Journal of Research in Nursing-Midwifery and Health Sciences

Factors Associated with Self-Management among Hemodialysis Patients and Research Instruments: An Integrative Review

2026-02-03T11:06:23+07:00

Abstract

Introduction: This integrative review aims to synthesize research on factors associated with self-management among patients undergoing hemodialysis. Relevant studies were searched from CINAHL Complete, PubMed, Wiley, ScienceDirect, Google Scholar, and Thai Journals Online (ThaiJO) published between 2018 and 2025. A total of nine full-text research articles were selected based on the Joanna Briggs Institute (JBI) criteria. Results: The findings indicate that factors with a low level of association with self-management among hemodialysis patients include knowledge about hemodialysis, anxiety, and access to healthcare services. Factors demonstrating moderate to high levels of association include knowledge of chronic kidney disease related to complication control and the effects of hemodialysis, social support, health literacy, psychological resilience, social capital, patient empowerment, self-efficacy, sense of coherence, family functioning, self-regulation, and depression. Conclusion: Factors with low levels of association should be further examined in studies exploring relationships with self-management among hemodialysis patients in different contexts or among newly initiated hemodialysis patients who may demonstrate different levels of self-management. Factors with moderate to high levels of association can be applied in predictive studies and intervention-based research to enhance self-management among patients undergoing hemodialysis. In addition, the Hemodialysis Self-Management Instrument is suitable for patients aged 18 years and older and can be applied across different theoretical frameworks.

Opportunities and Trends for Professional Nurse Entrepreneurs in the Digital Age

2025-12-19T10:51:40+07:00

Abstract

Introduction: The transition of the nursing profession toward the role of an entrepreneur represents a vital career path in the digital era and an aging society. Objective: This article aims to analyze the trends and opportunities for nurse entrepreneurs in Thailand, driven by several factors such as structural demographic shifts and digital technology. Specifically, Thailand's complete transition into an aged society has increased the demand for professional elderly care services. Meanwhile, technologies such as Artificial Intelligence (AI) and telemedicine have opened opportunities for nurses to establish diverse businesses. This article analyzes health and wellness market trends, highlighting the growth of businesses related to longevity and technology integration. Nurse entrepreneurs can operate in two primary categories: 1) Clinical-focused businesses, such as home healthcare services, and 2) Knowledge-based businesses, such as health consulting and the use of digital technology. Furthermore, it addresses the challenges faced by nurse entrepreneurs, including heavy workloads and complex legal frameworks. Results: Achieving success as a nurse entrepreneurship requires the integration of four core competencies: professional, organizational management, interpersonal, and personal competencies. Despite various challenges, it is essential for the Nursing Council and educational institutions to accelerate the modernization of legal regulations and curricula to foster an entrepreneurial spirit. Such support is a crucial element in enabling nurses to build sustainable businesses and contribute genuine value to society.

Contemplative Learning: Essential Skills and Applications in Nursing

2026-01-26T14:10:02+07:00

Introduction : This academic article aims to explain the concept and key components of contemplative learning, to present the essential skills required for this learning process, and to propose practical applications within the nursing profession. The content of the article is derived from a review and synthesis of relevant conceptual frameworks and empirical evidence. The synthesis indicates that contemplative learning comprises four major dimensions: the intrapersonal dimension, the interpersonal dimension, the contextual and pedagogy dimension, and the ethical-spiritual dimension. Learners are required to develop fundamental skills, including mindfulness, reflection, contemplative listening, generative dialogue, and compassion. These skills serve as essential tools for facilitating meaningful learning and can be applied to enhance nursing competencies in a balanced manner, integrating both professional knowledge and humanistic care. Conclusion : The integration of contemplative learning, grounded in the broader framework of contemplative education, into nursing education plays a significant role in the development of nursing students. Given that the nursing profession must address the complexity of healthcare systems and the vulnerability of human beings, this approach effectively supports the development of reflective thinking, emotional regulation, ethical decision-making, and compassionate care. Therefore, the application of contemplative education in Thai nursing education is not merely an addition of instructional methods, but rather the establishment of a comprehensive framework for professional development that responds to the needs of the profession and society. The ultimate goal is to cultivate nurses who possess professional expertise alongside a deep sense of humanity

Nutrition Support Programs for Patients with Advanced Cancer: An Integrative Review

2026-01-07T13:41:50+07:00

Introduction: This integrative review aims to synthesize existing conceptual frameworks and theories underpinning nutritional support programs, identify their key components, and evaluate the outcomes associated with these interventions for patients with advanced cancer. A comprehensive search was conducted across multiple electronic databases including PubMed, Cochrane, Medline, and ThaiJO, covering literature published between 2015 and 2024. The keywords used for searching included “palliative care” OR “palliative care for cancer patients” OR “end of life cancer patients” OR “cancer hospice care” OR “Advanced Cancer Palliative Care” AND “nutrition intervention” OR “nutrition intervention” OR “Dietary Support” OR “Nutrition Support Program” AND “improve nutrition status” OR “Optimized Nutritional Status,” as well as "chronic disease nutrition promotion". Following the application of inclusion criteria, a total of 10 pertinent articles were selected for assessment. Conclusions: The synthesis revealed that the formulation of nutritional promotion programs for patients with advanced cancer were grounded in two principal conceptual frameworks: 1) nutritional therapy in cancer patients, and 2) the family systems theory. The intervention characteristics indicate a multimodal approach categorized into three activities: 1) a nutritional counseling program combined with nutrition support, 2) a nutrition counselling program integrated with physical activity and/or symptom management and/or family involvement, and 3) digital platform-based nutritional promotion applications. The results of these programs demonstrated that the majority of the patients with advanced cancer exhibited enhancements in nutritional conditions, with positive outcomes observed over intervention approximately 6 weeks to 12 months.

Risk Factors of Peritonitis in Patients Receiving Peritoneal Dialysis, Vachira Phuket Hospital

2025-11-10T10:30:20+07:00

Objectives: To investigate the cumulative incidence, clinical characteristics, risk factors for peritonitis, and treatment outcomes of peritonitis in patients undergoing peritoneal dialysis. Method: A retrospective descriptive study was conducted on peritoneal dialysis patients at Vachira Phuket Hospital during the fiscal years 2021-2023. The data collection tools were examined for validity and reliability. Data were analyzed using chi-square statistics and point biserial correlation coefficient and for selecting the variables to be included in the prediction model using binary logistic regression. Results: The cumulative number of peritoneal dialysis patients during fiscal years 2021–2023 was 481. Peritonitis occurred in 191 patients (39.70%), with the number of infectious episodes ranging from 1 to 5, averaging 1.54 times per person. The factors associated with peritonitis were serum albumin levels, daily urine output, daily house cleaning, having pets in the house, handwashing, wearing masks, adherence to peritoneal dialysis procedures, and the location of dialysis fluid exchange. The analysis of predictive factors revealed that handwashing and wearing masks were significant factors in preventing peritonitis. (2021 Odds ratio (OR) = 0.073, 95%CI = 0.019, 0.284; 2022 OR = 0.061, 95%CI = 0.020, 0.183; 2023 OR = 0.046, 95%CI = 0.013, 0.155). The variables in the prediction model jointly explained 49.6% to 52.9% of the occurrence of peritonitis. The median treatment cost for peritonitis ranged from 17,619.27 to 43,660 baht. Conclusion: Peritonitis can be prevented by improving handwashing and wearing masks with close monitoring of adherence to dialysis procedures and home visits with the involvement of community networks to ensure correct practice. This approach will enhance patient safety and quality of life.

Factors Related to Resilience among Upper Secondary Students at a Rajaprajanugroh School in Thailand’s Three Southern Border Provinces

2025-02-11T13:40:23+07:00

Objectives: This study aimed to investigate (1) the overall and specific levels of life resilience, including the dimensions of “I Have,” “I Am,” and “I Can”; (2) perceived social support from family, school, and peers; (3) differences in resilience based on gender, grade level, and academic achievement; and (4) the relationship between perceived social support and resilience among upper secondary students at Rajaprajanugroh School in Thailand’s three southern border provinces. Methods: This study employed a quantitative, cross-sectional design with a descriptive correlational approach. The sample consisted of 104 upper secondary school students selected through two-stage sampling, including proportionate stratified sampling followed by simple random sampling. The research instrument was a questionnaire that demonstrated a very high level of content validity, and had an overall reliability coefficient of 0.95. Data were analyzed using descriptive statistics, t-test, One-way ANOVA, and Pearson’s correlation coefficient. Results: Students exhibited a high level of resilience, with the “I Am” dimension having the highest mean score, while the “I Can” dimension was at a moderate level. Family was reported as the highest source of perceived social support. No significant differences in resilience were found across personal demographic factors. A statistically non-significant moderate positive correlation was found between perceived social support and resilience Conclusion: Social support plays a vital role in promoting students’ resilience. The study’s findings can be used as a guideline for developing guidance or life skills activities that align with the context of the three southern border provinces.

Priority Needs and Approaches Toward Nursing Competency Development Among Registered Nurses Caring for Surgical Critical Cardiovascular and Thoracic Patients in Southern Thailand

2025-08-21T13:05:57+07:00

Abstract

Objective: This research aimed to explore the needs of nursing competency development among registered nurses caring for surgical critical patients in cardiovascular thoracic areas (CVT) in Southern Thailand and the development approaches. Methods: This descriptive research consisted of 127 samples of registered nurses who caring for CVT surgical critical patients from hospitals in Southern Thailand. The research instrument was a questionnaire divided into three parts: 1) personal information, 2) needs for competency development, and The questionnaire verified by 3 experts, presenting CVIs of 1.0 and 0.97, respectively. Part 1 had reliability values related to competency perception regarding actual performance and expectation, with Cronbach’s Alpha Coefficient of 0.99. Part 2 demonstrated a reliability value of Pearson Product Moment Correlation Coefficient at 0.87. Data were analyzed using mean, standard deviation, frequency, percentage, paired-samples t-test, and the Modified Priority Needs Index (PNImodified). Results: The overall competency perception related to actual performance presented a mean score at a high level. The overall competency perception regarding expectation revealed a mean score at the highest level, All mean scores of competency perception regarding expectation were significantly higher than these of the competency perception related to actual performance (p < .01). The first ranking of nursing competency needs was the quality improvement and research domain, the second ranking was the domain of assisting physicians conduct procedures and the third ranking was the medication management domain The most-preferred approaches of nursing competency development were learning from experienced colleagues and in-house training , respectively. Conclusion: Registered nurses caring for critically ill patients with CVT surgery in Southern Thailand revealed competency development in the domains of quality improvement and research, nursing care related to assisting physicians conduct procedures, and medication management. Most nurses preferred competency development through experiential learning and in-service training within their institutions.

Sociodemographic Factors Related to Physical Activity and Sedentary Behavior Among Pregnant Women with Overweight and Obese Before Pregnancy

2025-11-21T11:43:11+07:00

Abstract

Objectives: This study aimed to examine physical activity and sedentary behavior and the association between sociodemographic factors and both physical activity and sedentary behavior among pregnant women who were overweight or obese before pregnancy. Methods: A descriptive research design was conducted.
A total of 150 pregnant women who were overweight or obese before pregnancy were selected using purposive sampling based on demographic characteristics. Data were collected using three instruments: personal information questionnaires, pregnancy physical activity questionnaires, and sedentary behavior questionnaires between January and August 2021. Descriptive statistics were used to analyze the general characteristics, including frequency and percentage. The chi-square test was applied to analyze the relationships between sociodemographic factors and both physical activity and sedentary behavior. Results: The majority (90%) of pregnant women who were overweight or obese before pregnancy maintained adequate levels of physical activity, primarily through routine daily tasks and job-related activities. Furthermore, 81.3% of the participants reported high sedentary behavior, largely due to extended periods of sitting for work and computer use. The analysis identified significant associations between sedentary behavior and factors such as educational attainment, occupation, income sufficiency, and the number of pregnancies. No sociodemographic factors were significantly associated with physical activity. Conclusion: Pregnant women who are overweight or obese before pregnancy should be encouraged to increase physical activity and reduce sedentary behaviors to promote appropriate physical activity, particularly lesure-time or exercise-related activities, to enhance maternal health outcomes.

Factors Relates to Quality of Life among Patients with Chronic Obstructive Pulmonary Disease: A Literature Review

2025-07-18T13:44:32+07:00

Introduction: This literature review synthesized quality of life (QOL) factors and studied instruments used to measure QOL among patients with chronic obstructive pulmonary disease (COPD). Data was gathered from electronic databases, including Cumulative Index to Nursing and Allied Health Literature (CINAHL Plus) with full text, PubMed, ScienceDirect, Google Scholar, and Thai Journals Online (ThaiJO) between 2015 and 2025. Seven full research articles were selected that met Joanna Briggs Institute (JBI) inclusion criteria. The results indicated that the factors related to quality of life in COPD patient were categorized into eight domains, including: 1)functional ability; 2)medication adherence; 3)health status; 4)sociodemographics; 5)treatment and medication; 6)disease severity and comorbidities; 7)treatment history; and 8)duration of COPD. Conversely, four domains demonstrated QOL obstacles: 1)functional capacity and performance; 2)self-management and health behaviors; 3)symptom experience and feelings; and 4)disease severity and comorbidities. Conclusion: These findings indicated that factors strongly related to QOL comprised symptom burden and functional performance, which may be useful for predictive research. In contrast, insomnia, health literacy, social support, and insomnia management effectiveness had weaker, more ambiguous relationships. To investigate specific characteristics in study populations, the St. George Respiratory Questionnaire (SGRQ-C) offers versatile QOL assessment across diverse age groups, languages, and conceptual frameworks.

Nurses’ Technological Competency as Caring for Persons with End-Stage Renal Disease Receiving Hemodialysis in China and Related Factors

2025-04-08T14:06:45+07:00

Objective: This study examines the nurses’ practice of technological competency as caring persons with end-stage renal disease (ESRD) receiving hemodialysis and the relationship between nurses’ practice of technological competency as caring and related factors. The study was based on Locsin's Theory of Technological Competency as Caring in Nursing (TCCN). Methods: A descriptive correlational
cross-sectional design is used in this study to investigate hemodialysis nurses in Guizhou, China. WeChat and Questionnaire Star were used to collect data. The tools used in the study included the Practice of Technological Competency as Caring in Nursing Instrument (P-TCCNI), the Influence of Technology Questionnaire (ITQ), and a demographic data questionnaire. The content validity index (CVI) of P-TCCNI and ITQ was 1.00 and 0.94, respectively. The Cronbach’s alpha coefficient of P-TCCNI and ITQ was 0.8 for both, respectively. The data was collected in the tertiary hospitals in Guizhou province from October to December 2024. Altogether, 180 nurses were recruited for the study. Data was analyzed using SPSS 26 software. Results: The results showed that the total score of nurses’ practice of technological competency as caring in nursing was high (M = 89.42, SD = 14.92). A significant relationship was found between nurses’ practice of technological competency as caring in nursing and the influence of technology factor (r = 0.21, p = .003). There was no significant relationship between nurses’ practice of technological competency as caring for persons with ESRD receiving hemodialysis and nurses’ demographic factors (age, education level, total years of work experience, hemodialysis-specific work experience, specialized education and training, and workload). Conclusion: This study underscores the importance of influence of technology on nurses’ technological competency as caring for persons with ERSD receiving hemodialysis. Hospital institutions are encouraged to enhance nurses’ attitudes toward technologies in healthcare to increase the nurses’ technological competency in human caring.

Effects of Developing a Community Health Nursing and Primary Medical Care Course via the ThaiMOOC Platform on the Learning of 3rd and 4th Year Nursing Students

2026-01-26T13:43:28+07:00

Objective: This quasi-experimental study aimed to evaluate learning behaviors, comparative satisfaction, and pre- and post-test knowledge scores in a Community Health Nursing and Primary Medical Care course for 3^rd and 4^th year nursing students from network institutions through the ThaiMOOC platform. Kirkpatrick's Model was applied to evaluate learning outcomes among the participants. The sample included 203 3^rd and 4^thyear nursing students from 3 network nursing institutions during the 2024 academic year. Research instruments included 1) a personal information questionnaire, 2) knowledge tests, 3) a learning behavior questionnaire, and 4) a learning satisfaction questionnaire. The instruments were verified by experts. Data were analyzed using descriptive statistics and a paired t-test. The study found that 1) post-test knowledge scores were significantly higher than pre-test scores (p<.001); 2) overall learning behaviors of the nursing students were at the "highest frequency" level, with "practical application of knowledge" showing the highest mean (Mean = 4.39); 3) satisfaction with the content and design was at the "highest" level. The findings demonstrate that delivering the "Community Health Nursing and Primary Medical Care" course delivered via ThaiMOOC platform, while applying Kirkpatrick’s Model, effectively enhances nursing students' knowledge and learning behaviors. This model can be adapted to other subjects in the nursing curriculum to promote lifelong learning.

Prevalence and Factors Associated With Perineal Wound Infection in Postpartum Mothers After Vaginal Delivery: A Retrospective Analytical Study in a Secondary Hospital

2026-02-27T08:48:10+07:00

Objective: To determine the prevalence and identify risk factors associated with perineal wound infection in postpartum mothers following vaginal delivery. Methods: A retrospective analytical study was conducted using medical records of postpartum mothers who delivered vaginally at a secondary hospital between January 2021 and June 2024. Participants were selected using consecutive sampling. Data were analyzed using descriptive statistics, the Chi-square test or Fisher’s exact test, and multiple logistic regression, with statistical significance set at p < 0.05. Results: Among 294 postpartum mothers, the prevalence of perineal wound infection was 2.38% (95% CI: 0.96–4.84). Factors significantly associated with infection included third-degree perineal tear (Adjusted OR = 14.90; 95% CI: 1.44–154.20; p = 0.01), blood loss greater than 500 mL (Adjusted OR = 11.50; 95% CI: 2.31–57.30; p < 0.001), and suturing time ≥ 40 minutes (Adjusted OR = 9.20; 95% CI: 1.87–45.30; p = 0.02). Conclusion: Perineal wound infection after vaginal delivery has a low prevalence but remains a significant complication. The most strongly associated factor was third-degree perineal tear, followed by blood loss greater than 500 mL and prolonged suturing time. Therefore, close monitoring of high-risk mothers is recommended, along with improvements in clinical care to reduce blood loss and suturing time, thereby preventing infection.