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 Gender Sensitiveness in Nursing Practice <p>Abstract:<br>&nbsp; &nbsp;&nbsp; Gender is a socially constructed concept referring to a male, a female, or any of LGBTI (lesbian, gay, bisexual, transgender, and intersexual). Gender is related to health status at individual, familial, and social levels, and could be a factor causing a range of health problems. An international level gender is recognized as one of the social determinant of health. In Thailand, empirical evidence has identifed gender as a cause of mental health problems; physical health problems; drug, alcohol, and cigarette addiction; sexual harassment; and gender-related violence. Gender sensitiveness is, therefore, an essential qualifcation nurses should possess.<br>&nbsp; &nbsp; &nbsp; To ensure gender sensitiveness in nurses, the nursing curriculum is required to cover five major domains: 1) gender and social construction; 2) gender as a social factor indicative of health status; 3) gender-based violence; 4) abortion, contraception, and gender selection; and 5) ethical concerns. Gender sensitiveness in nursing practice generally involves 1) access to gender information; 2) respect to differences; and 3) minimisation of inequality, discrimination, prejudice, and stigmatisation.</p> Siriporn Chirawatkul Copyright (c) 2020 Thai Journal of Nursing Council 2020-07-17 2020-07-17 35 3 5 16 Healthcare Service Providers’ Perspective on Provision of Emergency Medical Services in Security Zones: A Qualitative Study <p>Abstract:<br>&nbsp; &nbsp;&nbsp; Objective:To explore healthcare service providers’ perspective on the provision of emergency<br>medical services (EMS) in security zones.<br>&nbsp; &nbsp;&nbsp; Design: Qualitative research.<br>&nbsp; &nbsp;&nbsp; Methodology: Sixty-nine participants were recruited through purposive sampling. They were divided into three groups: 9 administrators, 19 healthcare staff and emergency personnel members, and 41 trained volunteers who were members of the local emergency network in security zones. Data were collected during May to July 2019 through interviews and focus group discussions, using a set of questions pre-developed based on the National EMS Plan Framework. The data were analysed using the content analysis method.<br>&nbsp; &nbsp;&nbsp; Results: The study identifed four aspects of security-zone trauma management that differed signifcantly from those of standard emergency medical procedure. Firstly, in the prevention phase, every security zone had a community-engaged vigilance and prevention system in place, with the residents’ lifestyle adjusted to minimise risks. Secondly, during the pre-hospital care, military or police directives and orders were issued to ensure speed and accuracy in coping with the situation, in using proper resources, and in providing express air-ambulance service. Thirdly, during the emergency ward’s care, the priority was on establishing a system of consultation with medical specialists via telecommunications systems and on enhancing healthcare personnel’s potential to provide trauma patients with ongoing care. Fourthly, during the referral phase, the primary emphasis was on ensuring safe zones and rapid transfer. Despite occasional obstacles, provision<br>of emergency services in security zones still involved collaboration and integration from all stakeholders,<br>based on the country’s principle of seamless emergency service provision.</p> <p>&nbsp; &nbsp;&nbsp; Recommendations: Provision of integrated emergency services in security zones was different<br>from that in other areas. In security zones, the services had to be provided in a comprehensive manner and in conjunction with other local sectors, especially the police and the military, for effcient coordination, command, and team-working. However, it is recommended that emergency staff’s specialised competency be enhanced using proper technologies. Also, it is necessary that local communities’ space-oriented resources management potential be improved, to maintain self-reliance.</p> Preneed Songwatthana โชคชัย ขวัญพิชิต วิภา แซ่เซี๊ย ลัพณา กิจรุ่งโรจน์ จินตนา ดำเกลี้ยง หทัยรัตน์ แสงจันทร์ วรสิทธิ์ ศรศรีวิชัย วิจัย สกุลแก้ว Copyright (c) 2020 Thai Journal of Nursing Council 2020-07-17 2020-07-17 35 3 17 35 Selected Factors Predictive of Pain in Burn Patients <p>Abstract:<br>Objective: To study the predictive power that the selected factors of sex, age, depth and extent of wounds, comorbidity, anxiety, and depression had on pain in burn patients.<br>Design: Descriptive predictive study.<br>Methodology: The participant consisted of 126 purposively sampled adult burn patients treated at the burn clinics of one campus hospital and three tertiary care hospitals in Northeastern Thailand. Data were collected from April to October 2019 by means of 1) a demographic questionnaire; 2) the Charlson Comorbidity Index; 3) the Burn Characteristic Chart; 4) the Burn Specifc Pain Anxiety Scale; 5) the Depression Assessment Tool (9Q); and 6) the Pain Numeric Rating Scale. The data were analysed using Backward Multiple Linear Regression, with statistical signifcance set at the p-value of .05.<br>Results: The majority (69.84%) of the participants were male with an average age of 42.37 years (SD = 17.37). Nearly all of the participants (92.06%) reported moderate to severe pain scores (mean = 6.67, SD = 2.02). Flame burns were identifed by almost half of the participants (44.45%) as the most common cause of injury. The factors capable of signifcantly predicting levels of pain in the burn patients were anxiety (Beta = .443, p &lt; .01) and depression (Beta = .372, p &lt; .01), jointly explaining 57% of pain variation (adjusted R2 = .570, F = 84.00, p &lt; .001). Sex, age, comorbidity, and depth and extent of wounds, on the other hand, were not found capable of predicting pain in burn patients.<br>Recommendations: It is recommended that clinical nursing practice guidelines be developed for nurses to increase burn patients’ ability to manage their anxiety and depression, so that they can cope more effciently with the pain and suffering caused by their burn wounds.</p> Jintana Prasansak บุษบา สมใจวงษ์ Copyright (c) 2020 Thai Journal of Nursing Council 2020-07-17 2020-07-17 35 3 36 50 Development of Nursing Care Model for Post-Operative Head Injury Patients at Kamphaeng Phet Hospital <p>Abstract:<br>&nbsp; &nbsp;&nbsp; Objectives: To develop a nursing care model and study the outcomes of its implementation on head injury patients have undergone surgery.<br>&nbsp; &nbsp;&nbsp; Design: Research and development.<br>&nbsp; &nbsp;&nbsp; Methodology: This study was conducted in four phases: 1) situation analysis; 2) care model development; 3) implementation; and 4) outcome evaluation. The study participants were 28 registered nurses, 28 caregivers, and 56 post-operative head injury patients selected by means of purposive sampling. The patients were equally divided into two groups, one receiving standard care and the other treated with the researcher-designed nursing care model. The data were analysed using descriptive statistics, Chi-square, and t-test.<br>&nbsp; &nbsp;&nbsp; Results: The designed nursing care model for post-operative head injury patients was composed of three components: 1) the Head Injury Clinical Pathway KPH: SIMPLE +C guidelines; 2) nursing competency development; and 3) monitoring and follow-ups. The study of the model implementation outcomes showed the following. Firstly, the registered nurses displayed signifcantly higher knowledge, competency, and satisfaction concerning the model than before the implementation (p = .000, p = .000, p = .000, respectively). Secondly, the patients treated with the researcher-designed nursing care model experienced signifcantly less deterioration, whether caused by improper care, accidental loosening or disengagement of endotracheal tubes, or pressure sores, than did those receiving standard care (p = .016, p = .000, p = .044, respectively). Finally, the caregivers for the patients treated with the researcher-designed nursing care model displayed signifcantly higher satisfaction with the care quality than did the caregivers looking after the patients given standard care (p = .000).<br>&nbsp; &nbsp;&nbsp; Recommendations: The nursing care model for traumatic brain injury patients having undergone surgery effectively enhanced the registered nurses’ competency, improved the post-operative head injury patients’ conditions, and increased the nurses’ and caregivers’ satisfaction. It is, therefore, recommended that this model be more widely implemented in order to heighten the quality and effcacy of brain injury patient care.</p> Tippawan Wongjai จีราพรรณ อันบุรี Copyright (c) 2020 Thai Journal of Nursing Council 2020-07-17 2020-07-17 35 3 51 68 Registered Nurses’ Competency in Caring for Emerging Infectious Diseases <p>Abstract:<br>&nbsp; &nbsp;&nbsp; Objective: To develop components of competency that registered nurses caring for patients with emerging infectious diseases should possess.<br>&nbsp; &nbsp;&nbsp; Design: Descriptive study using the Delphi Technique.<br>&nbsp; &nbsp;&nbsp; Methodology: The informants were 21 contagious disease professionals consisting of four physicians specialising in infectious diseases, fve nursing lecturers or nursing professors in charge of infectious disease curricula, six nurses in the infectious disease prevention and control units, and six head nurses of the infectious disease prevention and control units of their hospitals. Conducted from July 2018 to July 2019, this study progressed in three phases. In Phase One, the 21 informants were interviewed about their views on registered nurses’ competency in caring for patients diagnosed with emerging infectious diseases. In Phase Two, the interview data were examined using content analysis and literature consultation. The outcome was used to formulate a questionnaire in which the informants would be asked to rate how important the issue stated in each item was. In Phase Three, the answers obtained from Phrase Two would be calculated in terms of the mean and interquartile ranges, after which they would be sent back to the 21 informants for confrmation of their answers. Then the confrmed data were recalculated in terms of the mean and interquartile ranges. To conclude the study, every component of competency rated with a mean of higher than 3.5 and an interquartile value of less than 1.5 was selected.<br>&nbsp; &nbsp;&nbsp; Results:In total, 48 components of competency were selected, which registered nurses caring for patients with emerging infectious diseases were expected to possess. These components were classifed in seven domains: 1) screening (3 components); 2) prevention, control, and vigilance of infectious diseases (15 components); 3) patient and family care (11 components); 4) emotional maturity (5 components); 5) professional ethics (3 components); 6) communication, coordination, and management skills (7 components); and 7) self-learning capacity (4 components).<br>&nbsp; &nbsp;&nbsp; Recommendations: Nurses are encouraged to use the fndings as self-development guidelines to improve their competency in every step of caring for emerging infectious disease patients, from before their arrival at the hospital, during the screening process, in the emergency and trauma department, and in the intensive care unit. The fndings can also be used to develop assessment tools for nurses caring for this group of patients.</p> Somporn Sungkeaw ธีรนุช ห้านิรัติศัย บุญใจ ศรีสถิตย์นรากูร Copyright (c) 2020 Thai Journal of Nursing Council 2020-07-17 2020-07-17 35 3 69 86 Correlation between Health Literacy and Self-Management amongst Older Thai Muslims with Hypertension <p>Abstract:<br>&nbsp; &nbsp;&nbsp; Objective: To examine any correlation between health literacy and self-management amongst older Thai Muslims with hypertension.<br>&nbsp; &nbsp;&nbsp; Design: Descriptive correlational study.<br>&nbsp; &nbsp;&nbsp; Methodology: A total of 88 participants were recruited. All of them were older Thai Muslims having been diagnosed with hypertension and receiving treatment at Health-Promoting Hospitals in Narathiwat province from January to February 2020. The instruments for data collection were the demographic and illness recording form, the health literacy questionnaire for older persons with hypertension, and the self-management questionnaire for older Thai Muslims with hypertension. The data were analysed using descriptive statistics and the Pearson correlation coeffcient.<br>&nbsp; &nbsp;&nbsp; Results: The participants displayed a moderate level of functional and overall health literacy, a high level of communicative/interactive health literacy, and a low level of critical health literacy. The participants’ overall self-management, treatment management, and role management were at a moderate level, whilst their emotional management and cooperation with follow-up appointments were at a high level. The participants’ overall, functional, communicative/interactive, and critical health literacy had a moderate-degree positive correlation with their overall self-management, at a statistically signifcant level of 0.01 (r = 0.469,<br>0.346, 0.403, and 0.344, respectively). When each aspect of self-management was taken into consideration, it was found that the participants’ health literacy had a moderate-degree positive correlation with their treatment and role management, at a statistically signifcant level of 0.01 (r = 0.443), but had a low-degree correlation with their emotional management and cooperation with follow-up appointments (r = 0.194 and 0.186, respectively).<br>&nbsp; &nbsp; &nbsp; Recommendations: The results of this study can provide fundamental information for nurses and healthcare professionals caring for older Thai Muslims with hypertension, to promote health literacy and self-management ability.</p> อามานี แดมะยุ ศิริรัตน์ ปานอุทัย พนิดา จันทโสภีพันธ์ Copyright (c) 2020 Thai Journal of Nursing Council 2020-07-17 2020-07-17 35 3 87 107 Development of an Ergonomic Self-Care Program for Aged Vendors <p>Abstract:<br>&nbsp; &nbsp; &nbsp; Objective: To develop an ergonomic self-care programme and test the feasibility of promoting it amongst older vendors.<br>&nbsp; &nbsp;&nbsp; Design: Developmental research.<br>&nbsp; &nbsp;&nbsp; Methodology: The programme was developed in two stages. The frst stage of the development involved three steps: (1) an analysis of existing bodies of knowledge and of older vendors’ work-induced illness situations; (2) research on and critical appraisal of empirical evidence; and (3) designing of ergonomic self-care activities by integrating the knowledge synthesised from the empirical evidence with a self-care promotion process and risk management guidelines. The second stage was for examination of the programme’s qualifcations in terms of content validity and practicability.<br>&nbsp; &nbsp;&nbsp; Results: The developed programme consisted of necessary self-care activities, namely,proper ergonomic working postures, appropriate management of working environment, and muscle-strengthening exercise. The programme, which continued for eight weeks, required both individual and group participation in seven components: (1) identifcation of job hazards;(2) basic education on knee osteoarthritis and low back pain in older adults, proper ergonomic working postures and appropriate management of working environment, to reduce disease severity; (3) prioritisation of risks; (4) designing ergonomic management methods; (5)<br>setting self-care goals and plans; (6) implementation; and (7) workplace visits. The results of the content validity check confrmed the programme’s conformity to its objectives and conceptual framework. In terms of practicability, the ergonomic self-care programme and the programme training session were practical for the older vendors’ context. The media used to provide exercise guidelines, however, was diffcult for the older vendors to comprehend and, therefore, needed to be simplifed.<br>&nbsp; &nbsp;&nbsp; Recommendations: It is recommended that the effcacy of the programme be studied in the target population in order to assess health-related changes in relation to self-care methods, pain levels, and severity of diseases.</p> Kanokwan Hounsri พัชรี คมจักรพันธุ์ แสงอรุณ อิสระมาลัย Copyright (c) 2020 Thai Journal of Nursing Council 2020-07-17 2020-07-17 35 3 108 120 High-Risk Pregnant Women’s Spiritual Experiences <p>Abstract:<br>&nbsp; &nbsp;&nbsp; Objective: To explore spiritual experiences that high-risk pregnant women had during their pregnancies.<br>&nbsp; &nbsp; &nbsp; Design: Qualitative research.<br>&nbsp; &nbsp;&nbsp; Methodology: The informants were 14 pregnant women treated at the maternity clinic of a tertiary hospital in lower-Northern Thailand. The informants were recruited by means of purposive sampling. Data were collected from April to October 2019 using in-depth interviews. Content analysis was employed for data analysis.<br>&nbsp; &nbsp;&nbsp; Results: The informants’ spiritual experiences could be summarised as follows. Firstly, a high-risk pregnancy was regarded as one that resulted from an individual’s karma and, therefore, involved more complication, caused greater danger, and required stricter healthcare practices than a normal pregnancy did. Secondly, major spiritual impacts of high-risk pregnancies consisted of frustration with the increased risk, fear of threats to themselves and their fetuses, worries about diffculties and limitations in their lives, and uncertainty about the outcomes of their pregnancies. Thirdly, the informants’ principal means of improving their spiritual health involved seeking spiritual support and spiritual self-development. Lastly, major factors in<br>the improvement of the informants’ spiritual health included care and encouragement from their families, sympathy from their colleagues, knowledge of their fetuses’ health, and experiences shared by other pregnant women.<br>&nbsp; &nbsp;&nbsp; Recommendations: This study identifed the spiritual experiences of high-risk pregnant women and their families. According to the fndings, the process of providing high-risk pregnant women with multi-dimensional care that responds to their physical, mental, social, and spiritual needs is a challenge to obstetric nurses in pursuit of true success in holistic nursing care.</p> ระวีวรรณ พิไลยเกียรติ อุทุมพร แหลมหลวง Copyright (c) 2020 Thai Journal of Nursing Council 2020-07-17 2020-07-17 35 3 121 138 Development of Instructional Video for Home Visits as Part of Family Health Services <p>Abstract:<br>&nbsp; &nbsp;&nbsp; Objective: To study an instructional video for home visits as part of family health services, as well as its impact on experts’ opinions, the effciency of the instructional video, and nursing students’ knowledge and opinions.<br>&nbsp; &nbsp;&nbsp; Design: Developmental research.<br>&nbsp; &nbsp;&nbsp; Methodology: The subjects, recruited by means of simple random sampling, consisted of 80 fourth-year nursing majors of the Faculty of Nursing, Chiang Mai University, in the academic year 2019. The research instruments consisted of an instructional video, an expert opinion survey form, a knowledge quiz form, and an opinion survey form for nursing students. The data were analysed using descriptive statistics and T-test statistics.<br>&nbsp; &nbsp;&nbsp; Results: Firstly, the experts were in the highest agreement on the quality of the instructional video. Secondly, the effciency of the instructional video (E1/E2) was at 73.82/89.78, where E1 meant ‘below the benchmark’ and E2 meant over the pre-determined benchmark of 75/75. Thirdly, the subjects’ average post-experimental score was signifcantly higher than their pre-experimental score (p &lt; .001). Finally, the subjects displayed high overall satisfaction with the instructional video.<br>&nbsp; &nbsp;&nbsp; Recommendations: The fndings showed that the instructional video for home visits as part of family health services effectively enhanced the students’ knowledge and satisfaction with the medium. It is recommended that this video medium be applied to courses or training programmes on family health services to increase nursing students’, nurses’, and healthcare professionals’ knowledge.</p> ศิวพร อึ้งวัฒนา สุกฤตา สวนแก้ว วิลาวัณย์ เตือนราษฎร์ เดชา ทำดี กัลยาณี ตันตรานนท์ สุมาลี เลิศมัลลิกาพร วันเพ็ญ ทรงคำ วชิระ สุริยะวงศ์ จิรานันท์ วงศ์สุวรรณ Copyright (c) 2020 Thai Journal of Nursing Council 2020-07-17 2020-07-17 35 3 139 153