https://www.tci-thaijo.org/index.php/TJONC/issue/feed Thai Journal of Nursing Council 2018-09-27T16:01:20+07:00 รศ. ดร สายพิณ เกษมกิจวัฒนา saipin2499@gmail.com Open Journal Systems วารสารสภาการพยาบาลเป็นวารสารทางวิชาการที่มีการประเมินบทความและงานวิจัย โดยผู้ทรงคุณวุฒิที่มีความเชี่ยวชาญเฉพาะสาขา (peer review) กำหนดออกรายสามเดือน ปีละ 4 ฉบับ จัดทำโดยสภาการพยาบาล เพื่อเป็นแหล่งในการเผยแพร่ผลงานวิชาการ ทั้งด้านการพยาบาลทางคลินิกและชุมชน การศึกษาพยาบาล การบริหารการพยาบาล https://www.tci-thaijo.org/index.php/TJONC/article/view/132962 Frailty in Older Adults: A Case Study 2018-09-27T16:00:41+07:00 ธัญยรัชต์ องค์มีเกียรติ thanyarat.ong@mahidol.ac.th <p>This article presents an analysis of a case study of frailty in older adults dwelling<br>in community. The analysis was based on a review of literature concerning the defnition<br>of frailty, screening and diagnosis, risk factors, and management of frailty in older adults.<br>According to the analysis presented herein, the article proposes that nurses should serve<br>as case managers and nurse-led interdisciplinary team specialists to properly manage<br>this condition.<br>Frailty is a common geriatric syndrome that is not caused by usual degenerative<br>conditions. It results in inability to cope with stress and could cause such undesirable<br>outcomes as diseases, disabilities, and physical, psychological, and social vulnerabilities,<br>leading to frequent hospitalization, high health expenditure and medical expense per<br>capita, and increased mortality rate. Frailty can be prevented if health is promoted and<br>restored before the onset of disability. Screening of frailty in older adults, which is<br>performed using various multidimensional instruments, is based upon the presence of<br>three or more of fve phenotypes, namely, muscle weakness, walking at an unusually<br>slow pace, low level of physical activities, exhaustion, and unintentional weight loss.<br>Regarding the present case study, frailty was found amongst illiterate, older female<br>aged higher than 80 with low socio-economic status and insuffcient income, who had<br>three or more underlying diseases, used four or more medications, received little support<br>from their family or community, pursued unhealthy lifestyle, and lived in environments<br>neither physically nor socially friendly to older adults. The gerontological nurses play<br>an important part of nurse-led role in coordinating effcient management on risk factors<br>that contribute to physical, psychological, and environmental aspects, in order to prevent<br>or delay frailty or reduce its severity.</p> 2018-09-27T13:13:45+07:00 ##submission.copyrightStatement## https://www.tci-thaijo.org/index.php/TJONC/article/view/123019 Pain Assessment and Pain Management in Comatose Patients after Craniotomy: A Case Study 2018-09-27T16:01:07+07:00 Supornpan - Kitbunyonglers gitbunyong@hotmail.com wongchan pachpichain pwongcha@hotmail.com <p><span style="color: #004000; font-family: 'Browallia New',sans-serif; font-size: x-large;">The intensity of pain during the frst 48 hours after craniotomy may range from<br>moderate to severe. Relief of suffering and reduction of possibly ensuing complications<br>require effective pain assessment and management. This case study demonstrates roles<br>of advanced practice nurses in assessing and managing pain in comatose patients after<br>craniotomy. The patients’ pain was assessed through observation of the patients’ behaviours<br>and physiological changes and recorded on the Nociception Coma Scale (NCS). Pain<br>management was performed based on reliable, up-to-date, appropriate, and interdisciplinarily<br>recognised empirical evidence. The principle underlying this method was to achieve a<br>balance between the patients’ ability to respond to neurological assessment and the quantity<br>of analgesics that would not affect the patients’ response. In addition, non-pharmacological<br>pain management methods, for example, positioning, environmental arrangement, and<br>careful performance of pain-inducing medical procedure, were found to increase pain<br>management effcacy in this group of patients.</span></p> 2018-09-27T13:31:28+07:00 ##submission.copyrightStatement## https://www.tci-thaijo.org/index.php/TJONC/article/view/136754 Effect of Music Therapy on Sleep Quality in Older Persons 2018-09-27T16:01:07+07:00 Sureerat Na-Wichian taptim17@hotmail.com Rojanee Chintanawat rojanee.c@cmu.ac.th Jakkrit Klaphajone makodica@yahoo.com Paradee Nanasilp paradee.n@cmu.ac.th <p>Objective: To examine how music therapy could beneft older adults’ sleep quality.<br>Design: Quasi-experimental research.<br>Procedure: Fifty-two participants were recruited according to the inclusion criteria<br>and equally assigned to the experimental and control groups (26 persons in each group).<br>The participants were older adults with poor sleep quality, living in Phitsanulok City’s<br>municipal area. The experimental group received one music therapy session (30-45<br>minutes) per day before bedtime, at least three days a week, for four consecutive weeks.<br>The control group, on the other hand, did not receive any music therapy. The instrument<br>used for assessing sleep quality was the Pittsburgh Sleep Quality Index (PSQI). Data<br>were analysed using descriptive statistics, independent t-test, and paired t-test.<br>Results: After receiving music therapy, the experimental group’s sleep quality<br>was signifcantly better that that of the control group (p &lt; .001). In addition, the<br>experimental group displayed signifcantly higher sleep quality than before they received<br>music therapy (p &lt; .001).<br>Recommendations: The fndings of this study indicate that music therapy can<br>improve sleep quality among older adults.</p> 2018-09-27T14:11:09+07:00 ##submission.copyrightStatement## https://www.tci-thaijo.org/index.php/TJONC/article/view/124419 Effects of a Case-Based Management Nursing Programme for Terminally Ill Patients on Their Perception of Symptom-Induced Suffering and Terminal Care Quality 2018-09-27T16:01:12+07:00 Kittikorn Nilmanat knilmanat@gmail.com Kallaya Kallaya Sae-chid ya200304@gmail.com <p>Objective: To compare terminally ill patients’ perception of symptom-induced suffering<br>and terminal care quality before and after participating in a case-based management nursing<br>programme for terminal patients.<br>Design: One-group experimental research with a pre-test and a post-test.<br>Procedure: This study was conducted between August and November 2017 in a tertiary<br>hospital in Songkhla province. Through purposive sampling, 30 patients were recruited based<br>on the following qualifcations: 1) being adult patients diagnosed with terminal illnesses and<br>referred by their physicians to the palliative care centre; 2) being informed by their physicians of<br>their terminal illnesses and advised to receive palliative care; and 3) being of completely sound<br>mind. The patients participated in the 5-day case-based management nursing programme for<br>terminally ill patients. This programme was implemented in 5 stages: 1) identifying and selecting<br>patients; 2) assessing and examining their problems; 3) planning necessary case-based care methods<br>based on the problems identifed; 4) implementing the programme according to plan; and 5)<br>evaluating the outcomes of the programme.<br>Data were collected through 1) the patient’s general records; 2) the Thai version of<br>the Edmonton Symptom Assessment System; and 3) the Thai version of the Palliative Care<br>Outcome Assessment Scale developed by the Nursing Division, Maharaj Nakhon Chiang Mai<br>Hospital. The Edmonton Symptom Assessment System and the Palliative Care Outcome Assessment<br>Scale were subjected to a validity test using Cronbach’s alpha coeffcients, and scored .76 and<br>.73 (n = 20), respectively. The general data were analysed using descriptive statistics, whilst<br>the comparison between the perception of symptom-induced suffering and that of the palliative<br>care outcomes was measured using paired t-tests.<br>Results: After participating in the programme, the patients displayed a signifcantly<br>lower average score on symptom-induced suffering (t = 5.89, p &lt; .001) and a signifcantly<br>higher average score on the perception of palliative care quality (t = 3.72, p &lt; .001).<br>Recommendations: It is suggested that this case-based programme be used in palliative<br>care centres as a means of alleviating symptom-induced suffering in terminally ill patients<br>and improving palliative care quality.</p> 2018-09-27T14:23:54+07:00 ##submission.copyrightStatement## https://www.tci-thaijo.org/index.php/TJONC/article/view/121610 Sexuality Education for Early Adolescents: A Review of Literature 2018-09-27T16:01:13+07:00 เบ็ญจมาศ โอฬารรัตน์มณี benjamat.han@mahidol.ac.th <p>This article analyses characteristics and outcomes of a sexuality education programme<br>for early adolescents in Thailand. Using the PICO framework to conduct a search through<br>the Thai Journal Citation Index Centre, ScienceDirect, PubMed, and Google Scholar,<br>the researcher obtained ten experimental studies that met the criteria. An analysis of<br>these studies led to the following fndings.<br>First, the sample population consisted of early adolescents aged 13-15 years,<br>living with their parents and having moderate study results.<br>Second, most sexuality education programmes were school-based. These programmes<br>were intended for early adolescents, took place from 1 to 8 times, and involved a variety<br>of media, such as lectures, discussions, role-playing, games, videos, and contraceptive devices.<br>With an aim to prevent risky sexual behaviours, these programmes focused on developing<br>a thinking process and life skills through three major activities: 1) providing sex education,<br>whose contents included physical change and sexual development in adolescents; risky<br>sexual behaviours and situations; sexually transmitted diseases; pregnancy; use of condoms;<br>refusal techniques; abortions; and sexual rights and equality; 2) peer-inspired creation of<br>proper attitudes towards safe sex; and 3) building life skills, which included critical and<br>creative thinking skills; awareness or perception of self-capacity; relationship building;<br>refusal techniques; problem-solving skill; critical decision-making skill; brainstorming<br>skill; and practical simulations.<br>Third, empirical evidence obtained through the literature review concerned sex<br>education assessment; attitudes towards safe sex and avoidance of risky situations; and<br>lack of assessment of risky sexual behaviours and sexual health, such as postponement of<br>sexual intercourses or avoidance of unplanned pregnancy. In most studies, evaluation<br>was performed at the end of experiments, without follow-ups or long-term evaluation.<br>It is recommended that sexuality education programmes be adjusted to include all<br>aspects of sexuality and provide enough information for adolescents to acquire through social<br>medias. In addition, assessment methods should be designed to focus on knowledge needed<br>for maximum prevention of risky sexual behaviours. Lastly, post-experimental follow-ups<br>and evaluation of sexual behaviour should be extended to at least three to six months.</p> 2018-09-27T00:00:00+07:00 ##submission.copyrightStatement## https://www.tci-thaijo.org/index.php/TJONC/article/view/116063 Sex Education for Adolescents in School: A Case Study in Bangkok 2018-09-27T16:01:14+07:00 วัลยา ธรรมพนิชวัฒน์ wanlaya.tha@mahidol.ac.th เบ็ญจมาศ โอฬารรัตน์มณ benjamat.han@mahidol.ac.th <p>Objective: To explore students’ needs for information on sex education, teachers’<br>and school administrators’ opinions on sex education for adolescents in school, and parents’<br>or caregivers’ attitudes towards adolescents’ sexual behaviors and sex education.<br>Design: Descriptive research.<br>Procedure: Quantitative and qualitative data were collected from three groups of<br>participants in two public secondary schools in Bangkok. The frst group (262 seventhand eighth-graders) completed the Needs for Sex Education Information questionnaire.<br>The second group (the students’ parents or guardians, totalling 227), responded to the<br>Attitudes towards Adolescents’ Sexual Behaviours and Sex Education questionnaire.<br>The third group (eight teachers and school administrators) participated in a semi-structured<br>interview. Descriptive statistics were used for quantitative data analysis, and content<br>analysis for the qualitative data.<br>Results: More than half of the students stated that they wanted their school to<br>increase the contents of sex education, particularly on pregnancy prevention and birth control,<br>decision-making and refusal skills, and sexually transmitted diseases. Teachers and school<br>administrators viewed sex education as a good approach to sexual risk prevention in<br>adolescents, and also identifed major limitations of the current sex education, which<br>included teachers’ lack of knowledge and skills, inadequate time, and absence of proper<br>teaching media. Effective school-based sex education should start at grades 4-6, along<br>with adjustment of its contents to meet the students’ needs and ongoing development of<br>teachers’ skills in giving sex education. Moreover, most of the parents or guardians<br>had positive attitudes towards sex education and realised that they should have a role in<br>teaching sex education to their adolescent children.<br>Recommendations: Teachers should be trained to improve their skills in giving<br>integrated, comprehensive sex education. Good communication between parents/<br>guardians and schools’ personnel should be established to enhance their collaboration<br>in teaching sex education. Further studies should focus on research and development<br>of school-based sex education models that can be applied to students at all levels.</p> 2018-09-27T14:48:54+07:00 ##submission.copyrightStatement## https://www.tci-thaijo.org/index.php/TJONC/article/view/121529 Caregiving Activities, Motivations for Caregiving, and Job Satisfaction of Paid Caregivers for Bed Bound Older Adults 2018-09-27T16:01:15+07:00 ณปภัช สิงห์เถื่อน rungtiwa.sin@gmail.com สุปรีดา มั่นคง supreeda.mon@mahidol.ac.th ยุพาพิน ศิรโพธิ์งาม yupapin.sir@mahidol.ac.th <p><br>Objective: To study 1) caregiving activities; 2) caregiving motivations; and 3) job<br>satisfaction of paid caregivers for bed bound older adults.<br>Design: Descriptive research.<br>Procedure: The participants were 36 paid caregivers to take care of bed bound older<br>adults at their homes for 1 month or more. Data were collected using three questionnaires (namely,<br>a questionnaire on demographic data; a questionnaire on their caregiving activities for bed<br>bound older adults; and a questionnaire on their satisfaction with the job of caring for bed bound<br>older adults) and an interview on their motivations to become caregivers for bed bound<br>older adults. The data were analysed using descriptive statistics and content analysis.<br>Results: More than two-thirds of the participants (69.4%) had not passed an older<br>adult caregiving training programme. Their major caregiving activities included an average<br>of 8.17 daily routine activities and 6.50 specialised care activities, in addition to mental,<br>emotional, and social activities. The participants’ caregiving motivations included their 1) need<br>for income; 2) love of caregiving; 3) bond with older adults; and 4) desire for knowledge and<br>experience, respectively.<br>The participants displayed a high overall degree of satisfaction with their job. The three<br>aspects offering the highest satisfaction were occupational pride, opportunity to live with elderly<br>people, and the opportunity to take care of older adults, respectively. In contrast, the three aspects<br>offering lowest satisfaction concerned their permitted holidays, welfare received, and income,<br>respectively.<br>Recommendations: According to the fndings, healthcare teams should provide paid<br>caregivers with proper training to improve their skills in caring for bed bound older adults and<br>responding to their complicated needs. Meanwhile, promotion of factors contributing to caregivers’<br>job satisfaction is also recommended.</p> 2018-09-27T14:57:26+07:00 ##submission.copyrightStatement## https://www.tci-thaijo.org/index.php/TJONC/article/view/127710 Conformity to Subjective Norm and Attitudes towards Breastfeeding in Public, as Observed in Mothers with Children Aged 6-12 Months 2018-09-27T16:01:16+07:00 สุพัชรี เกิดสุข kerdsuj@gmail.com พรรณรัตน์ แสงเพิ่ม parnnarat.san@mahidol.ac.th ทัศนี ประสบกิตติคุณ tassanee.pra@mahidol.ac.th <p>Objective: This study compared mothers who did breastfeeding in public with<br>those who did not in terms of their conformity to subjective norms and attitudes towards<br>breastfeeding in public.<br>Design: Descriptive comparative design.<br>Procedure: The sample consisted of 68 mothers who had their children, aged<br>between 6 and 12 months, immunised at Sukhaphap Dek Dee Clinic (Healthy Kids Clinic).<br>Data were collected by means of (1) a general profle form; (2) a ‘Mother’s Experience<br>in Breastfeeding in Public’ questionnaire; (3) an ‘Acceptance of Breastfeeding in Public’<br>questionnaire; and (4) an ‘Attitudes towards Breastfeeding in Public’ questionnaire’.<br>The data were analysed using descriptive statistics, Mann-Whitney U-test and an<br>Independent T-test.<br>Results: The study revealed no statistically signifcant difference between the two<br>groups of mothers in their conformity to subjective norms regarding breastfeeding in public<br>(.05 (Z = -1.313, p = .189)). However, the two groups displayed a statistically signifcant<br>difference in their attitudes towards breastfeeding in public (t = -2.325, df = 66, p &lt; .05).<br>Recommendations: It is recommended that nurses provide mothers with practical<br>preparatory guidelines to breastfeeding in public, and give them compliments, in order<br>to help them develop positive attitudes towards and confdence in breastfeeding in<br>public.</p> 2018-09-27T15:11:30+07:00 ##submission.copyrightStatement## https://www.tci-thaijo.org/index.php/TJONC/article/view/125288 Nutrition-Promoting Work at a Primary School in Nakhon Pathom Province 2018-09-27T16:01:20+07:00 ประกายมาศ บรรจงรักษา ooouiii@hotmail.com กมลรัตน กิตติพิมพานนท noppawan.pia@mahidol.ac.th นพวรรณ เปียซื่อ noppawan.pia@mahidol.ac.th ซู้หงษ์ ดีเสมอ noppawan.pia@mahidol.ac.th <p>Objective: To describe the work process, success and obstacles in the development of<br>nutrition and health among students, in Bandongkate school.<br>Design: Case study<br>Procedure: The participants included core-team students and members, instructors,<br>administrators, parents, food sellers, educational committee and the local government.<br>Through purposive sampling, 18 participants from Healthy Kids, Healthy Food (Dek Thai<br>Kam Sai) Project were selected. Data were collected using interview, observation, and feld<br>note with a follow up for data collection. Data were analyzed using content analysis.<br>Results: The school had work process in nutrition through planning that was integrated<br>with the Suffcient Economy Project existing in the school. An emphasis was on extending<br>poultry farm along with the development of the student cooperation system to deliver raw<br>products to the school lunch program. Success factors included the policy on health promotion<br>support that was clearly communicated and the staff included administrators, staff at all levels,<br>school networks, community and local government with their participation in students’ nutrition<br>and health promotion. In addition, the school provided learning environments for students<br>through resource utilization in the community and the integration of courses with eight activities<br>consisting of; farming, student cooperation, food services, monitoring nutritional status, developing<br>healthy habits, healthy environment, health services, and learning activities for agriculture,<br>nutrition, and health. The problems and obstacles were limited farming areas in the school and<br>discontinuity of information transfer when the responsible instructor moved.<br>Recommendation: The results revealed approaches to community participation and<br>integration of networking for learning environment in nutrition, leading to proper nutritional<br>status and quality of life among students, resulting from success and sustainable development.</p> 2018-09-27T15:33:35+07:00 ##submission.copyrightStatement##