Journal of health and health management

The Role of Nurses in Managing Trismus among Patients with Head and Neck Cancer Receiving Concurrent Chemoradioth

2025-11-07T20:29:30+07:00

Trismus is a common complication in head and neck cancer (HNC) patients who receive concurrent chemoradiotherapy (CCRT). Treatment side effects compromise the elasticity of the salivary glands, masticatory muscles, and temporomandibular joint, leading to fibrosis and the subsequent development of trismus. This condition exerts a long-term negative impact on the quality of life for HNC patients across multiple domains, including nutrition, speech, oral hygiene maintenance, and social integration. This article aims to present the nursing role in managing trismus in HNC patients receiving CCRT, covering its definition, mechanism of development, treatment modalities, and the specific nursing role in management. The paper highlights that nurses are instrumental in the screening, assessment, education, and guidance necessary for preventing trismus, as its establishment proves difficult to fully rehabilitate to the patient’s original maximal mouth opening. Consequently, prevention is a strategy that promotes a sustained improvement in the quality of life for HNC patients over the long term

Promoting Female and Infant Health to Reduce Inequalities in Access to Health Services by Using an Artificial Intelligence Pregnancy the Management System with a Mobile Application

2024-10-15T21:28:04+07:00

The purposes of this research were: 1. to develop a pregnant women data management system and mobile application, and 2. to evaluate the efficiency of the pregnant women data management system and mobile application. The sample group consisted of 30 users selected by judgment sampling, including doctors, nurses, pregnant women and system administrators. The research instruments consisted of 1) The pregnancy management system and 2) an evaluation form for the efficiency of management system. Descriptive statistics such as percentage, mean and standard deviation were used for analysis. The research results found that 1) The development of the management system found that the working system consisted of 4 main user groups, developed in the form of a web application, which can be used to meet the needs of users in the management system, alerting, and recording information, including providing knowledge in various aspects that are useful during pregnancy as a tool to promote knowledge and understanding in correct behavior. 2) The study of the efficiency of the management system found that the overall efficiency of the system was at a high level ( = 4.37, SD =.53), with the most efficient aspects being the aspect of working according to needs ( = 4.36, SD =.47) and the aspect of system usability ( = 4.35, SD =.56).

Experiences of Strategic Leadership Nursing Organization Management of the Nurse Executives in Community Hospitals in the COVID-19 Pandemic Situation: Phenomenological Research

2024-12-02T17:02:10+07:00

This research is a qualitative phenomenological approach aimed at exploring the meaning and constituent components of strategic leadership in nursing organization management by nursing executives in community hospitals during the outbreak of the Coronavirus Disease 2019 (COVID-19). A purposive sampling method was utilized selected based on specific criteria, consisting of 10 nursing executives from community hospitals. The primary research instrument was an in-depth interview guide, validated for content accuracy by specific experts. Data was conducted through in-depth interviews and analyzed using content analysis methodology. The research results revealed that the meaning of strategic leadership refers to the behaviors demonstrated by nursing executives in community hospitals in terms of strategic planning and preparing for forecasting and analyzing trends, identifying strengths, weaknesses, problems, and obstacles, participating in all situations, having organizational management skills in nursing, communicating risks under critical conditions, utilizing technology, and accessing up-to-date information during the COVID-19 pandemic.The participants categorized strategic leadership into seven key domains: 1) Innovative strategic thinking and planning 2) Relationships with all sectors within the organization 3) Development of current and future leaders 4) Operational execution and achievement 5) Building alliances 6) Cultivating a sense of organizational membership 7) Direction setting The findings of this study can be used as a lesson and a guideline for strategic management in nursing organization administration during the COVID-19 pandemic and other emerging infectious diseases in the future.

Development of Guidelines for Preventing Repeat Adolescent Pregnancies in Laksi District Community, Bangkok

2025-05-07T08:33:51+07:00

This mixed-methods research aimed to examine the situation of repeat pregnancy among adolescent mothers, assess their health literacy related to pregnancy prevention after childbirth, and develop community-based strategies for preventing repeat pregnancy among adolescents in Lak Si District, Bangkok. The study was conducted in three phases: (1) An exploration of the repeat pregnancy situation using purposive sampling of 12 adolescents and 30 stakeholders. Data were collected through in-depth interviews and focus group discussions guided by validated interview questions, and analyzed using the content analysis approach of Elo and Kyngäs (2008). (2) A survey of health literacy was conducted with 308 adolescents, selected through multi-stage random sampling. Data were collected using a health literacy questionnaire (IOC = 0.76-1.00; Cronbach’s alpha = 0.92) and analyzed with descriptive statistics, including frequency, percentage, mean, and standard deviation. (3) A prevention guideline was developed by synthesizing the findings from the first two phases, integrating concepts of health literacy and three key components of the Ottawa Charter, and validated by experts for appropriateness.The results revealed that: (1) Repeat pregnancy among adolescents remains present in the Lak Si community. (2) The mean health literacy score was low (M = 2.26, SD = 1.14). (3) The developed guideline emphasizes enhancing personal skills, creating supportive health-promoting environments, and strengthening community participation to establish a comprehensive support system.

Strengthening Resilience Affecting the Mental Health and Happiness of the Elderly in a Community in Bangkok

2025-06-30T09:03:18+07:00

This research aimed to: 1. Compare the mental health and happiness of elderly people who received strengthening enhauncing resilience in the experimental and control groups, to 2. compare the mental health and happiness of elderly people before and after the strengthening enhauncing resilience. The sample consisted of 50 elderly people in a community in Bangkok, who were recruited by purposive sampling and tested for strenthening enhauncing resilience. They were assigned to Group A and Group B. The aim was to ensure that the mean score of the strenthening enhauncing resilience in both groups were not different. Then, they were assigned by drawing lots to be the experimental and the control group. The instruments were: Set 1: The Strengthening Enhauncing Resilience test; Set 2: The Mental Health test; Set 3: The Short Happiness test; and Set 4: The Strengthening Enhauncing Resilience activity model. Content validity for Set 1 and 4 was .67 and .79, respectively. Validity for Set 2 and 3 were not assessed because they were developed by the Department of Mental Health. Reliability was measured using the Cronbach’s alpha coefficient. The reliability of Set 1: The Strengthening Enhauncing Resilience test, 2. Mental Health test and 3. Short Happiness tests had values of .87, .83 and .70, respectively. 4. The activity model for Strengthening Enhauncing Resilience was not found to be reliable. The activity model was a 4-act drama performance in which the sample performed 4 times. The analysis used MANOVA statistics. The results of the research found that the elderly who received strengthening enhauncing resilience in the experimental group had higher mental health and happiness scores than the control group, significantly at the .01 level. And after the elderly who received strengthening enhauncing resilience, their mental health and happiness scores were significantly higher than before receiving the strengthening enhauncing resilience experiment at the .01 level.

Factors Associated with the Health Care Behaviors of Caregivers of Elderly Persons in Ubon Ratchathani Province

2025-07-17T08:37:13+07:00

This cross-sectional analytical study aimed to: 1) study personal characteristics, levels of health literacy, social support, and health care behaviors of caregivers for older adults in Ubon Ratchathani Province; and (2) identify the factors associated with caregivers’ health care behaviors for older adults. The study sample comprised 532 village health volunteers, who were providing home-based and community-based care for older adults, and were selected through multistage random sampling. The data were collected using a structured interview questionnaire covering personal characteristics, health literacy, social support, and health care behaviors, with reliability coefficients of 0.98, 0.95, and 0.98, respectively. The data were analyzed using percentages, means, standard deviations, and multiple logistic regression at a significance level of 0.05. The results showed that most caregivers were female (75.19%), with a mean age of 53.98 years and an average of 7.60 years of caregiving experience. The majority reported having high levels of social support (87.03%), adequate health literacy (68.99%), and appropriate evidence-based health care behaviors for older adults (87.03%). Factors significantly associated with proper caregiving behaviors consisted of being female (Adjusted OR = 3.58; 95% CI: 1.92–6.68), receiving high levels of social support from health professionals (Adjusted OR = 8.70; 95% CI: 4.35–17.37), and having adequate to excellent health literacy in assessing health care information for older adults (Adjusted OR = 5.18; 95% CI: 2.39–11.23). These findings highlighted the importance of female caregivers, adequate health literacy in assessing health care information, and social support from health professionals in order to promote the appropriate caregiving behaviors and to ensure quality of care for older adults.

Learning Promotion Guideline to Enhance Health Literacy About E-Cigarette for the District Learning Encouragement Center in Nakhon Phanom Province

2025-07-29T07:55:55+07:00

This research purposes to study the level of health literacy about E-cigarette among learners at the District Learning Encouragement Centers in Nakhon Phanom Province and to propose guidelines for promoting learning to enhance health literacy about E-cigarettes within these centers. This research was mixed methods research, consisting of two phases. Phase 1 study the level of health literacy about E-cigarette. The sample were 404 learners who were enrolled in the first semester of the 2024 academic year at the District Learning Encouragement Centers in Nakhon Phanom Province. A stratified random sampling technique was used. The tools applied in the data were the questionnaire, and the statistical data analysis was conducted by employing frequency and percentage. Phase 2 development of learning promotion guidelines to enhance health literacy about E-cigarette. The key informants included 11 experts comprising administrators and teachers from the Nakhon Phanom Provincial Office of Learning Encouragement, as well as professionals in the fields of anti-smoking and E-cigarette campaigns, non-formal or lifelong education, and health communication, each with no less than two years of experience. The participants were selected through purposive sampling. Data were collected through focus group and analyzed using content analysis. The results that (1) the learners at the District Learning Encouragement Centers in Nakhon Phanom Province was at a very high level of Health Literacy About E-Cigarette (81.11 percent), and (2) the guidelines for promoting learning to enhance Health Literacy About E-Cigarette for the District Learning Encouragement Centers in Nakhon Phanom Province comprised the following components: principles of the guidelines, objectives, models of learning promotion, learning content, learning media, evaluation, and roles of related agencies.

A Study of Nurse Anesthetists’ Competency, In Tertiary Hospitals under the ministry of public health, Using the Delphi Technique

2025-08-19T15:31:58+07:00

The purpose of this descriptive research was to identify the competencies of nurse anesthetists working in tertiary care hospitals under the Ministry of Public Health. The study employed the Delphi technique 3 rounds and interview involved 19 experts with knowledge and experience in anesthesiology. The research process consisted of three steps: (1) interviewing experts to gather data on nurse anesthetist competencies, (2) analyzing the interview content to develop a questionnaire for experts to assess the importance of each competency, and (3) calculating the median and interquartile range and then distributed the questionnaire to the same group of experts for confirmation or revision of their responses. The final results were used to identify the core competencies of nurse anesthetists in tertiary care hospitals. The findings revealed seven competency domains: 1. Specialized Clinical Nurse Anesthesia Practice (27 items), 2. Anesthetic Drug Management (10 items), 3. Anesthesia Safety and Risk Management (14 items), 4. Communication and Coordination in Patient Care (7 items), 5. Leadership and Technology Utilization (12 items), 6. Quality Improvement in Nurse Anesthesia Practice (8 items), and 7. Ethics and Legal Issues (5 items). The study comprised 83 items, with median values ranging from 4.59 – 4.75 and interquartile ranges between 0.25 and 0.57 these findings suggest that nurse administrators should play a vital role in fostering competency development and implementing performance evaluation of nurse anesthetist, in order to enhance their professional competencies across all dimentions. These competencies can serve as guidelines for administrators in performance evaluation and development of nurse anesthetists and as essential input for curriculum development by the Royal College of Anesthesiologists of Thailand and other training institutions for nurse anesthetists.

Factors Affecting Self-Management Behavior among Type 2 Diabetes Mellitus Patients in Bangrakam District, Phitsanulok Province

2025-08-18T13:50:34+07:00

This cross-sectional study was conducted to investigate the factors affecting the selfmanagement behavior of type 2 diabetes patients in Bang Rakam District, Phitsanulok Province. The objectives were to study the self-management behavior of type 2 diabetes patients, and to study the factors affecting their self-management behavior. The sample consisted of 156 patients who were selected by the systematic random sampling method. The research instruments included (1) a personal data questionnaire, (2) a diabetes knowledge test, (3) a health-belief pattern questionnaire, (4) a social support questionnaire, and (5) a self-management behavior questionnaire. The content validity of the questionnaire was 1.00. The reliability of the diabetes knowledge test analyzed with Kuder-Richardson 20 (KR-20) was 0.76, while the reliabilities of the health-belief pattern, social support, and self- management behavior questionnaires analyzed with Cronbach’s Alpha coefficients were 0.80, 0.90, and 0.86, respectively. Descriptive statistics and stepwise multiple regression analysis were used for data analysis. The results revealed that 1) the sample group had a high level of self-management at 72.40% ( = 103.17, SD = 15.98), and 2) factors including social support, perceived self-efficacy in diabetes treatment, perceived benefits of diabetes prevention and treatment, and encouragement from neighbors could co-predict the self-management behavior of the sample group at 25.20% (R²= .252, p < .001).

Comparative Effects of Self-Foot Massage Using Wooden Stick Versus Using hand on Sensation, Balance, and Quality of Life in Individuals with Type 2 Diabetes Peripheral Neuropathy: A pilot study

2025-10-07T08:19:33+07:00

This study aimed to investigate the impact of self-foot massage using Thai massage sticks versus using hands on sensation, balance, and quality of life in individuals with type 2 diabetes and foot neuropathy. Seventeen participants aged 58.18 (±7.68) years were randomly assigned to two groups using wooden massage sticks (n=8) and the other using hand massages (n=9). Participants performed three sessions per week, with each session consisting of 30-minute foot massages and 30-second calf stretches, over the period of four weeks. The foot sensation was evaluated using the Semmes–Weinstein Monofilament Test, while balance was tested with the Time Up and Go Test and One Leg Stand Test. Quality of life was tested by the WHOQOL-BREF-THAI. The results showed that there were significant improvements in sensation and dynamic balance post-intervention (p < 0.05), but not quality of life for both groups. Nevertheless, the significant difference between groups was not found (p > 0.05). This study suggests that both methods may be effective in improving sensation and dynamic balance in individuals with diabetic neuropathy. However, no significant difference was found between the effectiveness of both self-foot massage techniques.

The Influence of Haze on Respiratory Health among the Elderly in Chiang Rai, Thailand

2025-10-22T09:38:40+07:00

This study aims to evaluate the impact of annual short-term haze exposure on respiratory health in elderly individuals residing in Chiang Rai Province.Methods: This was a cross-sectional study conducted on 46 elderly volunteers living in Chiang Rai province to examine the impact of haze on pulmonary function, respiratory muscle strength, and fractional exhaled nitric oxide (FeNO). The study compared measurements taken at the beginning of the haze season and after one month of exposure. Results: The study revealed that FeNO levels increased significantly after exposure to haze, with values of 23.65±16.69 ppb and 27.93±17.81 ppb (p<.05). However, there were no statistically significant differences in pulmonary function and respiratory muscle strength measurements one month after exposure. The baseline air quality level averaged PM2.5 at 67.98 μg/m³ and PM10 at 134.84 μg/m³, while the follow-up measurements after one month showed an average PM2.5 of 149.43 μg/m³ and PM10 of 321.13 μg/m³. Conclusion: Elevated levels of fine particulate matter contribute to increased airway inflammation in elderly, as detected by FeNO. However, this level of inflammation does not significantly affect pulmonary function or respiratory muscle strength.

Effect of Supervision Program of Shift Handover on Information Technology Towards Nursing Supervisor Digital Technology Competency

2025-09-09T14:03:26+07:00

This quasi-experimental one-group pretest-posttest design aimed to examine the effects of supervision program of shift handover on information technology towards nursing supervisor digital technology competency. Samples consisted of 30 unofficial-time nursing supervisions, selected by simple random sampling. The research instruments composed of two parts : (1) program of shift handover on information technology towards nursing supervisor digital technology competency, and (2) assessment tool for evaluating digital technology competency included, knowledge, attitudes, and skills about digital technology competency, with the reliability values of the three tests being 0.71, 0.89, and 0.95, respectively. Data were analyzed by using percentages, means, standard deviations and paired t-test. The results revealed that, after the experiment the unofficial-time nursing supervisions had competencies in all three aspects 1) Knowledge of digital technology 2) Attitudes of digital technology and 3) Digital skill of technology increase in mean scores showed a statistically significant (p-value < .05). Based on these findings, it is recommended that some hospitals can adopt this program for training and developing digital technology competency for unofficial-time nursing supervisors in shift of handover.

The Relationship Between HbA1c Levels in the First Trimester of Pregnant Women and Pregnancy Outcomes

2025-10-09T18:41:38+07:00

This study was a retrospective analytical study with the primary objective of examining the association between first-trimester hemoglobin A1c (HbA1c) levels in pregnant women and pregnancy outcomes. The study population consisted of singleton pregnancies, aged 18-45 years, who attended their first antenatal visit at Phaholpolpayuhasena Hospital, Kanchanaburi Province, between October 1, 2022 and September 30, 2024. Eligible participants were those who had their HbA1c measured during the first trimester yielding a total of 366 cases. The research instrument was a data extraction form developed by the investigators to collect retrospective information from medical records. The form comprised maternal demographic and clinical data, first-trimester HbA1c levels, and pregnancy outcomes. The results revealed that first-trimester HbA1c levels were significantly associated with the risk of gestational diabetes mellitus (GDM) (p < .05). Each 1% increase in HbA1c was associated with a 2.6- fold increase in the risk of developing GDM. An HbA1c cutoff of 5.7% yielded the highest discriminatory performance, with an overall accuracy of 73.5%. Furthermore, incorporating additional risk factors maternal age, BMI, family history of diabetes, and gravidity together with HbA1c substantially improved predictive performance, achieving an overall accuracy of 95.0%. In conclusion, first-trimester HbA1c measurement can serve as an early indicator of the risk for adverse pregnancy outcomes. Early identification of high-risk pregnancies through HbA1c assessment, combined with maternal risk factors, may facilitate timely monitoring and appropriate management to reduce complications for both mother and child.

Spiritual Health Spiritual Leadership and Workplace Spirituality Towards Job Performance of Teachers in the Schools of Sisters Saint Paul de Chartres in Bangkok

2025-09-17T14:51:20+07:00

This descriptive research aimed to: (1) study the levels of spiritual health, spiritual leadership, workplace spirituality, and job performance among teachers in Saint Paul de Chartres schools in Bangkok; (2) examine the relationships between spiritual health, spiritual leadership, workplace spirituality, and teachers’ job performance; and (3) analyze the combined predictive power of spiritual health, spiritual leadership, and workplace spirituality on teachers’ job performance.The sample consisted of 252 teachers from Saint Paul de Chartres affiliated schools in Bangkok. The sample size was determined using Krejcie and Morgan’s table with a 0.05 margin of error. Participants were selected through stratified random sampling based on school proportion, followed by convenience sampling. Data were analyzed using percentage, mean, standard deviation, Pearson’s product-moment correlation coefficient, and multiple regression analysis with the enter method.The research findings revealed that: (1) the teachers demonstrated very high levels of spiritual health, spiritual leadership, workplace spirituality, and job performance; (2) spiritual health, spiritual leadership, and workplace spirituality were positively correlated with job performance at a statistically significant level of .01 (r = .710, .775, and .851, respectively); and (3) spiritual leadership and workplace spirituality jointly predicted 73.3% of the variance in teachers’ job performance at a statistically significant level of .01.These findings provide essential insights for administrators in policy-making, management, and the development of spiritual health, spiritual leadership, and workplace spirituality among teachers in Saint Paul de Chartres affiliated schools in Bangkok, which can ultimately enhance teaching performance effectiveness.

A Study of Flight Nurse Roles

2025-06-16T07:56:37+07:00

The purpose of this descriptive research was to study the roles of flight nurses using the Delphi technique. Participants were 19 experts. The Delphi technique consisted of 3 Step: Step 1: To interview experts about the role of flight nurse; Step 2: To analyze the data from the interviews and to create a questionnaire for the experts to estimate the importance of the role of flight nurses; Step 3: To calculate the median and interquartile range from the data collected in the second round and to return the questionnaire to the same group of experts to confirm their answers. The data were then used to calculate the median and interquartile range again to summarize the role of flight nurses. The result of the research found that the role of flight nurses consisted of 6 roles as follows: 1) The role of aviation medicine nurse practice 16 items; 2) The role of manager of aviation and ground safety 8 items; 3) The role of manager of safety and risk management 16 items; 4) The role of coordinator and communicator 11 items; 5) The role of teamwork leader, management, and consulting 18 items and 6) The role of quality and service standards 11 items.

Effects of the Participatory Action Research on Health Behaviors and Risk of Metabolic Syndrome Among Nursing Department Personnel at Risk for Metabolic Syndrome of Private Hospital in Bangkok

2025-09-01T08:55:49+07:00

This study employed a participatory action research (PAR) design using a one-group pretest– posttest with follow-up assessment. The objectives were to compare mean scores of 3-Self health behaviors and metabolic syndrome risk factors before and after participation in the participatory action research intervention, as well as at follow-up ,among nursing personnel at a private hospital. The sample consisted of 50 nursing personnel aged 35-59 years who had at least three of the five metabolic risk components according to the IDF and AHA/NHLBI (2009) criteria, selected through purposive sampling. The study was conducted over 24 weeks, with health promotion program involving participant engagement for 12-weeks. These program comprising personalized health-risk information, nutrition and exercise education, individualized in-depth interviews, group discussions, and ongoing communication through a LINE group. Data were collected at week 12 and follow-up at week 24. Research instruments included a manual on knowledge and preventive behaviors for metabolic syndrome ,a personal information questionnaire, a 3-Self health behavior assessment form, and health data collection tools for metabolic syndrome risk assessment . Content validity was verified by three experts (IOC=.67-1.00)and reliabilities of .92, .79, and .76, respectively. Data were analyzed using descriptive statistics and repeated measures ANOVA. The findings revealed that : 1) participants’ mean scores for 3-Self health behaviors at post intervention and follow-up were significantly higher than at baseline (p < .05); 2) participants’ mean metabolic syndrome risk factors (MetS), including waist circumference and body mass index were significantly lower at post- intervention and follow-up compared to baseline (p < .05), while HDL levels significantly increased at post- intervention and follow-up compared to baseline (p < .05). Diastolic blood pressure (DBP) significantly increased at post- intervention and follow-up compared to baseline (p < .05), while systolic blood pressure (SBP), fasting blood sugar (FBS), and triglycerides levels decreased but not significantly.

Factors Associated with Cardiovascular Risk among Employees of a Private Hospital in Bangkok

2025-10-09T13:12:06+07:00

The objectives of this research were to examine the level of cardiovascular disease (CVD) risk and to identify factors associated with CVD risk among employees of a private hospital in Bangkok. The sample consisted of 261 employees, selected through simple random sampling. Data were collected using research instruments that included a personal information form, a behavioral questionnaire, and the Thai CV Risk Score assessment for estimating the 10-year risk of cardiovascular disease. Instrument quality was verified, yielding IOC values ranging from 0.80 to 1.00. Data were analyzed using descriptive statistics—frequency, percentage, mean, and standard deviation—and inferential statistics, including Pearson’s correlation and Spearman’s rank correlation. The results showed that the average age of participants was 34.37±9.26 years. Most were female (78.9%), single (65.9%), held a bachelor’s degree (54.8%), and had a monthly income greater than 20,000 THB (54.0%). The mean body mass index (BMI) was 24.21 kg/m², with 37.5% classified as normal weight. Regarding health behaviors, 44.4% reported no exercise, 62.8% experienced moderate stress, and 59.8% slept an average of 5-6 hours per night. Assessment of cardiovascular risk revealed that the majority of participants had a low 10-year CVD risk (99.23%). Analysis of personal factors associated with CVD risk showed significant correlations with age (r=0.698, p<0.001), education level (r=0.315, p<0.001), hypertension (r=0.371, p<0.001), dyslipidemia (r=0.261, p<0.001), cholesterol level (r=0.168, p=0.006), systolic blood pressure (r=0.399, p<0.001), and having a family member with heart disease, vascular disease, or stroke (r=0.357, p=0.011). All correlations were statistically significant at the 0.05 level. In contrast, no significant associations were found between behavioral factors and CVD risk.

Digital Technology for Rural Older Adults’ Health Management: Challenges, Support Systems, and Contextual Policy Approaches

2025-06-17T12:36:44+07:00

The digital transformation has opened new opportunities for elderly health management, particularly in rural areas where access to healthcare remains limited. This research aimed to: 1. Study the behavior and use of digital technology among elderly in rural communities related to health management; 2. Analyze the challenges and barriers to digital technology use among elderly in rural contexts; 3. Investigate support for promoting the use of digital technology in health management among elderly; and 4. Propose policy guidelines appropriate to the community context for promoting the use of digital technology for health management among the elderly. A qualitative research sample of 30 key informants was purposively selected, consisting of 14 elderly aged 60 and over, 8 community leaders, and 8 village health volunteers (VHVs). The research instruments included in-depth interviews and focus group discussions. Content validity was tested by three experts with a score of 0.8. Qualitative analysis was used to analyze thematic data, and data reliability was verified using triangulation and member checking. The findings indicated that the participants engaged in digital technology behaviors related to health management, including health communication, the use of health-related applications, and the search for health information. The primary challenge identified was the digital divide, stemming from disparities in skills, resources, and infrastructure, which hinder older adults in rural areas from fully utilizing digital technologies for health purposes. The barriers to digital technology use among older adults were found to derive from four main dimensions: individual factors, technological and accessibility factors, social and family factors, and service system and policy factors. Meanwhile, the mechanisms that support the adoption of digital technology in health care for older adults include policy formulation and the development of local operational plans to ensure continuous budget allocation. The recommended policy directions appropriate to the community context for promoting the use of digital technologies in older adults’ health management comprise: Developing participatory, locally relevant curricula, providing financial and resource support, strengthening digital infrastructure, and Advancing holistic policy integration. These strategies aim to enhance older adults’ skills and confidence in using digital technologies for self-care, ensure equitable access to devices and internet connectivity, expand digital infrastructure to remote areas, and promote the widespread provision of telehealth services. Furthermore, they encourage collaboration among national, local, and community-level stakeholders in developing digital health systems, as well as the establishment of national policies that systematically and sustainably integrate health and digital technology.

Development of a Nursing Care Model for Older Adults with Hip Fractures Undergoing Surgical Treatment at Pranangklao Hospital

2025-08-21T13:38:41+07:00

This study aimed to develop a nursing care model for elderly patients with hip fractures undergoing surgery. The research was conducted in three phases: Phase 1 involved a situation assessment; Phase 2 focused on the development of the nursing care model; and Phase 3 evaluated the outcomes following model implementation. The samples included of 70 medical records, an interdisciplinary team of 11 members, a quality improvement committee, 22 registered nurses, and 30 elderly patients with their caregivers in each group. Data were analyzed using content analysis, percentage, means, standard deviation, and dependent t-test. Results from Phase 1 revealed that patients had a mean length of hospital stay 10.8 days. Reported Complications included pressure ulcers 12.9%, urinary tract infections 10%, and deep vein thrombosis 4.3%. The key issues identified were non-standardized nursing practices, a lack of care coordinators, and the absence of continuity of care. Phase 2 resulted in the development of a nursing care model consisting of three stages of care planning, six categories of clinical practice guidelines, information-transfer protocols based on clinical pathway, patient and caregiver participation strategies, and a monitoring and evaluation system. In Phase 3, findings indicated that the mean length of hospital stay decreased to 7.36 days. The incidence of pressure ulcers declined to 3.3%, and no cases of urinary tract infections or deep vein thrombosis were reported. Patients expressed high levels of satisfaction, caregivers demonstrated moderate knowledge levels, and nurses showed statistically significant improvement in knowledge p < .01, with the highest level of adherence to the care model.

HbA1c Variability and Its Association with Complications Among Patients with Type 2 Diabetes in Changklang District, Nakhon Si Thammarat

2025-10-07T08:01:02+07:00

This study aimed to identify factors associated with HbA1c variability and to assess the relationship between HbA1c variability and diabetes-related complications among individuals with type 2 diabetes mellitus (T2DM) receiving care in Chang Klang District, Nakhon Si Thammarat Province. A total of 300 individuals with T2DM were included. Participants were selected using criterion-based sampling from the hospital’s electronic medical record system, which provided routinely collected secondary clinical data. Independent variables included sociodemographic characteristics (e.g., age, sex, body mass index) and health-related factors (e.g., comorbidities, medication use, and laboratory parameters). The primary dependent variable was HbA1c variability. Descriptive statistics (frequency, percentage, mean, and standard deviation) were used to summarize participant characteristics. Inferential analyses included chi-square tests, independent t-tests, Pearson’s correlation, and multivariate logistic regression. The analysis demonstrated that several personal and clinical factors—specifically BMI≥23 kg/m², a history of hypoglycemia or hyperglycemic crisis, metformin use, fasting blood sugar (FBS), and LDL cholesterol levels—were significantly associated with HbA1c variability (p<0.05). Individuals with BMI≥23 kg/m² had 1.63 times increased odds of high HbA1c variability (adjusted OR=1.63; 95% CI=1.03-3.66; p=.046). A history of hypoglycemia or hyperglycemic crisis was likewise associated with 2.53 times higher odds of HbA1c variability (adjusted OR=2.53; 95% CI=1.10-5.83; p=.029). In contrast, metformin use was protective, reducing the odds of high HbA1c variability by 0.62 times or approximately 38% (adjusted OR=0.62; 95% CI=0.50-0.81; p=.025). Higher FBS levels were also associated with increased odds of HbA1c variability (adjusted OR=1.12; 95% CI, 1.06-1.23; p=.005), as were elevated LDL cholesterol levels (adjusted OR=2.09; 95% CI, 1.03-4.23; p=.042). Meanwhile, age, sex, duration of diabetes, cardiovascular disease, and triglyceride levels were not significantly associated with HbA1c variability. HbA1c variability was positively correlated with a history of hypoglycemia or hyperglycemic crisis (r=0.450; p=.021), suggesting that greater variability is associated with an increased likelihood of acute glycemic events with statistical significance at .05.