Vajira Nursing Journal

Incidence and Factors Associated with Hypersensitivity Reactions in Breast Cancer Patients Receiving Taxanes via Peripheral Intravenous Administration in the Mahavajiravudh 6A Ward (Day Care Chemotherapy) at Vajira Hospital

Mon, 22 Jun 2026 00:00:00 +0700

Hypersensitivity reactions to taxane-based chemotherapy are clinically significant
adverse drug reactions that may affect treatment continuity. This prospective
descriptive study aimed to investigate the incidence and factors associated with
hypersensitivity reactions in breast cancer patients receiving taxane-based
chemotherapy via peripheral intravenous administration between April and
October 2025. The sample consisted of 275 patients selected by simple random
sampling. Research instruments included a demographic questionnaire,
a treatment history questionnaire, a stress assessment scale, and an anxiety
assessment scale. Data were analyzed using descriptive statistics and logistic regression analysis.
The results showed that the incidence of hypersensitivity reactions among breast
cancer patients receiving Taxane-based chemotherapy via peripheral intravenous
administration was 49.82%. Factors significantly associated with hypersensitivity
reactions at the .05 level included age ≥ 60 years (Adjusted OR = 6.73, 95%
CI = 1.15–39.53), body mass index of 30.0–34.9 kg/m² (Adjusted OR = 3.96, 95%
CI = 1.16–13.53) and ≥ 35.0 kg/m² (Adjusted OR = 4.53, 95% CI = 1.07–19.09),
history of drug allergy (Adjusted OR = 2.79, 95% CI = 1.15–6.76), high stress
level (Adjusted OR = 4.22, 95% CI = 1.21–14.68), very high stress level (Adjusted
OR = 3.42, 95% CI = 1.08–10.82), and high anxiety level (Adjusted OR = 3.03,
95% CI = 1.22–7.51). These findings may be used as a guideline for risk
assessment and monitoring planning to enhance the safety and effectiveness of
chemotherapy administration.

Prevalence and Risk Factors of Postoperative Complications Following Cesarean Section at Ramathibodi Hospital

Oranuch Intasaro, Sarunya Sirisuwan , Nuttaya Pornmalairungruang — Mon, 22 Jun 2026 00:00:00 +0700

This study aimed to investigate the prevalence and risk factors of postoperative
complications following cesarean section at Ramathibodi Hospital.
The instrument used was a data collection form validated for content validity
(IOC = 0.90) and inter-rater reliability (Cohen's kappa = 0.88). A retrospective
cohort study was conducted by reviewing electronic medical records of 340
pregnant women who underwent cesarean section between 2022 and 2024.
Data were analyzed using descriptive statistics and multiple logistic regression.
The results showed that the majority of participants were aged 26-35 years
(59.41%), had a normal body mass index (62.35%), and had a gestational age
≥37 weeks (55.29%). The overall prevalence of maternal complications following
cesarean section was 4.12%, with the majority being emergency cesarean
sections (74.12%). Common indications included previous cesarean section
(57.35%), fetal distress (28.24%), and malpresentation (19.41%). Additionally,
preterm delivery was found in 44.71%, resulting in a 28.80% neonatal intensive
care unit admission rate. Multiple logistic regression analysis revealed that
significant risk factors included maternal age >35 years, gestational age <37
weeks, and maternal comorbidities.
The findings suggest that healthcare systems should prioritize enhancing
antenatal care quality and implementing proactive management for high-risk
maternal groups, particularly older mothers and those with underlying
conditions, to improve health outcomes for both mothers and newborns.

Comparison of Outcomes Between Radial and Femoral Access Approaches in Patients Undergoing Cardiac Catheterization at Ramathibodi Chakri Naruebodindra Hospital

Nutchanat Jongpean, Natcha Khetlikhitworagoo, Nuttaya Pornmalairungruang — Mon, 22 Jun 2026 00:00:00 +0700

This retrospective study aimed to compare clinical outcomes of cardiac
catheterization between radial access and femoral access in patients undergoing
cardiac catheterization from January to December 2024. Medical records of 109
patients were reviewed, including 38 patients in the radial access group and 71
patients in the femoral access group. Continuous variables were analyzed using
the Mann–Whitney U test, and categorical variables were analyzed using Fisher's
exact test. A p-value of < .05 was considered statistically significant. The results
showed that patients in the femoral access group were significantly older than
those in the radial access group (p < .001) and had a higher proportion of prior
cardiac catheterization (p = .024). For the primary outcome, there was no
significant difference in vascular access site complications between the two
groups (2.6% vs. 2.8; p = 1.000), and no major complications were observed. For
secondary outcomes, the radial access group had a significantly shorter
procedural time (p = .030), a higher rate of same-day discharge (p = .001), and a
shorter length of hospital stay (p = .002), while contrast volume did not differ
significantly between groups.
In conclusion, this study found no difference in vascular access site complications
between radial access and femoral access. Nevertheless, radial access
demonstrated advantages in procedural efficiency and reduction of hospital stay.
These findings support consideration of radial access as a preferred approach in
eligible patients.

Quality of Life Among Patients After Coronary Stent Implantation in Banphaeo General Hospital

Wipawee Chaiwattana — Mon, 22 Jun 2026 00:00:00 +0700

This descriptive research aimed to study the level of quality of life and the
relationship between quality of life and personal factors among patients after
coronary artery stent implantation at Banphaeo Hospital (Public Organization).
The sample consisted of 80 patients with cardiovascular disease who had
undergone cardiac catheterization and coronary stent implantation for at least 3
months. Participants were selected by purposive sampling. The research
instruments included a general information questionnaire and a Thai version of
the quality of life scale for patients with coronary artery disease. Data were
collected through interviews from February to April 2025. Data were analyzed
using descriptive statistics, including Pearson correlation analysis and biserial
correlation analysis.
The results showed that the overall quality of life of the patients was at a good
level. The aspect with the highest satisfaction and importance was the
healthcare services received, accounting for 86.9%. Salt intake was negatively
correlated with satisfaction toward quality of life (r = - 0.263) and with
perceived importance of quality of life (r = - 0.258). Kidney disease was also
negatively correlated with perceived importance of quality of life (r = - 0.292).
Educational level was positively correlated with both perceived importance and
overall quality of life after coronary stent implantation.
In conclusion, patients after coronary stent implantation had a good level of
quality of life. Health education regarding self-care, treatment, and prevention of
complications should be promoted, especially among patients with kidney
disease and those who consume salty foods, in order to improve their quality of l
ife.

Factors Associated with the Success of One-Day Surgery: A Retrospective Study in Ramathibodi Chakri Naruebodindra Hospital

Angkhana Ingkharat, Kannika Khamon, Wasana Lavin — Mon, 22 Jun 2026 00:00:00 +0700

One-Day Surgery (ODS) is an increasing and popular treatment option in the
public health around the world due to its efficiency and cost-effectiveness.
Discharge without complications and avoiding unplanned hospitalizations are the
aims of ODS.
This study investigated related factors of successful ODSs among 178 patients
who underwent an ODS at Ramathibodi Chakri Naruebodindra Hospital from
1 January 2022 to 30 September 2024. Descriptive statistics were used to analyze
the data as follows: the frequency, percentage, mean, and standard deviation.
Fisher’s exact test and chi-squared test were employed to determine
associations between variables and ODS success rates. The results showed that a
total of 150 patients (84.27%) had a successful ODS, and the success-related
factors were the administration of multimodal analgesia (p = .008), muscle
relaxants (p = .009), prophylaxis postoperative nausea and vomiting (p = .015),
type of anesthesia (p < .001) and ASA classification (p = .023). In conclusion,
these findings emphasize the importance of perioperative management protocol
by implementing targeted pain strategy and PONV control to optimize ODS
success rates and resource utilization.

A Study of Professional Nurse Roles In Urban Medicine Service Center, Bangkok Metropolitan

Phiyapong Harnsri, Gunyadar Prachusilpa, Thinnakorn Buachu — Mon, 22 Jun 2026 00:00:00 +0700

The purpose of this descriptive research was to study of professional nurse roles
in urban medicine service centers, Bangkok Metropolitan, using the Delphi
technique. The study participants consisted of 18 experts who possessed relevant
qualifications and professional experience in urban health medicine. Purposive
sampling technique was used to recruit the participants. Three rounds of
questionnaires provided two sections: open-ended and 5-point rating scale. The
Data were analyzed by median and interquartile range.
Findings revealed that the professional nurse roles in urban medicine service
centers, Bangkok Metropolitan achieved consensus among experts with median
between 4.00-5.00 and interquartile range was ≤ 1.5. These roles consisted of 8
roles as follows: 1) the role of holistic care manager in urban contexts (with 14
items) 2) the role of health promoter and proactive risk manager in urban
society (with 6 items) 3) the role of coordinator and integrator of urban health
service networks (with 8 items) 4) the role of patient advocate and
empowerment facilitator in urban settings (with 8 items) 5) the role of quality
manager and developer of urban medicine knowledge (with 9 items) 6) the role
of crisis and disaster manager in urban areas (with 5 items) 7) the role of
strategic leader and urban health system manager (with 4 items) and 8) the role
of driver of innovation and digital health technology in urban health (with 6
items)

The Study of G6PD Deficiency and Associated Factors With Complications in Neonates With Jaundice in the Neonatal Intensive Care Unit

Inn-on Chanapan, Chayaporn Wongyai, Wasana Lavin — Mon, 22 Jun 2026 00:00:00 +0700

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a major cause of severe
neonatal jaundice. If not diagnosed and treated promptly, it can lead to
neurotoxicity and permanent brain damage. However, data regarding its
relationship with severe complications in the neonatal intensive care unit (NICU)
setting remains limited. This study aimed to determine the incidence of G6PD
deficiency and analyze the relationship between this condition and clinical factors
as well as other complications. This retrospective descriptive study included 128
jaundiced neonates who underwent G6PD enzyme testing at the NICU of
Ramathibodi Chakri Naruebodindra Hospital between January 1 and December 31,
2023. The research instrument was a personal and clinical data collection form,
which was validated for content by experts. Data were analyzed using descriptive
statistics, Fisher’s exact test, Pearson’s chi-squared test, and multiple logistic
regression to determine adjusted odds ratios (aOR) with 95% confidence intervals
(CI).
Among the 128 participants, the mean birth weight was 2,410.59 ± 976.68
grams, and the mean gestational age was 34.84 ± 4.71 weeks. The incidence of
G6PD deficiency was found to be 8.59% (11 cases). Multiple logistic regression
analysis revealed that G6PD deficiency was significantly associated with birth
asphyxia (aOR 16.54; 95% CI: 1.22–223.84, p = .035). Other factors, including
gender, intraventricular hemorrhage (IVH), patent ductus arteriosus (PDA), and
hypoglycemia, showed no statistically significant association (p >.05). Close
monitoring and active screening for G6PD deficiency should be considered for all
high-risk neonates, particularly those with a history of birth asphyxia, timely
clinical management and prevent permanent neurological disability.

The Role of Professional Nurses in the Implementation of Index Partner Testing for People Living with HIV at Ramathibodi Hospital

Laor Nakgul — Mon, 22 Jun 2026 00:00:00 +0700

Thailand has demonstrated a strong commitment to reaching the national goal of
ending AIDS, as outlined in the National Strategy to End AIDS 2017–2030. Key to
this effort is the ongoing development and improvement of service delivery
strategies that ensure safety and ethical standards for both healthcare providers
and patients. Based on the 2024 national HIV epidemiological data,
approximately 20% of new HIV cases were among partners of people living with
HIV. This highlights the vital role of index partner testing as a key part of
Thailand’s HIV response. Encouraging partners of HIV-positive individuals to
undergo HIV testing promotes early diagnosis and timely access to care, which
are essential in preventing onward transmission. The need is especially urgent
among high-risk populations, including key groups, sexual partners of people
living with HIV, and adolescents vulnerable to sexually transmitted infections.
Identifying individuals unaware of their HIV status not only helps connect them
to appropriate healthcare services but also accelerates treatment initiation,
reduces new HIV cases, reduces viral spread, and ultimately cuts down AIDS-
related deaths.

The Proactive Role of Nurses in Preventing Violent Behavior in Psychiatric Patients in Hospital Settings

Mon, 22 Jun 2026 00:00:00 +0700

Violent behavior among psychiatric patients poses significant challenges, affecting patients, families, healthcare providers, and the public health system. This article aims to present the proactive role of nurses in preventing violent behavior in psychiatric settings through a review of psychiatric nursing literature and violence management strategies. Key proactive nursing roles identified include regular risk assessment of psychiatric patients, ensuring a safe environment, effective medication administration, developing communication skills to foster trust, and crisis management using nonviolent techniques.
Implementing these proactive roles can reduce the risk of violent incidents, improve health outcomes for psychiatric patients, alleviate financial and emotional burdens on families, and protect the mental health of caregivers. Importantly, psychiatric nurses must uphold ethical principles and safeguard the human rights of patients in all aspects of care.

Nursing Management for Patients with Mooren's Ulcer Treated with Cyclophosphamide: Case Study

Panida Tukkin, Sasiwimon Deekum — Mon, 22 Jun 2026 00:00:00 +0700

Mooren’s ulcer is an autoimmune disease causing corneal destruction with a high
risk of permanent vision loss. Although Cyclophosphamide treatment is highly
effective, it carries severe complication risks. This study aimed to evaluate
holistic nursing care and discharge preparation using the D-METHOD model in a
patient with severe Mooren’s Ulcer receiving Cyclophosphamide and Mesna. A
case study was conducted on a 51-year-old Thai female with bilateral severe
Mooren’s Ulcer. Gordon's Functional Health Patterns and the nursing process
were utilized, focusing on ocular assessment, pain management, corneal
perforation prevention, and safe chemotherapy administration.
The results revealed that the patient's pain score decreased from 9/10 to 3/10
within 48 hours. Corneal inflammation subsided without perforation, and no
chemotherapy-related complications occurred. Furthermore, the patient
demonstrated correct knowledge and self-care practices according to the
D-METHOD criteria before discharge. In conclusion, nursing care emphasizing
specialized ophthalmic competencies and clear discharge planning prevents
medication-related complications and enhances patient self-care, serving as a
standard clinical guideline in tertiary care settings.

Neonatal Hygiene Care in the Transition Period: From Traditional Practices to Clinical-Based Recommendations

Tassanee Griffin — Mon, 22 Jun 2026 00:00:00 +0700

Neonatal hygiene care during the transitional period is crucial for maintaining
physiological stability. This academic article aims to review the literature and
present practice guidelines by comparing traditional approaches with clinical
indication-based recommendations to prevent hypothermia in healthy term
neonates. Data were collected from academic databases spanning the years 2021
to 2026.
The review findings indicate that nursing care based on physiological readiness
(body temperature ≥ 36.5 °C) yields superior outcomes compared to traditional
time-based routines. Key recommendations include delaying the first bath for at
least 6 to 24 hours, and utilizing a sponge bath under a radiant warmer
combined with the application of virgin olive oil to preserve skin moisture and
vernix caseosa. An exception applies in cases of maternal infection, where
immediate bathing is mandated for infection control.
In conclusion, transitioning care practices from habitual routines to clinical
indication-based guidelines not only mitigates the incidence of neonatal
hypothermia but also elevates safety standards and promotes optimal clinical
outcomes for newborns.

Innovation in Delivery Room Medical Instrument Preparation: Integrating Lean and 7S for Parturient and Neonatal Safety

Tassanee Griffin — Mon, 22 Jun 2026 00:00:00 +0700

This academic article aims to synthesize a model for optimizing medical
instrument management in the delivery room by integrating Lean thinking and
the 7S. The objective is to address delays and discrepancies in the delivery of
life-saving tools.
This article highlights the proactive role of practical nurse in transforming routine
workload into a quality system through the strategy of "easy to retrieve, obvious
when missing, visually pleasing, and always safe." The synthesis of the new
workflow demonstrates that the processes of de-cluttering and systematic
sorting of the conventional system, visual management implementation, and
workflow optimization will enhance time efficiency, reduce clinical risks, increase
parturient and neonatal safety, and improve cost-effectiveness, while also
elevating the satisfaction and confidence of the multidisciplinary team.

Proactive Nursing Care for Prevention and Management of MDRPI in Preterm Infants Receiving Non-invasive Ventilation: A Case Study

Kittisak Sophan, Waraporn Trairat — Mon, 22 Jun 2026 00:00:00 +0700

Preterm infants are at high risk of developing medical device-related pressure
injuries (MDRPIs) because of immature skin integrity and prolonged use of non-
invasive respiratory support. MDRPIs may lead to infection, prolonged
hospitalization, scarring, and reduced quality of life. This article aims to present
a case study of proactive evidence-based nursing care for the prevention and
management of MDRPIs in a preterm infant. The case involved a male preterm
infant born at 29+1 weeks’ gestation with a birth weight of 976 g who was
diagnosed with respiratory distress syndrome and received non-invasive positive
pressure ventilation (NIPPV). Upon admission, the risk of skin injury was assessed
based on the principles of the Neonatal Skin Risk Assessment Scale (NSRAS),
together with systematic skin assessment. On the third day of hospitalization,
non-blanchable erythema was observed on the nasal bridge, consistent with a
stage 1 MDRPI. Nursing interventions included increased frequency of skin
assessment and interface rotation, application of prophylactic dressings, and
adjustment of device fixation to reduce pressure and friction. Following
continuous proactive nursing care, the erythema improved within 72 hours and
completely resolved by day 10 without progression of the lesion or secondary
infection. Skin integrity was maintained throughout the period of NIV support.
Proactive nursing care integrating evidence-based practice with risk assessment,
continuous surveillance, appropriate device management, and prophylactic skin
protection played a crucial role in reducing the severity of MDRPIs and enhancing
patient safety among critically ill preterm infants.