Thai Journal of Nursing Council

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    Risk and Protective Factors of Self-Harm Behaviours
    (Thailand Nursing and Midwifery Council, 2010-04-01) Nattaya Patanavanichanun; Pattapong Kessomboon; Rujida Sirivattana
    This results aimed to study risk and protective factors for self-harm behaviour. The methodology was a case-control study. Population were those who conducted intentional self-harm behavior and received service from health services during 1st January to 31st December 2007. Samples were 43 cases of those who survived from self-harm for case group and 8 patients of general patients for control group. The instrument was interview questionnaire for self harm epidemiology developed by Department of Mental Health, 2007. Data analyses used were descriptive statistic, odd ratio and multiple logistic regression. The results shown that most of survived self harm’s patients were female (65.1%), aged 30-39 (27.9%), married (62.8%), occupation were laborer and farmer (32.6 % and 27.9%), educational level under elementary education or elementary education degree (46.5%). Regarding the self-harm methods, most of them were drug over used (39.5%). The main reasons of self-harm were being upset with close one blaming (48.8%), having conflicts with the close one (30.2%), being stimulated by many and strong problems in their life (51.2%). Eighteen point seven of the subjects had health problems including high blood pressure (0.0%), diabetes mellitus (37.5%), knee and back chronic pain (12.5%), depression (46.5%), living with alcoholic person (37.2%) and drug addicted person (4.7%). It was shown that the top problems which needed help and care were “mental health” (34.9%), “relationship with close person” (30.2%) and “income problem” (23.3%). Risk and protective factors related to self-harm were analyzed by logistic regression. It was shown that depression (adjusted OR=14.3; 95%C.I. : 0.02 , 0.26), conflict of close (adjusted OR=7.3; 95%C.I. : 0.05, 0.26), living with pusing alcoholics (adjusted OR=7.3; 95%C.I. : 0.04, 0.48) and drinking alcohols (adjusted OR=5.2; 95%C.I. : 0.06, 0.63) were risk factors (p \< 0.05). Living based on the principle of sufficiency economy was a protective factor for self-harm (adjusted OR= -8.98; 95%C.I. : -31.79, -2.54) at p value \< .05. Suggestion: There should be high risks screening for self-harm group especially person who has depression. Encouragement of good relationship a mang family members and closers, applying the principle of sufficiency economy for living and encouragement of community participation were recommended.
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    Development of a Clinical Nursing Practice Guideline for Prevention of Acute Delirium in Elderly Undergoing Gastrointestinal Surgery
    (Thailand Nursing and Midwifery Council, 2010-04-01) Kotchapanit Khantejit; Saipin Kasemkitwatana; Prangtip Chayaput
    This clinical nursing practice guideline (CNPG) for preventing acute delirium in elderly after gastrointestinal surgery was established by using evidence-based practice (EBP) model of Soukup (2000). Strategies for developing CNPG according to this model were Evidence triggered phase, Evidence supported phase, Evidence observed phase and Evidence-based phase. This study was only conducted to phase 3 of EBP model. Evaluation of research quality, scientific merit and feasibility of research results implementation was performed. From 14 evidence based, there were 2 CNPGs, 2 randomized controlled trials, 1 quasi experimental study, 7 cohort studies, and 2 retrospective studies. The summary of findings from those evidence-based studies was used to establish CNPG including assessment of risk factors for acute postoperative delirium, nursing intervention related to risk level assessment, and control of risk factors including promoting perception among elderly patients who has cognitive impairment, prevention and monitor contagious diseases, balancing water substance and electrolyte, accidental prevention, and controlling of postoperative pain. The validation of this CNPG was verified by 3 experts, were 1 gastrointestinal surgical doctor, 1 expert nurse instructor in caring for elderly patients after gastrointestinal surgery, and 1 expert surgical nurse in caring for elderly. The recommendations for nursing practice were mentioned. The CNPG should include a pilot study in order to evaluate the process and outcomes of this CNPG. The application into practice should be related to the organizational culture for maintaining continuous quality improvement. Evaluation for short and long terms outcomes from this CNPG implementation should be performed using outcome research.
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    An Evaluation of Health Promotion Competencies of Undergraduate Nursing Students
    (Thailand Nursing and Midwifery Council, 2010-04-01) Siriporn Khampalikit; Yuwadee Luecha; Julaluk Baramee; Areewan Klunklin; Kanogwan Suwanpatikorn; Wongduan Suwannakeeree; Prissana Puvanun; Pulsuk Siripul; Sukunya Prachusilpa
    This research aimed to compare health promotion competencies of undergraduate nursing students as perceived by students and instructors. The study samples comprised 508 senior nursing students from 10 faculties of nursing who were studying in second semester of 2006 academic year, and 257 instructors in the same undergraduate programs. All instructors taught both theoretical and practical nursing courses in the programs.  Two self- report questionnaires used for data collection in this study included demographic data form and the Professional Nurse’s Health Promotion Competencies Questionnaire. It consisted of 5 subscales: personal characteristic in health promotion, nursing activities in health promotion, management in health promotion, development of health promotion network, and research and knowledge management in health promotion. Cronbach’s alpha coefficient of the questionnaire was .96. Research coordinator for each nursing faculty distributed the questionnaires to students and instructors, simple randomly selected from 50 percent of the population. Mean, standard deviation and an independent t-test were used to compare the health promotion competencies as perceived by students and instructors.  Research findings showed that mean scores of the total scale of health promotions competencies of undergraduate nursing students as perceived by students and instructors were 3.50 and 3.38, respectively. Subscale mean scores of students’ perception ranged from 3.12 to 3.69 while subscale mean scores of instructors’ perception ranged from 2.72 to 3.65. There were statistically significant differences between mean scores of the total scale perceived by students and instructors at p \< .05. Statistical differences were also found in the management in health promotion subscale, development of health promotion network subscale, and research and knowledge management in health promotion subscales.  Research findings suggested that nursing faculties should establish health promotion competencies appropriate to educational level and expectations of stakeholders, and informed the students regarding the expected competencies in order to prepare them to meet the expectations.
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    Outcomes of Health Education and Home-Based Exercise Programs for Patients with Knee Osteoarthritis
    (Thailand Nursing and Midwifery Council, 2010-04-01) Suparb Aree-Ue; Naphaphorn Piyakhachornrot
    The​ ​purpose​ ​of​ ​this​ ​one​ ​group​ ​pre​-​ ​and​ ​posttest​ ​design​ ​study​ ​of​ ​the​ ​health​​ education​ ​and​ ​home​ ​based​-​exercise​ ​programs​ ​for​ ​patients​ ​with​ ​knee​ ​osteoarthritis​ ​is​ to​ ​assess​ ​outcomes​,​ ​in​ ​terms​ ​of​ ​improving​ ​OA​ ​knowledge​,​ ​self​-​efficacy​,​ ​behaviors​,​ and​ ​health​ ​outcomes​ ​(​pain​,​ ​stiffness​,​ ​physical​ ​function​ ​limitation​,​ ​quadriceps strength​ ​muscle​,​ ​and​ ​range​ ​of​ ​motion​)​.​ ​A​ ​total​ ​of​ ​104​ ​patients​ ​with​ ​knee​ ​OA​,​ ​who were​ ​personals​ ​of​ ​Ramathibodi​ ​Hospital​ ​and​/​or​ ​government​ ​services​,​ ​were​ ​recruited​ for​ ​the​ ​study​.​ ​Participants​ ​were​ ​given​ ​health​ ​education​ ​class​-​based​ ​sessions​ ​three​​ times​ ​and​ ​quadriceps​ ​exercise​ ​training​ ​class​-​based​ ​sessions​ ​followed​ ​by​ ​home​-​based​​ exercise​ ​adherence​ ​for​ ​12​ ​weeks​ ​of​ ​three​ ​times​ ​a​ ​week​.​ ​Instruments​ ​including​ ​1​)​ ​the​​ personal​ ​data​ ​questionnaire​,​ ​2​)​ ​the​ ​OA​ ​knowledge​ ​checklist​,​ ​3​)​ ​the​ ​OA​ ​self​-​efficacy​ ​questionnaire​,​ ​4​)​ ​the​ ​OA​ ​behaviors​,​ ​5​)​ ​the​ ​Modified​ ​WOMAC​ ​Scale​, 6​) Back​-​leg​ ​dynamometer​,​ ​and​ ​7​)​ ​Goniometer​ ​were​ ​used​ ​to​ ​assess​ ​outcomes​ ​at​ ​2​-​week​,​ ​8​-​and​ ​12​-​week​ ​follow​-​ups​.​ ​Data​ ​were​ ​analyzed​ by using​ ​repeated​ ​measures​ ANOVA​. Results​ ​It revealed​ ​that​ ​there​ ​was​ ​a​ ​significant​ ​improvement​ ​in​ ​OA​ ​knowledge​, ​ ​self​-​efficacy​,​ ​behaviors​,​ ​and​ ​health​ ​outcomes​ ​after​ ​enrollment​.​ ​The​ ​conclusions​ ​and recommendation​ ​from​ ​this​ ​study​ ​are ​that​ ​an​ ​integrated​ ​intervention​ ​between​ ​health​ ​education​ ​and​ ​home​-​based​ ​exercise​ ​training​ ​can​ ​be​ ​suggested​ ​to​ ​patients​ ​and​ ​health​ ​care​ ​providers​ ​for​ ​the​ ​management​ ​and​ ​prevention​ ​of​ ​knee​ ​OA​.
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    Spiritual Care for Chronic Illness Patients: Experiences of Professional Nurses
    (Thailand Nursing and Midwifery Council, 2010-04-01) Raweewan Pilaikiat; Jintana Rittharomya; Thunchanok Bootchan
    Spiritual care for chronic illness patients was an important dimension in health that professional nurses played a critical role. This qualitative research aimed to explore professional nurses’ experiences in spiritual care for chronic illness patients. Informants were seven professional nurses, who worked at medical ward in a hospital of Bangkok Metropolitan Administration. The data were collected during October 2006 to April 2007 by in-depth interviews and non-participant observation. Content analysis was adopted to analyze the data. Results of this study showed that experiences of spiritual care for chronic illness patients as perceived by professional nurses could be encapsulated in four main themes. 1) The meaning of spiritual care as the care follows the belief and dogma, care with love, care with kindness, care with gentleness and regard, and care as if relatives. 2) The important of spiritual care such as sources of spirit, supporting and trusting, making happiness, fostering self-esteem, and acknowledging one’s condition. 3) The guidelines of spiritual care were five aspects such as assessing about the belief and religious faith, giving a chance to perform a ceremony activities, facilitating patients for religious practices, encouragement and giving the relatives to participate in patient care. 4) There were two factors that affected spiritual care including the part of nurses and patients. The awareness, the experiences, the happiness in the work, working as a team, the senior nurse model, and nurse responsibility were the factors of nurses. Also, the trustworthiness and the contentment of patients were factors of patients.
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    Lean Management and Health Care Service
    (Thailand Nursing and Midwifery Council, 2010-04-01) Areewan Oumtanee
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    Impact of Nutritional Status on Health Status of Patients with Chronic Obstructive Pulmonary Disease
    (Thailand Nursing and Midwifery Council, 2010-04-01) Ladda Jampat; Siriorn Sindhu; Jom Suwanno; Piyatida Junlapeeya
    Malnutrition in patients with chronic obstructive pulmonary disease (COPD) accelerates the progress of the disease and decreases both physical functioning and overall health status. The purpose of this descriptive study was to examine whether nutritional status predicted health status of patients with COPD. Samples of 126 patients were purposive selected from those who had stable COPD, without any co-existing cardiac disease, and attending outpatient clinic at Suratthani hospital. Data was obtained at patient’s home. Nutritional status was determined by 24-hour calories intake, body mass index (BMI), serum albumin, and percentage of body fat. Health status was determined from physical functioning by performed six-minutes walk test. Data were analyzed using descriptive statistics, Pearson’s correlation coefficient, Chi-square, and odds ratio.The results of this study found that 31.75% of patients with COPD had low BMI and 13.49% had high BMI. Forty-eight percent of them had low percentage of body fat and 23% had low level of serum albumin. Twenty-nine percent of them had inadequate 24-hour caloric intake. Six-minutes walk test revealed that 28% of them were able to walk fewer than 300 meters. Serum albumin and 24-hour caloric intake were significantly correlated with physical function (r=.18, r=.28, p \< .05 respectively). Patients with abnormal BMI were 3.1 times more likely have poor physical functioning compared with those patients with normal BMI [χ2 (1) = 6.51, p \< .05, OR=3.1, 95%CI = 1.63-7.09]. These results suggest that health care providers should promote nutritional status in order to improve physical functioning and overall health status of patients with COPD.
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    AIDS and youths: Would We Win This Crisis
    (Thailand Nursing and Midwifery Council, 2010-04-01) Rungrat Srisuriyawet
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    Ethical Challenges in Conducting Research on Violence against Women
    (Thailand Nursing and Midwifery Council, 2010-04-01) Nanthana Thananowan
    Conducting research in the area of violence against women is not like other types of investigation because it entails unique ethical challenges. The issue of violence against women is delicate and sensitive. Abused women are mostly a group of vulnerable population. They usually refuse to answer about their victimization, feel ashamed or self-blame as a source of the violent problem, and fear of further violence. Thus, conducting research on violence against women need to be concerned about its ethical dilemmas. Researchers in this field should have better understanding about the ethical principles on violence against women according to World Health Organization (WHO), especially the safety, privacy, and confidentiality in order to get the right information that could be used as the evidence-based practice guideline to help abused women in the future.
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    Childrearing Behavior, Infant’s Health Problems and Nursing Care Needs among Care Providers of Infants
    (Thailand Nursing and Midwifery Council, 2010-04-01) Wipada Sangnimitchaikul; Pregamol Ratchanagul
    This study is the descriptive research aiming to identify information about childrearing behavior, infant’s health problems and nursing care needs. Subjects were 177 care providers who visited well baby clinic at Thammasat Chalermprakiet Hospital. Data has been collected by questionnaires developed by the researcher that includes information regarding childrearing behaviors, infant’s health problems, and nursing care needs. In addition, qualitative method through in-depth interview were used to gain information. Data analysis was conducted by frequency, percentage, mean, standard deviation, and content analysis approach.The findings have revealed that most of care providers had childrearing behaviors at good level. When considering in each item, it has been found that childrearing behaviors in terms of mouth and teeth care, bottle care, supplementary nutrition, and telling fairy tales were at poor level. The most frequent infant’s health problems included common cold and vomit. Additional information from in-depth interview among care providers who had childrearing behavior ranked at poor level demonstrated that they had inadequate information leading to inappropriate childrearing behaviors. With regards to nursing care needs, the provision of information about growth and development, nutrition, immunization, general care, and common health problems in infants was needed at high to highest levels. These findings suggested that nurse to develop strategy for effective information provision to lessen the problems and obstacles faced by care providers in childrearing. In addition, nurses should develop nursing intervention to enhance care providers’ competencies in raising infants with quality.
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    Nurse’s Role in Unfavorable Information “Breaking Bad News” Communication to Cancer Patients
    (Thailand Nursing and Midwifery Council, 2010-04-01) Jitchaya Boonnun; Prangtip Chayaput
    Disclosure of unfavorable news or “breaking bad news” in cancer patients may start at the time of making diagnosis, then, through the course of treatment continuously. It directly affects not only to patients and families causing fear, stress, and anxiety which may result in emotional and behavioral problems, but also to nurses and physicians involving in that communication or delivered information. It causes stress to them and fear to interact with those patients and families as well. Communication task for delivering unfavorable clinical information or bad news is sensitive and difficult for nurses who have no skill, experience, or guideline for communication. Nurses who take care of those patients involve many possibilities to convey in order to reassure and discuss more on the unfavorable medical information. Employing the SPIKES – Six-Step Protocol – which consists of setting up, perception, invitation, knowledge, emotion, strategy and summary, will help facilitating the effective communication. Moreover, it can be used as a guideline to establish communication skill for delivering the bad news. It helps nurses in gathering the data by using the appropriate questions and observing the reactions of patients, then, either responding to them or giving them the additional related information accurately. It also promotes and supports patients’ participation in the future treatment plan. Using SPIKES protocol will increase nurses’ confidence in communication with and being able to furnish the suitable care for those patients and families.
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    Scales for Assessment of Pressure Ulcer Healing
    (Thailand Nursing and Midwifery Council, 2010-04-01) Ponghatai Pumraya
    Accurate documentation on pressure ulcer healing is very significance because it can demonstrate the effectiveness of care. However, some problems of pressure ulcer healing records were found from the literature reviews and in clinical practices at Nopparatrajathanee hospital. These problems included incomplete, discontinuous, and inaccuracy. Utilization of appropriate instruments to monitor wound progress or wound healing is strongly recommended. This article is aimed to review the instruments used for pressure ulcer assessment. It was found that the first three instruments which most frequently used in the clinical practice were Pressure Ulcer Status Tool (PUSH Tool 3.0), Pressure Sore Status Tool (PSST) and Sessing Scale. The comparison was made among these three instruments in term of validity, reliability and feasibility. The result revealed that the Pressure ulcer Status Tool (PUSH Tool 3.0) is more reliable and feasible to use in clinical practice. It provides more details in determining the characteristics of pressure ulcers in many dimensions including size, depth, sign of infection, and the progression which reflect healing. While the other instrument had less details and is very complex to use by the non-specialist clinicians. In conclusion, PUSH Tool 3.0 was selected as a scale for assessment of pressure ulcer healing and progression at Nopparatrajathanee hospital. A plan to conduct a training program for nurses and other related health care providers as well as a plan to evaluate the effectiveness of this scale is recommended in further study.
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    Effects of Competency to Stand Trial Group Program on Competency to Stand Trial among Forensic Psychiatric Patients
    (Thailand Nursing and Midwifery Council, 2010-04-01) Utaya Nakcharoen; Benjawan Samsalee; Sulee Tungku; Panyupa Jengpaijit; Kesareeya Kanatham
    Enhancing the competency to stand trial among forensic psychiatric patients who were found incompetent to stand trial is essential. The aim is to protect their right in criminal proceeding as equal as the general person. The purpose of this quasi-experimental research was to study the effects of competency to stand trial group program on competency to stand trial among forensic psychiatric patients. The sample of this study consisted of 20 forensic psychiatric patients who were under criminal procedure code section 14 and sent for mental examination and competency to stand trial evaluation at the forensic psychiatric institution. The participants were drawn into two equal groups, experimental and control groups. The experimental group received seven sessions of the competency to stand trial group program. The control group received the conventional care as usual. The instruments used in this study including the demographic data form and the competency to stand trial group program which were developed by the investigator and the competency to stand trial assessment form was developed by Thasaniyom and Buppatha. The Mann Whitney U Test and Wilcoxon Matched Pair Signed Ranks Test were used for data analyses. The results showed that after the completion of the seven sessions of program, the experimental group had the mean scores of the competency to stand trial significantly after receiving group program higher than before receiving the group program (p=.01). In addition, the experimental group had the mean scores of the competency to stand trial significantly higher than those of the control group (p=.001). The competency to stand trial group program should be implemented as the legal rehabilitation standard of practice in the forensic psychiatric inpatient setting. The finding from this study can be utilized for the competency to stand trial individual program among forensic psychiatric patients who have limitation in group program.
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    The Effects of Empowering Care Program on Health Status and Health Service Satisfaction among Women with Hypertension
    (Thailand Nursing and Midwifery Council, 2010-04-01) Sakuntala Anuruang; Siriorn Sindhu; Napaporn Wanitkun; Aurawamon Sriyuktasuth
    The purpose of this quasi-experimental research was to compare the effects of participation in the Empowering Care Program on Health Status and Health Service Satisfaction among women with essential hypertension at the hypertension clinic, Pakthongchai Hospital, Nakhonratchasima Province. The samples were 76 women with hypertension selected by means of purposive sampling based on the inclusion and exclusion criteria and consecutive assignment by the tambon visited by a researcher. The women were separated into the experimental group and the control group. The program was an 8-week Empowering Care Program. The instruments for collecting data included a personal information questionnaire, health service satisfaction questionnaires, and health status measures (Systolic Blood Pressure, Diastolic Blood Pressure, Waist Circumference, and Total Cholesterol Level). Paired t-test or Wilcoxon Signed Rank test was applied for analyses of within-group differences between before and after participating in the program. To compare between control and experimental group at the end of program, independent t-test or Man-Whitney U test was used. Before participating in the program, no statistically significant differences of health status and health service satisfaction between control and experimental groups were found. By the end of the 8-week program, the results revealed that women with hypertension in the experimental group had better health status and higher scores of health service satisfaction than both before entering the program and those in the control group with a statistical significance at p \< 0.05.Suggestion from the study, the program should be considered for future studies among women with hypertension in other settings or women with other chronic illnesses.
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    Work Experience of Nurse Mentorship in a Governmental University Hospital
    (Thailand Nursing and Midwifery Council, 2010-04-01) Maream Prousoontorn; Areewan Oumtanee
    Nurse Mentorship is an important strategy to prepare novice nurses in their transition process to become professional nurses. This strategy has been widely used in governmental hospital in Thailand. The purpose of this qualitative study was to explain the mentoring work as experienced by professional nurses who were assigned to be mentor by the ward administrators. Sixteen professional nurses were willing to participate in this study. In-depth interview, non-participant observation and document review were employed for data collection. Data were analyzed by using coding and constant comparative method.The findings of work experiences of nurse mentors consisted of 6 categories: 1) being assigned to be a mentor, 2) preparing as a mentor, 3) getting to know each another, 4) acting as a mentor, 5) getting feedback, and ending mentor’s roles. According to study findings, the mentoring work began when a head nurse assigned nurses to be a mentor for a novice. Some were assigned immediately to take a mentor’s role but some had time to prepare themselves and got to know a novice before acting as a mentor. Each mentor used self-reflection as a strategy to improve their mentor’s role. After the end of mentoring process, the mentor reported either positive or negative experiences. Mentoring work would start again when a nurse was assigned to be a mentor. From the results of this study, it is recommended that the administrators should develop an effective strategy to strengthen the nurse mentorship system. Accordingly, it can facilitate the transition process of novice nurses to professional nurses.
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    Characteristics of an Excellent Nursing Service Department, Tertiary Hospitals
    (Thailand Nursing and Midwifery Council, 2010-04-01) Kesara Unchunbutr; Areewan Oumtanee
    The purpose of this research was to study excellent nursing service department characteristics in tertiary hospitals at 2012. An Ethnographic Delphi Future Research (EDFR) technique was applied. Twenty experts including 3 hospital administrators, 4 nursing administrators, 3 committee members from nursing organizations, 6 staff nurses and 4 nursing instructors were participated in this study. The study instruments were: (1) an interview guide for asking the experts to describe the excellent nursing service department, and (2) a questionnaire developed from the interview contents to ask a prior panel of experts for confirming the previous opinion. Study data were analyzed by using median and inter-quartile range to summarize the characteristics of excellent nursing service department. The results revealed that the excellent nursing service department characteristics were classified into 4 categories: 1. General characteristic of nursing service department, consisting of 4 subcategories: (1) Organizational structure: flexible to adjust toward changes, (2) Operation: use strategic planning and emphasize on possible goals, (3) Organizational climate: warm and caring climate, and (4) Organizational support: enhance a quality of working life of staff. 2. Nursing management, consisting of 4 subcategories: (1) General management: focus on decentralization, (2) Human resources management: effective develop both academic and growth of staff, (3) Applying knowledge management to work, and (4) Equal materials and budgeting management if comparing with other organizations. 3. Nursing service, consisting of 2 subcategories: (1) A variety of nursing care models and (2) Effective quality of care and continuous of quality improvement. 4. Staff characteristics consisting of 2 subcategories: (1) Basic competency and (2) Specific competency of nursing director and staff.
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    Factors Influencing Health Promoting Behaviors of Menopausal Women in Sawanpracharak Nakhonsawan Hospital Nakhonsawan Province
    (Thailand Nursing and Midwifery Council, 2010-04-01) Sudkanya Pancharean
    The objectives of this study were to investigate health promoting behaviors and to examine the factors influencing health promoting behaviors among menopausal women. This study was based on Pender’s Health Promoting Model as a conceptual framework. The subjects were 200 menopausal women who came to visit the doctors at the Menopausal Clinic in Sawanpracharak Nakhonsawan Hospital. The research instruments consisted of a demographic data questionnaire, health promoting behaviors questionnaire, perceived health status questionnaire and social support questionnaire. Data were analyzed by using descriptive statistics, Peason’s product moment correlation coefficients, and stepwise multiple regression. The result showed that the overall health promoting behaviors of the menopausal women were at a good level. The stepwise multiple regression analysis revealed that social support was the most powerful variable being able to predict health promoting behaviors at 25.80 percent (p \< .01) of the variable. Furthermore, Social support perceived health status, and educational level all together accounted for 38.10 percent (p \< .05) of the variance of health promoting behaviors.
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    Nursing Educational Management System for Producing Nurses of the Community: A Case Study at Faculty of Nursing, Chiang Mai University
    (Thailand Nursing and Midwifery Council, 2010-04-01) Yuwayong Juntarawijit; Waraporn Boonchien; Rangsima Poomsawat; Achara Sukonthasarn; Suparat Wangsrikhun
    This descriptive study aimed to develop appropriate selection processes, to study expected competencies of nurses of the community, and to investigate the producing processes and supporting factors in the nursing educational management system for producing nurses of the community. This study was conducted in participation with 75 related persons in the community and faculty members from the Public Health Nursing Department, Faculty of Nursing, Chiang Mai University (CMU). The instruments used in this study were surveys form, interview form and focus group guideline. Data were analyzed using content analysis. The results showed that; 1) persons involved in selecting students to be admitted into the project were representatives from the local organization and school, health personnel, community leaders, and people in the area. The criteria for student selection were as follows: student’s parent live in the area for 5-10 years, Thai nationality, age less than 25 years old, completed grade 12, grade point average of 2.5, certified of working experience by local health center/hospital, in good health, good conduct, involved in community activities, and pass the entrance paper and interview examination according to CMU’s admission process; 2) nurses of the community should have competencies in applying academic knowledge to work properly within the community context, proactive and passive working, leadership, management, and working as a team, good relations, skills in computer usage and information technology; and 3) producing processes and supporting factors for enhancing competencies were; the specification of the criteria for students before admission, student participation, setting of the teaching-learning process and extra activities besides the curriculum, and participation among related organizations in the community.
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    Meanings, Feeling, Motivation and Conditioning Factors of Nurses’ Practice on the Unrest Situations of the Three Southern Border Provinces
    (Thailand Nursing and Midwifery Council, 2010-04-01) Sunee Kraonual; Urai Hatthakit; Umaporn Boonyasopun
    This phenomenological study aimed to describe and explain nurses, practice experiences on the unrest situation of the three southern border provinces. The informants were 11 registered nurses who had been working in the unrest situation in the three southern border provinces. The data were collected using in-depth interviews with an interview guide developed by the researcher, between December 2006 and May 2007. The data were thematically analyzed according to Polit and Hungler.The meanings of nursing practice in the unrest situation in the three border provinces were classified into four themes: 1) being dangerous life as if working in the war, 2) being paranoid to work in conflictied and uncertain situation, 3) being nurses’ responsibilities to care for the patients, 4) being proud to do challenging work. The nurses expressed their feeling of the unrest situation work in three themes: 1) being stressed, 2) being scared of unsafe situation that might cause disability or death, 3) being sad and depressed. There were three motivation and conditioning factors for nurses to continuing practice on the unrest situation: 1) committed to workplace and colleagues, 2) attachment to their hometowns, 3) difficulty in obtaining permission to move out. This study provided a deeper understanding of nurses’ experience in practicing on the unrest situations of the three southern border provinces. These findings provided basic information that was beneficial for the further studing and planning and also encouraged nurses to continue working on the unrest situations.
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    Pre-hospital Emergency Care System for Trauma Patients: A Literature Analysis
    (Thailand Nursing and Midwifery Council, 2010-04-01) Pathma Moli; Orapan Thosingha; Siriorn Sindgu
    This literature analysis aimed at examining pre-hospital emergency care systems in trauma patients and analyzing emergency medical services, roles of nurses and other healthcare personnel, on caring for trauma patients at pre-hospital stage competency of nurses and its outcomes, possible legal issues in nursing practice and other personnel on emergency medical services. The literatures used for this analysis were research, academic review, expert opinions and related textbooks published between 1994 and 2007. Those literatures were analyzed and synthesized according to study objectives by 5 steps: 1) problem identification, 2) literature search, 3) data evaluation, 4) data analysis and 5) presentation.The findings revealed that pre-hospital emergency system for trauma patients was developed for disaster rescue. Main healthcare personnels of rescue team were physicians, nurses, and paramedics. Telephone system and dispatcher were use to get access to the system. Different telephone numbers were assigned in different countries. Most significant indicators was time to reach patient at the scene after dispatching. The less time was used, the more efficiency of system was. Guideline for patient management at the scene should be established. Important competencies for personnels in this system were clinical capabilities, communication and collaboration. Nurses play a significant role on performing duty at the dispatch center as a leader of advanced life support teams.The lessons learned from the analysis were the collaboration between advanced life supporting team and rescue team for guideline in dispatching, networking system and precise job descriptions and roles. Furthermore, legislation supports on emergency practice for personnel in this system should be provided. Nurses should improve their clinical competency and role to improve quality of work by using evidence-based practice related to trend and policy of the government.