Thai Journal of Nursing Council วารสารสภาการพยาบาลเป็นวารสารทางวิชาการที่มีการประเมินบทความและงานวิจัย โดยผู้ทรงคุณวุฒิที่มีความเชี่ยวชาญเฉพาะสาขา (peer review) กำหนดออกรายสามเดือน ปีละ 4 ฉบับ จัดทำโดยสภาการพยาบาล เพื่อเป็นแหล่งในการเผยแพร่ผลงานวิชาการ ทั้งด้านการพยาบาลทางคลินิกและชุมชน การศึกษาพยาบาล การบริหารการพยาบาล en-US (รศ. ดร สายพิณ เกษมกิจวัฒนา) (นางสาวภูษณิศา แก้วเขียว) Tue, 25 Dec 2018 14:10:56 +0700 OJS 60 Effects of Epilepsy on Children: Prevention and Treatment <p>Epilepsy is a chronic neurological disease with several physical, psychological,<br>emotional, social, and intellectual impacts on children. Epilepsy is caused by two<br>major kinds of factors: epilepsy-related factors and treatment-related factors.<br>Epilepsy-related factors include brain dysfunction, epilepsy symptoms, and frequency<br>and severity of each seizure. Treatment-related factors include prolonged use of<br>antiepileptic drugs or improper care, for example, irregular intake of antiepileptic<br>drugs, which could result in an uncontrollable seizure, and improper seizure<br>management.<br>Without proper care or treatment, epilepsy could have adverse effects on epileptic<br>children’s quality of life. Nurses, therefore, play an important part in preventing or<br>alleviating such impacts of epilepsy on children, as well as in providing caregivers with<br>advice, to enhance their capacity to take care of epileptic children. In addition, nurses<br>should possess accurate knowledge and understanding of epilepsy and its effects on<br>children. In response to such needs, this article presents important facts about epilepsy,<br>its common effects on children, factors related to its effects, and roles of nurses in<br>preventing epilepsy in children and caring for epilepsy-affected children.</p> ตะวันรัตน์ สกุลรุ่งจรัส ##submission.copyrightStatement## Tue, 25 Dec 2018 00:00:00 +0700 Quality of Life in Patients with Permanent Colostomies: A Challenge to Nursing Roles <p>A permanent colostomy results in a permanent change in the structure and<br>function of defecation, as the patient’s stools are passed out through a stoma instead of<br>the rectum. Such a change affects the patient’s quality of life and often leads to physical,<br>psychological, and social problems. Nevertheless, if the patient successfully adapts to<br>life with a permanent colostomy, s/he can live happily with the stoma.<br>Therefore, a new challenge for a nurse caring for a patient with a colostomy is to<br>enable him/her to live a normal life, or as close to a normal life as possible, with the<br>new stoma. This article proposes a new type of permanent stoma, its effects on the<br>patient’s quality of life, and the role of nurses in promoting better quality of life in a<br>patient with this new stoma. The main expected outcome is that nurses will be able to<br>take proper care of colostomy patients and their caregivers, empowering them to<br>improve their quality of life.</p> ศิริพรรณ ภมรพล ##submission.copyrightStatement## Tue, 25 Dec 2018 09:23:00 +0700 Effects of Nursing Case Management Programme on Care Outcomes in Patients with Multiple Trauma <p>Objective: To examine effects of a nursing case management program (NCMP) on<br>patients’ length of hospitalisation, their ability to perform activities of daily living (ADLs),<br>and their caregivers’ ability to perform ADLs and to prevent complications in the patients.<br> Design: Two-group only posttest experimental design<br> Methodology: The participants were patients with multiple traumatic injuries admitted<br>in a trauma ward, and their caregivers, forming a total of 40. Twenty (20 patient-caregiver<br>pairs) were assigned to a control group and the other 20 (20 patient-caregiver pairs) to an<br>experimental group. The experimental group received the NCMP for 14 days, during which<br>the control group was given standard care. The data-collecting instruments consisted of (1)<br>the Patient’s Daily Living Activities Questionnaire; (2) the Length of Hospitalisation<br>Record; and (3) the Caregiver’s ADL Ability and Complication Prevention Ability<br>Questionnaire. The data were analysed using descriptive statistics, independent t-test, and<br>Mann-Whitney U-test.<br> Results: The experimental group displayed signifcantly higher mean score on the<br>patients' ADLs, the caregivers' capability in performing ADLs and preventing complications<br>in the patients than did in the control group. The experimental group was also found to spend<br>signifcantly fewer days of hospitalization than did in the control group.<br> Recommendations: It is recommended that nurses implement this NCMP in patients<br>with multiple traumatic injuries as a means of reducing their length of hospitalisation,<br>enhancing the patients’ and their caregivers’ ability to perform activities of daily living, and<br>enabling the caregivers to prevent the patients from developing complications.</p> ดวงกมล สุวรรณ, วิภา แซ่เซี้ย; ประณีต ส่งวัฒนา ##submission.copyrightStatement## Tue, 25 Dec 2018 00:00:00 +0700 Effects of an Oral Care Programme on Oral Hygiene and Ventilator-Associated Pneumonia amongst Critically Ill Patients: A Randomised Controlled Trial <p style="margin: 0px; text-align: justify; line-height: normal; text-justify: inter-cluster;">Objective: To compare the scores on oral hygiene and rates of ventilator-associated<br>pneumonia (VAP) between critically ill patients receiving the oral care programme and those<br>receiving standard care.<br> Design: Double-blind, randomised controlled trial<br> Methodology: The sample consisted of patients with acquired brain injuries. The patients<br>were aged &gt; 18 years old, had a Glasgow Coma Score (GCS) of &lt; 8, and were intubated with an oral<br>endotracheal tube. The patients were assigned into the experimental group and control group by<br>means of block randomisation with allocation concealment. The method of double blinding was used<br>to prevent measurement biases from the patients/family and the data collector. The experimental<br>group received the oral care programme consisting of an oral assessment, the use of oral care<br>equipment and solutions, and oral care guidelines, while the control group received standard care.<br>The patients’ general data were analysed using descriptive statistics. Inter- and intra-group<br>comparisons of oral hygiene scores were analysed using the Mann-Whitney test and the Friedman<br>test, respectively. The VAP rates were compared using a Chi-square test.<br>Results: The study started with 26 members in the experimental group and 28 in the control<br>group. By the end of the study, however, the number of members of each group had decreased to 10<br>and 11, respectively. As measured on the 5th, 6th and 7th days of the study, the experimental group<br>displayed better oral hygiene than the control group did, with signifcantly lower average oral hygiene<br>problem scores (p = .009, p = .018 and p = .001, respectively). Similarly, the experimental group<br>showed a lower inclination to develop VAP than the control group did (11.5% and 14.3%,<br>respectively), but the difference was not statistically signifcant (p &gt; .05).<br> Recommendations: The oral care programme of this study contributed to the improvement of<br>critically ill patients’ oral hygiene, as well as reducing the rate of VAP development. It is, therefore,<br>recommended that this programme be put to regular use and applied to other medical units treating<br>patients who have similar characteristics.</p> สุพรพรรณ กิจบรรยงเลิศ; ตระการตา แซ่ฉั่ว, มลฤดี คงวัฒนานนท, ใจรพร บัวทอง, วงจันทร เพชรพิเชฐเชียร ##submission.copyrightStatement## Tue, 25 Dec 2018 09:53:33 +0700 Impact of Adjusted Cardiopulmonary Resuscitation Process on Return of Vital Signs and Spontaneous Circulation in Cardiac Arrest Patients in Emergency Unit <p>Objective: To study how effectively an adjusted cardiopulmonary resuscitation process (CPR)<br>could restore vital signs and spontaneous circulation in cardiac arrest patients treated in an emergency<br>unit.<br> Design: Quasi-experimental with a two group design.<br> Methodology:Thesampleconsistedof60cardiacarrestpatientsreceivingCPRinanemergency<br>unit of Kamphaengphet Hospital. The participants were divided equally and assigned to an unadjusted<br>CPR group and an adjusted CPR group. Data were collected through the patients’ medical records<br>and the CPR speeds recorded by the emergency unit’s video. The patients’ baseline characteristics<br>were analysed using descriptive statistics. The CPR time differences were compared using an<br>independent T-test, whilst the patients’ rates of return of vital signs and of survival were compared<br>using an Exact Probability test.<br> Results: There was no signifcant difference in baseline characteristics between the two groups.<br>However, the CPR process conducted by the adjusted CPR group was signifcantly faster than that<br>by the unadjusted CPR group. In the adjusted CPR group, chest compression, defribillation, tracheal<br>intubation, and adrenalin injection were completed in a signifcantly shorter time (p &lt; 0.05) than in<br>the unadjusted CPR group. In addition, the patients in the adjusted CPR group displayed signifcantly<br>higher rates of return of vital signs and of spontaneous circulation (hence survival) than their unadjusted<br>CPR counterparts did (p &lt; 0.05).<br> Recommendations: Adjustment of the CPR process by defning the working area, building<br>good teamwork, and systematically managing the equipment and medications can enhance the<br>effectiveness of CPR. With a faster speed, the adjusted CPR process is likely to increase cardiac<br>arrest patients’ chance of regaining vital signs and survival. It is recommended, therefore, that the<br>concept of CPR process adjustment be applied to emergency unit management.</p> ยุคลธร จิตรเกื้อกูล, อิทธิชัย ชัยแสงแก้ว, วรางคณา พูลเขียว, รัตนาภรณ์ กลมคีรี ##submission.copyrightStatement## Tue, 25 Dec 2018 10:07:35 +0700 Nursing Students’ Experience in an Intensive and Emergency Care Practicum <p>Objective: To describe the experience of nursing students undertaking an intensive<br>and emergency care practicum.<br> Design: Qualitative research.<br> Methodology: This study was conducted on 13 purposively sampled fourth-year<br>nursing students having passed a critical and emergency care practicum in intensive and<br>emergency care units. Data were collected through tape-recorded in-depth interviews and<br>analysed using the content analysis method.<br> Results: The participants described their critical and emergency care practicum<br>experienceasinvolvingtwomainissues. Thefrstwaspre-practicumfeelingsandexperience,<br>namely, their fear and anxiety about what could happen and whether or not they had suffcient<br>knowledge. The second was post-practicum feelings and experience, which concerned two<br>issues: (a) nursing process development and (b) cognitive and academic development.<br>Nursing process development involved a correct understanding of nurses’ roles, patients’ and<br>their families’ needs, and the truths about living and dying with dignity. Cognitive and<br>academic development concerned integration of bodies of knowledge, which enhanced the<br>students’ memory. In this respect, it was also found that monitoring teachers who understood<br>both the students and the practicum and shared their work experience were an influential<br>factor in the students’ training, development, knowledge integration, and nursing skill<br>enhancement.<br> Recommendations: A nursing practicum in intensive and emergency care units<br>provided students with valuable experience that could be integrated with their nursing<br>profession. The fndings of this study could also contribute to the improvement of bachelor<br>of nursing science programmes. More emphasis could be placed on integration of intensive<br>and emergency care, to help students foster a deeper understanding of their roles in caring for<br>patients and their relatives.</p> ฐิติพร ปฐมจารุวัฒน์; ธัญญารัตน์ บุญโทย, เยาวรัตน มัชฌิม ##submission.copyrightStatement## Tue, 25 Dec 2018 10:58:20 +0700 Gaps in Nutrition Care Process by a Multidisciplinary Team <p>Abstract<br> 1) To describe the process in the nutritional care system; and 2) to explore gaps in<br>nutritional care and approaches to nutritional care system improvement in a tertiary hospital.<br> Design: Qualitative research.<br>Methodology: Nine informants in the nutrition care team were recruited to form a<br>focus group, consisting of 2 physicians, 2 nurses, 3 dietitians, and 2 pharmacists. Data were<br>collected through focus group discussion and in-depth interviews. The data were then<br>analysed using content analysis.<br> Results: The implementation of the hospital’s nutrition care system consisted of three<br>parts: 1) the structure; 2) the process, comprising nutritional assessment, coordination,<br>referral, and nutritional therapy and monitoring; and 3) the outcome of the process. The gaps<br>in the nutritional care system, and hence the necessary approaches to its improvement, were<br>related to: 1) the staff’s work overload; and 2) disproportion between manpower and<br>increased workload. Possible solutions included adjustment of the work system to achieve a<br>better balance between the work scope, workload, and current manpower, which would result<br>in more effcient teamwork.<br> Recommendations: In tertiary hospitals, where the number of patients is usually large<br>and the complexity of the diseases is high, appropriate and systematic management of nutritional<br>care is extremely important. Proper nutritional therapy conducted by a multidisciplinary team<br>is required. However, as no clear standard has been established, the administrationof nutritional<br>care varies amongst healthcare practitioners. It is necessary, therefore, that hospitals clearly<br>defne the work scope, workload, policies, and career paths for their personnel.</p> ณัฐพิมณฑ์ ภิรมย์เมือง; กุลพงษ ชัยนาม, สุลักษณ วงศ์ธีรภัค, วัลลภัทร จันทร์ขจร, ธัญวรินทร ตั้งเสริมวงศ, พัชรวีร์ ทันละกิจ, ปิยานุช ไมตรีจร, พัชรินทร สุภาพโสภณ, สุทธิรัตน อินม่วงหิรัญโชต, กนกรัตน รุ่งทิวาสุวรรณ, สุกัญญา สุรกิจ, นพวรรณ เปียซื่อ ##submission.copyrightStatement## Tue, 25 Dec 2018 11:42:35 +0700 The Development of Nutritional Care Ability Enhancing Program on Caregivers for Home-based Elderly Bed-Ridden Patients Receiving Nasogastric Tube Feeding <p>Abstract:<br>This developmental research study aims to develop a program to promote caregivers'<br>ability to manage nutritional status in elderly bed-ridden patients receiving nasogastric tube<br>feeding. using Orem's theory of nursing, theory of nutritional therapy and put the empirical<br>evidence into practice. The study consisted of two phases: Phase1: The development of the<br>program consists of three steps: 1) Reviewing and analyzing knowledge. 2) Evaluating<br>empirical evidence and the integration of knowledge into the process of enhancing the ability<br>of caregivers. Study of the principles of nutrition therapy and 3) Content validity examination<br>by three experts. Phase 2: Assessment of feasibility the experiment was conducted with the<br>eight nurses of the municipal health centers in one district.<br> The program was divided into four stages: 1) Assessment of the caregiver's ability.<br>2) The caregiver's nutritional care 3) Follow-up visits. and 4) Evaluation <br>The results of the content validity. found that the caregiver's promotion plan, assessment<br>of the caregiver's ability and the caregiver's promotion guide is technically correct. The program<br>is consistent with the objectives and the research framework. In addition, highly qualifed<br>guides were added in the manual. Storing food blends and the description of the explanation<br>is now clearer than before. The results of possibility of program adoption found that the<br>caregiver's ability assessment activities, nutrition educators and follow up can be easily<br>understood. However, some of the contents in the manual are diffcult to understand. Therefore,<br>the researchers revised some parts of the manual. Researchers have improved more easily.<br> Recommendations: It is recommended that program performance should be tested with<br>caregivers of elderly bed-ridden patients receiving nasogastric tube feeding prior to<br>implementation.</p> ณัฐตินา วิชัยดิษฐ, กาญจน์สุนภัส บาลทิพย์, แสงอรุณ อิสระมาลัย, ฐปรัตน์ รักษ์ภาณุสิทธิ์ ##submission.copyrightStatement## Tue, 25 Dec 2018 11:54:33 +0700 Predictors of Survivorship Care Plan Delivery among Professional Nurses in Provincial Cancer Center <p>Abstract:<br> Objective: To study predictors of survivorship care plans (SCPs) delivery among professional<br>nurses in a provincial cancer center in central region of Thailand.<br> Design: Predictive correlational research<br>Methodology: A sample was 94 professional nurses who had delivered SCPs to cancer survivors.<br>Data were collected using perceived responsibility to survivorship care, confdence in survivorship<br>care delivery, perceived barrier for optimal survivorship care, and SCPs delivery questionnaires<br>developed by researcher from collaborative projects between countries in Asia-Pacifc regions “The<br>STEP Study”. A statistical analysis was conducted using Stepwise Linear Regression.<br> Results: Professional nurses providing cancer survivors care had average age of 36.53 years<br>(SD = 5.14) with average working experience of 12.20 years (SD = 5.62). Most of them graduated<br>with bachelor degree (89%) and recieved oncology specialty training (75%). Findings revealed a<br>high perceived responsibility to survivorship care (Mean = 116.08, SD = 15.97), moderate<br>confdence in delivery service (Mean = 178.75, SD = 44.85), moderate perceived barrier for<br>optimal survivorship care (Mean = 35.85, SD = 8.72), and moderate frequency of providing<br>survivorship care concerning SCPs delivery (Mean = 76.30, SD = 17.17). The higher the perceived<br>responsibility to survivorship care and confdence in delivery service are, the more frequency of<br>providing survivorship care by professional nurses is (r =.520, r =.679, p &lt; .05). Nurses with<br>higher educational level were more likely to have more perception of responsibility to survivorship<br>care (r = .238, p &lt;.05). Only the perception of responsibility to survivorship care and confdence in<br>delivery service could jointly explained the varience of the frequency of providing survivorship care<br>concerning SCPs delivery for 48.9% (R2 = .489, F = 5.084, β = .565, .204, p &lt; .05)<br> Recommendations: The perception of responsibility to survivorship care and confdence in<br>delivery service should be promoted among professional nurses. Especially, the oncology specialty<br>training should be offered in order to enhance the competency in cancer survivorship care delivery<br>for comprehensive service.</p> ณัฐมา ทองธีรธรรม; คนึงนิจ พงศ์ถาวรกมล, พิจิตรา เล็กดำรงกุล, พิมพ์จันท ปิ่นสุนทร ##submission.copyrightStatement## Tue, 25 Dec 2018 13:25:04 +0700