Thai Red Cross Nursing Journal

Discharge Planning for Patients Who Need Home Mechanical Ventilation: A Case Study

Khwanruean Wongmanee — Sat, 28 Dec 2024 00:00:00 +0700

Patients with chronic respiratory failure who require mechanical ventilation need a discharge plan to reduce hospital stay duration. Respiratory care nurses, who specialize in caring for this group of patients, collaborate with a multidisciplinary team to develop a discharge plan that ensures continuity of care across all phases: the acute phase, the transitional phase, and the continuing phase. The objective of this article is to describe nursing care and integrate the role of respiratory care nurses during the continuing phase of care. The article also applies the discharge planning concept, utilizing a discharge planning program for patients with chronic respiratory failure who use home mechanical ventilation.

The Intention to Engage in Advanced Care Planning among Patients with Heart Failure

Suchanaree Aunkum, Yaowarat Matchim, Ruankwan Kanhasing, Thanyarat Boontoi — Sat, 28 Dec 2024 00:00:00 +0700

This study aimed to 1) examine the intention to engage in advanced care planning, and 2) examine the differences in the intention to engage in advanced care planning among patients with heart failure, based on the New York Heart Association [NYHA] functional class, experience in caring for family members with terminal illnesses, and experience with perceived advanced care planning. A part of Ajzen’s theory of planned behavior, the concept of advanced care planning, and a literature review were used as a research framework. 196 participants with heart failure from outpatient departments of five tertiary hospitals in the Public Health Region 4, Thailand, were recruited based on the inclusion criteria: Simple random sampling was used to select participants who met the inclusion criteria. Instruments used for collecting data included 1) a demographic data form and 2) the Intentions for Advanced Care Planning Questionnaire [I-ACPQ]. Five experts validated the I-ACPQ, and the content validity index (CVI) was 1. The reliability of the instrument was tested among 30 patients with heart failure, and Cronbach's alpha was found to be 0.84. Data were analyzed using descriptive statistics and Chi-squared statistics.

This study revealed that the average age of the participants was 60.32 years (SD = 14.09). Most of the participants were male 52.55% (n = 103), 50% (n = 98) had graduated from primary school, 98.98% (n = 194) had co-morbidity, 58.16 (n = 114) had NYHA functional class II, 74.49% (n = 146) had no experience in caring for family members with terminal illnesses, 76.02% (n = 149) had no experience with perceived advanced care planning, and the intentions to engage in advanced care planning were at a moderate level (mean = 3.29, SD = 0.94). The participants with a different NYHA functional class showed no significant difference in the intention to engage in advance care planning. In contrast, different experiences in caring for family members with terminal illnesses and different experiences with perceived advanced care planning revealed statistically significant differences in the intention to engage in advanced care planning (p < .01)

Future studies should assess the intention to engage in advanced care planning among patients with heart failure with NYHA Functional Class II-IV, with an equal ratio in each class.

Comparative Health-Related Quality of Life among Kidney Transplant Recipients with Self-Management Behaviors and Body Mass Index

Sat, 28 Dec 2024 00:00:00 +0700

Despite recent advances in kidney transplant (KT) treatment and management, complications which may impact the quality of life of kidney transplant recipients (KTRs) and readmissions among this group have been reported. It is unclear whether patients with different self-management behaviors and body mass index levels experience a different health-related quality of life (HRQoL). This study aims to investigate the HRQoL of KTRs and compare the HRQoL among KTRs with different self-management behaviors and body mass index levels. Data were collected among 238 KTRs who visited the outpatient organ transplantation departments of Siriraj Hospital, Thammasat University Hospital, and Vajira Hospital from March to April 2024. The instruments used for data collection were validated by five experts and tested for reliability among 30 KTRs. These instruments included: 1) demographic and clinical data record forms; 2) the Kidney Transplantation Self-Management Scale [KTSMS], which yielded a content validity index (CVI) of .99 and Cronbach’s alpha of .90; and 3) the KDQOL-SF version 1.3, which yielded a content validity index (CVI) of .92 and test-retest reliability with a Pearson's coefficient of .99. Data were analyzed using descriptive statistics, independent simple t-tests, and one-way ANOVA.

Results: The overall HRQoL of the participants was at a good level (Mean = 78.41, SD = 8.70). Additionally, KTRs with high scores regarding self-management behaviors had higher HRQoL scores than those with lower self-management behaviors (p < 0.05). Moreover, KTRs with BMI > 23 kg/m² had a higher HRQoL than those with BMI < 18 kg/m²(p < 0.05). Conclusion: The results of this study can be used to promote self-management behaviors among KTRs to enhance their HRQoL.

Community Engagement and the Creation of Collaborative Networks Between Educational Institutions and Community Network Partners in Nursing Education

Amavasee Ampansirirat, Pornpun Manasatchakun — Sat, 28 Dec 2024 00:00:00 +0700

This descriptive qualitative research aimed to elucidate the creation of mechanisms for engagement and define the responsibilities and roles of network partners in organizing the Bachelor of Nursing Science program at Praboromarajchanok Institute through community engagement between educational institutions, communities, and health network partners. The study area was purposively selected from 30 nursing colleges under the Faculty of Nursing, Praboromarajchanok Institute. Eight nursing colleges were selected based on their community engagement initiatives and collaborative efforts in organizing nursing education. The participants included representatives from educational institutions, community hospitals, sub-district health-promoting hospitals, local government organizations, and community leadership groups, totaling 103 participants. Data were collected between August 2022 and August 2023 using focus group discussions and semi-structured interviews, followed by evaluation through thematic analysis.

The findings showed the creation of mechanisms for engagement could be divided into three themes: 1.1) developing teachers to be ready for community visits, 1.2) teaching students reflective thinking, and 1.3) connecting with communities. The responsibilities and roles of network partners in community engagement primarily involved providing support and assistance.

Conclusion and recommendation: Effective management of nursing education requires an understanding of the mechanisms to create cooperation and roles of network partners. These findings could lead to the development of educational programs and community engagement initiatives that address the needs of individuals, families, communities, and health systems.

Curriculum Evaluation of a Nursing Speciatly Training Program for Patients with Wounds, Ostomy, and Incontinence, Srisavarindhira Thai Red Cross Institute of Nursing

Wannarudee Phuthong, Anchalee Ngamvitroj — Sat, 28 Dec 2024 00:00:00 +0700

This research aimed to evaluate the curriculum of a nursing specialty training program for patients with wounds, ostomy, and incontinence. It investigated the opinions on the teaching and learning process, along with nursing competency, across three time points; before training, immediately after training, and three months following the training program. 101 participants were selected via purposive sampling, including 11 teaching staff members, trainees, supervisors, and trainees’ colleagues, comprise of 30 persons per group. Data were collected using curriculum evaluation forms to assess the teaching and learning process and the nursing competency of the trainees. Content validity was assessed by experts (0.85), and interrater reliability was high (0.90). Descriptive statistics and one-way repeated measures ANOVA were employed for data analysis.

Research results

1. The average opinion scores of the teaching staff group on the course objectives was at highest level (𝑥̅ = 4.56, SD = 0.51), while the opinion scores of the trainee group on readiness and appropriateness of the program was at high level (𝑥̅ = 4.38, SD=0.54 ). Both groups rated the means score of the curriculum structure at an appropriate level.

2. The opinion scores of the trainee group on nursing competency pre-training (𝑥̅ = 2.13, SD = 0.69) were at low level. However, these ratings improved significantly immediately after the training program (𝑥̅ = 4.09, SD = 0.65) and were rated high level at three months after training (𝑥̅ = 4.37, SD = 0.39). The teaching staff rated the nursing competency at high level immediately after training (𝑥̅ = 4.44, SD = 0.53). Before training, supervisors and colleagues rated the trainees’ competency at low level (𝑥̅ = 2.05, SD = 0.60 and 𝑥̅ = 1.61, SD = 0.68, respectively), but these ratings increased significantly three months post-training. The repeated measures ANOVA analysis indicated a statistically significant difference in the mean scores of trainees’ self-assessment of their competencies (F = 215.15, p < 0.001). These findings suggests that the trainees demonstrated a significant improvement in their competency following the training program.

The Factors Related to COVID-19 Prevention and Control Behaviors among Village Health Volunteers in Pathum Thani Province

Korawan Keaitipattanachai, Pregamol Rutchanagul, Wipada Sangnimitchaikul — Sat, 28 Dec 2024 00:00:00 +0700

This descriptive correlational research aimed to study disease prevention and control behaviors related to COVID-19 and describe the relationship of gender, educational level, work experience, knowledge of disease prevention and control, perceived severity of disease, perceived self-efficacy for disease prevention and control, social support, and perceptions of the disease prevention and control operations policy regarding disease prevention and control behaviors. The framework is based on the PRECEDE-PROCEED model. The sample consisted of 116 village health volunteers (VHVs) from four subdistricts working in Pathum Thani Province who were selected using multi-stage sampling. Data were collected using questionnaires on the following: personal data; perceived severity of COVID-19; perceived self-efficacy for COVID-19 prevention and control; social support; perceptions of COVID-19 prevention and control operations policy; and COVID-19 prevention and control behaviors. The content validity index for these items was 0.82, 1, 1, 0.97 and 1, respectively. The reliability of the instruments, as measured by Cronbach’s alpha, was 0.74, 0.82, 0.84, 0.83, and 0.90, respectively. Regarding knowledge about the prevention and control of COVID-19, the content validity index was 0.88. The reliability KR-20 was 0.75. Data were analyzed using point biserial correlation and Spearman’s correlation statistics.

The results revealed that the average score for disease prevention and control behaviors was rated as high (Mean = 26.72, SD = 4.50), and factors related to disease prevention and control behaviors were statistically significant, including work experience (r_s= .257, p < .01), perceived self-efficacy for the prevention and control of disease (r_s= .580, p < .01), perceived severity of disease (r_s= .455, p < .01), perceptions of the disease prevention and control operations policy (r_s= .709, p < .01) and social support, consisting of emotional support, appraisal support, information support, and instrument support (r_s= .587, p < .01).

In summary, community nurses can use factors such as perceived self-efficacy for the prevention and control of disease, reduce perceived severity of disease, improve perceptions of disease prevention and control operations policy, and develop social support into a program to promote COVID-19 prevention and control behaviors among village health volunteers in the community

The Effects of a Digital Media-Based Self-Efficacy Promotion Program Post-Discharge on the Self-Care Behaviors of Colorectal Cancer Patients with Ostomies

Sukanya Panyakom, Jariya Chensirimongkol — Sat, 28 Dec 2024 00:00:00 +0700

This quasi-experimental study aimed to evaluate the effect of a digital media-based self-efficacy promotion program on the self-care behaviors of colorectal cancer patients with ostomies. The sample consisted of newly diagnosed colorectal cancer patients who had undergone ostomy surgery two weeks after discharge from hospital; 30 patients were assigned to the control group and received standard care, while 30 patients were assigned to the experimental group and participated in a program to promote self-efficacy after discharge using digital media. Instruments included the digital self-efficacy enhancement program and a self-care behavior questionnaire for ostomy patients. All research instruments were validated by five experts, achieving content validity indices of 1.00 and 0.96, respectively, and a reliability coefficient of 0.91 using Cronbach’s alpha. Data were analyzed using frequency, percentage, mean, standard deviation, and t-tests. Results showed that the experimental group displayed significantly higher self-care behavior scores than the control group (p < .05).

In conclusion, the effect of the digital media-based program improved the self-care behaviors of colorectal cancer patients with ostomies post-discharge, as they promoted appropriate and correct self-care behaviors among this patient group.

Effectiveness of the Health Literacy Development Program and Health Behaviors on HbA1c Levels in Persons with Uncontrolled Type 2 Diabetes Mellitus

Patcharee Khonthong, Napassawan Boonprasert — Sat, 28 Dec 2024 00:00:00 +0700

This study was quasi-experimental research with a two-group pretest-posttest design, aiming to examine the effects of the health literacy and health behavior promotion program on HbA1c levels in persons with uncontrolled type 2 diabetes mellitus through a comparison of HbA1c levels before and after the experiment as well as between the experimental and control groups.

A purposive sampling method was used. Sample size was determined using G*Power software. 30 subjects were assigned to the experimental groups and the other 30 belonged to the control group. The experimental instruments were the programs developed from Nutbeam’s health literacy concept in combination with the 3E 2S health behavior principle of the Health Service Support Department. The experiment took 11 weeks with the activities organized at the subdistrict health promotion hospitals during the first two weeks and follow-up phone correspondenced in place of physical visits from week 3 to week 11. Data collection was conducted using a health literacy assessment form, a health behavior assessment form, and HbA1c level tests. The content validity indices of the questionnaires were found at 1.0 and 0.97 respectively, while the reliability of Cronbach’s alpha coefficients w .91 and .89 respectively. Descriptive statistics and t-tests were adopted to analyze the data.

The results indicated that 1) after the end of the program, the experimental group had significantly lower HbA1c levels (mean = 8.21, SD = 0.87) than they did before participation (mean = 9.44, SD = 1.19), and 2) a between-group comparison revealed that, after the end of the program, the experimental group had lower HbA1c levels (mean = 6.61, SD = 0.87) compared to the control group (mean = 8.69, SD = 1.44) at statistical significance of 0.01 level. Therefore, health literacy programs in combination with health behavior should be implemented among persons with uncontrolled type 2 diabetes mellitus so as to control their blood sugar levels

Factors Related to Palliative Care Competency among Professional Nurses in a Tertiary Hospital in Bangkok

Sat, 28 Dec 2024 00:00:00 +0700

This cross-sectional descriptive research aimed to examine the palliative care competency of professional nurses and the associated factors, including age, length of work experience, knowledge, attitude toward care of palliative care patients, and end-of-life care behaviors. Selected by purposive sampling based on the inclusion criteria, the sample consisted of 322 professional nurses from a tertiary hospital in Bangkok. The instruments used for data collection included a personal information record form, a palliative care knowledge assessment, a palliative care attitude assessment, an end-of-life care behavior questionnaire, and a palliative care competence assessment. The quality of the questionnaires was evaluated with content validity indices of 1, 1, 1, and .98, respectively and the Cronbach's alpha coefficients of .71, .81, .97, and .98, respectively. Data analysis was conducted using descriptive statistics, Pearson’s correlation coefficient, and Spearman’s rank correlation coefficient. The level of statistical significance was set at p-value < .05.

The study results showed that the overall palliative care competency ranged at a moderate level (𝑥̅ = 185.74 ; SD = 41.53). While age, work experience, attitudes, and end-of-life care behaviors were positively correlated with palliative care competency at a statistically significant level (r_sp= .153, r_sp= .147, r = .372, r = .684, p < .05, respectively), there is no statistically significant correlation between knowledge of palliative care and competency (r = .086, p > .183).

This study indicates the importance of enhancing practical skills and promoting positive attitudes toward palliative care to improve palliative care competency among nurses