Nursing Journal https://he02.tci-thaijo.org/index.php/cmunursing <p>พยาบาลสาร มหาวิทยาลัยเชียงใหม่ (Nursing Journal CMU) ดำเนินการจัดพิมพ์โดย<br />คณะพยาบาลศาสตร์ มหาวิทยาลัยเชียงใหม่ เพื่อเผยแพร่บทความวิจัย บทความวิชาการ<br />ที่เกี่ยวข้องกับการพยาบาลและสุขภาพ ระหว่างบุคคลากรที่อยู่ในวงการวิชาชีพและผู้ที่สนใจ</p> Faculty of Nursing, Chiang Mai University en-US Nursing Journal 2821-9120 <p>บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของวารสารพยาบาลสาร</p> <p>ข้อความที่ปรากฏในบทความแต่ละเรื่องในวารสารวิชาการเล่มนี้เป็นความคิดเห็นส่วนตัวของผู้เขียนแต่ละท่านไม่เกี่ยวข้องกับมหาวิทยาลัยเชียงใหม่ และคณาจารย์ท่านอื่นๆในมหาวิทยาลัยฯ แต่อย่างใด ความรับผิดชอบองค์ประกอบทั้งหมดของบทความแต่ละเรื่องเป็นของผู้เขียนแต่ละท่าน หากมีความผิดพลาดใด ๆ ผู้เขียนแต่ละท่านจะรับผิดชอบบทความของตนเองแต่ผู้เดียว</p> Nursing Care of Patients with Neurogenic Shock: Case Study https://he02.tci-thaijo.org/index.php/cmunursing/article/view/264899 <p> Neurogenic shock occurs as a result of the loss of sympathetic nervous system control. The primary cause is a traumatic spinal cord injury above the level of T6 to C2, which leads to widespread vasodilation, a reduction in peripheral vascular resistance, bradycardia, and low body temperature while the skin of the peripheral extremities may become warm and dry as the blood vessels relax. This leads to a potentially life-threatening complication. <br /> This paper describes spinal injury, neurogenic shock treatment, nursing assessment, and the role of nurses in managing neurogenic shock. Comprehensive care for patients experiencing neurogenic shock can be made possible through properly applying such information.</p> Khanuengnit Phetcharat Wimonporn Srichote Nadanong Pitchayakoon Copyright (c) 2023 Nursing Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2023-12-29 2023-12-29 50 4 252 261 Nursing Role in Preventing Postpartum Depression Among Mothers with High-Risk Pregnancies https://he02.tci-thaijo.org/index.php/cmunursing/article/view/265903 <p style="font-weight: 400;"> Postpartum depression is an abnormal mood disorder that often occurs within 6 to 8 weeks after childbirth. Mothers experiencing this condition typically exhibit feelings of sadness, desolation, reduced happiness, or decreased enjoyment in activities compared to their state before childbirth. They may also have limited interaction with their newborns and families, and this affects the overall well-being of both the mother and the infant. High-risk pregnancies can lead to elevated levels of anxiety and stress, increasing the likelihood of developing postpartum depression. Therefore, nurses and midwives play a crucial role in preventing the risk of postpartum depression. This role includes assessing both physical and mental well-being, providing education about postpartum depression, offering counseling, and closely monitoring for any unusual symptoms. For this reason, nurses and midwives should be well-informed about the management of postpartum depression in high-risk pregnancies to prevent its occurrence or provide swift assistance in dealing with postpartum mental health.</p> Patcharin Ngoenthong Tiamsorn Thongsawas Narisara Krisri Lawan Somboon Copyright (c) 2023 Nursing Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2023-12-29 2023-12-29 50 4 262 275 Caregiver Burdens and Perceived Self-Efficacy of Family Caregivers of Stroke Survivors During the COVID-19 Pandemic in Chengdu, the People’s Republic of China https://he02.tci-thaijo.org/index.php/cmunursing/article/view/264426 <p> Caregiver burden is common among family caregivers of stroke survivors, especially during the COVID-19 pandemic. A strong sense of self-efficacy for family caregivers might reduce this burden. The purposes of this correlational research were to explore caregiver burdens and self-efficacy, as well as the relationship between self-efficacy and caregiver burdens among family caregivers of stroke survivors during the COVID-19 pandemic in Chengdu, Sichuan Province, the People’s Republic of China. One-hundred and two participants from two tertiary hospitals in Chengdu, China were recruited by purposive sampling. The research instruments included a demographic data form, the Chinese version of the Caregiver Burden Inventory for measuring caregiver burden, and the Chinese version of the Caregiver Inventory for measuring perceived self-efficacy. The internal consistency of the two questionnaires were .96 and .91, respectively. Data were analyzed using descriptive statistics and Spearman’s rank-order correlation analysis.<br /> This study showed that the mean score for caregiver burden was 34.39 (SD = 14.50) while the mean score for perceived self-efficacy was 22.09 (SD = 3.25). The mean score was moderate for caregiver burden and high for self-efficacy. There was a negative correlation between perceived self-efficacy and caregiver burden among family caregivers of stroke survivors during the COVID-19 pandemic (r<sub>s</sub> = -.30, p &lt; .01).<br /> The findings could be used as basic information for developing programs to promote self-efficacy in family caregivers of stroke survivors during public health emergencies in China.</p> Min Yuan Chomphoonut Srirat Suparat Wangsrikhun Copyright (c) 2023 Nursing Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2023-12-20 2023-12-20 50 4 1 13 Interventions to Promote Sexual Function Among Acute Myocardial Infarction Patients after Percutaneous Coronary Intervention: A Systematic Review https://he02.tci-thaijo.org/index.php/cmunursing/article/view/264895 <p> Sexual dysfunction is a common problem after acute myocardial infarction. It often remains unaddressed at discharge and affects people’s quality of life. Therefore, it is important to promote sexual function in patients with myocardial infarction. The purpose of this systematic review was to review the knowledge on sexual function promotion interventions in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) using the Joanna Briggs Institute Systematic Review Guideline. This review was based on studies retrieved from electronic databases, including PubMed, THAIJO, CINAHL, ProQuest, EBSCO, Wiley Online, Science Direct, and Cochrane Library, done between 2013-2023. The main terms “sexual function”, “promoting interventions”, and “acute myocardial infarction” were found in 310 studies. The retrieved studies were appraised and selected using the tools developed by the Joanna Briggs Institute. Six studies met the review inclusion criteria (4 RCTs and 2 quasi-experimental studies). The studies included in the review varied in terms of their intervention’s timing, methods, and evaluation outcomes, Therefore, the results were summarized in narrative form to describe the intervention characteristics and determine the intervention outcomes. <br /> The results of this systematic review revealed that:<br /> 1. Four Interventions for promoting sexual function among AMI patients after PCI were found: 1) sex education; 2) counseling; 3) exercise to improve capacity, strength, and endurance of the pelvic floor; and 4) use of social media.<br /> 2. Regarding intervention outcomes, the results showed that they improved 1) sexual health, including sexual function, sexual behavior, and resumption of sexual activity shortly after AMI; 2) physical health outcomes, including improvement of exercise capacity and enhanced strength and endurance of pelvic floor; and 3) emotional outcomes, including reduction of fear about intercourse, decreased anxiety, depression and stress, and improvement of sexual satisfaction. <br /> The results of this systematic review can guide clinical practice in promoting sexual function among AMI patients especially using combined interventions for each individual patient. Study of the interventions is recommended for further research.</p> Jirapong Srithep Noraluk Ua-Kit Copyright (c) 2023 Nursing Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2023-12-20 2023-12-20 50 4 14 25 Development and Testing the Effectiveness of Emergency Department Critical Trauma Management Model Implementation https://he02.tci-thaijo.org/index.php/cmunursing/article/view/262322 <p> Proper initial management of critically ill trauma patients by multidisciplinary teams at emergency departments (ED) is crucial. This implementation study aimed to develop an ED Critical Trauma Management Model (EDCTM model) and to test its effectiveness on ED management duration and the mortality rate among critically ill trauma patients. The conceptual framework for EDCTM model development and implementation consisted of the clinical practice guidelines of the National Health and Medical Research Council (NHMRC), Australia. The three groups of samples in this study were as follows: 1) the model developer group included 4 participants (1 physician and 3 nurses); 2) the model user group consisted of 20 participants (6 physicians and 14 nurses); and 3) the critically ill trauma patient group consisted of 159 participants (110 persons before the model implementation and 49 persons during the model implementation). Information regarding the process and results of the ED critically ill trauma patient management was recorded in the OPServ program which was part of the hospital healthcare information system.<br /> The findings from the study revealed the following.<br /><span style="font-size: 0.875rem;"> 1. The EDCTM Model included 3 ED management phases: 1) ED preparation phase, 2) ED management phase, and 3) ED discharge preparation phase. The ISBAR was applied thoroughly for information handover wherever appropriate;<br /></span><span style="font-size: 0.875rem;"> 2. The EDCTM Model implementation decreased the mean of ED management duration from 74.51 (SD = 34.77) minutes to 59.76 (SD = 26.58) minutes; and decreased critical ill trauma patients’ mortality rate from 16.36% to 6.12%.<br /></span> The EDCTM model has shown its effectiveness in critically ill trauma management in this study. It should be continuously implemented, and yearly outcomes should be evaluated to prove its sustainability and effectiveness.</p> Preecha Sriboonruang Achara Sukonthasarn Suparat Wangsrikhun Copyright (c) 2023 Nursing Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2023-12-20 2023-12-20 50 4 26 42 Factors Related to Mental Health Status in Patients with Diabetic Retinopathy after the COVID-19 Outbreak at the Vitreous and Retinal Unit, Maharaj Nakorn Chiang Mai Hospital https://he02.tci-thaijo.org/index.php/cmunursing/article/view/263988 <p> Diabetic retinopathy can have an impact on patients’ mental health. This research aimed to study factors that correlate with mental health status and the relationship between anxiety, stress and depression of diabetic retinopathy patients’ after the COVID-19 outbreak. The sample consisted of 404 diabetic retinopathy patients who received services at the vitreous and retinal unit, Maharaj Nakorn Chiang Mai Hospital. Participants were obtained using a systematic sampling method which involved all patients except for one randomly selecting a queue card. The research tools included a general information questionnaire and the Depression, Anxiety, Stress Scales (DASS-21). Data were analyzed using chi-square and Pearson's correlation statistics.<br /> The research results found that personal factors that were related to depression levels included age, weight, body mass index, and duration of diabetes. Gender and education level had a relationship with anxiety levels while income had a relationship with stress levels. Moreover, anxiety and stress had a positive significant correlation with depression <br />(r = .97, p &lt; .001; r = .80, p &lt; .001, respectively)<br /> This study is helpful for nursing and hospital administrators to appropriately plan treatment and care for patients with diabetic retinopathy to reduce the risk of mental health problems, especially after the COVID-19 outbreak and beyond.</p> Sudthida Yodmuang Issaree Panyawan Copyright (c) 2023 Nursing Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2023-12-20 2023-12-20 50 4 43 55 Effectiveness of Implementing Clinical Practice Guidelines for Delirium Prevention and Management in Critically Ill Patients https://he02.tci-thaijo.org/index.php/cmunursing/article/view/262585 <p> Delirium, a common condition in critically ill patients, is the cause of more serious illness and delayed recovery of patients. Therefore, this symptom should be prevented and managed properly. The purpose of this implementation research was to determine the effectiveness of clinical practice guidelines (CPGs) for prevention and management of delirium in critically ill patients. The participants were critically ill patients who were admitted to the surgical intensive care unit and medical intensive care unit. The two groups of patients included: 1) 46 critically ill patients who were admitted to the intensive care unit (ICU) before implementation of CPGs, and 2) 43 critically ill patients who were admitted to the ICU during implementation of CPGs. The study framework was based on the CPG implementation and the strategy utilization of clinical practice guidelines of the Australian National Health and Medical Research Council. The study was conducted from December 2021 to April 2022. The data collection instruments were composed of 1) The Process Outcome Evaluation Form and 2) The Patient Outcome Evaluation Record Form. The data were analyzed using descriptive statistics.<br /> The results revealed that:<br /><span style="font-size: 0.875rem;"> 1. The percentage of patients receiving all aspects of preventive care for delirium and patients receiving appropriate and accurate management when experiencing delirium in the CPG implementation group was more than the group before CPG implementation, in terms of: 1) appropriate assessment of the risk factors for acute delirium for the first time within 24 hours of being admitted to the ICU and continued daily assessment (100%), whereas the group before CPG implementation was not assessed at all; 2) appropriate assessment of delirium for the first time within 24 hours of being admitted to the ICU (100%) and receiving continuous assessment at least once per shift (98.37%), whereas the group before CPG implementation was not assessed at all; 3) reorientation (100% and 34.44%); 4) promoting vision and hearing problems in people with disabilities (91.67% and 66.67%); 5) managing sedation (100%), whereas for the group before CPG implementation, this was not implemented at all; 6) early mobilization (97.13% and 43.42%); and 7) early weaning from mechanical ventilation (77.59% and 64.84%).<br /></span><span style="font-size: 0.875rem;"> 2. The percentage of patients receiving appropriate and accurate management when experiencing delirium in the CPG implementation group was more than the group before CPG implementation. In particular, the delirium’ patients were received correctly and physically restrained in an appropriate manner (74.19% and 47.54%).<br /></span><span style="font-size: 0.875rem;"> 3. The incidence rate of delirium in the CPG implementation group was less than that of the group before CPG implementation (18.60% and 23.91%), and the incidence rate of adverse events from delirium in the CPG implementation group was also less than that of the group before CPG implementation (37.50% and 81.82%).<br /></span> The findings of this study confirm that implementing CPGs for delirium prevention and management in critically ill patients yields positive patients’ outcomes by decreasing the incidence rate of delirium and adverse events. Therefore, the outcomes of CPGs implementation should be proposed to hospital administrative committees for continued use of these CPGs and for further expansion into other intensive care units.</p> Phonsuda Ngamsaeng Mayulee Somrarnyart Chiraporn Techaudomdach Kaweesak Chittawatanarat Copyright (c) 2023 Nursing Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2023-12-22 2023-12-22 50 4 56 76 Effects of the Comprehensive Discharge Planning Program on Adverse Events and Readmission to Medical Intensive Care Unit https://he02.tci-thaijo.org/index.php/cmunursing/article/view/262608 <p> Critical illness is a life-threatening health problem. Even after transfer to a general ward within the first 72 hours, recurrence of a critical condition or adverse events can be observed. This quasi-experimental research, using a two-group post-test-only design, aimed to study the results of a plan for comprehensive discharge from an ICU and to compare the occurrence of adverse events and ICU readmissions within 72 hours. The sample was purposively selected and comprised of 72 critically ill adult patients who were admitted to the medical intensive care unit of a tertiary hospital from December 2020 to January 2022. The sample was separated into a control group and an experimental group. Severity of illness and ages were equal in both groups. Consequently, there were 36 patients in the control group, a similar amount to the experimental group. The research instruments consisted of the Comprehensive Discharge Planning Program and an outcome record for transfer to the ICU within 72 hours. Validity and reliability of all analytical tools were approved, and statistical analysis was performed using the chi-square test. <br /> The results revealed that the group which received the comprehensive discharge planning program had significantly lower scores for respiratory problems and respiratory infections than the control group (p &lt; 0.05 and p &lt; 0.05, respectively), whereas the readmission scenario within 72 hours still demonstrated no significant difference.<br /> The research findings suggest that the comprehensive discharge planning program should be investigated on other ICU wards to produce further findings. This could benefit the creation of a guideline for a discharge plan for further distribution of patients from the ICU.</p> Suchada Luedung Chiraporn Tachaudomdach Mayulee Somrarnyart Copyright (c) 2023 Nursing Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2023-12-22 2023-12-22 50 4 77 90 Pain Experiences and Management Among Persons with Stroke https://he02.tci-thaijo.org/index.php/cmunursing/article/view/262535 <p> Persons with stroke have physical limitations and residual disabilities. Pain has been found to be an important problem, affecting patients in many aspects. The objectives of this descriptive research were to study pain symptoms and management, and its outcomes among persons with stroke. The participants consisted of both males and females, 3-12 months after a stroke, who were purposively selected. Research instruments included: 1) a general and clinical data record form, and 2) a pain experience and management interview form. Data were analyzed using descriptive statistics.<br /> The results demonstrated that the 3 most frequent characteristics of pain symptoms that participants experienced were 1) cramping, 2) dull pain, and 3) aching. Cramping was managed using non-steroidal anti-inflammatory drugs, Thai massage, and opioid drugs. The results of these methods showed that pain could be relieved. Management of dull pain involved participants applying non-steroidal anti-inflammatory drugs, opioid drugs, and Thai massage, and these methods could relieve participants’ pain perception. The management of aching included applying non-steroidal anti-inflammatory drugs, and opioid drugs, and these methods could relieve pain perception.<br /> The results of this study provide basic information for nurses and health care providers to use for providing suggestions regarding pain management or alternative appropriate care for managing pain symptoms in persons after stroke and their caregivers.</p> Puangpath Norach Chompoonut Srirat Jindarat Chaiard Copyright (c) 2023 Nursing Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2023-12-22 2023-12-22 50 4 91 101 Effect of PITS-Based Education to Enhance Health Literacy on Self-Management Among Older Persons with Hypertension https://he02.tci-thaijo.org/index.php/cmunursing/article/view/262530 <p> Promoting health literacy is important for older persons with hypertension as it leads to appropriate self-management. This experimental research aimed to investigate the effect of PITS-based education for enhancing health literacy on self-management among older persons with hypertension. The participants were older persons with hypertension attending three sub-district health promoting hospitals in Phayao province. Fifty-four participants were selected through simple random sampling and were then equally assigned into either the control or the experimental group with 27 participants in each. The experimental group was given group education four times, twice a week, and one session for individual education resulting in a total of five educational sessions over three weeks. The control group was given routine care. The experimental instruments included a teaching plan, the hypertensive health literacy manual, a hypertensive knowledge video, an understanding personal perception scale, and a health literacy questionnaire for older persons with hypertension. The data collection tools used in this study were a demographic and illness data recording form and a questionnaire on self-management behavior for older persons with hypertension. The data were analyzed using descriptive statistics, independent t-test, and dependent t-test.<br /> The results showed that the mean score for self-management of older persons with hypertension receiving PITS-based education (M = 91.89, SD = 10.16) was higher than those receiving routine care (M = 80.03, SD = 8.25) with a statistically significant difference (t = 4.70, p &lt; .001), and higher than that before experiment (M = 82.25, SD = 9.59) with a statistically significant difference (t = 14.67, p &lt; .001).<br /> The results indicate that PITS-based education can enhance health literacy and self-management among older persons with hypertension, and therefore, can be applied by healthcare professionals with this population.</p> Pitchaya Wongkutnon Sirirat Panuthai Dacha Thamdee Copyright (c) 2023 Nursing Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2023-12-22 2023-12-22 50 4 102 116 Factors Associated with the Acceptance of the Covid - 19 Full Dose Vaccination Among Adults with Chronic Disease in Prachin Buri Province https://he02.tci-thaijo.org/index.php/cmunursing/article/view/264445 <p> For patients with chronic diseases, COVID-19 infection poses the risk of serious illness and death; therefore, getting vaccinated is absolutely necessary. This cross-sectional research aimed to study acceptance of the COVID-19 full-dose vaccination among adults with chronic diseases in Prachin Buri Province. The sample was 300 patients with chronic diseases, ages 35-59, selected by simple random sampling, who registered for care at the chronic disease out-patient departments at secondary government hospitals. Research tools included e-questionnaires, consisting of personal information, knowledge of COVID-19 and COVID-19 vaccines, and health perceptions, including perceived susceptibility to COVID-19 infection, perceived severity of COVID-19, perceived barriers of the COVID-19 vaccine, perceived benefits of the COVID-19 vaccine, and advice from medical professionals. The Cronbach’s alpha coefficients were .74, .77, .86, .91, .91, and .91, respectively. Data were analyzed using descriptive statistics and binary logistic regression.<br /> The results showed that 86.3% of respondents were most accepting of COVID-19 vaccinations. The factors significantly associated with acceptance of COVID-19 full-dose vaccination among adults with chronic diseases were income (OR = 4.65, 95%CI = 1.894-11.459, p &lt; .01); perceived benefits of the COVID-19 vaccine (OR = 3.51, 95%CI = 1.791-6.914, p &lt; .05); perceived susceptibility to COVID-19 infection (OR = 2.07, 95%CI =1.048-4.094, p &lt; .001); and advice from medical professionals (OR = 2.68, 95%CI = 1.349-5.360, p &lt; .01). <br /> The results of this research suggest that healthcare professionals should communicate with patients regarding the risk of infection as the benefits of getting vaccinated and advice from healthcare professionals are critical in encouraging people with chronic diseases to get vaccinated.</p> Kanokwan Kongkairat Rungrat Srisuriyawate Pornnapa Homsin Copyright (c) 2023 Nursing Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2023-12-28 2023-12-28 50 4 117 129 Association between Heterologous Prime-boost Vaccination and Coronavirus Disease 2019 Among People in Phayao Province: A Matched Case-Control Study https://he02.tci-thaijo.org/index.php/cmunursing/article/view/261402 <p> Coronavirus disease 2019 is a respiratory disease that can cause severe illness if patients do not get COVID-19 vaccination. This research aimed to explore the association between heterologous prime-boost COVID-19 vaccination and COVID-19 incidence among people in Phayao province. This matched case-control study was conducted with a sample of 385 adults aged 18 years and over in Phayao province who were selected using the stratified two-stage random sampling method with a case/control ratio of 1:4 (77 cases and 308 controls). Data were collected in September 2022 and then analyzed for frequency, percentage, mean, standard deviation, and conditional logistic regression.<br /> The results showed that getting a heterologous prime-boost COVID-19 vaccination was significantly associated with incidence of COVID-19. Those who had received such a vaccination regimen were 56.0% less likely to be infected with Coronavirus 2019 than those who were not vaccinated, with statistical significance (OR<sub>adj</sub> = 0.44, 95% CI = 0.23-0.87, p = 0.017).<br /> The results of this study provide important information for promoting COVID-19 vaccination. People can use this information to decide on heterologous prime-boost vaccination for prevention of COVID-19.</p> Dara phisitphattanaphong Theerawut Thammakun Akaphol Kaladee Copyright (c) 2023 Nursing Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2023-12-28 2023-12-28 50 4 130 141 Effect of a Family Participation Promotion Program on Family Practice of Dental Care Among Preschool Children https://he02.tci-thaijo.org/index.php/cmunursing/article/view/262845 <p> Encouraging parental participation in dental health for preschool children will aid in the prevention of tooth decay problems. This quasi-experimental, two-group, pretest-posttest design aimed to investigate the effect of a family participation promotion program on families’ dental care practice for their preschool children. The participants, 36 parents of preschool children in a child development center, were assigned by simple random sampling to one of two groups of 18. One group received the program, and one did not. The sample group was selected under purposive sampling criteria. The research tools consisted of the family participation enhancement program devised by the researcher based on community participation and lasting for 8 weeks. It consisted of instructional plans, a family participation promotion manual, slide-show media, video instructors, a family participation promotion kit, and LINE apps. The data collecting instrument consisted of a questionnaire on family practices regarding the dental health care of their preschool children with a Pearson’s product moment correlation coefficient of .94. Data were analyzed using descriptive statistics, independent t-test, and paired t-test.<br /> The results indicated that the group receiving the program had a higher average score for family practice in the dental health care of their preschool children after receiving the program (Mean = 23.17, SD = 0.92) than before (Mean = 17.94, SD = 2.94) with a statistically significant difference (t = -9.085, p &lt; .001). After receiving the program, the group who had received the program had a higher average score for family practice in the dental health care of their preschool children (Mean = 23.17, SD = 0.92) than the group not receiving the program (Mean = 19.11, SD = 3.35) with a statistically significant difference (t = 4.940, p &lt; .001).<br /> The results from this study show that the family participation promotion program on family practice of dental care among preschool children can be used to promote the dental health care of preschool children. </p> Pilaiwan Pichairattanawong Wilawan Tuanrat Sivaporn Aungwattana Copyright (c) 2023 Nursing Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2023-12-28 2023-12-28 50 4 142 157 Factors Related to the Early Electric Smoking Stage Among Secondary School Students in Chachoengsao Province https://he02.tci-thaijo.org/index.php/cmunursing/article/view/264724 <p> Electronic cigarette smoking among adolescents is increasing continuously. This research aimed to study the prevalence of early-stage electronic cigarette smoking and to examine the factors related to early electronic cigarette smoking. Ecological system theory was used as the conceptual framework for this study. The sample was 321 upper secondary school students in Chachoengsao province. Data were collected using self-administered questionnaires which included information about demographic data, smoking, attitudes towards e-cigarette smoking, smoking law perceptions, school relationships, and media accessibility. Frequency, percentage, mean, standard deviation, and binary logistic regression were used for data analysis.<br /> The research results demonstrated that the prevalence of early-stage e-cigarette smoking among upper secondary school students was 16.2% while the mean age of e-cigarette smoking initiation was 16.4 years (SD = 1.06). The factors significantly associated with e-cigarette smoking at the early stage were attitude towards e-cigarette smoking (OR = 3.06, 95%CI = 1.605-5.845), cigarette smoking experience (OR = 3.83, 95%CI = 1.886-7.758), peer cigarette smoking (OR = 2.64, 95%CI = 1.430-4.861), peer e-cigarette smoking (OR = 3.85, 95%CI = 1.853-6.917), peer-persuasion to e-cigarette smoking (OR = 6.49, 95%C I= 3.426-12.287), and e-cigarette accessibility (OR = 2.41, 95%CI = 1.265-4.601).<br /> The research results will be beneficial to health personnel, teachers, and other people involved for developing effective programs focusing on enhancing attitudes and self-efficacy in avoiding direct and indirect peer influence, so as to prevent Thai adolescents from e-cigarette smoking.</p> Chutamas Maneekun Pornnapa Homsin Rungrat Srisuriyawet Copyright (c) 2023 Nursing Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2023-12-28 2023-12-28 50 4 158 169 Factors Affecting Smoking Behavior Among Vocational College Students https://he02.tci-thaijo.org/index.php/cmunursing/article/view/263652 <p> Smoking behavior arises from various factors, including intrapersonal, interpersonal, and extrapersonal factors. Understanding the factors affecting smoking behavior serves as a preventive measure and helps reduce the number of new smokers. This research employed a cross-sectional analytical approach with the objective of examining factors affecting cigarette smoking behavior among vocational college students, based on the environment concept of Neuman's Systems Model. The sample consists of 232 participants aged 18 and above, selected through a multistage random sampling process, with participants chosen using a stratified sampling method based on academic year and major for the first stage and subsequently, a simple random sampling method. The research utilized questionnaires on intrapersonal, interpersonal, and extrapersonal factors related to smoking behavior. The tool's quality was assessed by three qualified experts, yielding content validity indices of .97, 1.0, .96, and 1.0, respectively, and reliability was confirmed by Cronbach's alpha coefficients of .93, .94, .95, and .81, respectively. Data were analyzed using descriptive statistic and stepwise multiple regression. <br /> The research findings revealed that five factors significantly impact the smoking behavior of vocational college students: intrapersonal factors, including self-perceived quitting ability (β = -.23, p &lt; .05); interpersonal factors, such as the influence of smoking peers (β = .26, p &lt; .05) and family nurturing patterns (β = -.38, p &lt; .05); and extrapersonal factors, including societal attitudes toward smoking (β = .30, p &lt; .05) and anti-smoking campaigns (β = .23, p &lt; .05). The multiple correlation coefficient indicated a significant collective impact of these factors on smoking behavior (r = .258, p &lt; .05), predicting 6.7% of the variance (R2 = 0.67, p &lt; .05).<br /> In conclusion, the study demonstrated that factors based on the environment concept of Neuman's Systems Model significantly influence cigarette smoking behavior among vocational college students. Therefore, the development of smoking cessation interventions program should consider all five identified factors for effective implementation.</p> Parima Seetisan Petcharat Eiamla-or Chantana Lortajakul Copyright (c) 2023 Nursing Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2023-12-28 2023-12-28 50 4 170 184 Prevalence and Factors Related to COVID-19 Infection Among Pregnant Women at Mae Ai Hospital Chiang Mai Province https://he02.tci-thaijo.org/index.php/cmunursing/article/view/265358 <p> Pregnant women are a group at risk for COVID-19 infection which affects the health of pregnant women and their fetus. This retrospective case-control study aimed to explore the prevalence of and factors related to COVID-19 infection in pregnant women who came for antenatal care at Mae Ai Hospital, Chiang Mai Province, during October 2021-September 2022. The subjects included the medical records of pregnant women with and without COVID-19 infection. The cases group was match paired with the control group. The cases group consisted of 106 cases, and the control group consisted of 166 cases, resulting in a total of 272 cases. The research instrument was a data collection tool recording information about factors related to COVID-19 infection in pregnant women. Data were analyzed using descriptive statistics, chi-square test, Fisher’s exact test, and simple logistic regression test.<br /> The results revealed that:<br /><span style="font-size: 0.875rem;"> 1. Pregnant women were infected with COVID-19 at 13.28%.<br /></span><span style="font-size: 0.875rem;"> 2. Factors related to the COVID-19 infection of pregnant women included age ≥ 35 years (OR 3.09, 95%CI: 1.19-8.00); pregnancy ≥ 4 times (OR 5.13, 95%CI: 1.80-14.63); history of miscarriage (OR 2.98, 95%CI: 1.31-6.79); and not receiving the COVID-19 vaccine (OR 11.43, 95%CI: 6.08-21.51) with statistical significance (p &lt; .05)<br /></span> The findings in this study can be used to plan education for pregnant women and public health personnel and encourage pregnant women to get vaccinated against COVID-19 to prevent infection.</p> Jiraporn Nunchai Puttachard Kaewya Natakorn Ituporn Teerawat Manowan Copyright (c) 2023 Nursing Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2023-12-28 2023-12-28 50 4 185 197 Effect of a Mobile Application to Promote Sexual Health Literacy on Knowledge, Attitudes, Decision-Making, and Unwanted Pregnancy Prevention Behavior Among Female Adolescents https://he02.tci-thaijo.org/index.php/cmunursing/article/view/264168 <p> Promoting sexual health literacy is crucial for promoting appropriate sexual behavior and reducing the problem of unwanted adolescent pregnancy. This study was a randomized control trial aiming to examine the effect of a mobile application to promote sexual health literacy on knowledge, attitudes, decision-making, and unwanted pregnancy prevention behavior among female adolescents. Adolescent health literacy was applied as the framework for studying through the mobile application program. The sample consisted of eighty female secondary school students in the academic year 2022 in Chiang Rai Province, who were randomly assigned to an experimental (n = 40) or a control (n = 40) group. The experimental group received a mobile application to enhance sexual health literacy, whereas the control group received a pamphlet. A questionnaire was used to collect data on knowledge, attitudes, decision-making, and unwanted pregnancy prevention behavior. Data were analyzed using descriptive statistics, chi-square test, paired t-test, and independent t-test.<br /> The results showed that the mean scores for knowledge, decision-making, and unwanted pregnancy prevention behavior in the experimental group were statistically significantly higher than those before participating in the program (p &lt; .001) and were statistically significantly higher than those of the control group (p &lt; .001).<br /> The findings of this study indicate that employing the technology of a mobile application can boost understanding, good decision-making, and appropriate unwanted pregnancy prevention behavior among female adolescents.</p> Jiranee Panyapin Suphaphan Jansiri Pimkanabhon Trakooltorwong Nattapol Aunsri Copyright (c) 2023 Nursing Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2023-12-28 2023-12-28 50 4 198 213 The Relationship between Health Literacy and Health Promoting Behaviors of Pregnant Women with Gestational Diabetes Mellitus https://he02.tci-thaijo.org/index.php/cmunursing/article/view/263830 <p> Health literacy affects the self-care behaviors of pregnant women with gestational diabetes mellitus (GDM) and results in good pregnancy outcomes. The purpose of this descriptive correlational study was to investigate the relationship between health literacy and health-promoting behaviors of pregnant women with GDM. The sample included 80 pregnant women with GDM who visited the antenatal care department of the Bamrasnaradura Infectious Diseases Institute, from March 2021 to September 2022. The data collection instruments included questionnaires on health literacy and health-promoting behaviors of pregnant women with GDM. Data were analyzed using descriptive statistics and Pearson’s correlation coefficient.<br /> The results revealed that the participants had a good level of health literacy (M = 4<em>.</em>06, SD <em>= .</em>42<em>). </em>Health<em>-</em>promoting behaviors were at a moderate level (M = 2.16, SD = .27) while health literacy had a positive statistically significant correlation with health-promoting behaviors at a moderate level (r = .506, p &lt; .001).<br /> The results of this study can be used as a database for developing GDM guidelines for enhancing health literacy by promoting health behaviors.</p> Pilaiwan Jaichaun Lawal Rerkngam Mayurat Rukkiat Manee Nakanakupt Copyright (c) 2023 Nursing Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2023-12-28 2023-12-28 50 4 214 225 Activity-Based Costing of Services in a Cardiac Center, Lamphun Hospital https://he02.tci-thaijo.org/index.php/cmunursing/article/view/262759 <p> The activity-based cost of services is essential data for accurate pricing decisions. This descriptive study aimed to analyze the activity-based cost of services, to compare the cost of services with the fees of service units under the Ministry of Public Health, and to analyze the break-even point for non-invasive cardiology laboratory services in a cardiac center in Lamphun Province. The framework for activity-based costing, developed by Kaplan and Cooper, consists of four steps: 1) develop the activity dictionary; 2) determine cost drivers for each activity; 3) identify the organization’s services and customers; and 4) select activity cost drivers that link activity costs to the organization’s services and customers. The sample consisted of five personnel and the service activities data in the cardiac center. The tools used in the study included the activity dictionary, the time-spent record form, and the cost record form which were tested for objectivity by three experts. The interrater reliability of the two observers was 1.0. The cost data were analyzed using descriptive statistics.<br /> The results revealed that:<br /><span style="font-size: 0.875rem;"> 1. The activity-based cost of transthoracic echocardiography was 862.48 baht; the exercise stress test was 4,101.10 baht; the 24-hour Holter monitor electrocardiography was 704.23 baht; and the 48-hour Holter monitor electrocardiography was 718.73 baht.<br /></span><span style="font-size: 0.875rem;"> 2. The activity-based cost of the exercise stress test was higher than fees of service units under the Ministry of Public Health while the activity-based costs of transthoracic echocardiography and 24 and 48-hour Holter monitor electrocardiography were lower than the fees of service units under the Ministry of Public Health.<br /></span><span style="font-size: 0.875rem;"> 3. The break-even point of transthoracic echocardiography was 1,071 times per year; the exercise stress test was 230 times per year; the 24-hour Holter monitor electrocardiography was 64 times per year; and the 48-hour Holter monitor electrocardiography was 65 times per year.<br /></span> The hospital director and nurse administrators can use the data on activity-based costs to plan and manage resources effectively. In addition, a break-even point is important for planning service arrangements to be worthwhile and cost-effective while maintaining service quality in the cardiac center at Lamphun Hospital.</p> Warattaporn Chamrum Thitinut Akkadechanunt Kulwadee Abhicharttibutra Copyright (c) 2023 Nursing Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2023-12-29 2023-12-29 50 4 226 238 Intermittent Fasting and Adequate Protein Consumption for Obesity or Overweight Prevention: A Systematic Review https://he02.tci-thaijo.org/index.php/cmunursing/article/view/265580 <p> The condition of obesity or excess weight tends to increase the risk of chronic non-communicable diseases. The application of new knowledge can lead to disease prevention. This systematic literature review aimed to investigate the effectiveness of intermittent fasting and/or adequate protein intake in preventing obesity. The study established a framework for searching research databases and literature published nationally and internationally over the past 10 years. The analysis was conducted using research value assessment criteria at five levels of evidence reliability.<br /> The research results indicate that the foundational research aligns with the entry criteria and passes quality assessments, with a total of 23 randomized controlled trials and 6 controlled trials. There were 17 quasi-experimental studies which were considered as level 2 evidence. The literature review results summarize the top three most effective weight loss methods as follows: 1) intermittent fasting combined with at least a 20% calorie restriction over a period of 4 to 12 weeks; 2) adequate protein intake combined with calorie restriction; and 3) intermittent fasting combined with calorie restriction, adequate protein intake, and resistance exercise.<br /> This study suggests that nurse practitioners and medical personnel can adopt these practices to modify health behaviors in individuals with excessive body mass index. However, further research is recommended to investigate the effectiveness of weight loss using intermittent fasting in combination with calorie restriction and protein intake. This will provide sufficient and clear guidelines for future practices.</p> Nawaporn Wutthitham Supaporn Chaychit Laddawan Seangon Copyright (c) 2023 Nursing Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2023-12-29 2023-12-29 50 4 239 251 EDITORIAL https://he02.tci-thaijo.org/index.php/cmunursing/article/view/267001 Kannika Kantaruksa Copyright (c) 2023 Nursing Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2023-12-29 2023-12-29 50 4