Nursing Journal CMU

Editorial

Kannika Kantaruksa — 2026-06-30

Sarcopenia: A Silent Threat and Prevention from Adulthood to Older Age

Arunrat Utaisang — 2026-06-30

Sarcopenia is a condition characterized by a progressive loss of muscle mass and strength, leading to a decline in physical performance, increased frailty, a higher risk of falls, and reduced ability to perform daily activities. Although it is commonly regarded as a health problem among older adults, scientific evidence indicates that the degenerative process begins in mid-adulthood, with muscle mass decreasing by approximately 3–5% every decade. This condition is often described as a silent threat because it typically goes unrecognized in its early stages. Moreover, sarcopenia is closely associated with several chronic noncommunicable diseases, including type 2 diabetes, cardiovascular disease, and sarcopenic obesity, all of which significantly impact physical and mental health, quality of life, and healthcare expenditures.

Preventive and management strategies for sarcopenia should focus on comprehensive health promotion, emphasizing resistance exercise, adequate protein and vitamin D intake, and early screening beginning in adulthood to identify individuals at risk. Additionally, social and policy-level support such as community-based exercise programs, promotion of muscle health literacy, and integration of sarcopenia screening into primary healthcare services plays a crucial role in reducing the long-term burden of this condition.

This review aims to summarize current literature related to sarcopenia among middle-aged and older adults by exploring its underlying mechanisms, risk factors, and health, economic, and social impacts. It also presents evidence-based prevention and management approaches that can inform public health policy development and promote sustainable improvements in population health and quality of life.

Nursing Care for Frailty and Atrial Fibrillation in the Elderly: A Case Study

Udsaneyaporn Pollayut — 2026-06-30

Frailty in the elderly is a condition in which the body deteriorates and the ability to adapt decreases, resulting in a risk of health complications. Co-morbidities and frailty in the elderly are associated with physiological changes in the heart, leading to an increased risk of arrhythmias, particularly atrial fibrillation. Frail elderly individuals may exhibit subtle signs and symptoms of atrial fibrillation. Therefore, frailty assessment and screening for atrial fibrillation in the elderly are crucial for proper nursing care. This includes critical care, which emphasizes nursing care and the prevention of severe complications. Meanwhile, continuous care encompasses discharge planning, health promotion, the prevention and reduction of long-term complications, and rehabilitation supported by a multidisciplinary team. This approach takes into account individual patient needs to promote a sustainable quality of life for the elderly and their families.

Advancing Diabetes Remission within the Primary Health Care System: A Conceptual Analysis of Nurse Practitioners’ Roles and Opportunities

Pulawit Thongtaeng — 2026-06-30

Type 2 diabetes mellitus remains a major public health concern in Thailand. Despite standardized treatment guidelines, the rate of glycemic control remains suboptimal, reflecting the limitations of the conventional disease-control approach that focuses on symptom management rather than metabolic restoration. This highlights the need to adopt the concept of diabetes remission, which emphasizes addressing underlying causes and restoring sustainable metabolic balance.

This article presents a conceptual analysis using the chronic care model as the conceptual framework to examine three core aspects: 1) the concept of diabetes remission, which focuses on restoring normal glycemic levels without continuous use of glucose-lowering medications: evidence suggests that intensive weight reduction, dietary modification, and proactive community-based health promotion can help some patients achieve remission; 2) the role of nurse practitioners as leaders in integrated care, coordinating multidisciplinary teams across hospitals, families, and communities, while utilizing digital health technologies to monitor, empower, and support patients’ self-management continuously; and 3) the opportunities and strategies in primary health care, including the implementation of diabetes remission clinics and diabetes schools, real-time health data integration, and the establishment of community networks to support continuity of care.

Thus, advancing diabetes remission requires an integrated conceptual framework for sustainable diabetes remission care that links the roles of nurse practitioners, digital technologies, and community participation. Such integration can strengthen Thailand’s primary health care system, enhance remission rates, reduce the long-term disease burden, and promote the sustainability of the national health system.

Early Childhood Development Screening Techniques Using the Early Childhood Developmental Surveillance and Promotion Manual (DSPM): The Role of Nurses

Kaitsara Sen-Ngam — 2026-06-30

Early childhood is a period of rapid brain growth and development which is important for the development of executive function (EF). The Early Childhood Developmental Surveillance and Promotion Manual (DSPM) was developed by the Ministry of Public Health aiming to assess and screen five domains of early childhood development. These are gross motor develop- ment (GM); fine motor and intellectual development (FM); receptive language development (RL); expressive language development (EL); personal and social development (PS), and also executive functioning skills (EF). Developmental surveillance and screening of early childhood according to age range will help children who are suspected of delayed development to receive proper and timely development stimulation. Developmental surveillance and screening require the cooperation of parents, guardians, and caregivers.

This article aims to encourage nurses to recognize the importance of using the DSPM and understand the techniques for using it to assess early childhood development correctly and effectively for the good quality of life of children in early childhood.

Stroke Knowledge, Awareness, and Preventive Behaviors Among a Chinese Ethnic Minority Group with Hypertension in Guangxi, the People’s Republic of China

Rouhe Lu — 2026-06-22

Stroke knowledge, awareness, and preventive behaviors are essential for individuals with hypertension to reduce their risk of stroke. To date, information regarding these constructs in the Zhuang ethnic minority, who face cultural, linguistic, and healthcare access barriers, is limited. This descriptive correlation study aimed to examine stroke knowledge, awareness, and preventive behaviors among Zhuang populations with hypertension, and the relationship between stroke knowledge and prevention behaviors, and between stroke awareness and preventive behaviors. Purposive sampling was used to select 346 Zhuang with hypertension in Guangxi, the People’s Republic of China. The research instruments included the Stroke Knowledge and Sources of Knowledge Questionnaire, the Stroke Awareness Questionnaire, and the Stroke Preventive Behavior Questionnaire. Descriptive statistics and Spearman’s rank-order correlation were used for data analysis.

The findings indicated that participants had a moderate level of stroke knowledge, awareness, and preventive behaviors. A statistically significant weak positive correlation was found between stroke awareness and preventive behaviors (r = .247, p < .01), while no significant correlation was observed between stroke knowledge and preventive behaviors (r = -.035, p = .51).

This study’s findings reveal the need to enhance stroke knowledge, awareness, and preventive behaviors among a Chinese minority group with hypertension. To ensure the adoption of stroke preventive behaviors, nurses should focus on increasing stroke awareness among persons with hypertension.

Development of a Coaching Program Combined with LINE Application to Promote Self-Care Behaviors for Preventing Fluid Overload in Peritoneal Dialysis Patients: A Research and Development Study

Shutirawan Boonpok — 2026-06-22

Fluid overload is associated with increased morbidity and mortality among patients undergoing peritoneal dialysis (PD). This research and development study aimed to develop a coaching program combined with use of the LINE application and to compare self-care behaviors for the prevention of fluid overload and the incidence of fluid overload between patients in the experimental and control groups. The study sample consisted of 60 patients with stage 5 chronic kidney disease undergoing PD at the Peritoneal Dialysis of Muangsamsib Hospital. Participants were purposively selected and allocated into two groups: 30 patients in the experimental group who received the coaching program combined with the LINE application and 30 patients in the control group who received standard nursing care. Research instruments included the coaching program with the LINE application, a personal and health information questionnaire, a self-care behavior questionnaire, and a fluid overload incidence record form. Data were analyzed using descriptive statistics, chi-square test, risk difference, independent sample t-test, and ANCOVA.

The results demonstrated that:
1. The coaching program combined with the LINE application achieved a content validity index ranging from 0.82 to 1.00, which is considered acceptable.
2. After controlling for self-care behaviors scores to prevent fluid overload prior to the intervention, it was found that the self-care behavior scores to prevent fluid overload in PD patients after the intervention in the experimental group were significantly higher than in the control group (F(1, 57) = 342.03, p < .001).
3. The incidence of fluid overload among PD patients in the experimental group (13.33%) was significantly lower than the control group (43.33%) (c²= 6.648, p < .05).

The findings suggest that community hospitals can apply this program for patients undergoing PD, particularly the structured activities delivered through the LINE application, to effectively prevent fluid overload in PD patients.

Development of Practice Guidelines for Prevention of Post-Operative Acute Kidney Injury in Critically Ill Surgical Patients

Wajee Kitvarayut — 2026-06-22

Postoperative acute kidney injury (PO-AKI), a common complication in critically ill surgical patients, is complex and has various preventive steps, resulting in inconsistent nursing practices. Therefore, developing standardized practice guidelines for nurses is necessary. The objective of this study was to develop clinical practice guidelines for the prevention of PO-AKI in critically ill surgical patients. The framework is based on The ADAPTE Collaboration. Participants were divided into two groups: 1) five postoperative critically ill surgical patients who trialed the guidelines (n = 5), and 2) nineteen nurses who implemented the guidelines (n = 19). Research instruments included 1) a guideline screening form, 2) a guideline quality assessment form, and 3) a form to collect results of the effectiveness of using the guideline in clinical and process aspects. The guideline development had three phases: 1) the set-up phase, 2) the adaptation phase, and 3) the finalization phase. Data were analyzed using descriptive statistics.

The study findings resulted in clinical practice guidelines for the prevention of PO-AKI, which comprise six categories including 1) definition, diagnostic criteria and severity classification of PO-AKI, 2) guidelines for assessing risk, 3) nursing intervention guidelines, 4) guidelines for monitoring and reducing kidney damage, 5) monitoring and following-up guidelines, and 6) health education for patients and caregivers. The guidelines were assessed for quality using the AGREE II tool, with a total score of 93.09%. All nurses who tested the guidelines agreed they were feasible for preventing PO-AKI and could perform all items with an overall satisfaction score of 4.16. The highest average score for practical application in the organization was 4.79, and the lowest average satisfaction score in the aspect of ‘the practice could be easily followed and not complicated’ was 3.95.

These guidelines should be implemented and studied for their effectiveness in clinical and procedural outcomes.

Development and Implementation of Clinical Nursing Practice Guidelines for Prevention and Management of Postoperative Nausea and Vomiting

Teerasak Khongdee — 2026-06-22

Postoperative nausea and vomiting (PONV) is a common complication that occurs during the 24-48 hours after surgery and affects many aspects including healthcare costs. This research aimed to develop clinical nursing practice guidelines (CNPGs) for prevention and management of PONV and to assess the outcomes of implementing the CNPGs in a Southern hospital. The framework of this study is based on the Australian National Health and Medical Research Council (NHMRC). Participants consisted of two groups:1) patients undergoing elective surgery who were staying in the female surgical ward before and during implementation of the CNPGs (80 patients per group), and 2) 24 nurses who utilized the CNPGs. Data collection instruments consisted of 1) the CNPGs Implementation Opinion Survey Form, and 2) the Outcome Evaluation Form. Data were analyzed using descriptive statistics.

The results showed that the CNPGs for prevention and management of PONV consist of three important sections: 1) PONV prevention in the preoperative period, 2) PONV prevention and management in the intraoperative period while receiving anesthesia, and 3) PONV prevention and management in the first 48 hours of the postoperative period. Most of the recommendations in the CNPGs are based on strong evidence (level 1). The feasibility of the CNPG implementation was at a high level (79.17–100%). Postoperative nausea and vomiting were found in participants of the CNPG implementation group (6.25%) at a lower rate than in those from the pre-CNPG implementation group (30.00%). The severity of postoperative nausea in the CNPG implementation group was at a moderate level (100%), which was less than the moderate and severe levels in the pre-CNPG implementation group (81.82% and 18.18%, respectively). Participants in the CNPG implementation group were ‘very satisfied’ and ‘most satisfied’ with care (66.25% and 27.50%, respectively), compared with the pre-CNPG implementation group who reported ‘moderate’ and ‘very satisfied’ levels (17.15% and 68.75%, respectively).

The results of this study revealed that the CNPGs for prevention and management of PONV could be continuously applied to surgical patients to further improve the quality of patient care.

Factors Associated with Postoperative Recovery of Brain Tumor Patients During the Transition from Hospital to Home

Nichapa Phumson — 2026-06-22

Postoperative recovery during the transition from hospital to home among individuals with brain tumors is influenced by multiple related factors. This descriptive correlational study aimed to examine postoperative recovery and its relationships with readiness for hospital discharge, sleep quality, caregiver readiness, self-efficacy, and social support. The participants consisted of 123 individuals with brain tumors who had undergone surgery and attended follow-up visits at outpatient departments of three tertiary hospitals in Bangkok, along with 123 caregivers. Participants were selected using a multistage sampling method. The research instruments comprised a demographic questionnaire, the Readiness for Hospital Discharge Scale, the Verran and Snyder-Halpern Sleep Scale, the General Perceived Self-Efficacy Scale, the Social Support questionnaire, the Postoperative Recovery Profile, and the Preparedness for Caregiving Scale. Data were analyzed using descriptive statistics and the Pearson product–moment correlation coefficient.

The results indicated that overall postoperative recovery during the hospital-to-home transition was at a high level (M = 69.90, SD = 2.36). Factors significantly associated with postoperative recovery (p < .001) included readiness for hospital discharge (r = .500), sleep quality (r = .405), caregiver readiness (r = .368), and self-efficacy (r = .306), whereas social support was not significantly associated with postoperative recovery (r = .025, p = .781).

These findings indicate that nurses should prioritize comprehensive discharge preparation for both patients and caregivers, as well as promote sleep quality and self-efficacy, to enhance postoperative recovery outcomes among individuals with brain tumors during the transition from hospital to home.

Factors Predicting Health Behaviors of Persons with Transient Ischemic Attack at Least Six Months Post-Diagnosis

Tanyatorn Mongkolsukpirom — 2026-06-23

A transient ischemic attack (TIA) serves as a critical warning sign of a future stroke. Promoting appropriate and sustained health behaviors in individuals with TIA is essential for secondary stroke prevention. This predictive correlational study aimed to identify the key psychological predictors of health behaviors among individuals diagnosed with TIA at least six months post-diagnosis. The framework of this study was guided by Becker’s Health Belief Model (HBM). The participants comprised 160 individuals receiving outpatient care at three hospitals in Thailand. Quota sampling was employed to ensure proportional representation of the participants. Data were collected using the following instruments: 1) a personal information questionnaire, 2) the Health Behaviors among Persons with TIA Questionnaire, 3) the Perceived Susceptibility to Stroke Questionnaire, 4) the Perceived Severity of Stroke Questionnaire, 5) the Perceived Benefits of Health Behavior Questionnaire, and 6) the Perceived Barriers to Health Behavior Questionnaire. Data were analyzed using descriptive statistics and stepwise multiple regression analysis.

The findings revealed that only perceived barriers significantly predicted health behaviors (ß = –.431, p < .001), accounting for 18.1% of the variance (Adjusted R² = .181, F = 36.057, p < .001). Other components of the HBM, including perceived susceptibility, severity, and benefits, were not significant predictors.

These results highlight the need for nursing professionals to develop and implement targeted interventions that specifically reduce perceived barriers to health behavior adherence in individuals six months post-diagnosis. Nurses can play a critical role in supporting patients to sustain healthy behaviors and prevent recurrent strokes.

Effects of a Family Integrated Care Program on Participation in Care and Stress of Neurocritical Patients’ Families

Yupares Kavee — 2026-06-23

A neurological critical condition is an acute and severe critical situation that affects a patient’s consciousness, mobility, and communication. Because of the severity of the illness, these patients require intensive treatment and nursing care in a critical care unit. Additionally, patients’ families cannot take on the caregiver role and experience stress. This quasi-experimental design aimed to examine the effects of a family-integrated care (FICare) program on caregiving involvement, and family stress. Participants were selected through purposive sampling based on inclusion criteria and included 50 family members of neurocritical patients admitted to intensive care units in Lamphun Hospital. Participants were matched into pairs and equally assigned to either the control group or the experimental group, with 25 participants in each. The control group received routine nursing care, while the experimental group received care according to the FICare program. The research instrument consisted of two parts: 1) intervention tools, including the FICare program and a caregiver manual, and 2) data collection tools, including general information forms for patients and families, a family participation in care assessment, and a family stress assessment. Data were analyzed using descriptive statistics, independent t-test, and paired t-test.

The study found that families of neurocritical patients in the experimental group had significantly higher family participation in care mean scores (M = 63.24, SD = 0.43) than those of the control group (M = 29.40, SD = 4.56), t(48) = 62.73, p < .001. The families of neurocritical patients in the experimental group had significantly lower stress mean scores (M = 41.60, SD = 5.91) than those of the control group (M = 75.16, SD = 7.38), t (48) = 5.91, p < .001. Furthermore, family stress reduction was significantly greater in the experimental group (M = 43.08, SD = 4.41) than in the control group (M = 10.40, SD = 7.87), t(48) = 18.09, p < .001.

This study demonstrates the effectiveness of the family integrated care program in enhancing family participation in the care of neurocritical patients and in decreasing family stress.

Pain Experience, Pain Management, and Functional Status Among Persons with Joint Replacement After Hospital Discharge

Thitika Chaithian — 2026-06-23

Appropriate pain management after discharge is essential for the functional status of individuals who have undergone joint replacement. This descriptive study aimed to examine the pain experience, pain management, and functional status of individuals with joint replacement following hospital discharge. Participants consisted of 84 individuals who had been discharged after joint replacement surgery. The research instruments included the Brief Pain Inventory, the Pain Management Strategies Questionnaire, and the Lower Extremity Functional Scale (LEFS). Descriptive statistics were used for data analysis.

The results revealed that all participants experienced pain, including those with mild (57.14%), moderate (34.52%), and severe pain (8.33%). The average pain interference scores for those with mild, moderate, and severe pain were 1.23 (SD = 1.28), 2.88 (SD = 1.95), and 3.20 (SD = 1.70), respectively. The most frequently used pain management strategy identified by participants was taking oral pain medications. Cold compression was identified as the most commonly and frequently used non-pharmacological method. The functional status of participants was at a moderate level (M = 36.06, SD = 9.32). The average functional status scores for those with mild, moderate, and severe pain were 39.33 (SD = 9.40), 31.79 (SD = 7.79), and 31.26 (SD = 5.12), respectively.

The findings of this study provide fundamental insights into the pain experience, pain management, and functional status of individuals following joint replacement surgery after hospital discharge. Nurses can use this information in planning effective pain management and promoting the functional status of persons with joint replacement.

Effects of the Goal Attainment Exercise Program on Adherence to Exercise and Muscle Size Among Patients with Lower Extremity Fracture

Prakaydaw Tatan — 2026-06-23

Patients with lower limb fractures are required to exercise regularly to maintain muscle mass. This quasi-experimental study aimed to examine the effects of a goal attainment-based exercise program on exercise adherence and thigh muscle size in patients with lower limb fractures. Thirty patients with lower limb fractures were purposively selected and randomly assigned to two groups: an experimental group and a control group with 15 participants each. The research instrument was a goal attainment-based exercise program developed by the researcher based on King’s Goal Attainment Theory and a literature review. Exercise adherence was measured by an exercise adherence record form, which was also developed by the researcher. Thigh muscle size was measured as thigh circumference in centimeters. Data were analyzed using descriptive statistics, chi-square tests, and repeated measures ANOVA.

Research results showed that:
1. The experimental group demonstrated significantly higher exercise adherence than the control group (p < .001), with 10 participants in the experimental group adhering to the exercise program compared to only two in the control group.
2. When comparing thigh muscle size at the first follow-up visit to the first day of hospitalization, the experimental group showed a slight reduction in muscle size (mean difference = -1.15, SD = 1.49), while the control group experienced a greater reduction (mean difference = -2.16, SD = 1.67). However, the change in muscle size in the control group was not statistically significant.

The findings revealed the effectiveness of this goal attainment-based exercise program in improving exercise adherence. Nurses could apply this program to promote exercise adherence among patients with lower limb fractures.

The Development of a Food Safety Management Model for Community-Dwelling Older Adults: A Case Study in Nong Harn Subdistrict Municipality, San Sai District, Chiang Mai Province

Wannapa Pipattanawong — 2026-06-26

Safe food is a fundamental factor for human health, and food safety is a shared responsibility among all stakeholders. This participatory action research aimed to develop a safe food management model for community-dwelling older adults by integrating community participation principles (Appreciation- Influence-Control: AIC) with modern management concepts. The conceptual framework followed the “Upstream-Midstream-Downstream” approach and was implemented in the Nong Harn Subdistrict Municipality, San Sai District, Chiang Mai Province. A total of 36 purposively selected participants were stakeholders involved in food safety management, including older adults, caregivers, community leaders, food vendors, organic farmers, and representatives from local administrative and public health agencies. Data were collected through the AIC process, consisting of six steps: analyzing the current situation, envisioning a desirable and feasible future, prioritizing key issues, drafting action plans, developing the management model in collaboration with stakeholders, and presenting the findings to the community and related agencies. Content and thematic analyses were employed for data interpretation.

The study revealed that the food safety model for older adults comprised three core components of management: 1) Upstream-including multi-sectoral participation, promoting of safe food sources, and monitoring of food quality; 2) Midstream-involving participatory processes in food production and processing through knowledge sharing and dissemination, and development of a comprehensive local food safety system; and 3) Downstream - emphasizing the evaluation, monitoring, and promotion of safe food consumption for older adults with active involvement from all stakeholders.

The findings suggest that empowering families, communities, and local agencies is essential to ensure safe food environments for older adults. Relevant agencies should apply the research outcome by initiating community-based projects aligned with the local context, concretely and prospectively, for empirical outcomes.

Effect of a Fall Prevention Program on Fall Prevention Behaviors Among Elderly People with Osteoporosis

Sooksakao Kiennugul — 2026-06-26

Fall prevention behavior is important for elderly people with osteoporosis to prevent falls and various complications. This experimental research used a two-group, pre and post-test design. The objective was to compare the fall prevention behavior scores of elderly people with osteoporosis before and after participating in the program and between the program participants and a usual care group. The sample group consisted of 54 elderly people diagnosed with osteoporosis who received services at the Health Promotion Hospital, Health Center 2, Phitsanulok. Simple random sampling resulted in an experimental group (27 persons) and a control group (27 persons). Research instruments consisted of three parts, including Part 1: the screening tools, including a brain function assessment (Mini-Cog) and the Barthel ADL Index; Part 2: the data collection tools composed of a demographic data questionnaire and a measurement of fall prevention behaviors; and Part 3: the intervention tools, including a fall prevention program for elderly people with osteoporosis, developed by the researcher based on the PRECEDE-PROCEED Model concept, and a measurement tool for fall prevention behavior. Data were analyzed by descriptive statistics, independent t-test, and dependent t-test.

The results showed that, after the experiment, the group receiving the program had a significantly higher mean score for fall prevention behavior (M = 53.48, SD = 2.33) than before the experiment (M = 46.03, SD = 2.14) (t = -12.82, p < .001) and significantly higher than that of the control group (M = 50.96, SD = 6.05) (t = -2.02, p = .001).

Therefore, health personnel can apply the fall prevention program to promote fall prevention behavior in the elderly with osteoporosis.

Predictive Factors of Frailty Among Older Adults with Benign Prostatic Hyperplasia

Benjawan Khianhintang — 2026-06-29

Frailty is a common clinical syndrome in older adults, resulting from the decline of multiple physiological systems and leading to reduced adaptive capacity. This cross-sectional descriptive guided by Roy’s Adaptation Model aimed to investigate the predictive powers of urinary tract infection, sleep quality, multimorbidity, and polypharmacy, which were conceptualized as focal stimuli that trigger physiological adaptation related to frailty among older adults with benign prostatic hyperplasia. The participants consisted of 265 older male adults aged 60 years or above, who were diagnosed with benign prostatic hyperplasia and received care at a tertiary hospital in Bangkok. The research instru- ments included the demographic data questionnaire, clinical record forms, the Tilburg Frailty Indicator, and the Pittsburgh Sleep Quality Index. Data were analyzed using descriptive statistics and binary logistic regression analysis.

The results showed that the average age of the sample was 72 years (SD = 23). Frailty was reported in 68.3% of participants. Urinary tract infection, sleep quality, multimorbidity, and polypharmacy jointly predicted frailty in older adults with benign prostatic hyperplasia, accounting for 30% of the variance (Nagelkerke R² = 0.305, predictive accuracy = 76.2%, p < .05). All studied predictors of frailty could anticipate, including sleep quality (Adjusted OR = 6.498, 95% CI = 3.144–13.430, p < .001), urinary tract infection (Adjusted OR = 3.356, 95% CI = 1.082–10.412, p = 0.036), multimorbidity (Adjusted OR = 2.729, 95% CI = 1.370–5.437, p = 0.004), and polypharmacy (Adjusted OR = 2.070, 95% CI = 1.038–4.131, p = 0.039).

The findings indicate that nurses should promote knowledge and understanding of frailty among older adults with benign prostatic hyperplasia, manage sleep quality, screen high-risk groups with multimorbidity, prevent urinary tract infections, and monitor high-risk groups with polypharmacy in order to plan frailty prevention for older adults with benign prostatic hyperplasia.

The Effectiveness of Exercise on Lower Extremity Muscle Strength, Balance and Functional Mobility Among Older Adults: A Systematic Review and Meta-analysis

Nawaporn Wutthitham — 2026-06-29

Exercise in older adults is an important strategy for promoting muscle strength and physical performance. This systematic review and meta-analysis aimed to examine the effectiveness of exercise on lower extremity muscle strength, balance, and functional mobility among older adults. The PICO framework was applied to define the study components. A total of 65 quantitative research articles published between 2015 and 2024 were identified; 14 studies met the quality appraisal criteria and were included in the analysis which was conducted in accordance with the PRISMA 2020 guidelines. Data were analyzed using a random-effects model.

The systematic review revealed that exercise interventions were classified into two categories: single-component exercise programs (42.86%) and multicomponent exercise programs (57.14%). The majority of interventions were implemented 2–5 times per week, with each session lasting 30–60 minutes, over a duration ranging from 2 to 12 weeks. The primary outcomes consistently demonstrated statistically significant improvements in lower extremity muscle strength, balance, and functional mobility. In addition, secondary outcomes indicated reductions in fear of falling and enhancements in cardiovascular endurance. The meta-analysis demonstrated that exercise interventions had the greatest effect on mobility (Hedges’ g = 1.01, 95% CI = 0.63–1.39), followed by balance (Hedges’ g = 0.91, 95% CI = 0.48–1.34) and lower extremity muscle strength (Hedges’ g = 0.84, 95% CI = 0.36–1.32), with all outcomes reaching statistical significance (p < .001). Programs that were culturally congruent with the Thai context, particularly traditional Thai Ramwong dance, and the nine-square grid exercise combined with resistance band training demonstrated positive effects across all three outcomes.

The results provide empirical support for the adaptation and implementation of exercise programs available in Thai communities, emphasizing the importance of selecting modalities that are contextually relevant and aligned with the lifestyle patterns of older adults.

Factors Associated with Preparedness Behaviors for Active Ageing Among Students at a Private University

Winthanyou Bunthan — 2026-06-29

Thailand is already a complete aged society and is expected to soon transition into a super-aged society. This demographic shift has impacted every dimension of the country. Therefore, preparing in advance for healthy and active ageing is essential, particularly in terms of health, social participation, and life security. This cross-sectional study aimed to examine factors associated with preparedness behaviors for active ageing, based on the PRECEDE-PROCEED model. The participants consisted of 400 students in their final or penultimate year at a private university, selected through systematic random sampling. The research instruments comprised Part 1: personal information questionnaire; Part 2: questionnaire on factors based on the PRECEDE-PROCEED model; and Part 3: preparedness behaviors for active ageing questionnaire. Data were analyzed using descriptive statistics and Spearman’s rank correlation and point-biserial correlation.

The results revealed that the participants’ preparation behaviors for active ageing were at a high level (M = 2.04, SD = 0.50). The factors significantly associated with preparation behaviors included access to services (r_s = .594, p < .001), adequacy of facilities (r_s = .548, p < .001), support from others (r_s = .519, p < .001), self-efficacy in preparation (r_s = .510, p < .001), attitudes toward preparation (r_s = .387, p < .001), perceived benefits of preparation (r_s = .379, p < .001), knowledge about preparation (r_s = .262, p < .001), and age (r_s = .123, p = .014).

These findings provide a foundation for designing activities that promote preparation for active ageing among university students. Such activities needed to be tailored to the participants’ age and to emphasize fostering positive attitudes toward preparation, enhancing perceived benefits, and strengthening self-efficacy in adopting healthy practices. Furthermore, universities and related agencies are advised to ensure supportive environments by providing adequate facilities and accessible services to promote readiness for active ageing.

Parenting Stress, Social Support, and Postpartum Depression Among Mothers with Preterm Birth, the Lao People’s Democratic Republic

Thavisouk Chanthavongsa — 2026-06-30

Postpartum depression affects the physical and mental health of mothers with preterm birth. This descriptive correlational research aimed to explore parenting stress, social support, and postpartum depression among mothers with preterm birth in the Lao People’s Democratic Republic. The participants were 85 mothers with preterm birth receiving postnatal six-to-eight-week check-up at four central hospitals in the Lao People's Democratic Republic. The Lao version of research instruments included the Demographic Data Form, the Parental Stress Scale, the Mother Social Support Questionnaire, and the Edinburgh Postnatal Depression Scale. Data were analyzed using descriptive statistics and Spearman's rank correlation.

Results of the study revealed that 77.65% of the participants experienced a high level of parenting stress (M = 67.10, SD = 2.15). All participants (100%) received a high level of social support (M = 4.02, SD = 0.22), and 55.30% experienced postpartum depression. Social support had a moderate, statistically significant negative correlation with postpartum depression (r_s = -.47, p < .01), while parenting stress showed no statistically significant correlation with postpartum depression.

These results provide baseline information regarding parenting stress, social support, and postpartum depression among mothers with preterm births. Nurse-midwives should develop approaches that enhance social support to prevent postpartum depression among mothers with preterm birth in the Lao People’s Democratic Republic.

Effort-Reward Imbalance Among Nurses: A Scoping Review

Rosarin Rakpaosuwan — 2026-06-30

Effort-reward imbalance (ERI) is a crucial factor influencing job retention. However, no review of research summarizes the knowledge about ERI among nurses. This scoping review aimed to study the ERI situation, its antecedents and consequences, and the recommendations from research regarding ERI among nurses. This scoping review was conducted using the conceptual framework of Arksey and O’Malley. A systematic search of studies published between 2014 and 2024 identified 109 articles. After using research evidence screening and a data extraction form, 21 articles passed the screening criteria. They were analyzed for content to summarize the main findings according to the objectives of the scoping review.

The results of the review are as follows:
1. There are two ways to report the situation of imbalance between effort and reward. The first is by reporting the number or percentage of nurses with different ERI scores. The second is by reporting the average ERI level. Among the studies reviewed, 11 reported a balance (ERI ≤ 1), while 10 studies reported an imbalance (ERI > 1) in the ratio of effort to reward among nurses.
2. The antecedence of ERI among nurses can be classified into three groups: organizational factors (e.g., conflicts with supervisors, lack of support, abuse), work characteristics (e., department, shifts, overtime), and personal factors (e.g., demographics, mental health).
3. The consequences of ERI among nurses can be classified into two groups: health effects (e.g., stress, depression, and burnout) and organizational impacts (e.g., reduced care quality, lower job satisfaction, and increased turnover intention).
4. The recommendations from the research, for nursing and organization administrators, include taking care of nurses' welfare; providing training and counseling on how to manage fatigue, stress, and conflicts; creating a safe working environment; and promoting rewards for nurses.

This scoping review highlights the ERI among nurses and provides insights that hospital administrators can use to develop strategies for achieving better balance and improving nurse retention.