Journal of health and health management

Factors Affecting Performance for Local Wisdom Health of Village Health Volunteers in Wang Thong District, Phitsanulok Province

Mon, 22 Jun 2026 00:00:00 +0700

This descriptive research aimed to examine role perception, social support, network partnerships, work motivation, expertise, demographic characteristics, and the application of local health wisdom among village health volunteers (VHVs) in Wang Thong District, Phitsanulok Province, as well as to identify the factors influencing their application of local health wisdom. The study sample comprised 345 VHVs, selected through systematic sampling. Data were collected using a structured questionnaire and analyzed with descriptive statistics and stepwise multiple regression analysis. The findings revealed that social support was at a high level, while role perception, network partnerships, work motivation, and the application of local health wisdom were at moderate levels. The most influential factor on the application of local health wisdom was role perception (β = 0.212), followed by work motivation (β = 0.192), network partnerships (β = 0.170), single marital status (β = 0.123), and the number of areas of expertise in local wisdom and traditional Thai medicine (β = 0.107), respectively. These variables jointly predicted 27.6% of the variance in the application of local health wisdom among VHVs, while other factors were not significant predictors. The results suggest that relevant agencies should strengthen network partnerships, enhance role perception, increase work motivation, and provide continuous and systematic training to broaden specialized expertise. Additionally, policies should be developed to promote and support VHVs in applying local health wisdom in community health services.

Effectiveness of Unhealthy Beverage Consumption Surveillance Program among Undergraduate Students at Sirindhorn College of Public Health Phitsanulok, within the Framework of the PBRI Model Concept

Mon, 22 Jun 2026 00:00:00 +0700

The objectives of this quasi-experimental study using a three-group pretest-posttest design were 1) to create a between-group comparison of the mean pretest and posttest scores of health beliefs and unhealthy beverage consumption behaviors among a first experimental group, a second experimental group, and a control group, and 2) to generate a within-group comparison of the mean pretest and posttest scores of health beliefs and unhealthy beverage consumption behaviors within each group. The study was guided by the integration of the Health Belief Model and the PBRI Model Concept. The sample comprised 111 first-year undergraduate students at Sirindhorn College of Public Health Phitsanulok, divided equally into three groups of 37 students each. The participants were selected through simple random sampling with replacement. The research instruments consisted of 1) the Unhealthy Beverage Consumption Surveillance Program, 2) the “7-Color Warning Media,” and 3) a questionnaire on health beliefs and unhealthy beverage consumption behaviors, with content validity ranging from .60 to 1.00, and reliability coefficients of .98 for the health belief questionnaire and .87 for the consumption behavior questionnaire. Data were analyzed using descriptive statistics in percentage, mean, and standard deviation, as well as the Wilcoxon Signed-Rank Test, and the Kruskal–Wallis H Test. The findings indicated that 1) prior to the intervention, the first experimental group, the second experimental group, and the control group did not differ significantly in their levels of health beliefs and unhealthy beverage consumption behaviors. Following the intervention, the first experimental group demonstrated significantly higher scores in health beliefs and unhealthy beverage consumption behaviors than both the second experimental group and the control group at the .05 significance level. Moreover, the second experimental group exhibited significantly higher mean scores than the control group at the .05 level. When comparing within-group changes, 2) both experimental groups showed statistically significant increases in health beliefs and unhealthy beverage consumption behaviors from pretest to posttest at the .05 level, whereas the control group showed no statistically significant difference between the pretest and posttest measurements.

A Study of Career Ladder Competencies of Nurses in Burn Unit, Tertiary Hospitals

Sasipimon Manjit, Gunyadar Prachusilpa, Thinnakorn Buachu — Mon, 22 Jun 2026 00:00:00 +0700

This descriptive research aimed to establish career ladder competencies for nurses working in the burn unit of a tertiary care hospital. A three-round Delphi technique was employed, involving a panel of 20 experts in burn nursing and care. The study was conducted in three phases: (1) expert interviews to identify essential competencies; (2) development of a rating-scale questionnaire based on content analysis of the interviews; and (3) consensus-building through statistical analysis using medians and interquartile ranges, followed by expert re-evaluation for final validation. Research instruments included an interview guide and the Delphi questionnaire. Qualitative data were analyzed using content analysis, while quantitative data were analyzed using median and interquartile range. The study identified nine core competency domains for burn unit nurses: 1) Critical burn nursing care; 2) Infection and complication control; 3) Burn wound management; 4) Pain management; 5) Physical and psychosocial rehabilitation; 6) Nutritional management; 7) Discharge planning and end-of-life care; 8) Interdisciplinary communication and teamwork; and 9) Advanced technology and medical equipment utilization. While these core domains apply to all levels, proficiency levels vary across the career ladder: 1) Novice: Performs basic nursing care under professional supervision; 2) Advanced Beginner: Demonstrates capability in care planning and collaborative teamwork; 3) Competent: Collaborative care planning and utilization of evidence-based practice; 4) Proficient: Focuses on comprehensive, holistic nursing care and clinical judgment; and 5) Expert: Emphasizes team development and innovation.

A Study of Perioperative Nurse Roles in Robotic-Assisted Surgery

Wanatsanan Poorahong, Gunyadar Prachusilpa — Mon, 22 Jun 2026 00:00:00 +0700

The purpose of this descriptive research was to study the roles of perioperative nurses in robotic-assisted surgery. The Delphi technique was used in this study. Key informants were 20 experts in robotic-assisted surgery. The process of conducting research consisted of three steps. In step one, all experts were interviewed about robotic-assisted surgery. In step two, interview data were analyzed to develop a questionnaire, which was then sent to the same experts to gather their opinions to rate the importance of the identified roles of perioperative nurse in robotic-assisted surgery. In step three, the data were analyzed for median and interquartile range, and the results were sent back to the experts for confirmation of their opinions. The research instrument consisted of interview forms and questionnaires. Qualitative data were analyzed using content analysis, while quantitative data were analyzed using the median and interquartile range statistics. The results showed that the roles of perioperative nurses in robotic-assisted surgery consist of 6 components as follows: 1) perioperative nurse practitioner in robotic-assisted surgery, 2) resource manager, 3) quality improvement and research developer, 4) coordinator and communicator, 5) safety and risk manager, and 6) educator and consultant. Therefore, nursing administrators should use research data to guide the definition of perioperative nurse roles, aligning them with the required expertise, and to serve as a guideline for career development in robotic-assisted surgery.

Structured Exercise Therapy Combined with Balance Diet Pattern Program Development for Enhancing Executive Functions among Patients with Type 2 Diabetes Mellitus with Mild Cognitive Impairment: A Pilot Study

Saknarin Limcharoen, Piyathip Pradujprom, Yoottana Janthakhin — Mon, 22 Jun 2026 00:00:00 +0700

This quasi-experimental study, using a one-group pretest-posttest design, aimed to develop and evaluate the effects of a structured exercise program combined with a balanced dietary pattern on enhancing executive functions in patients with type 2 diabetes mellitus (T2DM) with mild cognitive impairment (MCI). Patients with type 2 diabetes mellitus are at increased risk of cognitive decline and impairments in executive functions, which may adversely affect long-term self-care behaviors. The pilot sample consisted of 10 patients with T2DM with MCI. Data collection tools included the Thai version of the Montreal Cognitive Assessment (MoCA-P) 8.3 and the Thai version of the Executive Function Behavioral Rating Scale. Data analysis used descriptive statistics and the paired t-test to assess differences at a significance level of p < .05. The results showed that the developed program, consisting of a structured exercise program combined with a balanced dietary pattern, was evaluated by experts and demonstrated high content validity (S-CVI/Ave = .97). The results of implementing the program with the sample showed that overall executive function (t = 2.55, p = .03) and the Behavioral Regulation Index (t = 2.43, p = .04) were statistically significantly improved. However, the Metacognition Index did not show a statistically significant difference (t = 1.18, p = .27). Conclusion: The developed program showed a tendency to enhance executive functions in patients with T2DM with MCI. It was recommended that this program should be further investigated through a full-scale study to confirm the validity, reliability, and sustainability of the outcomes across more diverse contexts.

Effects of a Community-Based Participatory Knee Health Promotion Network on Healthy Aging and Healthcare Access Among Older Adults in Rural Communities

Prattana Namee, Phattharaphon Sopha, Suppawit Kaewsap — Mon, 22 Jun 2026 00:00:00 +0700

This study aimed to develop a community-based network to promote knee health and well-being among older adults in Nonsamran Subdistrict, Mueang District, Chaiyaphum Province, where older adults comprise 29.47% of the population and the prevalence of knee osteoarthritis is 50.60%. A participatory action research (PAR) approach was employed, guided by Community-Based Learning (CBL) concepts. A total of 308 participants were involved in the study. The research was conducted in four phases: community situational analysis, development of a health network and knee care clinic, establishment of community volunteers known as “connectors,” and implementation of an adapted knee osteoarthritis exercise program. The findings showed that the community network was able to effectively establish a knee care clinic and a volunteer system linking households, the community, and health service providers. After participating in the 8-week exercise program, older adults demonstrated a significant reduction in pain, with mean scores decreasing from 6.54 ± 1.67 to 3.10 ± 2.18. Muscle strength significantly improved from 15.03 ± 3.59 to 12.49 ± 2.37, and balance performance significantly improved from 13.10 ± 3.05 to 10.79 ± 2.01 (p < .05). In conclusion, this participatory network model effectively promotes well-being among older adults, reduces the severity of knee osteoarthritis, and strengthens a sustainable community health system through integrated collaboration between the community and health sectors.

Entrustable Professional Activities on Psychomotor Skills among Newly Graduated Nurses: A Study on Private Higher Education in Metropolitan Bangkok

Rata Srisaart, Sudarat Suvaree, Pornsiri Punthasee — Mon, 22 Jun 2026 00:00:00 +0700

This study aimed to 1) examine the level of entrustment in performing professional nursing activities among newly graduated nurses, and 2) compare entrustment levels among newly graduated nurses, clinical nurses, and nurse managers. The sample consisted of 88 newly graduated nurses, 63 clinical nurses, and 28 nurse managers, selected using purposive sampling. The research instrument was a 92-item questionnaire developed based on the Entrustable Professional Activities (EPAs) framework, with a reliability coefficient of 0.97. Data were analyzed using descriptive statistics and the Kruskal–Wallis test. The results showed that newly graduated nurses rated their overall entrustment level at a very good level ( = 4.04). Fundamental, adult and elderly nursing, and community health nursing were rated at a very good level, whereas pediatric and obstetrical nursing were rated at a good level. In contrast, clinical nurses and nurse managers rated entrustment at a good level across all domains. Significant differences in entrustment levels were found among the three groups at the 0.05 level in several domains, with newly graduated nurses having the highest mean ranks. In conclusion, newly graduated nurses demonstrated good to very good levels of entrustment in performing professional nursing activities; however, differences in entrustment levels were observed among evaluators, particularly in pediatric and obstetrical nursing, which showed lower levels compared to other domains.

Development of an Outpatient Nursing Service System in the Medical Outpatient Department on Patient Satisfaction, Waiting Times, and Nursing Staff Satisfaction

Kanchana Khajonwattanakul, Panta Apiruknapanond, Maneerat Phaktoop — Mon, 22 Jun 2026 00:00:00 +0700

This research employed a quasi-experimental design with the objectives of developing an outpatient nursing service system in the internal medicine department, comparing patient satisfaction and waiting times between experimental and control groups, and studying the level of satisfaction of nurses and staff with the outpatient nursing service system in the internal medicine department. The sample consisted of: 1) 100 outpatients using the internal medicine department, divided into experimental and control groups of 50 each, selected using purposive sampling; and 2) 20 nursing staff members in the outpatient internal medicine department. The research instruments included a service time recording form, a patient satisfaction questionnaire, and a satisfaction questionnaire for outpatient nursing staff in the internal medicine department. The quality of the research instruments was verified. Based on the evaluation by 3 experts, the CVI (Content Validity Index) for the outpatient nursing service user satisfaction questionnaire was 0.92, and for the staff satisfaction questionnaire, it was 0.88. The reliability coefficient for the outpatient nursing service user satisfaction questionnaire was 0.90, and for the staff satisfaction questionnaire, it was 0.82. The statistical methods used for data analysis included descriptive statistics and an independent t-test, with a statistical significance level of .05. The research results showed that: 1) The developed outpatient nursing service system for the internal medicine department consists of three phases: (1) the pre-examination phase, which includes workload assessment and personnel allocation, communicating information to service users, assigning responsibility for preparation and setting guidelines; (2) the in-examination phase, which includes assigning additional responsible personnel, dividing appointment slots, and scheduling patient appointments; and (3) the post-examination phase, which includes the appointment system and the use of digital technology for scheduling appointments. 2) The satisfaction of outpatient nursing service users in the experimental group was significantly higher than in the control group at the p < .05 level. 3) The overall waiting time for services in the experimental group was significantly shorter than in the control group at the p < .05 level (t = 16.11, p = .000). And 4) The satisfaction of personnel with the use of the outpatient nursing service system for the internal medicine department was at a high level overall.

Effects of a Nursing Process-Based Management Model for Colonoscopy in Outpatients

Sudarut Junsiri, Panta Apiruknapanond, Maneerat Phaktoop — Mon, 22 Jun 2026 00:00:00 +0700

This quasi-experimental study employed a two-group pretest-posttest design and aimed to develop a management model for colonoscopy using the nursing process for outpatients. The population was divided into two groups: 1) outpatients scheduled for diagnostic colonoscopy, with sample size calculated using G*Power at a 95% confidence level, totaling 122 participants divided into control and experimental groups of 61 each, and 2) internal stakeholders involved in receiving outcomes from the outpatient endoscopy center. Two sets of research instruments were used, consisting of experimental instruments and data collection instruments with reliability coefficients of 0.95 and 0.92, respectively. Data were analyzed using percentages, means, and standard deviations, with Independent t-test and Paired t-test employed for statistical analysis. The research findings revealed that: 1) the efficiency and effectiveness of colonoscopy in the experimental group were significantly higher than the control group (p < .01); 2) external service users’ satisfaction after receiving services was significantly higher in the experimental group compared to the control group (p < .01); and 3) internal stakeholders’ satisfaction after implementing the developed model was significantly higher than before implementation (p < .01).

Factors Influencing Malnutrition in Patients with End-Stage Renal Disease Undergoing Continuous Ambulatory Peritoneal Dialysis

Siraprapa Pongpen, Wipa Wiseso, Chutima Chantamit-O-Pas — Mon, 22 Jun 2026 00:00:00 +0700

This predictive study aimed to examine factors influencing malnutrition and to determine the predictive power of dietary behaviour, oral and dental health conditions, depression, and social support on malnutrition in patients with End-Stage Renal Disease (ESRD) undergoing Continuous Ambulatory Peritoneal Dialysis (CAPD). The sample consisted of 119 patients who had undergone CAPD for at least three months at five peritoneal dialysis clinics in Chonburi Province, selected using purposive sampling. Data were collected using six instruments: a demographic questionnaire and tools assessing dietary behaviour, oral and dental health conditions, depression, social support, and malnutrition. The content validity index ranged from 0.90 to 1.00, and reliability coefficients were 0.84, 0.88, 0.80, 0.96, and 0.71, respectively. Data were analysed using descriptive statistics and stepwise multiple regression. The results indicated that dietary behaviour, oral and dental health conditions, and depression were significantly associated with malnutrition (r = .358, r = -.246, r = -.158, respectively; p < .05). Depression and dietary behaviour were identified as significant predictors of malnutrition, jointly accounting for 14% of the variance (Adjusted R² = .14, p < .001). Depression was the strongest predictor (β = .32, p < .001), followed by dietary behaviour (β = -.18, p < .05). These findings highlight the importance of screening for depression and promoting appropriate dietary behaviour to reduce the risk of malnutrition in CAPD patients.

Strategies for the Control of E-Cigarette Use among Undergraduate Students in Northeastern, Thailand: A Qualitative Study

Sirisup Sihawong, Kitti Laosupap, Phusanisa Meenakate — Mon, 22 Jun 2026 00:00:00 +0700

The global consumption of e-cigarettes showed an increasing trend, particularly among young people, and had widespread impacts on health, society, the economy, and the environment. This qualitative research aimed to explore strategies for controlling e-cigarette consumption among undergraduate students. Data were collected through in-depth interviews using a semi-structured interview approach. The informants consisted of 30 undergraduate students from a higher education institution in Ubon Ratchathani Province from a wide range of disciplines, covering science and technology, social sciences, and the humanities, selected through snowball sampling. Data were analyzed using content analysis. The study revealed that the strategies for controlling e-cigarette consumption among undergraduate students consisted of (1) University policy and management, (2) Education and awareness promotion, (3) Counseling and cessation support services, (4) Student participation, and (5) Technology and innovation utilization. The findings also revealed an important new insight that undergraduate students tended to respond more positively to e-cigarette control measures that emphasized supportive approaches and creative communication rather than measures that relied solely on punitive actions. Furthermore, integrating peer involvement, digital technologies, and easily accessible counseling services enhanced the effectiveness of university policies and facilitated more sustainable behavior change. These findings suggested that e-cigarette control in university settings should be implemented through an integrated support system that balances policy enforcement, the learning environment, and active student participation. The results of this study helped universities and related agencies formulate policies and operational guidelines that aligned with the context and needs of undergraduate students, thereby contributing to the development of more appropriate and effective operational models for e-cigarette control.

Effectiveness of a Fall Prevention Program for Elderly in Khok Kathiam Subdistrict, Mueang Lopburi District, Lopburi Province

Jantarat Kritarkhom, Arapa Boonyoo — Mon, 22 Jun 2026 00:00:00 +0700

This quasi-experimental study using a one-group pretest–posttest design aimed to examine the effectiveness of a fall prevention program among older adults. The study was conducted over a 12-week period. The sample consisted of 30 older adults selected by simple random sampling. Research instruments included a fall prevention program, a personal information questionnaire, and assessment tools for balance ability, risk of falling, fall prevention behaviors, and fear of falling. Descriptive statistics were used to analyze demographic data, and paired t-tests were employed to compare mean scores before and after the intervention. The results revealed that after participation in the program, older adults demonstrated significantly higher mean scores in balance ability (M=51.87, SD=3.23) and fall prevention behaviors (M=43.20, SD=4.23) compared with pre-intervention scores. In contrast, the mean scores for risk of falling (M=12.70, SD=3.03) and fear of falling (M=25.07, SD=6.71) were significantly lower after the intervention. The program can be applied as a health promotion strategy for older adults in other community settings.

Predictive Factors of Results for the Nursing and Midwifery Licensure Examination at a Private University

Parichart Tewapita, Petpailin Phibunnithikasem — Mon, 22 Jun 2026 00:00:00 +0700

This study aimed to examine the predictive power of factors influencing outcomes of the nursing and midwifery licensure examination. The sample consisted of 162 graduates from both the standard Bachelor of Nursing Science program and the 2.5-year accelerated program in the academic year 2024, drawn from a target population of 190 individuals at a private university. The research instruments comprised a background data record form, a six-part questionnaire covering personal information, academic background, achievement motivation, examination preparation behaviors, institutional support, and attitudes toward the examination, and an examination result record form. Content validity was established, yielding a Content Validity Index (CVI) ranging from .91 to .95. Data were analyzed using descriptive statistics and binary logistic regression analysis. The findings revealed that 59.3% of the sample passed all eight subjects of the licensure examination. Cumulative grade point average (CGPA), attitudes toward the examination, and achievement motivation collectively accounted for 35.4% of the variance in examination outcomes. Graduates with a CGPA of 3.00 or above were approximately 5.14 times more likely to pass the examination than those with a CGPA below 3.00 (OR = 5.144, 95% CI = 1.952-13.554, p < .001). Additionally, each one-point increase in attitude scores (OR = 1.101, 95% CI = 1.041-1.165, p < .001) and achievement motivation scores (OR = 1.055, 95% CI = 1.013-1.098, p < .05) was associated with a 1.10-fold and 1.06-fold increase in the likelihood of passing the examination, respectively. These findings may be applied to develop student support mechanisms that emphasize academic achievement enhancement alongside the promotion of positive attitudes and achievement motivation, thereby increasing the likelihood of successful licensure examination outcomes.

Effect of the Experiential Learning Program on Rational Drug Use Competency in Pediatric Patients Among Nursing Students

Sudarat Vongchulachat, Sunee Insing — Mon, 22 Jun 2026 00:00:00 +0700

This one-group pretest-posttest quasi-experimental research aimed to compare mean rational drug use knowledge scores before and after program participation; evaluate clinical and OSCE performance skills after the program; and assess students’ satisfaction with the program. The samples consisted of 61 third-year nursing students from Saint Louis College, selected using a stratified random sampling method. The research instruments consisted of 1) The experiential learning program (CVI = 1.00); 2) the knowledge questionnaire (KR-20 = 0.73); 3) the clinical skills evaluation form (reliability = 0.74); 4) the OSCE skills assessment form (CVI = 0.97); and 5) the program satisfaction survey (reliability = 0.90). Data were analyzed using percentage, mean, standard deviation and Paired t-test. The results are as followings; 1) The students’ mean knowledge score after the experiment ( = 41.16, SD = 4.78) was significantly higher than the mean score before the experiment ( = 34.2, SD = 4.43), p < .001; 2) the mean clinical performance skills was at a very good level ( = 3.85, SD = .09); 3) the mean OSCE-based skills was at a good level ( = 2.65, SD = .15); 4) satisfaction with the program was at the highest level ( = 4.74, SD = .33). The research findings demonstrate that the program effectively enhances students’ pediatric rational drug use competency. Consequently, it is recommended that experiential learning should be implemented in other clinical nursing practicum courses.

The Relationship Between Age and Distance of Spinal Curve in Mild Thoracic Kyphosis

Mon, 22 Jun 2026 00:00:00 +0700

Thoracic kyphosis is a disorder of the thoracic spine, characterized by excessive backward curvature. Several factors, besides age, are associated with an increase in thoracic kyphotic angle, particularly among older adults. However, the Distance from the Seventh Cervical Vertebra to Wall (C₇WD) evaluation method has not been specifically applied to clarify this association in early thoracic kyphosis. This study aimed to analyze the relationship between age and C₇WD in individuals with mild thoracic kyphosis. Understanding age-related influences in the preventable phase of thoracic kyphosis may support strategies to delay progression. Methods: A cross-sectional study was conducted among 108 participants aged 18-53 years. All participants were evaluated for thoracic kyphosis using the C₇WD method (<5 cm) and categorized into two groups: group 1 (18-38 years) and group 2 (40-53 years). The relationship between age and average C₇WD was analyzed using Pearson correlation and regression analysis, and group differences were compared with independent samples t-test. Results: The relationship between age and thoracic kyphosis distance measured by C₇WD showed a strong positive correlation (r = 0.792, p < .001). The correlation coefficient for the 40-53 years group was 0.871 (95% CI 0.745-0.997). The average C₇WD was significantly greater in the older group, with a mean difference of 0.87 cm (p < .001). Conclusion: C₇WD increased with age, even among participants with mild thoracic kyphosis. The C₇WD method may be useful for screening and monitoring thoracic kyphosis progression in clinical practice.

Self-healthcare Innovation for the Elderly with Thai Traditional Medicine in the Area of Mae Khao Tom Subdistrict, Mueang Chiang Rai District, Chiang Rai Province

Mon, 22 Jun 2026 00:00:00 +0700

The objective of this participatory action research was to develop self-healthcare innovations for the elderly with Thai traditional medicine in the area of Mae Khao Tom Sub-district, Mueang Chiang Rai District, Chiang Rai Province, which is a suburban community with potential for local wisdom in healthcare but lacks a systematic model of promoting self-healthcare. The samples were 60 elderly individuals selected by purposive sampling. The research was conducted in four stages: 1) the planning stage by studying health problems and needs of the elderly and community potential; 2) the operational stage by developing innovations through a participatory process; 3) the observation stage; and 4) the reflection stage, conducted in parallel with applying the developed innovations to the sample group with pre- and post-tests administered. Data collection tools included 1) a health problem survey, 2) pre- and post-tests, and 3) satisfaction assessments. Content validity was verified by five experts with an IOC value between 0.60-1.00. Data were analyzed using descriptive statistics including percentage, mean, standard deviation, and inferential statistics with a paired t-test. The results revealed that: 1) the elderly in Mae Khao Tom Sub-district faced health problems with a group of diseases treatable by Thai traditional medicine, and most valued and preferred using Thai herbs and wisdom in healthcare; 2) the community had a role and potential to develop self-healthcare innovations with Thai traditional medicine; 3) two innovations were developed: 3.1) a mobile Thai traditional medicine elderly clinic, and 3.2) a health promotion and prevention activity titled “4S: Longevity Health for the Elderly”; and 4) after using the innovations, the elderly scored significantly higher on self-healthcare knowledge than before at the 0.05 level (t = 21.53), showed improved self-healthcare behaviors, and could apply herbal knowledge in daily life. Overall, 93 percent of the elderly expressed the highest level of satisfaction with the innovations in all aspects.

Comparison of the Immediate Effects of Low-Load Prolong Stretching and Gross Passive Stretching on Pectoralis Minor Muscle Tightness in Office Workers

Varavee Temprom, Aleeya Binramun, Laksanaree Pranom — Mon, 22 Jun 2026 00:00:00 +0700

Shoulder pain is prevalent among office workers and is commonly associated with prolonged sitting and poor posture. Sustained postural deviation may alter scapular alignment and increase pectoralis minor tightness, contributing to pain and restricted shoulder mobility. Stretching interventions are frequently used to reduce muscle tightness and improve function. This study aimed to compare the immediate effects of low-load prolonged stretching and gross passive stretching in office workers with pectoralis minor tightness. Thirty participants aged 20-50 years who reported sitting for at least 4 hours daily were recruited. Participants were randomly assigned into two groups. Outcome measures included pectoralis minor length, which was used to calculate the Pectoralis Minor Index (PMI), shoulder external rotation range of motion (ROM), and acromion distance (AD). All variables were measured before and immediately after the intervention. Statistical significance was set at p < .05. The results showed that both stretching techniques significantly increased pectoralis minor muscle index (PMI) and shoulder external rotation, while significantly reducing the acromion distance (AD) immediately after treatment (p < .05). However, no statistically significant differences were found between the two groups. In conclusion, both low-load prolonged stretching and gross passive stretching are effective in improving muscle flexibility and shoulder external rotation range of motion in office workers with pectoralis minor tightness. The observed improvements may also be partially attributed to the concurrent stretching effect on the pectoralis major muscle.

Acute Effects of Progressive Muscle Relaxation Combined with Music Therapy on Stress Reactivity and Working Memory Following Maastricht Acute Stress Test in Health Science Students

Tichaporn Sookkua, Chayapa Gaewkumjaeng, Lallalin Suwannasri — Mon, 22 Jun 2026 00:00:00 +0700

This assessor-blinded randomized controlled trial examined the acute effects of Progressive Muscle Relaxation (PMR) combined with Music Therapy (MT) on stress reactivity and working memory following stress induction using the Maastricht Acute Stress Test (MAST). Fifty female health science students aged 18-25 years with moderate baseline stress were randomly assigned to an experimental group (PMR combined with MT) or a control group (n = 25 per group). Perceived stress, blood pressure, heart rate, and Operation Span scores were assessed before and after stress induction. Post-induction results showed that the PMR combined with MT group reported significantly lower perceived stress than the control group (p = .042, d = -.59) and demonstrated significantly higher working memory performance (p = .019, r = .33). However, no significant between-group differences were observed in physiological measures, including blood pressure and heart rate (p > .05). These findings suggest that PMR combined with MT may attenuate subjective stress reactivity and support working memory performance under acute stress conditions, although no differential effects were detected in physiological responses.

Exercise Capacity and Balance in Patients with Anemic and Non-Anemic Chronic Obstructive Pulmonary Disease (COPD)

Sarayoot Mongkol, Tichaporn Sookkua, Sukanya Kreeinthong — Mon, 22 Jun 2026 00:00:00 +0700

Chronic obstructive pulmonary disease (COPD) is a major public health problem associated with functional decline and reduced quality of life. Anemia is a common comorbidity in COPD and may further worsen physical performance, potentially increasing healthcare utilization and fall risk. The aim was to compare exercise capacity and balance performance among healthy individuals, non-anemic COPD patients, and anemic COPD patients. A cross-sectional study was conducted in 120 participants allocated into three groups: healthy controls (n = 40), non-anemic COPD patients (n = 40), and anemic COPD patients (n = 40). Exercise capacity was evaluated using the six-minute walk test (6MWT), and balance performance was assessed using the Timed Up and Go (TUG) test. Pulmonary function was measured by spirometry. Data were analyzed using one-way ANOVA with Bonferroni post hoc comparisons. The anemic COPD group demonstrated significantly shorter six-minute walk distance and longer TUG completion time compared with both non-anemic COPD patients and healthy controls (p < .05). Pulmonary function parameters were significantly lower in both COPD groups compared with controls, but did not differ between anemic and non-anemic COPD patients. Anemia is associated with additional functional limitations in COPD patients independent of airflow obstruction. Routine screening and integrated management of anemia may improve functional outcomes and support more effective rehabilitation planning in COPD care.

Nursing Care of Children with Acute Rheumatic Fever and Severe Myocarditis: the Role of Pediatric Critical Care Nurses

Nittaya Sribuarom — Mon, 22 Jun 2026 00:00:00 +0700

Rheumatic fever in children is an inflammatory condition that develops following infection with Group A β-hemolytic Streptococcus, most commonly occurring after upper respiratory tract infections such as pharyngitis or tonsillitis. Following the infection, an abnormal immune response (autoimmune reaction) may occur, resulting in multisystem inflammation. Clinical manifestations include arthritis, chorea (involuntary movements), subcutaneous nodules, and erythematous skin rashes. Recurrent or persistent infections may lead to inflammation of the heart and heart valves, causing valvular regurgitation or stenosis, most frequently involving the mitral valve. Physical examination often reveals a cardiac murmur, while echocardiography may demonstrate cardiomegaly and valvular abnormalities. Laboratory findings typically show elevated erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and antistreptolysin O (ASO) titers, indicating inflammatory activity and recent streptococcal infection. Major complications include heart failure and chronic valvular regurgitation, which may be life-threatening in pediatric patients. The critical roles of nurses in caring for pediatric patients with rheumatic fever in the pediatric intensive care unit include: (1) rapidly assess clinical conditions, particularly heart failure, fluid overload, and hypoxia; (2) ensure the administration of prescribed antibiotics, prevention of complications, provision of supportive care, and activity restriction to reduce inflammation and myocardial workload, along with close monitoring for symptoms such as dyspnea, chest pain, joint pain, and abnormal movements; (3) promptly report of any clinical deterioration to support the physician team’s clinical decision - making; (4) collect relevant medical history, including recurrent episodes of pharyngitis or incomplete antibiotic therapy; (5) facilitate laboratory investigations, including preparation for blood sampling, echocardiography, and electrocardiography (ECG); and (6) provide family education regarding the importance of diagnostic evaluation and treatment adherence to enhance cooperation in treatment. Effective nursing care enables healthcare providers to reduce disease severity, prevent long-term disability, promote patient safety, and improve the long-term quality of life of pediatric patients.