Thai Journal of Nursing and Midwifery Practice

Development and Evaluation of the Discharge Planning Model for Chronic Obstructive Pulmonary Disease Patients by Multidisciplinary Team, Medical Ward, Yala Hospital

Adeelah Sarai, Piyawan Phumivanichkit — Mon, 21 Oct 2024 00:00:00 +0700

Abstract: This research and development aimed to develop and evaluate a discharge planning model for chronic obstructive pulmonary disease (COPD) patients by a multidisciplinary team at the medical ward, Yala Hospital, during October 2022 - September 2023. The study comprised 3 phases. Phase 1 was studying the situation of discharge planning for patients with COPD. The sample was the medical records of 201 COPD patients and data from a focus group of representatives from the multidisciplinary team. Phase 2 was developing and implementing a discharge planning model for COPD patients by a multidisciplinary team. Phase 3 was evaluating the results of implementing the discharge planning model for COPD patients by a multidisciplinary team with two sample groups, namely 56 professional nurses in the medical ward and 70 COPD patients. The patient group was divided into two groups, each of 35 patients, to evaluate the outcome before and after implementing the discharge planning model. Data were analyzed using descriptive statistics and Chi-square to compare the unplanned readmission rate within 28 days. The study findings showed that discharge planning models for COPD patients by a multidisciplinary team was feasible and nurses were satisfied with the implementation at a high level. The readmission rate among COPD patients in the group receiving the discharge planning model by a multidisciplinary team was significantly lower than that among patients receiving regular discharge planning (p < .05). The developed discharge planning model can be used in practice and reduces the unplanned readmission rate. However, long-term follow-up study should be conducted.

Development of a Team Nursing Model for Prevention of Unplanned Extubation in Surgical Intensive Care Unit

Niphawan Chamthong, Saranya Tukchoosaeng — Mon, 28 Oct 2024 00:00:00 +0700

Abstract: This participatory action research aimed to develop and evaluate a team nursing model to prevent unplanned extubation. The sample comprised 56 nursing practitioners working in the surgical intensive care unit and 200 patients with oral intubation admitted in the surgical intensive care unit between February and September 2023. Data were collected by focus group discussion and survey report of the incidence of unplanned extubation. Data were analyzed by frequency, percentage and content analysis. The research revealed that the team nursing model for prevention of unplanned extubation involved 1) role and responsibility of team nursing, 2) training for promoting team learning and skills development, 3) implementing leadership in nursing teams, 4) double checking, 5) bedside shift rounds, 6) rapid rounds, 7) regular feedback and assessment, and 8) compliments for coworkers in team nursing. Nurses reflected their opinions that the team nursing model was of benefit and helpful, and increased nurses’ responsibility through supportive team nursing and engagement with a multidisciplinary team. The incidence of unplanned extubation decreased from 2.75 times per 1000 ventilator days to 0 times per 1000 ventilator days. This team nursing model can be used as a guideline to prevent unplanned extubation in surgical intensive care units and should be given sustained support for its successful implementation.

Effects of the Sexual Communication Program on Sexual Attitudes and Communication Skills of Parents and Female Junior High School Students

Pornpen Soda, Napaphen Jantacumma, Piyaorn Wajanatinapart — Mon, 21 Oct 2024 00:00:00 +0700

Abstract: This quasi-experimental research was a two-group pretest-posttest design which aimed to study effects of a sexual communication program on sexual attitudes and communication skills of parents and female junior high school students. The sample comprised 50 parents of female junior high school students and female students taken care by those parents purposively selected from two schools in Kumphawapi District, Udon Thani Province, and randomly assigned to an experimental group and a comparison group (25 per group). The instruments included the sexual communication program developed by applying David K. Berlo’s communication skill development theory. The program was organized in a workshop format, carried out 5 times over a period of 8 weeks. Data were collected at pre- and post- intervention using questionnaires on sexual communication attitudes and sexual communication skills that had already been tested for validity and reliability. Data were analyzed using descriptive statistics and t-test. The findings demonstrated that after intervention, the average score for attitude towards communication about sex and sexual communication skills of parents in the experimental group was better than before as well as significantly better than that of the comparison group (p < .05). In addition, the average score for attitude towards communication about sex and sexual communication skills perceived by female students of parents in experimental group was better than that of the comparison group (p < .05). Therefore, parents
should be educated to have a knowledge with good attitude on sexual communication, which would enhance better communication skills to talk to their teens.

Effect of Motivational Interviewing Program on Medication Adherence of Adolescents with Autoimmune Disease

Phakamat Saikhamfoo, Renu Pookboonmee, Soamarat Vilaiyuk, Jiraporn Punyoo — Tue, 12 Nov 2024 00:00:00 +0700

Abstract: The purpose of this one group pre-post quasi-experimental research was to examine the effect of motivational interviewing program on medication adherence of adolescents with autoimmune disease. The conceptual framework for this study was based on self-care theory and motivational interviewing. The program was applied to 17 adolescents who were 15-21 years old with autoimmune disease and poor medication adherence. The study instruments were the motivational interviewing program on medication adherence of adolescents with autoimmune disease. Data were collected using adolescents’ demographic data, Medication Adherence Report Scale (MARS) questionnaire, motivational interviewing record, and medication record. Data were analyzed using descriptive statistics and the medication adherence scores of adolescents with autoimmune diseases were compared using the Wilcoxon signed-rank test. The result of the study showed that after having motivational interviewing program on medication adherence of adolescents, the mean score and median score of Medication Adherence Report Scale: MARS of post-test were higher than pre-test at the statistical significance of 0.05 (Z = -3.634, p <.001). In conclusion, this motivational interviewing program could be used to improve medication adherence in adolescents with autoimmune disease who have poor medication adherence and should be further evaluated over a longer term and compared with a control group prior to applying it to adolescent groups with other chronic diseases.

The Effect of Self-Efficacy Enhancing Program for Caregivers on Perceived Self-Efficacy and Pneumonia Prevention Behaviors in Head and Neck Cancer Patients with Tracheostomy

Wantakan Raksthai, Ratjai Vachprasit, Wipa Sae-Sia — Sun, 24 Nov 2024 00:00:00 +0700

Abstract: This two-group repeated measures quasi-experimental design study aimed to examine the effects of the Self-Efficacy Enhancing Program (SEEP) for caregivers on perceived self-efficacy and pneumonia-prevention behaviors in head and neck cancer patients with tracheostomy. The sample consisted of 20 dyads of head and neck cancer patients and their caregivers selected from the Ear, Nose and Throat ward. Ten dyads were assigned to the experimental group, receiving usual care and the SEEP. The other ten dyads were assigned to the control group, receiving only usual care. The study intervention was the SEEP developed based on the Bandura framework. Instruments for data collection consisted of the Perceived Self-Efficacy of Caregivers Questionnaire and the Pneumonia-Prevention Behaviors of Caregivers Observation Form. The quality of all instruments was evaluated, yielding content validity index between .97 and 1.0, and reliability between .97 and .98. Data were analyzed using descriptive statistics, independent t-test, and two-way repeated measures ANOVA to compare the outcomes after intervention at days 3, 5 during hospitalization, and day 14 after hospital discharge. The results revealed that after participating in the program, the mean scores of perceived self-efficacy and behaviors of pneumonia-prevention among caregivers in the experiment group were significantly higher than those in the control group (F_{1, 17}=17.532, p <.001; F_{1, 17}= 109.188, p <.001, respectively). The results could be used as guidance for nurses to promote caregivers' self-efficacy which can increase the confidence and practice of caregivers to prevent patients from developing pneumonia. However, further study with a larger sample size should be carried out.

The Clinical Outcomes of a Nursing System for Hepatocellular Carcinoma Outpatients Undergoing Trans-Arterial Chemoembolization: A 10-year Retrospective Study

Rungtip Udomvisatson, Suthisa Temthup, Nutsiri Wuttichokmongkolkul — Mon, 16 Dec 2024 00:00:00 +0700

Abstract: This is a retrospective study aimed to evaluate the clinical outcomes of hepatocellular carcinoma (HCC) outpatients who received trans-arterial chemoembolization (TACE) at a university hospital in Southern Thailand. The sample consisted of 658 HCC outpatients, who received a total of 874 TACE times between 2012 and 2021. The tools used to record data were 1) a form to record complications after treatment, and 2) a form to record waiting times for accessing treatment. Data were analyzed using descriptive statistics. The results of the study showed that 32.95% of HCC outpatients who received TACE experienced complications, mostly common complications of post-embolization syndrome (23.56%). Serious but rare complications included liver function decline (1.26%), acute cholecystitis (0.23%), and renal function decline (0.11%). The average waiting time for accessing TACE was 57.20 days (standard deviation 12.23 days). It is concluded that the nursing system and treatment for HCC outpatients who received TACE are safe and effective in helping to reduce the waiting time for treatment. Therefore, a nursing system for HCC patients who receive TACE should be developed in which the procedure is performed and the patient allowed to go to home the same day to increase the quality of life for patients, reduce the waiting time for access treatment and help reduce the problem of a shortage of beds to accommodate patients in hospitals.

The Effects of a Motivational Enhancement and Educational Program on Cervical Cancer Prevention Behaviors, Anxiety and Rate of Follow-Up Colposcopy Among Women with Abnormal Pap Test

Supap Samabub, Sopen Chunuan — Mon, 16 Dec 2024 00:00:00 +0700

Abstract: Cervical cancer is a significant public health challenge with an increasing trend. When screening results indicate abnormalities, further diagnosis through colposcopy is required. However, the colposcopy follow-up rate among women with abnormal Pap test results remains low. This quasi-experimental study aimed to evaluate the effects of a motivational enhancement and educational program on cervical cancer prevention behaviors, anxiety levels, and colposcopy follow-up rates in women with abnormal Pap test results. Fifty-six women who met the inclusion criteria, were assigned equally into experimental group (n = 28) who received the motivational enhancement and educational program in addition to routine care and a control group (n = 28) who received routine care. Data collection instruments included the Demographic Characteristics Form, the Cervical Cancer Knowledge and the Cervical Cancer Prevention Behavior Questionnaire, and the Generalized Anxiety Disorder Questionnaire (GAD-7). Data were analyzed using descriptive statistics (frequencies, percentages, means, and standard deviations) and t-tests to evaluate the within-group and between-group differences. The results demonstrated that the experimental group had significantly higher mean scores for cervical cancer prevention behaviors and lower anxiety levels after receiving the program than before (p < .05). Comparisons between groups revealed that the experimental group had significantly better cervical cancer prevention behaviors, higher colposcopy follow-up rates, and lower anxiety levels than the control group (p < .05). Therefore, nurses should integrate this program into health promotion activities to ensure that women with abnormal cervical cell test results receive timely and appropriate treatment.

Development and Feasibility Study the Usage of Clinical Practice Guidelines of Patients with Aneurysmal Subarachnoid Hemorrhage

Chanapha Kaewsuay, Suchira Chaiviboontham, Sorayouth Chumnanvej — Tue, 17 Dec 2024 00:00:00 +0700

Abstract: This study aimed to develop and assess the feasibility of guidelines for patients with aneurysmal subarachnoid hemorrhage (aSAH) at a university hospital. The study included 55 nurses and 5 patients with aSAH. Data were collected using Nurse data record forms, Patient data record forms, Feasibility assessment forms for guideline implementation, Adherence record forms, and Clinical outcomes record forms. Descriptive statistics and Repeated Measures ANOVA were used for data analysis to compare the difference of knowledge score at pre, post training and after implementing a guideline at week 8. The study revealed that the guidelines covered 4 phases of care starting from pre and post treatment (operation or endovascular intervention) in the intensive care unit (ICU), recovery care in the general ward, and discharge planning. Nurses generally followed the guidelines closely and reported high satisfaction with their use. Notably, the average knowledge score of nurses regarding the care of aSAH patients significantly improved after training and guideline implementation (F=138.155, p = .001). There were no occurrences of cerebral vasospasm or ischemic stroke and reported the decrease in length of hospitalization rate from 17.81 to 16.8 days. So, implementing clinical practice guidelines would result in patients receiving care based on the standard, reducing clinical complications and the number of hospital days. However, the outcomes should be further evaluated in a larger sample size.

A Nursing Model for Managing Uncertainty in Illness and Enhancing Self-Efficacy Among Older Adult Patients with Ischemic Stroke: A case study

Chainarong Lakrab, Jinpitcha Sathiyamas , Banyaporn Bannaasan — Tue, 17 Dec 2024 00:00:00 +0700

Abstract: Older people experiencing their first stroke must cope with the issue of illness uncertainty, which has far-reaching consequences for both patient and family. The causes are often from a lack of understanding about the ailment, behavioral patterns, therapy choices, and determining the severity of affliction. This article presents an application of nursing model for managing uncertainty in illness combined with enhancing self-efficacy in a case study of geriatric stroke patients who had issues of health status perception and health behaviors which could delay post-illness rehabilitation. A self-efficacy framework was used as a guide which included verbal persuasion, viewing examples and experiences from others, assessing one's own successful experiences, and addressing physical and emotional environments throughout hospitalization phase. After application of this nursing model, it was shown to assist patients to set the goal for modifying health behaviors to prevent stroke recurrence with the engagement of family members. Patients were able to adopt appropriate health behaviors and felt confidence in self-care at home. This improves the patient’s quality of life and helps prevent stroke recurrence.

Bias in Quantitative Nursing Research: Identifying and Mitigating Common Pitfalls

Wongchan Petpichetchian — Sat, 19 Oct 2024 00:00:00 +0700

Abstract: Bias in research is a common issue that can reduce the validity and reliability of study findings. In quantitative nursing research, bias can occur at various stages of the research process, from problem formulation to the reporting of study results. This paper aims to identify common biases in quantitative nursing research and provide strategies to reduce these biases to improve research quality. The types of bias discussed include problem framing bias, theoretical/ conceptual bias, misclassification of research design, sampling bias, selection bias, uncontrolled confounders, inadequate protocol descriptions, measurement bias, low power and analysis bias, and bias in interpretation and reporting and inappropriate implications and recommendations. The paper explains and provides common examples of these biases, along with strategies to mitigate them. If researchers correctly conduct their studies at every stage, it can enhance the quality of nursing research, making the findings more reliable, applicable in practice, and more
suitable for future research.

Applying the Problem-Solving Therapy Program for psychiatric patients with suicidal ideations and behaviors

Akkaradech Klinpiboon — Mon, 16 Dec 2024 00:00:00 +0700

Abstract: Thailand is the 3^rd highest in the global ranking of suicide rates. Furthermore, 45% of psychiatric patients were found to be at high risk of suicide. Risk factors were found to include having a negative view of the problem, inappropriate problem-solving skills, impulsive feelings, low self-worth, denial and avoidance of problems, stress and depression. Suicide is not a terrible disease and can be prevented by having a good protective and monitoring system. Patients, family and significant people must clearly perceive and understand the problems and their causes, and this will enable to provide immediate assistance. This article aims to describe the concept and therapeutic scheme innovated from research and development of problem-solving therapy program for psychiatric patients with suicidal ideations and behaviors (PST-PPS) under the 5-factor model. A case study is applied in which patients are engaged in every step of therapy, helping them to learn and solve problems effectively through the process of identifying the problems and having a positive view of them, and also increasing the problem-solving skill with creative options and logical thinking skills on a daily basis. Supporting patients to increase their problem-solving skills step-by-step until they can direct themselves, initiating a good plan, and finding ways to solve their problems effectively would help patients to gain more problem-solving skills, and this can reduce suicidal thoughts and behaviors.