Vajira Nursing Journal

The related factors of development of new pressure injury in Intensive care and Stroke Unit in Ramadhibodi Chakri Naruebodindra Hospital

Luntiya Srithet — 2025-06-25

Pressure injuries are a significant complication for patients globally and are particularly prevalent among hospitalized individuals, especially those who are critically ill. This issue is complex and challenging to address. This study is a retrospective descriptive analysis aimed at examining the factors associated with the development of new pressure injuries in the Intensive Care and Stroke Unit (SICU) at Ramathibodi Chakri Naruebodin Hospital. The study period spanned from January 1, 2021, to December 31, 2022, utilizing an analytical retrospective approach. Data were collected from electronic medical records, with a sample group of 91 subjects. The analysis employed descriptive statistics and multinomial logistic regression, reporting Adjusted Odds Ratios (AOR) at a 95% confidence interval. The findings indicated that several factors were related to the development of new pressure injuries in the SICU at Ramathibodi Chakri Naruebodindra Hospital, including a length of stay in the SICU exceeding 7 days (p=0.004), fever at 38 degrees Celsius (p=0.047), a Body Mass Index (BMI) of less than 18.5 kg/m² (p=0.015), bedridden status (p=0.001), and the use of gait aids (p=0.037). This study highlights that personal factors contribute to the development of new pressure injuries, informing nursing care planning to effectively reduce the occurrence of new pressure sores tailored to each patient’s specific risk factors.

A study of clinical outcomes and its associated factors after total knee arthroplastyr total knee arthroplasty

Patcharaporn Natsawang — 2025-06-25

This study is a retrospective descriptive research project examining clinical outcomes and associated factors following total knee replacement surgery. Data were collected from the medical records of patients who underwent elective total knee replacement at Ramathibodi Chakri Naruebodindra Hospital, along with electronic medical records, from January 1, 2020, to December 31, 2021. A total of 154 patients were included. Data were collected by recording forms, including personal data and adverse clinical outcomes. The data were analyzed using descriptive statistics and logistic regression analysis. The results revealed that most patients experienced mild or no pain both before and after surgery, with no reported infections or complications. Additionally, postoperative knee flexion improved significantly, increasing preoperatively to more than 100 degrees within 12 weeks after surgery. The average length of hospital stay was no more than five days. The adverse clinical outcomes after total knee arthroplasty at 12 weeks showed that age and body mass index significantly predicted the occurrence of knee flexion stiffness at 12 weeks, including increasing age (OR=0.944, 95% CI=.897-.993), increasing body mass index (OR=0.927, 95% CI=.864 -.996), and increasing body mass index was found to increase the risk of knee extension stiffness 1.115 times (OR=1.115, 95% CI=1.034-1.201). The findings of this study can guide hospitals in surgical planning and the development of care protocols to reduce adverse clinical outcomes in patients undergoing total knee replacement, ultimately enhancing patient safety.

Prevalence and associated factors of COVID-19 patients attending the fever clinic at Vajira Hospital

Lertsilapa Iemphong — 2025-06-25

This cross-sectional descriptive study aimed to determine the prevalence of COVID-19 infection and to analyze the association between sociodemographic characteristics and clinical symptoms with RT-PCR test results among patients attending the fever clinic at Vajira Hospital. Medical records of patients who visited the clinic between April 1 and July 31, 2021 were reviewed. A total of 390 cases were included in the study. Data were analyzed using the chi-square test and logistic regression.

The results revealed that the prevalence of COVID-19 infection among the sample was 11.8% (46 cases). Sociodemographic factors such as gender, age, and occupation were not significantly associated with RT-PCR results. However, certain clinical symptoms showed a statistically significant positive association with RT-PCR positivity, including tachycardia (heart rate>100 bpm; OR=2.554, p=0.047), tachypnea (respiratory rate>20 breaths/minute; OR=5.051, p=0.005), sore throat (OR=4.962, p=0.002) and productive sputum (OR=54.234, p<0.001). Although symptoms such as elevated body temperature (>37.5°C), cough, myalgia, runny nose, dyspnea, headache, loss of appetite and anosmia were more frequently observed among COVID-19 positive patients, no statistically significant associations were found with RT-PCR results in this study.

Effect of a program to enhancing health of activity aging among dependent elderly living in community

Mukjarin Suttisai — 2025-06-25

This study employed a quasi-experimental, two-group design to examine the effectiveness of a health of active aging enhancement program for dependent older adults in the community. The sample consisted of 44 dependent older adults in Nong Khrok Subdistrict, Mueang District, Sisaket Province. Participants were randomly selected and assigned into experimental and control group, with 22 individuals in each group. The health of active aging enhancement program was developed based on the World Health Organization’s concept of vitality combined with Bandura’s self-efficacy theory. The research instruments consisted of three parts: 1) a demographic questionnaire, 2) a health vitality assessment questionnaire for the elderly, and 3) a satisfaction questionnaire regarding the program. The intervention tool was the Health Vitality Enhancement Program for community-dwelling dependent elderly individuals. The content validity of the instruments was reviewed by three experts, and reliability was assessed using cronbach’s alpha coefficient, yielding values of 1.00, 0.86, and 0.74 respectively. Data were analyzed using mean, standard deviation, paired t-test and independent t-test.

The findings revealed that the experimental group showed significantly higher mean scores in health of active aging status after participating in the program compared to before the intervention (p<.05). Additionally, when comparing the experimental group to the control group, the experimental group exhibited significantly higher mean scores in health of active aging status (p<.001). The results suggest that the health of active aging enhancement program is an effective tool for improving the health of active aging status of dependent older adults in community settings. The program also shows promise for adaptation and application in diverse community contexts,contributing to the enhancement of older adults quality of life.

Predicting factors of quality of life in colorectal cancer with colostomy

Anuttra Wunnasaweg — 2025-06-25

This predictive research aims to study the quality of life and factors predicting quality of life in colorectal cancer (CRC) patients with colostomy who received services at the ostomy and wound nursing care clinic, Ubon Ratchathani Cancer Hospital between October 2022 and September 2023 resulting. The study included 96 participants selected through simple random sampling. The research instruments comprised patients’ demographic data, the quality of life index of Padilla and Grant, CRC with colostomy knowledge assessment and self-care assessment scale of CRC patients with colostomy and reliability was tested by using cronbach’s alpha coefficient obtained at 0.93, 0.88, 0.94 and 0.86 respectively. Descriptive quantitative statistics and stepwise multiple regression analysis.

The results present as following of CRC with colostomy had moderate level of quality of life (x̄=54.34, S.D.=15.77 The highest mean score was in the self-image perception (x̄=76.82, S.D.=11.26), while the lowest mean score was in the response to diagnosis and nutritional treatment (x̄=44.63, S.D.=8.21). Significant factors predicting QOL were self-care (β=0.69, p=<0.001), followed by comorbidities (β=-0.33, p=0.010), age (β=0.21, p=0.014), and knowledge about CRC with colostomy (β=0.18, p=0.025). All variables together predicted 77.5% of quality of life (R²=0.600, p<.05).

The recommendations for patient care should include promoting self-care abilities, managing comorbid conditions, adjusting care plans to suit different age groups, and providing education about the disease and colostomy care. Additionally, emphasis should be placed on developing appropriate nutritional guidelines for this patient group, as this factor significantly impacts their quality of life

Prevalence of contracting sexually transmitted diseases among pregnant teenage girls, Bang Phli Hospital

Khemika Rojtangkom — 2025-06-25

This study aimed to examine the prevalence of sexually transmitted diseases (STDs) among adolescent pregnancies receiving antenatal care at Bang Phli Hospital in Samut Prakan Province from 2018 to 2022. Data were collected from the antenatal care (ANC) service records of pregnant adolescents aged 10 to 19 years who attended antenatal care and underwent blood testing. The data were analyzed using descriptive statistics, including frequency, percentage, mean, and standard deviation.

The study revealed that among 1,598 pregnant adolescents, the majority 1,537 cases (96.18%) did not have STDs, while 61 cases (3.82%) tested positive. Syphilis was the most common infection, accounting for 2.57%, followed by HIV at 1.25%. The trend of syphilis infections showed an increasing pattern, while HIV infections exhibited a declining trend. The findings indicate that STDs among pregnant adolescents continue to be a significant public health concern, particularly with the rising prevalence of syphilis. Therefore, it is essential to integrate action plans among relevant agencies to enhance education, expand access to comprehensive antenatal care services, and promote preventive measures against STDs among adolescents. These efforts will effectively contribute to reducing infection rates and improving sexual health outcomes in the target population

Survey of Barthel Activities of Daily Living, Cognitive Function and Frailty of Elderly Who Obtained Service in Faculty of Medicine Vajira Hospital, Bangkok Metropolitan

Pornsiri Kanokkarnjana — 2025-06-25

This descriptive study aimed to explore the ability of Barthel Activities of Daily Living, Cognitive Function (BADLs), and frailty status of older adults who obtained service at the Faculty of Medicine Vajira Hospital, Bangkok Metropolitan, between January 2023 and December 2024. The samples were 367 individuals who aged 60 years and older, including outpatients and inpatients. Data were collected using structured interviews comprising four sections (1) a personal information questionnaire (2) a BADLs assessment form (3) a cognitive function assessment form and (4) a frailty assessment form were analyzed using descriptive and one sample t-test.

The results found that the participants were 173 outpatients; the mean age was 73.48 years (standard deviation [SD] = 7.88 years). Of these, 0.6% were dependent on BADLs, 35.8% had cognitive impairment, and 16.7% were classified as frail. Among the 194 inpatients, the mean age was 70.14 years (SD = 7.46 years). Of these, 3.6% were dependent on BADLs, 12.4% had cognitive impairment, and 17.5% were identified as frail. Notably, there were no statistically significant differences among these outcomes among outpatients (p value=1.000, .238 and .355 respectively) and inpatients (p value= .231, .893 and .132 respectively) at the 30-day follow-up.

The findings can be utilized as a primary data to reform and develop the geriatric healthcare service systems, including referral pathways and continuous follow-up care for both outpatients and inpatients. These efforts aim to prevent hospital readmissions and remediate functional decline in elderly.

The role of nurse anesthetists in caring for patients undergoing colonoscopy at Ramathibodi Hospital

Laddawan Prajuabklang — 2025-06-25

The cancer registry of Thailand for the year 2022 reported that colorectal cancer is among the top five most common cancers among Thais, with an incidence rate that continues to rise annually. One of the causes of the disease stems from lifestyle behaviors that increase the risk of its occurrence, particularly dietary habits. This article aims to highlight the critical role of nurse anesthetists in the care of patients undergoing colonoscopy, particularly in the appropriate management of anesthesia, continuous monitoring of vital signs throughout the procedure, and effective response to potential complications, such as hypotension. Skilled nurse anesthetists play a key role in ensuring the smooth and safe conduct of colonoscopies by meticulously managing medication and closely monitoring patients. Furthermore, their expertise enhances the overall quality of care, reduces the risk of complications, and improves patient satisfaction, contributing positively to both treatment outcomes and patient recovery.

Nursing care of patients with abdominal aortic aneurysm after endovascular aneurysm repair (EVAR) with Atrial fibrillation (AF): a case study

Kittiyaphorn Panvilai — 2025-06-25

Abdominal Aortic Aneurysm (AAA) is a vascular disease commonly found in urban populations. Currently, treatment often involves endovascular aneurysm repair (EVAR), which has fewer complications compared to open surgery. However, patients with cardiovascular comorbidities, such as Atrial Fibrillation (AF), may still experience AF episodes postoperatively despite good preoperative control. This complication increases the risk of mortality, prolongs hospital stays, and raises healthcare costs. This article aims to analyze the challenges and integrate nursing roles in caring for patients with AAA undergoing EVAR who also have AF, ensuring patient safety and optimal nursing outcomes.

Applying Dodd’s Symptom Management Concept to Relieve Pain Using the Warm Comfort Blanket Innovation in Patients With Colorectal Cancer Receiving Oxaliplatin : A Case Study

Kampon Introntakun — 2025-06-25

Pain management in colorectal cancer patients receiving oxaliplatin is challenging because oxaliplatin often causes severe pain. Effective pain management can help reduce suffering and enhance patients’ quality of life. which emphasizes patient participation in self-care. It focuses on three key elements: the symptom experience, symptom management strategies, and outcomes.

One of the innovations developed by Mahavajiravudh Ward 6A at Vajira Hospital to relieve pain is the “Warm Happiness Blanket”. This blanket employs a temperature control system (26–37°C) applied to the area where patients receive oxaliplatin, which helps improve blood circulation, reduce lactic acid buildup, and relax muscles. As a result, it effectively relieves pain without causing skin burns.

This article presents the application of Dodd’s symptom management concept using the “Warm Happiness Blanket” innovation in a single-case study. The findings show that it can effectively relieve pain without complications and that the patient was satisfied. Therefore, this innovation can be beneficial for further application in caring for colorectal cancer patients receiving oxaliplatin who experience pain, as well as in other similar contexts.