Thai Red Cross Nursing Journal

Effects of Simulation-Based Teaching and Learning with Structured Debriefing on Nursing Students’ Learning Experiences in a Maternal-Neonatal Nursing Course: A Mixed-Methods Study

2026-04-29T18:15:01+07:00

Teaching and learning in maternal and child health nursing present significant challenges due to the complexity and high-risk nature of patient care. These conditions limit nursing students’ opportunities to engage in real clinical practice and to develop clinical

reasoning skills. Therefore, simulation-based learning combined with structured debriefing has been implemented to enhance students’ learning experiences. This study aimed to (1) examine the mean scores of nursing students’ learning experiences following simulation-based learning with structured debriefing in a maternal and child health nursing course, and (2) explore nursing students’ learning experiences after participation in this instructional approach.

Methods: A mixed-methods study was conducted with 36 fourth-year nursing students enrolled in a maternal and child health nursing course at a private university in Thailand. Research instruments included (1) quantitative data were collected using the Debriefing Experience Scale (DES), (2) qualitative data were obtained through focus group interviews and reflective observation; and (3) research intervention was a lesson plan integrating simulation-based learning with structured debriefing, consisting of three phases: 1) Pre-briefing 2) Simulation facilitation 3) Structured debriefing. Data were collected after completion of the learning activities. Quantitative data were analyzed using descriptive statistics and one-sample t-tests comparing observed mean scores with the corresponding subscale midpoint values. Qualitative data, obtained from focus group interviews and reflective observation during and after simulation-based learning, were analyzed using thematic analysis, and findings were integrated to provide a comprehensive understanding of students’ learning experiences.

Results: The findings indicated that nursing students reported high levels of positive learning experiences following structured debriefing. The mean score for experience during debriefing was 87.36 (S.D. = 7.62), while the mean score for the importance of debriefing was 88.22 (S.D. = 9.84). The results showed that all DES subscale scores were significantly higher than the neutral midpoint values (p < .001). Qualitative findings indicated that structured debriefing enhanced clinical reasoning through guided reflection and emotional expression as a catalyst for learning during simulation. Facilitator behaviors fostered a psychologically safe learning environment. Simulation with structured debriefing enhanced perceived readiness for clinical practice.

Conclusion: Simulation-based learning combined with structured debriefing is associated with positive learning experiences among nursing students in maternal and child health nursing education.

Development of a Health Behavior Promotion Model Integrating Primary Health Care Networks and Community Participation for Individuals at Risk of Hypertension in Health Region 8

2026-04-29T18:15:44+07:00

This sequential mixed-methods quasi-experimental study aimed 1) to describe the development of a health behavior promotion model involving the participation of primary care networks and the community for individuals at risk of hypertension in Health Region 8, and 2) to compare the health outcomes of a group at risk of hypertension before and after receiving a health behavior promotion program integrated with the participation of the primary healthcare network and the community.

The sample consisted of 276 individuals at risk of hypertension, and key informants included 70 individuals, comprising 35 public health personnel and 35 community network members. The study was conducted in four phases: 1) situational and contextual analysis, 2) model development, 3) model implementation, and 4) outcome evaluation. Research instruments included questionnaires, interview guides, focus group discussions, and a salt meter. Quantitative data were analyzed using descriptive statistics and paired t-tests, while qualitative data were analyzed through content analysis.

The results showed that after the implementation of the "MONGKUTESAN 4P Model," the sample group exhibited statistically significant positive reductions (p < 0.05) in health measurements, including blood pressure, body mass index (BMI), and waist circumference. The model consists of: partnership (building collaborative networks), people (human capacity development), process (a systematic "screening-adjusting-following up" workflow), and place (environmental management and innovation through the creation of "low-salt areas"). Furthermore, mean scores for overall health behaviors and their specific domains, namely diet control, exercise, rest and stress management, reduction of alcohol consumption, and smoking cessation, showed statistically significant improvement (p < 0.05). The findings suggest that the MONGKUTESAN 4P Model should be applied to populations at risk of hypertension to achieve positive outcomes, such as reductions in blood pressure, body mass index, and waist circumference.

Nursing Students’ Experiences in Promoting Older Adults’ Health by Integrating Cultural Arts in a Gerontological Nursing Practicum Course*

2026-04-29T18:15:36+07:00

Background: Older adults require continuous health promotion, particularly in Udon Thani Province in Northeastern Thailand, where local arts and cultural contexts differ from other regions. Nursing education should therefore integrate local arts and cultural practices into health promotion for older adults. This qualitative study aimed to describe the experiences of nursing students in promoting older adults’ health by integrating cultural arts into a gerontological nursing practicum course.

Methods: A qualitative study was conducted using Heideggerian hermeneutic (interpretive) phenomenology to explore and describe students’ lived experiences. The participants were sixteen third-year nursing students selected through purposive and snowball sampling. Data were collected through in-depth interviews, observations, field notes, and tape recordings. Trustworthiness was ensured through data triangulation and member checking. Data were analyzed using a phenomenological thematic approach informed by van Manen.

Results: Two main themes emerged: (1) organizing health promotion activities for older adults in a cultural context, in which students applied nursing knowledge to assess needs and design and implement culturally appropriate activities for older adults and the community; and (2) learning outcomes from cultural integration in nursing practice, reflecting students’ development of knowledge, skills, attitudes, teamwork, and professional nursing identity through authentic community engagement and experiential learning.

Conclusion: Integrating cultural arts into a gerontological nursing practicum enhances nursing students’ professional competence, particularly in delivering culturally congruent care. Such learning activities should be encouraged in other nursing courses to promote deep learning and sustainable professional development.

Prevalence of High Sodium and Low Potassium Levels and Factors Associated with Sodium Levels from 24-Hour Urinary Excretion among Patients with Stage 3 Chronic Kidney Disease at Ban Chang Hospital, Rayong Province

2026-04-29T18:15:57+07:00

The cross-sectional survey research aimed to explore the prevalence of high sodium and low potassium intake and examine the associations between age, gender, education level, body mass index (BMI), systolic and diastolic blood pressure levels, and estimated glomerular filtration rate (eGFR) with 24-hour urinary sodium excretion. The sample consisted of 126 patients diagnosed with stage 3a and 3b chronic kidney disease (CKD).Data were collected over a two-month period. Research instruments included a general data recording form and a dementia screening tool for elderly patients. Data were analyzed using descriptive statistics and the chi-square test.

The results found that the 84 participants had stage 3a chronic kidney disease (n = 84, 66.67%) while 42 had stage 3b chronic kidney disease (n = 42, 33.33%), with a mean age of 65 years (S.D = 7.24). The prevalence of high 24-hour urinary sodium (> 2,000 mg/day) was 57.90% (n = 73), while the prevalence of low potassium (< 3,510 mg/day) was 100%. The urinary excretion within 24 hours and all factors (gender, education, age, BMI, systolic, diastolic, and eGFR) showed no statistically significant association.

In conclusion, the participants with stage 3a and 3b CKD who received the service from Ban Chang Hospital, Rayong province, had high sodium (> 2,000 mg/d) and low potassium urinary excretion (< 3,510 mg/d). The associations between 24-hour urinary sodium excretion and all factors displayed no statistical significance (p > .05). However, healthcare providers should monitor patients’ sodium consumption or appropriately test urinary excretion over 24 hours to provide continuous consultation.

The Effects of an Integrated Preparation Program Combined Integrated with Religious Beliefs on Pain Coping Behaviors During the First Stage of Labor Among Primiparous Muslim Women

2026-04-29T18:15:27+07:00

This quasi-experimental study compared pain coping behavior scores during the first stage of labor between primigravida Muslim women who received an Islamic-integrated childbirth preparation program and those who received standard care. The sample consisted of 41 primigravida Muslim women at a secondary hospital care in Yala Province, assigned to an experimental (n = 20) and control group (n = 21) via time-based allocation. The intervention was developed from Dick-Read's Fear-Tension-Pain Theory integrated with Islamic practices including zikrullah, du'a, and Quran recitation, delivered across antenatal and intrapartum phases (CVI = .90). The data collection instrument was a pain coping behavior observation form covering five domains adapted from an existing labor pain coping observation tool (Cronbach's α = .85), with Visual Analog Scales for fear and pain as monitoring instruments. Data were analyzed using Mann-Whitney U test with Bonferroni correction (α = .025).

The experimental group had significantly higher pain coping behavior scores during both the active phase (Mdn = 5.0 vs. 4.0, U = 90.0, p < .001, r = .49) and transition phase (Mdn = 4.0 vs. 0.0, U = 55.0, p < .001, r = .63). These findings suggest that Islamic-integrated childbirth preparation effectively promotes pain coping behaviors and should be considered as a nursing practice guideline for Muslim women in culturally diverse settings.

Advanced Nursing Roles in Caring for Extremely Low Gestational Age Newborns through Family-Integrated Care

2026-04-29T18:15:17+07:00

Extremely low gestational age newborns (ELGANs), defined as infants born before 28 weeks of gestation, represent a physiologically fragile population at high risk for severe complications affecting long-term quality of life. This academic article, based on a literature review, aims to explain the definition, incidence, and physiology of ELGANs, as well as identify advanced nursing roles in caring for this group, according to the Family-Integrated Care (FICare) concept of building parental confidence in infant care. This concept encompasses ten key dimensions: 1) respiratory management, 2) thermal homeostasis management, 3) fluid and parenteral nutrition management, 4) promoting nutrition and gut immunity, 5) maintaining skin integrity and prevention of pressure injuries, 6) neuroprotective care and intraventricular hemorrhage prevention, 7) vital sign monitoring, 8) infection prevention and control, 9) hyperbilirubinemia management, and 10) psychosocial support for parents and families. The implementation of comprehensive care across these ten dimensions not only improves survival rates but also reduces disability and promotes sustainable quality of life for infants, while alleviating the burden on families. Recommendations include the systematic synthesis of evidence to develop clinical practice guidelines and further research to test the effectiveness of this approach within the Thai context.

The Role of Primary Care Nurses with Integration of Nurturing Care During the Era of Decentralization for Developing Child Health Systems from Birth to Age 3

2026-04-29T18:16:07+07:00

Early childhood is a critical period for laying the foundation of human development. However, many children still lack access to well-child clinics and suffer from malnutrition, neglect, or domestic abuse, while healthcare systems often struggle to adequately address these complex issues. The application of the Nurturing Care Framework (NCF) serves as a strategic approach for management and the enhancement of nursing roles. This article aims to conduct a system-level analysis and propose a framework for the role of primary care nurses in caring for children from birth to three years of age. The analysis covers: (1) the transfer of Subdistrict Health Promoting Hospitals to Provincial Administrative Organizations; (2) the Nurturing Care Framework (NCF); and (3) the role of primary care nurses in integrating this framework into practice.

The findings demonstrate that, prior to decentralization, nursing roles were primarily oriented toward health promotion, disease prevention, treatment, and rehabilitation at the individual and family levels. Following the transfer, these roles have tended to expand toward more system-oriented functions, including the use of health information, area-based coordination, and the integration of health, developmental, and caregiving dimensions. However, the implementation of these expanded roles remains constrained by limitations in regulatory mechanisms, health information systems, and the clarity of policy-related roles. This article proposes the Nurturing Care Framework (NCF) as a conceptual framework for explaining and defining nursing roles, thereby supporting the development of a more integrated, continuous, and context-responsive system of care for children from birth to three years within the context of decentralization.