Thai Journal of Nursing Council วารสารสภาการพยาบาลเป็นวารสารทางวิชาการที่มีการประเมินบทความและงานวิจัย โดยผู้ทรงคุณวุฒิที่มีความเชี่ยวชาญเฉพาะสาขา (peer review) กำหนดออกรายสามเดือน ปีละ 4 ฉบับ จัดทำโดยสภาการพยาบาล เพื่อเป็นแหล่งในการเผยแพร่ผลงานวิชาการ ทั้งด้านการพยาบาลทางคลินิกและชุมชน การศึกษาพยาบาล การบริหารการพยาบาล en-US (Saipin Kasemkitwattana) (นางสาวภูษณิศา แก้วเขียว) Fri, 15 Jun 2018 14:01:29 +0700 OJS 60 Design Thinking Process: New Perspective in Thai Healthcare System <p>Design thinking refers to a creative, human-centred thinking process. This system<br>of thinking can lead to transdisciplinary innovations because the ideas and imaginations<br>are derived from staff members with various organisational backgrounds. A prototype<br>created from a design thinking process can be promptly tested and adjusted to ensure it<br>ultimately produces the desired outcomes.<br>This article aims to describe a design thinking process developed using the D<br>School concept. This process involves 5 stages, namely, (1) Developing an in-depth<br>understanding; (2) Defning and interpreting problems; (3) Unlimited sharing of<br>imaginations and creative ideas; (4) Developing a prototype; and (5) Testing the<br>prototype.<br>In the context of Thai healthcare system, design thinking refers to creation of<br>innovations that not only respond to patients’ needs and hopes, but also address the<br>problems faced by the patients, caregivers, and healthcare personnel. Design thinking<br>also contributes to the planning of innovative healthcare services, as it can be applied<br>by nurses to systematically design clinical problem-solving approaches and healthcare<br>systems that effectively respond to patients’ needs.</p> นุชจรี กิจวรรณ ##submission.copyrightStatement## Mon, 11 Jun 2018 16:09:15 +0700 Postoperative Cognitive Dysfunction in Older Adults: Knowledge and Nursing Care Based on Empirical Evidence <p>Abstract<br> The incidence of Postoperative Cognitive Dysfunction (POCD) usually increases<br>in elderly people. However, because the knowledge of POCD is not widely known,<br>healthcare personnel may mishandle the condition, wrongly assuming that older adults’<br>memory loss is a normal age-related physiological consequence. Elderly patients with<br>POCD usually display slow postoperative recovery, a high rate of re-hospitalisation,<br>and an increased mortality rate. In addition, POCD affects the quality of life of both the<br>elderly patients and their families. Currently, mechanisms leading to POCD are not<br>fully understood, but they are believed to be related to several factors. As healthcare<br>personnel working closely with elderly patients, nurses are, therefore, required to develop<br>a better understanding of POCD. Such an understanding could enable them to properly<br>monitor any resulting abnormalities and provide elderly patients with suitable care<br>based on empirical evidence, to prevent or reduce POCD-related abnormalities in this<br>group of patients.</p> พรนภา นาคโนนหัน ##submission.copyrightStatement## Tue, 12 Jun 2018 00:00:00 +0700 Effects of Arm Swing Exercise Programme on Nutritional Status in Female Older Adults at Risk of Metabolic Syndrome <p>Abstract<br>Objective: To examine effects of an arm swing exercise programme on the nutritional<br>status of female older adults at risks of metabolic syndrome.<br>Design: One-group, self-control experimental research.<br>Procedure: The sample included 55 female older adults with excessive waist<br>circumferences, all residing in an urban community in Bangkok. Data collection, which<br>was by means of a questionnaire and baseline nutritional assessment, took place in 2<br>periods: a 4-week control period (from the start of the study to programme administration)<br>and a 4-week experimental period. The data were analysed using descriptive statistics,<br>one-way ANOVA with repeated measures, and multiple comparisons.<br>Results: After the program, the sample’s mean BMI (27.0 + 3.2 kg./m2) was<br>lower than before the programme (27.4 + 3.3 kg./m2) and lower than the baseline<br>(27.3 + 3.2 kg./m2), at a statistically signifcant level (F = 31.296, p &lt; .001). The<br>participants’ mean WC (93.6 + 8.9 cm) was lower than before the programme (94.7 +<br>9.2 cm.) and lower than the baseline (94.6 + 9.2 cm.), at a statistically signifcant<br>level (F = 18.645, p &lt; .001).<br>Recommendations: The results indicated that the arm swing exercise programme<br>was effective in reducing BMI and WC in female older adults. The programme, therefore,<br>could be applied by community nurse practitioners and health teams to promote better<br>health in female older adults residing in the communities.</p> <p>&nbsp;</p> Kobkul Kleebbua, นพวรรณ เปียซื่อ, นรีมาลย์ นีละไพจิตร, สุกัญญา ตันติประสพลาภ ##submission.copyrightStatement## Tue, 12 Jun 2018 10:31:17 +0700 Development of a Caring Procedure for Hospitalised Terminal Cancer Patients <p>Abstract<br> Objective: To develop a procedure to care for cancer patients in the terminal stage<br>of their lives.<br> Design: Developmental research.<br>Procedure: This study was conducted in 2 stages. In the frst stage, a caring procedure<br>for hospitalised terminal cancer patients was developed. The procedure development integrated<br>(i) the Australian Research Council’s clinical procedure development concept; (ii) the<br>palliative care framework under the standard nursing process (known as LIFESS) proposed<br>by Thailand’s National Health Security Offce; (iii) empirical evidence from 8 studies;<br>and (iv) Maharaj Nakhon Chiang Mai Hospital’s palliative care procedure. In the second<br>stage, the feasibility of the procedure was assessed. The procedure was employed by<br>10 registered nurses who volunteered as primary nurses, in a 2-week experiment with<br>terminal cancer patients hospitalised in the volunteer nurses’ ward.<br> Results: The caring procedure for hospitalised terminal cancer patients was<br>implemented in 2 stages. The pre-operational stage involved (i) receiving the patients’<br>terminal-stage diagnosis; (ii) informing the patients and/or their relatives of the diagnosis,<br>to seek a mutual caregiving agreement; and (iii) providing information to assist the patients<br>and/or their relatives in selecting caregiving methods. The operational stage concerned<br>(i) preliminary assessment of the patients’ conditions; and (ii) implementation of the<br>procedure according to the caregiving plan. Based on the feasibility assessment, the procedure,<br>reviewed by 3 specialists, displayed a content validity index of 0.89. The experiment<br>with the patients showed that the volunteer nurses unanimously regarded the procedure<br>as being simple, practical, and suitable for the context of caring for this group of patients.</p> Sang-arun Isaramalai, จารุภา สุพรรณสถิตย์ ##submission.copyrightStatement## Fri, 15 Jun 2018 13:58:31 +0700 Factors Associated with Sarcopenia Amongst Older Adults in Congested Communities in Bangkok <p>Abstract:<br> Objective: To describe rate of sarcopenia, and relationship between personal and<br>health factors with sarcopenia, muscle stungthand walking speed in older adults.<br> Design: Descriptive research.<br>Procedure: The participants were 83 older adults from 2 congested communities in<br>Bangkok. Data were collected by means of structured interviews and a set of instruments<br>designed to assess nutrition status, body composition, muscle strength, and walking speed.<br>Data were analysed using descriptive statistics and Chi-square test.<br>Results: The participants’ average age was 72.2 ± 6.7 years. Rate of sarcopenia was<br>9.6%. No signifcant relationship was found between sarcopenia and the participants’<br>overall personal and health factors. However, the participants’ muscle strength was<br>found signifcantly related to their history of falls (personal factor) and physical activity<br>(health factor), at χ2 4.375, p .036 and χ2 5.791, p .016, respectively.<br> Recommendations: Nurses are advised to promote physical activity and monitor<br>muscle strength in older adults, particularly those with a history of falls.</p> เดชา พรมกลาง, นพวรรณ เปียซื่อ, สุจินดา จารุพัฒน์ มารุโอ, สุกัญญา ตันติประสพลาภ ##submission.copyrightStatement## Tue, 12 Jun 2018 11:19:00 +0700 Situation of Occupational and Environmental Health Among Garment Workers: An Analysis of Community Enterprise <p>Abstract<br>Objective: To analyze the situation of occupational and environmental health among<br>garment workers working at community enterprises<br>Design: Descriptive study<br>Methodology: The study sample was 330 garment workers at community enterprises<br>in Sankampaeng District, Chiang Mai province. Interview forms were used to collect<br>data on (1) occupational health hazards; (2) health conditions related to risks; and<br>(3) working behaviour. Data were analyzed using descriptive statistics.<br> Results: Three most signifcant workplace hazards were identifed. These included<br>ergonomic hazard which were awkward, repetitive postures, and prolonged sitting<br>(87.6-97.0%); chemical hazard which was fabric dust (96.4%); and psychosocial<br>hazards including inconsistent incomes and rush working (80.0-83.0%). Unsafe<br>working conditions were linked to working with sharp tools (97.0%) or electricity-powered<br>machines (96.1%). The most common work-related illnesses were musculoskeletal<br>disorders (90.0%), and work-induced stress caused by inconsistent incomes and rush<br>working (55.2%). Work-related injuries during the past three month were 18.2% which<br>were non-fatal injuries. The injury causation was related to sharp tools (81.3%).<br>Concerning working behaviour, more than half of the samples adopted personal<br>protective equipment, whilst nearly two-thirds checked their appliances’ conditions<br>before use.<br> Recommendations: In order to improve garment workers’ quality of working<br>life, it is suggested that occupational health team place high importance on health protection,<br>effectively communicate work-related risks to workers, develop management strategies<br>for musculoskeletal disorders and work-induced stress, and continuously promote safe<br>working behavior.</p> chawapornpan chanprasit, วรันธรณ์ จงรุ่งโรจน์สกุล, ธานี แก้วธรรมานุกูล, วันเพ็ญ ทรงคำ ##submission.copyrightStatement## Tue, 12 Jun 2018 11:19:55 +0700 Mothers’ Experience of Having Their Children Undergoing Cardiac Surgery: A Qualitative Study <p>Abstract<br>Objective: To explore the experience of mothers whose children underwent cardiac<br>surgery.<br>Design: Descriptive qualitative research.<br>Procedure: Purposive sampling was used to recruit 30 participants, mothers<br>whose children had undergone cardiac surgery for the frst time at a university hospital<br>in Bangkok. Data were collected through 3 in-depth interviews with each participant.<br>The frst interview was conducted within 7 days after each child’s surgery, whilst the<br>second and third took place 2 weeks and 2 to 4 months after his/her discharge. Content<br>analysis was adopted to analyse the data.<br>Results: The mothers’ experience was studied in 3 stages: when they knew about<br>their children’s congenital heart diseases, when their children had cardiac surgery, and<br>when they gave their children post-discharge care. Their experience covered 5 aspects:<br>(1) feeling of loss and fear that their children might not survive; (2) reluctance and<br>unwillingness to let their children undergo surgery; (3) awareness of their children’s<br>need for surgery; (4) concern about their children’s post-operative conditions; and<br>(5) post-discharge care not being as complicated as before. In addition, most of the<br>mothers interviewed showed deep anxiety about their children’s lives and safety. They also<br>experienced varying degrees of uncertainty both before and after the surgery, depending<br>on the severity and complexity of their children’s cardiac disorders, changes in their<br>children’s conditions, and the information provided by the doctors and nurses.<br>Recommendations: Nurses should develop means of providing information to<br>enhance mothers’ ability to cope with stress and uncertainty, and to promote effcient home<br>care for their children after cardiac surgery. Also, further qualitative study should be<br>conducted to explore mothers’ experience in caring for children who have undergone<br>multiple cardiac operations as a result of their complex heart diseases.</p> อรุณรัตน์ ศรีจันทรนิตย์, วัลยา ธรรมพนิชวัฒน์ ##submission.copyrightStatement## Tue, 12 Jun 2018 13:43:40 +0700 Effects of Self-Effcacy-Promoting Programme with Cartoon Animation Videos on Knowledge, Anxiety, and Perceived Self-Effcacy in Patients Undergoing Cardiac Catheterisation <p>&nbsp; &nbsp;&nbsp;</p> <p><span style="font-family: Times New Roman;"><strong>Abstract</strong><br>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; <strong>Objective</strong>: To examine the effects that a self-effcacy-promoting programme adopting<br>cartoon animation videos could have on the knowledge, anxiety, and perceived self-effcacy<br>in patients undergoing cardiac catheterisation.<br><strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</strong> <strong>Design:</strong> Two-group experimental research with a pre-test and post-test.<br><strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; Procedure</strong>: This study was conducted on 39 cardiovascular patients who had undergone<br>catheterisation. Based on the order of their queue cards, the patients were randomly assigned to<br>an experimental group and a control group. The experimental group was treated with a self-effcacypromoting programme that adopted cartoon animation videos, pamphlets, and home visits.<br>The control group received standard care. Each patient was asked to respond to a personal<br>information questionnaire and 3 pairs of pre-tests and post-tests, each designed to measure<br>the patient’s knowledge, anxiety, and self-effcacy perception before the experiment and 2 times<br>(the frst day and the fourth week) after cardiac catheterisation. Data were analysed using<br>descriptive statistics, a paired t-test, an independent t-test, and two-way ANOVA with repeated measures on one factor.<br><strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp; Results:</strong> After the experiment, the experimental group displayed signifcantly higher average<br>scores on knowledge and self-effcacy perception (p = .001, p &lt; .001), and a signifcantly lower<br>anxiety level (p &lt; .001), on the frst day and in the fourth week after cardiac catheterisation.<br>However, no signifcant difference was found between the 2 groups’ average pre- and postexperimental knowledge scores, self-effcacy perception scores, and anxiety levels.<br><strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp; Recommendations:</strong> It is recommended that this cartoon-animation-integrated self-effcacypromoting programme be used as an intervention to enhance self-effcacy perception and promote<br>self-care behaviour, both of which could prevent complications in cardiac catheterisation patients.</span></p> จุฑาพร ศรีจันทร์, จุฬารักษ์ กวีวิวิธชัย, นารีมาลย์ นีละไพจิตร, ธรรมรัฐ ฉันทแดนสุวรรณ ##submission.copyrightStatement## Tue, 12 Jun 2018 14:18:05 +0700 Factors Related to Self-Care Behaviours in Older Adults with Heart Failure <p>Abstract:<br>Objective: To study relationships that comorbidities, family relationship, instrumental<br>support, and trust in healthcare teams could have with elderly heart failure patients’<br>self-care behaviours.<br>Design: Descriptive correlation research.<br>Procedure: This study used the situation-specifc theory of heart failure self-care<br>model developed by Riegel, et al, as the conceptual framework. The sample consisted<br>of 116 older adults with heart failure, aged 60-79 years. Data were collected by using<br>Charlson Comorbidity Index (CCI), together with interviews on family relationship,<br>instrumental social support scales (for heart failure), trust in healthcare teams, and heart<br>failure patients’ self-care behaviours. The data were analysed using descriptive statistics<br>and Spearman's correlation coeffcient.<br>Results: The participants showed a low level of comorbidities (mean ±SD of<br>2.48 ±1.24) and scored highly on family relationship, instrumental support, trust in<br>healthcare teams, and elderly heart failure patients’ self-care behaviours (means ±SDs<br>of 68.85 ±12.69, 20.62 ±5.46, 44.16 ±4.28, and 83.70 ±10.64, respectively).<br>An intervariate relationship analysis revealed a statistically signifcant relationship between<br>the heart failure patients’ self-care behaviours and comorbidities, family relationship,<br>instrumental support, and trust in healthcare teams (r = 0.191, p &lt; 0.05, r = 0.360, p &lt; 0.01,<br>r = 0.348, p &lt; 0.01, and r = 0.221, p &lt; 0.05, respectively).<br>Recommendations: Nurses and healthcare teams should encourage family members<br>to improve family relationship and should provide instrumental support for older adults<br>with heart failure.</p> ประภัสสร พิมพาสาร, วิราพรรณ วิโรจน์รัตน์, นารีรัตน์ จิตรมนตรี ##submission.copyrightStatement## Tue, 12 Jun 2018 14:17:33 +0700