the influence of self-esteem and self-control on electronic cigarette smoking avoidance behavior among lower secondary school students. The sample consisted of 443 lower secondary school students from four schools in Songkhla Municipality, selected using a multi-stage sampling method. The research instruments included a self-esteem scale, a self-control scale, and an electronic cigarette smoking avoidance behavior scale. The reliability of the instruments, as measured by Cronbach’s alpha coefficients, was .77, .87, and .98, respectively. Data were analyzed using descriptive statistics and stepwise multiple regression analysis.

The results revealed that students reported high levels of self-esteem (M = 3.26, SD = .40) and self-control (M = 3.37, SD = .39), while electronic cigarette smoking avoidance behavior was at the highest level (M = 3.56, SD = .44). Multiple regression analysis indicated that both self-esteem (Beta = .51) and self-control (Beta = .27) significantly influenced electronic cigarette smoking avoidance behavior at the .05 level. Together, these variables explained 52.0% of the variance in smoking avoidance behavior (R²Adjusted = .52, p = .001).

These findings suggest that self-esteem and self-control are important protective factors in preventing electronic cigarette use among lower secondary school students. The results can be applied to the planning and implementation of life skills enhancement activities that focus on strengthening students’ self-esteem and self-control. Furthermore, the findings provide fundamental evidence for the development of school guidance curricula and preventive measures aimed at reducing the initiation and continuation of electronic cigarette use among adolescents.

Editorial Board