The Journal of Boromarajonani College of Nursing, Suphanburi

Effects of a behavior modification program on knowledge and behavior in older persons with hypertension

Supim Mahanithiwong — 2025-09-01

Hypertension is one of the leading causes of premature death worldwide. This quasi-experimental research aimed to study the Effects of a behavior modification program on knowledge and behavior in older persons with hypertension. Samples were 70 persons and were divided into 2 groups as experimental group and control group. Each group included 35 persons. A control group that did not use a behavior modification program and an experimental group that used a behavior modification program for a period of 12 week. The tools used to collect data include personal information questionnaires, knowledge assessment form for elderly people with hypertension, behavior assessment form for elderly people with hypertension and a behavior modification program. Data were analyzed for describing the characteristic of samples by means, standard deviation and comparing the difference of results between experimental group and control group by Wilcoxon-signed rank test and Mann Whitney U test.

The research results found that after the experiment: 1) Knowledge and behavior in elderly people with hypertension in the experimental group were significantly higher than the control group at p<.05. 2) The experimental group had higher knowledge and behavior in elderly people with hypertension after the experiment than before the experiment, with statistical significance at p<.05. The study results concluded that a behavior modification program had an effect on improving knowledge and behavior change in elderly people with hypertension. Therefore, health personnel can further apply a behavior modification program to promote knowledge and behavior modification in elderly people with hypertension.

Effect of programs for postnatal maternal and infant care education at Prasat Hospital, Surin Province

Chattiya Imsamran — 2025-09-01

This study aimed to examine the effects of a self-care and infant care educational program for postpartum mothers at the Obstetrics and Gynecology Ward, Prasat Hospital, Surin Province, between January and February 2025. A purposive sample of 30 postpartum mothers was recruited. Research instruments consisted of (1) the educational program on self-care and infant care, with a content validity index (CVI) of .93, and (2) three sets of questionnaires: general information, knowledge assessment (KR-20 = 0.82), and self-care practice assessment (Cronbach’s α = 0.86). Data were analyzed using descriptive statistics and paired samples t-test.

The results revealed that before participating in the program, mothers had a moderate level of knowledge (M = 11.20, SD = 2.19), which increased to a high level after the intervention (M = 13.77, SD = 1.76). For self-care and infant care practices, the mean score before the program was already at a high level (M = 82.60, SD = 5.99) and significantly increased after the program (M = 88.40, SD = 6.73). Both knowledge and practice scores improved significantly compared with pre-program scores (p < .001).

Policy recommendations suggest integrating the educational program into standard postpartum care in community hospitals, with the development of clear guidelines and postpartum parent classes linked to antenatal care services. In practice, nurses should employ diverse teaching strategies such as lectures, demonstrations, and digital media, provided at times when mothers are most ready to learn, and follow-up through home visits or online platforms to strengthen mothers’ confidence and reduce postpartum complications.

The Role of Nursing Student Leaders in Promoting Health Literacy for E-Cigarette Prevention: A Qualitative Study

Kanyaphat Pongchangyou — 2025-09-01

E-cigarettes represented a significant public health threat among Thai youth, with rising prevalence, particularly among adolescents lacking health literacy and media awareness. Previous studies have indicated that health literacy programs effectively improve youth health behaviors; however, qualitative evidence regarding the roles and experiences of nursing student leaders after participating in such programs remains limited. Thus, this qualitative descriptive study aimed to explore the perspectives, intentions, roles, experiences, and communication strategies of nursing student leaders in promoting health literacy for e-cigarette prevention among youths. Eighteen purposively selected nursing student leaders participated in three focus group discussions, and data were analyzed using thematic analysis.

Seven themes aligned clearly with the study objectives emerged: (1) firm intention to avoid e-cigarettes, (2) dissemination of health literacy knowledge to peers, families, and communities, (3) tailored communication strategies for specific groups, (4) positive impacts of the program on attitudes and behaviors, (5) leadership roles in driving social change, (6) motivational strategies encouraging youth engagement, and (7) strategic plans toward an e-cigarette-free society. Findings underscored the substantial potential of nursing student leaders to effectively transfer health literacy and positively influence youth health behaviors. Thus, future support and continuous development of nursing student leaders' roles and communication strategies are recommended to enhance youth health literacy and prevent e-cigarette use effectively.

Effectiveness of Promotion Program on Prevention Behaviors toward Bullying and Bullying Victimization by Applying the Theory of Planned Behavior among Lower Secondary School Students, Surat Thani Province

Aphirak Triyuang — 2025-09-01

This quasi-experimental study aimed to examine the effectiveness of a behavior promotion program designed to prevent both victimization by and perpetration of bullying, applying the Theory of Planned Behavior among lower secondary school students in Surat Thani Province. The sample consisted of 75 students aged 13–16 years, divided into two groups: an experimental group (n=39) and a comparison group (n=36). The experimental group participated in the ECHO Anti-Bullying Program, which was conducted in four sessions of 50 minutes each over a four-week period. Meanwhile, the comparison group received conventional promotion activities for bullying prevention. Data were collected using questionnaires created by researchers administered before and after the intervention and analyzed using descriptive statistics, paired t-tests, and independent t-tests.

The results revealed that, post-intervention, the experimental group had significantly higher mean scores than the comparison group (p < .05) regarding attitudes toward the behavior (M=4.38, SD=0.30, t=6.09), subjective norms (M=4.41, SD=0.29, t=7.25), perceived behavioral control (M=4.32, SD=0.29, t=3.99), behavioral intentions (M=4.49, SD=0.26, t=5.39), and actual behaviors related to preventing bullying victimization and perpetration (M=4.40, SD=0.30, t=4.41).

In conclusion, the behavior promotion program focusing on addressing intrapersonal causal factors by applying the Theory of Planned Behavior was effective in enhancing factors associated with bullying prevention among lower secondary school students in Surat Thani Province.

Developing an Active Learning Management Program to Promote Media Literacy Skills in E-Cigarette Advertising Media on Internet Network among Junior Secondary School Student

Chaiwat Nalaem — 2025-09-01

This descriptive research aims to develop a learning management program to enhance media literacy skills among junior secondary school students. The study was conducted in two phases: Phase 1 involved developing an active learning management program to promote media literacy regarding electronic cigarette advertising on the internet among junior secondary school students. The program was designed based on the concept of media literacy combined with active learning, in order to create a health education learning activity plan aimed at behavioral change using the Intervention Mapping (IM) approach. Phase 2 focused on assessing the quality of the program by key informants. Research instruments included a tool quality assessment form for data collection instruments, with the program being evaluated by three experts selected through purposive sampling. Data were analyzed using descriptive statistics, namely the mean (M) and standard deviation (SD). The results revealed that the active learning management program to enhance media literacy on electronic cigarette advertising via the internet for junior secondary school students consisted of four health education learning activity plans. The activities were conducted once a week, each lasting 50 minutes, and were integrated into health education courses, student development subjects, or other activities according to the school context. The learning process emphasized hands-on student engagement and participation, focusing on the content of media literacy related to electronic cigarette advertising on the internet, utilizing various health education strategies. Overall, the expert evaluation indicated that the program was of very high quality. (M=4.64, SD=0.43)

Needs Assessment of Early Childhood Development Center Administration for Promoting Age-Appropriate Child Development in the Context of COVID-19 Endemic

Anucha Promkanya — 2025-09-01

This research aimed to assess the needs for managing early childhood development centers to promote age-appropriate child development under the endemic COVID-19 situation. A cross-sectional survey research design was employed with a sample of 385 participants obtained through stratified random sampling, comprising local government administrators, center directors, early childhood teachers, and child caregivers. The research instrument was a needs assessment questionnaire covering five dimensions: management, learning management, health and safety care, personnel, and community participation. The instrument was validated by experts (IOC = 0.67-1.00) and tested for reliability (Cronbach's alpha = 0.94). Data were analyzed using descriptive statistics and the PNI<sub>modified</sub> index.
The findings revealed that overall needs were at a high level (PNI<sub>modified</sub> = 0.386). The management dimension showed the highest need (0.434), requiring development in strategic planning, staff motivation, and resource allocation. This was followed by the personnel dimension (0.423), which emphasized the need for enhancing teacher competency, and the community participation dimension (0.388), which required establishing partnership-based collaboration.
The research concluded that developing flexible management systems, enhancing teacher capacity, and promoting intensive community participation are urgent needs for strengthening early childhood development centers in the endemic COVID-19 era and appropriately supporting child development. These findings provide crucial insights for upgrading the quality of early childhood education to meet new challenges effectively.

Effect of a Self-Efficacy Enhancing Program on Dietary and Exercise Behaviors in Patients with Coronary Artery Disease After Receiving Percutaneous Coronary Intervention Treatment

Napapan Thongsantia — 2025-09-01

This study aimed to examine the effects of a self-efficacy enhancing program on dietary and exercise behaviors among patients with coronary artery disease (CAD) after receiving percutaneous coronary intervention (PCI) treatment. This research is a quasi-experimental study using a two-group posttest design. Purposive sampling was used to recruit 56 patients with CAD who had received PCI at Petcharat Cardiac Intensive Care Unit 4C and Petcharat Ward 16B, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, between June 2024 and January 2025. Of these, 28 patients were assigned to a control group that received standard care, while the remaining 28 patients in the experimental group received a self-efficacy enhancing program on dietary and exercise behaviors. The research instruments included: 1) the General Perceived Self-Efficacy Scale, Thai version translated by Sukmak et al. (2001); 2) a self-efficacy enhancing program on dietary and exercise behaviors developed based on the self-efficacy framework by Bandura (1997) in combination with the literature review; 3) a handbook on disease and appropriate health behavior regarding diet and exercise; 4) video media presenting a symbolic model on appropriate eating behavior; 5) video media presenting a symbolic model on appropriate exercise behavior by Ashton (2008); 6) a questionnaire on dietary behavior specific to cardiovascular disease, Thai version translated by Tantikusum (2010) .The reliability coefficient of the questionnaire was 0.81.; and 7) a questionnaire on exercise behavior of patients with acute myocardial infarction after undergoing coronary angioplasty by Lanwong (2015). The reliability coefficient of the questionnaire was 0.82. Analysis of data was conducted using descriptive statistics, and the Mann-Whitney U and independent t-test.
The findings revealed that the experimental group which received the self-efficacy enhancing program had significantly higher scores for both dietary (M = 59.00) and exercise behaviors (M = 43.50) compared to the control group (M = 37.00; M = 21.00) (p < 0.05). These results indicate that the program was effective in promoting healthy dietary and exercise behaviors among patients with coronary artery disease after percutaneous coronary intervention. Integration of the program with educational manuals and a LINE Official Account is recommended to stimulate and monitor these health behaviors in this patient group. Furthermore, consideration should be given to incorporating the program into post-treatment rehabilitation, providing staff training, and allocating resources to support sustainable behavior change.

The development of a Health Promotion Model Based on Praboromarajchanok Institute Model (PI model) for Happy Organization in Boromarajonani College of Nursing Chiangmai

Sudthicharat Charoenphong — 2025-10-27

This participatory action research aimed to develop a health promotion model based on the Praboromarajchanok Institute Model (PI Model) for fostering a happy organization at Boromarajonani College of Nursing Chiang Mai. The study was conducted from January 2023 to January 2024 and consisted of 3 phases. The first phase involved preparation, including analysis of input factors and organizational context, as well as quantitative data collection from 120 personnel using questionnaires on demographic characteristics, health status, happiness, mental health, health literacy, and organizational happiness. Qualitative data were also collected from 30 participants through focus group discussions, in-depth interviews, non-participant observations, and field notes. The second phase focused on model development, in which 50 personnel and 10 researchers collaboratively identified problems, planned interventions, implemented activities, and monitored and refined the processes. The third phase emphasized evaluation and validation of the model, using descriptive statistics for quantitative data and content analysis for qualitative data.
The findings revealed that the developed health promotion model comprised six key components: (1) leadership-driven organizational mobilization, (2) employee participation, (3) health promotion systems under the PI Model, (4) integrated policy-driven activities, (5) systematic monitoring and support through information technology, and (6) health dialogue forums and lesson learned. Implementation of the model demonstrated improvements in both physical and mental health among personnel. The number of individuals at risk for diabetes and hypertension decreased, while the proportion of those with normal blood sugar and blood pressure increased. Overall health literacy was rated at a good level (M = 4.34, SD = 0.45). Mental health remained within the normal range, with no signs of depression, and workplace happiness was enhanced. Stakeholders also evaluated the model as effective (M = 3.67, SD = 0.45).
This study underscores that fostering participation at all organizational levels, coupled with enhancing health literacy, serves as a critical foundation for promoting individual and organizational well-being. Such efforts contribute to the development of a sustainable happy organization and provide a prototype for adaptation in other educational institutions.

Factors predicting discharge readiness in patients with closed fracture of a leg undergoing internal fixation surgery in orthopaedic ward at Ratchaburi Hospital

Pitchawee Sinsawad — 2025-10-27

The descriptive study aimed to explore predictive power between discharge readiness and related factors: length of stay, illness representation (symptoms associated with illness, perception of illness) and quality of discharge teaching. Fifty-four samples were recruited from patients with closed fracture of a leg undergoing internal fixation surgery via recruit sample follow inclusion criteria. The instruments applied consisted of the Revised Illness Perception Questionnaire (IPQ-R), the Quality of Discharge Teaching Scale (QDTS), and the Readiness for Hospital Discharge Scale (RHDS), which were tested for the reliability. Their Cronbach’s alpha coefficient values were .70, .85, .96, and .96 respectively. Data were collected during April 2022 to August 2022. Descriptive statistics, Pearson’s Product Moment Correlation, Point Biserial Correlation and Enter method multiple regression were used to analyze the data. The results of the study showed that Symptoms associated with illness had negative association with Discharge readiness at significant p value of.05 (rpb = -.375). Moreover the result revealed that perception of illness and quality of discharge teaching related to the discharge readiness positively and significantly (r = .578, r = .653, p< .001). Symptoms associated with illness, (Beta= -0.260). Perception of, (Beta=0.432) and quality of Discharge teaching (Beta=0.552) could jointly explain 58.9 % of the variance in discharge readiness of patients with closed fracture of a leg undergoing internal fixation surgery. The study suggested that nurses have to concern discharge readiness of patients with closed fracture of a leg undergoing internal fixation surgery, have to teach the content pertinent to the patients’ needs appropriate to the shorter limited time (LOS), and have to find strategies to promote these patients to perceive and interpret the meaning of their illness positively.

The Effectiveness of A DASH Diet Promotion Program Combined with Self-Efficacy Theory to Prevent Hypertension among Working Adults in Nakhon Nayok Province

Sasima Ngamaneknuntakul — 2025-10-28

This quasi-experimental study aimed to evaluate the effectiveness of a DASH diet promotion program combined with self-efficacy theory to prevent hypertension among working adults in Nakhon Nayok Province. The sample consisted of 74 participants aged 35–59 years who were screened as being at risk for hypertension, with blood pressure levels in the range of 130–139/80–89 (mmHg). Participants were randomly assigned to either an experimental group or a comparison group (37 each). The intervention lasted four weeks. Data collection tools included a general information questionnaire, self-efficacy and outcome expectation scales related to hypertension prevention behaviors, a behavior assessment scale, and a blood pressure record form. Data analysis was performed using both descriptive and inferential statistics. The descriptive statistics comprised frequency distribution, percentage, mean, and standard deviation. Inferential statistics were conducted using paired sample t-test and independent t-test.
The results showed that after participating in the program, the experimental group demonstrated significantly higher scores in self-efficacy, outcome expectations, and hypertension prevention behaviors compared to the comparison group (p < .05). Furthermore, both systolic and diastolic blood pressure levels in the experimental group were significantly lower than those in the comparison group after the intervention (p < .05).
The research findings suggest that the program should be implemented to modify dietary behaviors and reduce blood pressure levels in individuals at risk for hypertension. The program's dietary component, which is based on the self-efficacy theory, may need to be adapted to fit the specific context and lifestyles of at-risk populations living in other areas.

The Effects of Health Literacy Enhancement Program through Chatbot Integrated with Husband’s Support on Blood Glucose Level Control Behavior and Blood Glucose Level among Pregnant Woman with Gestational Diabetes: A Quasi-Experimental Study

Sutida Supanee — 2025-09-01

This quasi-experimental research aimed to compare the effects of health literacy enhancement program through chatbot integrated with husband’s support on blood glucose level control behavior and blood glucose level among pregnant women with gestational diabetes mellitus. Participant were 54 pregnant women with gestational diabetes mellitus who received antenatal care services at Suratthani hospital in Suratthani Province from February to May 2025. 27 participants were allocated to each group. The research instruments consisted of 3 parts: 1) health literacy enhancement program through chatbot integrated with husband support; 2) the data collection instruments, comprising 2 forms: the general information form, and the self-care blood glucose level control behavior questionnaire. and 3) The research control instruments: the blood glucose level control behavior record form and the husband's support that the pregnant women received during intervention. The Data were analyzed using descriptive statistics, chi-square, and independent t-tests and the hypothesis was evaluated using independent t-test, paired t-test, McNemar test, and chi-square.
The results showed that the blood glucose level control behavior and proportion of normal blood glucose levels of pregnant women with gestational diabetes mellitus who had received the program were significantly higher than before receiving the program (p < .001). When comparing between groups, it was found that the blood glucose level control behavior and proportion of normal blood glucose levels of pregnant women with gestational diabetes mellitus who received the program were significantly higher than those of the control group (p < .001). The health literacy promotion program via chatbot with husband’s support helped improve blood glucose level control behavior of pregnant women with gestational diabetes mellitus and increased the proportion of pregnant women with gestational diabetes mellitus who achieved normal blood glucose level.