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 Older End-Stage Renal Disease Patients: A Challenging Role for Community Nurses in Aging Society <p>Abstract:<br>Population ageing inevitably affects community nurses’ work, requiring them to adjust their healthcare service roles to be consistent with the changing social and cultural context. In particular, as the number of end-stage renal disease patients is likely to rise, community nurses’ role as palliative care providers is increasingly important. In this role, they are required to: 1) prepare family caregivers; 2) prepare relevant<br>personnel and sources of support; 3) manage the patients’ symptomatic pain; 4) provide spiritual care consistent with the social and cultural context; and 5) support the patients’ families to cope with grief and loss. By performing these role-required duties, community nurses are able to help end-stage renal disease patients improve their quality of life in a dignifed manner. It is, therefore, essential that community<br>nurses’ effciency in providing palliative care for end-stage renal disease patients be developed in preparation for the future demand for healthcare services in an ageing population.</p> สาคร อินโท่โล่ Copyright (c) 2020 Thai Journal of Nursing Council 2020-05-07 2020-05-07 35 2 5 14 Impact of Transitional Care Programme for Patients with Chronic Ischaemic Heart Disease on Health Behaviour and Risk of Recurrent Cardiovascular Events <p>Abstract<br>Objective: To study the impact that a transitional care programme could have on<br>chronic ischaemic heart disease (IHD) patients’ health behaviour and risk of recurrent<br>cardiovascular events.<br>Design: One-group quasi-experimental research with a pre-test and a post-test.<br>Methodology: The sample was 77 IHD patients treated at the Cardiology Clinic of Kamphaeng Phet Hospital. The subjects were recruited based on the inclusion criteria. All the subjects participated in the transitional care programme for chronic ischaemic heart disease patients, which was developed based on Meleis et al’s Concept of Transition. The subjects’ healthcare behaviour was assessed three times: before programme participation, in the sixth month of the programme, and during the one-year follow-up period. Their risk of recurrent cardiovascular events was assessed twice: before programme participation and during the<br>one-year follow-up period. The entire research period lasted from January 2018 to April 2019.<br>Data were collected using 1) a healthcare behaviour questionnaire; 2) a clinical data recording form; and 3) the cardiovascular disease (CVD) risk prediction tool developed by the University Medical Center Utrecht, the Netherlands. Healthcare behaviour comparison was performed using Repeated Measure ANOVA, and the risk of recurrent CVD was calculated using Chi-Square Test.<br>Result: The participants demonstrated signifcant improvement in the following aspects of healthcare behaviour: treatment preparation, food consumption, exercise, emotion management, and abstinence from smoking. Their improvement was evident in all of the three assessment periods: before programme participation (p = .000), in the sixth month of the programme (p = .000), and during the one-year follow-up period (p = .000). The patients’ risk of recurrent CVD was also signifcantly decreased (p = .001), with abstinence from smoking, systolic blood pressure, and HDL levels identifed as controllable factors.<br>Recommendations: The transitional care programme for chronic ischaemic heart disease patients increased treatment effcacy by motivating patients to improve their healthcare behaviours and control risk factors, thereby reducing the risk of recurrent cardiovascular events. It is suggested that this programme be clinically implemented in the future.</p> จิราพร มณีพราย Copyright (c) 2020 Thai Journal of Nursing Council 2020-05-07 2020-05-07 35 2 15 31 Impact of Early Rehabilitation Programme on Post-Open Abdominal Surgery Gastrointestinal Patients’ Ability to Perform Activities of Daily Living <p>Abstract<br>Objective: To compare two groups of post-open abdominal surgery gastrointestinal patients in terms of their competency to perform activities of daily living (ADLs), with one group receiving only standard care and the other receiving both standard care and an early rehabilitation programme, using King’s Theory of Goal Attainment as a conceptual framework.<br>Design: Two group quasi-experimental research with a pre-test and post-test.<br>Methodology: The sample was 64 male and female gastrointestinal patients who had undergone elective open abdominal surgery in the general surgery unit at a university hospital from July 2016 to February 2017. The sample was selected based on preset inclusion criteria and paired according to age- and surgery-related information. The frst 32 participants were assigned to the control group, which received only standard care, and the remaining 32 participants were assigned to the experimental group, which received both standard care and the early rehabilitation programme developed based on King’s Theory of Goal Attainment. General<br>information, treatment data, and data on each participant’s ability to perform activities of daily living were collected in three stages—the preoperative period, Day 1 after open abdominal surgery, and Day 3 after open abdominal surgery. The data were analysed using descriptive statistics, statistical analysis of covariance (ANCOVA), and repeated measures two-way analysis of variance (ANOVA).<br>Results: The patients in both the control and experimental groups were able to perform the patients’ activity of daily living better on the third day after open abdominal surgery than on the frst day with statistical signifcance (p&lt;.01). Furthermore, the patients in the experimental group were able to perform activity of daily living better at 48 hours after open abdominal surgery that the control group with statistical signifcance (p&lt;.01)<br>Recommendations: The application of the early rehabilitation programme should integrate both preoperative instructions and postoperative patient care in order to allow patients to regain or improve their ability to perform activities of daily living.</p> อรวรรณ หลงเวช ผ่องศรี ศรีมรกต สุพร ดนัยดุษฏีกุล เชิดศักดิ์ ไอรมณีรัตน์ Copyright (c) 2020 Thai Journal of Nursing Council 2020-05-07 2020-05-07 35 2 32 51 Impact of a Self-Management Programme Monitored through the Application LINE on Eating Behaviour, Arm-Swing Exercise Behaviour, and Blood Glucose Levels in Women with Gestational Diabetes Mellitus <p>Abstract:<br>Objective: To study the effectiveness of a self-management programme, monitored using the LINE application, in the eating behaviour, arm-swing exercise behaviour, and blood glucose levels in women with gestational diabetes mellitus.<br>Design: Two-group quasi-experimental research with a pre-test and a post-test.<br>Methodology: The sample consisted of 78 women with gestational diabetes mellitus who were examined at Thammasat Hospital. The participants were recruited via the purposive sampling method and equally divided into a control group and an experimental group. The experiment was conducted between August and December 2018. The experimental group participated in the self-management programme and was given education on gestational diabetes mellitus, diet control, arm-swing exercise, self-monitoring activities, self-evaluation activities, and self-reinforcement. During the programme, the participants were monitored through the LINE application. The control group, on the other hand, received standard care. The data-collecting instruments consisted of 1) an eating behaviour questionnaire; 2) an arm-swing exercise<br>behaviour questionnaire; and 3) measuring of the blood glucose levels. The data were analysed<br>using frequency distribution, percentage, Chi-square test, T-test statistics, and an analysis of covariance.<br>Results: At the gestational age of 36 weeks, the experimental group and control group displayed statistically signifcant differences in their average eating behaviour, arm-swing exercise behaviour, and fasting blood glucose level scores.<br>Recommendations: The midwives should bring Self-Management Programming and The LINE Application Tracking to take care of women with gestational diabetes mellitus, so that they can control blood glucose levels.</p> ปิยะพร ศิษย์กุลอนันต์ พรสวรรค์ คำทิพย์ Copyright (c) 2020 Thai Journal of Nursing Council 2020-05-07 2020-05-07 35 2 52 69 Impact of Brain Exercise Programme on Older Adults’ Cognition <p>Abstract<br>Objectives: To compare older adults’ cognition before and after receiving a brain exercise programme.<br>Design: One-group quasi-experimental research with a pre-test and a post-test.<br>Methodology: The participants, recruited via random sampling, were 30 older adults living in Bang Sai sub-district, Muaeng Chon Buri district, Chonburi province. Data collection was conducted from May to July 2018. The instruments consisted of 1) a demographic data form; 2) Montreal Cognitive Assessment (MoCA); and 3) a six-week brain exercise programme. In the frst week, the brain exercise programme focused on educating the participants on dementia and its prevention. From the second to the sixth weeks, the programme engaged the participants in weekly three-hour sessions of brain-exercising activities and practices. The outcome of the programme was evaluated in the tenth week. The data were analysed using descriptive<br>statistics and paired t-test.<br>Results: After participating in the brain exercise programme, the older adults’ average cognition score was higher than that before the intervention (p &lt; .001). Category-wise, the participants displayed signifcant cognitive improvement in visuospatial/executive, name recognition, concentration, and delayed recall areas (p = .007; p = .018; p = .005; and p = .008, respectively). However, no signifcant differences were found between their pre- and post-intervention mean scores on language use, abstraction, and orientation (p &gt; .05).<br>Recommendations: The fndings of this preliminary study proved that this brain exercise programme could stimulate older adults’ cognition. However, it is recommended that the study be repeated and include a control group, so as to more accurately measure the effectiveness of the programme before applying it to older adults in general.</p> จุฑามาศ วงจันทร์ มยุรี ลี่ทองอิน สิริมาศ ปิยะวัฒนพงศ์ Copyright (c) 2020 Thai Journal of Nursing Council 2020-05-07 2020-05-07 35 2 70 84 Factors Influencing Depressive Symptoms in Caregivers of Older Adults with Dementia <p>Abstract<br>Objective: To study the influences of dementia severity, comorbidities of older adults with dementia, comorbidities of caregivers, health status of caregivers, preparedness for family care, and mutuality between older adults and caregivers on depressive symptoms among caregivers of older adults with dementia.<br>Design: Descriptive predictive study<br>Methodology: A sample of 122 caregivers who had been taking care of older adults with dementia at least 14 hours/week for at least 3 months was recruited at a memory clinic of one tertiary hospital in Bangkok. Data were collected using questionnaires for demographic data, Charlson comorbidity index, health condition perception, preparedness for family care, mutuality between older adults and caregivers and Center for Epidemiologic Studies Depression scale. Data were analyzed using multiple linear regression.<br>Result: The older adults had mild level of dementia and moderate level of comorbidity severity. The caregivers of the older adults with dementia were descendants and had no comorbidity with moderate level of health status. They had moderate level of preparedness, a rather high level of mutuality and low depressive symptoms. Preparedness for family care and health status of caregivers were found as signifcant factors which could explain for 35.4% of variance (Adjust R2=0.354, F=9.277, p=0.000) However, level of dementia, comorbidities of older adults with dementia, comorbidities of caregivers and mutuality did not signifcantly predict depressive symptoms among caregivers of older adults with dementia.<br>Recommendations: Preparedness and health status of caregivers had influences on depressive symptoms among caregivers of older adults with dementia. The higher level of preparedness and the better health status of caregivers, they are more likely to have less depressive symptoms. Therefore, nurses should prepare caregivers to being ready and promote their health status in order to prevent depressive symptoms from caring for the older adults with dementia.</p> บุษรา หิรัญสาโรจน์ วิราพรรณ วิโรจน์รัตน์ นพพร ว่องสิริมาศ วรพรรณ เสนาณรงค์ Copyright (c) 2020 Thai Journal of Nursing Council 2020-05-07 2020-05-07 35 2 85 98 Factors Related to Burn Patients’ Post-Discharge Quality of Life <p>Abstract:<br>Objective: To study the correlation between burn patients’ post-discharge quality of life and the factors of burn injury severity, burn injury pain, wound itchiness, and sleeplessness, during the patients’ follow-up visits to the hospital.<br>Design: Descriptive correlational research.<br>Methodology: Based on pre-set criteria, 60 burn patients aged 18 years and older were recruited, each with a history of deep second-degree burns covering at least 10% of the total body surface area. The patients were receiving post-discharge follow-up treatment at two tertiary hospitals in Bangkok. Data were collected from October 2016 to December 2017 by means of a demographic data questionnaire, a brief version of the Burn Specifc Health Scale (BSHS-B), the pain numeric rating scale, the itch numeric rating scale, and the<br>Insomnia Severity Index (ISI). The data were analysed using descriptive statistics and Spearman’s rank correlation coeffcient.<br>Results: According to the fndings, most of the subjects were males (63.33%) with a mean age of 43.10 years (SD = +14.19). The sample registered a high average overall quality of life score of 122.83 (= 122.83, SD = 26.09). In the domains of heat sensitivity and work, the subjects showed moderate scores of 10.87 (= 10.87, SD = 6.12) and 8.25 (= 8.25, SD = 5.63), respectively. Most of the subjects (70%) had severe burns, with nearly all (96.67%) suffering from wound itchiness, nearly half (48.33%) from sleeplessness, and 40% from wound pain. Sleeplessness was found to be in a negative correlation with the subjects’ quality of life (r = -0.48, p &lt; 0.01). Burn injury severity, wound pain, and wound itchiness were not found to have any signifcant correlation with the subjects’ post-discharge quality of life (r = -0.13, p = 0.32; r = -0.08, p = 0.55; and r = 0.04, p = 0.77, respectively). Wound pain and wound itchiness, by contrast, had a positive correlation with the subjects’ sleeplessness (r = 0.30, p &lt; 0.05; and r = 0.32, p &lt; 0.05, respectively).<br>Recommendations: The fndings can be used as a guideline for nurses to coordinate with physicians in promoting sleep in burn patients, with an emphasis on behaviour adjustment and administration of sleep-inducing medications, in order to help burn patients gain suffcient rest and improve their quality of life.</p> สุมิตรา แป้นคุ้มญาติ สุพร ดนัยดุษฎีกุล อรพรรณ โตสิงห์ พรพรหม เมืองแมน อังคณา ตันวัฒนากูล Copyright (c) 2020 Thai Journal of Nursing Council 2020-05-07 2020-05-07 35 2 99 115 Caregivers’ Stress and Coping with Stress from Caring for Terminally Ill Patients in a Palliative Care Unit <p>Abstract:<br>Objectives: To study caregivers’ levels of stress and their means of coping with stress from caring for terminally ill patients admitted to a palliative care unit.<br>Design: Descriptive research.<br>Methodology: Seventy-three family caregivers of terminally ill patients admitted to a palliative care unit of a tertiary hospital in Thailand were recruited through purposive sampling from July to November 2018. The research instruments were: 1) a demographic questionnaire; 2) a stress-measuring scale for caregivers of terminally ill patients; and 3) the Jalowiec Coping Scale (JCS). Data were collected by the researcher and analysed using descriptive statistics, including mean, percentage, and standard deviation.<br>Results: The family caregivers displayed a moderate average level of stress. A categoryspecifc analysis identifed the physical conditions of the terminal ill patients as the most influential cause of the caregivers’ stress, followed by the caregivers’ psychological, economic, social, and environmental conditions, respectively. To cope with stress, the caregivers used both problem focus coping and emotional focus coping. with greater emphasis on the latter.<br>Recommendations: The study fndings could be used as baseline data for nursing care planning to assess family caregivers’ stress and to promote their use of appropriate problem focus coping and emotional focus coping.</p> ทรงสุดา ยงพัฒนจิตร สุปรีดา มั่นคง นุชนาฏ สุทธิ Copyright (c) 2020 Thai Journal of Nursing Council 2020-05-07 2020-05-07 35 2 116 131 Sex, Age, and Blood Pressure Level and Their Predictive Correlation with Overweight/Obesity in Hypertension Patients Treated at Primary Care Facilities <p>Abstract:<br>Objectives: To examine the predictive correlation that the factors of sex, age, and blood pressure level had with overweight/obesity in hypertension patients treated at primary care facilities.<br>Design: Descriptive correlational predictive study.<br>Methodology: This study was based on secondary data obtained from three cross-sectional study projects conducted on a total 782 hypertension patients. Based on the data, the patients were classifed: 1) into the obese (BMI ≥ 23.0 kg/m2) and non-obese (BMI &lt; 23.0 kg/m2) groups, according to the Asian BMI criteria; 2) into six 10-year age groups (from under 45 as early adults to 85 or older as the oldest-old); and 3) into four JNC-7 blood pressure groups, according to their systolic and diastolic blood pressure readings. The correlations between the factors of sex, age, and blood pressure level were then analysed using the univariate logistic regression analysis, to identify their predictive power for overweight/obesity.<br>Results: Approximately two-thirds of the patients (66.2%) were overweight/obese, and no signifcant difference in obesity likelihood was observed between males and females (OR = 1.38, 0.93-2.06, p = 0.104). Overweight/obesity was found in a correlation with a young age and a high diastolic blood pressure, but not with a systolic blood pressure and the ability or inability to control the blood pressure according to the criteria.<br>Compared with the early adults, the middle-old and the oldest-old displayed a reduced overweight/obesity risk (OR 0.24, 95% CI 0.11-0.51, p = 0.000 and OR 0.14, 95% CI 0.05-0.37, p = 0.000, respectively). However, the risk increased three times amongst the middle adults (OR 2.79, 95% CI 1.10-7.03, p = 0.026). In addition, patients in pre-hypertension and hypertension stages were found to face two-time higher risk (OR<br>1.94, 95% CI 1.34-2.82, p = 0.000 and OR 2.14, 95% CI 1.09-4.16, p = 0.039, respectively).<br>Recommendations: A high prevalence of overweight/obesity is found in males and females with hypertension. The obesity risk increased amongst young people with high diastolic blood pressures. The risk was detected in patients in all systolic blood pressure categories, regardless of their blood pressure control ability or inability. For this reason, weight monitoring, weight control, and weight loss guidelines should be added to the routine care for all hypertension patients.</p> ชิดชนก มยูรภักดิ์ จอม สุวรรณโณ Copyright (c) 2020 Thai Journal of Nursing Council 2020-05-07 2020-05-07 35 2 132 148