https://he02.tci-thaijo.org/index.php/TJONC/issue/feed Thai Journal of Nursing Council 2022-08-07T00:23:10+07:00 รศ. ดร สายพิณ เกษมกิจวัฒนา saipin2499@gmail.com Open Journal Systems <p>วารสารสภาการพยาบาล เป็นวารสารวิชาการที่มีการประเมินโดยผู้ทรงคุณวุฒิเฉพาะสาขา กำหนดออกราย 3 เดือน ปีละ 4 ฉบับ โดยสภาการพยาบาลเป็นเจ้าของ มีเป้าหมายเพื่อเป็นแหล่งในการเผยแพร่ผลงานวิชาการของพยาบาลวิชาชีพ และความก้าวหน้าในศาสตร์สาขาการพยาบาล ทั้งด้านการพยาบาลทางคลินิกและชุมชน การศึกษาพยาบาล การบริหารการพยาบาล และที่เกี่ยวข้อง</p> https://he02.tci-thaijo.org/index.php/TJONC/article/view/256934 Impact of Insomnia Management Programme on Insomnia Severity in Older Persons with Heart Failure 2022-04-25T15:44:14+07:00 Woranan Theesudapan jindarat.c@cmu.ac.th Jindarat Chaiard jindarat.c@cmu.ac.th Rojanee Chintanawat rojanee.c@cmu.ac.th <p><strong>Objective:</strong> To examine the impact that an insomnia management programme had on insomnia severity in older persons with heart failure</p> <p><strong>Design:</strong> Two-group quasi-experimental study with a pretest and posttest</p> <p><strong>Methodology:</strong> The subjects were 48 male and female older persons with heart failure, aged between 60-75 years, treated in the outpatient department of a tertiary hospital from January to June 2021. The subjects were purposively sampled and equally assigned to a control group (24) and experimental group (24); however, one of the experimental group members withdrew from the study due to the Covid-19 situation. Whilst the control group received standard nursing care, the experimental group received both standard nursing care and the insomnia management programme, which had been developed by the researchers based on the concept of cognitive and behavioural therapy for insomnia and based on reviewed literature. The data collection tools consisted of a personal information record form and the Insomnia Severity Index (ISI). The ratio of older persons with heart failure was determined using McNemar’s Test, based on a comparison of their insomnia severity degrees before the intervention and in weeks 6 and 10 after the intervention. The ratio of heart failure incidence in older persons in the control group and the experimental group before the intervention and in weeks 6 and 10 after the intervention was determined using Fisher’s Exact Test.</p> <p><strong>Results:</strong> The degrees of insomnia severity in weeks 6 and 10 after the intervention were significantly lower in the subjects participating in the insomnia management programme than in those receiving only standard care (p &lt; .05), and also significantly lower than all of the subjects’ average pre-intervention insomnia severity degree (p &lt; .01).</p> <p><strong>Recommendations</strong>: Nurses and healthcare professionals are advised to receive special behavioural therapy training in order to apply this programme to caring for older persons with sleep problems. Further studies based on this or any similar framework should be designed to measure other related aspects, for example, performance of daytime functions, fatigue, quality of life, and sleep-related beliefs and attitudes.</p> 2022-08-07T00:00:00+07:00 Copyright (c) 2022 Thai Journal of Nursing Council https://he02.tci-thaijo.org/index.php/TJONC/article/view/258614 Development of Integrated Discharge-Planning Programme for Stroke Patients 2022-07-10T14:55:39+07:00 Khanuengnij Srisakhot nij2505@gmail.com Potjanee Kuleelung nij2505@gmail.com Benchaporn Aungvanit nij2505@gmail.com Boonmee Sondos nij2505@gmail.com Suwallaya Sriruksa nij2505@gmail.com <p><strong>Objective: </strong>To develop a discharge-planning programme for internal medicine stroke patients, and to assess two aspects of the programme outcomes, namely, the caregivers, in terms of caregiving preparedness, direct care-induced stress, and quality of life, and the patients, in terms of preventable complications and need for re-admission</p> <p><strong>Design:</strong> Research and development</p> <p><strong>Methodology</strong>: This study was conducted between October 2021 and June 2022 in four stages: 1) analysis of discharge-planning situation; 2) development of an integrated discharge-planning programme for stroke patients, based on Naylor’s theory of transitional care; 3) trial of the developed programme on two pairs of patients and caregivers, followed by evaluation of outcomes and adjustment of the programme for increased reliability; and 4) utilisation of the adjusted programme and final outcome assessment.</p> <p>The research was designed as a two-group quasi-experimental study with a post-test. The participants were 30 pairs of stroke patients and their caregivers selected based on the inclusion criteria and equally assigned to a control group and an experimental group, 15 pairs in each. Whilst the control group received the standard discharge plan, the experimental group participated in the researcher-developed integrated discharge-planning programme.</p> <p>Data were collected from the caregivers and the patients. The data from the caregivers were collected through a personal information form, the preparedness scale, the direct care-induced stress scale, and the quality of life scale. The data from the patients were collected through a personal information form, the preventable complication scale, and the re-admission records. The data were analysed based on frequency, percentage, mean, chi-square statistics, and T statistics.</p> <p><strong>Results:</strong> The caregivers in the experimental group achieved significantly higher mean scores on caregiving preparedness and pre-discharge quality of life than those in the control group did (p &lt; .05). However, the two groups’ mean score on direct care-induced stress did not differ significantly (p &gt; .05). One month after discharge, the experimental group also achieved significantly higher mean scores on caregiving preparedness and pre-discharge quality of life than the control group did (p &lt; .05), and displayed a significantly lower level of direct care-induced stress than the control group did (p &lt; .05). As for the patients, neither the experimental group nor the control group displayed any complications. Whereas two of the patients in the control group were re-admitted, none of those in the experimental group was.</p> <p><strong>Recommendations:</strong> It is recommended that hospitals have a policy to apply this integrated discharge-planning programme to treating internal medicine stroke patients, to promote their caregivers’ caregiving preparedness and quality of life.</p> 2022-08-07T00:00:00+07:00 Copyright (c) 2022 Thai Journal of Nursing Council https://he02.tci-thaijo.org/index.php/TJONC/article/view/256237 Effect of Noise Reduction Guideline Implementation on Nurses’ Noise Control Behaviour and on Noise Levels in the Neonatal Intensive Care Unit 2022-03-07T11:05:39+07:00 Natthanicha Panpayap wanlaya.tha@mahidol.ac.th Wanlaya Thampanichawat wanlaya.tha@mahidol.ac.th Sudaporn Payakkaraung sudaporn.pay@mahidol.ac.th <p><strong>Objective:</strong> To compare the nurses’ mean score on noise control behaviour and the noise levels in the neonatal intensive care unit (NICU) before and after the implementation of the noise reduction guideline </p> <p><strong>Design:</strong> One group quasi-experimental research with a pre-test and a post-test </p> <p><strong>Methodology:</strong> The subjects were 18 registered nurses operating in the neonatal intensive care units of Bamrasnaradura Infectious Diseases Institute and Panyananthaphikkhu Chonprathan Medical Center. The subjects’ implementation of the noise reduction guideline was promoted through education, mentorship, equipment support, poster reminders, and feedback. Three kinds of data were collected. First, the noise level in each of the NICUs was measured in two positions for two consecutive days, 24 hours per day. Second, information on each of the NICUs’ environment was recorded. Third, the nurses’ noise control behaviour was observed from two months before the implementation to two months after. Descriptive statistics, paired t-test and Wilcoxon signed-rank test were used for data analysis. </p> <p><strong>Results:</strong> The subjects’ average post-implementation noise control behaviour score was significantly higher than their pre-implementation score (p &lt; .05). The median noise levels in each critical care room (position 1) and the intermediate care room (position 2) were significantly reduced after the implementation (p &lt; .01).</p> <p><strong>Recommendations:</strong> It is recommended that all of the healthcare professionals operating in the NICU be encouraged to apply this guideline to enhance their noise control capability and reduce noise levels in the NICU. </p> 2022-08-07T00:00:00+07:00 Copyright (c) 2022 Thai Journal of Nursing Council https://he02.tci-thaijo.org/index.php/TJONC/article/view/256542 Experiences of Caregivers of Critically Ill Pediatric Patients in End-of-Life Stage: A Phenomenological Study 2022-03-07T10:48:38+07:00 Hathaichanok Nitikul hathaichanok.nit@cra.ac.th Saowanee Songprakon supawadee@nurse.tu.ac.th <p><strong>Objective: </strong>To describe and explain the experiences of family caregivers caring for their critically ill children in their end-of-life stage in a pediatric intensive care unit </p> <p><strong>Design:</strong> Phenomenological study </p> <p><strong>Methodology:</strong> The participants, who were purposively sampled, were 11 parents and chief caregivers of critically ill infants and children with life threatening illnesses or in their end-of-life stage treated in a campus hospital. Data were collected one or two times from each participant, through in-depth individual interviews, non-participatory observation, and field note recording. The data were qualitatively analysed using van Manen’s method. Data reliability was established based on Lincoln and Guba’s criteria. </p> <p><strong>Results: </strong>The experiences of family caregivers caring for their critically ill children in their end-of-life stage were described as belonging to 12 themes classified into van Manen’s four ‘worlds’. First, the ‘lived body’ refers to uncertainty and bittersweet conditions in life, sufferings, stress, heartbreak, and need for strength. Second, the ‘lived time’ is marked by waiting for a miraculous healing, refusing to wish a quick death (in order to fulfill one’s desires), and coming to terms with losses. Third, the ‘lived relations’ refer to moral support from the life partner, assistance from the family, and caregiving from the nurses and physicians. Finally, the ‘lived space’ means flexibility for engaging family members to provide caregiving and help cope with loneliness. </p> <p><strong>Recommendations:</strong> For nurses and other healthcare professionals caring for critically ill children in their end-of-life stage, this study could provide a better understanding of family caregivers caring for their critically ill children, as well as preliminary information for the development of a caregiving model for this group of pediatric patients in line with the Thai social context. </p> 2022-08-07T00:00:00+07:00 Copyright (c) 2022 Thai Journal of Nursing Council https://he02.tci-thaijo.org/index.php/TJONC/article/view/258081 Predictive Factors for Self-Management Amongst Older Persons with Knee Osteoarthritis 2022-06-03T18:01:39+07:00 Naruephat Duwao ming735@hotmail.com Rojanee Chintanawat rojanee.c@cmu.ac.th Nattaya Suwankruhasn nattaya.s@cmu.ac.th <p><strong>Objective:</strong> To examine self-management exercised by older persons with knee osteoarthritis and the predictive power that the factors of health literacy, social support, and perceived self-efficacy could have on self-management</p> <p><strong>Design:</strong> Predictive correlational research</p> <p><strong>Methodology:</strong> The participants were 120 older persons diagnosed with knee osteoarthritis and treated at four health-promoting hospitals in Muang district, Phrae province. The data collection sites were selected through multi-stage random sampling, whilst the subjects were recruited by means of convenient sampling. The data collection period was from August to October 2021. The research tools consisted of a personal information questionnaire, a self-management evaluation, a health literacy evaluation, a social support evaluation, and a perceived self-efficacy evaluation. The data were analysed using descriptive statistics and multiple regression analysis.</p> <p><strong>Results:</strong> The subjects displayed a high overall score on self-management and also a high score on each of the three factors. Health literacy, social support, and perceived self-efficacy were jointly capable of predicting 74% self-management amongst the subjects, at a statistically significant level of .001. Of these factors, social support had the highest predictive power for self-management (β = .557, p &lt; .001), followed by perceived self-efficacy (β = .342, p &lt; .001), and health literacy (β = .133, p &lt; .001), respectively.</p> <p><strong>Recommendations:</strong> Healthcare professionals may apply the research findings to developing a self-management programme for older persons with knee osteoarthritis, with emphases on social support, perceived self-efficacy, and heath literacy.</p> 2022-08-07T00:00:00+07:00 Copyright (c) 2022 Thai Journal of Nursing Council https://he02.tci-thaijo.org/index.php/TJONC/article/view/256882 Factors Predicting Self-Care Behaviours in Patients with Coronary Artery Disease 2022-04-08T14:43:24+07:00 Lapasrada Nachai lapas257@gmail.com Sarinrut Sriprasong sarinrut.sri@mahidol.edu Chogjit Seneha chongchit.san@mahidol.ac.th Thamarath Chantadansuwan dansuwan_t@yahoo.co.th <p><strong>Objective:</strong> To investigate the predictive power that cognitive representation of illness, emotional response, knowledge of the disease, and frailty could have on self-care behaviours in patients with coronary artery disease</p> <p><strong>Design:</strong> Predictive correlational research</p> <p><strong>Methodology:</strong> The subjects were 158 male and female patients aged 18 and above, recruited via simple random sampling. The subjects, who were diagnosed to have developed coronary artery disease for at least 6 months, were treated at a specialised tertiary hospital. Data were collected between April and July 2021, using a personal information questionnaire, the Self-Care of Coronary Heart Disease Inventory, the Brief Illness Perception Questionnaire, the Coronary Artery Disease Education Questionnaire (short version), and the Frailty Scale Questionnaire. Descriptive statistics and logistics regression analysis were used to analyse the data.</p> <p><strong>Results:</strong> The majority of the sample (79.7%) were male with an average age of 62.27 years (SD = 9.08). Most of the subjects (75.3%) displayed a high overall level of self-care behaviour.The analysis of predictive power revealed that cognitive representation of illness, emotional response, knowledge of the disease, and frailty were able to jointly predict 11.6% self-care behaviours in coronary artery disease patients (Nagelkerke R2= 0.116). The factors identified as having significant predictive power on self-care behaviours were high level of knowledge of the disease (OR = 5.54, 95% CI = 1.43 – 21.47, p = .013) and high level of cognitive representation of illness (OR = 2.45, 95% CI = 1.05 – 5.74, p = .038).</p> <p><strong>Recommendations:</strong> Nurses and members of a healthcare staff should educate coronary artery disease patients on the disease process and cognitive representation of the illness, to promote better self-care behaviours.</p> 2022-08-07T00:00:00+07:00 Copyright (c) 2022 Thai Journal of Nursing Council https://he02.tci-thaijo.org/index.php/TJONC/article/view/255608 Factors Predicting Postoperative Recuperation in Patients Having Undergone Hepatectomy 2022-04-21T13:24:52+07:00 Tanyalak Cheewaprapai kessiri.won@mahidol.ac.th Kessiri Wongkongkam kessiri.won@mahidol.ac.th Suporn Danaidutsadeekul suporn.dan@mahidol.ac.th Pongserath Sirichindakyl kessiri.won@mahidol.ac.th <p><strong>Objective:</strong> To study the predictive power of perioperative blood loss, preoperative nutritional status, comorbidity, and state anxiety on hepatectomy patients’ postoperative recuperation </p> <p><strong>Design: </strong>Descriptive predictive study design </p> <p><strong>Methodology:</strong> The subjects were 126 patients having received open abdominal hepatectomy surgery at two tertiary hospitals. The research framework employed was based on Roy’s theory of adaptation. Data were gathered from the patients’ medical records and topical interviews according to the data-gathering instruments, namely, the Modified Nutrition Alert Form, Charlson’s Comorbidity Index, State Anxiety Inventory Y-1, and Quality of Postoperative Recovery-40. The data were analysed using descriptive statistics and multiple regression analysis with enter method, with significance level set at .05. </p> <p><strong>Results: </strong>The subjects’ highest score was in the category of postoperative, pre-discharge recuperation (X = 177.56, SD = 16.301). The subjects had low perioperative blood loss ( X = 635.95, SD = 803.960), moderate preoperative malnutrition (X = 7.41, SD = 3.176), high preoperative comorbidity (X = 4.63, SD = 3.019), and moderate state anxiety (X = 51.34, SD = 7.094). A predictive power analysis showed that perioperative blood loss, preoperative nutritional status, preoperative comorbidity, and state anxiety could jointly predict 11% (R2 = 0.110, F (df1, df2) = 3.724 (4, 121), p = 0.007) postoperative recovery in patients who had undergone hepatectomy. Perioperative blood loss and state anxiety were identified as having significant influence on the prediction of postoperative patients’ recuperation, at (β = -0.247, β = -0.179, p &lt; 0.05), respectively.</p> <p><strong>Recommendations : </strong>Perioperative blood loss and state anxiety could jointly predict hepatectomy patients’ postoperative recovery. Nurses should, therefore, be aware of the importance of assessing perioperative blood loss and focus on preparing a surgical method that effectively minimises perioperative blood loss, maintains postoperative water balance, and regulates postoperative state anxiety, in order to enhance the patients’ postoperative recovery. </p> 2022-08-07T00:00:00+07:00 Copyright (c) 2022 Thai Journal of Nursing Council https://he02.tci-thaijo.org/index.php/TJONC/article/view/256887 Comparative Study of Factors Related to Traumatic Shock Between Adult and Older Adult Injured Patients 2022-04-08T10:08:00+07:00 Nongnuch Panhom wallada.cha@mahidol.ac.th Wallada Chanruangvanich wallada.cha@mahidol.ac.th Prangtip Chayaput prangtip.cha@mahidol.ac.th Orapan Thosingha nsots@mahidol.ac.th <p><strong>Objective:</strong> To compare between adult and older adult injured patients’ traumatic shock in relation to the factors of transportation time, severity of injury (SI), and comorbidity </p> <p><strong>Design:</strong> Cross-sectional study </p> <p><strong>Methodology: </strong>The sample consisted of 209 injured patients aged 18 and above, treated in a trauma and emergency department. The research instruments were: 1) a demographic and injury history form; and 2) a record form for transportation time, injury severity score (ISS), comorbidity, shock index, and age shock index. The data were analysed using the Mann-Whitney U test, Chi-square, and the binary logistic regression, with the significance level set at 0.05. </p> <p><strong>Results: </strong>The majority of the subjects (70.81%) were adults, with the leading causes of injury being falls from height (42.62%) and traffic accidents (31.75%), respectively (χ2 = 14.85, p &lt; .01). Occurrence of traumatic shock was more common in injured older adults than in injured adults (73.77% VS 22.97%; OR = 7.67, 95% CI = 3.35-17.58, p &lt; .01). In most cases (69.38%), the transportation time did not exceed 60 minutes, and had no significant relationship to shock (χ2 = 2.21, p = .14). Both the adult and older adult injured patients displayed mild degrees of injury on the ISS (55.74% VS 67.57%). Shock was most frequent in cases with an ISS score of under 15, and significantly more common in older adults than in adults (85.71% VS 57.89%). Comorbidity was identified as a factor more significantly related to shock in older adult than in adult injured patients (75.00% VS 33.33%). Also, injury severity degrees were significantly related to, and also influenced, occurrence of shock (χ2 = 25.01, p &lt; .01; OR = 4.70, 95% CI = 2.04-10.83; OR = 9.34, 95% CI = 3.37-25.87; p &lt; .01). Comorbidity, on the other hand, was significantly related to shock (χ2 = 16.83; p &lt; .01) but was not found to influence it. </p> <p><strong>Recommendations:</strong> Because age and injury severity could influence shock in older adult patients, nurses are advised to take these two factors into careful consideration to plan for appropriate caregiving.</p> 2022-08-07T00:00:00+07:00 Copyright (c) 2022 Thai Journal of Nursing Council https://he02.tci-thaijo.org/index.php/TJONC/article/view/257143 Symptoms and Signs, Self-Management of Symptoms, and Emergency Department’s Management of Older Adults with Congestive Heart Failure 2022-04-19T15:48:54+07:00 Surasak Mulsrisuk supreeda.mon@mahidol.ac.th Supreeda Monkong supreeda.mon@mahidol.ac.th Nuchanad Sutti nuchanad.jea@mahidol.ac.th <p><strong>Objective: </strong>To examine older adults’ symptoms and signs of congestive heart failure and self-management behaviour, as well as the emergency department’s management of such older adults </p> <p><strong>Design: </strong>Descriptive research </p> <p><strong>Methodology:</strong> The subjects were 163 purposively sampled older adults with congestive heart failure treated in the emergency department of a tertiary care hospital from February to May 2021. The research instruments consisted of: 1) a demographic data questionnaire; 2) a questionnaire on the signs and symptoms of congestive heart failure in older adults and their self-management behaviour; and 3) the emergency department’s records of management of the older adults during their visits. The data were analysed using descriptive statistics, including the frequency, percent- age, mean, and standard deviation. </p> <p><strong>Results:</strong> According to the findings, the five most common symptoms were orthopnea (83.44%), pitting edema (68.10%), dyspnea on exertion (66.26%), paroxysmal nocturnal dyspnea (PND) (61.35%), and chest pain (39.26%), respectively. The most common atypical symptoms were nausea (22.86%), dry cough (20.86%), fatigue (20.25%), decreased appetite (17.78), and loss of appetite (14.72), respectively. The majority of this subjects (92.21%) preferred sitting as a means of self-management, whilst about half (48.49%) chose to lie down with their heads elevated and less than one-fifth (16.36%) resorted to deep breathing. The emergency department’s primary means of managing the subjects were pharmacological treatment (100%) and oxygen therapy (72.08 %), respectively. </p> <p><strong>Recommendations:</strong> The results of this study suggested that the evaluation of clinical and atypical symptoms of heart failure in older adults are complex. Therefore, nurses should possess the necessary knowledge and competency in screening older adults with congestive heart failure according to their symptoms, to determine care priority and to give them and their caregivers proper advice on the signs, symptoms, and appropriate post-discharge self-management methods. </p> 2022-08-07T00:00:00+07:00 Copyright (c) 2022 Thai Journal of Nursing Council