Journal of Nursing and Public Health Research

The Use of Artificial Intelligence in Designing Case-Based Learning to Promote Analytical Thinking Among Nursing Students

Wannapa Srion — 2025-11-12

In the 21st century, nursing education requires a transformation in learning approaches to develop nursing students’ critical thinking skills and prepare them for the rapidly evolving and complex healthcare system. This article aims to present an instructional approach integrating Artificial Intelligence (AI), particularly ChatGPT, in the design of Case-Based Learning (CBL) to enhance critical thinking among nursing students. Drawing from Constructivist Learning Theory and Critical Thinking Theory, this paper explores how AI can simulate realistic clinical scenarios, generate open-ended questions, adjust case complexity, and provide immediate feedback. Literature reviews indicate that AI-enhanced learning significantly improves academic performance, student engagement, and critical thinking skills. However, concerns remain regarding the reliability of AI-generated content, the potential erosion of students’ clinical judgment, and ethical implications. The paper emphasizes the instructor's role in supervising, tailoring, and validating AI-generated learning content to ensure alignment with course objectives and learning outcomes. Rather than replacing human reasoning, AI should be a supportive tool that facilitates deep learning and encourages reflective clinical decision-making. Integrating AI with CBL is thus a promising strategy for fostering analytical and reflective competencies in nursing students, equipping them with the cognitive agility and judgment required to meet the challenges of modern healthcare practice.

Community Nurse Practitioner’s Role in Rational Drug Use for the Elderly with Chronic Disease: Applying a Chronic Care Model

Achariya Churyen — 2025-11-24

Older persons have physiological changes that reduce the effectiveness of many body systems, increasing their vulnerability to chronic illnesses. These disorders frequently need the administration of many drugs simultaneously. Such age-related physiological changes influence both the pharmacokinetics and pharmacodynamics of medications, increasing the likelihood of medication-related issues, particularly in community settings where adequate pharmaceutical support services are missing. Community nurse practitioners play a vital role in promoting rational drug use and successfully preventing and treating medication-related issues through patient and family education, evaluation, and monitoring. The Chronic Care Model (CCM) is a well-known framework for managing chronic illnesses efficiently. It prioritizes patient involvement, health promotion, risk factor reduction, and continuous management through team-based treatment in which the patient plays an active role. This paradigm promotes high-quality treatment outcomes and is particularly well-suited to managing medication usage in older persons with chronic diseases who live in the community. This article aims to 1) describe the physiological changes associated with aging and their impact on drug use -related problems in older adults with chronic diseases, and 2) propose a community-based medication management approach by applying the six core componants of the CCM framework, which are: health system, self-management support, delivery system design, decision support, clinical information systems, and community resources and policies within the scope of community nurse practitioners to enhance rational drug use in elderly patients with chronic illnesses.

Health Literacy, 3E 2S Health Behaviors, and Quality of Life among People in Chanthaburi Province

Phakwarin Phattharasirisomboon — 2025-08-20

This cross-sectional study aimed to examine health literacy, 3E 2S health behaviors, quality of life, and factors associated with quality of life among people in Chanthaburi Province. The sample consisted of 400 individuals aged 18 years and older, selected through multistage sampling. Data were collected between August and December 2024. Research instruments included the Health Literacy Questionnaire, the 3E 2S Health Behavior Assessment, and the Thai version of the WHOQOL-BREF questionnaire, with Cronbach’s alpha coefficients of .801, .714, and .862, respectively. The reliability of the health literacy knowledge section was verified using KR-20, yielding a value of 0.76. Data were analyzed using descriptive statistics and stepwise multiple regression analysis.

The study revealed that the average health literacy score was at a good level (Mean = 47.81, S.D. = 6.84). The average score for 3E 2S health behaviors was also at a good level (Mean = 22.52, S.D. = 3.67), while the average quality of life score was at a moderate level (Mean = 92.01, S.D. = 12.80). The factors of health literacy (ß = 0.23), 3E 2S health behaviors (ß = 0.16), and age (ß = –0.16) were found to be significant predictors of quality of life among people in Chanthaburi Province, accounting for 12.2% of the variance (R²= 0.12, p-value < 0.05). Therefore, it is recommended that systematic and continuous programs be developed to promote health literacy and 3E 2S health behaviors from an early age in order to improve the quality of life of the population in Chanthaburi Province.

Effect of the Fall Prevention Literacy Enhancement Program on Fall Prevention Behaviors Among Older Adults

Sarayut Khamkhat — 2025-08-21

This quasi-experimental study with a two-group pretest-posttest design aimed to compare fall prevention behavior scores among older adults before and after participating in the program, as well as between the experimental and control groups. The sample consisted of 54 older adults aged 60 years and above who were at risk of falling, divided equally into an experimental group and a control group (27 participants each). Research instruments included: 1) screening tools, such as the Activities of Daily Living (ADL) assessment, Mini-Cog cognitive assessment, a health literacy questionnaire on fall prevention in older adults, and a fall risk assessment tool; 2) the intervention tool, which was a fall prevention health literacy promotion program; and 3) data collection tools, including a general information questionnaire and a fall prevention behavior questionnaire for older adults. Data were analyzed using descriptive statistics to describe the general characteristics of the participants. Paired t-tests were used to compare fall prevention behavior scores before and after the intervention within each group, and independent t-tests were used to compare the scores between the experimental and control groups after the intervention.

The results revealed that the fall prevention behavior scores of older adults in the experimental group after participating in the program were significantly higher than before the intervention (p-value < 0.001), and also significantly higher than those of the control group (p-value < 0.001). These findings suggest that healthcare professionals can utilize this program as a guideline for effective fall prevention, potentially reducing fall incidents and their associated consequences.

Social Support and Caregiver Burden among Caregivers of Older Adults with Chronic Kidney Failure Receiving Continuous Ambulatory Peritoneal Dialysis

Sirikaan Karanwattanakull — 2025-08-21

This descriptive correlational study aimed to examine the relationship between social support and caregiver burden among caregivers of older adults with chronic kidney failure receiving continuous ambulatory peritoneal dialysis (CAPD). The sample consisted of 123 primary caregivers of older adults with chronic kidney failure undergoing CAPD, who were registered at San Sai Hospital, Chiang Mai Province. The sample was selected using purposive sampling. The research instruments included a personal and general health information questionnaire for caregivers, a caregiver burden scale, and a social support scale for caregivers of older adults with chronic kidney failure receiving CAPD. Data were analyzed using descriptive statistics and Pearson’s correlation coefficient.

The findings revealed that the participants had a mean age of 54.57 years (S.D. = 6.99), with the majority being female (81.31%). Most caregivers were either the children or daughters-in-law of the older adults (60.17%). The caregivers reported moderate levels of social support and perceived caregiver burden (Mean = 3.88, S.D. = 0.75; Mean = 51.97, S.D. = 7.63, respectively). Social support was found to have a moderate negative correlation with perceived caregiver burden among caregivers of older adults with chronic kidney failure receiving continuous ambulatory peritoneal dialysis (r = -0.60, p-value < 0.001). These findings may serve as a foundation for healthcare professionals to develop interventions aimed at reducing caregiver burden in this population.

The Effects of a Problem-Solving Therapy Program on Stress in Women Newly Diagnosed with Breast Cancer

Oakkharawat Jityen — 2025-08-22

This quasi-experimental study with a two-group pretest–posttest design aimed to compare the mean stress scores before and after participation in a problem-solving therapy program among newly diagnosed breast cancer women. The sample consisted of 58 participants, including newly diagnosed breast cancer women in the experimental group and a control group receiving routine nursing care, with 29 participants in each group. Participants were selected using multi-stage random sampling. Data collection instruments included a general information record form, a stress assessment scale, and a problem-solving measurement scale. The intervention tool was a problem-solving therapy program designed to reduce stress in newly diagnosed breast cancer women. Descriptive statistics were used to analyze general information. The mean stress scores before and after the program within the experimental group were analyzed using the Wilcoxon signed-rank test, while differences in mean stress scores between the experimental and control groups were analyzed using the Mann–Whitney U test.

The results showed that the mean stress score of the experimental group before participation in the program was significantly higher than after participation (p-value < 0.05). Moreover, the mean stress score of the experimental group was significantly lower than that of the control group (p-value < 0.05). These findings indicate that the problem-solving therapy program effectively reduces stress in newly diagnosed breast cancer women. Therefore, it should be implemented as an intervention to alleviate stress in this population.

The Secret of Long Living: A Case Study from Northern Thai Elderly Villagers

Chayanisa Kemathad — 2025-11-12

This qualitative research aimed to explore the self-care experiences and health care practices of the oldest-old in relation to longevity, within the catchment area of Don Kaew Subdistrict Municipality, Mae Rim District, Chiang Mai Province. The participants were 20 oldest-old adults aged 85 years and over. Data were collected using a semi-structured in-depth interview questionnaire and analyzed through content analysis based on the process of Miles and Huberman.

The findings on the experiences of self-care for longevity revealed that older adults adopted diverse approaches to self-care, which were closely connected to their ways of life. The results were categorized into five main themes: 1) support from family and community, 2) management of physical health, 3) appropriate dietary practices, 4) a simple and self-reliant lifestyle, and 5) stress and mental health management. The study indicated that older adults in Northern Thailand practiced holistic health care encompassing physical, mental, social, and spiritual dimensions. These practices relied on behavioral adaptation, family and community support, and integration with local culture. The knowledge gained from this study can be applied to develop self-care guidelines for the oldest-old at the individual, community, and policy levels, thereby promoting sustainable quality of life.

Social Support and Quality of Life among Older Adults in Khlong Nam Lai Subdistrict, Khlong Lan District, Kamphaeng Phet Province

Chayaporn Boonruangsak — 2025-11-24

This cross-sectional study aimed to examine the levels of social support and quality of life, as well as the relationship between social support and quality of life among older adults in Khlong Nam Lai Subdistrict, Khlong Lan District, Kamphaeng Phet Province. The participants were 365 older adults residing in Khlong Nam Lai Subdistrict, selected using stratified random sampling. The research instruments included a personal information record form, a social support questionnaire, and the Thai version of the World Health Organization Quality of Life-BREF questionnaire for older adults. Descriptive statistics were employed to analyze general data, while Spearman’s correlation coefficient was used to examine the relationship between social support and quality of life among the participants.

The findings revealed that the majority of participants were female (51%) and early older adults aged 60-69 years (62.74%). The overall mean score of social support was at a moderate level (Mean = 3.40, S.D. = 0.67). When considering each dimension, financial support had the highest mean score (Mean = 3.44, S.D. = 0.64), followed by physical support (Mean = 3.42, S.D. = 0.72). The overall mean score of quality of life was also at a moderate level (Mean = 3.44, S.D. = 0.71). By dimension, social interaction had the highest mean score at a good level (Mean = 3.77, S.D. = 0.61), whereas the dimension of facing death had the lowest mean score (Mean = 2.97, S.D. = 0.91). A moderate positive correlation was found between social support and quality of life among older adults, which was statistically significant at the 0.05 level (r = 0.31, p-value < 0.001). The results suggest that enhancing quality of life in older adults should focus on promoting social support in financial, physical, material, and emotional aspects, which may contribute to their overall health and well-being.

Curriculum Evaluation of the 2020 Revised Practical Nurse Certificate Program of Boromarajonani College of Nursing, Chiang Mai

Jintana Pornsumritchok — 2025-11-24

This evaluative research aimed to assess the revised 2020 Certificate in Practical Nursing Curriculum of Boromarajonani College of Nursing, Chiang Mai, using the CIPP evaluation model (Context, Input, Process, Product). The evaluation covered four components: context (scope and environment), input (resources), process (teaching and learning management), and product (graduate outcomes). The sample consisted of 208 participants, including administrators and instructors, graduates, and employers. The research instruments included a curriculum evaluation form and a semi-structured interview guide. Quantitative data were analyzed using descriptive statistics, while qualitative data were analyzed using content analysis.

The findings revealed that the overall evaluation of the curriculum was rated at the highest level (Mean = 4.65, S.D. = 0.52). The highest score was obtained in the context dimension (Mean = 4.76, S.D. = 0.44), followed by input (Mean = 4.62, S.D. = 0.49), product (Mean = 4.61, S.D. = 0.59), and process (Mean = 4.59, S.D. = 0.55), respectively. Qualitative analysis indicated that the curriculum structure is clear and systematic, active learning plays an essential role in facilitating in-depth understanding, and graduates demonstrate strong practical skills, particularly in providing basic care, which aligns with employers’ perceptions. Recommendations from the study include improving curriculum quality by updating course content to reflect changing health service needs, increasing clinical practice hours, and strengthening a systematic advisory support system to enhance students’ professional competencies and enable them to reach their full potential.

Effect of a Self-Management Program on Uncontrolled Type 2 Diabetes Mellitus among Orchardists in Pak Chong District, Nakhon Ratchasima Province

Wijitra Poomkhuntod — 2025-11-28

This quasi-experimental study with a two-group pretest–posttest design aimed to examine the effects of a self-management program among fruit orchard farmers with uncontrolled type 2 diabetes. The sample consisted of 60 individuals with uncontrolled type 2 diabetes who worked as fruit farmers in Pak Chong District, Nakhon Ratchasima Province. They were divided into an experimental group, comprising 30 farmers from Klang Dong Subdistrict, and a control group, comprising 30 farmers from Nong Nam Subdistrict. Participants were selected using simple random sampling. The research instruments included: 1) an eight-week self-management program, 2) a general information questionnaire, 3) a self-management behavior questionnaire, and 4) a blood glucose record form. Descriptive statistics were used to analyze general information, and differences in mean scores of self-management behaviors and blood glucose levels between the experimental and control groups before and after the intervention were analyzed using the Independent t-test or the Mann–Whitney U test for non-normally distributed data. Differences within each group before and after the intervention were analyzed using the Paired t-test or the Wilcoxon Signed Ranks Test when data were not normally distributed.

The results revealed that 1) after participating in the program, the experimental group had significantly higher mean self-management behavior scores than before the intervention and higher than those of the control group at the 0.05 significance level, and 2) after the program, the experimental group had significantly lower mean blood glucose levels compared to before the intervention and lower than those of the control group at the 0.05 significance level. These findings indicate that the self-management program for individuals with uncontrolled type 2 diabetes effectively improved self-management behaviors and reduced blood glucose levels. Therefore, public health agencies may adopt and implement this program in other communities with individuals who have uncontrolled type 2 diabetes to enhance diabetes management and reduce the overall health burden at the community level.

Development of an Educational Media via LINE Official Account on Pressure Ulcers for Caregivers of Bedridden Patients

Siriorn Buarapa — 2025-12-01

This research and development study aimed to: 1) examine the situation, problems, and needs for educational media among caregivers of bedridden patients; 2) develop educational media on pressure ulcers through a LINE Official Account (LINE OA); 3) compare caregivers’ knowledge before and after using the media; and 4) evaluate their satisfaction with the media. The sample consisted of eight participants in a focus group discussion and 56 caregivers of bedridden patients. The research instruments included a focus group interview guide, educational media delivered via LINE OA, a knowledge test, and a satisfaction questionnaire. Quantitative data were analyzed using descriptive statistics and Paired-Sample t-test, while qualitative data were analyzed using content analysis.

The results revealed that the educational media on pressure ulcers delivered through LINE OA consisted of five electronic poster topics—Pressure Ulcers: Essential Information, Common Bony Prominence Sites, Appropriate Nutrition for Bedridden Patients, Prohibited Foods, and Pressure Ulcer Prevention—along with six video clips covering the definition of pressure ulcers, risk factors, prevention measures, wound cleaning materials and methods, care for each stage of pressure ulcers, and foods that promote wound healing. The comparison of knowledge scores showed that caregivers had significantly higher knowledge after using the media than before, at the 0.05 level. Caregivers also reported a very high level of satisfaction with the media, particularly regarding practical applicability and content quality, which were rated at high levels. Overall, the results indicate that educational media delivered through LINE OA is an appropriate approach for supporting caregivers of bedridden patients, as it is easily accessible, convenient to use, and effective in enhancing knowledge on pressure ulcer prevention.

Effects of Developing the Potential of Teachers and Personnel on the Maintenance of Knowledge and Skills in First Aid and Basic Life Support, Don Kaew Neramitpunya School, Mae Rim District, Chiang Mai Province

Pimonpan Niamhom — 2025-12-02

This one-group pretest–posttest quasi-experimental study aimed to compare the retention of knowledge and skills in basic first aid and basic life support among teachers and staff at Donkaew Neramitpunya School, Mae Rim District, Chiang Mai Province. The study sample consisted of 38 teachers and staff members. Research instruments included a basic first aid and basic life support training program, a personal information questionnaire, a knowledge assessment form, and a skills assessment form for basic first aid and basic life support. Descriptive statistics were used to analyze general information. Differences in knowledge scores before training, immediately after training, and at 9-month follow-up were analyzed using the Friedman test. Differences in first-aid and basic life support skills between immediately after training and 9 months after training were analyzed using the paired t-test.

The findings revealed that participants’ knowledge and skills significantly increased immediately after the training and remained higher than pre-training levels at the 9-month follow-up (p-value < 0.001). However, specific practical skills including tepid sponging to reduce fever, patient transfer, choking assistance, wound care, and fracture management showed a significant decline at 9 months, as did basic life support skills (p-value < 0.05). These results indicate that the training program effectively enhanced knowledge and skills; however, periodic refresher training is essential to maintain long-term competency in first aid and basic life support.

Health Status and Quality of Life among Older Adults after the COVID-19 Pandemic in Chiang Mai Province

Nitcha Tipwan — 2025-12-02

This cross-sectional analytical study aimed to examine the health status and quality of life of older adults, as well as the relationship between health status and quality of life after the COVID-19 pandemic. The sample consisted of 360 elderly people (aged ≥ 60 years old) who were living in Chiang Mai Province and selected samples through a multistage random sampling method. The research instruments included a demographic data questionnaire, the activities of daily living (ADLs), the Basic Geriatric Screening, and the Thai version of the World Health Organization Quality of Life Brief-Thai (WHOQOL-BREF-THAI). Descriptive statistics were used to analyze general data, and the relationship between health status and quality of life was examined using Chi-Square.

The results revealed that the majority of the participants were female (74.17%), aged between 70 and 79 years old (47.78%). Most of the participants had medical conditions with comorbidities (57.22%). Additionally, the analysis indicated that health-related factors significantly associated with quality of life included oral health problems, visual health, nutritional status, and knee osteoarthritis. These findings can serve as a guideline for promoting the health of older adults in the post–COVID-19 period to enhance their well-being and quality of life in the long term.