The Southern College Network Journal of Nursing and Public Health

Developing an Educational Model for Sustainable Primary Health Care System

Sat, 13 Dec 2025 00:00:00 +0700

Primary Health Care (PHC) serves as the foundation for achieving sustainable and equitable health systems. This study aims to Direction, Policy and Vision of the Praboromarajchanok Institute, the driving mechanism of "5 Excellences" strategic linkages develop an educational model that aligns with the Sustainable Development Goals (SDGs), particularly Goal 3 (Good Health and Well-being), Goal 4 (Quality Education), Goal 5 (Gender Equality), Goal 10 (Reduced Inequalities), and Goal 17 (Partnerships for the Goals). Policy and practice analysis revealed that developing an education system for sustainable PHC requires integration across four key dimensions: (1) curriculum integration that reflects community health contexts and equity principles; (2) place-based learning to strengthen local health understanding; (3) the use of digital health technologies to enhance accessibility and reduce disparities; and (4) the establishment of strong multi-sectoral partnerships among academic institutions, government agencies, private sectors, and communities under the “Partnership for SDGs” framework. The proposed model contributes to the development of competent and socially responsible health professionals who can effectively drive primary health care toward achieving sustainable national health goals.

Coaching: Concepts, Benefits, and the Promotion of Coaching in Nursing Organizations

Natthawat Wongchan, Saranya Pimolkatekul, Primpiriya Jindawan — Tue, 02 Dec 2025 00:00:00 +0700

In the era of rapid transformation in healthcare service systems, nursing organizations require effective tools to drive personnel toward excellence. The coaching approach, although unscientific, may serve as a mean to develop nurses’ potential, strengthen their leadership, and therefore enhance the quality of patient care. This article aims to present the concept of coaching and describe its benefits within the nursing profession, including its applications in nursing practice, nursing education, leadership development, and the preparation of novice nurses. In addition, it proposes strategies for promoting coaching within nursing organizations, encouraging nurse administrators to choose coaching as a tool develop nursing competencies, foster organizational commitment, support nurse retention, and ultimately advance the nursing profession to adapt confidently to ongoing changes in the modern healthcare context.

Servant Leadership of Nursing College Administrators under the Jurisdiction of Faculty of Nursing Praboromarajchanok Institute, Ministry of Public Health

Ruja Kaeomaungfang, Vorakarn Suksodkiew — Sun, 23 Nov 2025 00:00:00 +0700

This mixed-methods research aimed to (1) examine the components of servant leadership among administrators in nursing colleges under the Faculty of Nursing, Praboromarajchanok Institute, Ministry of Public Health, and (2) validate these components. The study sample consisted of 28 nursing colleges affiliated with the Faculty of Nursing, Praboromarajchanok Institute, Ministry of Public Health. Sixteen informants were selected from each college, yielding a total of 448 participants. Research instruments included a semi-structured interview guide, a perception questionnaire, and a confirmatory component questionnaire. Data were analyzed using frequency, percentage, mean, standard deviation, and exploratory factor analysis. The findings revealed that:

1. Servant leadership among the nursing college administrators comprised five components: (1) leadership in nursing education management, (2) emphasis on individuality, (3) dedication and self-sacrifice, (4) morality and ethics, and (5) leadership in community service. Together, these five components with 58 indicators explained 65.52% of the total variance, with eigenvalues of 27.00, 23.93, 9.12, 5.99, and 5.53, respectively.

2. The results of the confirmatory analysis showed complete agreement among five experts (100%) regarding the accuracy, appropriateness, feasibility, and usefulness of the five identified components of servant leadership among the nursing college administrators.

Therefore, the identified components and indicators of servant leadership can be applied to promote servant leadership among administrators, which in turn may enhance organizational effectiveness.

The Effects of an Online Motivational Enhancement Therapy Program on Drinking Behavior among Patients with Alcohol Use Disorder

Kanlaya Namnorin, Hunsa Sethabouppha, Chalinee Suvanayos — Sun, 23 Nov 2025 00:00:00 +0700

This quasi-experimental research aimed to examine the effects of an online motivational enhancement therapy (MET) program on drinking behaviors among patients with alcohol use disorder (AUD). The participants were 36 patients diagnosed with AUD who had been discharged after receiving inpatient alcohol treatment at Non Sa-at Hospital, in the Province of Udon Thani. Patients were randomly assigned to either the experimental or control group. The research instruments included 1) an alcohol withdrawal assessment form, 2) a personal information questionnaire, 3) an alcohol drinking behavior assessment form, and 4) the online motivational enhancement therapy program for individuals with AUD. The program consisted of five online therapy sessions, each lasting 30–45 minutes, conducted once a week for five consecutive weeks, with a one-month follow-up assessment. Data were analyzed using descriptive statistics, independent t-tests, and one-way repeated measures ANOVA. The results were as follows.

1. In the experimental group, the mean percentage of non-drinking days—both immediately after the intervention and at the one-month follow-up—was significantly higher than that of the control group receiving routine nursing care (p-value < .001). However, there was no significant difference in the mean percentage of heavy-drinking days between the two groups.

2. Within the experimental group, the mean percentage of heavy-drinking days after the intervention and at the one-month follow-up was significantly lower than before the intervention (p-value < .01), while the mean percentage of non-drinking days was significantly higher (p-value < .001).

These results indicate that the online motivational enhancement therapy program can reduce drinking behaviors among individuals with alcohol use disorder. The results can serve as empirical evidence for developing treatment guidelines and future research to create care models that better address patient needs and align with the current social context.

Nursing Services at a Tertiary Hospital for Outpatients with Hepatitis C: A Time-Driven and Activity-Based Cost Analysis

Nopparat Neamsukonsakool, Phechnoy Singchungchai — Wed, 26 Nov 2025 00:00:00 +0700

This descriptive research aimed to determine and analyze the time-driven activity-based costs of nursing services for patients with hepatitis C in a tertiary hospital’s outpatient department. The studied population, included in the nursing cost report, consisted of 27 nursing personnel and 30 patients with hepatitis C, receiving outpatient services, and selected through purposive sampling. The research instruments comprised two sets, covering nine main nursing activities, with a content validity index (CVI) of 1.00 as well as an observation form reliability coefficient of 0.92. Data were analyzed using descriptive statistics, including frequency, percentage, and mean. The results showed that:

1. The total nursing activity cost based on overall time criteria for 9 main activities is 53,551.82 Baht.

2. The nursing activity costs according to time criteria per activity are as follows: Drug administration verification activity by nurses has the highest cost per activity at 623.40 Baht. Pre-consultation activity has a cost per activity of 509.81 Baht. Administration and support activities have a cost per activity of 296.94 Baht. Nursing activities during examination and consultation have a cost per activity of 105.20 Baht. Nursing health education and infection prevention activities have a cost per activity of 100.45 Baht. Nursing activities during waiting for examination have a cost per activity of 85.62 Baht. Post-examination nursing activities have a cost per activity of 80.17 Baht. Special laboratory testing referral nursing activity has a cost per activity of 49.38 Baht. The HCV card activity has the lowest cost per activity of 41.53 Baht.

3. The total nursing activity cost per patient per visit according to time criteria is 1,784.09 Baht.

This study highlights that time-driven cost analysis provides empirical data that reflect the actual cost of nursing services relative to service duration. Applying time-driven cost management principles in nursing practice is essential to enable healthcare organizations to determine accurate service costs, enhance resource utilization efficiency, and improve precision in management planning. Ultimately, this contributes to more effective and efficient nursing activities and healthcare service delivery for patients.

Consumer Protection among District Public Health Executives: A Study on Perception of Roles and Legal Compliance

Chaiwisut Autthamo, Noppcha Singweratham, Pallop Siewchaisakul — Tue, 02 Dec 2025 00:00:00 +0700

This cross-sectional study aimed to examine the perception of roles, legal compliance, and confidence in consumer protection practices among district public health executives. The objectives were to 1) assess the district public health executives’ perceptions of their legal role and responsibilities, 2) compare levels of both role perception and confidence in performing consumer protection duties, and 3) explore the relationships between perceived roles and confidence in performing consumer protection tasks. The sample consisted of 298 district public health executives selected through multistage sampling. Data were collected using an electronic questionnaire divided in three parts: general information, perception of legal roles and responsibilities, and legal compliance practices. The content validity index of instrument ranged from .67 to 1.00, while its reliability coefficient was at the .73 level. Data were analyzed using descriptive statistics frequency, percentage, mean, and standard deviation and inferential statistics, including independent t-test, one-way ANOVA, and Pearson’s correlation, with a significance level of .05. The results were as follows.

1. The district public health executives had a high level of role perception. However, they had never performed certain duties such as drug destruction under the Drug Act B.E. 2510 (1967). Some officers performed duties beyond their legal authority, such as requesting documentation under the Medical Device Act B.E. 2511 (1968) (12.13%). More importantly, 33.45% of officers did not possess an official identification card as required by law. Most legal operations were carried out in collaboration with other agencies. The officers’ confidence in performing consumer protection tasks was at a moderate level.

2. Factors such as gender, age, length of service, educational level, and regional location showed no significant differences in role perception or confidence in performing consumer protection duties.

3. There was a positive correlation between role perception and confidence in performing legal duties related to consumer protection.

Therefore, it is recommended that the roles and responsibilities among Provincial Public Health Offices, District Public Health Offices, and other relevant agencies be clearly defined. Furthermore, operational manuals and additional trainings should be provided, along with the issuance of official identification cards to all authorized officers in accordance with legal requirements.

Relationships between Health Literacy, Fluid Retention Prevention Behaviors, and Fluid Retention among Patients with Heart Failure, Medical Heart Failure Clinic, Lampang Hospital

Panadda Sawasdee, Kannika Kongbunkird, Anurak Sangchan, Piyawara Kajaree — Tue, 02 Dec 2025 00:00:00 +0700

This descriptive correlational research aimed to examine: 1) the level of health literacy 2) the level of fluid retention prevention behaviors 3) the level of fluid retention, and 4) the relationships among these variables in patients with heart failure. The study included 84 patients attending the Medical Heart Failure Clinic at Lampang hospital between September 2023 and May 2024. Participants were selected through purposive sampling based on specific inclusion criteria. Data were collected using three instrumnets: the Health Literacy Questionnaire, the Fluid Retention Prevention Behaviors questionnaire, and the Fluid Retention Status Assessment Questionnaire. The content validity indices of these instruments were .80, .99, and 1.00, respectively, and the Cronbach’s alpha coefficients were .95, .86, and .90, respectively. Data were analyzed using descriptive statistics and Spearman’s rank correlation. The research results are as follows.

1. Health literacy was predominantly at a high level, including functional health literacy (53.58%), interactive health literacy (51.19%), and critical health literacy (67.86%)

2. Fluid retention prevention behavior was predominantly at a high level (70.20%).

3. Fluid retention was predominantly at a low level (57.14%).

4. Health literacy had a low, statistically significant, positive relationship with fluid retention preventive behaviors (𝑟𝑠 = .27, p-value < .05), and health literacy had a moderate statistically significant, negative relationship with fluid retention (𝑟𝑠 = -.44, p-value < .01).

Therefore, the study confirms that professional nurses should promote health literacy among patients with heart failure to encourage appropriate, effective self-management behaviors and help prevent fluid retention recurrence among patients with heart failure.

Accelerating Malaria Elimination in Conflict-Affected Areas of Southern Thailand : An Operational Model from Yala Province

Pathomporn Prikchoo, Preeyaporn Suida, Panyasiri Junnoi — Tue, 02 Dec 2025 00:00:00 +0700

This mixed-methods study aimed to 1) evaluate the results of malaria elimination activities implemented during 2017 - 2024 in Yala Province, 2) draw lessons learned from program implementation and utilize them to improve future programming. The study was conducted in three steps. These were 1) extracting and analyzing output and impact data from the malaria information system managed by the Division of Vector Borne Diseases (DVBD), 2) utilizing DVBD’s questionnaires and conducting a quantitative survey among 558 participants in five districts where activities have been implemented, to obtain outcome level results on malaria knowledge and preventive behaviors, and 3) conducting semi-structured interviews with public health officials and focus group discussion with relevant community partners on the inputs and processes. The outputs, outcomes and impact data were measured against the indicators and targets set by the Department of Disease Control. Data were analyzed using descriptive statistics and content analysis.

1. Significant progress toward malaria elimination has been made, most of the important indicators exceeded those of national targets. Patients receiving treatment according to National Treatment Guidelines were at 100%; at-risk population sleeping under insecticide treated net the night before the survey was at 86.70%; and the Annual Parasite Incidence (API) per thousand population decreased from 6.74 in 2017 to 0.12 in 2024. However, Yala has not been able to stop local malaria transmission for 3 years.

2. Lessons learned indicated that public health agencies implemented a case-data feedback strategy, returning malaria case information by village to enhance community awareness and ownership. This fostered collaboration between health authorities and local communities, expanding preventive, diagnostic, and treatment services. Youth Muslim Association communicators worked with community and Islamic religious leaders to convey malaria knowledge in linguistically and culturally appropriate ways, thereby improving health behaviors and participation.

Recommendations are that to improve program performance, relevant health agencies need to establish a two-way open communication channel for timely reporting malaria cases, so to achieve malaria elimination. Responsible public health agencies need to develop future programs planning with local resources.

Opinion and Perspectives of Relevant Personnel on the Roles, Missions, and Organizational Structures of Provincial and District Public Health Offices Following the Transfer of Subdistrict Health Promoting Hospitals to Local Administrative Organizations

Wed, 10 Dec 2025 00:00:00 +0700

This study employed a descriptive research design to explore the perspectives of relevant personnel regarding the roles, functions, and organizational structures of Provincial Public Health Offices (PPHO) and District Public Health Offices (DPHO) following the transfer Sub-district Health Promoting Hospitals (SHPHs) to local administrative organizations (LAOs). The investigation examined three perspectives: (1) self-assessment by PPHO and DPHO, (2) mutual assessment between PPHO and DPHO, and (3) assessment of PPHO and DPHO by regional/general hospitals. The study sample consisted of Provincial Chief Medical Officers, directors of regional and general hospitals, and DPHO personnel nationwide, totaling 752 participants selected through purposive sampling. Data were collected using an electronic questionnaire comprising three sections: general information, perceptions regarding the roles and functions of DPHO, and perceptions regarding the roles and functions of PPHO. The questionnaire demonstrated an index of item-objective congruence ranging from .67 to 1.00 and a reliability coefficient of .73. Data were analyzed using descriptive statistics.

Results indicated that perceptions toward restructuring the roles and functions of PPHO were largely consistent, except for the issue of downsizing and reducing workforce capacity in units previously responsible for SHPHs operations. PPHO and DPHO personnel disagreed with this adjustment, whereas regional/general hospital directors agreed. Regarding DPHO, most participants shared similar views except on issues such as reducing positions to essential ones only, merging DPHOs into district clusters, and integrating DPHO roles under PPHO supervision. PPHO and DPHO personnel opposed these measures, while regional/general hospital directors were supportive.

These findings suggest that structural and managerial reforms of PPHO and DPHO should be considered with a flexible approach, independent of administrative district boundaries. Possible strategies include establishing clusters or merging selected DPHOs with PPHO, adjusting organizational size to match health functions and population health needs rather than geographical areas, thereby enhancing efficiency and responsiveness in public health service delivery.

The Effects of Listening to the Qur’an on Anxiety among Thai Muslim Older Adults before Undergoing Surgery with General Anesthesia

Abdulvaris Tokyusoh, Decha Tamdee, Jittawadee Rhiantong — Wed, 10 Dec 2025 00:00:00 +0700

This experimental research aimed to examine the effects of listening to the Quran on reducing anxiety among Thai older adults of Muslim culture prior to surgery under general anesthesia. The sample consisted of 68 elderly patients scheduled for surgery with general anesthesia. Participants were randomly assigned to either the experimental group or the control group, with 34 participants in each group. The experimental group listened to Quranic recitation from a tablet, through noise-cancelling earbuds, while the control group wore the same headphones without audio and received routine nursing care. Data were collected using 1) a personal and health information record form, and 2) the Thai version of the Spielberger State Anxiety Inventory, which had a reliability coefficient of .94. Data were analyzed using descriptive statistics, independent t-tests, and paired t-tests. The findings were as follows.

1. The experimental group showed a significantly lower mean anxiety score after listening to the Quran compared to before the intervention (p-value < .001).

2. The mean anxiety score in the experimental group was significantly lower than that of the control group (p-value < .001).

These results indicate that quranic recitation can effectively reduces preoperative anxiety among Thai older adults undergoing surgery with general anesthesia, in a Muslim cultural context. Nurses can apply this intervention as part of preoperative nursing care to help alleviate anxiety in this population.

The Effectiveness of a Growth Mindset Promotion Program on Reducing Stress among Undergraduate Students at Kamphaeng Phet Rajabhat University

Sat, 13 Dec 2025 00:00:00 +0700

This one-group repeated measures quasi-experimental design study aimed to compare the stress levels of undergraduate students before, after, and one week following participation in a "growth mindset promotion program". The study also examined pairwise differences in stress levels across the three time points. The participants were 30 undergraduate students at Kamphaeng Phet Rajabhat University who had moderate or higher stress levels and voluntarily participated in the study. The research instruments included: 1) the program, which demonstrated content validity indices ranging from 0.67 to 1.00, and 2) the Perceived stress scale questionnaire with a Cronbach’s alpha coefficient of .82. The total possible scores ranged from 0 to 40, interpreted as low (0–13), moderate (14–26), and high (27–40) stress levels. Data were collected at three time points: before the intervention, immediately after, and one week after program completion. Data were analyzed using descriptive statistics (frequency, percentage, mean, standard deviation, and median), the Friedman test, and the Wilcoxon signed-rank test. Results showed that :

1. Stress scores across the three measurement points differed significantly (c ²= 20.157, df = 2, p-value < .001), with a moderate effect size (Kendall’s W = 0.34). The median stress score decreased from 30.00 (IQR = 10.00) before the intervention to 24.50 (IQR = 9.00) immediately after, and further to 21.00 (IQR = 9.00) at the one-week follow-up.

2. Pairwise comparisons using the Wilcoxon signed-rank test indicated statistically significant reductions in stress across all time points (p-value < .05), with moderate to large effect sizes (r = .39 – .72).

The results indicate that the promotion program was effective in reducing students’ stress levels and that the effect persisted after program completion. The program can be applied to preventive mental health promotion activities for university students and adapted for students in other faculties to broaden its impact.

Development of a Lifestyle-Coaching Model to Prevent Complication among Muslim Older Adults with Type 2 Diabetes in Yala Province

Sureeporn Siriyapan, Prapapen Suwan — Mon, 15 Dec 2025 00:00:00 +0700

This research and development study aimed to investigate the situation, develop a lifestyle-coaching model, and examine its effectiveness for preventing complications among older adults from Muslim communities with type 2 diabetes. Study was divided in three phases. First one was a situation analysis, including a quantitative study among 250 older adults with type 2 diabetes, as well as a qualitative study, using focus group discussions with 35 participants, including 15 older adults with type 2 diabetes, 10 caregivers, and 10 healthcare providers. Quantitative data were analyzed using descriptive statistics, while qualitative data were analyzed using content analysis. The second phase consisted in the development of a lifestyle-coaching model, based on the concept of lifestyle coaching and validated by five experts. Third phase was dedicated to the model implementation and evaluation. The effectiveness of the model was tested using a one-group pretest–posttest quasi-experimental design with 35 older adults, determined through G*Power analysis. Data were analyzed using descriptive statistics and paired t-test. The results showed as follows.

1. The self-care behavior of Thai older adults from Muslim cultural background with type 2 diabetes was at a moderate level. The highest-performing behavior was dietary management (75.20%), followed by medication adherence (40.40%). Qualitative data indicated that lifestyle coaching is a new approach that requires coaching skills, and no prior studies were found on providing coaching services for this population.

2. The developed lifestyle-coaching model emphasized three dynamic components (HBC) that interact continuously and dynamically to promote sustainable behavioral change including health service system (H), behavior changer coaching (B), and communication (C).

3. After implementation, participants showed significantly higher mean scores in self-care behaviors and overall health status compared to before the intervention (p-value < .05). The incidence of diabetes-related complications decreased, and satisfaction with the coaching activities was at the highest level.

This study suggest that the developed model is effective in improving health behaviors and enhancing well-being. It supports the Ministry of Public Health’s strategic plan for reducing and preventing the severity of non-communicable diseases. Therefore model can be expanded to health promotion units across all health regions.

The Effects of a Community Empowerment Program to Promote Self-Care on Ergonomic Self-Care and Severity of Knee Osteoarthritis among Older Rubber Tappers

Sirisuk Chuyen, Patcharee Komjakraphan, Aporntip Buapeth — Mon, 15 Dec 2025 00:00:00 +0700

This quasi-experimental study on osteoarthritis among older rubber tappers aimed to evaluate the effects of a community empowerment program to promote self-care, based on the concept of community empowerment and integrated with Orem’s Self-Care Theory. The sample consisted of 60 purposively selected participants, divided into an experimental group (n = 30) and control group (n = 30). The experimental group received routine care along with a 12-week community empowerment program developed for this study, while the control group received only routine care. Research instruments included the new community empowerment program to promote self-care (IOC = 1), an ergonomic self-care behavior assessment (CVI = .82; reliability = .87), and the Thai version of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (CVI = .77; reliability = .97). Data were analyzed using descriptive statistics frequency, percentage, mean, and standard deviation and t-tests. The results showed as follows.

1. After the intervention, the experimental group demonstrated a statistically significant increase in ergonomic self-care scores (t = 46.33, p-value < .001) and a significant decrease in knee osteoarthritis severity scores (t = 48.08, p-value < .001) compared to baseline.

2. Following the intervention, the experimental group had significantly higher ergonomic self-care scores than the control group (t = 1.03, p-value = .03), and significantly lower knee osteoarthritis severity scores (t = 27.13, p-value < .001).

The findings indicate that the community empowerment program effectively improved ergonomic self-care behaviors and reduced the severity of knee osteoarthritis. Health agencies and community leaders may apply this program to promote health and prevent or delay knee degeneration among older adults engaged in rubber tapping.

Development of Safety Performance Measurement Instrument for Charge Nurses in Tertiary Hospitals

Thu, 18 Dec 2025 00:00:00 +0700

This descriptive research aimed to develop and evaluate the quality of an instrument measuring safety performance among charge nurses in tertiary care hospitals, based on the safety performance framework proposed by Griffin and Neal (2000). The sample consisted of 160 charge nurses working in tertiary care hospitals. Instrument development procedures included a literature review, operational definition formulation, item construction, content validation by experts, and assessment of instrument quality. Data were collected using the newly developed safety performance questionnaire. Content validity yielded a content validity index of .89, and reliability analysis demonstrated a Cronbach’s alpha coefficient of .89. Construct validity was examined through exploratory factor analysis and confirmatory factor analysis.

The results indicated that the developed instrument showed construct validity consistent with the theoretical framework and empirical data. The confirmatory factor analysis demonstrated an excellent model fit (χ²= 2.63, df = 34, p-value = 1.00, RMSEA = 0.00). The instrument comprised two major components: (1) Compliance with safety requirements (4 indicators) and (2) Participation in safety-related activities (6 indicators), with factor loadings ranging from 0.78 to 0.85, meeting acceptable criteria.

This study highlights the importance of a psychometrically sound instrument for assessing safety performance among charge nurses. Such an instrument can support nurse administrators in evaluating safety practices and enhancing patient safety systems within healthcare services.

Effects of a Breastfeeding Promotion Program for Primigravida Women on Knowledge, Attitudes, Subjective Norms, Perceived Behavioral Control, and Intention for Exclusive Breastfeeding for 6 Months

Tue, 23 Dec 2025 00:00:00 +0700

A quasi-experimental two-group pretest-posttest design was conducted to compare the effects of a breastfeeding promotion program for primigravida women on knowledge, attitude, subjective norms, perceived behavioral control, and intention for exclusive breastfeeding for 6 months with standard hospital care. The study participants were 80 primigravida women receiving services at the antenatal care department of Khon Kaen Hospital, divided into control and experimental groups of 40 participants each. Sample selection was conducted using purposive sampling. The control group received standard hospital care according to hospital guidelines. The experimental group received a breastfeeding promotion program including training skills, return demonstration, and knowledge of exclusive breastfeeding for 6 months by specialist nurses from breastfeeding clinic. Data were collected using a breastfeeding knowledge questionnaire, the Iowa Infant Feeding Attitude Scale (IIFAS), a subjective norms questionnaire, a breastfeeding perceived behavioral control questionnaire, and an intention for exclusive breastfeeding for 6 months questionnaire. Data collection was conducted between September 2024 and August 2025, and data were analyzed using paired t-test and independent t-test statistics. The research findings showed that:

1. After receiving the program, the experimental group showed a significantly higher mean scores for knowledge (M = 8.28, SD = 1.01), attitude (M = 68.80, SD = 6.51), subjective norms (M = 51.75, SD = 4.46), perceived behavioral control (M = 79.72, SD = 5.94), and intention for exclusive breastfeeding for 6 months (M = 45.55, SD = 3.08) after participating in the program compared to before participating in the program, with statistical significance at the 0.001 level (p-value < .001).

2. After the intervention, the experimental group also demonstrated significantly higher mean scores for knowledge (M = 8.28, SD = 1.01), attitude (M = 68.80, SD = 6.51), subjective norms (M = 51.75, SD = 4.46), perceived behavioral control (M = 79.72, SD = 5.94), and intention for exclusive breastfeeding for 6 months (M = 45.55, SD = 3.08) compared to the control group, with statistical significance at the .001 level (p-value < .001).

Therefore, the breastfeeding promotion program for primiparous women based on the Theory of Planned Behavior can enhance knowledge, strengthen intention, and increase confidence in exclusive breastfeeding among first-time pregnant women. Nurses can implement this program in antenatal care clinics with other groups of pregnant women and monitor exclusive breastfeeding for six months and continued breastfeeding up to two years.

Effects of a Self-Efficacy Promotion Program on Stroke Prevention Behaviors in Urban Hypertensive Patients with Uncontrolled Blood Pressure at Vajira Hospital

Tue, 23 Dec 2025 00:00:00 +0700

This two-group pre-posttest quasi-experimental study aimed to examine the effects of a self-efficacy enhancement program on stroke prevention behaviors among patients with uncontrolled hypertension living in an urban area at Vajira Hospital. The sample consisted of 60 participants who were purposively selected and assigned to the experimental and control groups, with 30 participants in each group. The research instruments consisted of: 1) the experimental instruments, including the self-efficacy enhancement program developed based on Bandura’s concept and a health education handbook; and 2) the data collection instruments, including a personal information questionnaire and a stroke prevention behavior assessment form. Three experts evaluated the content validity of the program, the health education handbook, and the behavior assessment form, yielding content validity indices of .92, 1.00, and .86, respectively. The behavior assessment form demonstrated a reliability coefficient of .85. Data were analyzed using descriptive statistics, paired t-test, and independent t-test. The results revealed that:

1. After the intervention, the experimental group had a significantly higher mean score in stroke prevention behavior than pre-intervention scores (p-value < .05).

2. After the intervention, the experimental group also had a significantly higher mean score in stroke prevention behaviors than the control group (p-value < .05).

These findings can serve as a foundation for developing clinical practices and health promotion strategies for stroke prevention. Healthcare teams may consider applying the self-efficacy enhancement program for patients with uncontrolled hypertension in urban settings or in other communities with similar characteristics.