Nursing Journal CMU

Editorial

Kannika Kantaruksa — 2026-09-30

Dyadic Coping in Colorectal Cancer Patient-Caregiver Dyads: A Scoping Review of Influencing Factors and Interventions from a Systemic-Transactional Perspective

Jing Su — 2026-09-23

Colorectal cancer is the third most common cancer globally; it affects both patients and their caregivers. Dyadic coping (DC) refers to the process in which partners jointly manage stressors within their relationship. Dyadic coping represents a critical interpersonal process through which patient–caregiver dyads jointly manage cancer-related stress. However, existing evidence on its influencing factors, the shared illness and relational experiences of these dyads, and targeted interventions remains fragmented and lacks systematic theoretical integration. Based on the systemic-transactional theory, this scoping review aims to synthesize evidence on factors influencing DC, dyadic experiences, interventions, and intervention efficacy among colorectal cancer (CRC) patients and their caregivers. Following the JBI scoping review framework and PRISMA-ScR guidelines, nine databases (CNKI, Wanfang, CBM, VIP, PubMed, Web of Science, Cochrane Library, CINAHL, Embase) were systematically searched for studies published between January 1995 and April 2025. In accordance with the PICOS criteria, data from included studies were processed, with study screening, data extraction, and thematic analysis independently completed by two reviewers.

This scoping review included results from a total of 22 articles (10 quantitative, 2 qualitative, 10 intervention studies), with 18 originating from China, reflecting research priorities in high-burden regions. DC-related factors were categorized into individual, relational, and environmental levels based on the systemic-transactional model (STM), including demographic characteristics; disease stage; stoma surgery and treatment-related burden; psychological distress; communication patterns; social support; and cultural values. Four qualitative themes consistent with STM were identified: support systems and interaction (common DC), challenges (stress communication), family adaptation (positive DC), and social resource utilization (environmental context). Interventions were classified into three types: STM-based, dyadic illness management, and relationship-strengthening, all of which improved DC skills, relationship quality, and psychological well-being, with high feasibility and acceptability.

This scoping review synthesized evidence regarding DC in CRC patient-caregiver dyads, clarifying multilevel associated factors, DC experiences, and effective intervention approaches. Cultural differences underscore the necessity of culturally adapted interventions in Chinese clinical settings. Future research should develop culturally appropriate programs, investigate policy-level support, and integrate DC assessment and skills training into routine oncology practice to improve outcomes for both patients and caregivers.

Factors Related to Dietary Adherence Among End-Stage Renal Disease Persons Receiving Hemodialysis in Sichuan Province, the People’s Republic of China

Qiaoling Wang — 2026-09-23

Dietary adherence is critical for hemodialysis patients to manage fluid balance; regulate electrolytes and blood pressure; and reduce complication rates. This descriptive correlational study aimed to examine the relationship between the core constructs of dietary adherence and dietary adherence behaviors, guided by the Health Belief Model (HBM). This study was conducted with 193 end-stage renal disease patients undergoing hemodialysis. The research instruments included the Renal Adherence Behavior Questionnaire (RABQ) and the Dietary Health Belief Questionnaire (DHBQ). Data were analyzed using descriptive statistics and Spearman correlation.

Results demonstrated suboptimal dietary adherence (M = 57.70, SD = 6.85), with moderate levels across all health belief domains: perceived susceptibility (M = 12.28, SD = 3.97), perceived severity (M = 15.78, SD = 2.83), perceived benefits (M = 13.13, SD = 3.78), and perceived barriers (M = 21.71, SD = 6.74). Moreover, correlation analyses revealed significant associations: perceived severity (r = .910, p < .001) and perceived benefits (r = .877, p < .001) showed strong positive correlations with adherence; perceived susceptibility demonstrated a moderate positive correlation (r = .429, p < .001); and perceived barriers exhibited a strong negative correlation (r = -.820, p < .001).

These findings suggest that the Health Belief Model can be used to explore factors significantly influencing dietary adherence in end-stage renal disease patients undergoing hemodialysis. Clinical interventions targeting these cognitive factors may enhance adherence behaviors in this population.

Effects of a Frailty Prevention Program for Older Adults with LINE Application on Health Literacy and Health Behaviors

Theraporn Pluknikorn — 2026-09-23

Frail older adults are at increased risk of falls, disability, and mortality. However, development of specific prevention strategies for this population remains unclear. The aim of this quasi-experimental study was to examine the effects of a frailty prevention program for older adults with LINE application on health literacy and health behaviors. The program was developed based on Nutbeam’s health literacy concept and Pender’s Health Promotion Model with information technology through the LINE application. Fifty participants were recruited, consisting of 24 in the experimental group and 26 in the control group. Research instruments included the frailty prevention program, a personal information questionnaire, a health literacy questionnaire, and a health behavior questionnaire covering food consumption behavior and exercise behavior. Data were analyzed using descriptive statistics, independent t-test, and dependent t-test.

The results showed that after receiving the program, the scores for health literacy, overall health behaviors, food consumption behaviors, and exercise behaviors of the experimental group were significantly higher than those of the control group (p < .05). Also, after the program, the experimental group’s scores for health literacy, overall health behaviors, food consumption behaviors, and exercise behaviors were significantly higher than those at baseline (p < .05).

The findings suggest that this program is feasible and effective for preventing frailty among older adults.

Predictive Factors of Mild Cognitive Impairment Among Older Adults with Type 2 Diabetes Mellitus

Sirikaan Karanwattanakull — 2026-09-23

Mild cognitive impairment (MCI) is commonly found among older adults with type 2 diabetes mellitus. This population is at greater risk of accelerated cognitive decline due to chronic metabolic abnormalities. Understanding the factors associated with MCI in this group is crucial for early detection and long-term prevention of dementia. This predictive correlational study aimed to examine the prevalence and predictive factors of MCI among older adults with type 2 diabetes mellitus. A total of 160 participants who received service at a sub-district health promoting hospital in San Sai District, Chiang Mai Province, were recruited. Data collection instruments included: (1) a demographic data form, (2) the Thai version of the Mild Cognitive Impairment assessment, (3) a sleep quality assessment questionnaire, (4) a depression assessment questionnaire, and (5) the 5-meter walk test. Data were analyzed using descriptive statistics, correlation analysis, and multiple regression analysis.

The results of this study revealed the following:
1. The prevalence of MCI among older adults with type 2 diabetes mellitus was 30% (M = 18.50, SD = 4.52). The mean blood glucose level was within the normal range (M = 120.91, SD = 27.11). Sleep quality was at a poor level (M = 6.56, SD = 3.20). The average depression score indicated no depression (M = 7.79, SD = 4.47). Physical function was at a poor level (M = 11.36, SD = 2.55).
2. Physical function was significantly negatively correlated with MCI (r = –.284, p < .01). Blood glucose level, sleep quality, and depression were not significantly associated with MCI.
3. Physical function significantly predicted MCI among older adults with type 2 diabetes mellitus, accounting for 75% of the variance. Among the predictors, physical functioning had the strongest predictive effect (β = –.284, p < .001).

Based on the study findings, diabetes management should be integrated with the monitoring and promotion of physical functioning in primary care settings to prevent or delay cognitive decline among older adults with type 2 diabetes mellitus.

Access, Predictive Factors, and Outcomes of Primary Health Care Services Among Older Adults in Urban Communities

Niramol Somtua — 2026-09-23

Thailand has become a complete aged society, resulting in a significant increase in primary health care service demands. However, older adults in urban communities continue to face multidimensional barriers to service access. This study aimed to examine the level of primary health care access, analyze predictive factors, and explore primary health care service outcomes among older adults in urban communities. An explanatory sequential mixed methods design was employed. Quantitative data were collected from 180 older adults in an urban community in a northeastern province, using proportional stratified sampling, and qualitative data were gathered from 111 key informants. Quantitative data were analyzed using descriptive statistics and multiple regression analysis, while qualitative data were analyzed using thematic analysis.

The findings revealed that older adults accessed primary health care at a high level overall (M = 3.90, SD = 0.55). The highest dimension was service acceptability, followed by affordability, physical accessibility, availability, and accommodation, respectively. Significant predictors of health care access included monthly income, distance to health service units, activities of daily living (ADL) level, presence of a caregiver, and health rights knowledge. The model explained 48.0% of the variance in health care access (R² = .480, Adjusted R² = .460, p < .001). The qualitative findings enabled the synthesis of four integrated service delivery models: home ward care, NCD clinic and NCD school, community pharmacy, and telemedicine through VHV networks. Overall satisfaction with primary health care services was at a high level, particularly regarding interpersonal relations and staff competency.

The findings indicate a positive direction for primary health care service delivery in urban communities. However, proactive service delivery, reduction of physical access barriers, bridging the digital divide, and strengthening community support systems are needed to ensure equitable and sustainable care for older adults.

Technology Acceptance and Health Technology Use Behavior Among Older Adults

Nursaheeda Chemama — 2026-09-25

Rapid advancements in health technology have positioned technology as a vital tool for promoting the health of older adults. Nevertheless, limitations remain regarding technology acceptance and usage among Thai older adults. This research employed an explanatory sequential mixed methods design to investigate technology acceptance levels and health technology usage behaviors, analyze relationships with personal factors, and qualitatively explore the experiences and perspectives of older adults. The participants consisted of 134 older adults who resided in the Yala Municipality area, selected via simple random sampling for the quantitative phase, and 16 key informants selected via purposive sampling for focus group discussions. Research instruments included demographic, technology acceptance, and usage behavior questionnaires, alongside a focus group guide. Data were analyzed using descriptive statistics, chi-square tests, Spearman’s rank correlation, and content analysis.

The findings revealed that overall technology acceptance among older adults was at a high level (M = 3.66, SD = 0.61). Specifically, attitude toward use scored highest (M = 3.92, SD = 0.82), while data security scored lowest (M = 3.33, SD = 0.77). Conversely, overall health technology usage behavior was at a moderate level (M = 1.92, SD = 0.79). Education, occupation, and income significantly correlated with technology acceptance (p < 0.05). Notably, data security showed the strongest positive correlation with usage behavior (r = 0.48, p = 0.00). Qualitative findings clarified that despite positive attitudes, limited usage stemmed primarily from data security concerns, system complexity, and a lack of local support mechanisms.

Consequently, technology design should prioritize simplicity and high-level security features to foster sustainable and practical usage among older adults.

Information Needs and Quality of Life Among Patients with Lymphoma Receiving Chemotherapy at Out-Patient Clinic, University Hospital

Punyaphat Bumrungmeung — 2026-09-28

Although chemotherapy can cure lymphoma, it can bring about complications. Therefore, patients may have information needs for managing any symptom depending on its cause. Additionally, chemotherapy can significantly impact patients’ quality of life in many aspects. This descriptive research proposed to study the levels of information needs and quality of life among patients who received chemotherapy at the outpatient clinic of a university hospital. The purposive sample technique was used to recruit 127 study participants who were newly diagnosed with lymphoma and made an appointment to receive chemotherapy. The research instruments were the HINQ-62 (Hematological Information Need Questionnaire - 62) and the WHOQOL-BREF-THAI (The World Health Organization Quality of Life assessment). The data were analyzed using descriptive statistics.

The study showed that the overall level of information needs among the participants had the highest average score (M = 4.47, SD = 0.49). When considering each aspect, the medical tests and prognosis aspect had the highest average score (M = 4.65, SD = 0.55), followed by the disease, symptoms, treatment and side-effects aspect (M = 4.59, SD = 0.50), the self-care aspect (M = 4.49, SD = 0.57), and the psychosocial aspect (M = 4.33, SD = 0.73). The aspect of etiology, sleep, and physical changes had the lowest average score, though still at a high level (M = 4.08, SD = 0.69). Regarding quality of life, the overall average score was at a moderate level (M = 3.54, SD = 0.44). When considering each aspect, the environment aspect had the highest average score at a good level (M = 4.72, SD = 0.45), followed by the psychological aspect (M = 3.75, SD = 0.60). The social relationship aspect had a moderate average score (M = 3.50, SD = 0.62). The physical aspect had the lowest average score, also at a moderate level (M = 3.20, SD = 0.54).

These results are baseline data to set the priority of needs for the teaching plan and enhance patients’ quality of life in each aspect appropriately.

Effects of a Health Belief Promotion Program through the Line Application on Medication Use Behaviors and Blood Pressure Levels Among Patients with Post-Hypertensive Urgency

Athiwan Wongpetcharat — 2026-09-28

Hypertensive urgency is a common clinical emergency among patients with hypertension due to uncontrolled blood pressure. This experimental research aimed to study the effects of a health belief promotion program, delivered through the LINE application, on medication use behaviors and blood pressure levels among patients with post-hypertensive urgency. The participants consisted of 48 patients with post-hypertensive urgency. Participants were selected using simple random sampling and randomly assigned to either the experimental or control groups, with 24 participants in each group. The experimental group received usual nursing care in combination with the medication use behavior promotion program based on the health belief model framework developed by Rosenstock. The program involved (1) enhancing individual health beliefs by providing educational infographics delivered through the LINE application; and (2) promoting cues to action by sending medication reminder messages, assessing barriers to medication use through the LINE application, and conducting follow-up telephone calls. The intervention lasted four weeks. The control group received only routine care. Data were collected using a demographic questionnaire and a medication use behaviors questionnaire and were analyzed using descriptive statistics, independent t-test, and paired t-test.

The findings revealed that the experimental group who received the health belief promotion program through the LINE application for four weeks had mean medication use behavior scores that were significantly higher than those before the intervention (t = 12.62, p < .05) and significantly higher than those of the control group (t = -5.52, p < .05). The experimental group also had mean systolic blood pressure and mean diastolic blood pressure levels that were significantly lower than those before the intervention (t = -11.61, p < .05; t = -6.24, p < .05) and significantly lower than those of the control group (t = 2.53, p < .05; t = 1.85, p < .05).

The findings of this study indicate that the health belief promotion program through the LINE application improves medication use behaviors and reduces blood pressure levels. Therefore, healthcare teams should consider implementing this program among patients with post-hypertensive urgency to promote appropriate medication use.

Effects of a Nurse Promotion Program on Pain Management Practices and Pain Response in Preterm Infants Undergoing Retinopathy of Prematurity Eye Screening

Jitiyada Wongrueang — 2026-09-28

Retinopathy of Prematurity (ROP) is a condition characterized by abnormal development of the blood vessels in the retina. It is most common in premature infants. The screening process for ROP is known to cause significant pain in these infants. This quasi-experimental study, employing a two-group pretest-posttest design, aimed to evaluate the effects of a nursing promotion program for pain management in preterm infants undergoing ROP screening on nursing practices and infant pain responses. The participants consisted of 20 nurses working in the Neonatal Intensive Care Unit (NICU) and the Neonatal Critical Care Unit (NCCU), with 54 instances of ROP screening in preterm infants. The research instruments comprised two parts: (1) the intervention tool, which was the nursing promotion program for pain management in preterm infants undergoing ROP screening, and (2) the data collection tools, including a nursing practice observation form and a neonatal pain assessment scale. Data were analyzed using descriptive statistics, Wilcoxon signed-rank test, the Mann-Whitney U test, and the Friedman test.

The results revealed that after participating in the program, the experimental group had a significantly higher median pain management practice score for preterm infants undergoing ROP screening compared to before the program (Mdn = 20.00, IQR = 1.00 vs. Mdn = 15.00, IQR = 2.00) (Z = -2.345, p = .019). Additionally, the median pain scores of preterm infants in the experimental group at 1 minute and 5 minutes post-screening were significantly lower than those of the control group (Z = -4.453, p < .001; Z = -3.767, p < .001).

Supporting the implementation of the nursing promotion program based on the PRECEDE-PROCEED Model can enhance the efficiency of nursing practices and reduce pain in preterm infants.

The Effects of a Scout Method–Based Learning Experience Program on the Development of Kindergarten Children in a Private School

Phatphitcha Kruthangka — 2026-09-28

Early childhood is a critical period for brain development and learning. Providing experiences that are appropriate to children's developmental characteristics and natural ways of learning is therefore essential for promoting their overall development. This quasi-experimental study aimed to compare the developmental outcomes of kindergarten children who participated in a Scout Method-based learning experience program with those who received regular classroom instruction. The participants were 60 preschool children aged 3-6 years from a private school, who were randomly assigned to either an experimental group (n = 30) or a control group (n = 30) using simple random sampling. The research instruments consisted of (1) a Scout Method–based learning experience program comprising five activity plans, each implemented over three consecutive weeks with one 2-hour session per week, for a total intervention period of 15 weeks, and (2) the Developmental Surveillance and Promotion Manual (DSPM) assessment developed by the Thai Department of Health. Data were analyzed using descriptive statistics and the independent samples t-test.

The results showed that the experimental group had significantly higher overall develop- mental scores than the control group (t = 5.82, p < .05). Domain-specific analyses revealed that the experimental group achieved significantly higher scores in gross motor development and personal-social development than the control group (t = 5.04, p < .05; t = 2.19, p < .05). However, no significant differences were observed between the two groups in fine motor and cognitive development, receptive language, or expressive language (p > .05).

These findings indicate that the Scout Method-based learning experience program is effective in promoting the overall development of preschool children and supports its integration into the early childhood curriculum to foster age-appropriate development.

Effects of the Transition-to-Home Program on Maternal Confidence in Care and Readmission of Late Preterm Infants

Warunee Sri-in — 2026-09-29

Late preterm infants closely resemble term infants, leading to similar care practices and discharge timing. However, they remain at increased risk for health complications that may result in hospital readmission. This quasi-experimental study aimed to compare maternal confidence in caregiving and readmission rates among late preterm infants between mothers who received the Transition-to-Home Program and those who received routine nursing care. The participants included 54 mother–infant dyads, purposively selected and divided into experimental (n = 27) and control (n = 27) groups. Research instruments consisted of (1) the Transition-to-Home Program comprising three components: readiness assessment, preparation for transition with content tailored to the needs of late preterm infants, and role enhancement through follow-up support via a LINE Official Account; (2) the Maternal Confidence Questionnaire; and (3) the Readmission Record Form. Data were analyzed using descriptive statistics, the Mann–Whitney U test, the Friedman test, and the Wilcoxon signed-rank test.

Results showed that the experimental group’s maternal confidence scores increased significantly from baseline (Mdn = 58.00, IQR [48.00, 63.00]) to week 1 after discharge (Mdn = 63.00, IQR [60.00, 65.00]) and week 4 (Mdn = 67.00, IQR [64.00, 70.00]). At both follow-up points, confidence scores were significantly higher than those of the control group (Z = -2.84, p < .05 and Z = -3.52, p < .01, respectively). Readmission rates within 28 days were 11.11% in the experimental group and 14.81% in the control group, with no statistically significant difference.

This study demonstrates that the Transition-to-Home Program effectively enhances maternal confidence in caring for late preterm infants, although it did not significantly reduce readmission rates. Future research should incorporate content on home-management of neonatal jaundice, a major cause of readmission, to further strengthen program outcomes and reduce the burden of rehospitalization.

Safety Leadership of Head Nurses and Safety Culture Perceived by Registered Nurses in General Hospitals, Southern Thailand

Montira Ruensirikul — 2026-09-29

The head nurse is the primary nursing administrator who plays a key role in systematically implementing safety management policies. The purpose of this descriptive correlational research was to study the level of safety leadership of head nurses, the safety culture as perceived by registered nurses, and the relationship between head nurses’ safety leadership and safety culture as perceived by registered nurses in general hospitals in the southern region of Thailand. The participants consisted of 132 registered nurses. Data were collected using a QR code-based questionnaire divided into three parts: (1) general information, (2) a safety culture questionnaire, and (3) a head nurse safety leadership questionnaire. Data were analyzed using descriptive statistics and Spearman’s rank correlation coefficient.

The results revealed that the overall level of safety leadership of head nurses was at a very high level (M = 4.31, SD = 0.51). The dimension with the highest mean score was safety coaching leadership (M = 4.34, SD = 0.61). The overall level of safety culture was also at a very high level (M = 4.31, SD = 0.51), with information culture showing the highest mean score (M = 4.36, SD = 0.60). The relationship between head nurses’ safety leadership and safety culture as perceived by registered nurses in general hospitals in the southern region of Thailand showed a strong positive correlation that was statistically significant (r_s = .778, p < .01).

Nursing administrators can utilize these research findings to promote a culture of safety, focusing on developing safety leadership among head nurses.

Nurses’ Roles in Metaverse Hospitals: A Document Analysis Using a Foresight Approach

Sangtien Youthao — 2026-09-29

Digital health systems and metaverse technologies are transforming healthcare delivery and nursing practice toward patient care through digital platforms and virtual environments. However, knowledge regarding nurses’ roles in metaverse hospitals remains limited, and a clear conceptual framework is still lacking. This conceptual study aimed to analyze and propose a framework for nurses’ roles in metaverse hospitals within the context of digital health transformation. The study employed a narrative literature review, conceptual analysis, and a systems-based foresight approach, together with a case study of the Seoul Metaverse initiative in the Republic of Korea as a reference model. Data were analyzed through trend analysis, identification of driving forces, and scenario development.

The findings revealed that metaverse hospitals are likely to emerge as an extension of future healthcare systems, significantly transforming nursing roles. Four key scenarios were identified: (1) avatar-based nursing practice in virtual hospital environments; (2) integration of nursing services across physical, online, and metaverse settings; (3) the role of nurses as digital health managers working with artificial intelligence for proactive and preventive care; and (4) the integration of health information systems and nursing informatics to support data-driven and ethical decision-making.

In conclusion, metaverse hospitals may serve as complementary healthcare environments that expand nursing roles and improve healthcare accessibility and continuity of care. However, as this study is based on conceptual analysis without empirical data, the findings represent plausible scenarios rather than generalizable results. Future studies should incorporate empirical research to validate and extend these findings in real-world contexts.

The Development of a Surveillance and Continuous Care System for Psychiatric Patients with Substance Abuse and High Risk of Violence through Community Participation in the Service Area of Mukdahan Hospital

Kobsak Pimanpang — 2026-09-29

Continued drug use damages the brain areas that control thought and emotion, resulting in a lack of self-control and potentially leading to aggressive and violent behavior towards oneself, one’s family, and the community. This can result in a high risk of violence for psychiatric patients with substance abuse disorders. This research and development aimed to develop and evaluate the effectiveness of a surveillance and continuous care system for psychiatric patients with substance abuse and a high risk of violence through community participation mechanisms in the service area of Mukdahan Hospital. The study proceeded by three phases: (1) situation analysis from key informants; (2) development of a prototype system; and (3) effectiveness evaluation, using a pretest-posttest design with independent experimental and control groups (33 each). The participants were psychiatric patients with substance abuse and a high risk of violence, selected by purposive sampling. Instruments included the continuous surveillance and care system, in-depth interview guidelines, the Overt Aggression Scale (OAS), and the Prasri Violence Severity Scale (PVSS). Data were analyzed using descriptive statistics, ANCOVA, and GEE.

The findings from Phase 1 revealed three systemic problems: (1) decreased observation of risky behaviors and warning signs; (2) discontinuity in community care; and (3) community fear related to the problem. In Phase 2, a prototype system was developed comprising two processes: surveillance of violent behavior and prevention of repeated violence. In Phase 3, the effectiveness of the surveillance and continuity-of-care system was evaluated. The experimental group had significantly lower aggressive behavior scores and violence risk severity scores than the control group at each monthly follow-up (p < 0.001). Overall, the mean difference in aggressive behavior scores between the control and experimental group was 0.70 (95% CI: 0.49–0.90, p < 0.001). Similarly, the overall mean difference in violence risk severity scores was 5.79 (95% CI: 4.44–7.14, p < 0.001) with lower scores observed in the experimental group.

These findings indicate that the system was effective. Therefore, it should be further implemented in high-risk areas as a step toward provincial-level implementation. This expansion should involve the integration of relevant agencies and community stakeholders to establish community-level operational teams.

Stakeholders’ Needs for Graduate Competencies and Educational Management of the Bachelor of Nursing Science Program at Boromarajonani College of Nursing Nakhon Phanom: A Qualitative Study

Chaiwat Inchaiya — 2026-09-30

In an era of rapid health system transformation driven by technological advancements and rising societal expectations for quality care, nursing education must adapt its curricula to develop graduates whose competencies meet contemporary healthcare demands. This qualitative research aimed to explore stakeholders’ needs regarding graduate competencies and educational management within the Bachelor of Nursing Science program at Boromarajonani College of Nursing, Nakhon Phanom. Thirty key informants were purposively selected from seven stakeholder groups, including administrators, multidisciplinary professionals, nurse educators, nursing students, alumni, service users, and community leaders. Data were collected through in-depth interviews, focus group discussions, and document analysis. The data were analyzed using inductive content analysis. The trustworthiness of the findings was ensured through data and methodological triangulation, as well as member checking.

The research findings revealed four main themes: (1) Desired Professional Competency: emphasizing digital health literacy, systems thinking, and the integration of simulation-based learning; (2) Ethics and Professional Morality: focusing on adherence to professional codes of conduct combined with humanized care; (3) Communication and Collaboration: highlighting language proficiency and multidisciplinary teamwork within a broader multicultural context; and (4) Learning and Self-Development: aiming to cultivate leadership and a growth mindset for adapting to future challenges. These findings align with the Program Learning Outcomes (PLOs) of the 2026 Bachelor of Nursing Science curriculum.

In conclusion, the study reflects the desired graduate competencies based on stakeholders' expectations. These findings provide crucial empirical evidence for curriculum development and nursing education management to effectively respond to health system dynamics and specific regional contexts.

Translation and Pilot Testing of the Guideline Assessment Tools of the ADAPTE Collaboration: Thai Version

Nuttamon Vuttanon — 2026-09-30

The ADAPTE Collaboration recommends adapting existing clinical practice guidelines rather than developing new ones, to conserve time and resources. This process requires reliable, contextually appropriate assessment tools. Since the original tools are in English, a rigorous translation into Thai is necessary to ensure cultural equivalence and quality prior to implementation. This methodological pilot study aimed to translate the ADAPTE Collaboration’s guideline assess- ment tools into Thai and test their quality properties. The study followed a two-phase process: (1) Four tools were translated, using an integrated approach based on Jones et al.’s cross-cultural adaptation process and Beaton et al.’s dimensions of cultural equivalence, and (2) Content validity was assessed by six experts, and inter-rater reliability was examined among three reviewers who evaluated four selected clinical practice guidelines. Data were analyzed using descriptive statistics, the scale-level content validity index (S-CVI/Ave), and Kendall’s coefficient of concordance.

The results showed that the S-CVI/Ave for the four translated tools-the Currency Survey; the Search and Selection of Evidence Evaluation Sheet; the Consistency between Evidence, its Interpretations, and Recommendations Evaluation Sheet; and the Acceptability/Applicability Evaluation Sheet-were 1.00, 0.90, 0.81, and 1.00, respectively. The Kendall’s coefficients of concordance were 0.70, 0.71, 0.67, and 0.79, respectively (p < .05).

The findings confirm that the translated tools are culturally equivalent to the originals and demonstrate acceptable content validity and inter-rater reliability. The tools can be effectively used by educators and healthcare organizations to assess and adapt existing clinical practice guidelines.

Developing Clinical Practice Guidelines Using the GRADE-ADOLOPMENT Approach: Concept and Application

Pratum Soivong — 2026-09-30

Evidence-based practice plays an important role in enhancing quality of care and patient outcomes; enhances confidence in clinical decision-making; and supports nurses' professional development. Clinical practice guidelines are essential for translating evidence into practice. This article aims to clarify the GRADE-ADOLOPMENT approach, a systematic and transparent method for developing clinical practice guidelines based on existing recommendations. This approach involves selecting recommendations through three pathways: (1) Adoption: implementing existing recommendations with little or no modification; (2) Adaptation: tailoring recommendations to a new context, taking into account available resources, service delivery systems, and patient values; and (3) De novo development: creating new recommendations when the existing evidence or prior guidelines are insufficient or inappropriate. Additionally, a case study is presented on developing perioperative hypothermia management guidelines emphasizing contextual appropriateness and illustrating how to apply the GRADE-ADOLOPMENT approach to develop these guidelines.

Family Caregivers’ Concerns about End-of-Life Symptoms in Palliative Home Care for Persons with Metastatic Spinal Cancer: Lessons Learned

Apichat kardosod — 2026-09-30

This lessons-learned academic article presents the researcher’s fieldwork experiences gained from working with Thai family caregivers of persons with metastatic spinal cancer receiving palliative home care. The purpose of this article is to reflect on the researcher’s learning process in qualitative research, particularly in relation to engaging with sensitive issues, building trust with participants, and positioning oneself appropriately as a researcher within a highly vulnerable context. This reflection employs a reflective approach grounded in the concepts of bracketing and ethical reflexivity to explore how the researcher learned through being present with, listening to, and accompanying participants during periods marked by loss and emotional distress. The reflect analysis highlights three key lessons: (1) confronting emotional distress arising from listening to family caregivers’ narratives about end-of-life symptoms, which underscored the importance of researcher self-care; (2) learning to maintain professional boundaries while practicing empathy through deep listening, thereby creating a safe space for participants to share their experiences; and (3) interpreting caregivers’ experiences through cultural and religious frameworks, which broadened the researcher’s understanding of spiritual dimensions in nursing care.

This article reflects the learning journey of a qualitative researcher working with vulnerable populations and demonstrates the value of reflective practice in strengthening ethical research competencies. The lessons derived contribute to the development of nursing practices that respect human dignity within end-of-life care and palliative care contexts.

The Role of Psychiatric Nurses in Promoting Resilience Among Caregivers of Individuals with Dementia

Chalinee Suvanayos — 2026-09-30

Dementia is a progressive neurodegenerative condition characterized by a decline in cognitive function, memory, emotion, behavior, and the ability to perform activities of daily living. Family caregivers of people with dementia, particularly those caring for individuals who exhibit behavioral and psychological symptoms of dementia (BPSD), such as aggression, irritability, wandering, or delusions, often experience substantial stress, caregiver burden, and psychological distress. Promoting resilience is therefore considered a key mechanism that enables caregivers to adapt to stressful caregiving situations, restore psychological well-being, and maintain sustainable mental health. According to Grotberg's resilience framework, resilience comprises three fundamental components: "I have," "I am," and "I can." These components serve as protective factors that strengthen caregivers' ability to cope effectively with caregiving-related stress.

Psychiatric nurses play a pivotal role in integrating resilience into the psychiatric nursing process through comprehensive assessment, nursing diagnosis and planning, implementation of nursing interventions, and evaluation of outcomes. In addition, psychiatric nursing practice encompasses four essential dimensions: health promotion, prevention, therapeutic intervention, and rehabilitation, all of which contribute to strengthening caregivers' resilience. Nursing interventions aimed at enhancing resilience help caregivers adapt more effectively to caregiving-related stress, reduce caregiver burden, improve their capacity to manage the behavioral and psychological symptoms of dementia, and ultimately enhance the quality of life of both caregivers and people living with dementia. Furthermore, these interventions foster caregivers' recognition of their own strengths and self-worth, strengthen social support networks, and develop constructive problem-solving skills. Consequently, caregivers experience reduced stress, greater psychological resilience, enhanced emotional well-being, and improved overall quality of life.

Non-pharmacological Symptom Cluster Management in Children with Cancer Receiving Chemotherapy and Nursing Roles

Wannita Sonkongdang — 2026-09-30

Symptom cluster management is essential, as children with cancer receiving chemotherapy often experience complex and interrelated symptoms. Symptom clusters commonly comprise both subjective self-reported symptoms and objective clinical observations. Non-pharma- cological management represents a key approach for addressing the complexity of symptom clusters, and nurses play a central role in implementing and coordinating integrated care. This article aims to present non-pharmacological approaches to symptom cluster manage- ment and to delineate the roles of nurses in reducing symptom severity and enhancing the quality of life of children with cancer receiving chemotherapy.

Non-pharmacological symptom cluster management in pediatric oncology encom- passes psychological interventions, mindfulness-based interventions, physical activities, and complementary and alternative therapies. These approaches are effective and safe, with an emphasis on age-appropriate application and commonly observed symptom clusters. Framed within holistic nursing care and family-centered care principles, non-pharmacological interventions can reduce symptom severity and promote overall well-being among children with cancer and their families. In addition, pediatric oncology nurses play crucial roles in symptom assessment and monitoring, clinical care, family support, care coordination, and research and innovation development to enhance the clinical outcomes of children with cancer. Therefore, incorporating non-pharmacological symptom cluster management into routine cancer care is essential for optimizing patient outcomes, improving quality of life, and supporting long-term survivorship in children with cancer receiving chemotherapy.