Nursing Journal of The Ministry of Public Health

Factors Influencing Intention to Change Preconception Lifestyle among Reproductive Women Working in Eastern Economic Corridor

Sat, 31 Aug 2024 00:00:00 +0700

Intention to change preconception life style among reproductive females results in pregnant

women’s health. This predictive study aimed to determine the intention to change the preconception

lifestyle and its predictors among reproductive-age women. Participants were 287 reproductive-age

women who were working in the Eastern Economic Corridor and came to get marriage certificates at

district offices in Chachoengsao province, Chon Buri province, and Rayong province. Data were

collected by self- reported questionnaires. The content validity values of the questionnaires were

.93-1.00 and Cronbach’s coefficients were .75-.89. Descriptive statistics and standard multiple

regression analysis were used to analyze the data. The results of the study showed that the intention

to change the preconception lifestyle of the sample was rated at a high level ( Mean= 61. 48,

SD=6.82). Perceived self-efficacy (ß=.747, t=17.985, p<.001), subjective norm (ß=.123,

t=2.983, p=.003), and perceived barriers in preconception care (ß=-.073, t=-2.244, p=.026)

were significant predictors and together explained 71. 10% of the variance of intention to change

preconception lifestyle (R2=.711, F3,283=231.750, p<.001). The findings of this study suggested

that nurses and other health care providers should enhance women’s perceived self-efficacy and their

positive social norms and decrease women’s perceived barriers to preconception care.

The Results of Teaching by Integrating Learning Concepts T5 Model in the Ethics and Laws in the Nursing Profession Course

Benjaporn Saovapha; Sirirat Sripattrangkul — Sat, 31 Aug 2024 00:00:00 +0700

Research to develop teaching and learning methods is important for all teachers. The quasi-experimental research aims to study teaching results by integrating learning concepts from the T5 model into the course of Ethics and Laws in the Nursing Profession, including learning achievements and student satisfaction. The sample was 56 nursing students in the Bachelor of Nursing Science program at Boromarajonni College of Nursing Nakhon Lampang, Faculty of Nursing, Praboromaraichanok Institute,in the academic year 2022, selected by purposive sampling. The research instruments include a teaching plan for integrating learning concepts, the T5 model, the learning achievement evaluation form, and an assessment of satisfaction with the teaching style. The IOC test was 1.00 and .87, respectively. Data were analyzed using descriptive statistics, including frequency, percentage, mean, and standard deviation. The results of this study showed that the learning achievement of the sample group passed the specified evaluation criteria by 100 percent. The overall satisfaction with teaching by integrating the T5 model learning concept was at its highest average score (Mean=4.61, SD=.33). Therefore, the results of this study reveal the adaptation and changes of the teachers and students relating to the circumstances and effects of the COVID-19 pandemic.

Development of a Palliative Care Model for End-stage Patients by the Participation of Network Partners in the Community, Phan Don Subdistric, Kumphawapi District, Udon Thani Province

Charunee Promseanpang; Napaphen Jantacumma; Pimsupa Junthanasod — Sat, 31 Aug 2024 00:00:00 +0700

Community partnerships play key roles in palliative care for people at the end of life. The research and development study aims to: 1) study the situation of problems and needs in late-stage palliative care; 2) develop a model for palliative care in the late stages; and 3) study the effectiveness of the developed palliative care model.he study was divided into three stages. Phase I examined the situation, and the samples were families of 10 patients who died before 2021, 10 multidisciplinary teams, and 10 network partners. The study tool consisted of semi-structured questions for in-depth interviews and focus group discussions. Phase II: development of a late-stage palliative care model with the participation of network partners in the community. The sample consisted of six terminally ill patients, 10 multidisciplinary teams, and 10 network partners. The tool was a set of semi-structured questions for focus group discussion. Phase III: evaluate the effectiveness of the model; the sample was the same as in Phase II. The tools were composed of two parts: 1) a good death assessment form, comprising 35 items with a content validity of.98; and 2) a satisfaction assessment form for patients, multidisciplinary teams, and network partners. The qualitative data were analyzed by content analysis, and the quantitative data were analyzed using descriptive statistics. The results of this research revealed that 1) the end-of-life patients had physical,mental, social, and economic problems requiring psychological care, managing physical disturbances, support for medical supplies, and religious activities; 2) guidelines for the implementation of end-stage palliative care emphasized holistic care, physical, mental, social, and spiritual, using the WHO 2002 concept of six topics; and 3) after intervention, all patients received care according to the guidelines of the "Phan Don Model" and had a good death. In addition, it was also found that the patients and their families had the highest level of satisfaction, and the satisfaction scores of multidisciplinary teams and network partners were significantly higher than before using the model. Therefore, this model could be used as a guideline with partnership network participation for caring for end-of-life patients in the community.

A Study of Breastfeeding and Executive Function in Early Childhood Children

Wipawee Prabhong; Patcharin Saree; Panadda Thanasetkorn — Sat, 31 Aug 2024 00:00:00 +0700

Breastfeeding may have some potential to improve executive function during early childhood. This descriptive research study aimed (1) to investigate the relationship between the duration of breastfeeding and executive function in early childhood children and (2) to compare executive function in early childhood children classified by different patterns of breastfeeding in the first 6 months. The data were collected from a sample group of 330 children aged 2-3 years who had a history of exclusively breastfeeding for at least 1 month and were studying at the early childhood level of the child development center under the local administrative organization (LAO)in the 2022 academic year in the area of Muang Ratchaburi district, Ratchaburi province. The research instruments included two sets of questionnaires. Set one was for parents. It was a questionnaire used to assess breastfeeding information, and the second set for teachers was a standard assessment of executive thinking skills. The data were analyzed using the frequency distribution, percentage, mean, standard deviation, Pearson's correlation, and one-way ANOVA. The results showed that the duration of breastfeeding had a positive relationship with the behavior related to EF skill at the low level (p<.05) (r=.141) and a negative relationship with the behavioral problems related to EF dysfunctions at the low level (p<.05) (r=-.122). Moreover, a comparison of executive function in early childhood children classified by the patterns of breastfeeding in the first 6 months, including breast-fed alone, mixed breast and bottle-fed, and bottle-fed alone, found no difference.

Health Literacy and Elderly Health Care Practice of Village Health Volunteers in Health Region 6

Apichat Sabaijai, Aim-utcha Wattanaburanon, Wanlop Jaidee; Sunisa Sangjun — Sat, 31 Aug 2024 00:00:00 +0700

Health literacy can enhance competencies among village health volunteers (VHVs). The objective of this analytic cross-sectional research was to investigate the impact of personal factors on health literacy concerning the care of elderly individuals, focusing on the health care practices of (VHVs) in Health Region 6. The study involved a sample size of 381 participants selected through multi-step random sampling. Data were collected by using a self-developed questionnaire. The data were analyzed using descriptive statistics and multiple regression statistics. The results revealed that the majority of the participants were female, constituting 83.99%, and had an average age of 54.3 years (SD=10.08 years). Notably, VHVs exhibited high levels of overall health literacy, with 95.8% reporting very good and good levels. Regarding the elderly health care practices of VHVs, the study found that 71.65% of VHVs demonstrated very good and good levels of overall elderly health care practices. For the ability to use technology (utilizing applications or other programs), 69.55% of VHVs required assistance or guidance from others. The factors influencing the practices of elderly health care by the VHVs consisted of personal factors and health literacy factors. or the personal factors, the ability to use technology, which included using applications or other programs with assistance or guidance from others (B=-4.759, 95% CI: (-4.086) - (-.817)), plays a significant role. Regarding the health literacy factors, self-management skills (B=1.225, 95% CI: .777-1.732) and communication skills (B=1.207, 95% CI: .708-1.705) were pivotal determinants. These factors collectively contribute to predicting health care practices for the elderly among the VHVs, accounting for 22.9%. Therefore, the VHVs should be supported to enhance self-management skills, effective communication skills, and the ability to use basic technology for communication in order to more effectively provide health care to the elderly.

Health Literacy and Health Behaviors of Student Age 10-18 Year

Orapin Sikaow; Suthisri Trakulsithichoke — Sat, 31 Aug 2024 00:00:00 +0700

Health literacy should start at a young age. Students with higher health literacy may have more healthy behaviors, resulting in a better quality of life. Adolescents with low health literacy are also associated with low self-assessment of their health, obesity, and inappropriate health behaviors. This research objective was to study health literacy and health behavior. The relationship between health literacy and health behavior; the relationship between certain factors (gender, grade point average, body mass index, participation in health promotion activities) and the health behaviors of students aged 10 -18 years. The participants were students in a school under the Educational Service Area Office 1, Mueang District, Pathum Thani Province. Multistage random sampling was used to obtain the selected school, classrooms, and students. The classrooms were selected according to age in 3 groups: upper primary school students aged 10 -12 years, junior high school students aged 13-15 years, and high school students aged 16-18 years, for a total of 286 students. The instrument consisted of questionnaires to assess health literacy, health behavior, and participation in health promotion activities for students aged 10-18 years, adapted from the Health Education Division Ministry of Public Health. The Cronbach coefficients of the questionnaires were.88, .70, and .75, respectively. The data were analyzed using descriptive statistics. Pearson Correlation and Chi-Square Statistics. The results found that the health literacy scores of the students were at a good level in all 3 sample groups, while health behaviors were at a fair level. It was also found that the health literacy of the overall students was not related to health behavior. However, the relationships among subgroups were found to show that health literacy had a low positive statistically significant relationship with health behavior (p<.05) among the students in upper-primary school and high school. The results also revealed that GPA has a statistically significant relationship with the health behavior of students (p<.05). Therefore, it can be suggested that the students should be encouraged to have good health habits and receive nutritious, clean, and safe food. The health promotion activities for students should be based on the participation of students, teachers, and parents. Future research should develop a program promoting health literacy and health behavior in various aspects.

Evaluation of Unused Medication Costs among Patients with Non-Communicable Diseases

Nataphon Wassana; สุภาภรณ์ คำเรืองฤทธิ์ — Sat, 31 Aug 2024 00:00:00 +0700

Costs in the health care system for patients with chronic non-communicable diseases are continually increasing, resulting from the increased incidence of the disease. This quantitative research aimed to evaluate the cost of unused medication among patients with non-communicable diseases in district health promoting hospitals. In 2020, an assessment form was used to collect data from 177 patients who had at least one of these non-communicable diseases, including diabetes, hypertension,hyperlipidemia, and kidney disease, at Ban Khao Thong District Health Promoting Hospitals, Phayuha Khiri District, Nakhonsawan. The results revealed that the total cost of the unused medications was 4,187.90 Baht. The average of unused medication costs was 23.79 Baht (SD=29.77) per patient per visit. The highest-cost medications returned were antihypertensive drugs, antidiabetic drugs, and antilipidemic drugs, respectively. In particular, patients with two or more non-communicable diseases have a higher return cost. Cluster analysis showed that patients with a return drug value higher than the average were 4 1 - 6 0 years old and had two non- communicable diseases. It can be concluded that if such a drug problem is systematically solved among this group of patients, it will tremendously reduce the costs of residual medicine.

Effect of food consumption promoting program and food for high blood pressure application on food consumption behavior among hypertensive patients

Amornrat Natason; Somluk Tepsuriyanont — Sat, 31 Aug 2024 00:00:00 +0700

Health coaching is a process to help diabetic patients to understand their health behavior problems,and change their health behaviors according to their health conditions. This study involved quasi-experimental research using a two group pretest- posttest design, aiming to investigate the effects of a health coaching program on diabetic patients’ self-care behaviors. The subjects were 38 people diagnosed with diabetes mellitus over six months. These were selected using match paired sampling and equally divided into two groups- controlled and experimental groups. Research instruments included a health coaching program for diabetic patients and a questionnaire assessing self-care behaviors with a reliability of . 70. During a period of experimentation, the people in experimental groups participated in health coaching, lasting five weeks, by face to face communication three times and by phone two times. Self-care behaviors were assessed before and after health coaching participation. Data were analyzed using descriptive statistics and the Wilcoxon sign rank test. The findings revealed that after health coach participation, the experimental group showed a higher level of self- care behaviors, compared to those before participation ( p<. 01) and those in the controlled group ( p<. 001) . This finding indicates that health coaching should be integrated in diabetic healthcare services to improve patients’ self- management skills.

Effects of Health Coaching Program on Self-care Behaviors among Diabetic Patients

Surachet Mueangchai; Mintra Promlee; Chettha Kaewprom — Sat, 31 Aug 2024 00:00:00 +0700

Health coaching is a process to help an individual understand their health behavior problems and change their health behaviors according to their health conditions. This study involved quasi-experimental research using a two-group pretest-posttest design, aiming to investigate the effects of a health coaching program on diabetic patients’ self-care behaviors. The subjects were 38 people diagnosed with diabetes mellitus over the period of six months. These were selected using match-paired sampling and equally divided into two groups: controlled and experimental groups. Research instruments included a health coaching program for diabetic patients and a questionnaire assessing self-care behaviors with a reliability of.70. During a period of experimentation, the patients in the experimental group participated in health coaching, lasting five weeks, by face-to-face communication three times and by phone two times. Self-care behaviors were assessed before and after health coaching participation. The data were analyzed using descriptive statistics and the Wilcoxon sign rank test. The findings revealed that after health coach participation, the experimental group showed a higher level of self-care behaviors compared to those before participation (p<.01) and those in the controlled group (p<.001). This finding indicates that health coaching should be integrated into diabetic healthcare services to improve patients’ self- management skills.

Factors Influencing the Competency of Village Health Volunteers in Caring for Community-dwelling Older Adults Living with Chronic Illnesses

Sat, 31 Aug 2024 00:00:00 +0700

Village health volunteers’ competencies to provide care for the elderly with chronic illnesses depend on several factors. This predictive study aimed to investigate the caring competency of older adults living with chronic illness among village health volunteers and the factors influencing the caring competency of older adults living with chronic illness among village health volunteers. The participants were 111 village health volunteers, recruited using a simple random sampling technique. Data were collected using the knowledge-related to caring for older adults living with chronic illness questionnaires (KR-20 =.62), an attitude questionnaire, a motivation questionnaire, and a caring competency questionnaire for older adults living with chronic illness. The reliability of these questionnaires was tested using Cronbach's alpha coefficient, resulting in values of .72, .89, and .98, respectively. Data were analyzed using multiple linear regression analysis. The results of this study revealed that the participants had a high level of caring competency for older adults living with chronic illness (Mean=115.23, SD=16.53). The significant predictive factors of caring competency for older adults living with chronic illnesses were the motivation to look after older adults living with chronic illnesses (β =.545) and experienced training for caring for older adults (β =.306). These factors jointly predicted caring competency for older adults living with chronic illnesses at 46.30%. This study highlights that the caring competency of older adults living with chronic illnesses among village health volunteers can be developed by motivating them to look after older adults living with chronic illnesses. Moreover, village health volunteers should be trained continuously regarding knowledge related to caring for older adults living with chronic illnesses in the community.

Health Literacy among Pregnant Women Who Have Gestational Diabetes Mellitus

Sat, 31 Aug 2024 00:00:00 +0700

Gestational diabetes is the most common pregnancy complication that affects maternal and neonatal health due to maternal poor glycemic control, resulting from a lack of knowledge and health management. This descriptive research aimed to study the level of health literacy and factors related to the health literacy of gestational diabetes. The participants consisted of 105 pregnant women diagnosed with gestational diabetes in Phontong, Salaphum Hospital, Roi -Et province, and Yasothon Hospital,Yasothon province. These participants were selected by purposive sampling. Data were assessed by the 4-dimension health literacy questionnaire, which has an index of item objective congruence of .93 and a Cronbach’s alpha coefficient of .98. The data were analyzed using descriptive statistics and Spearman's correlation coefficient. The results showed that the overall mean of health literacy among pregnant women was at a fair level (mean=72.63, SD=15.63). The level of health literacy in the dimension of self-management of health was the lowest (mean=70.64, SD=16.94). Regarding the factors related to the health literacy of gestational diabetes, it was found that the level of education positively correlated with health literacy at a low level (r=.34, p<.05). Therefore, to enhance the ability of pregnant women with gestational diabetes, health personnel should establish health services to promote self-management of health, especially for those who have a low level of education.

A Comparitive Study of Pregnancy Outcomes between Pregnant Teenagers and Adults at Uthai Thani Hospital

Sinaporn Klomyong; Jatupat Sripum; Thitima Karabutr, Atchara Kulanuwat — Sat, 31 Aug 2024 00:00:00 +0700

Teenage pregnancy may result in health problems for both the mother and the newborn. This retrospective descriptive research aimed to study the situation of teenage pregnancy and compare pregnancy outcomes between teenage and adult pregnant women who gave birth at Uthai Thani Hospital from October 1, 2022, to September 30, 2023. The sample was divided into two groups,including the group of 129 teenage pregnant women younger than or equal to 19 years and the group of 881 adult pregnant women aged 20-34 years. Data were collected from the data collection form of the Uthai Thani Provincial Public Health Office. They were composed of five parts, including 1)demographic data; 2 ) antenatal care history; 3 ) labor data; 4 ) complications during pregnancy,delivery, and after birth; and 5 ) data of newborns. Data were analyzed using descriptive statistics,the chi-square test, and Fisher’s exact test. Regarding the comparison of pregnancy outcomes, it was found that there were statistically significant differences in pregnancy outcomes (p<.05) in that the pregnancy outcomes of teenage pregnant women were lower than those of adult pregnant women for the first antenatal care before 12 weeks of pregnancy, receiving 8 times of prenatal care according to quality criteria, cesarean section surgery, hypertension during pregnancy, and gestational diabetes. On the contrary, the pregnancy outcomes of teenage pregnant women were higher than those of adult pregnant women for syphilis infection, normal labor and delivery, premature birth, and newborns weighing less than 2,500 grams. Therefore, public health personnel should encourage teenage pregnant women to be aware of the importance of continuous prenatal care starting in the first trimester, as well as health promotion, premature labor prevention, and prevention of the complications of sexually transmitted diseases such as syphilis.

The Effectiveness of a Fall Prevention Program on Fall Prevention Behaviors and Balance among the Elderly with Early Stage of Knee Osteoarthritis in Community

Sat, 31 Aug 2024 00:00:00 +0700

Promotion of body balance and fall prevention are necessary activities for improving quality of life among the elderly with knee osteoarthritis. This quasi-experimental, one-group pretest-posttest study aimed to evaluate a fall prevention program's effects on fall prevention behaviors and balance in 30 elderly community members with early-stage knee osteoarthritis. Participants were aged over 60 years and were selected through purposive sampling. The instruments used included a questionnaire to assess sociodemographic data and another one to assess fall prevention behaviors. The Berg Balance Scale (BBS) and the Timed Up and Go Test (TUG)were also used to collect the data. The questionnaires' reliability values ranged from .75 to .95. The program of the study was developed based on self-efficacy theory as its conceptual framework. The elderly participated in an 8-week fall prevention program that included health education, demonstrations, and practical exercises. The program activities also included verbal persuasion and emotional arousal. Data analysis utilized descriptive statistics, and comparisons were made using paired t-tests. The results revealed that the mean score of fall prevention behaviors after the program (mean=66.43, SD=4.94) was higher than that before the program (mean= 58.76, SD=4.29), the mean score on the Berg Balance Scale after the program (mean=51.26,SD=6.22) was higher than that before the program (mean=42.96, SD=9.86), and the mean score on the Timed Up and Go test after the program (mean=13.63, SD=5.51) was lower than that before the program (mean=17.57, SD=7.21) with statistically a significant level at .05 (t( 2 9 ) FPB = -6 .9 7 , t( 2 9 ) BBS = -3.73, and t(29)TUGT = 2.88, respectively). The results suggest that a fall prevention program for the early stage of osteoarthritis should be implemented among the elderly in the community to promote body balance, which can reduce the risk of falls.

Effects of Computer-Assisted Instruction on Oxygen Therapy in Children on Knowledge and Skills of Nursing Students

Chanikan Kasamrat, Sermsri Santati, จริยา วิทยศุภร — Sat, 31 Aug 2024 00:00:00 +0700

Computer-assisted instruction is an alternative way of learning management to prepare nurse students’ readiness for nursing practice. This quasi-experimental research aimed to examine the effects of computer-assisted instruction on oxygen therapy in children. The content was developed according to Bandura's self-efficacy theory, and computer lessons were created according to Mayer's cognitive theory of multimedia learning. The participants consisted of 88 nursing students who met the inclusion criteria and were randomly selected. These students were randomly assigned to the experimental group and the control group of 44 students. The experimental group received the computer-assisted instruction program, while self-study from documents and textbooks was used in the control group. Data were collected by using a questionnaire to assess demographic information, and tests were also used to examine knowledge and skills about oxygen therapy in children. The data were collected three times: prior to the intervention, immediately, and 5 weeks after the intervention. Descriptive statistics, one-way repeated measure ANOVA, the Friedman test and the Mann-Whitney U test were used to analyze the data and test research hypotheses. The results indicated that there were no differences in knowledge and skills regarding oxygen therapy in children at baseline between the two groups (p>.05). After implementing computer-assisted instruction, knowledge and skills scores in the experimental group were significantly higher than those of the control group (p<.05), both immediately and 5 weeks later. Thus, it can be concluded that computer-assisted instruction effectively improves knowledge and skills regarding oxygen therapy in children among nursing students. Therefore, other lessons may be developed based on the concept of computer-assisted instruction to enhance learning outcomes for the Bachelor of Nursing Science students.

Factor Influencing Metabolic Syndromes among Older Adults with Non—Communicable Diseases

Nongnuch Suapumee; Wantanee Naksrisang — Sat, 31 Aug 2024 00:00:00 +0700

Metabolic syndrome among the elderly is related to several factors. This cross-sectional analytical study aimed to examine the factors influencing metabolic syndromes among older adults with metabolic syndromes who received health care service at the NCD Clinic Plus, Suan Kluai Subdistrict Health Promoting Hospital, Ratchaburi Province. The participants consisted of 427 older adults who met the inclusion criteria of the study. These older adults were diagnosed with at least one disease - hypertension, diabetes mellitus, or dyslipidemia - and received health care services at the NCD Clinic Plus. Data were collected using a questionnaire for interviewing, and a data recording form was applied for collecting clinical symptoms from the medical records of OPD patients. The data were analyzed using descriptive and logistic regression statistics, presenting the odds ratio and 95% CI. The results of the study found that the prevalence of metabolic syndrome in older adults with chronic non-communicable diseases (NCDs) was 74.90%, and 78.50% of them were women. Metabolic syndrome was found in the youngest old group (60-69 years old) and the middle old group (70-79 years old) by 42.40% and 45.90%, respectively. Furthermore, metabolic syndrome was found in 51.50% of the elderly who take polypharmacy. Regarding the factors significantly influencing metabolic syndromes among the elderly, it was found that females, living in a three-generation family, and taking multiple medications could increase the chances of metabolic syndromes by 2.91 times (OR=2.91; 95%CI: 1.63-5.16), 1.79 times (OR=1.79; 95%CI: 1.09-2.95) and 9.71 times (OR=9.71; 95%CI: 5.40-17.40), respectively. Concerning the oldest old group (age 80 years old and over), this group showed a reduced chance of metabolic syndromes by 76.00% (OR=.24; 95%CI: .10-.54). Therefore, health care providers should pay attention to the risky groups for NCDs, including female older adults aged 60-79 years, living with various generations of family members, and taking polypharmacy in order to effectively prevent them from NCDs.

The Development of a Clinical Nursing Practice Guideline for Care of Hypertension Patients with Atrial Fibrillation in the Community, Loei Province

Chanya Chantababpasee; Sutteeporn Moolsart; Noppawan Piaseu — Sat, 31 Aug 2024 00:00:00 +0700

Caring for hypertensive patients with atrial fibrillation needs a clinical nursing practice guideline to minimize harm to patients. This study was conducted to: 1) study the problems and needs of hypertensive patients with atrial fibrillation; 2) develop a clinical nursing practice guideline ( CNPG) for the care of hypertensive patients with atrial fibrillation in the sample community; and 3) examine the effectiveness of CNPG. This clinical nursing practice guideline ( CNPG) was developed according to Soukup’ s concept. The participants were purposively selected based on the process of the study, which was divided into three steps: 1) Evidence- triggered phase: the sample consisted of 12 patients and 12 registered nurses; 2) Evidence-support phase: the sample consisted of 11 textbooks and research papers, 12 registered nurses, and 5 experts; and 3) Evidence-observed phase: the sample group consisted of 15 patients and 15 registered nurses. Research tools included: 1) a focus group guideline; 2) a brainstorming guideline; 3) the Appraisal of Guidelines Research and Evolution II; 4) questionnaires assessing knowledge, self- care behavior, and clinical data; and 5) a satisfaction questionnaire. Data were analyzed by descriptive statistics, content analysis, and the Wilcoxon signed rank test. The results illustrated the problems and needs of patients, including 1)the physical problems of heart palpitations, dyspnea, dizziness, fatigue, and bleeding tendency; 2) a lack of self-care knowledge; and 3) a fear of communicating with personnel and society. It was also revealed that the quality assessments of the CNPG by AGREE II were 92.86% overall and 90.00–97. 78% for each item. In addition, it was found that after CNPG testing, the knowledge and self-care behaviors of patients significantly improved, and the nurses’ satisfaction with using the CNPG was at its highest level. However, the clinical outcomes were not statistically significantly different. his may result from the time limitations of implementing the guideline.