Thai Journal of Nursing Council https://he02.tci-thaijo.org/index.php/TJONC วารสารสภาการพยาบาลเป็นวารสารทางวิชาการที่มีการประเมินบทความและงานวิจัย โดยผู้ทรงคุณวุฒิที่มีความเชี่ยวชาญเฉพาะสาขา (peer review) กำหนดออกรายสามเดือน ปีละ 4 ฉบับ จัดทำโดยสภาการพยาบาล เพื่อเป็นแหล่งในการเผยแพร่ผลงานวิชาการ ทั้งด้านการพยาบาลทางคลินิกและชุมชน การศึกษาพยาบาล การบริหารการพยาบาล Thailand Nursing and Midwifery Council en-US Thai Journal of Nursing Council 1513-1262 A Conceptual Analysis of Spiritual Distress https://he02.tci-thaijo.org/index.php/TJONC/article/view/244710 <p>Spiritual distress is a phenomenon frequently found in critical, chronic, and terminal patients. However, an extensive review of literature has revealed no conceptual analysis of spiritual distress, despite its significance to healthcare. To build a clear and profound understanding of the meaning and characteristics of spiritual distress, this study adopted Walker and Avant’s approach to conceptual analysis.<br>According to the conceptual analysis, major characteristics of spiritual distress included physical expression, psychological expression, loss of love and good relationship, loss of self-esteem, loss of meaning and purpose of life, and loss of inner strength. Antecedents of spiritual distress often include illnesses, mental health problems, internal conflicts, loss of loved or respected people, lack of social support, and lack of spiritual and religious practices. A common consequence of spiritual distress is the weakened ability to cope with problems. The results of this conceptual analysis could be applied to developing spiritual distress evaluation instruments, to conducting further relevant research, and to improving nursing practices to alleviate spiritual distress.</p> Yuttachai Chaiyasit Khwanparpat Chanbunlawat Rattiya Thong-orn Onuma Kaewkerd Copyright (c) 2021 Thai Journal of Nursing Council http://creativecommons.org/licenses/by-nc-nd/4.0 2021-04-03 2021-04-03 36 2 5 17 Sleep Quality of Older People in the Community https://he02.tci-thaijo.org/index.php/TJONC/article/view/227420 <p>In older people, sufficient sleep is integral to physical restoration and conducive to good health. Sleep is assessed qualitatively, and poor sleep quality is usually found more in older people than in adults and in children. Even so, poor sleep quality in older people is often overlooked, and no serious attention has been paid to this condition. Such inattention could result in the aggravation of sleep quality and lead to various physical, psychological, social, and economic adverse effects, all of which are factors that could heighten the mortality rate. Healthcare professionals, therefore, play an important part in assessing sleep quality in older people and in finding ways to improve their sleep quality and overall quality of life.<br>The primary objective of this article was to review literature related to sleep quality in older people in communities. This article discusses definitions of sleep, sleep quality in older people, sleep quality assessment, factors contributing to sleep quality, effects of poor sleep quality on older people, and sleep quality management for older people with poor sleep quality. This article also presents basic knowledge for observing, preventing, and addressing the problem of poor sleep quality in older people</p> Sureerat Na Wichian Copyright (c) 2021 Thai Journal of Nursing Council http://creativecommons.org/licenses/by-nc-nd/4.0 2021-04-03 2021-04-03 36 2 18 31 Effects of Health Literacy Programme on Intensive Care Unit Visitors’ Hand Hygiene Behaviour https://he02.tci-thaijo.org/index.php/TJONC/article/view/247416 <p>Objective: To examine how effectively a health literacy programme could improve intensive care unit visitors’ hand hygiene behaviour<br>Design: Two-group quasi-experimental research with a pretest and a posttest</p> <p>Methodology: The participants, aged between 18 and 59, were 76 visitors to patients in an intensive care unit. The participants were equally assigned to a control group, which received standard care, and an experimental group, which received a health literacy programme. The programme was administered for two days, both to each individual and to the entire group, and was evaluated using the health literacy assessment<br>tool and the hand hygiene behaviour observation form. The data were analysed using descriptive statistics, chi-square statistics, the Wilcoxon signed-rank test, and the Mann-Whitney U test.<br>Results: According to the findings, the experimental group’s mean health literacy score was significantly higher than the control group’s (p &lt; .05). The experimental group also earned significantly higher mean scores on frequency and correctness of hand washing than did the control group (p &lt; .05).<br>Recommendations: It is recommended that the health literacy programme be used to remind visitors to intensive care units to consistently maintain hand hygiene behaviour and quality, to prevent the spread of infectious diseases.</p> Penkhae Suksatit Wallada Chanruangvanich Orapan Thosingha Leilai Paitoonpong, Copyright (c) 2021 Thai Journal of Nursing Council http://creativecommons.org/licenses/by-nc-nd/4.0 2021-04-03 2021-04-03 36 2 32 48 Impact of Individual and Family Self-Management Programme on Hemodialysis-Treated Patients’ Adherence to Phosphorus Control and on Their Calcium x Phosphorus Product https://he02.tci-thaijo.org/index.php/TJONC/article/view/247274 <p>Objective: To examine the impact of an individual and family self-management programme on patients treated with hemodialysis in terms of their adherence to phosphorus control and their calcium x phosphorus product<br>Design: Two-group quasi-experimental research with repeated measurements<br>Methodology: The sample consisted of 59 patients treated with hemodialysis and a<br>phosphate-binding medication at a tertiary hospital. Twenty-nine of the patients were assigned to the experimental group and 30 into the control group. The experimental group participated in an individual and family self-management programme developed based on Ryan &amp; Sawin’s (2014) Individual and Family Self-Management Theory. The programme was administered in three stages: 1) knowledge and belief building; 2) improvement of skills and self-regulation ability; and 3) social facilitation. The instruments for data collection consisted of: 1) a demographic questionnaire; 2) a questionnaire on the history of illness and hemodialysis; 3) a questionnaire on phosphorus control behaviour; and 4) a clinical outcome record form. The data were analysed using descriptive statistics, chi-square tests, and the repeated measures ANOVA.<br>Results: The experimental group’s mean post-intervention score on adherence to phosphorus control was significantly higher than its pre-intervention score, and also significantly higher than that of the control groups as measured in weeks 4, 6, and 8. Moreover, the experimental group’s ratio of patients with &lt; 55 mg2/dl2 calcium x phosphorus products was significantly higher than that of the control group (p &lt; 0.5).<br>Recommendations: It is recommended that nurses apply this individual and family<br>self-management programme to treating hemodialysis patients in order to promote phosphorus control behaviour and reduce calcium x phosphorus products.</p> Areerat Chamnan Sirilak Kitsripisarn Adis Tasanarong Copyright (c) 2021 Thai Journal of Nursing Council http://creativecommons.org/licenses/by-nc-nd/4.0 2021-04-03 2021-04-03 36 2 49 65 Effects of Psychological Distress Management Programme on Problem- Coping Ability of Adolescents Affected by Unrest in Southern Thailand https://he02.tci-thaijo.org/index.php/TJONC/article/view/200317 <p>Objective: To examine the effects of a psychological distress management programme on the problem-coping ability of adolescents who were affected by the unrest in southern Thailand<br>Design: Two-group quasi-experimental research with a pre-test and a post-test<br>Methodology: This study was conducted on 50 purposively sampled participants,<br>students aged between 15 and 18 at two secondary schools in Narathiwat province. The participants were equally assigned to an experimental group and a control group. The experimental instrument was a psychological distress management programme, administered in four sessions. The data collection instruments consisted of a demographic recording form, the Psychological Impact<br>Scale for Crisis Event-10 (PISCES-10), and a coping ability assessment form. The data were analysed based on the frequency, percentage, and mean, whilst the chi-square was used to test the differences between the two groups. Paired t-test was employed to analyse both groups’ pre-test and post-test results, and independent t-test was used to compare the post-test results of the control and experimental groups.<br>Results: The experimental group’s post-intervention mean score on problem-coping ability was significantly higher than its pre-intervention score (p &lt; .05). Also, after the intervention, the experimental group’s mean score on problem-coping ability was significantly higher than the control group’s (p &lt; .05).<br>Recommendations: The psychological distress management programme could help adolescents to properly cope with situations inducing psychological distress. Therefore, community psychologists, educational counselors, and community public health personnel may apply this programme to assisting psychologically distressed adolescents to make proper situational adjustment and reduce psychological distress.</p> Thanyalak Pengchareon Vineekarn Kongsuwan Wandee Sutharangsri Copyright (c) 2021 Thai Journal of Nursing Council http://creativecommons.org/licenses/by-nc-nd/4.0 2021-04-03 2021-04-03 36 2 66 79 Chronic Obstructive Pulmonary Disease Patients’ Symptomatic Experiences https://he02.tci-thaijo.org/index.php/TJONC/article/view/246340 <p>Objective: To examine the five most common symptoms found in chronic obstructive pulmonary disease (COPD) patients: dyspnea, fatigue, insomnia, anxiety, and depression.<br>Design: Descriptive research<br>Methodology: The participants were 168 COPD patients treated at the COPD Clinic<br>of the Central Chest Institute of Thailand. The data-collecting instruments were: 1) a demographicrecording form; 2) the Dyspnea, Fatigue, and Insomnia Assessment Scale (DFIAS); and 3) the Hospital Anxiety and Depression Scale (HADS). The data were analysed using descriptive statistics.<br>Results: The majority of the participants (98.2%) were male aged averagely 71.48<br>years (SD = 8.71). Moderately severe COPD was detected in 39.3% of the participants. Dyspnea, fatigue, and insomnia were perceived by 100%, 91.7%, and 58.9% of the participants, respectively. Mild dyspnea frequency, moderate dyspnea severity, and mild dyspnea distress were perceived by 63.7%, 48.8%, and 63.1% of the participants, respectively. Overall, 79.2%, 50%, and 79.2% of the participants perceived low degrees of fatigue frequency, severity, and distress, respectively, whilst 44%, 38.1%, and 45.2% confirmed their perception of low degrees of insomnia frequency, severity, and distress. Anxiety and depression, however,<br>were found in only 0.6% of the participants.<br>Recommendations: This study reflected the importance of conducting dyspnea, fatigue, and insomnia assessment in COPD patients. Nursing care approaches based on empirical evidence are, therefore, advised to provide pharmaco-therapeutic and non-pharmaco-therapeutic support to help COPD patients to effectively manage their symptoms.</p> Buachompoo Ekkamart Yaowarat Matchim Jinpitcha Mamom Piamlarp Sangsayunh Copyright (c) 2021 Thai Journal of Nursing Council http://creativecommons.org/licenses/by-nc-nd/4.0 2021-04-03 2021-04-03 36 2 80 92 Parents’ and Nurses’ Attitudes towards Parental Presence during Pediatric Invasive Procedures https://he02.tci-thaijo.org/index.php/TJONC/article/view/247359 <p>Objective: To compare parents’ and nurses’ attitudes towards parental presence during pediatric invasive procedures&nbsp;<br>Design: Descriptive comparative study<br>Methodology: This study was conducted on two conveniently sampled groups. The<br>first group consisted of 100 parents of sick children, ranging from neonates to 15-year-olds, who were hospitalised in the pediatric care units, neonatal care units, wards for sick neonates, and pediatric wards of three tertiary hospitals affiliated to the Bangkok Metropolitan Administration. The second group consisted of 115 nurses stationed in their respective units or wards for a minimum of one year. Data were collected using a questionnaire on attitudes towards parental presence during pediatric invasive procedures. Descriptive statistics, independent t-test and<br>one-way ANOVA were used for data analysis.<br>Results: The parents’ and the nurses’ attitudes towards parental presence during pediatric invasive procedures were significantly different (p&lt;.05). Also, nurses having different number of years of pediatric care experience and having served in different types of ward displayed significantly different attitudes (p&lt;.05). However, the differences in the parents’ sexes, in their experience of being present with the children during pediatric invasive procedures, and in their children’s age groups did not result in the difference of parents' attitudes (p&gt;.05).<br>Recommendations: Empirically developed guidelines for parental presence during<br>pediatric invasive procedures are strongly recommended, to efficiently increase the benefit of parental presence during invasive procedures</p> Jiraporn Rattanawong Tassanee Prasopkittikun Arunrat Srichantaranit Copyright (c) 2021 Thai Journal of Nursing Council http://creativecommons.org/licenses/by-nc-nd/4.0 2021-04-03 2021-04-03 36 2 93 109 Healthcare Problems and Healthcare Service Accessibility for Children with Craniofacial Anomalies: Caregivers’ Perceptions https://he02.tci-thaijo.org/index.php/TJONC/article/view/244688 <p>Objective: To explore caregivers’ perceptions regarding healthcare and healthcare service accessibility problems faced by children with craniofacial anomalies Design: Descriptive research<br>Methodology: The primary participants, recruited using convenience sampling and inclusion/exclusion criteria, were 121 primary caregivers of children with non-cleft craniofacial anomalies treated at a super-tertiary hospital in Bangkok. Data from the primary participants were collected via three questionnaires, on personal information, child care problem perceptions, and access to health services. The secondary participants were 13 purposively sampled caregivers, who supplied additional data via focus group discussions. The data were collected between October 2018 and September 2019 and analysed using descriptive statistics and content analysis.<br>Results: More than four-fifths (80.20%) of the caregivers had a low degree of overall perception of children’s healthcare problems, whereas about three-fourths (75.20%) displayed a high degree of overall perception of children’s access to healthcare services. The qualitative data revealed three major aspects of child healthcare problems, namely, (1) caring difficulty, variety of problems, and frequent hospital visits; (2) mental problems and demand for social<br>understanding and acceptance; and (3) high care and travel expenses. Regarding access to child healthcare services, two issues were identified. First, information on the hospital’s and physician’s specialisation played an important part in decision-making. Second, the healthcare team’s perspective and network could affect the method of treatment.<br>Recommendations: Healthcare team members are advised to assist children with congenital craniofacial anomalies who are faced with severe and complex health problems to have better and quicker access to healthcare services through referrals to super-tertiary hospitals for appropriate treatment during the first year of life.</p> Nantaga Sawasdipanich Bussara Chaithat Artiteeya Dangsomboon Copyright (c) 2021 Thai Journal of Nursing Council http://creativecommons.org/licenses/by-nc-nd/4.0 2021-04-03 2021-04-03 36 2 110 128 Activities and Outcomes of Primary Medical Care Provided by Nurses in Primary Care Units of Health Service Region 4 https://he02.tci-thaijo.org/index.php/TJONC/article/view/246908 <p>Objective: To describe the activities, outcomes, problems, and obstacles concerning provision of primary medical care by nurses in Primary Care Units of Health Service Region 4 (this study was a part of the research project entitled ‘Roles and Responsibilities of Nurses in Mobilising Primary Care Systems’, conducted by the Thai Nursing and Midwifery Council)<br>Design: Descriptive research using quantitative and qualitative data collection&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; Methodology: The sample consisted of: (1) 35 registered nurses providing primary medical care in primary care units; and (2) 205 patients receiving primary medical care from the nurses. Data were collected by means of a questionnaire, structured interviews, and participatory observation. The data were analysed using descriptive statistics and content analysis. Results: All the participating nurses were female, averagely aged 43.1 ± 7.6 years. About two-thirds (65.7%) were registered nurse practitioners, with a median of 6.0 years of<br>experience in Primary Care Units. The nursing activities in which the nurses were most involved included health education, and counseling patients and their families in healthcare matters. The nurses’ overall satisfaction was high, with professional value regarded as the most satisfactory. The major problems faced by the nurses included staff shortage, insufficient budget and facilities, too many KPIs, and lack of a medical consultation system. Amongst the patients, respiratory problems were identified as the most common health condition, in 23.4%, and of these, nearly three-fourths (73.9%) recovered after treatment. The patients’ overall satisfaction was high, averagely 93.4 ± 9.1 points, with the nurses’ service identified as the most satisfactory.<br>Recommendations: Benefits, facilities, and training for ongoing skill development should be provided for nurses to improve the quality of nursing care in primary care units.&nbsp;</p> Anongnat Kaewprasong Noppawan Piaseu Nareemarn Neelapaichit Suhong Deesamer Copyright (c) 2021 Thai Journal of Nursing Council http://creativecommons.org/licenses/by-nc-nd/4.0 2021-04-03 2021-04-03 36 2 129 144