Nursing Science Journal of Thailand

Nursing Faculties’ Attitudes and Perceptions on Integrating Medical Cannabis Content into Undergraduate Nursing Curricula

Sirinapa Kongsak — 2026-02-23

Purpose: To explore attitudes and perceptions of an integration of the medical cannabis content into undergraduate nursing curricula from the perspectives of nursing faculties within a context of Thailand.

Design: A qualitative descriptive study.

Methods: Purposive sampling technique was used to recruit 15 participants working in a nursing faculty in Southern Thailand. The data was collected between February 2020 and August 2020 through individual in-depth interviews using a semi-structured interview guide. All interviews were tape recorded and transcribed verbatim for each participant. All participants identifiers were removed from the data. Data were analyzed using content analysis to determine key results from the transcription of the recorded interviews.

Main findings: The achievement of data saturation was achieved after interviewing 15 participants (14 female, 1 male). The ages ranged from 29 to 56 years with an average of 39.6 years. All participants reported lack of participation in education on medical cannabis as well as the preparation of nursing students in caring for patients using medical cannabis. Two main themes emerged from content analysis: professional ambivalence and conditional recommendations for integration. The theme professional ambivalence was divided into two sub-themes: perceived benefits and risks of medical cannabis and acknowledging the need for integration. The theme conditional recommendations for integration consisted of two sub-themes, including call to action for the proper integration and key elements of a successful integration.

Conclusion and recommendations: The nursing faculties held favorable views of integrating medical cannabis content into the nursing curricula regardless of their divergent attitudes, perceptions, and concerns toward medical cannabis. They perceived a dual role: first, educating students on the principles of safe, quality care for medical cannabis patients, and second, supervising them to develop clinical competency with this patient population. The comprehensive education and training of medical cannabis is therefore required to strengthen the nursing faculties’ competency to ensure their readiness in preparing nursing students and for patients that use medical cannabis.

Factors Predicting Severity of Postoperative Pulmonary Complications within the First 7 Days among Open-Heart Surgery Patients

Angwara Jintabunditwong — 2026-02-23

Purpose: To examine the predictors of severity of pulmonary complications within seven days after open-heart surgery, including hemoglobin levels, obstructive sleep apnea, atrial fibrillation, inotropic drug use, duration of intubation, and readiness for ventilator weaning.

Design: A cross-sectional study.

Methods: The participants were 148 open-heart surgery patients aged ≥ 18 years who were admitted to a university hospital in Bangkok, Thailand. Data were collected using the Thai version of a cognitive function assessment, a questionnaire and recording form on personal information, health status, illness, and treatment, scores for the use of inotropic and vasoactive drugs, and an assessment tool for the severity of complications. Multiple linear regression with the enter method was used to examine the predictors of the severity of pulmonary complications.

Main findings: The average age of the participants was 64.2 (SD = 10.99) years. The average severity of postoperative pulmonary complications was 17.20 (SD = 10.65) points. Significant predictors of the severity of postoperative pulmonary complications were obstructive sleep apnea (B = 9.60; 95%CI [.12, 19.08], p = .04) and duration of intubation (B = .12; 95%CI [.06, .17], p < .001). Hemoglobin level, atrial fibrillation, readiness for ventilator weaning, and the amount of inotropic drugs use were not significant predictors.

Conclusion and recommendations: Healthcare providers should assess risk factors of severity of postoperative pulmonary complications, particularly those with a history of obstructive sleep apnea and prolonged intubation. In addition, development guidelines for assessing the severity of postoperative pulmonary complications are crucial for effectively preventing these complications.

Factors Predicting Fear of Activity in Patients with Coronary Artery Disease after Percutaneous Coronary Intervention

Netnapa Srimora — 2026-02-23

Purpose: To determine the factors predicting fear of activity in patients with coronary artery disease after percutaneous coronary intervention.

Design: A cross-sectional research design.

Methods: The sample consisted of 108 patients with coronary artery disease after percutaneous coronary intervention who received follow-up care at the outpatient department of a super tertiary hospital. Data were collected using a personal data questionnaire, Tampa Scale for Kinesiophobia Heart, Frail Scale Questionnaire, Brief-Illness Perception Questionnaire, Family Support Questionnaire, and Neighborhood Scales. Data were analyzed by using descriptive statistics and multiple linear regression.

Main findings: All study factors could together explain 57.3% (R² = .573) of the variance in the fear of activity in patients with coronary artery disease who had undergone percutaneous coronary intervention. The significant predictors of fear of activity were family support (β = .41, p < .001), illness perception (β = .27, p = .007), frailty (β = .24, p = .001), and neighborhood (β = - .19, p = .048).

Conclusion and recommendations: Nurses should develop guidelines for managing fear of activity among patients with coronary artery disease after percutaneous coronary intervention, reduce frailty, provide education to reduce threatening illness perceptions, promote the appropriate involvement of family members in care, and foster a safe environment that facilitates activity.

Factors Influencing Quality of Life in Patients with Permanent Cardiac Pacemakers

Porta Rattanapant — 2026-02-23

Purpose: This study aimed to examine the predictive power of health literacy, self-monitoring, family support, and patient-healthcare provider communication on the quality of life in patients with permanent cardiac pacemakers.

Design: A cross-sectional research design.

Methods: The sample included 130 patients with permanent cardiac pacemaker who were followed up at an adult cardiac device clinic of a super tertiary hospital in Bangkok. Data were collected using a set of questionnaires including personal information, quality of life, health literacy, self-monitoring, family support, and patient-healthcare provider communication. Data were analyzed using descriptive statistics and multiple regression statistics.

Main findings: The results revealed that 59.2% of the respondents were female, with a mean age of 71.15 years (SD = 13.42). Overall, the quality of life had a good level. Health literacy, self-monitoring, family support, and patient-healthcare provider communication were able to jointly explain 32% of the variances in quality of life of patients with permanent cardiac pacemaker (R² = .32). Family support, and patient-healthcare provider communication could significantly predict the quality of life in patients with permanent cardiac pacemaker (β = .17, p < .05; and β = .34, p < .05, respectively).

Conclusion and recommendations: Family support and patient-healthcare provider communication can predict quality of life in patients with permanent cardiac pacemakers. In care for these patients, family involvement should be promoted, and healthcare professionals should focus on communication with patients and their families by emphasizing two-way communication, setting shared care goals, and providing options for actions.

Factors Predicting Activities of Daily Living among Sepsis Survivors after Hospital Discharge

Ekarin Piwnuan — 2026-02-23

Purpose: To study the power of prediction of cognition, sepsis severity, length of stay and nutrition status on the activities of daily living (ADL) among sepsis survivors after hospital discharge.

Design: A cross-sectional study with predictive correlational design was employed.

Methods: A simple random sampling was performed to recruit 106 sepsis survivors post hospital discharge after 2 weeks including both males and females aged ≥18 years. Instruments used for data collection included demographic questionnaires, medical history records, the Barthel Index - Thai version, Nutrition Triage 2013, and the Thai Mental State Examination. Multiple regression was used for data analysis.

Main findings: Cognition, sepsis severity, length of stay and nutrition status could significantly predict ADL two weeks post-discharge; and cognition emerged as the strongest predictor (β = .42, p < .001). All study factors could together explain 76% of the variance in ADL outcomes among sepsis survivors (R² = .76).

Conclusion and recommendations: Cognition, sepsis severity, length of hospital stay, and nutritional status were significantly predict ADL in sepsis survivors at two weeks post-discharge. These findings support the implementation of systematic two-week follow-up protocols for sepsis survivors following hospital discharge. The results provide foundational evidence for developing longitudinal intervention programs aimed at enhancing ADL recovery among sepsis survivors in future research endeavors.

Predictive Factors of Postpartum Depression in First-time Mothers

Pipattra Thammajarun — 2026-02-23

Purpose: To determine the predictive powers of age, income, type of delivery, COVID-19 disease, stress, intimate partner violence, and social support on postpartum depression in first-time mothers.

Design: Predictive correlational design.

Methods: The sample consisted of 227 first-time mothers at 4-6 weeks post-partum, recruited from the family planning clinic at a tertiary hospital in Bangkok. Data were collected by using the Personal Information Questionnaire, the Thai Perceived Stress Scale, the Abuse Assessment Screen, and the Multidimensional Scale of Perceived Social Support, respectively. Data were analyzed by using descriptive statistics, Pearson’s and point biserial correlation coefficients, and multiple linear regression analysis.

Main findings: All factors accounted for 88% of the variance in postpartum depression (R² = .88). Significant predictors of postpartum depression among first-time mothers included age (β = .49, p < .001), stress (β = .28, p < .001), COVID-19 diagnosis during pregnancy (β = .14, p < .001), type of delivery (β = .09, p < .001), and social support (β = - .07, p < .05).

Conclusion and recommendations: The findings of this study can inform screening and risk assessment for postpartum depression in first-time mothers, and support mental health care planning by midwives.

Factors Predicting Self-Management Behavior among Patients with Uncontrolled Type 2 Diabetes Mellitus in Wenzhou, China

Mengyao Xiang — 2026-02-23

Purpose: Effective self-management behavior is essential for improving glycemic control and preventing complications in patients with type 2 diabetes mellitus (T2DM). This study aimed to identify key predictors influencing the self-management behavior of patients with uncontrolled T2DM in Wenzhou, China.

Design: A predictive correlational design was used in this study.

Methods: A simple random sampling method was used to enroll 102 patients with T2DM from the First Affiliated Hospital of Wenzhou Medical University, Zhejiang Province, China. The study instruments included the Chinese version of the Diabetes Self-Management Questionnaire, the T2DM Knowledge Questionnaire, the Chinese Self-Efficacy for Diabetes Scale, and the Social Support Rating Scale. Data were analyzed using descriptive statistics, Pearson product moment correlation, and multivariate linear regression analysis.

Main findings: The self-management behavior scores of patients ranged from 10 to 42 ( = 27.34 ± 6.69). The average scores for T2DM knowledge, self-efficacy, and social support were 21.76 ± 6.28, 106.75 ± 26.96, and 32.27 ± 5.78, respectively. Multivariate analysis revealed that self-efficacy was the only significant predictor of self-management behaviors among patients with type 2 diabetes mellitus (β = .62, p < .001). The model explained approximately 51% of the variance in self-management behaviors (R² = .51), and the overall regression model was statistically significant.

Conclusions and recommendations: Self-efficacy was a strong predictor of self-management behavior among patients with uncontrolled T2DM in Wenzhou. Nursing intervention focusing on self-efficacy enhancement with the integration of diabetes knowledge and social support may effectively strengthen self-management behaviors and improve patient outcomes.

Factors Associated with Depressive and Anxiety Symptoms among Middle Adolescents Two Years after the COVID-19 Outbreak in the Bangkok Metropolitan Region

Orawan Chantharat — 2026-02-23

Purpose: This study aimed to explore the prevalence of depressive and anxiety symptoms and to examine the associations between sex, awareness of COVID-19 infection, family income, family relationships, adverse life events, and internet addiction with moderate to severe levels of depressive and anxiety symptoms among middle adolescents two years after the COVID-19 outbreak.

Design: A cross-sectional descriptive study.

Methods: This study employed a cross-sectional design involving adolescents aged 15-18 residing in Bangkok and its surrounding metropolitan area. A total of 439 adolescents were included in this study. Data were collected from November 2021 to February 2022, using online questionnaires. Univariable and multivariable logistic regression analyses were conducted to examine associations between study variables and moderate to severe depressive and anxiety symptoms.

Main findings: The prevalence of depressive symptoms was 55.1% and anxiety symptoms were 65.2% among middle adolescents during the past two years of the COVID-19 outbreak. These conditions may overlap, as some adolescents experienced both depressive and anxiety symptoms. The multivariable logistic regression models explained 21% of the variance in moderate to severe depressive symptoms and 31% of the variance in moderate to severe anxiety symptoms. Family relationships were significantly associated with lower odds of depressive and anxiety symptoms. In contrast, middle adolescents who experienced adverse life events had approximately twofold higher odds, while those with internet addiction had approximately fourfold higher odds of moderate to severe depressive and anxiety symptoms after controlling for the other variables.

Conclusion and recommendations: This study identified protective factors and risk factors associated with moderate to severe levels of depressive and anxiety symptoms in a crisis. School nurses and health care providers should screen and tailor intervention management to prevent the occurrence of depressive and anxiety symptoms among middle adolescents in crisis.