Nursing Journal CMU

EDITORIAL

Kannika Kantaruksa — 2024-03-27

Factors Predicting Self-Management Among Elderly Monks with Hypertension

Sutthinan Codrington — 2024-03-03

Self-management refers to actions taken by persons with chronic disease to improve their quality of life. This predictive correlational study aimed to describe self-management, health literacy, self-efficacy, and social support and to examine the factors predicting self-management in elderly monks with hypertension. A purposive sampling of 196 elderly monks with hypertension were recruited through health care services from the outpatient department of a university hospital. Participants responded to interview forms which included personal information and information on illness-related data records, self-management behaviors, health literacy, self-efficacy, and social support. Descriptive statistical analysis and stepwise multiple regression analysis were used to analyze the data.

The research findings indicated that the participants had self-management, health literacy, self-efficacy, and social support at a moderate level. Health literacy, self-efficacy, and social support collectively predicted self-management in the sample, accounting for 88.7% of the variance (β = 0.887, F = 15.578, p < .001). Health literacy was the highest predictor (β = .617, p < .001), followed by social support (β = .547, p < .001) and self-efficacy (β = .079, p < .05).

The findings provide foundational information to promote health literacy and social support enhancing self-management for elderly monks with hypertension.

Knowledge, Adherence, and Barriers Related to Ventilator-Associated Pneumonia Prevention Among Critical Care Nurses in Baoshan, the People’s Republic of China

Renjing Jiang — 2024-03-11

Ventilator-associated pneumonia (VAP) is the most common complication found among patients who use mechanical ventilation as a life support measure. To improve the quality of nursing practice related to VAP prevention, baseline information regarding knowledge, adherence, and barriers related to VAP prevention among critical care nurses should be explored. This descriptive correlational design aimed to explore knowledge, adherence, and barriers to VAP prevention among critical care nurses in Baoshan City, the People’s Republic of China. The relationship between knowledge and adherence was also determined. Purposive sampling was used to recruit 142 critical care nurses from six hospitals in Baoshan City, Yunnan province, the People’s Republic of China. Measurement tools were composed of 1) the demographic data record form, 2) questionnaires related to knowledge towards prevention of VAP (QKVAP), and 3) the Questionnaire on VAP Prevention Compliance and Barriers (QVAPCB). The Chinese versions of these instruments were used. The internal consistency of the QKVAP using the KR-20 formula was .81, and the Cronbach's alpha coefficients of the QVAPCB adherence and barrier parts were .91 and .87, respectively. Data were analyzed using descriptive statistics and Spearman's rank-order correlation test.

The results of this study were as follows:
1. The majority of participants (81.69%) had knowledge of VAP and VAP prevention at a fair level;
2. The majority of participants (95.07%) perceived adherence to VAP prevention at a sufficient level;
3. Knowledge was positively related to adherence to VAP prevention at a low level (r = .255, p < .001);
4. The top three barriers towards VAP prevention perceived by critical care nurses were forgetfulness to perform some evidence-based procedures (90.14%), staff shortages in the unit (82.39%), and noncompliance of patients in performing VAP prevention practice (59.15%).

The study findings provide baseline information regarding critical care nurses’ knowledge and adherence, as well as the barriers to complying with VAP prevention. Further research should explore the factors influencing collaboration on and barriers to VAP prevention related to the use of ventilators in each ICU in order to have strategic plans to improve the VAP prevention.

The Effects of an Educational Program for Heart Failure Prevention Using Telephone Monitoring on Symptoms and Quality of Life Among Patients with Valvular Heart Disease

Apinya Wongpiriyayothar — 2024-03-21

Patients with valvular heart disease will experience fewer symptoms of heart failure and have a higher quality of life if they learn about heart failure prevention. This experimental research design aimed to examine the effects of an educational program for heart failure prevention using telephone monitoring on symptoms and quality of life (QOL) among patients with valvular heart disease. The sample consisted of 44 patients who followed up for treatment at Mahasarakham Hospital. Table random sampling was used to assign the patients to an experimental or a control group. The research instruments included the Educational Program, the Symptom Severity Scale, and the SF-36 for measuring QOL. The reliabilities of the questionnaires were 1.00 and .88, respectively. Data were analyzed using descriptive statistics, Mann-Whitney-U test, Wilcoxon signed-rank test, t-test and paired t-test.

The results showed that after the intervention, the experimental group had statistically significantly lower perceived symptom severity scores for dyspnea on exertion and nausea than the control group (p < .05). The experimental group had statistically significantly lower symptom severity scores for dyspnea on exertion, orthopnea, foot and ankle swelling, dry cough, fatigue, nausea, dizziness, palpitation, and chest pain than before the intervention (p < .05). There was no difference in QOL scores between groups. However, the experimental group demonstrated a significantly greater change in QOL scores, compared to the control group. The experimental group also had statistically significantly higher QOL scores than before the intervention (p < .05).

The study indicates that this educational program can reduce the severity of crucial HF symptoms and improve the QOL of patients with valvular heart disease. Therefore, nurses should apply it to prevent HF in these patients.

Obstacles and Supportive Behaviors of Emergency Nurses Regarding End-of-life Patient Care

Sutthatip Yuayai — 2024-03-21

Emergency department (ED)care focuses on caring for patients with life-threatening conditions, causing end-of-life (EOL) care to be neglected. This descriptive study aimed to explore obstacles and supportive behaviors of emergency nurses regarding end-of-life patient care. The sample was comprised of 385 emergency nurses, conveniently recruited according to inclusion criteria. The research instrument consisted of the Perceived Obstacles and Supportive Behaviors in Caring for End of Care of ED Nurses Questionnaire. The Cronbach’s alpha coefficients of the Perceived Obstacles and Supportive Behaviors in Caring for End of Care subscales were .85 and .80, respectively. The data were organized and analyzed using descriptive statistics.

The study found that the top three obstacles in caring for EOL patients among ED nurses were: restrictions on family members in the ED during cardiopulmonary resuscitation (M = 3.39, SD = 0.81), insufficient time to provide quality EOL care because nurses have to do activities to save the patient's life (M = 3.31, SD = 0.84), and the ED design is poorly conducive to the privacy of dying patients and their grieving family (M = 3.30, SD = 0.83). The top three supportive behaviors in caring for the EOL of patients among ED nurses were: good communication between doctors and nurses caring for dying patients (M = 3.52, SD = 0.68), a process for physicians involved in the patient's care to agree on the same care guidelines (M = 3.36, SD = 0.81), and a process for family members to accept that the patient is dying (M = 3.23, SD = 0.77).

The results of the study could be used as basic information for planning and improving the quality of EOL patient care among ED nurses in the future.

Factors Related to Readiness to Care of Caregivers of Critical Illness Survivors before Hospital Discharge

Nutvadee Krasae — 2024-03-21

Caregivers of critical illness survivors are important in terms of caring for those survivors during rehabilitation and helping them with all activities. The purpose of this descriptive correlational research was to study factors involved in the readiness to care of caregivers. Participants were 85 caregivers of patients who had survived a critical illness before discharge from a university tertiary hospital in the northern region. The research instruments were composed of a Personal Record Form for caregivers, the Readiness to Care Questionnaire for caregivers, a questionnaire on Social Support from Healthcare Provider for caregivers, and an Anxiety Assessment. Validity and reliability of all analytical tools were approved. Data were analyzed using descriptive statistics and Pearson's correlation coefficient statistics.

The results showed that the participants were at a high level of readiness to care (M = 85.32, SD = 26.42), received social support from their healthcare provider at a moderate level (M = 74.70, SD = 19.92), and had anxiety at a moderate level (M = 46.77, SD = 9.60). In addition, social support from the healthcare provider was significantly positively correlated with the readiness to care of caregivers of intensive care unit survivors (r = .53, p < 0.01). Caregivers’ anxiety was significantly negatively correlated with the readiness to care of caregivers of intensive care unit survivors (r = - .52, p < 0.01).

The findings of this study can be used as basic information for nurses to prepare caregivers’ readiness in caring for critical illness survivor patients. Furthermore, they can be used to improve the quality of nursing services.

Effects of a Health Promotion Program on Foot Ulcer Prevention Behavior Among Uncontrolled Type 2 Diabetes Mellitus Patients

Junya Konyai — 2024-03-22

Foot ulcers are a common complication in people with type II diabetes who are unable to control their blood sugar levels. The purpose of this quasi-experimental two-group pre-posttest design was to investigate the effects of a health promotion program on foot ulcer prevention behavior for patients with uncontrolled type 2 diabetes. The sample was obtained by simple random sampling and consisted of 72 uncontrolled type 2 diabetes mellitus patients. The subjects were assigned to an experimental group or a control group with 36 people in each group. The research instruments were divided into 2 parts: part 1 consisted of a demographic characteristic questionnaire and a behavioral questionnaire on preventing foot ulcers, with reliability coefficients of .88; part 2 consisted of a health promotion program to prevent foot ulcers in patients with type 2 diabetes who cannot control their sugar levels. Data were analyzed using descriptive statistics, paired t-test, and independent t-test.

The results of the study showed that after participation in the program, the mean score of foot ulcer prevention behavior for the experimental group (M = 96.41, SD = 9.11) was significantly higher than that before participation (M = 88.86, SD = 13.2) (t = -7.47, p <.01) and that of the control group (M = 78.02, SD = 9.81) with statistical significance (t = 8.23, p < .01).

This study showed that the health promotion program for patients with type 2 diabetes who are unable to control their blood sugar levels can increase health promotion behavior to effectively prevent foot ulcers. Health care providers can use these results to develop guidelines for patient care.

Effects of a Positive Caring Aspect Enhancement Program on Positive Caring Aspects and Well-Being Among Caregivers of Older Persons with Chronic Disease

Orawan Pankong — 2024-03-22

Chronic disease affects the disabilities of older people. The family caregiver is a key person in caring for older people with chronic diseases. This quasi-equivalent control group design aimed to evaluate the effects of a positive caring aspect enhancement program on positive caring aspects and well-being among caregivers of older persons with chronic disease. Fifty caregivers were selected by purposive sampling, and simple random sampling was used to assign them to an experimental group or a control group in equal numbers. The experimental group participated in the Program for Enhancing the Positive Caring Aspects for 6 weeks, while the control group received usual care. Data was collected using the Positive Aspects of Caregiving Questionnaire and the General Well-Being Schedule, and analyzed using descriptive statistics, one-way and two-way repeated measure ANOVA.

The results found that:
1. After the experiment, positive caring aspects in the experimental group were significantly higher than those before participation in the program (p <. 05) and were significantly higher than those of the control group (p < .05).
2. After the experiment, well-being in the experimental group was significantly higher than before participation in the program (p < .05) and was significantly higher than that of the control group (p < .05).

The results of this study suggest that a program for enhancing positive caring aspects can be applied to caregivers of older people with chronic diseases in communities.

Effect of PITS-based Education to Enhance Health Literacy on Self-Management Among Older Persons with Chronic Obstructive Pulmonary Disease

Jiratchaya Donchai — 2024-03-22

Appropriate self-management among older persons with chronic obstructive pulmonary disease (COPD) requires health literacy enhancement including cognitive and social skills both of which can be developed with PITS models that emphasize patient-centered care in order to achieve skill adaptation and learning. This experimental research aimed to study the effect of PITS-based education to enhance health literacy on the self-management of older persons with COPD. The sample consisted of older persons with COPD receiving services at sub-district health promoting hospitals in Maelao district, Chiang Rai province. Fifty-four subjects were randomly selected and equally assigned into either a control or an experimental group, with 27 subjects in each group. The experimental group was provided with group education 4 times, twice a week, and one session for individual education resulting in a total education period of 5 times over 3 weeks. The control group was given routine care. The research instruments included a teaching plan, the health literacy manual for chronic obstructive pulmonary disease patients, teaching for health literacy enhancement via the COPD patients’ video, an understanding personal perception scale, and a health literacy for COPD questionnaire. Data collection tools consisted of a personal and illness data recording form and a questionnaire on self-management behaviour for older persons with COPD. Data were analysed using descriptive statistics, independent t-test, and dependent t-test.

The results revealed that the mean score for self-management of older persons with chronic obstructive pulmonary disease receiving PITS-based education was higher than the score for those receiving routine care (p < .001), and higher than before, at a significant level (p < .001).

The results indicate that PITS-based education can enhance health literacy and self-management among older persons with chronic obstructive pulmonary disease. Hence, healthcare personnel can apply PITS-based education as a guideline for enhancing self-management among older persons with chronic obstructive pulmonary disease.

The Effect of an Empowerment Enhancing Program for Village Health Volunteers on Drug Delivery Service Practices to Persons with Chronic Non-Communicable Diseases in Communities

Preeda Sutthiprapa — 2024-03-22

Empowering village health volunteers’ effectiveness regarding drug delivery service practices to persons with chronic non-communicable diseases in communities results in continuity of treatment and reduces the risk of complications of chronic non-communicable diseases in those communities. This quasi-experimental study, with a two-group, pretest-posttest design, aimed to study the effect of an empowerment enhancing program for village health volunteers on drug delivery service practices to persons with chronic non-communicable diseases in communities. The participants included 50 village health volunteers who worked in a health promoting hospital in Saraphi district, Chiang Mai province, and who were assigned to two groups with 25 participants in each by simple random sampling. The research instruments consisted of 1) an 8-week empowerment enhancing program for village health volunteers, developed by the researcher based on Gibson’s empowerment theory; 2) a handbook and media on drug delivery service practices to persons with chronic non-communicable diseases; and 3) an assessment form on drug delivery service practices to persons with chronic non-communicable diseases which was verified for content accuracy by six experts demonstrating a content validity index of .96 and a Cohen’s kappa coefficient of .85. The data were analyzed with descriptive statistics, Wilcoxon signed-rank test, and Mann-Whitney U test.

The results showed that the experimental group had higher mean scores (M = 20.92, SD = 0.27) for drug delivery service practices for persons with chronic non-communicable diseases in the community (M = 2.96, SD = 1.46) than before receiving the empowerment enhancing program, with a statistically significant difference (Z = -4.407, p < 0.001), and higher than those of the control group (M = 3.92, SD = 1.14) with a statistically significant difference (Z = -6.418, p < 0.001).

The results of this research can be used as guidelines for community nurse practitioners and health care teams to promote and enhance the potential of village health volunteers, with knowledge, confidence, and skills, to provide drug delivery services to people with chronic non-communicable diseases in the community, effectively, accurately, and efficiently.

The Effect of a Participatory Learning Program on Opisthorchiasis Preventive Behaviors of At-risk Populations in a Community

Janetitsiri Trakultasanor — 2024-03-26

Opisthorchiasis is a major contributor to the development of cholangiocarcinoma. Despite long-term efforts to control opisthorchiasis, incidence of the disease continues to persist. Therefore, it is crucial for at-risk populations to adopt preventive behaviors against opisthorchiasis. This quasi-experimental research aimed to compare preventive behaviors for opisthorchiasis among an at-risk community population before and after receiving a participatory learning program. The study also aimed to compare the preventive behaviors between a group that received the program and a group that received regular services over an 8-week period. The sample consisted of 54 individuals from at-risk populations in a community, divided into an experimental group of 27 individuals and a control group of 27 individuals. The study was conducted in Ban Had district in Khon Kaen province. The research tools included the participatory learning program developed by the researcher. Data collection tools included a general information questionnaire and a questionnaire on opisthorchiasis preventive behaviors. The content validity index (S-CVI) of the tools was .99, and reliability was assessed using Cronbach's alpha coefficient with a reliability value of .87. Data analysis was performed using descriptive statistics, Mann-Whitney U test, and Wilcoxon matched-pairs signed-ranks test.

The results showed that the experimental group, who received the participatory learning program for 8 weeks, had a mean score (M = 87.66, SD = 3.05) for opisthorchiasis preventive behaviors which was significantly higher than their pre-program score (M = 71.08, SD = 4.13) (p < .001). The experimental group also had a significantly higher mean score compared to the control group which received regular services (M = 69.56, SD = 2.99) (p < .001).

This study demonstrates that the participatory learning program can effectively promote opisthorchiasis preventive behaviors among at-risk populations in a community.

The Effect of an Empowerment Program on Care Practices of Local Caregivers in Caring for Bedridden Older Persons with Pressure Ulcers in a Community

Nonglak Kumchom — 2024-03-26

Promoting local caregivers to have the confidence and skill to effectively care for bedridden older persons with pressure ulcers in communities can significantly reduce complications associated with managing pressure sores in this population. This quasi-experimental research, using a two-group, pretest-posttest design, investigated the effect of an empowerment program on care practices of local caregivers in caring for bedridden older persons with pressure ulcers in a community. The participants were sixty local caregivers working in Phetchabun Province. The participants were selected by purposive sampling and assigned to an experimental group (n = 30) or a control group (n = 30). The research instruments consisted of 1) an empowerment program on care practices for bedridden older persons with pressure sores; 2) a manual and media on care practices for bedridden older persons with pressure sores, and the caregiver 4.0 application; and 3) an assessment form on care practices for bedridden older persons with pressure sores which was verified for content accuracy by six experts, yielding content validity indices of .95 while reliability was confirmed by Kuder-Richardson (KR-20) at .93. The data were analyzed with descriptive statistics, paired t–test, and independent t–test statistics.

The results showed that the experimental group had higher mean scores for care practices (M = 29.46, SD = 1.63) than before participating in the empowerment program (M = 3.43, SD = 1.27) and higher than those of the control group (M = 3.26, SD = 1.28) with statistical significance (t = -68.72, p < 0.001 and t = -69.02, p < 0.001, respectively).

This finding can be used as a guide for community nurses and health care teams to promote the empowerment of local caregivers to ensure and maintain the practices of caring for bedridden older persons with pressure sores in the community, accurately, and efficiently.

The Effects of a Health Belief Model–based Program on Tuberculosis Preventive Behaviors Among Male Prisoners

Nasroh Yunus — 2024-03-26

Tuberculosis (TB) infection rates among prisoners typically tend to increase. TB prevention is, therefore, important. This study quasi-experimental research used a pretest-posttest design with a comparison group. The purpose of the research was to study the effects of a Health Belief Model–based program on TB preventive behaviors among male prisoners. The sample of male prisoners was divided into an experimental group and a comparison group, each with 36 participants. The experimental group underwent 4 weeks of the Health Belief Model–based program for TB prevention with the results measured after the 4 weeks. The research tools consisted of the Health Belief Model-based program; a general information questionnaire; and the TB prevention behaviors questionnaire, the reliability of which was .80. Data were analyzed by descriptive statistics, independent t-test, and paired t-test.

The results show that the experimental group had an average score for TB prevention behaviors (M = 3.39, SD = .102) higher than before the experiment (M = 3.19, SD = .137) and higher than that of the comparison group (M = 3.14. SD = .116) with a statistically significant difference (t = 6.96, p < .001; t = 9.77, p < .001, respectively)

The study results are beneficial for nurses working in prisons and other staff who are involved to apply this perception-enhancing program to prevent TB infection in prisons effectively.

Effects of an Educational Program to Enhance Health Literacy on Sexually Transmitted Disease Prevention Behaviors Among 7th-grade Student Leaders in a High School in Savannakhet Province, LAO PDR

Lotchana Nonpasith — 2024-03-26

Sexually transmitted infections among high school students in Laos continue to present a health issue for this group. Therefore, promoting behaviors to prevent them is of great importance. This quasi-experimental research using a two-group pretest–posttest design aimed to study the effects of an educational program to enhance health literacy on sexually transmitted disease prevention behaviors among 7th-grade student leaders in a high school in Savannakhet Province, LAO PDR. The sample group consisted of 126 high school student leaders (Grade 7) divided into an experimental group and a comparison group of 63 people each for a period of 6 weeks. The tools used in the study had two parts. Part 1 was a program to promote health literacy towards sexually transmitted infection prevention behaviors using a teaching model based on the Medagogy theory using PITS teaching principles. Part 2 was the data collection form, which consisted of a behavioral questionnaire for prevention of sexually transmitted infections. Cronbach's alpha coefficient was checked for reliability at .92. Data analysis used descriptive statistics, independent t-test, and paired t-test.

After undergoing the educational program to promote health literacy, the experimental group had a significantly higher mean score (M = 93.11, SD = 18.94) for sexually transmitted infection prevention behaviors than before (M = 65.13, SD = 15.79) receiving the program (p < .001) and their behavior in preventing sexually transmitted infections after the experiment was significantly higher than that of the comparison group (M = 78.32, SD = 16.45) (p < .001).

The study revealed that the educational program can enhance health literacy on sexually transmitted disease prevention behaviors among high school student leaders, and therefore, it could be applied to groups of students in other areas with similar contexts.

The Development and Effects of a Clinical Nursing Practice Guideline for Amphetamine Patients with Aggressive Behaviors in Regional Health 12

Rattiya Sanseree — 2024-03-26

Clinical nursing practice guidelines are guidelines developed from a review of empirical evidence to be used to support nurses’ decision-making in providing appropriate patient health care. This research and development aimed to develop and evaluate nursing guidelines for amphetamine patients with aggressive behavior. The development process has 2 phases: 1) develop guidelines by determining the problems, review the literature, develop draft guidelines check, and evaluate the quality of the guidelines by 5 experts, and 2) Evaluate the effectiveness of the guidelines. The sample consisted of registered nurses and amphetamine patients with aggressive behavior. Multi-stage sampling was used to select 30 hospitals from hospitals with drug clinics in Health Region 12 (7 provinces, 89 hospitals). Thirty nurses were selected by purposive sampling while 60 amphetamine patients were equally and randomly assigned to either the experimental or control group. The experimental instrument was the nursing guidelines for amphetamine patients with aggressive behavior. The data collection instruments were a satisfaction assessment and the feasibility of the use of guidelines for nurses, and an aggressive behavior scale for patients. Chi-square statistics and t-tests were used for data analysis.

The results found that:
1. The nursing guidelines for amphetamine patients consisted of 3 phases of the nursing process: pre-event, during event, and post event. Content validity (CVI) = .96, AGREE II value = 89.29%, feasibility of use = 90-100%, and overall satisfaction with the use of the guidelines was at a high level (M = 3.00)
2. After implementing the nursing guidelines, significantly lower aggressive behavior mean scores were found, between after (M = 1.33, SD = 1.54) and before (M = 10.80, SD = 3.20), (t = 17.68, p < .05). The mean scores for aggressive behavior of patients in the experimental group who received the guidelines (M = 1.33, SD = 1.54) were significantly lower than those in the control group who received usual care (M = 10.87, SD = 3.31) (t = -14.31, p < .05).

This guideline could be used in caring for amphetamine patients with aggressive behavior in other hospitals.

Quality Improvement of the Well-Child Clinic Care Model on Parental Health Literacy and Child Health Outcomes

Sasithorn Lerdpiromluk — 2024-03-26

The Well-Child Clinic plays an important role in promoting good health and development during early childhood. Providing a Learning process for parents in the clinic can enhance the knowledge, understanding, and ability of parents to raise their children correctly and appropriately. This developmental research aimed to develop a care model on parental health literacy and child health outcomes, for a well-child clinic at a tertiary hospital. The Department of Health’s (Ministry of Public Health) guidelines for implementing a well-baby clinic and Nutbeam and Pengchan’s concepts of promoting health literacy were used as the guidelines for developing the model. The purposive sampling consisted of 30 parents of early childhood-aged children, and 30 early childhoods. The research was conducted in four phases: 1) analyzing the situation, 2) developing the service model, 3) implementing the developed model, and 4) evaluating the results. The research instruments consisted of the well-child clinic care model and a program to promote parental health literacy. The data collection tools consisted of a demographic form, a focus group interview form, a health literacy questionnaire, a breastfeeding record form, a child health record form, a growth chart, and a Developmental Surveillance and Promotion Manual (DSPM). Data were analyzed using descriptive statistics and paired t-test.

The results show that parents' health literacy improved. The mean overall health literacy score after the experiment (Mean = 172.03, SD = 18.23) was significantly higher than before the experiment (Mean = 154, SD = 14.02) (t = -7.08, p < 0.001). All infants received continuous breastfeeding. After parents participated in the program, however, child health outcomes including nutritional status, oral health, and development remained the same as before participation.

Well-Child Clinic Care Model development could increase parental health literacy in raising their children which may have a positive impact on early childhood health outcomes.

Maternal Health Literacy and Health Behaviors During Pregnancy of First-Time Pregnant Women

Patcharida Yeethohun — 2024-03-27

Maternal health literacy and health behaviors during pregnancy are very important for the health status of pregnant women and their fetus. The purpose of this descriptive correlational research was to explore the relationship between maternal health literacy and health behaviors during pregnancy of first-time pregnant women. The participants were 84 primigravida pregnant women attending antenatal care at Maharaj Nakorn Chiang Mai Hospital and Health Promotion Center Region 1 Chiang Mai. The research instruments consisted of 1) a personal information questionnaire; 2) the maternal health literacy scale by Guttersrud et al., translated into Thai by Waraphok et al., with reliability determined by a Cronbach’s alpha coefficient of .88; and 3) a questionnaire on the health behavior of pregnant women developed by the researchers, with content validity of 1. The questionnaire’s reliability was tested by Cronbach’s alpha coefficient, yielding a value of .86. Data were analyzed by descriptive statistics and Spearman’s rank correlation coefficient.

The research found that:
1. Participants (63.10%) had a high level of maternal health literacy with a mean score of 64.02 (SD = 11.67).
2. Participants (79.76%) had a high level of health behaviors during pregnancy with a mean score of 176.15 (SD = 23.77).
3. Maternal health literacy had a statistically significant positive correlation with health behaviors during pregnancy of first-time pregnant women at a high level (r = .81, p < .001).

The results of this study can be used as basic information and as a guideline for healthcare personnel to improve maternal health literacy. This can improve health behaviors during pregnancy among first-time pregnant women.

Interpreting Arterial Blood Gas and the Role of Nurses in Caring for Patients with Abnormal Arterial Blood Gas

Nuttapol Chaihan — 2024-03-27

Abnormalities in the body's acid-base balance can lead to critical complications. In certain cases, the irregularity is so severe that it poses a life-threatening risk to the patient. Nurses must be able to do arterial blood gas (ABG) analysis. The objectives of this article are to: 1) present the physiological basis for arterial blood gas evaluation; 2) present a systematic 5-step blood gas analysis method; and 3) present the role of nurses in caring for patients with abnormal arterial blood gas values. The steps in evaluating and analyzing arterial blood gases consist of determining: 1) the partial pressure of O₂ in arterial blood; 2) the concentration of hydrogen ions; 3) the respiratory and metabolic components; 4) whether the respiratory or metabolic value is consistent with the pH value; and 5) whether compensation is present. Three case scenarios are also provided to assist the reader in practicing ABG interpretation. The ability to reliably assess ABGs enables nurses to assist in restoring a patient's acid-base balance.

Post-Intensive Care Syndrome: Assessment Tools and Prevention

Chanon Khanantai — 2024-03-27

Post-intensive care syndrome (PICS) occurs in over half of critically ill patients who survive treatment in the ICU. This condition consists of 3 groups of impairments: 1) physical impairments, 2) cognitive impairments, and 3) mental health impairments. PICS leads to increased disability and mortality. This article aims to present the pathophysiology, risk factors, assessment, and prevention of PICS through ABCDEF Bundle care. Nurses can apply knowledge from this review in caring for ICU patients to prevent PICS.

The Nurse's Role in the Nursing Care of Patients Undergoing Transcatheter Aortic Valve Implantation: A Case Study

Kronthip Inmueang — 2024-03-27

Severe aortic valve stenosis is a common medical problem with rising prevalence in older adults, affecting their health outcomes and quality of life. Previously, patients have often undergone standard surgeries, such as aortic valve replacement via full sternotomy; however, this approach might not be suitable for patients with a high surgical risk. Transcatheter aortic valve implantation has, thus, become an increasingly preferred alternative surgery since it could minimize mortality and adverse consequences. Additionally, this technique could reduce hospital stay durations and minimize wound size. However, some risks could also arise. Consequently, this essay attempts to present how nursing care is offered, covering the pre-and post-operative periods, and self-care once patients have returned home to prevent disease recurrence while enhancing the patient's quality of life and achieving health outcomes.

Nursing Care of Malnourished Hemodialysis Patients: A Case Study

Chiraphorn Phrakhunanan — 2024-03-27

Chronic kidney disease (CKD) involves permanent abnormalities for kidney structure or function. Disease severity is progressive to stage V, known as end-stage kidney disease, at which point patients should receive renal replacement therapy. Hemodialysis is a high quality renal replacement therapy and very popular in Thailand. However, hemodialysis can result in a catabolic state and loss of amino acids during dialysis. Furthermore, the patient may experience uremia symptoms that cause anorexia, nausea, and vomiting. Thus, hemodialysis patients are more likely to develop malnutrition. The purpose of this article is to present a case study on nursing care for malnourished hemodialysis patients, involving a patient who had been on hemodialysis for seven years and was malnourished. However, the patient refused a feeding tube. The patients’ nutritional status was determined by dietary assessment, clinical assessment, and a nutrition assessment tool. This information was collected to determine the related nursing diagnosis followed by modifications to the nursing care plan and provision of nursing care. In addition, an evaluation of nursing care and patient responses were continuously analyzed.