Effects of a Gratitude-Promoting Program on Purpose in Life and Heart Rate Variability among Vulnerable Thai Youth: A Quasi-Experimental Study

Karnsunaphat Balthip; Danita Atiwiwat

doi:10.60099/prijnr.2026.279654

Authors

Karnsunaphat Balthip Faculty of Nursing, Prince of Songkla University, Thailand. https://orcid.org/0000-0001-5491-202X
Danita Atiwiwat Faculty of Science, Prince of Songkla University, Thailand. https://orcid.org/0000-0002-3420-033X

DOI:

https://doi.org/10.60099/prijnr.2026.279654

Keywords:

Adolescents, Gratitude, Heart rate variability, Nursing, Purpose in life, hailand, Vulnerable youth, Wellness

Abstract

Purpose in life plays a crucial role in positive youth development. However, limited evidence exists on interventions that simultaneously foster psychological purpose and physiological regulation among vulnerable youth. This quasi-experimental study examined the effect of a gratitude-promoting program on purpose in life and heart rate variability among vulnerable Thai youths. Initially, 60 vulnerable Thai youth aged 18–24 years were enrolled through simple random sampling from two informal education schools in Southern Thailand. Due to unstable living conditions, the final analysis included 37 participants (21 in the control group; 16 in the experimental group). The study was conducted from July to September 2022. The experimental group received a 10-week gratitude-promoting program in addition to the routine education, while the control group received routine education only. Outcomes measures included a demographic questionnaire, the Purpose in Life Scale for Thai Adolescents and heart rate variability recorded using a Polar H10 Chest Strap monitor. Data were analyzed using generalized estimating equations. Results from the adjusted generalized estimating equations model indicated significant group-by-time interaction effects at all follow-up assessments, with greater improvements in purpose in life in the experimental group. In contrast, the control group showed a decline in week 22. For heart rate variability, interaction effects were time-specific, and the mean heart rate decreased significantly in week 22. Indicators of heart rate variability, including the percentage of successive normal-to-normal intervals, differences more than 50 milliseconds, and the root mean square of successive differences, increased significantly in week 10. These findings suggest that gratitude-based interventions may enhance psychological well-being and physiological regulation among vulnerable youth. Nursing professionals can integrate this intervention into routine holistic health promotion for vulnerable youth to enhance purpose in life, emotional regulation, and wellness. However, before integration into health promotion practices by nurses, more research with larger sample sizes, a greater number of clusters, and more rigorous study designs is recommended.

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