Nursing Journal of The Ministry of Public Health

A Development of Promoting Behavior Model for Noise-Induced Hearing Loss Prevention from Working Employees in Stone Milling Factory Mueang District Chonburi Province

Pornarut Pongsawasdi; Nipatsorn Boonyasanti, Chaiya Tanteng — Tue, 29 Apr 2025 00:00:00 +0700

Occupational hearing loss can be prevented by enhancing noise-induced hearing loss-preventing behaviors. This research and development aimed to develop and study the effectiveness of a promoting behavior model for noise-induced hearing loss prevention from working employees in stone milling factories. Phase 1: Studying the behavior of using hearing protection devices among stone mill factory workers. Quantitative data were collected from a simple random sampling of 72 employees using a behavioral questionnaire. Qualitative data were gathered from five key informants, including human resources personnel and safety officers of the factory, through in-depth interviews, as well as from focus group discussions with 10 workers. Phase 2: Developing a promoting behavior model for noise-induced hearing loss prevention from working employees in a small sample group of 10 people from a stone milling factory. Phase 3: Implementing the model and evaluating its effectiveness. The sample was divided into an experimental group and a comparison group, with 36 participants in each group. The research instruments included the behavioral promotion model, a personal information questionnaire, a behavioral assessment questionnaire, a questionnaire on stages of behavior change, a process of behavior change questionnaire, and a behavior change stage evaluation form. The content validity was checked with the item consistency index of .99, and the Cronbach's alpha coefficient was found to be appropriate at .79-.94. The data were analyzed using descriptive statistics and t-tests. Research results found that Phase 1: The employees’ behavior in using hearing protection devices ranged from the pre-contemplation stage to the maintenance stage, with the highest proportion observed in the action to maintenance stage (38.89%). Phase 2: The behavioral promotion model consisted of five activities, including reinforcing for noise protection, identifying supportive factors, addressing behavioral conditions, managing the environment, and raising awareness about noise protection. Phase 3: After implementing the model, the experimental group showed a statistically significant increase in noise protection behavior compared to both the pre-intervention stage and the comparison group. The results in this study indicate that the promoting behavior model for noise-induced hearing loss prevention has an effect on preventing behaviors of working employees in stone milling factories.

Factors Predicting Ventilator-Associated Pneumonia Caused by Multidrug Resistant Organisms in Critically Ill Patients

Paweena Harakun; Donwiwat Saensom — Tue, 29 Apr 2025 00:00:00 +0700

Critically ill patients often have life-threatening illnesses and are prone to organ failure, particularly respiratory failure, which requires intubation and ventilator support. This case-control study was conducted to identify factors predicting ventilator-associated pneumonia caused by multidrug-resistant organisms (VAP-MDR) in intensive care units of a secondary care-level hospital. The subjects were 328 intubated critically ill patients admitted between October 2016 and September 2022. The sample consisted of 164 cases with VAP-MDR and 164 controls without. Data were collected from medical records using a data collection form that assessed demographic information, patient-related risk factors, treatment-related risk factors, and sputum culture results with antimicrobial susceptibility. Descriptive statistics were used to summarize demographic information and risk factor characteristics, while logistic regression analysis was used to identify factors predicting VAP-MDR. The results revealed that the patient-related predictor of VAP-MDR was the APACHE II score (OR_adj=1.06, 95%CI=1.02-1.11, p=.006). Treatment-related predictors of VAP-MDR included ventilator days of 7 or more (OR_adj=3.63, 95%CI=2.24-5.89, p<.001) and reintubation (OR_adj=2.02, 95%CI=1.18-3.45, p=.010). Therefore, to prevent the occurrence of VAP-MDR, measures should be implemented to reduce ventilator days, prevent reintubation, and consider using non-invasive ventilation when appropriate.

Effect of Empowerment and Counseling Program on Hopelessness in Family Caregivers of Stroke Patients

Tue, 29 Apr 2025 00:00:00 +0700

Continuous care for stroke patients at home can cause burdensome to family caregivers, which may lead to feelings of hopelessness and depression. This quasi-experimental research aimed to study the effects of an empowerment and counseling program on the hopelessness of family caregivers taking care of stroke patients in the community. The participants were composed of 64 family caregivers of stroke patients from various communities selected by a simple random sampling technique. The research instruments included an empowerment and counseling program and a questionnaire assessing hopelessness. Data were analyzed using descriptive statistics, independent t-test, and paired t-test. The results showed that the levels of hopelessness after receiving the program in both experimental and control groups of stroke caregivers were mostly moderate, with 50.00% and 56.25 %, respectively. In addition, it was found that family caregivers receiving the empowerment and counseling program had a significantly lower mean hopelessness score after the intervention compared to before receiving the program (t=-9.86, p<.01), and the group of family caregivers receiving the empowerment and counseling program had a significantly lower mean score of hopelessness after the intervention compared to the group receiving regular advice (t=2.79, p<.01). The findings of this study indicate that the empowerment and counseling program helps stroke caregivers feel empowered and hopeful and enables them to continue caring for the patients.

The Effects of the Program Happy Reminiscence Therapy on Quality of Life in Older Persons with Dementia with Depressive Symptoms in Elderly Home

Panudchanard Phoosri, Sasiwimon Booranarek; Malinee Youjaiyen — Tue, 29 Apr 2025 00:00:00 +0700

Happy reminiscence may promote quality of life among the elderly. This quasi-experimental research, which employed a two-group pre-test post-test design, aimed to examine the effects of the Happy Reminiscence Therapy program on quality of life and depressive symptoms among the elderly with dementia and depressive symptoms. The participants were the residents of an elderly home care facility, who were diagnosed with senile dementia and depressive symptoms. They were recruited by a purposive sampling technique and divided into an experimental group and a control group, with each group composed of 32 participants. The research instruments consisted of the experimental instrument, which was the happy reminiscence therapy, and the data-collection instruments, including the demographic data questionnaire, Thai Mini-Mental State Examination (TMSE), Barthel Activities of Daily Living index (Thai version), WHOQOL – BREF – THAI, and Cornell Scale for Depression in Dementia (Thai version). Data were analyzed using descriptive statistics, the Friedman test, the Whitney U test, and the Wilcoxon signed-rank test. The results revealed that after the intervention and at the 1-month follow-up, the mean scores of quality of life and depressive symptoms of the experimental group were significantly better than the control group. The results indicate that the Happy Reminiscence Therapy program could increase the quality of life and decrease depressive symptoms among the elderly with early dementia with depressive symptoms in the elderly home care.

Development of a Nursing Care Model for Elderly Patients with Undergoing Total Hip Arthroplasty at Nakhonphanom Hospital

Panudda sathitwat; Laddawan Puttaruksa; Anantaporn Nitidechwisit — Tue, 29 Apr 2025 00:00:00 +0700

Hip replacement surgery for the elderly has increased, so the development of a nursing care model for elderly patients receiving total hip arthroplasty suitable for a particular context is necessary. This study aimed to develop and evaluate a nursing model for elderly patients undergoing hip replacement surgery at Nakhon Phanom Hospital from September 2022 to February 2024. The study was conducted in two phases: Phase 1 focused on developing the nursing model through situation analysis, model design, and pilot implementation involving 12 multidisciplinary healthcare professionals. Phase 2 involved evaluating the model’s effectiveness, using 30 elderly patients, 30 caregivers, and 30 nurses through interviews, medical record reviews, and satisfaction assessments. The developed nursing practice guideline consisted of four key phases: Preoperative Care, which focused on patient readiness, risk reduction, and enhanced recovery; Intraoperative Care, ensuring patient safety and minimizing complications; Postoperative Care, emphasizing complication monitoring, pain management, and rehabilitation; and Continuing Care, aimed at long-term recovery monitoring, reducing complications, and preventing hospital readmissions. The study results showed significant improvements, including reduced surgery waiting time, shorter hospital stays, and lower medical costs. Additionally, no hospital readmissions were recorded within 28 days, and patients demonstrated a statistically significant improvement in performing daily activities. Caregivers exhibited high levels of knowledge and caregiving competence, while all groups reported the highest level of satisfaction. In conclusion, this nursing model promotes structured, comprehensive, and continuous care for elderly patients receiving total hip arthroplasty. The case management nurses play a crucial role in improving clinical outcomes, fostering collaboration, and enhancing the long-term quality of care for elderly patients undergoing hip replacement surgery.

Effectiveness of Interactive Media on Rational Drug Use in Psychiatric Nursing on Knowledge and Satisfaction of Nursing Students

Tue, 29 Apr 2025 00:00:00 +0700

Rational drug use in psychiatric nursing is essential for patient safety and quality of life. Therefore, developing nursing students’ competencies in rational drug use in psychiatric nursing is very crucial. This quasi-experimental research aimed to examine the effects of interactive media on rational drug use in psychiatric nursing on the knowledge and satisfaction of nursing students. The study employed a purposive sampling technique to recruit a sample of 88 third-year nursing students from a nursing college under the Faculty of Nursing, Praboromarajchanok Institute, in the academic year 2021. The participants were divided into an experimental group and a control group, each consisting of 44 students, using a matched-pair method based on their cumulative grade point average. The research instruments included an experimental tool, which was an interactive media on rational drug use in psychiatric nursing for nursing students, and the data collection tools, which composed of a knowledge test on rational drug use in psychiatric nursing and a satisfaction questionnaire on the use of interactive media in rational drug use in psychiatric nursing. The validity of the instruments was evaluated using the Index of Item-Objective Congruence (IOC), yielding values ranging from .80 to 1.00. Data were analyzed using descriptive statistics and t-tests. The results showed that the mean scores of knowledge in the experimental group before and after using the interactive media showed a statistically significant difference. Additionally, the mean scores of knowledge in the experimental group and the control group also showed a statistically significant difference. Furthermore, the nursing students in the experimental group expressed the highest level of satisfaction with the interactive media on rational drug use in psychiatric nursing for the overall and all aspects of satisfaction. Thus, it can be concluded that this interactive media on rational drug use in psychiatric nursing is practical to promote knowledge about rational drug use among nursing students.

Factors Predicting Health Behaviors According to the 4D Principles Among Parents of Early Childhood in the Context of the Southern Border Provinces

Tue, 29 Apr 2025 00:00:00 +0700

The study of predicting factors on parents’ health behaviors based on the 4D principle provides information for developing health promotion among young children. This predictive correlational research aimed to examine the levels and factors predicting health promotion behaviors based on the 4D principle among parents of early childhood. The sample consisted of 92 parents of preschool children who received services at a well-child clinic of a health promotion hospital, Regional Health Promotion Center 12, Yala. The sample was selected through purposive sampling, and data collection occurred from March to August 2024. Data were gathered using questionnaires on access to health information and services, health literacy, verification of health information and services, communication and social support, self-management of health, and health promotion behaviors based on the 4D principle among parents of preschool children. The Cronbach's alpha reliability coefficients of these questionnaires were .82, .70, .71, .91, .91, and .71, respectively. Data were analyzed using descriptive statistics and stepwise multiple regression. The results revealed that the overall mean score of health promotion behaviors based on the 4D principle was at a very high level. Communication and social support were able to predict 29.40% of the variance in health promotion behaviors based on the 4D principle among parents of preschool children (R²=.29). Therefore, health professionals can utilize communication and social support factors to develop programs that effectively promote health behaviors based on the 4D principle among parents of preschool children.

Factors Influencing Health Literacy in Early Childhood Rearing Practices among Grandparents in Chanthaburi Province

Tue, 29 Apr 2025 00:00:00 +0700

Early childhood is a critical period for brain development and lifelong well-being. In the Thai context, health literacy of grandparents serves as essential information for fostering proper caregiving practices that support the development and growth of young children. This cross-sectional analytical study aimed to examine the situation of health literacy in early childhood rearing practices and to identify the factors influencing health literacy among grandparents caring for young children in Chanthaburi Province. A total of 250 grandparents raising grandchildren aged from birth to 4 years, 11 months, and 29 days were selected through multi-stage random sampling. Data collection involved face-to-face interviews to assess health literacy in early childhood rearing practices conducted from August to September 2024. This research instrument had a content validity index of .93 and a Cronbach's alpha reliability coefficient of .91. Descriptive statistics and stepwise multiple linear regression analysis were applied to analyze the data. The results revealed that the majority of grandparents (74.40%) had insufficient health literacy in early childhood rearing practices. The significant predictors of health literacy in early childhood rearing practices included having a phone/communication device, literacy skills, having a grandmother as the main caregiver, being a member of a community group, receiving tangible support from village health volunteers, appraisal support from administrative organizations, and emotional support from public health officers. These factors collectively accounted for 34.00% of the variance in health literacy (R²=.340, p<.001). These findings suggest that healthcare personnel and relevant agencies should develop tailored interventions to enhance grandparents’ health literacy regarding the influencing factors of appropriate early childhood rearing practices. Such programs should leverage grandparents’ learning potential and provide targeted support based on their specific contexts and needs.

Development of Monitoring and Evaluating Problems of Stroke Patients for Referral Form for Post Stroke Patients in Community

Tue, 29 Apr 2025 00:00:00 +0700

Stroke patients need to be evaluated and monitored for their problems for a long-term care. This research aimed to develop a form for monitoring and evaluating problems of post-stroke patients in the community if needed. The methodology employed a research and development design, which consisted of a survey of problems, developing and testing the tool, and tool evaluation. This study was conducted among three groups of participants: (1) 15 post-stroke patient caregivers, (2) 20 experts evaluating the continuing care for post-stroke patients in the community, (3) a group of 60 persons trying the tool, and (4) 336 people for the tool evaluation. The research tools included (1) a form evaluating the consistency of continuing care for post-stroke patients in the community, (2) a questionnaire assessing general data, and (3) a form assessing and evaluating problems of post-stroke patients in the community. Data were collected using questionnaires and analyzed using descriptive statistics. The Cohen's Kappa statistic was used to evaluate inter-rater reliability (IRR). The monitoring and evaluating problems of stroke patients in the community form for referral was developed as a checklist composed of 13 items, including: 1) Receiving a visit from a public health official after being discharged from the hospital; 2) Weakness after being discharged from the hospital; 3) Problems of communication with others after a stroke; 4) Daily activities; 5) Poor balance in a sitting position; 6) Spasticity; 7) Pain; 8) Chance of an accident by falling; 9) Fecal and urinary incontinence after suffering a stroke; 10) Emotional problems; 11) Intellectual disability; 12) Problems of relationships with family; and 13) Living after a stroke. This tool showed the highest consistency between raters, with 98.81 percent and a Kappa statistic value of 1. Therefore, this tool is suitable to use for monitoring and evaluating the post-stroke patients in the community at least once a week in order to properly and timely manage them, resulting in more efficient post-stroke care in the community.

Proposed Policy and Model of Community-Engaged Nursing Education to Strengthen Health System

Chiraporn Worawong, Pornpun Manasatchakun — Tue, 29 Apr 2025 00:00:00 +0700

Community-engaged nursing education to produce a nursing workforce in the health system's needs is very crucial. However, no sustainable model has been found for nursing education with community engagement in the nursing education system in Thailand. This mixed-method research was designed to develop a proposed policy and model of community-engaged nursing education to strengthen the health system. The research was divided into 3 phases, including 1) studying the real situations, 2) developing proposed policy and models of community-engaged nursing education, and 3) assessing the feasibility and appropriateness for implementation of the proposed policy and model developed. Eighty participants included administrators, students, faculty, alumni, and community delegates. The research instrument included questionnaires and semi-structured interviews. Data were collected by using questionnaires and focus groups. The descriptive statistics were used to analyze quantitative data, and analytic induction was used to analyze qualitative data. The findings of this study revealed learning models of community-engaged nursing education frequently used included 1) community-based learning, 2) project-based learning, 3) service learning, and 4) interprofessional education. The proposed policy of community-engaged nursing education from this research comprised 5 topics, including 1) developing a plan to produce nurse graduates responding to the needs of the current and future health system, 2) developing/revising the nursing curriculum to be consistent with the local contexts and dynamics of the health system, 3) establishing joint policies and action plans at the organization/local level, 4) building capacity, systems, and mechanisms to drive work at the local level, and 5) developing tools to monitor and evaluate changes, outcomes, and impact. The recommendation from this research is to develop a community lab model for community-engaged nursing education where communities are truly engaged in the nursing education system.

Health Conditions of the Elderly and Their Expectations for Community-Based Healthcare in the Eastern Economic Corridor (EEC) Communities

Tue, 29 Apr 2025 00:00:00 +0700

Providing healthcare service for elderly living in the Eastern Economic Corridor (EEC) should be based on individual needs and contextual consideration. This research aimed to study the health status of older adults in the Eastern Economic Corridor (EEC) in physical, mental, and social dimensions; analyzed their expectations for healthcare services; examined the roles of communities and networks in elderly care; and proposed appropriate models for healthcare that suited the local context. This qualitative study used document analysis, observation, and in-depth interviews. The sample consisted of 180 individuals, including older adults aged 60 and above, as well as those involved in elderly healthcare. The research instrument was a structured in-depth interview guide covering five main topics: (1) the health situation of older adults, (2) self-care and elderly care practices in the community, (3) traditional wisdom and local healthy food knowledge, (4) healthcare needs and expectations of older adults, and (5) the role of communities in elderly care: empowering networks and expectations for sustainable care. Each interview lasted approximately 30–40 minutes, allowing participants to express their opinions freely. The instrument was validated by five experts in gerontological nursing, policy administration, and community networking. The tool showed an average Content Validity Index (CVI) of 0.83 and a reliability score of 0.97, both of which exceeded standard benchmarks, indicating its appropriateness and reliability. Data were analyzed by categorizing responses into three groups: similar opinions (thesis), contrasting opinions (anti-thesis), and synthesized opinions (synthesis), which were summarized into conceptual knowledge (conceptualization). The research findings revealed that: (1) Most elderly in the community suffered from chronic diseases caused by daily lifestyle habits and relied on services from village health volunteers (VHVs) and sub-district health-promoting hospitals, as well as medications for treatment. (2) The elderly required knowledge on health restoration and health promotion. (3) Communities possessed health wisdom, such as the use of herbal remedies and exercise. (4) The elderly expected communities to utilize local wisdom, build stronger communities, and improve health care systems. (5) There was a need to develop elderly health care networks involving local administrative organizations (LAOs), VHVs, and improved health communication to ensure consistent access to care. Recommendations: An integrated health care model tailored to the needs of the elderly and community context should have been developed.

Factors Related to Consumption Behaviors of Containing-cannabis Foods and Beverages Among High School Students in Ban Bueng District, Chonburi Province

Thidarat Inthapanya, Nisakorn Krungkraipetch, Pornnapa Homsin — Tue, 29 Apr 2025 00:00:00 +0700

The growing trend of cannabis legalization has sparked curiosity among adolescents to taste cannabis-infused foods and beverages. This correlational research aimed to investigate factors associated with the consumption of cannabis-infused foods and beverages. The sample consisted of 293 high school students in grades 10 to 12 during the 2023 academic year from Ban Bueng District, Chonburi Province, Thailand, selected through cluster sampling. The research instrument was an online questionnaire covering eight sections: personal information, attitudes toward cannabis-infused food and beverage consumption, perceived risk of overdose from consuming such products, accessibility of cannabis-infused foods and beverages, parental acceptance, peer influence, media influence, and consumption behavior. All questionnaire sections demonstrated high internal consistency with Cronbach's alpha coefficients ranging from .82 to .98. Data were analyzed using point-biserial and Pearson correlation coefficients. The results indicated that the sample demonstrated a low level of consumption behavior for cannabis-infused foods and beverages (mean=19.03, SD=7.92). Statistically significant factors associated with consumption behavior included parental acceptance (r=.66, p<.001), attitude (r=.63, p<.001), academic performance (r=-.58, p<.001), perceived risk of overdose (r=.45, p<.001), peer influence (r=.43, p<.001), media influence (r=.30, p<.001), and accessibility (r=.13, p<.05). These findings can inform the development of prevention strategies and monitoring programs aimed at reducing cannabis-infused food and beverage consumption among adolescents. Key interventions may include shaping adolescents' and families' attitudes towards recognizing the risks and consequences, as well as teaching refusal skills to resist peer pressure.