Nursing Journal of The Ministry of Public Health

Virtual Reality Development to Create Knowledge for Self-Monitoring of Blood Glucose and Self-Care among Older Adults in Buriram City Municipality

Potjana Pojundee — 2025-08-29

Enhancing elder to have capacity to monitor blood sugar level and to care themselves is necessary. The objectives of this research were to 1) develop virtual reality for the self-monitoring of blood glucose and self-care among older adults, and 2) evaluate pretest-posttest and satisfaction with the devised virtual reality. This work uses a research & development (R&D) approach with 3 steps as follows. 1) Systematic review (SR)-based development: PICo and quality function deployment (QFD) were used, wherein 3 categories of content that created health awareness included 1) self-monitoring of blood glucose (SMBG), 2) creating awareness of blood glucose control, and 3) promoting physical and mental health. Virtual reality with 12 knowledge bases was designed, mainly used online. 2) Pretest-posttest comparison: The population included 4,161 older adults in Buriram City Municipality. The samples included 98 older adults in Buriram City Municipality Health Center Region 2, obtained by purposive sampling. Pre-tests and post-tests were used. After data analysis by paired t-tests, it was found that the post-test scores for older adults who used virtual reality were significantly higher than the pre-test scores (p < .01). and 3) Satisfaction evaluation: The participants included 400 older adults in Buriram City Municipality Health Center Region 2, obtained by stratified sampling. A structured questionnaire was used. Data were analyzed by mean and SD. It was found that the participants showed a high level of satisfaction with the new virtual reality (mean=4.08; SD=.42). Based on the findings of this research, it can be concluded that the developed virtual reality media can promote self-care among the elderly.

Effects of First Aid Diabetes Mellitus Program using the Creative Drama Process for Village Health Volunteers

Chanthawan Vichaipon — 2025-08-29

The potential of village health volunteers has a direct impact on supporting public health care. This quasi-experimental research aimed to examine the effects of the first aid diabetes mellitus program using the creative drama process on knowledge, skills, and self-confidence in village health volunteers. The sample consisted of 42 village health volunteers who were selected by simple random sampling technique. The experimental group (n=21) received the first aid program for diabetic patients using the creative drama process for 5 weeks, which consisted of 4 steps: physical and mental preparation, motivation, preparation of drama skills and drama activities, and evaluation. The contents of this program included first aid training for looking after diabetic patients suffering with hypo-hyperglycemia, drowsiness, seizures, shock, and unconsciousness. The comparison group (n=21) received a first aid diabetes mellitus program according to the standards of the sub-district health promoting hospital. The research instruments included the knowledge- related first aid for patients with diabetes mellitus questionnaire, skill assessment scale, and self-confidence appraisal scale. Their content validities were checked, and the reliability coefficients were found to be .79, .77, and .95, respectively. Data were analyzed using paired t-tests and independent t-tests. The results demonstrated that the mean scores of knowledge related to first aid for patients with diabetes mellitus, skills, and self-confidence in the experimental group were higher than before providing the program and were significantly higher than the comparison group. Therefore, the first aid program for diabetic patients using the creative drama process can be able to increase knowledge, skills, and self-confidence in village health volunteers to provide first aid for diabetic patients with emergency complications before transferring them to the medical facility.

Influences of Illness Perception on Medication Adherence in Muslim Patients with Myocardial Infarction after Percutaneous Coronary Intervention

Rusna Maramoh — 2025-08-29

Medication adherence after percutaneous coronary intervention (PCI) is crucial for effectively treating myocardial infarction. This predictive study aimed to examine the levels and influence of illness perception on medication adherence in Muslim patients with myocardial infarction after percutaneous coronary intervention. The sample group consisted of 60 Muslim patients with myocardial infarction after percutaneous coronary intervention at the outpatient department of Yala Hospital. The samples were selected using purposive sampling. The data were collected from January to March 2024. Questionnaires on illness perception and medication adherence were used, with reliability coefficients of .80 and .81, respectively. Data were analyzed using descriptive statistics and multiple regression analysis. The results indicated that the overall mean score for medication adherence was high (mean=3.72, SD=.21). Illness perception related to treatment or symptom control was found to predict 20% of medication adherence (R²adj=.20) in Muslim patients with myocardial infarction following coronary angioplasty. Therefore, healthcare providers can utilize patients' perceptions of treatment and symptom control to develop programs aimed at promoting medication adherence in patients with myocardial infarction after coronary angioplasty effectively.

The Effect of the Reminiscence Group Program on the Self-esteem of the Elderly at Srithanya Hospital

Aree Pinthong — 2025-08-29

Many elderly people often experience a decline in self-esteem. Thus, promoting self-esteem is important in helping to reduce depression and enhance good mental health. This randomized controlled trial research, with a two-group pre-test post-test design and follow-up for 2 weeks of experimentation, aimed to examine the effect of happy reminiscence therapy on the self-esteem of elderly patients with depressive symptoms. The sample consisted of elderly psychiatric patients with depression who were being treated at Srithanya Hospital. The subjects were obtained by simple random sampling, consisting of 32 subjects in the experimental group and 32 subjects in the control group. The research instrument was reminiscence therapy. The Thai Mini-Mental State Examination (α=.80), the Rosenberg Self-Esteem scale (α=.78), and the Thai Geriatric Depression scale (α=.83) were used to assess variables. Data were analyzed using descriptive statistics, the Friedman test, the Mann-Whitney U test, and the Wilcoxon Signed-Rank test. The results of the study revealed that, at the end of the program, the experimental group had a significantly higher mean score of self-esteem compared to before participating in the program and to the control group. In addition, the experimental group showed a significantly lower mean score of depressive symptoms compared to before participating in the program and to the control group. These findings indicate that the reminiscence group therapy program can enhance self-esteem and reduce depressive symptoms among elderly patients with psychiatric disorders experiencing depression.

Development of Participatory Telemedicine Service System for Elderly with Non-Communicable Diseases in Kaeng Sanam Nang District, Nakhon Ratchasima Province

Naphat Paechaiyaphum — 2025-08-29

Currently, telemedicine plays an important role in accessing healthcare services, especially for the elderly with non-communicable diseases (NCDs); telemedicine must be developed appropriately. This research and development was conducted in three phases, each with corresponding objectives: 1) to explore the context and needs of users of participatory telemedicine services for older adults with chronic non-communicable diseases, 2) to develop a telemedicine service system, and 3) to evaluate the results of using telemedicine services. The study participants comprised 206 older adults with NCDs and 23 individuals working in public health and community-based services. The tool used is a collaborative telemedicine service system developed for the elderly with non-communicable diseases. The intervention lasted three months. Data were analyzed using descriptive statistics, content analysis, and the Wilcoxon signed-rank test. The findings were as follows: 1) 100% of the older adults were unfamiliar with telemedicine systems and lacked access to communication devices. 2) The developed participatory telemedicine service system comprised three service access points: community-based, hospital-based, and sub-district health promotion hospital-based. 3) In terms of health outcomes, a statistically significant improvement was observed among older adults with diabetes who achieved better blood glucose control. Among those with hypertension, significant differences were found in both systolic and diastolic blood pressure levels. Regarding satisfaction, both service users and providers reported high satisfaction levels across all dimensions. The study concludes that the developed system can be effectively integrated into community health services and used to strengthen collaborative health network operations.

Factors Influencing the Quality of Life for Caregivers of Individuals with Disabilities

Chakraphan Kunoy — 2025-08-29

Caring for people with disabilities for a long time usually leads caregivers to health problems and minimizes their quality of life. This descriptive research aimed to examine the quality of life among caregivers of people with disabilities, the relationships between age, income, years of education, and number of persons with disabilities under their care and caregivers' quality of life, as well as to identify the predictive factors of their quality of life. The study was conducted in BanPong District, Ratchaburi Province. The sample consisted of 130 caregivers selected through multi-stage random sampling based on predetermined criteria. The research instruments included a general information record for persons with disabilities, a general information form for caregivers, and the WHO Quality of Life-BREF Thai version (WHOQOL-BREF-THAI), with a Cronbach’s alpha coefficient of .84. Data were analyzed using descriptive statistics, Pearson’s correlation coefficient, and multiple regression analysis. The results revealed that the overall quality of life among caregivers was at a poor level (M=42.40, SD=9.65). Income was positively correlated with quality of life (r=.539, p<.001), whereas the number of persons with disabilities under care was negatively correlated (r=–.225, p<.01). Age, income, and number of persons with disabilities under care were significant predictors of caregivers’ quality of life, accounting for 34.6% of the variance (adjusted R²=.346, p<.001). These findings highlight the importance of promoting caregivers’ quality of life holistically, especially the older caregivers, including providing financial support, reducing caregiving burden, and fostering continuous development in all aspects of well-being.

The Effect of Group Integrative Reminiscence Program on Self-esteem in Older Adults with Depression

Jutha Patangkaro — 2025-08-29

Older adults with depression often experience low self-esteem. Reminiscence therapy is an effective alternative treatment that can enhance psychological well-being and self-esteem. This quasi-experimental study aimed to examine the effect of a group integrative reminiscence program on the self-esteem of older adults with depression. The participants were older adults diagnosed with depression who received continuous outpatient services at a tertiary psychiatric hospital. All participants had low to moderate levels of self-esteem were selected by simple random assignment into an experimental group and a control group, with 30 participants in each group. The research instruments included the group integrative reminiscence program, a personal information questionnaire, and the Rosenberg Self-Esteem Scale in the Thai version. Data were analyzed using descriptive statistics and inferential statistics, including paired t-tests, and repeated measures ANOVA. The study found that, both immediately after completing the program and one month later, the experimental group showed a statistically significant increase in self-esteem scores, which were also higher than those of the control group at both time points. Furthermore, within three months after the intervention, the experimental group demonstrated an increase in self-esteem compared to before the program. However, at the three-month follow-up, no statistically significant difference was observed between the experimental and control groups. Based on these findings, it can be concluded that the integrated reminiscence group therapy program can enhance self-esteem among elderly individuals with depression for approximately three months. Therefore, this type of program should be implemented periodically to provide continuous mental health care for elderly patients with depression.

The Effects of a Learning Enhancement Program Integrated with Chatbot on Knowledge and Screening Practices for Cholangiocarcinoma among At-Risk Population

Ampai Sudsom — 2025-08-29

In areas with persistently high incidence rates of cholangiocarcinoma over many years, the development of an effective model for promoting knowledge and screening among at-risk groups is critically needed. This study aimed to investigate the effects of an educational program utilizing experiential learning cycle theory combined with chatbot technology on knowledge and screening practices for cholangiocarcinoma among at-risk populations. A quasi-experimental, single-group pre-test post-test design was employed with 31 purposively selected participants from the target at-risk population for cholangiocarcinoma screening. Participants engaged in an 8-week educational program incorporating experiential learning theory and chatbot technology. Data were collected using a questionnaire on knowledge and screening practices for cholangiocarcinoma, an observational checklist for screening practices, and a satisfaction assessment for the chatbot innovation. Data were analyzed using descriptive statistics and the Wilcoxon signed-ranks test. The results showed that after participating in the program, the mean scores of the sample group increased significantly in all aspects. The mean differences (MD) of the increases were as follows: 1) knowledge of liver fluke and cholangiocarcinoma: MD=1.65 (95% CI=1.09–2.20), 2) knowledge of cholangiocarcinoma screening: MD=3.32 (95% CI=2.66–3.99), 3) screening practice performance: MD=6.55 (95% CI=6.10–6.99), and 4) the chatbot innovation “Cholangiocarcinoma Awareness” received an overall user satisfaction rating at a high level. These findings reveal that the educational program utilizing experiential learning cycle theory in conjunction with chatbot technology can enhance knowledge and basic screening skills for cholangiocarcinoma among at-risk populations.

Symptom Perception, Symptom Management, and Healthcare-Seeking Behaviors among Individuals with Anaphylaxis

Jiraporn Juasanthia — 2025-08-29

Individuals with anaphylaxis experienced a wide range of allergic reactions, leading to diverse perceptions, symptom management, and healthcare-seeking behaviors. Delays in seeking care can be life-threatening. This qualitative study aimed to understand symptom perception, symptom management, and the decision-making process regarding hospital visits among individuals with anaphylaxis. An in-depth interview utilizing semi-structured and non-participant observation was employed for data collection. Participants were 25 individuals with a history of anaphylaxis, recruited through purposive sampling from the emergency department of Srinagarind Hospital between April and November 2023. Data were analyzed using content analysis, with trustworthiness ensured through triangulation. The average age of participants was 42.7 years, with 52% being male and 52% having experienced anaphylaxis more than once. Participants recognized anaphylaxis when experiencing symptoms in the respiratory and cardiovascular systems. This perception was associated with recognizing the life-threatening severity of symptoms, including the ability to identify the trigger. Those with prior anaphylaxis experience recognized symptoms more quickly than those with a gradual symptom onset. The study also found that television and knowledge gained from others influenced the rapid recognition of anaphylaxis symptoms. Symptom management included observing symptoms, avoiding the allergen, using oral and topical medications, managing discomfort, and deciding to visit the hospital when symptoms worsened. This study highlights the diverse experiences and management strategies of individuals with anaphylaxis, emphasizing the need for tailored educational interventions to improve healthcare-seeking behaviors.

Factors Associated with Perceived Self-Efficacy in Self-Adjusting of Diuretic Among Patients with Reduced Ejection Fraction Heart Failure

ภาสวรรณ เทอำรุง — 2025-08-29

Perceived self-efficacy in adjusting diuretics among patients with heart failure may affect their ability to control fluid overload. Understanding the related factors will help promote patients’ competence in adjusting medication. This descriptive study aimed to examine 1) self-efficacy, 2) knowledge about heart failure and fluid overload management, and 3) the relationships between personal factors, knowledge about heart failure and fluid overload management, and self-efficacy in self-adjustment of diuretic medication. The sample consisted of 75 patients with heart failure with reduced ejection fraction from the Heart Failure Clinic at Sakon Nakhon Hospital. The study was conducted from February to April 2024. The research instruments included 1) a personal and health information questionnaire, 2) a questionnaire on knowledge about heart failure and fluid overload management, and 3) a questionnaire on self-efficacy in self-adjustment of diuretic medication. All questionnaires had a content validity index of 1.0 and a Cronbach's alpha coefficient of .89. Descriptive statistics, including frequency, percentage, mean, and standard deviation, were used for data analysis. Differences between groups based on personal and health factors were analyzed using t-tests and F-tests. Relationships were analyzed using Pearson's correlation coefficient. The results of this study showed that: 1) The sample group had a mean self-efficacy score of 29.00 (SD=6.31) and overall confidence in self-adjustment of diuretic medication with a mean score of 6.95 (SD=2.74); 2) Knowledge about heart failure and fluid overload prevention had a mean score of 9.92 (SD=1.43); and 3) The factor significantly associated with self-efficacy in diuretic medication self-adjustment was knowledge (r=.229, p=.048, 95% CI (.002, 0.433)). Therefore, heart failure clinics should promote knowledge about fluid overload prevention to enhance patients' confidence in self-adjustment of diuretic medication.

The Outcome of Management in Sepsis and Septic Shock Patient Who Admitted to an Emergency Department at Jainad Narendra Hospital: 6-Months Retrospective Observational Cohort Study

Dusit Klamthuk — 2025-08-29

Sepsis and septic shock are life-threatening conditions and a major public health problem worldwide. This retrospective cohort study aimed to study the outcomes of management for patients with sepsis and septic shock in the emergency department (ED) at Jainad Narendra Hospital. The sample consisted of 227 patients with sepsis and septic shock who received care in the ED. They were selected using a purposive sampling method. The research instruments were the data recording form, including the personal information and treatment received, and the management outcomes form. Data were analyzed using descriptive statistics and the Wilcoxon signed-rank test. The research findings revealed that the average time from patient arrival at the ED to diagnosis was significantly longer than the established criteria of 15 minutes at the .05 significance level (mean=27.06, SD=35.95, median=15.00), while the average time from diagnosis to the administration of antibiotics was significantly different from the established criteria of 60 minutes at the .05 significance level (mean=32.79, SD=28.17, median=25.00). Additionally, 74.01% of the patients received intravenous fluid within 3 hours, 7.49% received vasopressor medication, and 72.20% were treated in the ED within 2 hours. These measures contributed to a survival rate of 79.70%. The findings of this study indicate that certain aspects of the care process for patients with infections and septic shock in the emergency department may still require improvement, such as the screening and initial assessment, in order to facilitate faster diagnosis and treatment. Such improvements could help increase the survival rate of patients.

Effects of a Health Literacy Program on Health Behavior and Blood Sugar Levels of Older Adults in a High-Risk Group for Diabetes

Kittichai Kaedpan — 2025-08-29

Health literacy is a fundamental basis that enables older adults to access, understand, inquire, make decisions, and appropriately apply health information. This quasi-experimental study aimed to evaluate the effectiveness of a health literacy promotion program on health literacy, health behaviors, and fasting capillary blood glucose among older adults at risk of diabetes. The study population consisted of older adults aged 60 years and above who had fasting capillary blood glucose levels between 100 and 125 mg/dL and had never been diagnosed with diabetes. A total of 60 participants were included and divided into experimental and control groups, with 30 participants in each group, using simple random sampling combined with matching. The experimental group received a 12-week health literacy promotion program, while the control group received routine care from the sub-district health-promoting hospital. Research instruments included the Health Literacy Questionnaire (3E2S), the Health Behavior Questionnaire (3E2S), the health literacy promotion program, and the personal health record book Towards Health Literacy for Diabetes Prevention. These instruments demonstrated acceptable content validity (I-CVI = .94–1.00) and reliability (Cronbach’s alpha = .89 for the Health Literacy Questionnaire and 0.87 for the Health Behavior Questionnaire). Data were collected between February and May 2025 and analyzed using descriptive statistics, t-tests, and repeated measures ANOVA. The results showed that the experimental group had significantly higher health literacy and health behavior scores after the intervention compared with before the intervention and with the control group. Moreover, fasting capillary blood glucose decreased continuously and was significantly lower than that of the control group. In conclusion, this program was effective in promoting health and can be applied as a strategy for diabetes prevention among older adults at risk.