Nursing Research and Innovation Journal

Nursing Care for Prevention of Sternal Wound Infection in Patients after Coronary Artery Bypass Graft Surgery

Pinyo Jaroensuk — 2024-04-19

Sternal wound infection in patients after coronary artery bypass graft (CABG)surgery is an important complication that affects physical and psychological dimensions.The physical dimension may include wound pain, isolation, delayed wound healing,wound dehiscence, re-operation, and prolonged length of stay; the psychological dimension may include hopeless, depression, and feeling of insecurity. From this literature review, factors related to sternal wound infection among patients after CABG surgery are as follows: 1) the host (e.g., age, gender, obesity, malnutrition, anemia,
comorbidities, level of hemoglobin A1 C, estimated glomerular filtration rate, and left ventricular ejection fraction, and attitude toward surgical wound care), 2) the agent(e.g., pathogen), and 3) the environment (e.g., types of surgery and duration time of surgical site infection). This article aims to describe factors related to sternal wound infection, nursing care for preventing sternal wound infection, and patient self-care at home, leading to prevention of sternal wound infection, patient safety, and increased quality of life.
Keywords : Coronary artery bypass graft surgery, Nursing care, Prevention, Sternal wound infection

Roles of Nurses in Caring for Patients with Cardiac Arrhythmias by Installing a Holter Monitor: A Case Study

Nattira Chanviavit — 2024-04-19

Cardiac arrhythmia is a condition in which the heart rate is irregular; the heart rate is faster or slower than normal unsuitable for the body’s condition at that time. This feature may also include abnormal heart rhythms.Checking for abnormal heart rhythms with an electrocardiogram (ECG)is the easiest and fastest way to examine with a simple procedure that provides preliminary answers. However, for those with occasional or short-term arrhythmias, the arrhythmia may not be detected during their visit.Consequently,a 24-hour continuous ECG recorder with a Holter monitor has been used to detect more abnormalities in the ECG. This article aims to explain the roles of nurses in assessing, caring, and providing nursing care to patients who need continuous ECG recording 24 hours before, during, and after the Holter monitor installation. Accurate nursing care tailored to each patient will enable him/her to receive continuous and effectivecare. The patients can behave correctly per suggestions, leading to aquick and accurate diagnosis.
Keywords: Cardiac arrhythmia, Holter monitor, Role of nurses

Editorial Note

Supreeda Monkong — 2024-04-19

Factors Influencing Self-Concept of Adolescents with Epilepsy

Chuthathip Mongkholkham — 2024-04-19

This cross-sectional descriptive study was designed to investigate the self-concept of adolescents with epilepsy and its influencing factors of gender, severity of epilepsy, and family functioning on the self-concept of adolescents with epilepsy guided by Bracken’s Self-Concept Model. A total of 82 adolescents with epilepsy, 12-18 years of age,were selected by purposive sampling from pediatric neurology outpatient clinics from three tertiary care medical centers, who had a minimum standard score above 70 on the Peabody Picture Vocabulary Test, Fourth Edition. Participants completed the Demographic Questionnaire, Epilepsy Severity Scale, Piers-Harris Self-Concept Scale,3rd Edition, and General Functioning 12-item Subscale. Neurology clinic charts were reviewed for the type and frequency of seizures, and the number of antiepileptic drugs.The data were analyzed using descriptive statistics and multiple regression. The findings revealed that the participants had an average level of self-concept overall and in most domains. However, they had a low level in two domains of self-concept: happiness and satisfaction, and intellectual and school status. Epilepsy severity and family functioning could co-predict overall self-concept by 7.10 % significantly, while there was no correlation between gender and self-concept. Based on the study findings, nursing implications should screen individuals' self-concept (particularly happiness and satisfaction, intellectual and school status), and emphasize the severity of epilepsy and family functioning to promote adolescents with epilepsy for a positive self-concept.
Keywords : Adolescents, Epilepsy, Self-concept

Factors Related to Sleep Duration and Night Waking in Hospitalized Infants with Cyanotic Congenital Heart Disease

Porntiwa Sanpawut — 2024-04-19

This study aims to describe factors related to sleep duration and night waking in infants aged 6–12 months old with cyanotic congenital heart disease (CCHD) who were admitted to a pediatric cardiology ward at a tertiary hospital between December 2019 and September 2021. Data were obtained using the Demographic Data Record Form, Sleep-related Factors Questionnaires (the severity of heart failure, temperament,and caregiving activity), and the Infants’ Sleep-wake States Record Form. The record forms were assessed using video recording of the infants during 24 hours, and the data were then analyzed using descriptive statistics, the Pearson product-moment correlation coefficient, and Spearman’s rho correlation. The results revealed that most hospitalized infants with CCHD had a mean total sleep duration during the 24 hours of 770.44 minutes. The average number of night waking was 14.26 times/night. According to the correlation analysis, the severity of heart failure did not show a statistically significant correlation with sleep duration or night waking. Temperament was moderately and significantly correlated with sleep duration but not with night waking. Caregiving activities were moderately and significantly correlated with sleep duration and night waking. These results demonstrate that nurses and healthcare professionals should be aware of sleep problems in infants with cyanotic congenital heart disease and plan interventions to manage sleep disturbance to ensure good sleep quality.
Keywords: Congenital heart disease in infants, Cyanotic congenital heart disease, Night waking, Sleep duration

Effects of Teaching with Multimedia on Knowledge, Behavior in Face-down Positioning, and Satisfaction in Patients with Retina Diseases Undergoing Ophthalmic Gas Injection and in Face-down Position

Angun Noyudom — 2024-04-19

This two-group quasi-experimental study aimed to examine the effects of teaching with multimedia on knowledge, behavior in face-down positioning, and satisfaction with the teaching in patients with retina diseases undergoing ophthalmic gas injection and in face-down positions in a tertiary hospital.Purposive sampling with inclusion criteria was used to recruit 60 participants, divided into the experimental group (n = 30) and the control group (n = 30). The experimental group received teaching with multimedia plus usual care, while the control received only usual care. The research intervention used multimedia,namely caring for people with retinal disease afte rundergoing surgery with gas injection and in a face-down position. The instruments for data collection were the Demographic Data Form, the Knowledge Questionnaire, the Behavior in Face-Down Positioning after Surgery Questionnaire, and the Satisfaction with Multimedia Questionnaire. Data analyses were performed using descriptive statistics and the non-parametric Mann-Whitney U test. The findings revealed that at the pretest, the mean ranks of knowledge in the experiment and control groups were not significantly different. After the experimental group received multimedia teaching, the mean ranks of knowledge and postoperative behavior in the face-down position were significantly higher than those in the control group. The experimental group also had a significantly higher mean rank of knowledge after receiving multimedia teaching than the pretest. In addition, the participants in the experimental group were very satisfied with multimedia teaching. The study’s results demonstrate the effects of multimedia in providing knowledge and advising people with retinal disease undergoing gas injection to perform correctly.Therefore, teaching with multimedia is a method of choice to enhance patients’ knowledge by seeing pictures and hearing sound effects. This will allow a more accurate understanding of the contentand methods of performing face-down position and increase satisfaction with the service received.
Keywords :Face down position,Multimedia,Ophthalmic gas injection,Retinal diseases

Quality of Life and Satisfaction with Immediate Breast Reconstruction after Mastectomy in Patients with Breast Cancer

Pintong kitbun — 2024-04-19

This descriptive cross-sectional research aimed to explore the quality of life and satisfaction with immediate breast reconstruction after mastectomy in patients with breast cancer.Purposive sampling was used to select a sample of 80 patients diagnosed with breast cancer undergoing immediate breast reconstruction after mastectomy. They were recruited at an outpatient surgical department clinic in a university hospital in Bangkok, Thailand. The instruments used for collecting data comprised the Demographic Data Form and the BREAST-Q Version 2.0© Reconstruction Module Postoperative Scales(Thaiversion),consisting of two parts: quality of life and satisfaction. Data were analyzed using descriptive statistics. The quality of life had three domains (physical well-being,psychosocial well-being, and sexual well-being), it was found that the physical well-being domain had the highest mean score,while the sexual well-being domain had the lowest.For the satisfaction part, the domains were analyzed, the mean satisfaction with care was the highest; however, the satisfaction with the information subdomain was lower than other subdomains. Among the four types of surgery,the quality of life in terms of physical well-being, particularly the chest of the patients receiving latissimus dorsi flap, had the highest mean score. However, the satisfaction with breasts of transverse rectus abdominis myocutaneous flap reconstruction had the highest mean score. The results of this study can be used as basic information for patients and healthcare providers to decide on optimal breast reconstruction that meets the patients’demands and to develop care to enhance sexual well-being.
Keywords: Breast cancer, Immediate breast reconstruction,Mastectomy, Quality of life,Satisfaction

The Effect of a Discharge Planning Program for Patients after Coronary Artery Bypass Graft Surgery on Knowledge of Self-Care after Surgery, Self-Care Behaviors, and Satisfaction

Atchara Ponchai — 2024-04-19

This quasi-experimental study with a one-group pretest-posttest design aimed to 1)compare the self-care knowledge of patients before and after receiving a discharge planning program for patients after coronary artery bypass graft (CABG) surgery; 2) compare the self-care behavior of the patients after receiving the discharge planning program between the first and the second hospital follow-ups; and 3) explore the satisfaction of the patients with the discharge planning program. A total of 26 patients after CABG surgery at a university hospital in Bangkok were recruited by purposive sampling. The discharge planning program consisted of three phases: the pre-operation phase—patient preparations before CABG surgery; the post-operation phase—visiting patients on the ward after CABG surgery and patient preparation before hospital discharge; and the post-discharge phase—patient follow-up by providing telephone calls and visiting at outpatient clinic. Data were collected using the Personal Data Questionnaire, Self-Care Knowledge Questionnaire, Self-Care Behaviors Questionnaire,and Satisfaction with Discharge Planning Program Questionnaire.Data were analyzed using descriptive statistics, paired t-test, and Wilcoxon signed rank test. The results of the study showed that 1)after receiving the discharge planning program, the mean score of self-care knowledge of patients after CABG surgery was significantly higher than that before receiving the discharge planning program; 2) at the second hospital follow-up, the mean rank of self-care behaviors of patients after CABG were significantly higher than that at the first hospital follow-up; and 3) the patients had a high level of satisfaction with the discharge planning program. In conclusion, the discharge planning program positively promoted knowledge and self-care behaviors of patients after CABG surgery. However, the generalization is limited because this study did not have a control group.Therefore, the program’s effectiveness should be further tested before being used as a guideline in patients undergoing CABG surgery.
Keywords: Coronary artery by past graft surgery, Discharge planning program, Knowledge,Satisfaction, Self-care behaviors

Effects of Counseling Interventions in Persons with Prediabetes and Prehypertension on Health Indexes

Oratai Somnarin — 2024-04-19

This pre-experimental research aimed to investigate the effect of counseling intervention in persons with prediabetes and prehypertension on blood glucose and lipid levels,blood pressure, body mass index, and waist circumference. The sample was recruited by purposive sampling of 29 community-dwelling people with prediabetes and prehypertension.The counseling interventions were guided by the Health Action Process Approach conceptual framework, including five meetings: establishing relationships, explaining knowledge about potential diseases and blood examination indexes, recommending proper exercise, selecting healthy diets, and setting mutual goals to solve health problems. The group discussion was conductedamong 3-5 persons per group.Data were collected using a health problem interview form, blood examination, and physical examination (blood pressure, body mass index, and waist circumference) at pre- and post-counseling interventions for 12 months. Data were analyzed using descriptive statistics, paired t-test, and Wilcoxon’s signed rank test. The findings revealed that most of the sample had to go to work hurriedly in the morning. They could not have breakfast but had a meal in the evening or before sleeping. They did not have time and they lacked the knowledge and motivation for exercise. They were often stressed and anxious about the economic problems and responsibility for their family.After the intervention for 12months, the mean scores of health indexes:blood glucose, total cholesterol, triglyceride,diastolic blood pressure, body mass index, and waist circumference were significantly lower than those of the pre-intervention. However, low-density lipoprotein and high-density lipoprotein in blood and systolic blood pressure were not significantly different from the pre-intervention. In conclusion, the counseling intervention program could reduce some important health indexes in persons with prediabetes and prehypertension. However, generalizability is limited with the pre-experimental design, so this program should be further tested for its effectiveness with an experimental design in people with prediabetes and prehypertension.
Keywords: Counseling intervention, Health index, Prediabetes, Prehypertension

Factors Related to Sleep Quality among Nursing Students in Southern Nursing College Network

Thanaporn Darakai — 2024-04-19

This cross-sectional survey research aimed to examine factors related to sleep quality among nursing students at Southern Network College of Nursing. The sample consistedof 251 students from the Bachelorof Nursing Program in the 1st-4th year of the academic year 2021 by simple random sampling. Research tools comprised the General Information Questionnaire,the Pittsburgh Sleep Quality Index,the Sleep Hygiene Questionnaire, the Depression Anxiety Stress Scale (DASS-21), and the Bedroom Environment Assessment. Data were analyzed using descriptive statistics and Spearman rank correlation. Results revealed that 92%of the sample were female, with a mean age of 20.97 years, and reported poor sleep quality of 74.90%. The significant negative factors related to sleep quality were sleep hygiene, anxiety, year of study, depression,and bedroom environment, respectively. Therefore, educational institutions should be concerned with students’ sleep hygiene, care for mental health problems by the year level, and provide a bedroom environment conducive to sleep for nursing students.
Keywords: Bedroom environment, Mental health problem, Nursing students, Sleep hygiene, Sleep quality