Thai Journal of Nursing Council 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 Palliative Care for Chronic Renal Failure Patients: Issues and Recommendations for Development <p><span class="fontstyle0">&nbsp; &nbsp; &nbsp;A primary goal of palliative care for chronic renal failure patients is to promote their and their families’ quality of life. Such palliative care should cover all the relevant stages, from the diagnosis, to the treatment, to the end-stage care, and to family care after the patient’s death. Major principles of palliative care for chronic renal failure patients consist of 1) identifying the patients in need of palliative care; 2) symptomatic<br>assessment and management; and 3) mutual decision making and advance care planning.</span></p> <p><span class="fontstyle0">&nbsp; &nbsp; &nbsp;Directly responsible for providing palliative care, nurses play a signifcant role in educating and providing information for the patients, giving holistic care to the patients and their families, collaborating with multidisciplinary teams, performing continuous self-development, and upholding the professional ethics.&nbsp;</span></p> <p><span class="fontstyle0">&nbsp; &nbsp; &nbsp;Recommendations for development include integration of palliative care with the early stage of renal diagnosis, development of palliative care teams’ knowledge and skills, improvement of the organisation’s ethical system and mechanisms, and development of research studies that meet accepted standards.</span></p> kittikorn Nilmanat Samonnan Thasaneesuwan Phenpitcha Tinkaew Copyright (c) 2021 Thai Journal of Nursing Council 2021-09-23 2021-09-23 36 04 5 16 Obstructive Sleep Apnea Patients’ Compliance with Treatment of Continuous Positive Airway Pressure: A Literature Review <p><span class="fontstyle0">&nbsp; &nbsp; &nbsp;Obstructive sleep apnea (OSA) is a disorder caused by constriction of the upper respiratory tract during sleep, resulting in hypoxia and sleep disturbances. Obstructive sleep apnea requires specifc treatment using continuous positive airway pressure (CPAP), which is a high-effcacy standard method of treatment. To obtain maximum beneft of the CPAP treatment, the patient’s compliance is an essential factor. However, it is presently found that OSA patients’ compliance with this method of treatment is at a relatively low level. Causes of this could vary from physiological factors, such as sex, age, and symptomatic severity, which are immutable, to psychosocial and cognitive factors, such as perception of susceptibility, severity, benefts, self-effcacy, and obstacles, which are adjustable or ameliorable.<br>&nbsp; &nbsp; &nbsp; This article primarily attempts to increase nurses’ or healthcare professionals’ understanding of factors related to patients’ compliance with the treatment. With such factors properly managed, treatment compliance can be promoted, which could reduce complications and expenses to be incurred. Accordingly, nurses are advised to conduct regular assessments of the CPAP machine, make regular enquiries about the patients’ problems and obstacles in using the machine, and promote the patients’ self-effcacy in using the CPAP machine, to encourage the patients’ compliance with the treatment method.</span></p> Chestharid Borriboon Jindarat Chaiard Chiraporn Tachaudomdach Copyright (c) 2021 Thai Journal of Nursing Council 2021-09-23 2021-09-23 36 04 17 30 Competency and Career Path of Nurses in Thai Correctional System: Opportunities for Development <p><span class="fontstyle0">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp;A prison is a community of a large number of inmates many of whom suffer health problems ranging from underlying diseases to diseases acquired during imprisonment. This condition necessitates multi-dimensional healthcare, including health promotion, disease prevention, medical treatment, and rehabilitation. Because nurses operating in a correctional facility play a signifcant part in providing healthcare services for the inmates, these nurses are expected to possess task-specifc, in addition to principal and general professional, competency. These nurses are also expected to possess legal and ethical understanding, along with skills in coordinating with offcials from other correctional divisions to arrange proper healthcare services for the inmates. Correctional facility nurses, therefore, should be trained to enhance their specifc competency in response to their role in providing healthcare services for inmates who have complicated health problems and are confned to a more disease-prone environment than are ordinary people. Also, a career path for correctional facility nurses should be more clearly defined.<br>&nbsp; &nbsp; &nbsp; This article discusses issues related to the working condition of correctional facility nurses, their required areas of competency, and their career path. The recommendations offered, which are applicable to the policymaking, organisational, and individual levels, are concerned with the direction of developing correctional facility nurses’ competency and career path, to optimise their potential, lift their morale, and increase their motivation to continue serving in correctional facilities.</span></p> Nantaga Sawasdipanich Supa Puektes Vichuda Kongpromsuk Kanokwan Chewchuapun Copyright (c) 2021 Thai Journal of Nursing Council 2021-09-23 2021-09-23 36 04 31 43 Concept Analysis of Well-Being in Older Adults <p>&nbsp; &nbsp; &nbsp; &nbsp; <span class="fontstyle0">This study using hybrid models of Schwartz-Barcott and Kim to analysis concept of well-being in older adults. The primary objective of the study was to analyse attributes of well-being as determined by older adults in terms of its antecedents and consequences. The study was conducted in three stages. The theoretical stage involved an integrated review of literature. Next, the field study stage was conducted using in-depth interviews of 27 older adults in both urban and rural areas, to obtain empirical data. Each informant was interviewed twice, each session lasting about 30 minutes. The final stage was devoted to content analysis and thematic analysis.&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</span></p> <p><span class="fontstyle0">&nbsp; &nbsp; &nbsp; &nbsp; According to the analysis, wellbeing as perceived by the older adults could be defined as incorporating life satisfaction, self-esteem, good health, happiness, and life goals. The following were identifed by the older adults as attributes of well-being: 1) awareness of life circumstances; 2) life valuing; 3) life satisfaction; 4) self-care capacity; 5) social activity capacity; 6) good quality of life; and 7) balance between needs and responses to them. Two major factors were identifed as antecedents to well-being: 1) intrapersonal factors (namely, self-acceptance, autonomy, self-built delight, and peace of mind) and 2) interpersonal factors (namely, respectability, mutual reliance, social acceptance, and family harmony). Consequences of well-being were considered to include: 1) self-care capacity; 2) good interpersonal relationship; 3) awareness of the quality<br>of life; 4) life goals; 5) ability to contribute to the family and society; and 6) behavioral competence.&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</span></p> <p><span class="fontstyle0">&nbsp; &nbsp; &nbsp; &nbsp;The viewpoints of the older adults in this study concerning wellbeing could be applied to the planning of health care programmes for older adults. Emphasis should be placed on building constructive relationships within the family, to promote wellbeing and better quality of life in older adults in accord with their perception. <br></span></p> Kerdsiri Hongthai Copyright (c) 2021 Thai Journal of Nursing Council 2021-09-23 2021-09-23 36 04 44 59 Experiences of Patients Receiving Transplants of Donated Allogeneic Stem Cells <p>&nbsp; &nbsp; <span class="fontstyle0"><strong>Objective</strong>: </span><span class="fontstyle2">To examine the experiences of hematological malignancy patients who received transplants of donated allogeneic stem cells</span></p> <p><span class="fontstyle2">&nbsp; &nbsp; <span class="fontstyle0"><strong>Design</strong>: </span>Descriptive qualitative research </span></p> <p><span class="fontstyle2"><span class="fontstyle0">&nbsp; &nbsp; <strong>Methodology: </strong></span>The informants, selected via purposive sampling, were 13 hematological malignancy patients having received transplants of donated allogeneic stem cells in the previous six months to two years. Data were elicited through in-depth interviews, which were then transcribed verbatim and analysed using Colaizzi’s method, up to the point of data saturation.</span></p> <p><span class="fontstyle2">&nbsp; &nbsp; <span class="fontstyle0"><strong>Results</strong>: </span>According to the results, the patients’ main experiences, observed in three stages, were as follows: <br></span></p> <p><span class="fontstyle2">&nbsp; &nbsp; <span class="fontstyle0">1. Before allogeneic stem cell transplantation 1) “Why me?”; 2) “Fighting with hope”; 3) “Waiting for an HLA match”; 4) “Effects of illness and treatment on living”; and 5) “Preparation for allogeneic stem cell transplantation”. 2. During allogeneic stem cell transplantation 1) “The allogeneic stem cell transplant as a life saver”; 2) “The pain during treatment”; 3) “How to cope with the illness”; and 4) “The joy of returning home and fear of leaving the hospital”. 3. After allogeneic stem cell transplantation 1) “Adjustment and self-care”; 2) “Death is inevitable”; 3) “Worries about recurrence of disease and change in self-image”; and 4) “Living with the present”.</span> <br></span></p> <p><span class="fontstyle2"><span class="fontstyle0">&nbsp; &nbsp; <strong>Recommendations</strong>: The research findings can be used as baseline data to assist healthcare professionals to build an understanding of allogeneic stem cell transplant patients’ experiences and to increase nursing care efficacy. <br></span></span></p> Jeeranun Jinagub Jiraporn Kespichayawattana Noppamat pudtong Copyright (c) 2021 Thai Journal of Nursing Council 2021-09-23 2021-09-23 36 04 60 79 Effect of Preparatory Information Provision Program on Anxiety in the Patients Undergoing Brain Tumor Surgery <p><span class="fontstyle0">&nbsp; &nbsp; &nbsp;<strong>Objective</strong>: </span><span class="fontstyle2">To test the effect of the preparatory information provision program on anxiety in patients undergoing brain tumor surgery.</span></p> <p><span class="fontstyle0"><strong>&nbsp; &nbsp; &nbsp;Design</strong>: </span><span class="fontstyle2">Two-group quasi-experimental research with a pre-test and a post-test. </span></p> <p><span class="fontstyle0">&nbsp; &nbsp; &nbsp;<strong>Methodology</strong>: </span><span class="fontstyle2">The samples consisted of patients undergoing brain tumor surgery and admitted to a neurosurgery ward of a tertiary hospital between April and September 2020. The samples were randomly assigned to the control and experimental groups, 27 cases per group. The experimental group received the Preparatory Information Provision Program developed by the researchers, including a video and booklet by applying self-regulation theory as a conceptual framework. And the control group received routine nursing care. Data collection tools included the personal and health information record form, the State-Trait Anxiety Inventory. The personal and health data were analyzed using descriptive statistics. Compare the anxiety scores using the Wilcoxon Signed Ranks Test and Analysis of Covariance (ANCOVA).<br></span></p> <p><span class="fontstyle0">&nbsp; &nbsp; &nbsp; <strong>Results</strong>: </span><span class="fontstyle2">The results showed that the anxiety scores were statistically signifcantly lower after receiving the Preparatory Information Provision Program (p=.001). The anxiety scores of the treatment group were statistically signifcantly lower than the control group (p=0.000).<br></span></p> <p><span class="fontstyle0">&nbsp; &nbsp; &nbsp;<strong>Recommendations</strong>: </span><span class="fontstyle2">Nurses can apply the Preparatory Information Provision Program to fit with institutional context to reduce patients' preoperative anxiety. Future research can examine the effects of the program on postoperative and pre-discharge anxiety.</span></p> wanwisa pasethakung Nichapatr Phutthikhamin Copyright (c) 2021 Thai Journal of Nursing Council 2021-09-23 2021-09-23 36 04 80 93 Factors Predicting Postoperative Malnutrition in Trauma Patients <p>&nbsp; &nbsp; &nbsp;<span class="fontstyle0"><strong>Objective</strong>: </span><span class="fontstyle2">To study the predictive powers of injury severity, energy intake during 72 hours after surgery, and fever during 72 hours after surgery towards malnutrition in postoperative trauma patients</span></p> <p><span class="fontstyle2">&nbsp; <strong>&nbsp;&nbsp; </strong><span class="fontstyle0"><strong>Design</strong>: </span>Predictive correlation research <br></span></p> <p><span class="fontstyle2">&nbsp; &nbsp; &nbsp;<span class="fontstyle0"><strong>Methodology</strong>: </span>The subjects were 137 trauma patients admitted to the surgery ward of a tertiary hospital. The data collection instruments consisted of: (i) a general information record form; (ii) a form for recording injury severity, energy intake and need, and temperature during 72 hours after surgery; (iii) a fluid intake and discharge record form; and (iv) a malnutrition assessment form. The data were analysed using the binary logistic regression analysis, with the signifcance level set at 0.05. <br></span></p> <p><span class="fontstyle2">&nbsp; &nbsp; &nbsp;&nbsp; <span class="fontstyle0"><strong>Results</strong>: </span>The majority of the subjects were male (70.10%). Symptoms of malnutrition became apparent in over three-thirds (76.60%) of the subjects on the eighth day after being admitted for treatment, with 78.80% of these subjects recording ≥ 9 injury severity level. All the subjects’ average energy intake was 784.2 Kcal, lower than half of the estimated energy need average of 1,704.36 Kcal, whilst fever was found in 37.20% of the subjects. The analysis revealed that injury severity, energy intake during 72 hours after surgery, and fever were capable of predicting malnutrition in trauma patients by 31%, at a statistically signifcant level of .01 (Nagelkerke R2 = 0.31, p &lt; 0.01). <br></span></p> <p><span class="fontstyle2">&nbsp; &nbsp; &nbsp; <span class="fontstyle0"><strong>Recommendations</strong>: </span>Nurses are advised to pay close attention to trauma patients’ nutrition, especially those with the injury severity level of ≥ 9, to ensure the patients receive more than 50% of the recommended average individual energy need. <br></span></p> nattika thawongpia Wallada Chanruangvanich Orapan Thosingha Supparerk Prichayudh Copyright (c) 2021 Thai Journal of Nursing Council 2021-09-23 2021-09-23 36 04 94 113 Factors Predicting Acute Kidney Injury Among Critically lll Older Patients After Non-Cardiac Surgery <p>&nbsp; &nbsp; <strong><span class="fontstyle0">Objective: </span></strong><span class="fontstyle2">To examine the predictive power of preoperative hemoglobin, the revised cardiac risk index, peri-operative erythrocyte transfusion, and time of operation toward acute kidney injury among critically ill older patients after non-cardiac surgery.</span></p> <p><span class="fontstyle0">&nbsp; &nbsp; <strong>Design</strong>: </span><span class="fontstyle2">Retrospective predictive correlational design with cross-sectional study </span></p> <p><span class="fontstyle0">&nbsp; &nbsp; <strong>Methodology</strong>: </span><span class="fontstyle2">The researcher recruited a total sample of 278 older patients who met the criteria, aged 60 years and over, received any major surgeries except cardiac surgery and were admitted to Intensive Care Unit after surgery. Data were analyzed using descriptive statistics and binary logistic regression. Roy adaptation model was employed as a conceptual framework for explaining physiologic adaptation.</span></p> <p><span class="fontstyle0">&nbsp; &nbsp; <strong>Results</strong>: </span><span class="fontstyle2">Most of samples were females with an average age of 74.77 years (SD=8.35).An occurrence of post-operative acute kidney injury was 50%. The predictive power analysis results illustrated that pre-operative hemoglobin, revised cardiac risk indexes, received peri-operative erythrocyte transfusion and time of operation could jointly predict acute kidney injury with explained variance of 52.4% (Nagelkerke R2=.524). The findings also revealed that pre-operative hemoglobin indicating anemia, revised cardiac risk indexes at high risk, peri-operative erythrocyte transfusion more than 500 ml., less than or equals to 500 ml., and time of operation equal or more than 120 minutes could put the critically ill older patients after non-cardiac surgery at risk of acute kidney injury for 3.779, 8.819, 7.154, 2.141 and 3.560 times, respectively.</span></p> <p><span class="fontstyle2">&nbsp; &nbsp; <strong>Recommendation</strong>: The study findings could be utilized as a clinical information for planning nursing care of critically ill older patients undergoing non-cardiac surgeries at ICU admission describing physiologic adaptation by Roy adaptation model. In addition, nurses should closely monitor acute kidney injury because they are at high risk, especially ones with high revised cardiac risk indexes and peri-operative erythrocyte transfusion more than 500 ml.</span></p> Narin Pipattanawarrakhun Prangtip Chayaput Virapun Wirojratana Wallada Chanruangvanich Copyright (c) 2021 Thai Journal of Nursing Council 2021-09-23 2021-09-23 36 04 114 130 Chronotypes and Scheduling Needs of Nurses Operating in University-Affliated Hospitals <p>&nbsp; &nbsp; &nbsp; <span class="fontstyle0"><strong>Objective</strong>: </span><span class="fontstyle2">To examine university-affliated hospital nurses’ chronotypes and corresponding shift-scheduling needs</span></p> <p><span class="fontstyle0">&nbsp; &nbsp; &nbsp;<strong> Design</strong>: </span><span class="fontstyle2">Descriptive study</span></p> <p><span class="fontstyle0">&nbsp; &nbsp; &nbsp;<strong> Methodology</strong>: </span><span class="fontstyle2">The sample consisted of 831 nurses having served in the nursing divisions of university-affliated hospitals for a minimum of one year and assigned to at least one afternoon or night shift per month. Data were collected using a questionnaire distributed and retrieved via Google Form. The questionnaire consisted of three parts: 1) the demographic data form; 2) the scheduling needs survey; and 3) the Thai version of the Morningness-Eveningness Questionnaire (T-MEQ). The data was analysed using descriptive statistics and a chi-square test. </span></p> <p><span class="fontstyle0">&nbsp; &nbsp; &nbsp; <strong>Results</strong>: </span><span class="fontstyle2">The majority of the nurses (64.7%) exhibited the intermediate chronotype, which correlated significantly to the need to be assigned to work sessions that overlapped night shifts, 10-hour-per-day work, assignment to one shift type, work experience, types of patients under care, marital status, and personal responsibilities (p &lt; 0.05). Concerning scheduling needs, slightly over half of the nurses (51.4%) preferred the morning shift, about three-fourths (73.9%) preferred sessions overlapping the morning shift, and nearly all (93.5%) wished they could choose when to have holidays. Also, a huge majority of the nurses (90.5%) wanted to avoid being rotated or seconded to a different division, whilst nearly two-thirds (65.8%) wanted to avoid being assigned to only one shift type. Work experience, types of patients under care, marital status, and personal responsibilities correlated significantly to shift-scheduling needs and assignment to one shift type (p &lt; 0.05). </span></p> <p><span class="fontstyle0">&nbsp; &nbsp; &nbsp; <strong>Recommendations</strong>: </span><span class="fontstyle2">It is recommended that hospital administrators and ward managers survey the nurses’ chronotypes and scheduling needs, offer them opportunities to choose the shift types, and make shift scheduling more flexible.</span></p> Daranee Pipatkulchai Auengporn Pituksung Ratree Chimchalong Janthana Namthep Copyright (c) 2021 Thai Journal of Nursing Council 2021-09-23 2021-09-23 36 04 131 145