Journal of Nursing and Public Health Research

Effects of a Case-Based Medication Adherence Promotion Program among Uncontrolled Hypertensive Patients at a Private Hospital in Bangkok

Siriwan Turongruang — 2026-06-16

This quasi-experimental study with a two-group pretest–posttest design aimed to: 1) compare medication adherence scores and blood pressure levels among patients with uncontrolled hypertension before and after participation in a case management medication adherence promotion program; 2) compare medication adherence scores and blood pressure control outcomes between the experimental and control groups after the intervention; 3) compare adaptation scores based on Roy’s Adaptation Theory between the experimental and control groups after the intervention; and 4) examine patient satisfaction with the program. The sample consisted of 60 patients with uncontrolled hypertension and low medication adherence scores, divided equally into an experimental group and a control group (30 participants each) using matching and random assignment. The experimental group received a case management medication adherence promotion program developed based on Roy’s Adaptation Theory integrated with the World Health Organization’s five-dimensional adherence framework for a period of 6 weeks, with continuous support through the Line application throughout the study. The control group received standard care. Research instruments included the 8-item Morisky Medication Adherence Scale (MMAS-8), the Roy Adaptation Assessment Questionnaire, and a satisfaction questionnaire. Data were analyzed using independent and paired t-tests.

The findings revealed that, after completion of the program, the experimental group demonstrated a statistically significant increase in medication adherence scores from 3.80 to 6.40 points (p-value < 0.001), which was significantly higher than that of the control group (p-value < 0.001). The experimental group also achieved a mean reduction in systolic blood pressure of 19.70 mmHg, and 70% of participants achieved the treatment target of <130/80 mmHg compared with 30% in the control group (p-value = 0.001; RR = 2.33; NNT = 2.50). In addition, the experimental group had significantly higher adaptation scores across all four modes of Roy’s Adaptation Theory compared with the control group (p-value < 0.001). Participants also reported a very high level of satisfaction with the program (Mean = 4.60, S.D. = 0.40). Therefore, the case management medication adherence promotion program based on Roy’s Adaptation Theory combined with digital support through the Line application was effective in improving medication adherence, reducing blood pressure, and enhancing holistic adaptation among patients with uncontrolled hypertension. The program should be applied in primary healthcare services and extended to the management of other chronic diseases.

Effects of a Self-Management Program on Slowing the Progression of Stage 3 Chronic Kidney Disease in the Primary Care Network of Mueang Chi Health Promoting Hospital, Mueang Lamphun District, Lamphun Province, Thailand

Sirimas Pongkhanngern — 2026-07-01

This quasi-experimental study employed a one-group pretest–posttest design to compare the mean knowledge scores, self-management behavior scores, and estimated glomerular filtration rate of patients with stage 3 chronic kidney disease before and after participation in a self-management program. The sample consisted of 40 patients with stage 3 CKD and comorbid diabetes mellitus and/or hypertension who received care at the chronic disease clinic of the Primary Care Network, Mueang Chi Health Promoting Hospital, Lamphun Province, Thailand. Participants were selected using simple random sampling. The research intervention was a self-management program developed based on the Self-Management Concepts of Kanfer and Gaelick-Buys integrated with the 5A Behavior Change Model for Self-Management Support. Data collection instruments included a CKD knowledge questionnaire and a self-management behavior assessment questionnaire. Data were analyzed using descriptive statistics, and pretest–posttest comparisons were performed using the paired t-test.

The results showed that after participating in the self-management program, the participants’ mean knowledge score significantly increased from 19.85 (S.D. = 2.49) to 21.90 (S.D. = 2.59), and the mean self-management behavior score significantly increased from 68.72 (S.D. = 14.91) to 77.60 (S.D. = 7.79) (p-value < 0.001). However, no statistically significant difference was found in the mean estimated glomerular filtration rate (eGFR) before and after participation in the program (p-value = 0.14). These findings indicate that the self-management program effectively improved knowledge and self-management behaviors among patients with stage 3 CKD. Although no significant change in eGFR was observed during the 12-week intervention period, the program may serve as a useful approach for enhancing nursing services and chronic kidney disease management in primary care settings by promoting patients’ self-management capabilities.

Factors Influencing Infection Prevention and Control Behaviors Among Registered Nurses

Jutamas Chueseeda — 2026-07-09

This predictive correlational study aimed to examine the level of infection prevention and control behaviors and the factors influencing these behaviors among registered nurses. The sample consisted of 135 registered nurses working at Vajira Hospital, selected through multistage sampling. The research instrument was a set of questionnaires comprising demographic information, perceived susceptibility, perceived severity, perceived benefits, perceived self-efficacy, cues to action, health literacy, and infection prevention and control behaviors. Data were analyzed using descriptive statistics, and predictive factors were analyzed using stepwise multiple regression analysis.

The results showed that most registered nurses demonstrated a very high level of infection prevention and control behaviors, accounting for 87.41%. Stepwise multiple regression analysis revealed that health literacy (ß=0.47), cues to action (ß=0.24), and perceived benefits (ß=0.16) jointly predicted infection prevention and control behaviors among registered nurses, explaining 55.70% of the variance (R² = 0.55, Adjusted R² = 0.54, F = 54.90, p-value < 0.001). These findings can be used as a guideline for designing innovations or programs to promote infection prevention and control behaviors among registered nurses by enhancing health literacy, establishing clear cues to action, and strengthening perceived benefits of adherence to standard practices.

Development of a Participatory Model for Promoting Early Childhood Development by Grandparent Caregivers: A Case Study of Huai Yang Kham Child Development Center, Chun District, Phayao Province

Jutamas Ponmark — 2026-07-14

This action research aimed to develop a participatory model for promoting early childhood development among grandparents at Huai Yang Kham Child Development Center, Chun District, Phayao Province. The participants consisted of two groups: 1) a model development group comprising seven stakeholders, including a child development center teacher, representatives from the local administrative organization, a subdistrict health-promoting hospital, village health volunteers, and grandparents; and 2) an implementation group consisting of 20 grandparents serving as primary caregivers of children from skipped-generation families. The research instruments included: 1) a participatory model for promoting early childhood development among grandparents, 2) a semi-structured interview guide exploring the current situation of grandparents' practices in promoting child development, and 3) a questionnaire assessing grandparents' child development promotion behaviors. Qualitative data were analyzed using content analysis, while quantitative data were analyzed using descriptive statistics and the paired t-test.

The results indicated that the developed participatory model for promoting early childhood development among grandparents was comprised of 4 activities: 1) surveillance and promotion of child development using the Developmental Surveillance and Promotion Manual (DSPM); 2) providing caregivers with knowledge and skills about developmental promotion; 3) monitoring of child development; and 4) developing a system for referring children who are suspected of developmental delays. An evaluation of the implementation of the grandparent-participatory model for promoting early childhood development revealed a statistically significant difference (p-value < 0.01) in the average scores of grandparents’ child-development-promoting behaviors prior to and post-implementation. Findings suggest that healthcare professionals can apply this model to promote early childhood development in skipped-generation families through the encouragement of grandparents' participation and effectively screening and referring children suspected of developmental delays.

Current Situation and Development Approach for Health Services to Enhance Health Literacy and Self-Management Among Patients with Chronic Obstructive Pulmonary Disease

Nongnaphat Rungnoei — 2026-08-05

This qualitative phenomenological research aimed to explore the current situation and development approach for health services designed to enhance health literacy and self-management skills among patients with Chronic Obstructive Pulmonary Disease (COPD). The study was conducted in COPD clinics of hospital under the Ministry of Public Health in a southern province of Thailand. The participants consisted of 15 professional nurses and 38 COPD patients. Data were collected using open-ended questions, verified using methodological triangulation and peer debriefing, and analyzed using content analysis according to the reflexive thematic analysis process.

The findings revealed that the current service delivery situation can be divided into four main themes: 1) service delivery models, 2) health literacy and self-management skills status, 3) systemic obstacles to service access, and 4) psychosocial impacts and economic burdens. The guidelines for healthcare service development are divided into six main themes: 1) developing integrated service models, 2) enhancing practical skills of patients, 3) establishing a screening and follow-up system for patients based on severity, 4) creating learning materials that meet patient needs, 5) increasing two-way communication channels for symptom monitoring, and 6) supporting the role of families and communities. This study indicates that healthcare services lack continuity. Patients also possess insufficient health literacy and self-management skills regarding. Meanwhile, service delivery is constrained by limited time, personnel, and learning resources. The acquired knowledge can be utilized to develop service approaches that meet patients' needs, resulting in a better quality of life and reducing the burden on the healthcare system.

The Effect of a Mindfulness-Based Cgnitive Therapy Program on Anxiety and Depression among Patients with Breast Cancer Receiving Chemotherapy

Sinakan Chapat — 2026-08-06

This quasi-experimental study using a two-group repeated-measures design aimed to examine the effects of a Mindfulness-Based Cognitive Therapy (MBCT) program on anxiety and depression among patients with breast cancer receiving chemotherapy. The sample consisted of 40 patients with breast cancer receiving chemotherapy at the outpatient department of Chonburi Cancer Hospital. The research participants were divided into two groups: an experimental group and a control group, with 20 participants in each group. The experimental group participated in the MBCT program consisting of four sessions, each lasting 60-90 minutes, whereas the control group received usual care. The research instruments included the MBCT program and the Thai version of the Hospital Anxiety and Depression Scale (HADS). Data were collected at three time points: before the intervention, immediately after the intervention, and at follow-up. Data were analyzed using repeated-measures analysis of variance, and pairwise comparisons were performed using the Bonferroni post hoc test.

The results revealed that participants in the experimental group had significantly lower mean anxiety scores at both the post-intervention and follow-up assessments compared with the pre-intervention assessment (F_(2,38) = 267.77, p-value < 0.001, η² = 0.93). Similarly, the mean depression scores significantly decreased following the intervention (F_(2,38) = 376.66, p-value < 0.001, η² = 0.95). Between-group comparisons showed that the experimental group had significantly lower mean anxiety scores than the control group at both the post-intervention and follow-up assessments (F_(2,76) = 99.92, p-value < 0.001, η² = 0.72). Likewise, the experimental group demonstrated significantly lower mean depression scores than the control group (F_(2,76) = 120.77, p-value < 0.001, η² = 0.76). The findings indicate that the Mindfulness-Based Cognitive Therapy (MBCT) program was effective in reducing anxiety and depression among patients with breast cancer receiving chemotherapy. The program should therefore be integrated into standard care to enhance the effectiveness of psychosocial care and rehabilitation for this patient population.

Experiences and Meanings of Buddhist Beliefs and Lower Lanna Cultural Values in Family Members' Decision-Making for Critically Ill Patients: A Hermeneutic Phenomenological Study

Seubtrakul Tantalanukul — 2026-08-06

This qualitative study aimed to understand and interpret the meanings of Buddhist beliefs and Lower Lanna cultural practices within the decision-making experiences of family members of critically ill patients in Uttaradit, Phrae, and Nan provinces. A hermeneutic phenomenological qualitative approach was employed. Sixteen key informants were selected using purposive and snowball sampling. Data were collected through individual in-depth interviews and analyzed using van Manen's thematic analysis.

The finding revealed four major themes: 1) illness interpretation through a karmic and merit-based lens that motivated active caregiving rather than passive acceptance; 2) the use of Lower Lanna cultural rituals including life-extension ceremonies, votive offerings, and merit dedication as mechanisms for managing uncertainty in crisis situations; 3) seniority-based family authority structures and the role of Buddhist monks as ethical consultants who share collective moral responsibility in decision-making; and 4) the application of Buddhist teachings on intention and letting go to derive meaning and adapt to outcomes. The essence of the experience revealed that Buddhist beliefs and Lower Lanna cultural practices function as a "meaning space" enabling family members to sustain dignity amid uncertainty, operating alongside biomedical care as complementary systems rather than barriers to treatment. The contribution of this study lies in uncovering the meaning dimensions of decision-making within the Lower Lanna cultural context, an area that has not been systematically examined. Nurses should assess family belief systems as part of initial admission, provide space and time for families to perform cultural rituals alongside medical treatment, and communicate medical information in ways that reasonably accommodate family consultation with elders and Buddhist monks.

Effects of a Program Based on the COM-B Model and the Behaviour Change Wheel on Food Sanitation Knowledge, Practices, and Motivation Among Food Handlers, and on the Physical and Biological Standards of Street Food Stalls in Phuket Municipality

Nichakarn Vetchasit — 2026-08-07

This quasi-experimental study aimed to examine the effects of a program based on the COM-B model and the Behaviour Change Wheel (BCW) theory on food sanitation knowledge, behaviors, and motivation among food handlers, as well as the physical and biological food sanitation standards of street food vendors in Phuket City Municipality. Sixty participants were recruited and equally assigned to an experimental group (n=30) and a control group (n=30). The research instruments included a COM-B and Behaviour Change Wheel-based intervention program, a demographic questionnaire, a food sanitation knowledge test, questionnaires assessing food sanitation practices and motivation, and a food sanitation standards inspection checklist. Data were analyzed using descriptive statistics, paired t-test, independent t-test, analysis of covariance (ANCOVA), one-way repeated measures ANOVA, and two-way repeated measures ANOVA.

The results showed that, after the intervention, the experimental group demonstrated significantly higher food sanitation knowledge, practices, and motivation than before the intervention (p-value < 0.001) and significantly higher scores than the control group (p-value < 0.001). The physical food sanitation standards of street food stalls in the experimental group improved significantly at Weeks 8, 12, and 16 (p-value < 0.001) and were significantly higher than those of the control group. Although the biological food sanitation standards improved in both groups compared with baseline, no significant difference was found between the groups (p-value = 0.08). The findings suggest that the COM-B model and Behaviour Change Wheel-based program is effective in improving food sanitation knowledge, practices, motivation, and physical sanitation standards among food handlers. The program may serve as a practical guideline for public health agencies, local administrative organizations, and street food vendors to enhance food sanitation practices and strengthen food safety.

Management of Compassion Fatigue among Nurses

Watcharin Chaithong — 2026-05-20

This article proposes strategies to prevent compassion fatigue among nurses. Currently, nurses are continuously exposed to work-related stress, which leads to both mental and physical health problems. Compassion fatigue is one of the outcomes of working under pressure and continuous exposure to patients’ suffering. It has been found that nurses experience compassion fatigue at prevalence rates exceeding 50%, with levels ranging from low to high. This condition not only affects attitudes toward the profession and quality of work life but also increases turnover intention and impacts patient safety and quality of care. Studies indicate that compassion fatigue is associated with long working hours, heavy workloads, lack of organizational support, job characteristics, and insufficient coping skills. Therefore, managing this issue requires systematic implementation at both the individual and organizational levels. Furthermore, promoting compassion satisfaction, a positive feeling derived from helping others. The implementation of these strategies is expected to reduce compassion fatigue, increase job satisfaction, enhance professional commitment, and support nurse retention, ultimately contributing to the long-term sustainability of the healthcare system.