Journal of Research in Nursing-Midwifery and Health Sciences

Maternal Obesity: Health Impacts and Care

Nopparat Tharana — 2026-08-20

Introduction: Obesity represents a significant public health issue, with a consistently rising prevalence among women globally. In the United States, around 40% of women are identified as obese, with almost 10% considered severely obese, underscoring the scale of this problem and its significant effects on women’s health throughout all phases of the childbearing cycle, including pregnancy, labor, and postpartum recovery. As a result, obesity is a major worldwide health issue, impacting maternal and neonatal results.Obesity negatively impacts women’s health. Pregnant women with obesity face a higher likelihood of experiencing several pregnancy related complications, including gestational hypertension, urinary tract infections, gestational diabetes mellitus, and preterm birth. Obesity during labor is linked to an elevated risk of labor dystocia and surgical procedures, leading to higher cesarean section rates. These elements lead to an increased risk of complications during and after delivery, such as postpartum hemorrhage, infections at the surgical site, and slow wound healing. Moreover, maternal obesity has been demonstrated to adversely impact lactogenesis and milk production, thus creating difficulties for effective breastfeeding. Conclusions: This article aims to review and synthesize the impacts of obesity on women during pregnancy, labor, and the postpartum period. It also proposes comprehensive care guidelines to effectively promote maternal and infant health, including the effects on breastfeeding. Emphasis is placed on essential care, which includes assessing nutritional status and body mass index (BMI) before pregnancy, controlling weight gain during pregnancy, closely monitoring obstetric complications, providing appropriate care during labor, as well as providing continuous monitoring and counseling in the postpartum period. These measures aim to increase breastfeeding success in mothers with obesity.

Effects of a Capacity Building Program for Village Health Volunteers on Diabetes and Hypertension Risk Groups in a Semi-Urban Context

Srisuda Lundputh — 2026-06-12

Objective: To examine the effects of a capacity-building program for village health volunteers (VHVs) on diabetes mellitus and hypertension prevention among at-risk populations in a semi-urban context. Methods: This quasi-experimental study employed a one-group pretest–posttest design and was conducted in two phases: (1) program development based on a literature review and community contextual data from 207 VHVs, and (2) program evaluation among 47 pairs of VHVs and at-risk populations. The intervention consisted of 10 sessions implemented over a three-month period using a hybrid approach combining onsite and online activities. Research instruments included questionnaires assessing VHV knowledge, perceived benefits, and perceived self-efficacy regarding diabetes mellitus and hypertension prevention for at-risk populations. The stress test questionnaire and measurements of blood pressure and blood glucose levels. Data were analyzed using descriptive statistics, paired t-tests, and Wilcoxon signed-rank tests. Results: After participation in the program, VHVs demonstrated significantly increased scores in knowledge, perceived benefits, and perceived self-efficacy regarding diabetes mellitus and hypertension prevention (p < .001). At-risk populations showed significantly improved preventive health behavior scores (p < .001). Significant reductions were also found in systolic blood pressure, diastolic blood pressure, and blood glucose levels (p < .05), whereas stress levels showed no substantial change. Conclusion: The VHVs capacity-building program effectively enhanced competencies in non-communicable disease prevention and promoted health behavior modification among at-risk populations. The findings support the appropriateness of applying a hybrid learning approach within primary health care services in semi-urban community settings.

Development Outcomes of a Pregnancy Prevention Model for Adolescent Students in Educational Opportunity Expansion Schools through Networking Participation in Rayong Province

Raengchai Suksila — 2026-06-19

Objective: This study aimed to develop and evaluate a model for preventing pregnancy among primary school female students at educational opportunity expansion schools through the participation of network partners. Method: This operatory action research was conducted in three phases: 1) phenomenon exploration and planning 2) action and reflection, and 3) evaluation. In phases 1–2, the respondents consisted of 25 participants, including representatives from educational institutions, public health services, local administrative organizations, and the provincial office of social development and human security. Phase 3 involved 78 female students in grades 7–9. The data collection tools included 1) a pregnancy prevention program, 2) a health literacy questionnaire, 3) in-depth interviews, and 4) focus group discussions. Quantitative data analysis using descriptive statistics, paired t-test and t-test, and qualitative data analysis using content analysis. Results: Phase 1 revealed that the obstacles to preventing teenage pregnancy include unfriendly services, stigmatizing social norms, lack of sexual education and life skills, limited opportunities for continuing education, and insufficient collaboration among stakeholders. In addition, the program was developed using strategies based on the health literacy framework, comprising knowledge training, media literacy and communication skills, self‑health management, and access to services through media. Phase 2 revealed that network partners carried out their assigned roles while refining the accuracy and appropriateness of the program, ensuring its relevance and feasibility for practical application. Phase 3 showed that the mean scores of health literacy differed significantly at the .05 level both within and between groups. After receiving the program, the experimental group demonstrated higher average scores than the control group. Conclusion: The development of a pregnancy prevention model for adolescents through the participation of network partners effectively enhanced the health literacy of female students.

Attitude and Efficiency of Handwashing Among the Second Year Nursing Students towards Learning Management with a Smart Hand Hygiene Detector

Saengtip Leelakarn — 2026-06-25

Objective: To examine the attitudes and efficiency of hand washing among the second-year nursing students towards learning management with a smart hand hygiene detector. Methods: This study was descriptive research. The sample consisted of 103 second-year nursing students selected using purposive sampling based on inclusion criteria and willingness to participate in the study. Data were collected using: 1) a general information questionnaire, 2) a handwashing attitude scale, and 3) a handwashing effectiveness assessment scale. The data were analyzed using descriptive statistics. Results: The attitude towards hand washing among 68.93% of participants was at a very good level, and 31.07% of participants were at a good level. Regarding the effectiveness of hand washing towards learning management with the smart hand hygiene detector, 75.73% of the participants performed effective hand washing (passed the evaluation), while 24.27% performed hand washing ineffectively (failed the evaluation). The back of hands was the most ignored area. Conclusion: Learning management with a smart hand hygiene detector improved attitudes and practices regarding hand washing among nursing students. Nevertheless, ineffective hand washing was still observed in a segment of the participants. Therefore, searching for the causes to develop teaching methods is necessary, as well as finding factors or ways to make the handwashing of nursing students more effective.

Lived Experiences of ICU Nurses in Caring for Patients Who are Dying with COVID-19: Aesthetic Expression

Borwarnluck Thongthawee — 2026-06-26

Objectives: To explain the meaning of ICU nurses’ experiences in caring for end-stage COVID-19 patients through aesthetic expression. Methods: This study is a qualitative research employing a hermeneutic phenomenological approach. The participants were ten registered nurses working in ICUs of advanced tertiary hospitals under the Bangkok Metropolitan Administration, who were on duty during the COVID-19 outbreak in 2019. Data were collected through drawings and in-depth individual interviews using semi-structured interview guides from June 2024 to December 2024. Pictures and interview transcriptions were analyzed based on Waraporn Kongsuwan’s Aesthetic Nursing Theory. Trustworthiness of the study was established following Lincoln and Guba’s criteria. Results: The study found that participants described the meaning of ICU nurses’ experiences in caring for end-stage COVID-19 patients in four thematic categories: (1) “forced to grow up” – being unprepared but having to carry on, (2) caring for hope, (3) A noble profession and (4) joy in the last breath. Conclusion: The findings provide insight into the meaning of ICU nurses’ experiences in caring for end-stage COVID-19 patients. This understanding can serve as foundational information for improving care for COVID-19 patients and for developing nurses’ professional competence in all dimensions. Moreover, healthcare organizations should assess the physical and psychological impacts on nurses in order to promote their well-being in constrained and high-pressure contexts, thereby ensuring the continued delivery of high-quality nursing care.

Effects of a Care Support and Education Program on Self-Care Behaviors of Adolescents with Thalassemia at a hospital in Nakhon Phanom Province

Wassamon paprom — 2026-07-03

Objective: This research study aimed to investigate the effects of a care support and education program on self-care behaviors of adolescents with thalassemia. Methods: The participants consisted of 50 adolescents with thalassemia, selected by a purposive sampling method. They were divided into a control group and an experimental group (25 people per group). The experimental group received the care support and education program, which consisted of the following activities: 1) health education delivered via the LINE application and the health education guide, entitled “When I Have Thalassemia”
2) promotion of self-care behaviors through demonstrate and return demonstrations on selecting appropriate foods and 3) Providing follow-up inquiries and encouragement through telephone conversations and text messages via the LINE application. The control group received usual care. Data were collected using a self-care behavior questionnaire for adolescents with thalassemia, developed based on Orem’s Self-Care Deficit Nursing Theory (CVI = 0.90, α = 0.87), analyzed using independent t–test and paired t-test at significant level .05. Results: After participating in the program, adolescents with thalassemia in the experimental group had significantly higher mean self-care behaviors than at baseline (p < .001). 2) Adolescents with thalassemia in the experimental group had significantly higher mean self-care behaviors scores than those in the control group (p < .001). Conclusion: This care support and education program can serve as a guideline for promoting self-care among adolescents with thalassemia, enabling them to care for themselves more effectively.

Problems and Preparation Needs of Nursing Students Prior to Clinical Practicum in Caring for Critically Ill Medical Patients

Sayamon Noosen — 2026-07-11

Objective: To explore the problems and preparation needs of nursing students prior to their clinical practicum in caring for critically ill adult and older adult patients with medical conditions. Methods: A qualitative descriptive research approach was used. Data were collected from 14 nursing students from the Faculty of Nursing, Prince of Songkla University, Hat Yai Campus, who met the selection criteria. The participants were in their 3th or 4th year for the academic year 2024 who had experience in a clinical practicum caring for critically ill medical patients. Data were collected through focus group discussions, consisting of 4–5 participants in each group, conducted in November 2025, and content analysis following Krippendorff's approach was applied. The trustworthiness of the qualitative study was established based on the criteria of Lincoln and Guba. Findings: Problems and obstacles in preparedness included four main points: 1) Learning materials were uninteresting and difficult to understand, 2) Self-practice equipment differed from the materials and was insufficient, 3) There was limited time for preparation, and 4) Anxiety and lack of confidence in their abilities. Needs regarding the form of preparedness included four main points: 1) Need to be given a summary of essential knowledge for review, 2) Need to have accessible animated learning materials, 3) Need to practice in simulated situations, and 4) Need to learn from the experiences of friends or seniors. Conclusion: The study findings indicate that nursing students encounter challenges in preparing for clinical practice, including knowledge resources, training equipment, and psychological readiness, all within a limited time span. The obtained data can be used as a guideline for developing e-learning platforms and learning models that meet students' needs and effectively support preparation for clinical practicum in adult and gerontological nursing care of critically ill medical patients.

Development of Purpose in Life Enhancement Program for Holistic Health among Village Health Volunteers

Nawaporn wongsuwan — 2026-07-17

Objectives: To develop a purpose in life enhancement program to holistic health among village health volunteers. Methods: The program development process consisted of two phases: (1) development of program’s component, and (2) feasibility testing. Results: The developed program, entitled “Purpose in Life Enhancement Program for Holistic Health among Village Health Volunteers,” comprised two components: (1) a PIL enhancement program, and (2) a LINE Official Account “Purpose in Life.” The program included three stages: preparation, implementation, and evaluation. The implementation stage involved two main activities: (1) identifying what matters in life and practicing gratitude, and (2) designing a life path and consistent and committed practice based on the principles of altruism and the Sufficiency Economy Philosophy. The evaluation stage was conducted on the tenth week after seven sessions of implementing. Content validity was assessed by three experts indicated that the program components and procedures were appropriate, with an index of item-objective congruence (IOC) of 1.00. A feasibility test with 10 village health volunteers showed that the program was highly understandable and applicable in daily life. However, participants suggested reducing the frequency of daily gratitude journaling to enhance practicality. Conclusion: The developed program is appropriate and application for village health volunteers. Future studies should evaluate its effectiveness with a larger sample.

Effect of a Blended Learning Program on Healthcare-Associated Infection Diagnostic Efficiency Among Infection Control Ward Nurses

Wipaporn Srisontorn — 2026-07-17

Objective: To compare the healthcare-associated infection (HAI) diagnostic efficiency of infection control ward nurses in an experimental group before and after participating in a blended learning program, and between groups. Methods: A quasi-experimental two-group pretest-posttest design was employed. Participants were infection control ward nurses equally allocated to an experimental group and a control group (n = 25 per group). The research instruments comprised: 1) a four week blended learning program for HAI diagnosis, and 2) a diagnostic record form based on simulated clinical scenarios. The content validity was established through review by six experts. The diagnostic record form yielded an interrater reliability with Cohen's kappa = 1.00 when evaluated among infection control nurses. Data were analyzed using descriptive statistics. Within-group differences in HAI diagnostic performance were examined using paired samples t-test and the Wilcoxon signed-rank test, while between-group comparisons were conducted using the independent samples t-test and the Mann–Whitney U test. Results: Following program completion,the experimental group showed statistically significant increases in HAI diagnostic accuracy from 58.00% to 82.25% (p < .001), sensitivity from 53.71% to 80.57% (p < .001), specificity from 88.00% to 94.00% (p = .180), and positive predictive value from 96.91% to 98.89% (p = .093). The experimental group’s outcomes following program completion were significantly superior to those of the control group (p < .001). Conclusion: The findings indicate that the blended learning program can be applied to enhance knowledge and improve HAI diagnostic efficiency among infection control ward nurses in similar healthcare settings.

Development and Preliminary Feasibility Evaluation of a Health Chatbot to Enhance Maternal Behaviors for Developmental Promotion in High-risk Infants: A Pilot Study

Chamaipon nakpangpis — 2026-08-05

Objective: This study aimed to develop and conduct a preliminary feasibility evaluation of a health chatbot designed to enhance maternal behaviors in promoting high-risk infant development. Methods: This developmental research consisted of two phases. Phase 1 involved chatbot development, including content development, conceptual framework and conversational flow design based on Bandura's Social Cognitive Theory, system and interaction design, multimedia development, and content validation by experts. Phase 2 was a pilot study to evaluate the chatbot's preliminary feasibility. Five mothers of at-risk infants used the chatbot for 7 days. Feasibility was assessed in three domains: system functionality, user engagement, and preliminary outcomes. Maternal behaviors for promoting at-risk infant development were assessed using the Maternal Behavior for Promoting At-Risk Infant Development Questionnaire (CVI = .86, α = .97), and infant development was evaluated at 2 months of age using a standardized developmental assessment. Results: The developed chatbot delivered health information and guidance through text, infographics, and videos, based on social cognitive theory to enhance maternal self-efficacy. System testing demonstrated that the chatbot functioned as intended with satisfactory stability. In the pilot phase, all participants completed the 7-day program, although one participant reported unstable internet connectivity. Following the intervention, all mothers demonstrated engagement in developmental promotion behaviors across all five domains at least three days per week. Regarding preliminary developmental outcomes, three infants achieved age-appropriate development in all five domains, while the remaining infants achieved age-appropriate development in four and three domains, respectively. Conclusion: The development and preliminary feasibility evaluation demonstrated that the health chatbot was feasible for use in promoting maternal behaviors that support the development of at-risk infants. The chatbot showed satisfactory system functionality, user engagement, and promising preliminary outcomes. However, further research with larger sample sizes is needed to confirm feasibility and evaluate the long-term effectiveness of the chatbot.

Effects of Thai MOOC-Based Adult Nursing Course Delivery on Knowledge and Learning Satisfaction for Nursing Students Across Network Institutions

Malee Kumkong — 2026-08-13

Objectives: To investigate the effects of Thai MOOC-based learning in an Adult Nursing course on knowledge and satisfaction among nursing students from the Nursing Education Network. Methods:A quasi-experimental study was conducted among 178 third-year nursing students from three nursing institutions. The research instruments consisted of: (1) a learning management plan and online learning modules for the Adult Nursing course on the Thai MOOC platform (IOC = 0.67–1.00); (2) a knowledge test (CVI = .83; KR-20 (Pre-test) = .79 และ KR-20 (Post-test) = .81); and (3) a satisfaction questionnaire (CVI = .87, α = .87). Results: 1. Most participants were female (97.19%) aged between 20 and 22 years, with a mean age of 20.47 years (SD = .57), and preferred to study in the late morning (9:01 a.m.–12:00 p.m.), reported by 52.81%. 2. The mean post-test knowledge score (M = 31.60, SD = 4.92) was significantly higher than the pre-test score (M = 20.38, SD = 6.86) (t = 48.04, p < .001). 3. Overall satisfaction was at the high level (M = 4.20, SD = .64). Conclusion: The findings support the implementation of Thai MOOC-based learning in the Adult Nursing course to enhance teaching and learning for nursing students.

Needs Assessment and Perspectives of Nursing Students and Instructors Regarding the Development of an E-Book for Psychiatric Nursing Vocabulary

Wilawan Christraksa — 2026-08-19

Objective: To explore the needs and perspectives of nursing students and instructors toward the development of a psychiatric nursing terminology e-book. Methods: This descriptive qualitative study was conducted through a focus group of 39 participants, including 32 nursing students and 7 faculty instructors from the Faculty of Nursing, Prince of Songkla University. Participants were purposively selected based on the specified eligibility criteria and their willingness to participate in the study. Research instruments included (1) personal data questionnaire; (2) semi-structured interview guides; (3) field notes; (4) course needs assessment documents; and (5) the original e-book. Conventional content analysis was employed to analyze the qualitative data. Results: Participants emphasized that the e-book was beneficial. Content analysis revealed 5 core themes regarding further development: (1) accurate, clear, and easy-to-understand definitions with contextual examples; (2) multimedia integration (audio pronunciations, illustrations, QR codes, and interactive exercises); (3) direct linkage of terminology to clinical practice in psychiatric wards; (4) categorized content structure with a user-friendly search system; and (5) alignment with expected course learning outcomes and clinical competencies. Conclusion: Users demand a scientifically accurate terminology e-book embedded with multimedia elements that support self-directed learning and clinical application. These findings provide foundational data for designing an e-book prototype to enhance mental health and psychiatric nursing education.