Thai Journal of Cardio-Thoracic Nursing

Nursing care for pediatric patients with extravasation: a case study

2023-08-18T09:20:46+07:00

The most severe complication of peripheral intravenous in children was the fluid leakage from blood vessels into tissue injury or extravasation. Due to severe cases, it takes several months to heal or may be to the point of disability, affecting to quality of life of both pediatric patients and families. Nurses play important roles in caring during intravenous fluid therapy, including the ability to assess early warning signs as quickly as possible. Nursing care should be started before giving fluids, choosing the location of the blood vessel, selecting an equipment, type of fluid, and the duration fluid administration. The nurses should monitor every hour after fluid administration such as a site assessment when fluids or medications are running through the line, including assessing the initial symptoms and prevention of extravasation continuously. This article provides an example of a case study and nursing care for increasing the quality of nursing and safety of children treated with peripheral intravenous fluids

Nursing care for patients with non-ST segment elevation myocardial infarction (NSTEMI) to have the decision-making time to go to hospital

2023-06-05T01:33:13+07:00

Decision-making time is a time that is personally relevant and important for patients with non-ST segment elevation myocardial infarction (NSTEMI). Symptoms and signs of the NSTEMI are not clear. Most patients therefore wait to see symptoms and thus do not decide to receive treatment immediately after symptoms appear. If the patient decides to receive treatment late, it will cause the diagnosis and treatment to be delayed as well. This results in ischemia or permanent death of the heart muscle. This leads to cardiac shock and ultimately causes the patient's death. Nurses play an important role in encouraging patients to decide to seek treatment. Therefore, nurses must have the ability to assess factors affecting the decision to receive treatment and plan nursing care to provide appropriate information for each patient before returning home. As a result, the patients can decide to receive treatment at the right time to prevent complications and to reduce the chance of patient death. This article therefore aims to present knowledge to promote the decision to seek treatment immediately after symptoms appear in NSTEMI patients.

Development of an alternative food menu from vegetables for patients with diabetes mellitus

2023-06-04T23:34:15+07:00

This study aimed 1) to develop an alternative food menu from vegetables for patients with diabetes mellitus (D.M.) and 2) to examine the satisfaction level of alternative food menus from vegetables. The sample group used in the study was a total of 20 stakeholders, consisting of 10 patients with D.M., six family members caring for patients with D.M., three village health volunteers, and one nurse including 30 patients with D.M. Measurements used in the research included: 1) In-depth Interview, 2) discussion questions group for three focus groups, and 3) a patients’ satisfaction questionnaire. Data were analyzed using descriptive statistics and content analysis.

Developing vegetable alternative menus for diabetic patients was conducted with the participation of community stakeholders including situation analysis, problem-solving, planning, Implementation, and evaluation. Results indicated that the sample group lacked knowledge in choosing food to control sugar. They want a menu for diabetic patients that they could make by themselves. The alternative food menus with low calorie and low sugar were made responded to their needs such as the menu made from vegetables with good taste that family members can eat together in daily life. The ingredients used for cooking were generally available, inexpensive, and basically prepared by patients with D.M. or their families. Then, the developed menu that was cooked for the 30 diabetes patients to eat, and their satisfaction was in the high to the highest level.

This research suggests that nurses should recommend and advise patients and family caregivers to prepare alternative food menus from vegetable to control D.M. for patients and their family.

Development of an emergency response nursing model for pediatrics at Queen Sirikit National Institute of Child Health

2023-09-29T08:39:22+07:00

This study utilized a research and development framework to develop a model and evaluate the effectiveness of an emergency response nursing model for pediatrics at Queen Sirikit National Institute of Child Health. The sample included 625 control group and 628 experimental group pediatric patients, as well as 46 professional nurses. The model was developed using the 3P-PDSA method, which was divided into four phases. Phase 1: conducting a situation analysis and factors that affected the inappropriate emergency response of pediatric patients. The control group data were collected from the medical records of all patients admitted to the three wards. Phase 2: developing an assessment tool using Pediatric Early Warning Scores (PEWS). Nurses were on a 6-month job training period to familiarize themselves with the tools before applying them to patients. Phase 3: comparing results between the control and experimental groups. Phase 4: evaluating and adapting the model to each unit's specific situations and contexts.

The findings revealed that the emergency response nursing model comprised assessment tools such as an escalation guide, and communication guidelines for multidisciplinary teams. A comparison between previous nursing responses and emergency responses indicated: 1) a significant difference in unplanned admissions to the Pediatric Intensive Care Unit (PICU) (P< 0.05). 2) There is no statistically significant difference in the number of resuscitations and deaths among pediatric patients (p > 0.05), as determined by Fisher’s Exact Test. 3) Nurses in the experimental group expressed high to very high satisfaction levels with the emergency response assessment model.

This study suggested that this emergency response nursing model effectively enhances the emergency response for pediatric patients and should be applied in other healthcare settings to decrease the mortality rate.

The effect of self-efficacy promotion program in applying Qigong with phase 1 cardiac rehabilitation on anxiety among acute coronary syndrome patients undergoing percutaneous coronary intervention

2023-10-07T23:00:19+07:00

This quasi-experimental research aimed to study the effects of a self-efficacy promotion program for cardiac rehabilitation phase 1 with applied Qigong Effects on anxiety among acute coronary syndrome patients undergoing percutaneous coronary intervention. The sample consisted of patients diagnosed with acute myocardial infarction, 60 people were divided into a control group of 30 people and an experimental group of 30 people. The control group received normal care. The experimental group received a self-efficacy promotion program in applying Qigong together with cardiac rehabilitation phase 1. The research tool of data collection and intervention consisted of 1) a personal questionnaire 2) a self-efficacy scale in heart patients. 3) STAI Form Y-1, and 4) Self-Efficacy Promotion Program in applying Qigong with Phase I Cardiac Rehabilitation. Data were analyzed using descriptive statistics and t-test.

The study found that after two weeks of participating in the program, the mean scores of state anxiety in experimental group (mean=22.43, SD=4.43) were lower than the control group (mean=57.83, SD=9.42) (t=20.60, p<.001)

Suggestions for applying research, this program should be applied to acute coronary syndrome patients for the rehabilitation period. As a result, Qigong is a practice for the whole body and mindfulness, resulting in a peaceful mind and concentration leads to reduce anxiety and diminish the effects after myocardial ischemia.

Effects of a self-management support program on symptoms occurrence and health care utilization in patients with chronic obstructive pulmonary disease

2023-08-31T11:16:04+07:00

The purpose of this quasi-experiment research was to study the effect of a self-management support program on symptoms occurrence and health care utilization in patients with chronic obstructive pulmonary disease (COPD). The subjects were 60 patients with COPD who attended the outpatient clinic of Central Chest Institute of Thailand. They were purposive sampling and divided into an experiment and a comparison group equally (30 people per group). The experiment group received a self-management support program whereas the comparison group obtained the routine nursing care. The instruments for data collection were personal and illness-related questionnaires, symptoms assessment form, and health care utilization record form. Data were analyzed using descriptive statistics, Chi-square, Fisher’s exact, and Mc Nemar test.

Results revealed that after receiving the program, the experiment group had symptoms on sputum production, sputum color change, cough, wheeze, running nose, sore throat and fever as well as health care utilization significantly less than before and had significantly less wheeze and health care utilization than the comparison group.

The findings indicate an evidence that a self-management support program could reduce symptoms and health care utilization in patients with COPD. Therefore, it should be applied to nursing practice for caring patients with COPD.

Health behaviors and risk factors management of the non-pharmacological treatment among asthmatic patients in Health Region 4, Thailand

2023-08-30T08:42:01+07:00

This descriptive research aimed to examine health behaviors and risk factors management of the non-pharmacological treatment among asthmatic patients. The participants comprised 319 asthma patients, who were ≥ 18 years of age. They had come to be examined at the asthma clinic or outpatient department of 9 secondary care, 2 tertiary care and 1 super tertiary care in Health Region 4 in Thailand. The data were collected from August 2020 to October 2021. The research instruments were composed of 1) a demographic data form; 2) risk factors management and behavior affecting asthma control assessment and 3) the State-Trait Anxiety Inventory (STAI) form. The data were analyzed using descriptive statistics including frequency, percentage, mean and standard deviation.

The result revealed that health behaviors and risk factors management of the non-pharmacological treatment among asthmatic patients were at moderate levels (mean=146.20, SD=14.82). For each dimension, the environmental dimension means scores were at a high level (mean=46.63, SD=6.94). The emotional anxiety dimension means scores were at a low level (mean=31.14, SD=6.23). The eating dimension was at a moderate level (mean=14.62, SD=2.54). The exercise dimension was at a moderate level (mean=19.08, SD=7.17).

The result of this study can be used as basic information for developing an asthma care program that encourages asthmatic patients to manage risk factors and behavior modification in all 4 dimensions leads to success in asthma control.

Surveying of cardiovascular screening for football (soccer) players among Thai professional football (soccer) clubs

2023-10-07T23:07:39+07:00

This survey research aimed to investigate cardiovascular screening protocols for professional football players in the highest-level football clubs in Thailand. The sample group consisted of representatives from the highest-level professional football clubs in Thailand for the 2022/2023 season, totaling 16 clubs. The sample selection is purposive, and data was collected from May to June 2023 using an online questionnaire (Google Form). The questionnaire comprised questionnaires about general information, details of cardiovascular screening for each club, statistics on occurrences of sudden cardiac arrest in football players, and methods of prevention and management of such incidents.

Results indicated that the representatives from 14 professional football clubs provided data, resulting in a response rate of 87.5%. The research found that every club conducts cardiovascular screening for all their football players. The screening included medical history taking and physical examinations by physicians, as well as electrocardiograms were done for all clubs. However, only 64.3% of the clubs conduct echocardiograms, and 78.6% assess cardiac fitness tests. Most clubs use screening criteria from the Asian Football Confederation (AFC), with 35.72% of clubs using additional criteria from the International Football Association (FIFA).

This research suggests that it is essential to include cardiovascular screening for professional football players, comprising medical history taking, physical examinations, electrocardiograms, and cardiac fitness tests, at least once a year. In addition, in the group of football players aged 35 and older, there should be a risk assessment for cardiovascular diseases as well.