Nursing Science Journal of Thailand

Nurses’ Perceptions on the Use of Thai Version of the Critical-Care Pain Observation Tool-Neuro (Th-CPOT-Neuro) in Thai Neurosurgical Patients: A Qualitative Study

Khomapak Maneewat — 2026-06-08

Purpose: To explore neurosurgery nurses’ perceptions regarding the use of the Critical Care Pain Observation Tool Neuro Thai version (Th-CPOT-Neuro).

Design: A qualitative descriptive study.

Methods: A semi-structured interview approach was used with open-ended questions. Ten registered nurses who had been trained and had bedside experiences using the Th-CPOT-Neuro were recruited, and data saturation was achieved. The interviews lasted for 20-40 minutes. Qualitative content analysis was employed to analyze the data and derive meaningful findings.

Main findings: Nurses’ perceptions on the use of the Th-CPOT-Neuro, as derived from the data analysis, were categorized into three major themes and six sub-themes. The major themes consisted of: 1) acceptability, with two sub-themes — usability/high satisfaction and improper handling for exceptional conditions; 2) feasibility, with two sub-themes — efficient training and conditional restriction; and 3) clinical utility, with two sub-themes — worth implementing and lack of engagement. Some participants suggested revising the scoring system to enable accurate calculation of the total score when an individual domain is missing, thereby enhancing its validity. They emphasized the importance of implementing a comprehensive interdisciplinary training program for healthcare professionals to ensure accurate tool application. They agreed to adopt the Th-CPOT-Neuro into their daily practice instead of the standard CPOT to optimize pain assessment in neurosurgical patients.

Conclusions and recommendations: The Th-CPOT-Neuro containing a unique pain-related behavior is suitable, useful, and easy-to-use for the assessment of pain in neurosurgical patients both in intensive care unit and in other care settings. Its implementation into daily practice in the Thai hospital context with a comprehensive interdisciplinary training program could enhance an optimal pain assessment in neurosurgical patients.

The Effects of a Telehealth Program in Inguinal Hernia Patients Receiving One-Day Surgery on the Activity Daily Living, Complication, and Rehospitalization Rate

Sunanta Ditprasert — 2026-06-08

Purpose: This study aimed to examine the effects of a telehealth program on activities of daily living, postoperative complication, and rehospitalization rates among patients undergoing one-day inguinal hernia surgery.

Design: This study used experimental, two-group, pretest–posttest design.

Method: This study was conducted at a tertiary hospital in one province of Thailand. The study population comprised patients aged 18 years and older who underwent elective one-day inguinal hernia surgery in an operating room. A total of 52 participants who met the inclusion criteria were recruited using convenience sampling and randomly assigned into two groups using computer generated randomization: a control group receiving routine care (n = 26) and an intervention group receiving a telehealth care program, in addition to routine care (n = 26). Data collection instruments included: (1) a demographic questionnaire, (2) the Barthel Index for Activities of Daily Living to assess physical functioning, (3) a rehospitalization assessment form, and (4) a postoperative complication assessment form.

Main findings: The intervention group demonstrated a significantly higher mean score for activities of daily living compared with the control group. In addition, the incidence of postoperative complications was significantly lower in the intervention group than in the control group. However, no statistically significant difference was observed between two study groups in terms of rehospitalization rates.

Conclusion and recommendations: The telehealth program effectively improved postoperative functional recovery and reduced the incidence of complications among patients undergoing one-day inguinal hernia surgery. The telehealth program should be further developed for hospital use.

Factors Predicting Acute Kidney Injury among Patients with Sepsis at Emergency Department

Riyakorn Chalermsuk — 2026-06-08

Purpose: To examine the predictive power of health literacy, perceived severity of disease, family support, prehospital time, and the incidence of acute kidney injury among patients with sepsis in the emergency department.

Design: A cross-sectional predictive research design.

Methods: A total of 151 participants, both male and female, aged 18 years or older, and diagnosed with sepsis, were selected using convenience sampling from the Emergency Department of a tertiary hospital located in Bangkok. Data were collected using Mini-Cognitive Assessment Instrument, general information form, Acute Kidney Injury Assessment form, Health Literacy in Emergency Illness Scale, the Perceived Severity of Disease Scale, and the Chinese Family Support Scale. Data analysis was performed using descriptive statistics and logistic regression.

Main findings: Health literacy, perceived severity of disease, family support, and prehospital time jointly predicted acute kidney injury (AKI) in patients with sepsis by explaining 45% of its variance (Nagelkerke R² = .45). Participants with moderate and adequate health literacy had a reduced likelihood of developing AKI by 84% (OR = .16, 95%CI [.05, .52], p = .002) and 95% (OR = .05, 95%CI [.01, .17], p < .001), respectively. Participants with high perceived severity of disease had a 62% lower likelihood of developing AKI (OR = .38, 95%CI [.15, .99], p = .05). In contrast, participants with prehospital times exceeding 72 and 120 hours after symptom recognition had approximately fourfold increased odds of developing AKI (OR = 4.09, 95%CI [1.12, 14.88], p = .033 and OR = 3.92, 95%CI [1.27, 12.15], p = .02, respectively). Although family support was associated with AKI (c² = 10.07, p = .007), it did not predict AKI when the other study variables were controlled.

Conclusion and recommendations: Nurses and healthcare professionals should apply the findings of this study to the planning and delivery of care for patients with sepsis, focusing on the enhancement of health literacy, perceived severity of disease, and family involvement at the early stage of sepsis. Such interventions can promote timely healthcare-seeking behavior, reduce disease severity, and prevent the development of acute kidney injury.

Predictive Factors of Postoperative Complications in Prostate Cancer Surgery within 30 Days

Walailuk Khumkoon — 2026-06-08

Purpose: To determine the predictive power of comorbidities, frailty, and preoperative physical status on the postoperative complications in prostate cancer surgery within 30 days.

Design: Predictive correlational design.

Methods: The sample comprised of 152 patients with prostate cancer who underwent radical prostatectomy at a super tertiary hospital in Bangkok. Data were collected using personal and clinical case record form, the Charlson Comorbidity Index, the Thai version of the Edmonton Frailty Scale, the American Society of Anesthesiologists (ASA) physical status classification, and Clavien-Dindo Classification of Surgical Complications. Data were analyzed using descriptive statistics and binary logistic regression analysis.

Main findings: The participants’ mean age of the participants was 68.97 years (SD = 5.69). Postoperative complications within 30 days after radical prostatectomy was about 57.2%. The results demonstrated that all study factor could together explain 17.2% of the postoperative complications within 30 days after prostate cancer surgery, (Nagelkerke R² = .172). Patients with frailty had a 4.63-fold higher likelihood of developing postoperative complications compared with non-frail patients (OR = 4.63; 95%CI [1.73, 12.37], p = .02). In contrast, comorbidities and preoperative physical status did not significantly predict postoperative complications within 30 days after prostate cancer surgery (p > .05).

Conclusion and recommendations: Frailty could predict postoperative complications within 30 days after prostate cancer surgery. Therefore, healthcare providers should assess frailty during the preoperative period to plan appropriate interventions to prevent or mitigate the severity of postoperative complications.

Factors Influencing Quality of Life among Overweight and Obese Patients with Type 2 Diabetes

Rungrudee Khowijitphaisan — 2026-06-08

Purpose: To examine the influence of income, health literacy, access to healthcare services, residential environment, and family support on the quality of life of overweight and obese patients with type 2 diabetes.

Design: Cross-sectional predictive research design.

Methods: The sample consisted of 101 patients with type 2 diabetes who were overweight and/or obese and attending a diabetes clinic at a tertiary hospital in Eastern Region. The inclusion criteria were: aged 20 years and older, body mass index (BMI) ≥ 23 kg/m², diagnosis of type 2 diabetes for at least 3 months, and current treatment with oral hypoglycemic agents. The research tools included a personal information questionnaire, a health record form, the Short Versions of the European Health Literacy Survey (HLS-EU-Q16), a Health Service Access Questionnaire, the Neighborhood Scale, the Family APGAR Questionnaire, and the Modified Diabetes Quality of Life Questionnaire (MDQoL-17). Data were analyzed using descriptive statistics and stepwise multiple regression analysis.

Main findings: The participants had an average age of 54.24 years (SD = 9.04), and 54.5% were female. Among them, 86.1% reported good quality of life, 77.2% had sufficient health literacy, 91.1% had high access to healthcare services, 89.1% had abundant environmental resources in their residential areas, and 100% had good family support. Health literacy (β = .21, p < .05), access to healthcare services (β = .20, p < .05), and family support (β = .20, p < .05) were significant predictors of quality of life, explaining 15% of the variance (R² = .15).

Conclusion and recommendations: The results of this study support the Social Determinants of Health framework. Health literacy, access to services, and family support significantly predicted the quality of life of overweight and obese patients with type 2 diabetes. The findings suggest that nurses should implement nursing interventions to enhance health literacy and facilitate the accessibility of health services among this patient group. Family involvement in nursing intervention should also be encouraged.

Effect of Brief Motivational Interviewing Program on Contraceptive Implant Use among Adolescent Mothers

Simaporn Anusat — 2026-06-08

Purpose: This study aimed to examine the effects of a brief motivational interviewing program on the use of contraceptive implant among adolescent mothers.

Design: Quasi - experimental posttest-only design with two groups.

Methods: The participants consisted of 64 adolescent mothers aged 15-19 years who were admitted at a postpartum ward of a tertiary hospital in Bangkok. They were divided into two groups of 32 participants each. The control group received standard nursing care, while the experimental group received a brief motivational interviewing program in addition to standard care. Chi-squared test and Fisher’s exact test was used for statistical comparisons.

Main findings: Adolescent mothers in the experimental group used contraceptive implants before discharge (81.3%) significantly higher than that in the control group (40.6%) (χ² = 11.09, p < .05).

Conclusion and recommendations: A brief motivational interviewing session can help adolescent mothers recognize the consequences of repeat pregnancy and understand the importance of postpartum contraceptive implant use. To support the effective care of adolescent mothers, it is recommended that training sessions on motivational interviewing techniques be conducted for professional nurses to enhance their capacity in providing care for this population. Additionally, a counseling manual on contraceptive should be developed based on the principles of motivational interviewing.

Factors Predicting Preconception Health Behavior among Pregnant Women Working in Industrial Factories in Chonburi Province

Marisa Lappermsub — 2026-06-08

Purpose: To study the preconception health behavior among pregnant women working in industrial factories and its predicting factors.

Design: Predictive correlational research.

Methods: The sample consisted of 216 pregnant women working in industrial factories who attended antenatal care clinics in Queen Savang Vadhana Memorial Hospital and social security center, include the Laem Chabang, Sahapat, and Bo Win branches between February and July 2025. Participants were selected according to inclusion criteria. Data were collected using questionnaires and analyzed using descriptive statistics and hierarchical multiple regression

Main findings: The findings revealed that perceived benefits, perceived barriers, beliefs regarding preconception care, family support, and receipt of preconception care information combinedly explained 45% of the variance in preconception health behavior among pregnant women working in industrial factories (R² = .45, F(5, 210) = 34.31, p < .001). Among these factors, family support (β = .21, p = .002) and receipt of preconception care information (β = .57, p < .001) were found to be statistically significant predictors of preconception health behaviors.

Conclusion and recommendations: Family support and receipt of preconception care information were found to be predictors of preconception health behaviors among pregnant women working in industrial factories. Midwives can apply these findings as a guideline for developing programs that promote preconception health behaviors to achieve healthy pregnancies and improve pregnancy outcomes.

Factors Associated with Anxiety among Families of Patients in Intensive Care Unit, in Wenzhou, China

Qianqian Li — 2026-06-08

Purpose: This study aimed to assess anxiety levels in family members of ICU patients and determine the relationship between disease severity, social support, resilience and anxiety.

Design: Descriptive correlational research design.

Methods: A descriptive correlational study was conducted at the Second Affiliated Hospital of Wenzhou Medical University, China, involving 101 family members of patients admitted in the ICU for at least 24 hours with the following inclusion criteria: being a primary caregiver, aged over 18 years, not having a history of diagnosed mental disorders, and well literate in Mandarin. Data were collected using demographic questionnaire, Self-Rating Anxiety Scale, 14-item Resilience Scale, Social Support Rating Scale, and Acute Physiology and Chronic Health Evaluation II. Pearson product moment correlation was used to explore the relationships between anxiety and the independent variables.

Main findings: Half of family members (50.5%) exhibited mild to severe anxiety levels. Female participants exhibited significantly higher anxiety than male participants. The severity of disease was positively correlated with anxiety (r = .40, p < .001), while resilience (r = - .70, p < .001) and social support (r = - .62, p < .001) were negatively correlated with anxiety.

Conclusion and recommendations: Anxiety among family members of Intensive care unit patients were correlated with disease severity, social support, and resilience. These findings underscore the need for healthcare interventions that enhance resilience and social support to mitigate anxiety and improve the emotional well-being of ICU family members.