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 en-US saipin2499@gmail.com (รศ. ดร สายพิณ เกษมกิจวัฒนา) phusanisa.tnmc@gmail.com (นางสาวภูษณิศา แก้วเขียว) Tue, 06 Oct 2020 16:04:17 +0700 OJS 3.1.2.4 http://blogs.law.harvard.edu/tech/rss 60 Holistic Palliative Care for End-Stage Renal Disease Patients Undergoing Non-Dialysis Treatment: A Case Study https://he02.tci-thaijo.org/index.php/TJONC/article/view/240579 <p>End-stage renal disease (ESRD) incapacitates the kidney’s filtering function, resulting in accumulation of waste products in the body. The disease’s progression to the end stage is accompanied by an increase in severity of symptoms. In this stage, the patients suffer from agitation and pain, which affect their physical, mental, emotional, and social abilities. This article presents a case study of end-stage renal disease patients who chose non-dialysis treatment and experienced severe symptomatic progress. The patients, whose symptoms included nausea, vomiting, loss of appetite, fatigue, hyperventilation, edema, and stupor, were taken by their family members to hospital each time a symptomatic change occurred. However, the mismatch between the patients’ needs and their family members’ expectations affected both parties and complicated the caregiving process, both in terms of retarding the disease’s progression and increasing the families’ readiness to care for the patients during their terminal stage.</p> <p>&nbsp;</p> <p>What the ESRD patients needed was a holistic palliative care programme. The implementation of such a programme, which was systematically co-designed by multidisciplinary teams and the patients’ family caregivers, required the skills and expertise of advanced registered nurses. The programme was based on a five-step procedure: 1) assessment and analysis of patients; 2) planning for retardation of renal disease progression; 3) management of symptomatic changes; 4) process of participatory decision making; and 5) provision of holistic care. This programme produced good-quality care outcomes, and allowed peaceful, fully dignified departure from this world whilst filling the families with pride in the deceased’s decision and satisfaction with the caregiving service.</p> กัลปังหา โชสิวสกุล, แสงทอง ธีระทองคำ Copyright (c) 2020 Thai Journal of Nursing Council http://creativecommons.org/licenses/by-nc-nd/4.0 https://he02.tci-thaijo.org/index.php/TJONC/article/view/240579 Tue, 06 Oct 2020 10:25:44 +0700 Working-Age Northeastern Thai Males’ Perception of Causes of Depression https://he02.tci-thaijo.org/index.php/TJONC/article/view/241853 <p>Objective: To explain causes of depression as perceived by working-age Northeastern Thai males.</p> <p>Design: Qualitative research</p> <p>Methodology: This study was conducted in Khon Kaen province during March 2019 to April 2020 on 23 working-age Northeastern Thai males diagnosed with major depressive disorders. These key informants were recruited by means of purposive sampling, the main inclusion criteria being (i) male, (ii) aged between 18 and 59 years, and (iii) without severe mental symptoms. Data were collected using in-depth interviews, which were audio-recorded. Content analysis based on Colaizzi’s approach was employed to analyse the data.</p> <p>Results: In the working-age Northeastern Thai males’ perception, depression resulted from a number of causes, namely, 1) failure to succeed in their expected roles; 2) failure to build financially secure families; 3) relationship problems with life partners; 4) feeling that their lives were being controlled; and 5) childhood abuse.</p> <p>Recommendations: Masculinity is linked to the causes of male depression. Therefore, development of male depression prevention approaches requires educating the public, especially men, to realise the effects of rigidly fixated ideas of masculinity on occurrence of depression. In addition, there is an urgent need to develop gender-sensitive psychosocial interventions and to promote greater flexibility in the perception of gender norms and roles.</p> เนตรชนก แก้วจันทา, สมพร รุ่งเรืองกลกิจ Copyright (c) 2020 Thai Journal of Nursing Council http://creativecommons.org/licenses/by-nc-nd/4.0 https://he02.tci-thaijo.org/index.php/TJONC/article/view/241853 Tue, 06 Oct 2020 10:41:07 +0700 Characteristics of a Good Death as Perceived by Related People in the Upper Northern Thai Context https://he02.tci-thaijo.org/index.php/TJONC/article/view/237173 <p>Objective: To describe characteristics of a good death according to related people’s</p> <p>perception and in the upper Northern Thai context</p> <p>Design: Qualitative descriptive research</p> <p>Methodology: The informants, recruited via purposive sampling, consisted of (i) terminal chronic patients; (ii) their caregivers; and (iii) palliative care teams of hospitals in three upper Northern Thai provinces. Then, based on a review of literature relevant to the characteristics of a good death, data collection methods were developed, namely, focus group discussion for 10 groups of 8 informants (80 in total) and in-depth interviews for 45 informants. Both the discussion and the interviews were audiotaped and recorded in writing during April to June 2019. The data were analysed using content analysis.</p> <p>Results: A good death, as perceived by related persons in the upper Northern Thai context, was characterised by five features: 1) absence of physical discomfort; 2) psychological and spiritual tranquility; 3) preparedness for death; 4) ability to determine the place of death; and 5) assurance of post-mortem care.</p> <p>Recommendations: People involved in policymaking and end-of-life care can use the findings to formulate indicators of palliative care outcomes for people in their end-of-life stage.</p> ศิริรัตน์ ปานอุทัย, ชมพูนุท ศรีรัตน์, ทิพาพร วงศ์หงษ์กุล Copyright (c) 2020 Thai Journal of Nursing Council http://creativecommons.org/licenses/by-nc-nd/4.0 https://he02.tci-thaijo.org/index.php/TJONC/article/view/237173 Tue, 06 Oct 2020 11:06:36 +0700 Predictors of Distress in Family Caregivers of Neurosurgery Patients during Palliative Care https://he02.tci-thaijo.org/index.php/TJONC/article/view/242438 <p>Objectives: To examine predictive powers of the patients’ functional ability, the caregivers’ needs, the caregivers’ preparedness, and diagnosis time in relation to the distress experienced by the caregivers of the neurosurgery patients during palliative care</p> <p>Design: Descriptive predictive study Methodology: This study sample was 109 patients during the 3rd to 5th days of post-neurosurgery palliative care, whose index of activity of daily living was ≤ 75 points, and 109 family caregivers providing the patients with during-hospitalisation and post-discharge care. All of the subjects were receiving treatment at the surgery ward of a tertiary hospital in Northeastern Thailand. The data-collecting instruments consisted of 1) a demographic questionnaire for the patients and their family caregivers; 2) the Palliative Performance Scale for Adult, or PPS (Suandok version); 3) the Problems and Needs in Palliative Care Questionnaire—Caregiver Form, or PNPC-c; 4) the Preparedness for Caregiving Scale; and 5) the Distress Thermometer. Multiple regression statistics with the enter method was used for analysis.</p> <p>Results: High distress was found in 43.1% of the family caregivers. Functional ability assistance for activities of daily living was needed in 86.2% ( = 30.30, SD = 11.26) of the patients. Most (73.1%) of the family caregivers’ greatest need was the means of caring for the patients ( = 15.48, SD = 3.01), whilst 48.6% displayed a moderate level of care preparedness (48.6%, = 17.96, SD = 7.34). For more than half (62.4%) of the patients, the diagnosis took five days or less (≤ 5 days; = 9.79, SD = 10.66). The factors capable of significantly predicting the family caregivers’ distress were the caregivers’ needs, caregivers’ preparedness, and diagnosis time, respectively (β = .346; β = -.203; β = -.188, p &lt; .05).</p> <p>Recommendations: Nurses are advised to assess, during the three to five days of palliative care following the patients’ neurosurgery, the caregivers’ distress, assistance needs, and pre- and post-operative care preparedness. This is to ensure the nurses’ readiness to provide the caregivers with prompt and timely help.</p> ศศิธร อิ่มมณี, วัลย์ลดา ฉันท์เรืองวณิชย์, Prangtip Chayaput, Parunut Itthimatin Copyright (c) 2020 Thai Journal of Nursing Council http://creativecommons.org/licenses/by-nc-nd/4.0 https://he02.tci-thaijo.org/index.php/TJONC/article/view/242438 Tue, 06 Oct 2020 11:29:59 +0700 Impacts of an Empowerment Programme on Family Caregivers’ Ability to Assist Stroke Patients to Perform Joint Exercise https://he02.tci-thaijo.org/index.php/TJONC/article/view/241976 <p>Objective: To study possible impacts that an empowerment programme could have on family caregivers’ ability to enable stroke patients to do joint exercise</p> <p>Design: Quasi-experimental research, with one-group repeated measurements</p> <p>Methodology: The sample consisted of 21 participants from families with hemorrhagic and ischemic stroke patients. The participants were supporting the patients at their homes as family caregivers. In this study, the participants received a six-week empowerment programme developed based on Gibson’s (1995) empowerment framework. The programme emphasised: 1) discovery and analysis of realities, as well as problems and obstacles related to joint exercise; 2) critical reflection and thorough review of joint exercise practice, to reach mutual problem-solving agreements; 3) decisions on proper exercise activities and plans for exercise methods suitable for individual stroke patients and their families; and 4) maintaining of effective exercise methods, through home-visit and phone-mediated follow-ups, for the purposes of assurance, encouragement, and assessment. The datagathering instruments consisted of 1) a questionnaire on general information of each family; and 2) an assessment form focusing on family caregivers’ performance in helping stroke patients with their joint exercise. The data were analysed using descriptive statistics and the Wilcoxon Matched Pairs Signed-Ranks test.</p> <p>Results: After the programme intervention, the participants displayed a significant increase in their mean score on supporting stroke patients’ performance of joint exercise (p &lt; 0.01).</p> <p>Recommendations: The empowerment program can be used as a guideline to promote family-based joint exercise practice for stroke patients, and as a means of increasing the family caregivers’ knowledge, ability, and confidence in providing the patients with continuous care.</p> ทัศมาภรณ์ สุทธิรักษ์, รังสิยา นารินทร์, วิลาวัณย์ เตือนราษฎร์ Copyright (c) 2020 Thai Journal of Nursing Council http://creativecommons.org/licenses/by-nc-nd/4.0 https://he02.tci-thaijo.org/index.php/TJONC/article/view/241976 Tue, 06 Oct 2020 14:03:41 +0700 Benefits of a Self-Care-Promoting Programme for Cataract Surgery Patients’ Knowledge and Self-Care Behaviour https://he02.tci-thaijo.org/index.php/TJONC/article/view/236274 <p>Objective: To examine cataract surgery patients’ improvement in their knowledge and self-care behaviour after receiving a self-care-promoting programme.</p> <p>Design: Two-group quasi-experimental research, with a pretest and a posttest</p> <p>Methodology: The subjects, recruited by means of purposive sampling, were 50 cataract surgery patients treated at a tertiary hospital between April and July 2018. They were divided into a control group (n = 25) and an experimental group (n = 25). The control group received standard nursing care, whilst the experimental group received a self-care-promoting programme. The self-care programme comprised: 1) a video on cataract; 2) a lesson on pre- and post-cataract-surgery self-care; 3) a lesson on using sterilised eye wipes, eyedrops, eye swabs, and eyeshields; 4) a post-cataract surgery self-care manual; and 5) a plan for pre- and post-surgery phone-mediated monitoring. Data were collected between April and August 2018, through 1) a test of knowledge of cataract and post-surgery self-care and 2) a form designed to assess cataract patients’ post-surgery self-care behaviour. The data were analysed using descriptive statistics and independent and dependent t-test.</p> <p>Results: The experimental group’s post-intervention mean scores on cataract knowledge and on self-care behaviour were significantly higher than their pre-intervention scores, and also significantly higher than the control group’s scores (p &lt; .05).</p> <p>Recommendations: The results indicated that the self-care-promoting programme increased the patients’ knowledge and improved their self-care behaviour. Hence, it is recommended that this programme be applied to patients having undergone cataract surgery to enhance their self-care ability.</p> ปรัศนีย์ พันธุ์กสิกร, ศิริลักษณ์ กิจศรีไพศาล Copyright (c) 2020 Thai Journal of Nursing Council http://creativecommons.org/licenses/by-nc-nd/4.0 https://he02.tci-thaijo.org/index.php/TJONC/article/view/236274 Tue, 06 Oct 2020 14:25:44 +0700 Impacts of Health Belief Promoting Programme on Self-Practice Behaviour in Older Patients Having Undergone Hip Arthroplasty https://he02.tci-thaijo.org/index.php/TJONC/article/view/241416 <p>Objective: To examine impacts that a health belief promoting programme (HBPP) could have on older patients’ self-practice behaviour after hip arthroplasty</p> <p>Design: Two-group quasi-experimental research with a pretest and a posttest</p> <p>Methodology: The sample consisted of 32 older patients diagnosed with hip fractures who had undergone hip arthroplasty. Recruited by means of purposive sampling, the subjects were equally divided into an experimental group and a control group, with each member of one group paired with one of the other based on their age, sex, and education level. The experimental group was treated with the HBPP, which involved promotion of self-efficacy, whilst the control group received only standard care. Data were collected twice, before HBPP and in the fourth week after HBPP, via interviews with the subjects on their post-arthroplasty self-practice behaviour. The data were analysed using Wilcoxon Signed Rank test and Mann-Whitney U test.</p> <p>Results: In the fourth week after HBPP, a statistically significant difference (z = -4.85; p &lt; .001) was evident between the experimental group’s and the control group’s self-practice behaviours (M = 67.19, SD = 4.43 vs M = 37.99, SD = 4.02). Besides, the experimental group’s fourth-week self-practice behaviour score (M = 67.19, SD = 4.43) was significantly higher (z = -3.52; p &lt; .001) than its pre-experiment score (M = 30.43, SD = 2.59).</p> <p>Recommendations: As HBPP has the potential to improve older hip arthroplasty patients’ self-practice behaviour, nurses should be specifically trained to apply it to caring for this group of patients.</p> phatchararin naimkerd, Narirat Jitramontree, Suporn Danaidutsadeekul Copyright (c) 2020 Thai Journal of Nursing Council http://creativecommons.org/licenses/by-nc-nd/4.0 https://he02.tci-thaijo.org/index.php/TJONC/article/view/241416 Tue, 06 Oct 2020 14:41:36 +0700 Application of Lean Concept to Improving Service Processes of Cardiovascular Clinic, Maharaj Nakorn Chiang Mai Hospital https://he02.tci-thaijo.org/index.php/TJONC/article/view/241569 <p>Objective: To improve the service processes of the Cardiovascular Clinic, Maharaj Nakorn Chiang Mai Hospital, using the Lean Concept</p> <p>Design: Developmental research</p> <p>Methodology: This study employed a sample of 13 members of the Cardiovascular Clinic’s personnel and was conducted in three stages: pre-development, development, and post-development. The study sample was the number of observations of individual activities in the nursing service processes, ranging between 20 and 74 as calculated based on the standard time. The research instruments comprised 1) a table explaining activity types in the service process; 2) a process flow diagram; 3) an activity value analysis form; 4) an activity time recording form; and 5) group-interview question guidelines concerning obstacles to and recommendations for service process improvement. The data were analysed using descriptive statistics, namely, mean, SD, and range. The problems, obstacles, and recommendations were analysed using the content analysis.</p> <p>Results: In total, four major service processes and 19 individual activities were improved through the Lean Concept, with the number of individual activities reduced from the pre-development stage by three. The standard duration of an improved service process was 93.59 minutes, which was 36.07 minutes faster than the pre-development duration. The major obstacles and recommendations identified concerned 1) the administration; 2) the personnel; 3) the communication; and 4) the equipment.</p> <p>Recommendations: Nursing administrators can use the findings of this study as baseline data to implement the Lean Concept to improve the quality of service provided by other units within the organisation.</p> นฤมล ไชยวารีย์, ฐิติณัฏฐ์ อัคคะเดชอนันต์ , บุญพิชชา จิตต์ภักดี Copyright (c) 2020 Thai Journal of Nursing Council http://creativecommons.org/licenses/by-nc-nd/4.0 https://he02.tci-thaijo.org/index.php/TJONC/article/view/241569 Tue, 06 Oct 2020 00:00:00 +0700 The factors predicting health behaviors among pregnant migrant women in Chon Buri province https://he02.tci-thaijo.org/index.php/TJONC/article/view/240384 <p>Objective: To study the health behaviour of pregnant migrant workers in Chon Buri province and factors that could predict such behaviour</p> <p>Design: Predictive correlational research</p> <p>Methodology: The subjects were 197 pregnant migrant workers from Cambodia, Myanmar, and Laos, who received antenatal care services in public hospitals in Chon Buri province. Data were collected from August to October 2019, via 1) a demographic information questionnaire; 2) a health perception questionnaire; 3) a pregnancy-related belief questionnaire; 4) an antenatal health behaviour benefit perception questionnaire; 5) a health service accessibility questionnaire; and 6) a health behaviour questionnaire. The data were analysed using descriptive statistics and Stepwise Multiple Regression.</p> <p>Results: The subjects had a moderate level of health behaviour (M = 95.30, SD = 13.80). The factors capable of significantly predicting the subjects’ health behavior were pregnancy-related beliefs and perception of antenatal health behaviour benefits, with a combined predictive power accounting for 61% of the subjects’ health behaviour(p &lt; .05).</p> <p>Recommendations: Nurses and healthcare providers should assess pregnant migrant workers’ beliefs regarding pregnancy and their perception of benefits of during-pregnancy health behaviour. Based on the outcomes of this assessment, a nursing intervention could be developed to promote constructive pregnancy-related beliefs and perception of antenatal health behaviour benefits, both of which could promote good health behaviour amongst pregnant migrant workers.</p> ช่อทิพย์ ผลกุศล, ศิริวรรณ แสงอินทร์ Copyright (c) 2020 Thai Journal of Nursing Council http://creativecommons.org/licenses/by-nc-nd/4.0 https://he02.tci-thaijo.org/index.php/TJONC/article/view/240384 Tue, 06 Oct 2020 15:23:23 +0700