Thai Red Cross Nursing Journal

The Experiences of Exclusive Breastfeeding over Six Months

2023-10-16T00:34:10+07:00

This qualitative descriptive research aimed to explore the experiences of working mothers who exclusively breastfed over six months. Fifteen participants were purposively selected for the study based on the inclusion criteria of being full-time working mothers and engaging in exclusive breastfeeding for at least six months. The study was conducted in the Bueng Ka Sam community, located in the Nong Suea district of Pathum Thani province. Data were collected through in-depth interviews and analyzed using content analysis. The trustworthiness of the study was ensured by adhering to the criteria set by Lincoln and Guba.

The experiences of exclusive breastfeeding over six months reported by the mothers were captured into four major categories, which were: 1) intention to breastfeed, encompassing subcategories including knowledge of benefits of breast milk and breastfeeding to save money; 2) overcoming difficulties, which included subcategories of latching issues, insufficient milk supply, and reducing barriers; 3) support from family, colleagues, or neighbors, including family, employers and colleagues, and neighbors; and 4) outcomes of breastfeeding, including mother-child bonding and a sense of pride.

Findings from this study imply that working mothers had to manage their day-to-day breastfeeding in various situations to achieve exclusive breastfeeding for over 6 months, and they required support from various sources. It is suggested that health care professionals may need a long-term management plan and appropriate intervention program to better promote and support exclusive breastfeeding.

Structural Equation Modeling of Job Performance among Nursing Instructors

2022-11-24T15:23:42+07:00

The aim of this research is to develop and examine the consistency of the structural equation model of job performance among nursing instructors and to study the direct, indirect, and total effects between intrinsic motivation, job characteristics, self -identification, and meaningful work on the job performance of nursing instructors. The sample consisted of 220 nursing instructors with more than 1 year of work experience from 40 nursing education institutions using proportional stratified random sampling. Data were collected using 5 measures: job performance, meaningful work, self-identification, intrinsic motivation, and job characteristics, with Cronbach's alpha coefficients of 0.70, 0.90, 0.87, 0.91, and 0.85, respectively. Data were analyzed using the LISREL program.

The results of the study found that: 1) the structural equation model of job performance among nursing instructors was consistent with empirical data. The calculated indices provided good model fit as follows: Chi-square value (x²) = 140.25, df = 86, x²/df =1.63, SRMR = 0.048, RMSEA = 0.054, CFI = 0.99, GFI = 0.93; and 2) intrinsic motivation had the most influential total effect on job performance, followed by job characteristics. Intrinsic motivation had both direct and indirect effects on job performance through self-identification and meaningful work. It was also found that job characteristics had an indirect effect on job performance through meaningful work.

Results of this study recommend that educational institution administrators and supervisors create plans and strategies to enhance performance among nursing instructors, both in terms of practical teaching and knowledge development, through developing both the intrinsic motivation and specific job characteristics appropriate for nursing instructors.

Prevalence and Associated Factors of Depression and Insomnia among Intensive Care Unit Nurses in a Tertiary Care Hospital

2024-02-26T13:58:11+07:00

A descriptive correlational study was conducted to identify the prevalence and associated factors of depressive symptoms and insomnia among nurses who experienced and worked during the COVID-19 pandemic in an intensive care unit at a university hospital. Data were collected during the COVID-19 pandemic. A total of 124 intensive care unit nurses were recruited using stratified random sampling. All nurses completed three questionnaires: 1) a demographic data form; 2) the Patient Health Questionnaire-9 form (PHQ-9) with a cut-off point PHQ-9 equal to or greater than 9, with a sensitivity of 84%, specificity of 77%, positive predictive value of 21%, negative predictive value of 99, positive likelihood ratio of 3.71, and Area Under the Curve (AUC) = 0.89; and 3) the Insomnia Severity Index (ISI), which has a sensitivity of 86.1% and specificity of 87.7% reported at the cut-off point equal to or greater than 10. The data were analyzed using descriptive statistics, Chi-squared test, and multivariate logistic regression.

This study revealed that the average age of the intensive care unit nurses was 33.95 (SD = 9.61)years old. The most common pre-existing condition was allergies, prevalent in 19.4% of nurses. The most prevalent existing psychiatric condition was depression, prevalent in 5.6% of nurses. Approximately 5.6% of nurses use sedatives or sleep aids such as melatonin and antihistamines. The average duration of work was 11 (SD = 9.54) years. Most intensive care unit nurses sleep less than 6 hours per night, accounting for 57.3%. The prevalence of depressive symptoms was 9.68%. Factors associated with depressive symptoms included individuals
who had a day-shift schedule of eleven hours or more (adjusted OR = 6.80, 95% CI: 1.16-40.01, p-value = 0.034), and those who reported a total sleep time of less than 6 hours per night (adjusted OR = 15.11, 95% CI: 1.03-221.19, p-value = 0.047). In terms of insomnia, a prevalence of 15.32% was observed. Factors related to insomnia included a history of psychiatric disorder (adjusted OR = 9.35, 95% CI: 1.01-86.62, p-value = 0.049), using sedatives or sleep aids (adjusted OR =16.49, 95% CI: 1.61-169.36, p-value = 0.018), a total sleep time per night of less than six hours (adjusted OR =19.42, 95% CI: 2.56-147.1, p-value = 0.004), and working in an internal medicine intensive care unit or intensive cardiac care unit (adjusted OR = 5.31, 95% CI: 1.31- 21.55, p-value = 0.019). As such, it is important to promote work schedules appropriate to the needs of intensive care nurses and emphasize the significance of rest during shifts to help reduce the prevalence of depressive symptoms and insomnia.

Predicting Factors to 30-Day Hospital Readmission in Patients with Acute Heart Failure

2024-03-20T08:18:01+07:00

This prospective cohort study aimed to investigate the readmission rate of 30-day readmission with acute heart failure (AHF) and the predicting factors including comorbidity severity, malnutrition, family support, self-care, and post-discharge follow-up methods. Andersen’s behavioral model of health service was employed as a framework guiding this study. The sample comprised 163 hospitalized patients with heart failure, both male and female, aged 18 years and older, who had discharge plans from two super tertiary hospitals in Bangkok. Data were collected between February and September 2022 using a general profile questionnaire, the Charlson Comorbidity Index (CCI), Controlling Nutritional Status (CONUT), the Family Adaptation, Partnership, Growth, Affection, and Resolution Questionnaire (APGAR), the Self-Care of Heart Failure Index (SCHFI), and a post-discharge questionnaire. The instruments were validated, and the reliability testing results ranged from 0.86 to 1.0. The data were analyzed using descriptive statistics, Chi-square test, and Point-biserial correlation. Logistic regression analysis was employed to examine the predictive power of 30-day readmission risk, with the statistical significance level set at .05.

The study’s results revealed that the average age of participants was 66.23 years old (SD = 15.53). Among the participants, 53.4% were female, had a moderate level of comorbidity severity (Mean = 4.60, SD = 2.32), 50.3% had mild malnutrition, and had a high level of family support (Mean = 17.55, SD = 3.98). The level of self-care was found inadequate in all three aspects of self-care maintenance (Mean = 65.33, SD = 15.43), symptom perception (Mean = 61.13, SD = 17.83), and self-care management (Mean = 55.18, SD = 17.45). The follow-up methods were mainly hospital visit with a cardiologist (83.4%). The readmission rate was found to be 11.0% of the total sample. The comorbidity severity and malnutrition variables were significantly correlated with 30-day readmission with AHF (r_pb= .240, and
r_pb = .204, respectively). The predictive factors of 30-day readmission with AHF included inadequate self-care maintenance (OR = 4.522, 95% CI = 1.083–18.885, p = 0.039), comorbid severity (OR = 1.331, 95% CI = 1.070–1.657, p = 0.010), and malnutrition (OR = 1.325, 95% CI = 1.033–1.700, p = 0.026).

Recommendations to effectively reduce the risks of 30-day readmission associated with AHF, nurses should develop a comprehensive discharge planning program by concerning the severity of comorbidities, assess and coordinate for patients to receive an appropriate diagnosis and management of malnutrition, and patient education specific to self-care for HF.

Teratogens and Fetotoxic Agents: The Role of Nurses

2024-01-26T15:17:02+07:00

Currently, numerous hazardous substances exist in the environment, including teratogens and fetotoxic agents. Exposure to such substances through food consumption, therapeutic medicines, substance abuse, unsafe work unsafe environments, and unsafe products during pregnancy can result in fetal abnormalities. Therefore, pregnant women should avoid exposure to these harmful substances. Nurses in antenatal care units are the health personnel closest to pregnant women and, as such, are important in helping to prevent exposure to harmful substances among pregnant women. This article aims to present the behavioral issues in pregnant women, policies to reduce the risk of chemical hazards, the meaning of harmful substances and teratogens, fetal development at different stages when exposed to harmful substances, types of harmful substances and effects on the fetus, and nurses’ roles in preventing harmful substances from causing abnormalities in the fetus.

Nursing Care for Health Promotion through Recreational Activities in Elderly People in the New Normal Era at Red Cross Health Station No. 2 (Sukumal Anamai) in Bangkok

2024-03-11T14:52:02+07:00

Thailand is transitioning into an aging society, with the elderly population increasing. Elderly people, with varying statuses of health, require daily support to maintain their routines, achieve self-sufficiency, and foster social initiatives, which are all crucial for enhancing their quality of life. Recognizing these needs, professional nurses, particularly those working at Red Cross Health Station No. 2 (Sukumal Anamai) in Bangkok under the Relief and Community Health Bureau of The Thai Red Cross Society, have created a campaign to promote health among older adults. This initiative is characterized by the implementation of recreational activities for older adults by focusing on a holistic approach to their well-being, including physical health, mental health, intelligence, and social aspects, designed around the principles of five dimensions of happiness. This article aims to outline a comprehensive care strategy for older adults in the contemporary environment, acknowledging the concept of “new normal” aging and its implications. This resonates with the evolving concept of activity theory concerning the elderly, advocating recreational activities for the elderly as a vital component of their care. Through case studies of successful initiatives, this article serves as a guide for community-based nursing professionals; it also offers insights for implementing effective health promotion strategies to elevate the overall welfare of the elderly in Thailand's rapidly aging society, ensuring their seamless integration into society.

A Case Study of Congestive Heart Failure and Discharge Planning for an Adolescent Pediatric Patient with Congenital Heart Disease

2023-05-14T20:01:23+07:00

Congestive heart failure is the most common complication found in pediatric patients with congenital heart disease, leading to insufficient blood circulation to various parts of the body, which may lead to shock or even death. The condition is mainly caused by structural abnormalities in the patient's heart and blood vessels present since birth. Various risk factors and improper self-care by the patients can accelerate the development of heart failure. The goal of treatment is to prevent and control heart function deterioration, which is an important role for nurses. The purpose of this article is to present a case study of heart failure in an adolescent pediatric patient with complex congenital heart disease, including symptoms, pathophysiology, treatment guidelines, discussion, and a nursing care plan before discharge from the hospital, using the D-METHOD concept to guide nurses in providing effective care to this group of patients.

Auditory Binaural Beats Stimulation on Working Memory Functions of Adult and Aging Groups: A Literature Review

2024-02-21T17:04:55+07:00

Advancing age is associated with various changes in cognitive capacities, including a decline in working memory functioning (WMF) and some aspects of attention. There has been a growing interest in the use of auditory binaural beats (BB) stimulation for a wide array of applications, ranging from investigating behavioral changes to treating certain health conditions. BB is an auditory illusion perceived when two slightly different frequencies are played separately into each ear. This phenomenon is believed to influence brainwave activity and has been studied for its potential effects on various health aspects. A significant portion of research and application surrounding BB stimulation predominantly explores its psychological effects, with limited attention given to its cognitive implications for individuals susceptible to cognitive decline or impairments. This article aims to review the current body of literature regarding the study of BB stimulation in Western nations, the effects of BB stimulation, the mechanisms underlying BB stimulation and its applications, factors affecting the effectiveness of BB stimulation, the study of BB stimulation within the context of Thailand, and the implications for nursing research and practice. This article brings to the forefront the potential influences of BBs stimulation on the cognitive-behavioral parameters of WMF and attention. The differences in study designs and applications of BBs stimulation and its parameters (e.g., oscillatory bands, frequency range, and stimulation durations), in addition to individual characteristics, can yield different results. Understanding their differential effects and factors associated with the BBs stimulation will enable optimal translation and integration of these modalities to effectively address individual needs and maximize therapeutic outcomes. This knowledge will serve as a guideline for nursing and other allied healthcare professionals, policymakers, and academics in their efforts to improve cognitive performance and potentially delay cognitive decline in later life.