Thai Red Cross Nursing Journal

E-cigarettes and the Prevention of Vaping among Children and Adolescents: Challenges and the Role of Community Nurses

Nipawan Sriyoha — 2025-12-29

Electronic cigarettes, or e-cigarettes, have become a significant and steadily increasing public health concern in Thailand, particularly among children and adolescents. Many users believe that e-cigarettes are safer than traditional cigarettes, less addictive, and useful for smoking cessation. However, numerous studies in Thailand and abroad have confirmed that e-cigarettes contain highly addictive nicotine, as well as heavy metals, carcinogens, and a various other harmful chemicals found in flavored e-liquids. Misconceptions about the safety of e-cigarettes remain widespread among young people. This article aims to highlight the growing problem of e-cigarette use among children and adolescents in communities, define the behavior of e-cigarette use, explore influential factors, and describe the impact of e-cigarettes on young people. Furthermore, it proposes the role of community nurses in preventing e-cigarette use through the three levels of disease prevention. These recommendations serve as practical guidelines for community health practitioners to apply evidence-based strategies to effectively prevent e-cigarette use in local communities.

The Role of Nurse Anesthetists in Caring for Patients with Autism Undergoing Dental Treatment under General Anesthesia

Jitpisut Munsil — 2025-12-29

Dental treatment using anasthesia is considered an effective approach for individuals with autism spectrum disorder, as it enables dentists to provide comprehensive and effective dental treatment while reducing the risks associated with treatment resistance. This approach presents a significant challenge for nurse anesthetists because individuals with autism may have impairments in communication, social interaction, and emotional control, and may display aggressive and uncooperative behavior. In addition, autistic patients frequently present with mental and physical comorbidities such as attention deficit hyperactivity disorder (ADHD), anxiety disorders, epilepsy, and obesity, which may increase the risk of complications following dental treatment. Nurse anesthetists should provide pre-anesthesia care and monitoring both during and after general anesthesia to ensure the safety of the patient and minimize complications following the use of general anesthesia in dental treatment. In addition, nurse anesthetists play a crucial role as nurse practitioners, safety managers, educators, and quality developers of anesthesia services.

This article aims to present knowledge and promote understanding about the definition of autism; the causes and factors contributing to autism; the diagnosis and severity of autism; comorbidities and disorders in autistic individuals; oral health issues in autistic individuals; dental treatment for autistic individuals and its limitations; and complications regarding general anesthesia in autistic individuals in terms of nursing practice, diagnosis, planning, nursing and evaluation. Emphasis is placed on the important role of nurse anesthetists in caring for patients with autism undergoing treatment under general anesthesia, with the aim of providing effective anesthesia nursing guidelines based on the nursing process.

The Role of Home Health Care Nurses in the Transitional Care of Stroke Patients from Hospital to Home, King Chulalongkorn Memorial Hospital

Wipawan Tongtiam — 2025-12-29

Stroke is a major global health problem and a leading cause of disability, profoundly affecting patients and their families across physical, psychological, social, and economic dimensions. This impact necessitates increased reliance on care, especially during the critical post-discharge and home-return transition period, where patients and families must adjust to substantial life changes. Consequently, home health care nurses play a crucial role in bridging the transition and supporting continuous care from the hospital to the home. Their support helps patients and families effectively manage self-care, reduce the risk of complications and hospital readmission, and ultimately improve quality of life by utilizing standard, evidence-based care guidelines. Therefore, the objectives of this article are to describe post-discharge stroke and its impact on patients and caregivers, present the concept of the transitional care model (TCM) care system as well as provide guidelines for transitional stroke patients from hospital to home by utilizing the transitional care framework, and explain the roles of home health care nurses in stroke patients. This work is intended to enhance the knowledge of nursing professionals and serve as a guide for further developing a more effective home visit system for stroke patients.

Predicting Factors on Exercise Behaviors among Older Adults at the Third Age University in Chiang Rai

Damkoeng Vadhanavira — 2025-12-29

This predictive research aimed to: 1) examine exercise behaviors among older adults at the Third Age University, Chiang Rai Municipality; 2) investigate the relationships between personal factors, including age, gender, marital status, chronic diseases, duration of participation, and attitudes toward exercise with exercise behaviors; and 3) predict the influence of these factors on exercise behaviors based on the Theory of Planned Behavior (TPB). The sample consisted of 217 older adults enrolled in the 2021 academic year, selected via simple random sampling. The research instruments included a general information questionnaire, an attitude toward exercise questionnaire, and an exercise behavior questionnaire. These instruments were validated by three experts, yielding a content validity index (CVI) of 0.95. Reliability testing revealed Cronbach’s alpha coefficients of 0.87 for the attitude questionnaire and 0.89 for the behavior questionnaire. Data were analyzed using descriptive statistics, chi-squared test, Spearman’s rank correlation, and binary logistic regression analysis.

The results indicated that the participants' overall exercise behavior was at a low level, with a mean score of 1.63 (S.D. = 0.34). Factors significantly correlated with exercise behaviors included age (x²(2) = 13.02, p < .01, negative correlation) and duration of participation (ρ = 0.187, p = .006, positive correlation), whereas attitudes toward exercise showed no significant correlation (ρ = −0.050, p = .500). Binary logistic regression analysis confirmed that age (B = −0.223, p = .001, OR = 0.800, 95% CI = 0.701–0.913) and duration of participation (B = 0.187, p = .005, OR = 1.206, 95% CI = 1.058–1.373) significantly predicted exercise behaviors. Conversely, overall attitude did not significantly predict exercise behaviors (B = −0.098, p = .841). The model explained 12.5% of the variance (Nagelkerke R² = 0.125). These findings suggest that age serves as the primary risk factor reducing exercise behaviors, whereas continuous participation enhances them. This aligns with research in the Thai context indicating that social support within older adult communities plays a crucial role. Therefore, health promotion programs should be tailored to specific age groups and encourage long-term engagement to mitigate physical limitations and improve the quality of life for older adults in similar contexts.

Factors Influencing the Performance of Palliative Care Roles among Community Nurses, Maha Sarakham Province

Pongsagon Sitit — 2025-12-29

Community nurses play a crucial role in providing palliative care for end-of-life patients at home, as they are the primary care personnel with the closest connections to individuals and communities. However, factors predicting their performance in this role have not been studied comprehensively or in sufficient depth. This predictive correlational study aimed to study the role of community nurses in palliative care for end-of-life patients and the predictive factors influencing this role. The sample comprised 240 community nurses in Maha Sarakham Province who met the specified criteria and were selected via cluster sampling. Data were collected from May to August 2024 using a six-part questionnaire: a palliative care role performance questionnaire, a role performance knowledge questionnaire, a role performance skills questionnaire, a role performance resource questionnaire, a role performance motivation questionnaire, and a role performance information access questionnaire. All instruments were reviewed for content validity by five experts and demonstrated reliability coefficients of 0.99, 0.78 (KR-20), 0.99, 0.98, 0.99, and 0.98, respectively. Descriptive statistics and stepwise multiple regression analysis were used for data analysis.

The results indicated that community nurses in Maha Sarakham Province demonstrated a moderate level of palliative care role performance in caring for end-of-life patients (Mean_adj = 2.44, S.D. = 0.30). Caregiving experience (β = .48) and role performance skills (β = .28) jointly predicted 51% of the variance in palliative care role performance (R²_adj = .51, F = 123.95, p < .001). Recommendations: A program should be developed to enhance community nurses’ palliative care performance, with an emphasis on strengthening role-related skills, particularly among nurses with limited experience. Experienced nurses should be supported to serve as mentors or consultants to improve the overall effectiveness of end-of-life palliative care within the community.

Development of a Massive Open Online Course in Mental Health and Psychiatric Nursing for Nursing Students

Orrawan Khongtor — 2025-12-29

This research and development study aimed to develop a Massive Open Online Course (MOOC) teaching Mental Health and Psychiatric Nursing and to examine its effectiveness. The course developers consisted of ten nursing instructors with more than six years of teaching experience teaching Mental Health and Psychiatric Nursing courses, selected through purposive sampling. The sample group included 174 third-year nursing students from three educational institutions, selected through simple random sampling. Research instruments included a knowledge test, an online learning behavior questionnaire, and a satisfaction questionnaire regarding the MOOC on the Thai MOOC platform. The index of item-objective congruence ranged from 0.67 to 1.00, and the reliability coefficients were 0.74, 0.94, and 0.96, respectively. Data were analyzed using descriptive statistics and the Wilcoxon Signed-Rank Test. The results revealed that the developed MOOC consisted of seven lessons incorporating video-based instruction and online learning materials. Post-test knowledge scores (Median = 35, IQR = 7) were significantly higher than pre-test scores (Median = 22, IQR = 10.50) (Z = –11.09, p < 0.001). The students demonstrated frequent online learning behaviors (𝑥̅ = 4.12, S.D. = 0.65) and reported the highest level of satisfaction with the course (𝑥̅ = 4.47, S.D. = 0.58). The study concluded that the MOOC developed via the Thai MOOC platform effectively enhanced nursing students’ knowledge, promoted positive learning behaviors, and resulted in high satisfaction. Therefore, integrating this MOOC with conventional teaching methods is recommended to further improve learning outcomes.

Pediatric Nurses’ Practices and Barriers in Family-Centered Care

Petsunee Thungjaroenkul — 2025-12-29

This descriptive research aimed to: (1) examine barriers to family-centered care (FCC) among pediatric nurses, (2) investigate pediatric nurses’ practices of FCC, and (3) compare differences in FCC practices between nurses working in pediatric wards and those working in pediatric and neonatal intensive care units (PICUs/NICUs). The sample consisted of professional nurses who provided care for pediatric and neonatal patients in a tertiary hospital and met the inclusion criteria. Data were collected using a demographic questionnaire, the Thai version of the Family-Centered Care Practice Questionnaire based on the framework of Wilson and Dunst, and a perceived barriers to FCC practice questionnaire developed by the researcher. Data were analyzed using descriptive statistics and independent t-tests.

The results showed that the overall mean score of perceived barriers to family-centered care among pediatric nurses was at a moderate level (Mean = 2.18, S.D. = 0.56). The most frequently reported barriers were organizational factors (Mean = 2.24, S.D. = 0.69), followed by nursing personnel factors (Mean = 2.21, S.D. = 0.60). The overall mean score of FCC practice among pediatric nurses was at a high level (Mean = 3.73, S.D. = 0.32). Nurses working in PICUs/NICUs demonstrated significantly higher overall FCC practice scores (Mean = 3.80, S.D. = 0.25) than those working in pediatric wards (Mean = 3.65, S.D. = 0.38) (p < 0.05).

When comparing specific dimensions, relational-oriented practice scores among PICU/NICU nurses were significantly higher than those of pediatric ward nurses (p < 0.05), whereas no significant difference was found in participatory care practice between the two groups.

The findings suggest that hospital administrators should address organizational and nursing personnel barriers to enhance the implementation of family-centered care in pediatric nursing. Additionally, pediatric ward nurses should strengthen relational-oriented practices by incorporating identified organizational and personnel barriers into quality improvement plans to promote effective family-centered care.

The Effect of Nutritional Promoting Program for Preschool Children on Food Management Behaviors of Caregivers

Yarpirun Saopeng — 2025-12-29

This research used a quasi-experimental design to study the effect of a nutritional promotion program for preschool children on the food management behaviors of caregivers. The sample consisted of 50 caregivers of children aged 3-6 years studying at the Child Development Center of Maejo Municipality, San Sai District, Chiang Mai Province in the academic year 2024. The caregivers were divided into a control group of 25 and an experimental group of 25. The research instruments were: 1) a program for caregivers to promote preschool children’s nutrition based on Pender's health promotion model, and 2) a questionnaire on the food management behaviors of caregivers for preschool children. The questionnaire was checked for validity using a CVI value of 0.80, and the reliability of the questionnaire, using Cronbach’s alpha coefficient, was found to be 0.75. Data were analyzed using descriptive and inferential statistics, including paired t-tests and independent t-test.

The study revealed:

The mean score of the food management behaviors in the experimental group after receiving the nutrition promotion program (Mean = 76.12, S.D. = 3.75) was higher than the mean score of food management behaviors before receiving the nutrition promotion program (Mean = 68.56, S.D. = 3.88), with statistical significance (t = 7.059, p < .05).
The mean score of the food management behaviors in the experimental group (Mean = 76.12, S.D. = 3.75) after receiving the nutrition promotion program was higher than the mean score of food management behaviors in the control group, which received routine care (Mean = 68.04, S.D. = 5.86), with statistical significance (t = −5.812, p < .01).

The results of this research can be used as a guideline for the appropriate promotion of caregivers’ food management behaviors for preschool children.

Development of a 360° Interactive Virtual Reality Simulation on Normal Labor for Undergraduate Nursing Students

Nuttaya Onpiw — 2025-12-29

Currently, instructional media employing a 360° Interactive Virtual Reality Simulation on normal labor remains limited in nursing education. Therefore, this study aimed to 1) develop a 360° Interactive Virtual Reality Simulation on Normal Labor for undergraduate nursing students; 2) evaluate its effectiveness; 3) compare students’ mean knowledge scores on normal labor before and after using the simulation; and 4) assess student satisfaction with the simulation. This study employed a research and development design using a quantitative approach with a quasi-experimental one-group pretest–posttest design. The sample consisted of 41 fourth-year undergraduate nursing students. The research was conducted from October 2024 to January 2025. The intervention was a 360° Interactive Virtual Reality Simulation on Normal Labor. The data collection instruments included a learning media quality assessment form, a knowledge assessment form on normal labor, and a learning media satisfaction assessment form. All instruments were validated by three experts, yielding Index of Item-Objective Congruence (IOC) values of 1.00, 1.00, and 1.00, respectively, and reliability coefficients of 0.84 and 0.87. Data were analyzed using descriptive statistics and paired t-test.

The research findings revealed the following: 1) The development of the 360° Interactive Virtual Reality Simulation on Normal Labor for undergraduate nursing students was grounded in standard institutional textbook content for normal labor, incorporating the ADDIE Model based on Kruse’s concept and Gagné’s Nine Events of Instruction. Learning was delivered through virtual reality headsets over a 45-minute session. The overall quality of the developed simulation was rated at the highest level (𝑥̅ = 4.43, S.D. = 0.39). 2) The effectiveness of the learning media, assessed using the E1/E2 formula, was 81.33/89.33, with an effectiveness index of 0.85. 3) post-intervention mean knowledge scores were significantly higher than pre-intervention scores (t = −24.69, p < .001). 4) Overall student satisfaction with the learning media was high (𝑥̅ = 4.13, S.D. = 0.54).

Conclusion The research findings demonstrated that the 360° Interactive Virtual Reality Simulation on Normal Labor is a process of learning with modern technology which is appropriate for promoting knowledge of Normal Labor process among undergraduate nursing students and serves as an alternative for teaching and learning in the 21^st century.