Nursing Science Journal of Thailand

Breastfeeding Promoting Experiences of Nurses Infected with COVID-19

Sudaporn Payakkaraung — 2024-08-12

Purpose: To explore the breastfeeding promotion experiences during the COVID-19 pandemic in Thailand of nurses infected with Corona Virus 2019.

Design: A descriptive phenomenological study.

Methods: In-depth interviews were conducted with 20 nurses infected with COVID-19 and involved in breastfeeding promotion. Participants were selected using purposive and snowball sampling methods. Interviews were guided by a semi-structured format, tape-recorded, and transcribed verbatim. Data were analyzed using Colaizzi’s method of data analysis with thematic analysis to identify emergent themes.

Main findings: The study involved 20 nurses aged 29-59 with an average age of 42.80 (SD±8.23) years. Most participants (40%, n = 8) worked in a lactation clinic with work experience ranging from 5-38 years with an average of 19.55 years (SD±9.60). The major findings consist of 3 main themes and 8 sub-themes, of which 3 main themes are: 1) adjusting mindset and perspective in promoting breastfeeding, 2) changing the services approach, and 3) driving practical policies with experience, knowledge, and evidence.

Conclusion and recommendations: COVID-19-infected nurses acknowledged that promoting breastfeeding during the COVID-19 pandemic faced several challenges. Experience as COVID-19 patients encouraged them to adjust their attitude to provide better nursing care, develop a novel approach, and be a leader in driving practical policy with experience, knowledge, and evidence. Relevant stakeholders should focus on providing practical policies and developing an effective support system for promoting breastfeeding in pandemic situations.

Factors Influencing Gestational Hypertension and Preeclampsia of Parturients During the First Stage of Labor

Kamonrat Songnok — 2024-08-12

Purpose: To determine the predictive powers of age, pre-pregnancy BMI, anxiety during labor, and intimate partner violence on gestational hypertension and preeclampsia of parturients during the first stage of labor.

Design: Case-control study.

Methods: The sample consisted of 195 postpartum mothers who had normal and operative delivery for at least 24 hours from a tertiary hospital in Bangkok. Total participants were divided into 2 groups: the 65 cases were diagnosed with gestational hypertension and preeclampsia during the first stage of labor and the 130 controls had normal blood pressure during the first stage of labor. Data were collected by using the Personal Data Questionnaire, the Obstetric Records, the Anxiety during Labor Questionnaires, and the Abuse Assessment Screen, respectively. Data were analyzed by using descriptive statistics, chi-square tests, and multiple logistic regression analysis.

Main findings: The results indicated that age, pre-pregnancy BMI, anxiety during labor and intimate partner violence could significantly explain 36% (R²= .36) of the variance in gestational hypertension and preeclampsia among partutients during the first stage of labor and had a prediction accuracy of 76.9% (overall percentage = 76.9). The predictive factors included anxiety during labor (OR = 6.83, 95%CI = 3.10, 15.05), pre-pregnancy BMI which included obesity (OR = 5.73, 95%CI = 2.27, 14.46) and overweight (OR = 3.29, 95%CI = 1.39, 7.80), and intimate partner violence (OR = 2.92, 95%CI = 1.27, 6.70), respectively.

Conclusion and recommendations: Anxiety during labor, pre-pregnancy BMI, and intimate partner violence affected GHT and PE in the first stage of labor. Therefore, midwives should screen those risk factors and develop a care model for parturients to prevent GHT and PE during the first stage of labor.

Factors Influencing to Health – Related Quality of Life among Patients with Pulmonary Tuberculosis

Chataya Poomprasert — 2024-08-12

Purpose: This study aimed to investigate the predictability of duration of illness, treatment system, fatigue, and health behaviors on health-related quality of life among pulmonary tuberculosis patients.

Design: Predictive correlational study design.

Methods: The sample was 129 patients diagnosed with pulmonary tuberculosis and treated with anti-tuberculosis drugs who came for follow up at the Internal Medicine Department, outpatient building at a university hospital in Bangkok. Inclusion criteria included: being new cases, recurrent cases, or relapse cases who were not in the contagious stage and had improved conditions; having a good conscious; being able to communicate Thai; and having no cognitive impairment. Exclusion criteria included: being diagnosed with psychiatric problems and having COVID-19 infected. The instruments used in the study included; 1) The demographic data and illness history form 2) The Revised Piper Fatigue Scale (PFS-12), 3) The Health Behavior Questionnaire, and 4) The Short Form Health Survey 36 (SF-36). Data were analyzed using descriptive statistics and multiple regression analysis.

Main finding: The sample had a mean score of overall health-related quality of life of 63.43 (SD = 19.26) and 38% of them reported that their current health status was similar to that of the previous year. All independent variables could explain 34% of the variances in health-related quality of life among pulmonary tuberculosis patients (R²= .34). Fatigue was the strongest predictor of health-related quality of life followed by health behavior and duration of illness ( = - .48, p < .001, = .16, p < .05, = .15, p < .05), respectively.

Conclusion and recommendation: As fatigue, health behaviors, and duration of illness could predict health-related quality of life among patients with pulmonary tuberculosis, nurses should assess their health-related quality of life and it influencing factors and create programs for reducing fatigue and promoting health behaviors that are tailored to their duration of illness in order to increase the health-related quality of life of patients with pulmonary tuberculosis.

The Effect of Empowerment Program on Family Members' Caring Behaviors for Patients with Hypertension

Pianghathai Kingsangval — 2024-08-12

Purpose: To study the effects of a family member empowerment program on family members’ caring behaviors for patients with hypertension.

Design: Quasi-experimental.

Methods: The sample was consisted of 86 family members mainly responsible for the care of patients with hypertension living in communities, Bangkok, divided into experimental and control groups with 43 each. The experimental group received the empowerment program applied from Gibson’s empowerment concept, which contained the following activities: discovering the reality by exchanging experiences of care among caregivers, obtaining advices through handbook and short video clips about care for patients with hypertension, and receiving phone calls encouraging proper decision making and practices in care with respect to dietary intake, exercise, medication adherence, stress relief, and keeping appointments. Moreover, 6 short messages and 4 callings were offered to the experimental group for maintaining efficient practice. The control group received home visit and general health education. Caring behaviors were assessed before and 8 weeks after the program. Data were collected by using a demographic questionnaire, a questionnaire on family members’ perceived empowerment, and a questionnaire on caring behavior for patients with hypertension. Data were analyzed using independent t-test and paired t-test.

Main findings: After participating in the program, the experimental group had significantly higher mean scores of caring behaviors for patients with hypertension than the control group (t₍₈₄₎ = 10.75, p < .001). Compared to means scores of family members’ caring behaviors for patients with hypertension in the experimental group prior to the program, the scores after the program were significantly higher (t₍₄₂₎ = 10.28, p < .001).

Conclusion and recommendations: The empowerment program was effective in improving family members' caring behaviors for patients with hypertension. An empowerment program should be designed for both patients with hypertension and their family members. Moreover, the program should be adapted for family members in caring for patients with others chronic diseases.

Predictive Factors of Perceived Maternal Self-Efficacy in Preterm Infant Care Post- Discharge during the COVID-19 Pandemic

Podchanawan Yataw — 2024-08-12

Purpose: To investigate factors influencing mothers’ perceived self-efficacy in preterm infant care post-hospital discharge during the COVID-19 pandemic.

Design: Predictive correlational research.

Methods: The study sample include 121 mothers of preterm infants who were admitted and discharged from the semi-critical neonatal unit in three tertiary care hospitals in Bangkok, Thailand from June to December, 2022. The data were collected on the hospital discharge day and 2 weeks thereafter. On the discharge day, the following tools were used: 1) Maternal Health Literacy in Preterm Infant Care Questionnaire. 2) Maternal Participation in Hospitalized Infant Care Questionnaire, and 3) Maternal Readiness for Infant Discharge Questionnaire. At 2 weeks after discharge, the Mothers’ Perceived Self-efficacy in Preterm Infant Care Questionnaire was used. Descriptive statistics and multiple regression were used for data analysis.

Main findings: Maternal readiness for infant discharge remained the most predictive of mothers’ perceived self-efficacy in preterm infant care ( = .55, p < .001), followed by maternal health literacy in preterm infant care ( = .16, p = .047). These two variables collectively predicted mothers’ perceived self-efficacy in preterm infant care after hospital discharge by 39% (R² = .39, F_{(2, 118)} = 25.14, p < .001).

Conclusion and recommendations: In situations with limited neonatal unit visits, maternal readiness for infant discharge and maternal health literacy in preterm infant care can predict mothers’ perceived self-efficacy in preterm infant care after hospital discharge. Appropriate ways to promote maternal readiness for infant discharge and maternal health literacy in preterm infant care should be determined to make mothers aware of their own ability to take care of preterm infants at home after hospital discharge.

Effects of a Planned Behavior Program via Smartphone Applications on Asthma Care Behavior and Asthma Symptom Control in School-age Children with Asthma

Nattakan Karanyapassakul — 2024-08-12

Purpose: To study the effects of a planned behavior program via smartphone applications on asthma care behavior and asthma symptom control in school-age children with asthma.

Design: Quasi-experimental research.

Methods: The sample included 50 school-aged children from easy asthma clinics at 2 hospitals in Nakhon Pathom province. The participants were assigned into the control group (N = 25) and experimental group (N = 25) matched by age and level of asthma symptom control. In the 8-week program period, the control group received usual care, and the experimental group received a planned behavior program via smartphone applications, which employed Ajzen planned behavior theory. The instruments were asthma symptom control questionnaires and asthma care behavior questionnaires. Data were analyzed by independent t-test and a chi-square test.

Main findings: The results revealed that the experimental group had significantly higher scores of asthma care behavior than the control group. (t = 4.46, p < .001), and the experimental group had a significantly higher percentage of children with asthma symptom control levels than those in the control group. (² = 7.22, p < .05).

Conclusion and recommendations: It has been shown that a planned behavior program via smartphone applications can improve asthma care behaviors and levels of asthma symptoms control in school-aged children with asthma. Health care personnel should apply the program to promote asthma care behavior and symptom control among school-aged children with asthma.

Predicting Factors of Executive Function Problems in Preschool Aged Children

Lukkhanidtha Arunyakittiphoom — 2024-08-12

Purpose: The purpose of this study was to examine the predictive power of screen time, sleep duration, two types of parenting behavior (supportive parenting and hostile parenting) and household chaos on executive function problems in preschool aged children.

Design: A predictive correlational design.

Methods: The study sample consisted 186 pairs of parents or primary caregivers and their preschool-aged children (aged 3-5 years) who received services at 8 private nurseries located in Bangkok Metropolitan Region. Subjects were recruited through convenience sampling. Data were collected using a personal information questionnaire, a screen time questionnaire, a sleep duration questionnaire, a parenting questionnaire and a household chaos questionnaire, and the executive function problems questionnaire among preschoolers. The data were analyzed by using descriptive statistic, Pearson correlation and multiple linear regression.

Main findings: The findings indicated that household chaos significantly predicted executive function problems. ( = .23, p < .01). However, screen time, sleep duration and parenting including supportive parenting and hostile parenting did not predict executive function problems. (p > .05).

Conclusion and recommendations: Household Chaos was found to be significantly predictor of executive function problems. Therefore, pediatric and community nurses are encouraged to incorporate assessments of domestic chaos into their preschool home visit plans. Strategies to advise parents or primary caregivers on managing household chaos should be developed to mitigate the risk of executive function problems in preschoolers.

Factors Predicting Infection Prevention Behaviors among Caregivers of Children with Cancer Undergoing Chemotherapy

Thatchkorn Klaisuban — 2024-08-12

Purpose: The objective of this study was to assess the predictive power of health literacy, family support, and home environment on the infection prevention behaviors of caregivers of children with cancer undergoing chemotherapy.

Design: Predictive correlational research.

Methods: The study consisted of 80 caregivers of children with cancer, aged 1-15 years, all types of cancer at every state of treatment, who were followed up both inpatient and outpatient units at two tertiary hospitals in Bangkok. Convenience sampling was used to select the caregivers being the primary caregivers of the children while at home, aged 18-59 years, and able to communicate Thai language. Data were collected by using 5 questionnaires including 1) Demographic Data Questionnaire, 2) The Infection Prevention Behaviors Questionnaire, 3) The Health Literacy Questionnaire, 4) The Family Support Questionnaire, and 5) The Home Environment Questionnaire. The data were analyzed using descriptive statistics and stepwise multiple regression.

Main findings: The results revealed that overall prevention infection behaviors were high ( = 116, SD = 11.69). The mean score of health literacy ( = 91.95, SD = 7.02) family support ( = 66.18, SD = 9.08) and home environment ( = 14.04, SD = 1.36) were also high. Health literacy was the only factor that could predict infection preventive behaviors ( = 0.30, t = 2.77, p < .01).

Conclusion and recommendations: The caregivers' infection prevention behaviors were influenced by their level of health literacy. Consequently, it is imperative for nurses and healthcare professionals to thoroughly assess the health literacy of caregivers. Then provide support by implementing interventions designed to enhance health literacy in order to improve understanding and application of infection prevention knowledge. These interventions should provide additional channels to access to knowledge, including the preparation of fruits and vegetables, as well as oral assessment and oral hygiene to prevent infections in children with cancer undergoing chemotherapy.