Nursing Journal CMU

Pragmatism Philosophy: Application for Nursing Profession Improvement

Wongduan Suwannakeeree — 2026-03-31

Nursing is the process of care focusing on responding to individual human needs. This process is implemented for service users by nurses’ actions, interrelationships, and recognition of the connection between humanity and compassion. Nursing care requires supportive data, both objective and subjective. To achieve quality of nursing outcomes, it is necessary to consider knowledge and realities across four metaparadigms: person, environment, health, and nursing. These require exploration, proof, and development. The philosophy of pragmatism accepts diverse methods of knowledge inquiry from individual experiences and scientific processes. Truth is something that dynamically changes and can be applied to practice for solving problems. These perspectives are relevant to the nursing profession, which focuses on solving problems for service users based on their needs or health conditions, in the context of continuously changing environmental factors. These nursing phenomena require knowledge for solving specific problems.

This article’s objective was to present pragmatism philosophy in terms of its dimensions and its application for professional nurses, educators, researchers, and nursing administrators, as well as those interested in applying it to achieve continuous professional development.

Treatment Burden Among Older Adults with Diabetes in Community Settings: Challenges and Primary Care Support Strategies

Junjira Seesawang — 2026-03-31

Diabetes is a major health concern among older adults, many of whom face a significant treatment burden-defined as the workload and responsibilities required to manage their condition, such as medication adherence, lifestyle modifications, and coordination with healthcare services. This burden is particularly pronounced among community-dwelling older adults who often experience barriers such as limited healthcare access and low health literacy. These challenges can lead to poor treatment adherence and diminished quality of life.

This academic article is a conceptual synthesis on treatment burden, aiming to present a comprehensive analysis of the context and components of treatment burden among community-dwelling older adults with diabetes. The discussion encompasses five key areas: 1) dimensions of treatment burden, 2) approaches for assessing treatment burden, 3) factors influencing treatment burden, 4) challenges faced by the primary healthcare system in mitigating treatment burden among older adults living with diabetes, and 5) strategies within the primary healthcare system to alleviate treatment burden among older adults.

The primary healthcare system, as a key mechanism for community-based care, should be designed to minimize such burdens. At the same time, it should promote the ability of older adults to maintain a good quality of daily life that genuinely aligns with their individual contexts. Such an approach is essential for achieving long-term, sustainable improvements in quality of life for older adults living with diabetes.

Editorial

Kannika Kantaruksa — 2026-03-31

Effects of an Individual and Family Self-Management Program on Self-Management Behaviors and Hemoglobin A1C Level Among Older Adults with Uncontrolled Diabetes Mellitus: A Randomized Controlled Trial

Thiranai Songpimai — 2026-02-06

Uncontrolled diabetes mellitus in older adults requires effective self-management strategies involving both the patients and their families. This randomized controlled trial (RCT) aimed to examine the effects of the Individual and Family Self-Management Program (IFSMP) on self-management behaviors (SMB) and hemoglobin A1C levels (HbA1C) among older adults with uncontrolled diabetes mellitus. The participants were 52 older adults with uncontrolled diabetes mellitus attending San Na Meng Municipal Public Health Service Center and Ban Pa Kang Subdistrict Health Promoting Hospital in San Sai District, Chiang Mai Province (26 each in the experimental and control groups). The experimental group received the IFSMP for 4 weeks. The data were analyzed using descriptive statistics, independent t-tests, paired t-tests, chi-square, and McNemar tests.

The study results found that the mean self-management behavior scores of participants in the experimental group significantly increased after participating in the program (M = 111.30, SD = 5.14) compared to before participating in the program (M = 81.26, SD = 8.27, t = -14.159, p < .001) and compared to the control group (M = 79.92, SD = 7.71, t = 17.37, p < .001). The proportion of older adults who could control their HbA1C levels after participating in the program was significantly higher than before the program (p < .001) and compared to the control group (p < .001).

This study demonstrates the effectiveness of the IFSMP. Therefore, health professionals can apply this program to improve SMB in older adults with uncontrolled diabetes mellitus, thereby decreasing HbA1C levels.

Effectiveness of Aromatherapy on Sleep Quality Among Patients with Cancer Admitted to Healthcare Facilities: A Systematic Review

Pitchaya Sinkhanarak — 2026-02-06

Poor sleep quality is common in cancer patients, especially those in healthcare facilities. Aromatherapy is one non-pharmacologic intervention to promote sleep quality. This systematic review aimed to identify the effects of aromatherapy on sleep quality among patients with cancer in healthcare facilities. The main outcome was sleep quality, and secondary outcomes were insomnia and anxiety. This study was conducted using the Joanna Briggs Institute systematic review process. Published and non-published randomized controlled trials and quasi-experimental research in English and Thai language from 2010 to 2021 were identified in databases, resulting in 504 studies, 493 of which were omitted due to non-eligibility. Therefore, 11 studies remained, three of which met the critical appraisal evaluation. These three were randomized controlled trials, two of which were analyzed by meta-analysis.

The meta-analysis of the two studies revealed no statistical significance regarding the effectiveness of aromatherapy on sleep quality in the control or experimental groups (P = 0.41) with very high heterogeneity (I² = 96%). Regarding the anxiety outcome, one study indicated that massage with lavender essential oil could reduce anxiety and increase sleep quality levels in colorectal cancer patients in the preoperative period. However, the number of studies was limited. Therefore, the effectiveness of aromatherapy on the sleep quality and anxiety of patients with cancer in healthcare facilities was inconclusive. The certainty of the evidence for outcomes was at low and moderate levels.

These results suggested that repeated studies should be done in this population to evaluate aromatherapy's effectiveness. However, the application should be considered based on its appropriateness for patients’ health conditions and the setting contexts.

Interventions to Promote Dietary Self-Management Behaviors Among Acute Coronary Syndrome Patients with Comorbidities: A Systematic Review

Sunisa Lada — 2026-03-09

Dietary self-management behaviors can reduce the risk of recurrent events in patients with acute coronary syndrome (ACS), especially among those with comorbidities. However, promoting and sustaining these behaviors remains a significant challenge in ACS management. This systematic review aimed to summarize the findings of studies on interventions to promote dietary self-management behaviors in ACS patients with comorbidities. It follows the Joanna Briggs Institute's systematic review guidelines, focusing on studies published between 2014 and 2024 which included randomized controlled trials and quasi-experimental studies on interventions to promote dietary self-management in ACS patients with comorbidities. Eight studies met the inclusion criteria and passed the quality assessment. The reviewed studies demonstrated diversity in intervention design, data collection, and outcome evaluation. Therefore, a content analysis was conducted.

The results of this systematic review found that
1. Five interventions for promoting dietary self-management behaviors included 1) Providing knowledge and individual consultation, 2) Recording and monitoring self-behavior, 3) Motivational enhancement, 4) Social and family support, and 5) Use of digital technology and mobile applications.
2. Outcomes of those interventions included: 1) Physical health: Favorable biochemical changes, including increased HDL, decreased LDL, total cholesterol, FBS, and reduced BMI; 2) Psychosocial: Positive attitude development, enhanced self-efficacy, and increased motivation, contributing to sustained behavioral changes; and 3) Self-control: Improved dietary self-management behaviors.

This systematic review recommends that further primary research be conducted on interventions aimed at promoting dietary self-management behaviors in patients with ACS and comorbidities. Such research would generate evidence-based data to identify the most effective and appropriate strategies for supporting dietary self-management in this patient population.

Development of Clinical Practice Guidelines for the Care of Patients with Chest Drainage Tubes to Prevent Dislodgement and Obstruction after Open-Heart Surgery: A Pilot Study

Supaporn Nin-aram — 2026-03-10

Displacement and occlusion of chest drainage tubes are common problems in patients following open-heart surgery, leading to complications that affect the quality of nursing care. This study aimed to develop clinical practice guidelines for preventing dislodgement and obstruction of chest tubes, based on Soukup’s Evidence-Based Practice Model. The research process consisted of three phases: 1) Evidence-triggered phase, 2) Evidence-supported phase, and 3) Evidence-observed phase. Data collection tools included a chest tube displacement and occlusion incident record form and a nurse satisfaction questionnaire. The data were analyzed by descriptive statistics.

The resulting clinical practice guidelines for preventing dislodgement and obstruction of chest tubes included: 1) chest tube care; 2) care of the insertion site; 3) drainage system management; and 4) assessment of complications. The clinical practice guidelines were reviewed for quality by five experts. The content validity index (CVI) was 0.95. The result of pilot-testing the guidelines, with two post–open-heart surgery patients admitted to the cardiovascular thoracic intensive care unit at Khon Kaen Hospital, revealed that within 72 hours postoperatively, no incidence of chest tube displacement or occlusion were observed. The guidelines were also trialed with three nurses of the same unit, who reported a satisfaction level of 94%.

The findings indicate that implementing the guidelines is feasible, with adjustments made to reduce redundancy in nursing activities. However, further studies in similar settings are recommended before broader clinical application.

Effects of a Supportive-Educative Nursing System on Self-Care Behaviors and Body Weight Control in Persons Receiving a Long-Term Intravenous Catheter for Hemodialysis

Witthaya Samerchue — 2026-03-20

End-stage renal disease patients with long-term intravenous catheters must receive support and be educated to be able to take care of themselves. This quasi-experimental study aimed to study the effects of supportive and educational nursing on self-care behavior and weight control. The participants consisted of 60 patients with end-stage renal disease who received long-term intravenous catheters and received hemodialysis at a private hospital in Phitsanulok province. They were divided into an experimental and a control group with 30 participants per group. The experimental group received supportive and educational nursing while the control group received routine nursing care. The research instruments included a general information questionnaire, a supportive and educational nursing plan developed based on Orem's concept, slide presentation media, a self-care manual, a self-care behavior assessment form, an electronic scale (in kilograms), and a body weight record. Data were analyzed using descriptive statistics, chi-square test, Fisher's exact test, paired t-test, and independent t-test.

The results of the study revealed that the self-care behavior scores of the experimental group after receiving supportive and educative nursing (M =65.73, SD = 3.66) were significantly higher than before (M = 42.33, SD = 1.68) (p < .001) and significantly higher than the control group (M = 45.83, SD = 2.56) (p < .001). After the experiment, 22 people in the experimental group (73.3%) and 20 people in the control group (66.7%), had controlled their weight according to the criteria, but there was no statistically significant difference.

Supportive and educative nursing can promote better health behaviors in patients with end-stage renal disease who have long-term intravenous catheters for hemodialysis. A long-term follow-up should be done to confirm its effectiveness.

Predictors of Oral Health Literacy and Intention of Dental Service Utilisation Among People with Type 2 Diabetes

Siriporn Kijja — 2026-03-20

Diabetes is a risk factor for periodontal disease. Oral health literacy and the intention to seek dental care among individuals with diabetes contribute to their utilization of dental services for the prevention of oral health problems. This cross-sectional prospective study examined predictors of oral health literacy and intention of dental service utilisation among 176 people with type 2 diabetes. The research instrument was a questionnaire consisting of 1) general information, 2) social support, 3) health media use, 4) oral health literacy, and 5) intention of dental service utilisation. Data were analyzed using descriptive statistics, multiple regression, and logistic regression analysis.

The study results found that people with type 2 diabetes had a moderate level of oral health literacy and intended to seek dental services if they had oral health problems at 56.80 %. The personal characteristics were found to be gender, age, and education level. The situational factors were internet access, social support, and health media use which significantly predicted oral health literacy (p < .01). Moreover, social support, health media use, and age were statistically significant predictors of oral health literacy in type 2 diabetes patients. The results of the logistic regression analysis found that personal characteristic factors, situational factors, social support, health media use, and oral health literacy explained 51.1% of the chance of intention to seek dental services. In addition, gender, education level, social support, and oral health literacy were found to have statistically significantly influences on the intention to seek dental services (p < .05). Women had 3.237 times more intention to receive dental services than men. People with a higher education level than primary school had 3.874 times more intention to receive dental services than people with a lower education level. Those with higher social support scores had a 1.157 times increase in their intention to seek dental services, while those who had higher oral health literacy scores had a 1.093 times increase in the chance of having the intention to seek dental services when controlling for risk of periodontitis and duration of diabetes.

The study results can be used as information to develop guidelines for the care of people with type 2 diabetes to promote oral health literacy by encouraging family members, friends, and health care providers to participate as supporters in the use of health media. These supporters should be able to assess and select appropriate health information formats according to individual abilities and place importance on increasing oral health literacy levels.

The Development of an Innovative Fluid Alert Device for Patients Undergoing Abdominal Paracentesis

Siraphop Changpean — 2026-03-20

Ascites is a significant complication of liver cirrhosis that affects patients’ health and quality of life. Patients with this condition often require paracentesis to drain the ascitic fluid from the abdominal cavity. This study aimed to develop an ascitic fluid alert device innovation for addressing the problems and the needs of healthcare personnel in managing ascitic fluid and to evaluate user satisfaction with the innovation. This research employed a research and development (R&D) design, conducted in three phases: 1) assessment of the current situation through a literature review and related studies, 2) development of a fluid alert device, and 3) pilot testing and evaluation of user satisfaction. The sample consisted of 34 participants, including registered nurses and nursing instructors. Data were collected using a general information questionnaire and a satisfaction questionnaire regarding the use of the innovation. Descriptive statistics were used for data analysis.

The developed innovation consisted of a fluid alert device for patients undergoing abdominal paracentesis. The results revealed that the fluid drainage alert device could accurately notify the volume of drained ascitic fluid. Overall user satisfaction was rated at the highest level (M = 4.91, SD = 0.42) in terms of usability and safety.

In conclusion, the developed fluid drainage alert device effectively enhanced patient care efficiency, reduced the workload of healthcare personnel, and demonstrated potential for implementation in healthcare settings to improve the quality of care for patients undergoing abdominal paracentesis.

Effects of an Individual and Family Self-Management Promotion Program on Self-Management Behaviors and Functional Capacity Among Older Persons with Chronic Obstructive Pulmonary Disease

Jiraporn Yasueb — 2026-03-23

Elderly people with Chronic Obstructive Pulmonary Disease (COPD) need to be encouraged to engage in self-management behaviors so that they can control the recurrence of the disease. The objective of this two–group, pre–posttest experimental research was to study the effects of a program to promote the self-management of individuals and families on self-management behavior and on the functional capacity of elderly people with COPD. The participants consisted of 56 elderly people in Mae Moh Subdistrict, Mae Moh District, Lampang Province who had been suffering from COPD for 6 months or more with disease severity levels of 3-4, and who were randomly assigned to a control and an experimental group with 28 per group. The study tools were divided into three components: 1) a sample screening tool, including the short portable mental status questionnaire (SPMSQ form), an assessment of ability to carry out daily activities, and a questionnaire on self-management behavior of elderly people with COPD; 2) research tools, including the program to promote self-management of individuals and families of elderly people with COPD; and 3) data collection tools, including a personal data interview form, a data recording form for physical function, and a self-management behavior questionnaire for elderly people with COPD. Data were analyzed using descriptive statistics, independent t-test, and dependent t-test.

The results found that after completion of the program, the mean self-management behavior scores of the elderly with COPD who received the program (M = 87.68, SD = 7.53) were significantly higher than those receiving usual care (M = 61.64, SD = 3.57) (t = -16.525, p < .001) and higher than before receiving the program with statistical significance (M = 63.11, SD = 9.19) (t = -12.689, p < .001). Physical function among the group who received the program (M = 377.64, SD = 17.88) was greater than that of the group receiving usual nursing care with statistical significance (M = 363.61, SD = 21.42) (t = -2.662, p = .010) and significantly more than before the experimental group received the program (M = 364.86, SD = 22.09) (t = -4.012, p < .001).

The results of this research can be used as a guideline for health personnel to apply programs to promote the self-management of individuals and families in promoting self-management behavior so that elderly people with COPD have good self-management behavior and the ability to perform physical functions to control recurrence of the disease.

Factors Predicting Caregiver Burden in Caregivers of Bedridden Older Adults

Atchamat Pandang — 2026-03-23

Providing care for bedridden older adults is complex and time-consuming, often impacting the physical and mental health of caregivers, leading to caregiver burden. This correlational predictive study aimed to assess caregiver burden among caregivers of bedridden older adults, and examine factors predicting caregiver burden, including social support, stress, and hours of care per day. Using purposive sampling, the study included 120 caregivers of bedridden older adults who: identified as the primary caregiver, were family members, had been providing unpaid care for at least three months, and resided in Nakhonsawan Province. The research instruments included a personal information questionnaire, the Zarit Burden Interview (ZBI), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Perceived Stress Scale (PSS). Data were analyzed using descriptive statistics and multiple linear regression analysis.

The results showed that caregivers of bedridden older adults had an average caregiver burden score that was mild to moderate (M = 24.89, SD = 15.27). Social support, stress, and hours of care per day collectively predicted 29% of the variance in caregiver burden among caregivers of bedridden older adults. Stress was the strongest predictor of caregiver burden (β = 0.51, p < 0.01), followed by social support (β = -0.17, p = 0.03). However, hours of care per day did not significantly predict caregiver burden (β = -0.05, p = 0.54).

The results of this study can provide essential information for nurses, medical personnel, and public health policymakers in designing and developing healthcare services. These services aim to improve access to social support for caregivers of bedridden older adults, helping them manage stress and reduce caregiving burden, ultimately ensuring that bedridden older adults receive effective care.

Life Perspectives, Hopes, and Adaptation of Elderly Akha: A Case Study of an Akha Community in Northern Thailand

Pimrat Boonyapuk — 2026-03-24

Elderly individuals from ethnic minority groups inevitably face social and economic changes that affect their mental well-being. Understanding their lived experiences is therefore essential for developing appropriate care. This qualitative case study aimed to understand the experiences of life perspectives, hope, and adaptation among the Akha elderly in a community in Northern Thailand. The informants were twelve purposively selected Akha elders (six males, six females) who participated in three focus groups. Data were collected through semi-structured interviews and non-participant observation, and analyzed using thematic analysis.

The findings revealed four key themes: 1) acceptance of fate and living in peace; 2) hope tied to the future of the next generation; 3) creating self-worth through work and family responsibilities; and 4) faith and inner strength through endurance. The findings indicate that while the elderly face vulnerabilities, their resilience is deeply rooted in familial roles, community responsibilities, and spiritual beliefs. Their hope is collectivist in nature, focusing on the well-being of their descendants rather than personal goals.

These findings highlight the necessity of developing mental health care models that are culturally sensitive, transcend Western concepts, and support and reinforce the existing sociocultural sources of strength within the Akha community, recognizing the value of caregiving roles and integrating spiritual beliefs into care plans.

Resilience of Nurses in Nakornping Hospital, Chiang Mai Province

Chanita Ramyothin — 2026-03-24

Resilience is significant for nurses to cope with stress. The resilience of nurses enables them to persist with hard work and adapt to changes that affect intention to stay, while reducing turnover rates. Therefore, it is necessary to foster resilience in nurses. The purpose of this descriptive research was to examine the resilience of nurses in Nakornping Hospital. The participants included 297 nurses who have at least one year of working experience, randomly selected from 17 nursing departments. The research instruments consisted of 1) a personal data form, and 2) the Thai version of the Connor-Davidson Resilience Scale (CD-RISC-25). The data were analyzed using descriptive statistics.

The results revealed that:
1. The resilience of nurses at Nakornping Hospital, Chiang Mai was at a moderate level (M = 76.79, SD = 11.25).
2. The median resilience score of nurses at Nakornping Hospital, Chiang Mai was 75, with quartile 1, quartile 2, quartile 3, and quartile 4 ranges being 47-70, 71-75, 76-84, and 85-100.

The results of this study can raise awareness for nursing administrators and can be used as information to determine strategies to strengthen the resilience of nurses at Nakornping Hospital.

Experience of Registered Nurses Returning to Practice After Resignation

Kampon Introntakun — 2026-03-25

The shortage of registered nurses is affecting the overall healthcare system. Understanding the factors influencing nurses’ decisions to leave the profession and their subsequent return is therefore an important area of inquiry. This study employed qualitative descriptive research with the objective of exploring the experiences of registered nurses regarding resignation and return to practice. The participants consisted of 20 registered nurses who had previously resigned and later decided to return to the profession, recruited through purposive sampling. The research instruments included the researcher, personal notes, field notes, an audio recorder, and a semi-structured in-depth interview guide. Data collection was conducted through in-depth interviews, and analysis followed the conventional content analysis approach described by Hsieh and Shannon.

The findings revealed that the experiences of registered nurses regarding resignation and return to practice had three main themes comprising nine subthemes:
1. Causes for resignation consisted of three subthemes: 1) exhaustion leading to burnout, 2) inadequate compensation relative to cost of living, and 3) desire to pursue new and challenging experiences and to follow personal aspirations.
2. Reasons for returning to practice consisted of four subthemes: 1) a sense of familiarity and comfort in the former workplace, 2) recognition of opportunities for growth and self-development, 3) improved welfare and compensation, and 4) pride in being part of the organization.
3. Key factors in retaining nurses within the organization consisted of two subthemes: 1) the transmission of a positive organizational culture that facilitates effective practice in line with genera-tional needs, and 2) appropriate workload management.

The results of this study provide valuable insights for nursing administrators in developing policies and strategies aimed at enhancing motivation, strengthening support systems, and promoting sustainable retention of registered nurses within the workforce.

Psychological Safety and Organizational Commitment of Nurses in Tertiary Hospitals

Sangduen Khankhai — 2026-03-26

Nurses’ organizational commitment is an attitude that benefits the organization and positively impacts their work performance. Psychological safety in collaborative work contributes to fostering organizational commitment. The purposes of this descriptive correlational research were to study psychological safety and organizational commitment, and the relationship between psychological safety and organizational commitment of nurses in tertiary hospitals. The participants were 119 registered nurses selected by multi-stage sampling. The research instrument included the Psychological Safety Scale and the Organizational Commitment Scale. Data were analyzed by using descriptive statistics and Spearman’s rank correlation coefficient.

The findings revealed that nurses in tertiary hospitals perceived a high level of psychological safety (M = 5.15, SD = .75) and had a moderate level of organizational commitment (M = 3.30, SD = .39). Nurses perceived three dimensions of organizational commitment at a moderate level, including affective commitment, continuance commitment, and normative commitment (M = 3.38, SD = .52; M = 3.18, SD = .72; and M = 3.34, SD = .49, respectively). Psychological safety and organizational commitment among nurses in tertiary hospitals had a moderately, statistically significant positive correlation (r_s = .316, p < .01). Psychological safety had a moderate and statistically significant positive correlation with the affective commitment and normative commitment dimensions (r_s = .342 and r_s = .355, p < .01, respectively).

Nursing administrators should cultivate psychological safety among nurses by developing an organizational culture that embraces team collaboration, thereby enhancing nurses’ organizational commitment.

Safety Climate and Safety Behavior of Nurses in Regional Hospitals, Northern Region

Pisanu Singsai — 2026-03-27

A safe climate-the environment and infrastructure in a hospital that enhances patient safety-also promotes the safety behavior of nurses. This descriptive correlational study aimed to examine safety climate, safety behavior, and the relationship between safety climate and safety behavior of nurses in regional hospitals in the Northern Region. The participants were 120 nurses in two regional hospitals in the Northern Region, selected using the multistage sampling method. The research instruments included 1) a demographic data form; 2) the Patient Safety Climate in Healthcare Organizations (PSCHO) questionnaire; and 3) the Safety Behavior Scale (SBS). Descriptive statistics, Pearson’s correlation, and Spearman's rank correlation were used to analyze the data.

The results revealed that: 1) The percentage of problematic responses regarding the overall safety climate as perceived by nurses was 17.57% (SD = 18.51). In terms of percentages of problematic responses regarding the safety climate subscales, the top three were learning, fear of blame, and fear of shame (51.11%, 22.33%, and 19.58%, respectively). 2) The safety behavior of nurses was at a high level (M = 48.44, SD = 6.60). 3) The overall safety climate was positively correlated with the safety behavior of nurses at a moderate level (r = .311, p < .01).

The findings of this study are beneficial for hospital administrators and nursing administrators to design strategies that can promote the safety climate and safety behaviors of nurses in regional hospitals in the Northern Region.

Quality of Life of School-aged Children Living with Chronic Illness: A Convergent Mixed Method Study

Pregamol Rutchanagul — 2026-03-27

Quality of life for school-aged children with chronic illnesses requires holistic care from family, school, and healthcare professionals. This descriptive study used a mixed-methods, convergent triangulation design aimed at examining the quality of life of school-aged children living with chronic illness. The participants consisted of school-aged children who visited the outpatient department or were admitted to the pediatric ward at one study hospital. The first phase was quantitative and used a survey method. The participants in this phase comprised 184 school-aged children. Participants were selected using a convenience sampling method based on predetermined criteria. Data were collected using the Pediatric Quality of Life Inventory (PedsQLTM 4.0) and a demographic questionnaire. Descriptive statistics and chi-square test were employed for analyzing quantitative data. The second phase employed a qualitative method, utilizing semi-structured interview questions for in-depth interviews. Purposive sampling was employed to select 16 school-aged children. Content analysis was used for qualitative data analysis.

Results of the quantitative study showed the overall quality of life of school-aged children with chronic illnesses at a good level, with 57.6% classified as having normal quality of life and 42.4% as having lower quality of life. The domains of quality of life–physical, emotional, and social functioning–were at a normal level, while the school functioning domain was at a lower level. When comparing illnesses and quality of life levels, no significant difference was found between different chronic diseases and PedsQL scores. The results of the qualitative data analysis revealed three major aspects of the quality of life of school-aged children living with chronic illnesses, including: 1) living a normal life within limitations – a perspective from children with good quality of life; 2) a life different from others – a reflection from children with poor quality of life; and 3) the burden of managing their own health.

The results of this study provide a deeper understanding of the quality of life among school-aged children living with chronic illnesses. These insights can serve as a foundation for developing structured support interventions, especially in the education domain, and for formulating strategies to support their adaptation to illness.

Factors Related to Care Behaviors Among Caregivers of Children with Congenital Heart Disease After Heart Surgery

Thanatchaporn Pantib — 2026-03-30

Care behaviors among caregivers of children with congenital heart disease after heart surgery are crucial for the optimal health status of children after the surgery. This correla- tional study aimed to examine factors related to care behaviors among caregivers of children with congenital heart disease after heart surgery. The sample consisted of caregivers of children aged 1 to 6 years with acyanotic congenital heart disease after undergoing open-heart surgery, who attended follow-up appointments within the first two weeks post-surgery at the pediatric cardiology clinic at 5 tertiary hospitals in the northern region, with a total of 85 cases. The research instruments included a demographic data record form, the Care Behaviors of Caregivers of Children with Congenital Heart Disease After Heart Surgery Questionnaire, the Self-Efficacy of Caregivers Questionnaire, and the Social Support Questionnaire. Data were analyzed using descriptive statistics and Spearman’s correlation coefficient statistics.

The research results showed that the overall care behaviors of caregivers of children with congenital heart disease after heart surgery were at a high level (M = 66.95, SD = 8.22), accounting for 65.9%. Caregivers' self-efficacy and social support were significantly positively correlated with care behaviors at a high level (r = .736, r = .759, p < .001, respectively).

These findings can be used as preliminary data to promote more efficient care behaviors among caregivers of children with congenital heart disease after heart surgery during the first two weeks at home in order to provide correct and appropriate care for their children.

Effect of a Virtual Reality Technology Program on Fear of Vaccine Injections in Preschool Children

Pornrawin Anunchaithanakhul — 2026-03-31

Injection-related pain and fear are common adverse reactions in preschool children undergoing vaccination, and they influence vaccine acceptance. Intense fear can have adverse effects on their physical, mental, and behavioral health. This quasi-experimental study aimed to investigate the effect of a Virtual Reality (VR) technology program on preschool children's fear of vaccine injections. The participants consisted of 52 preschool children aged 3-5 years, who came to receive vaccinations at a well-baby clinic. The participants were selected purposively, and divided into an experimental group and a control group with 26 children in each. The operation was carried out with the control group first, followed by the experimental group. The experimental group received the VR program and routine nursing care. The control group received routine nursing care. The research tools included the VR technology program, a child's demographic data form, the Children's Face Fear Scale, and the Children's Fear Behavior Observation form. Data were analyzed using descriptive statistics, Mann-Whitney U test, and Wilcoxon signed-rank test.

The research results showed that preschool children in the experimental group showed a significant reduction in fear behavior scores after participating in the program, with results reaching statistical significance (Z = -4.497, p < .01), and significantly lower scores compared to the control group (Z = - 6.307, p < .01).

The results suggest that the VR program can reduce preschoolers’ fear of vaccinations. The adoption of VR programs should be promoted to reduce fear of vaccination and provide preschool children with positive memories of vaccinations to enhance their mental development.

Factors Related to Medical Adherence Among Caregivers of Children with Reactive Airway Disease

Arpaporn Tat-injun — 2026-03-31

Medication adherence among caregivers of children with reactive airway disease is important for controlling symptoms of the disease in children younger than 5 years old. These children depend on their caregivers for medicine administration. This descriptive correlational study aimed to examine medication adherence among caregivers of children with reactive airway disease and to investigate the relationships between caregiver personal factors, perceptions of reactive airway disease, and caregiver medication adherence. The participants, purposively selected using stratified sampling, were 85 primary caregivers who provided care for their children, aged under 5 years of age, with reactive airway disease for at least 6 months. Data were collected at two private hospitals in Chiang Mai. Research instruments included the Personal Information Questionnaire, the Perception of Reactive Airway Disease Questionnaire, and the Inhalers Therapy Adherence Questionnaire. Data were analyzed using descriptive statistics, Spearman's rank correlation, and eta correlation coefficients.

The results showed that 60% of participants demonstrated a high level of medication adherence (M = 32.70, SD = 7.26). Income and education levels were positively and significantly correlated with medication adherence (η = .23, p < .01 and η = .26, p < .01, respectively). Age and duration of caregiving were negatively and significantly correlated with medication adherence (r = -.22, p < .05 and r = -.22, p < .05, respectively). In addition, perception of reactive airway disease was positively and significantly correlated with medication adherence (r = .39, p < .01).

This study’s findings serve as preliminary data for nurses’ awareness of factors affecting medication adherence among caregivers of children with reactive airway disease and may be used to develop appropriate care plans for children requiring continuous inhalation therapy.

Factors Related to Depression Among Expectant Fathers

Jiraporn Nunchai — 2026-03-31

The transition to fatherhood may lead to emotional changes, physical signs and symptoms, and develop into depression. This descriptive correlational research aimed to study depression and factors related to depression among expectant fathers. The participants were 115 expectant fathers whose partners were between 28-36 weeks of gestation in antenatal care at Mae Suai Hospital, Chiang Rai province and Mae Ai Hospital, Chiang Mai province. The research instruments were the 9Q Depression Screening Tool, Generalized Anxiety Disorder (GAD-7), and the Social Support Questionnaire of expectant fathers. Data were analyzed using descriptive statistics, chi-square tests, and Spearman rank correlation coefficient.

The results revealed that:
1. Participants accounting for 8.70% were found to have depression, with a mean score of 8.60 (SD = 2.07), indicating mild symptoms of depression.
2. Factors related to depression among expectant fathers included anxiety, which had a positive correlation with depression (r = .714, p < .001) and social support which had a negative correlation with depression (r = -.276, p < .01). However, age, occupation, number of times becoming a father, history of mental illness, and pregnancy complications were not significantly correlated with depression among participants.

These findings can be used as baseline data for screening depression in expectant fathers who accompany their partners for antenatal visits between 28-36 weeks of gestation.

The Effect of a Hope Enhancement Program with Family Participation on Relapse Prevention in Patients with Addiction Thanyarak Pattani Hospital

Kingkamon Tianual — 2026-03-31

Relapse after treatment remains a significant concern among individuals with substance use disorders, driven by various underlying factors. Effective relapse prevention requires the engagement of family members, particularly through the enhancement of hope in both patients and their families. This quasi-experimental study aimed to compare scores for relapse prevention behavior between two groups of patients receiving inpatient treatment at Thanyarak Pattani Hospital. A total of 52 participants were purposively selected and assigned to an experimental group and a control group. The experimental group received a researcher-developed hope enhancement program involving family participation, based on Snyder’s Hope Theory. One family representative per patient participated in weekly activities for a period of four weeks. The control group received routine care provided by the hospital. The research instruments included the hope enhancement with family participation program, and a relapse prevention behavior assessment. Data analysis was conducted using descriptive statistics and independent t-tests.

The results revealed that after the intervention, the experimental group demonstrated significantly higher mean scores for relapse prevention behaviors at 2 weeks post-discharge (M = 3.45, SD = 0.52) compared with the control group (M = 3.10, SD = 0.57) (t = -2.308, p < .05), as well as at 3 months post-discharge, the experimental group had significantly higher mean scores (M = 3.48, SD = 0.8) compared with the control group (M = 2.8, SD = 0.9) (t = -2.859, p < .01)

The findings of this study demonstrated that involving family members in the intervention process by encouraging them to collaboratively set goals, identify solutions, and foster motivation toward achieving these goals was effective in enhancing the patients’ morale, instilling hope, and providing clear objectives for drug abstinence. This approach was an effective strategy in promoting relapse prevention behaviors among individuals with substance use disorders.

Effect of a Motivation Enhancing Program on Retinal Self-examination Among Uncontrolled Type 2 Diabetes Adults in Communities

Nootchanun Inton — 2026-03-31

Diabetic retinopathy is a complication of diabetes that reduces vision and can lead to vision loss. Screening for diabetic retinopathy is an important strategy for early detection and monitoring of eye complications in diabetic patients. Retinal self-examination procedures should be promoted for continued practice. This quasi-experimental research aimed to study the effects of a motivational enhancement program on self-monitoring of retinal screening for diabetic retinopathy in adults with type 2 diabetes who were unable to control their blood sugar levels in a community in Chiang Mai province. The participants were selected using simple random sampling and were composed of a control group and an experimental group (25 people each). The research instruments consisted of a motivation enhancing program on retinal self-examination for diabetic retinopathy surveillance among uncontrolled type 2 diabetes persons, developed from Roger’s Protection Motivation theory. Data were collected using a demographic data questionnaire and a self-retinal examination questionnaire and were analyzed using descriptive statistics, paired sample t-test, and independent t-test.

The study results showed that after the intervention, the experimental group who received the motivation-enhancing program had significantly higher average retinal self-examination scores (M = 58.56, SD = 2.39) which were higher than before receiving the program (M = 27.64, SD = 4.21) (t = 31.90, p < .001) and higher than those of the control group (M = 29.20, SD = 3.26) with statistical significance (t = 37.93, p < .001).

The outcomes demonstrated that this motivation-enhancing program can be used effectively for retinal self-examination in uncontrolled type 2 diabetic people.

Development and Evaluation of a Massive Open Online Course for Nursing Students: Geriatric Care

Sunida Arttanuchit — 2026-03-31

Massive Open Online Courses (MOOCs) represent an educational innovation that promotes lifelong learning, especially for 21st-century learners. By utilizing computer technology and the internet, MOOCs offer flexible, accessible learning opportunities to a broad audience, regardless of location or background. This quasi-experimental, one-group pretest-posttest study aimed to investigate the effects of using a MOOC on Geriatric Care via the Thai MOOCs platform among nursing students who had completed the Geriatric Care course in the academic year 2024. A simple random sampling method was used to recruit 174 nursing students from three nursing institutions. Participants enrolled in the Geriatric Care MOOC via the Thai MOOCs platform. Data collection instruments included a personal information questionnaire, a knowledge test, an online learning behavior questionnaire, and an online learning satisfaction questionnaire. The experimental tool was the Geriatric Care MOOC on Thai MOOCs. Personal information, online learning behaviors, and online learning satisfaction were analyzed using descriptive statistics. Knowledge scores before and after the online course were compared using a Wilcoxon signed-rank test, with statistical significance set at p < .05.

The research findings revealed:
1. Nursing students' knowledge scores after completing the Geriatric Care MOOC via the Thai MOOCs platform were significantly higher than before the course, with statistical significance (Z = −11.416, p < .001).
2. Nursing students' behaviors toward the Geriatric Care MOOC via the Thai MOOCs platform were at a frequent practice level (mean = 4.21, SD = 0.82).
3. Nursing students' satisfaction with the Geriatric Care MOOC via the Thai MOOCs platform was at the highest level (mean = 4.62, SD = 0.42).

These findings suggest that the Geriatric Care course delivered via the Thai MOOCs platform could enhance students' knowledge. Therefore, it should be integrated into regular teaching and learning strategies to promote academic achievement and increase student satisfaction.