Nursing Journal of The Ministry of Public Health

The Effects of Empowerment Program on Self-Care Behaviors and Hemoglobin A1C among Diabetes Mellitus Type II Patients with Uncontrollable Glycemic Control

Ananya Kooariyakul — 2025-12-30

Empowerment is a process that enhances an individual's confidence, enabling them to achieve goals and accomplish tasks effectively and autonomously. This quasi-experimental study utilized a one-group pretest-posttest design. The objective was to study the effects of an empowerment program by comparing the mean scores of self-care behaviors and hemoglobin A1c (HbA1c) levels among patients with uncontrolled type 2 diabetes before and after participating in the program. The sample consisted of 31 patients with uncontrolled type 2 diabetes who received medication continuously from Mon Din Daeng Subdistrict Health Promoting Hospital, Tha-Sao Subdistrict, Uttaradit Province. Data were collected using the following questionnaires: a personal information questionnaire, an HbA1c record form, and a self-care behavior questionnaire, which was checked for content validity by three experts. The Index of item objective congruence (IOC) was between .67 and 1.00. The reliability, calculated using Cronbach’s alpha coefficient, was .89. Data were analyzed using descriptive statistics and paired t-tests. The results found that after participating in the empowerment program, the patients with uncontrolled type 2 diabetes demonstrated significantly higher self-care behavior scores and significantly lower HbA1c levels compared to before participating in the program. Therefore, healthcare providers should foster patient empowerment to enhance motivation and confidence in managing their own blood glucose levels.

The Effect of Video Preparation on Preoperative Anxiety in Surgical Patients Under General Anesthesia

Jitpisut Munsil — 2025-12-30

General anesthesia for major surgery presents a physically and mentally challenging situation that often causes patient anxiety. Nurse anesthetists play a crucial role in reducing this anxiety through preoperative preparation. This quasi-experimental research aimed to compare anxiety levels before and after preparation, evaluate the effectiveness of video-based preparation versus routine nursing care, and compare patient satisfaction with anesthetic services. The sample consisted of 66 patients undergoing orthognathic surgery (jaw surgery) who exhibited moderate to severe anxiety. Participants were assigned through simple random sampling into a control group (n=33) and an experimental group (n=33). The research instrument was a preoperative and general anesthesia preparation video developed by the researcher (CVI=.84). Data collection tools included the State Anxiety Inventory (Form X-I) and a satisfaction assessment form, which demonstrated reliability with Cronbach’s alpha coefficients of .90 and .83, respectively. Data were analyzed using descriptive and inferential statistics, including Fisher’s exact test, Pearson chi-square test, paired t-test, independent t-test, and Mann-Whitney U test. The results indicated that prior to preparation, there was no significant difference in anxiety scores between the two groups. However, after the preparation, the experimental group showed a statistically significant decrease in anxiety scores, and this reduction was significantly greater than that of the control group. Conversely, there was no significant difference in the anxiety levels of the control group before and after routine preparation. Furthermore, the experimental group reported higher satisfaction with the video-based intervention compared to routine care. In conclusion, video media is effective in reducing preoperative anxiety and enhancing patient satisfaction.

The Effects of Hot and Cold Herbal Compress Therapy on Pain Relief among Older Adults with Knee Osteoarthritis, Suratthani Province

Titaporn Worapanwisit — 2025-12-30

Osteoarthritis of the knee is a common problem in the elderly, leading to significant difficulty in walking. The study examined the effects of combined hot and cold herbal compress therapy on pain relief among elderly individuals with osteoarthritis in Suratthani Province. This quasi-experimental research aimed to compare pain levels between elderly patients who received hot and cold herbal compresses and those in a control group. Additionally, it evaluated pain levels before and after a 4-week treatment period using these compresses. The research was conducted at the Sriwichai Community Health Center in Mueang District, Suratthani Province, involving a sample of 104 elderly participants. The sample size was determined using the G*Power program, and the participants were divided into two groups: 52 in the experimental group and 52 in the control group. The experimental group received hot and cold herbal compresses for 30 to 40 minutes, 2 to 3 times daily. The severity of knee pain was assessed at the end of the 2^nd and 4^th weeks. Data analysis was performed using descriptive statistics and repeated-measures analysis of variance. The results indicated a significant decrease in the mean knee pain score, which dropped from 7.80 (SD=1.0) to 5.10 (SD=1.2) after 2 weeks of treatment and then to 3.20 (SD=1.1) after 4 weeks of treatment. It was also found that the knee pain scores varied significantly over time (F2, 204=92.48, p<.001, η²=.48). In conclusion, the application of herbal compresses appears to be an effective method for reducing knee pain levels in patients with osteoarthritis, showing significantly better results compared to the control group.

Factors Predicting Glycemic Control Behaviors among Patients with Uncontrolled Diabetes Mellitus in Samutprakarn Province

Prisana Akaratanapol — 2025-12-30

Poor glycemic control in patients with diabetes can lead to serious complications and significantly impact their quality of life. This study aimed to identify factors that predict glycemic control behavior among patients with uncontrolled diabetes mellitus in Samutprakarn province. The sample included 153 diabetic patients, selected using a simple random sampling method. Health literacy and health behaviors among diabetic patients were measured through questionnaires, which were found to have reliability coefficients of .84 and .70 using Cronbach’s alpha. Statistical methods employed in the analysis included percentages, means, standard deviations, and multiple regression analysis. Among the participants, 108 were women, representing 70.6% of the sample. The most common age range was 61-70 years, accounting for 39.9% of the respondents. In terms of diabetes duration, 54.9% of participants had been living with the condition for 10-20 years. Regarding blood sugar levels, 51% of the participants had levels ranging from 101 to 160 mg/dL. The study found that effective communication about diabetes, understanding media literacy related to diabetes, and self-management for blood sugar control were key predictors of glycemic control behavior among patients with uncontrolled diabetes mellitus. Together, these factors accounted for approximately 33% of the observed variance in glycemic control behavior. Specifically, the influences were as follows: effective communication about diabetes, understanding media literacy related to diabetes, and self-management for blood sugar control. These findings suggest that all three factors can be utilized to develop a program aimed at enhancing knowledge and promoting activities that encourage behavioral adjustments for better blood sugar control in patients with uncontrolled diabetes mellitus.

The Effect of Prevention and Reduction Depression Program on Burden and Depression among Caregivers’s Schizophrenia Patients in Community

Adcharaphan Homsukhon — 2025-12-30

Continuous care for patients with schizophrenia in the community can lead to caregiver burden and depression. This quasi-experimental research aimed to examine the effects of a prevention and reduction depression program on burden and depression among caregivers of schizophrenia patients in the community. The participants were composed of 40 caregivers of patients with schizophrenia living in Photharam District, Ratchaburi Province, selected by simple random sampling. The research instruments included a prevention and reduction depression program, a general information questionnaire, the Patient Health Questionnaire-9, and the Zarit Burden Interview. Data were analyzed using descriptive statistics, the paired t-tests, and the independent t-tests. The results revealed that, in the experimental group, caregiver burden after participating in the program was significantly lower than before participation and was also significantly lower than that of the control group receiving routine care. Similarly, depression levels in the experimental group decreased significantly after the intervention and were significantly lower than those in the control group. In conclusion, the depression prevention and reduction program in this study effectively reduced caregiver burden and depression among community-based caregivers of patients with schizophrenia, thereby enhancing their quality of life and potentially preventing future depression.

Effectiveness of the Sodium Consumption Surveillance Program Based on the Seven-Color Life Traffic Ping-Pong Model among First-Year Students at Sirindhorn College of Public Health Phitsanulok

Phubadin Poonpipit — 2025-12-30

Continuous consumption of sodium in amounts exceeding the body’s requirements is a contributing factor to the development of chronic non-communicable diseases (NCDs). This quasi-experimental research with a two-group pretest-posttest design aimed to examine the effectiveness of the sodium consumption surveillance program based on the seven-color life traffic ping-pong model among first-year students at Sirindhorn College of Public Health Phitsanulok. The sample consisted of 72 first-year students, equally divided into an experimental group and a control group through simple random sampling with replacement. The experimental group participated in activities based on the program, while the control group continued with their usual academic activities, such as attending regular classes or conducting self-study. Data were collected using a questionnaire before the intervention in December 2024 and again after 12 weeks in February 2025. Data analysis employed descriptive statistics, including frequency distribution, percentage, mean, and standard deviation, and inferential statistics, including independent samples t-tests and paired samples t-tests. The results revealed that, prior to the intervention, the experimental and control groups did not differ significantly in health beliefs and sodium consumption behaviors. After the intervention, the experimental group showed significant improvements in health beliefs and sodium consumption behaviors compared with the control group and their pre-intervention scores, with statistical significance. These findings indicate that the program effectively improved health beliefs and sodium consumption behaviors among students.

Development and Effectiveness Evaluation of a Holistic Ecological Health Promotion Model for Buddhist Monks: A Participatory Case Study in Kuti Cheevaphiban, Uttaradit Province

Seubtrakul Tantalanukul — 2025-12-30

Noncommunicable diseases are significant health problems among Buddhist monks that require appropriate and sustainable health promotion approaches. This research aimed to (1) study health problems and needs of monks in Kuti Cheevaphiban, (2) develop a holistic ecological health promotion model for monks, and (3) evaluate the effectiveness of the developed model. This research and development study was conducted in three phases: Phase 1 investigated health problems and needs using mixed methods research with 200 quantitative samples and 41 qualitative informants. Phase 2 developed the model through participatory action research and expert consultation with 9 experts. Phase 3 implemented and evaluated the model's effectiveness using a one-group pretest-posttest quasi-experimental design with 38 monks. Research instruments included questionnaires, holistic well-being assessment forms, health behavior assessment forms, and health indicator records. Data were analyzed using descriptive statistics and the paired t-tests. Phase 1 results showed that monks had multiple chronic diseases, particularly hypertension, diabetes, and overweight, and expressed needs for health promotion approaches integrating Buddhist principles, community participation, and environmental improvement in Kuti areas. Phase 2 results revealed that the developed model comprised six main components: principles, objectives, a five-step implementation process, four-dimensional main activities, stakeholder roles, and supporting factors. Expert evaluation of the model demonstrated the highest appropriateness level. Phase 3 results on model effectiveness indicated that after program participation, monks showed statistically significant improvements in all dimensions of holistic well-being, better health behaviors, and significantly improved health indicators. In conclusion, the holistic ecological health promotion model integrating the One Health concept, community participation, and the Buddhist principle was highly effective in promoting monks' well-being. Therefore, the model should be expanded and integrated with local health policies for sustainability.

Effects of Self-Efficacy Enhancement Program on Preventing Work-Related Back Pain among Support Personnel at Banmi Hospital

A-pa Hongthong — 2025-12-30

Medical staff and hospital support personnel are at risk of developing back pain due to the nature of their work. This quasi-experimental research utilized a two-group pre-post design to examine the effects of a self-efficacy promotion program aimed at preventing work-related back pain among support personnel at Ban Mi Hospital. The study applied self-efficacy theory alongside ergonomic knowledge. The sample consisted of support staff divided into an experimental group of 25 individuals and a comparison group of 25 individuals, selected through stratified random sampling. The experimental group participated in the program for six weeks, engaging in organized activities on four occasions. Data were collected using questionnaires, back pain assessment forms, and body flexibility. The reliability test was conducted using Cronbach's alpha coefficient, which ranged from .73 to .86. The analysis involved the descriptive statistics as well as the inferential statistics, including paired and independent t-tests. The results indicated that, following the intervention, the experimental group showed a statistically significant increase in mean scores related to self-efficacy in preventing back pain, expectations of the benefits of practicing preventive measures, behaviors aimed at preventing back pain, and levels of back muscle flexibility, compared to the control group. Additionally, the experimental group experienced a statistically significant reduction in work-related back pain levels compared to the control group. Overall, the findings indicate that the program effectively helps prevent back pain and promotes self-care behaviors among support personnel.

The Development of a Ventilator Weaning Model Conducted in the Surgical Ward of a Hospital Located in Kanchanaburi Province

Janthana Nahathaiphokin — 2025-12-30

Early weaning from mechanical ventilation reduces the risk of ventilator-associated pneumonia and promotes faster patient recovery. This research and development study aimed to examine the situation of mechanical ventilator use, to develop a ventilator weaning model, and to evaluate the outcomes of implementing the developed ventilator weaning model in a surgical ward. The study applied an evidence-based practice development approach guided by the Conduct and Utilization of Research in Nursing (CURN) framework. The participants consisted of two groups: 16 registered nurses and 88 critically ill surgical patients. The research instruments included a knowledge assessment questionnaire on mechanical ventilator weaning, a nursing practice assessment form related to the ventilator weaning process, and a ventilator weaning practice guideline (ASC₂E₂F bundle). The results revealed that in the male surgical ward, the highest proportion of successful ventilator weaning occurred within 1–7 days, accounting for 17 patients (26.20%). An equal number of patients (26.20%) experienced unsuccessful ventilator weaning. The developed ventilator weaning model comprised three components: assessment of patient readiness prior to ventilator weaning, assessment during the weaning process, and assessment of readiness prior to endotracheal tube removal. The developed ventilator weaning model for surgical patients emphasized nurse education and increased family participation in patient care. The outcomes were evaluated in 2 dimensions. 1) Regarding process outcomes, nurses demonstrated significantly higher knowledge of ventilator weaning guidelines after the training compared with before the intervention. 2) In terms of clinical outcomes, significant improvements were observed following implementation of the model, including reductions in ventilator-associated pneumonia, reintubation within 48 hours, and duration of ventilator weaning. In conclusion, the application of the ASC₂E₂F bundle ventilator weaning bundle effectively enhanced the quality of care and improved clinical outcomes among surgical patients undergoing mechanical ventilator weaning.

The Effects of a Discharge Planning Program on Nursing Outcomes in Patients with Mandibular Fractures Treated with Mandibular Fixation Surgery

Anusara Donjak — 2025-12-30

Effective discharge planning leads to improved patient outcomes. This quasi-experimental study aimed to examine the effects of a discharge planning program on nursing outcomes among patients with mandibular fractures undergoing open reduction and internal fixation. The sample comprised 55 patients treated at a tertiary hospital in Northeastern Thailand, selected through consecutive sampling based on predefined inclusion criteria. The control group (n=27) received routine care, while the experimental group (n=28) received the program, which consisted of nutritional education, oral care skill training, jaw exercise practice, and continuous follow-up. Research instruments included a knowledge of self-care questionnaire, a self-care ability scale, an oral care skill assessment form, an Oral Assessment Guide, and a nursing outcomes record form. Data were analyzed using descriptive statistics and inferential statistics, including the chi-square test, independent t-test, Wilcoxon signed-rank test, and Mann–Whitney U test. The results demonstrated that the experimental group had significantly higher knowledge of self-care, self-care ability, oral care skills, and maximal mouth opening compared to the control group. Additionally, the experimental group experienced significantly less weight loss than the control group. Within-group comparisons showed significant improvements in knowledge of self-care, oral care skills, and self-care ability in the experimental group after the intervention. These findings indicate that the discharge planning program effectively enhances nursing outcomes among the patients with mandibular fractures undergoing surgical fixation. Therefore, nurses should integrate such a program into routine care to improve patients’ self-care readiness and promote better recovery outcomes.

Enhancing Food Security and Nutrition in Early Childhood: Development and Effect of the Central Kitchen Model in Thai Child Development Centers

Pattaraporn Charoenbut — 2025-12-30

Nutrition plays a vital role in early childhood development. However, rural child development centers struggle with inconsistent meal quality due to fragmented food service systems and limited nutritional expertise in developing standardized meal menus. This study aimed to develop and evaluate the Central Kitchen Model (CKM) to enhance the nutritional quality of meals in child development centers (CDCs). Using a Participatory Action Research (PAR) approach, the study employed a three-phase approach: (1) baseline assessment of current practices and nutritional status, (2) collaborative model development through stakeholder workshops that engaged 35 participants, including teachers, cooks, and parents, across nine CDCs in Ubon Ratchathani Province, and (3) implementation and evaluation over a 12-week period. The implementation involved standardizing meal preparation protocols, conducting nutrition education workshops for staff and parents, and promoting locally sourced ingredient integration. Nutritional outcomes were evaluated using the INMUCAL Program Version 3.0, anthropometric measurements, and behavioral assessments. Post-intervention analysis revealed significant improvements in meal nutritional value, with average energy content increasing from 349.42 to 414.34 kcal and protein levels rising from 14.00 to 16.96 g. Children's vegetable recognition scores improved from 1.70 to 2.65, and their ability to identify vegetable-based dishes increased from 1.80 to 3.55. Children’s height measurements showed significant improvement, indicating positive growth outcomes. The model fostered community engagement through participatory menu planning and local ingredient sourcing, demonstrating CKM's potential to address childhood malnutrition through sustainable food security and nutrition practices. This framework offers a scalable approach for enhancing child health outcomes and empowering communities to achieve long-term nutritional stability.

A Follow-up Study on the Pedagogical Development of Rational Drug Use in Bachelor of Nursing Science Programs

Kamolrat Turner — 2025-12-30

Rational Drug Use (RDU) is critical because it maximizes patient benefits, enhances safety, and reduces healthcare costs. This follow-up study, which applied a research and development approach, aimed to 1) follow up on RDU competencies and identify educational factors associated with RDU competencies; 2) develop innovative RDU teaching media; and 3) evaluate RDU knowledge after learning through innovative RDU teaching media of nursing students. This study was conducted in three phases. Phase I was conducted to assess RDU competencies among nursing graduates: the sample comprised 1,388 graduates in Academic Year (AY) 2018 and 1,428 in AY 2019 from Bachelor of Nursing Science programs across Thailand. The data were analyzed using descriptive statistics and Pearson's correlation. Phase II was conducted to develop innovative RDU teaching media based on Phase I. Phase III was conducted to evaluate nursing students’ RDU knowledge after learning through the innovations developed in Phase II. The sample comprised 40 who learned through a virtual reality simulation and 88 who learned through an interactive video, with 44 in each experimental and control group. Paired and independent t-tests were used to analyze the data. The results showed that 1) the nurses who graduated in AY 2019 achieved high RDU competency scores across domains and significantly higher overall competencies than graduates in AY 2018. RDU competencies were positively correlated with attitudes toward RDU, didactic management, and instructors’ support. 2) The two innovative RDU teaching media developed showed E1/E2 efficiency criteria scores of 64.94/72.96 and 97.27/90.00, respectively. 3) The innovative RDU teaching media significantly increased nursing students' knowledge of RDU. This study indicates that RDU curriculum reforms improve nursing graduates' RDU competencies. Instructors' support in creating innovative RDU teaching can enhance nursing students' RDU knowledge.