Belitung Nursing Journal最新文献

Background: Millions of adults in Thailand serve as caregivers, facing significant public health challenges related to caregiver burden and well-being. Resilience is linked to better caregiver outcomes, yet the predictors of resilience are not fully understood.

Objective: This study aimed to identify the factors predicting resilience among caregivers of people with chronic illness.

Methods: A descriptive, cross-sectional design was used with a sample of 172 caregivers selected through multi-stage random sampling. Data were collected between February 2020 and January 2021 using validated instruments. Data were analyzed using descriptive statistics, bivariate analysis, and multiple regression analysis, with significance set at p <0.05.

Results: Caregiver resilience scores were within the normal range (Mean = 61.40, SD = 8.735). In bivariate analysis, 7 out of 10 variables-age, stress, self-efficacy, social support, self-esteem, attitude toward care, and family functioning-were significantly associated with caregiver resilience (p <0.05). Multiple regression analysis revealed that key factors significantly predicting caregiver resilience included self-esteem (β = 0.213, p <0.001), attitude toward care (β = 0.268, p <0.001), family function (β = 0.317, p <0.001), and age (β = -0.114, p = 0.037). In contrast, stress (β = -0.230, p <0.001) and knowledge (β = -0.182, p = 0.001) were negatively related to resilience, indicating that higher stress levels diminish coping abilities and that greater caregiving knowledge may contribute to emotional burden. Together, these predictors explained 56.8% of the variance in caregiver resilience (R² = 0.568), highlighting their substantial influence on caregivers' ability to manage caregiving challenges.

Conclusion: This study identifies key factors that influence caregiver resilience, particularly family support, self-esteem, and attitude toward care, while also highlighting the negative impacts of stress and age on resilience. Nurses play a crucial role in enhancing caregiver resilience by focusing on these factors through family-centered interventions, stress management programs, and psychosocial support. Strengthening these areas can significantly improve the quality of life for both caregivers and patients, leading to more effective caregiving outcomes.

Background: Despite the effectiveness of antiretroviral therapy (ART) in reducing HIV-related morbidity and mortality, the retention of HIV care remains suboptimal in Southeast Asia.

Objective: This systematic review and meta-analysis aimed to investigate the coverage of retention in care and the likelihood factors for retention in HIV care among Southeast Asian people living with HIV, to inform targeted interventions and policy improvements.

Methods: Following the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) guidelines, this study included observational studies reporting factors associated with retention in HIV care among Southeast Asian adults, with searches conducted in PubMed, Scopus, Cochrane Library, and CINAHL up to July 15, 2024. Demographic and clinical factors were analyzed using a random-effects model with the generalized linear mixed-effect model (GLLM) to estimate proportion and the DerSimonian-Laird method to estimate odds ratios (OR) with 95% confidence intervals (CI), assessing heterogeneity using the I² statistic.

Results: Among the eleven studies with 46,480 pooled participants analyzed, the coverage of retention in care revealed a pooled proportion of 75.2% (95% CI: 66.7-82.1). Significant clinical factors associated with a higher likelihood of retention included high CD4 count (≥200 cells/mm³) (OR 2.17 (95%CI: 1.19-3.97, p = 0.01), WHO stage 3-4 (OR 2.06, 95%CI: 1.09-3.87, p = 0.02), not being on ART (OR 6.88, 95%CI: 1.89-25.06, p = 0.001), hemoglobin levels ≥10 g/dL (OR 0.50, 95% CI: 0.25-0.99, p = 0.04), and demographic factors of employment (OR 1.18, 95% CI: 1.02-1.38; p = 0.03). Other clinical factors, such as HIV stage, TB co-infection, drug abuse/substance use, and hemoglobin levels, did not significantly affect the likelihood of retention. Similarly, demographic factors such as age, gender, education, marital status, and geographic setting also showed no significant impact on likelihood retention.

Conclusion: Retention in care among Southeast Asian people living with HIV was still below 95%. Clinical factors, particularly high CD4 counts, WHO stage, and the absence of ART, were likelihood factors for retention in HIV care, whereas other clinical and demographic factors studied did not show a significant impact. A universal test and treatment strategy is required to improve retention in care.

Background: Thailand's rapidly aging population presents unique challenges, particularly in promoting health and well-being among pre-older adults. Physical deterioration and related health complications become increasingly prevalent in this demographic, affecting quality of life, independence, and community involvement. Preparing for deterioration and quality aging involves taking proactive steps to address the physical declines associated with aging while enhancing overall well-being. This approach helps ensure a high quality of life as individuals age, enabling them to remain active and independent during the transition to older adulthood.

Objective: This study aimed to evaluate the effectiveness of the Active Senior Program in preparing for physical deterioration and enhancing the quality of aging among pre-older adults in Prachin Buri Province, Thailand.

Methods: This quasi-experimental study included 80 pre-older adults aged 50 to 59 years, divided into two groups using purposive sampling: the intervention group (n = 40) and the control group (n = 40). The intervention group participated in a five-week Active Senior Program, while the control group received a self-exercise handbook. The study was conducted from August to December 2023. Assessments involved interviews and the completion of an evaluation form at baseline, post-intervention, and three-month follow-up. Data analysis was performed using descriptive statistics and a repeated-measures ANOVA test.

Results: The analysis showed statistically significant differences in body mass index (F = 6.770, p = 0.011), waist circumference (F = 6.975, p = 0.011), and exercise behavior scores (F = 57.428, p <0.001) between the intervention and control groups at the three-month follow-up. Furthermore, within the intervention group, these parameters had statistically significant differences from baseline to the three-month follow-up (p <0.001). However, there were no significant differences in muscle mass observed between or within the groups.

Conclusion: This study highlights the effectiveness of the Active Senior Program in promoting exercise behavior, reducing body mass index, and decreasing waist circumference among pre-older adults. Nurses are crucial in implementing and supporting such interventions within primary care. Integrating this program can foster long-term health, independence, and quality aging. Sustained collaboration between healthcare providers and policymakers is essential to ensuring its long-term success and maximizing community well-being.

Trial registry number: Thai Clinical Trials Registry (TCTR20250217006).

Background: The educational environment is crucial to student learning and professional development in nursing education. The Dundee Ready Educational Environment Measure (DREEM) is a widely used tool for assessing educational environments in health professions. However, its psychometric properties have not been sufficiently evaluated in the Moroccan context, particularly among nursing students.

Objective: This study aimed to examine and validate the psychometric properties of the Arabic version of the DREEM scale in a sample of Moroccan nursing students.

Methods: A cross-sectional study was conducted between May and July 2023 among 445 undergraduate nursing students at the Higher Institute of Nursing Professions and Health Techniques in Meknes, Morocco. Data were collected using the Arabic-translated DREEM questionnaire. Principal Component Analysis (PCA) was conducted to assess variance distribution, while Confirmatory Factor Analysis (CFA) was used to test model fit using key indices. Reliability was measured using Cronbach's alpha, and intra-class correlation coefficients (ICCs) were calculated for test-retest reliability.

Results: PCA confirmed a five-factor structure, with the first two principal components explaining 19.13% and 23.61% of the total variance. CFA results showed that the students' perceptions of learning (SPL) and academic atmosphere (SPA) subscales had good to acceptable fit, while the students' perceptions of teachers (SPT) and academic self-perception (SASP) subscales demonstrated moderate to marginal fit. The Arabic DREEM scale exhibited good internal consistency, with a Cronbach's alpha of 0.87. Sociodemographic factors, including gender, scholarship status, and rural-urban background, influenced students' perceptions of their educational environment.

Conclusion: This study confirmed the reliability and validity of the Arabic version of the DREEM scale for assessing nursing students' educational environments in Morocco. However, variability in model fit across subscales suggests the need for further refinement to enhance cultural adaptation. Findings highlight disparities in teaching quality, academic support, and student engagement, emphasizing the importance of improving teacher-student interactions, interactive teaching methods, and social support systems to enhance learning outcomes.

Background: Patients with cancer are more likely to develop infections from several factors, and an infectious complication is the leading cause of death in this population. Therefore, nurses should provide educational media to these patients for infection prevention.

Objective: This study aimed to examine the effectiveness of using an online instructional video to prevent infections among patients with cancer in Thailand.

Methods: A quasi-experimental design was conducted from May 2020 to March 2021 at a cancer hospital in northeast Thailand. The participants consisted of 54 patients with cancer (27 each in the experimental and control group). The experimental group participants received four weeks of online video instruction at home, while the control group received the usual education from nurses. The data collection instruments included a demographic data questionnaire, a knowledge test, an infection prevention practice questionnaire, and a video media satisfaction questionnaire. Statistical analyses included descriptive statistics, chi-square test, Fisher's exact test, paired t -test, and independent t -test.

Results: After receiving the online instruction video, the experimental group had a significantly higher score for infection prevention knowledge, increasing from 17.52 to 20.93 (t = -6.575, p <0.001), and infection prevention practice, rising from 52.07 to 61.33 (t = -3.954, p = 0.001). The control group had no significant increase in the knowledge score (17.04 to 18.04) (t = -1.328, p = 0.100) or practice score (53.41 to 54.44) (t = -0.797, p = 0.217). The experimental group showed a significantly higher mean knowledge score (t = 4.473, p <0.001, large effect size with a Cohen's d of 1.22) and practice score (t = 3.121, p = 0.002, large effect size with a Cohen's d of 0.85) during post-intervention than the control group.

Conclusion: The findings support the use of online video as instructional media to enhance knowledge and practices regarding infection prevention among patients with cancer. This online video should be implemented for nurses and healthcare providers to promote knowledge and practices in the prevention of infections among patients with cancer in other hospitals.

Trial registry number: Thai Clinical Trials Registry (TCTR20241030009).

Background: Delirium is a common but often underrecognized complication in hospitalized older adults. It is associated with poor outcomes, including longer hospital stays, increased mortality, and long-term cognitive decline. While numerous studies have explored factors contributing to delirium, there is a lack of research on the context of older adults in Bangkok, Thailand. Understanding the predictors of delirium is crucial for early detection and prevention, particularly in an urban hospital setting.

Objective: This study aimed to determine the incidence rate of delirium and identify factors associated with its development in hospitalized older adults.

Methods: A prospective cohort study was conducted in four internal medicine wards of a large urban hospital in Bangkok, Thailand. Data were collected from 168 hospitalized older adults (≥60 years) over a 7-day period following admission. The Confusion Assessment Method (CAM), the Mini-Mental State Examination (TMSE), and the Systemic Inflammatory Response Syndrome (SIRS) scores were used to assess delirium and cognitive impairment. Data were collected between January 2022 and October 2022, and participants were evaluated on Day 1 (24 hours after admission), Day 3, and Day 7 or before discharge. Descriptive statistics and multivariate logistic regression were used to analyze predictors of delirium.

Results: The incidence rate of delirium among hospitalized older adults was 20.80%, with 19.00% developing delirium within the first 24-48 hours of admission. Multivariate analysis revealed that cognitive impairment (OR_adj = 7.81, p <0.001), infection (SIRS) (OR_adj = 3.80, p = 0.025), age (OR_adj = 1.09, p = 0.010), and the presence of caregivers prior to admission (OR_adj = 0.11, p = 0.008) were significant predictors of delirium. The model explained 35.30% of the variance in delirium occurrence.

Conclusion: This study highlights the high incidence of delirium among hospitalized older adults and identifies key risk factors, including cognitive impairment, infection, age, and the presence of caregivers. Early delirium screening, including the use of the CAM and TMSE, should be integrated into nursing care for delirium prevention. Infection prevention and effective management strategies should also be prioritized to reduce delirium risk.

Background: Stroke is a leading cause of disability among older adults, with long-term effects on their independence and quality of life. In Thailand, while previous studies have explored aspects of post-stroke rehabilitation, there remains a gap in understanding how to effectively integrate healthcare services, community resources, and cultural practices into a comprehensive, sustainable rehabilitation model.

Objective: This study aimed to explore community-based rehabilitation for older adults post-stroke in Thailand.

Methods: An ethnographic research design was employed to examine community-based rehabilitation practices. Participants included 88 key informants, comprising older adults post-stroke (n = 21), family members (n = 24), local administrative officials (n = 7), healthcare professionals, caregiver representatives, public health volunteers, village/sub-district headmen (n = 12), community organization members (n = 15) and general informants (neighbors and relatives) (n = 9). Data collection methods included participant observation, in-depth interviews, group discussions, and document reviews conducted from May 2023 to August 2024. Content analysis was applied, with triangulation ensuring data validity. Findings were further confirmed by informants and qualitative research experts.

Results: Community-based rehabilitation for older adults post-stroke consisted of three interconnected domains: 1) Support Systems and Infrastructure, including family caregiver involvement, healthcare services, emergency care, community rehabilitation programs, and public services; 2) Social and Economic Support, encompassing community welfare initiatives, volunteer networks, financial stability measures, and legal protections; and 3) Administrative and Management Systems, comprising integrated planning for older adults, data and information management, welfare accessibility, and culturally embedded care approaches. These elements created a comprehensive and sustainable rehabilitation framework.

Conclusion: The study highlights the importance of an integrated rehabilitation system that combines healthcare, socioeconomic support, and administrative mechanisms. Findings emphasize the need for advanced training in case management and coordination for community nurses and call for culturally sensitive rehabilitation protocols that merge traditional Thai healing practices with contemporary medical care. These findings align with global recommendations for sustainable rehabilitation and highlight the importance of culturally sensitive approaches. Strengthening formal and informal care networks can enhance rehabilitation outcomes and improve the quality of life for older adults post-stroke.

Background: Smartphone addiction and poor sleep quality are prevalent health concerns that negatively impact students' physical and mental well-being, which could affect their academic performance. However, research on this subject in Morocco remains limited.

Objective: This study aimed to examine the impact of smartphone addiction on sleep quality and identify risk factors that moderate this relationship among nursing students.

Methods: This cross-sectional study was conducted from March to July 2023, involving 451 nursing students aged 17 to 23 at the Higher Institute of Nursing Professions and Health Techniques in Meknes, Morocco. Participants completed the Mobile Phone-Related Sleep Risk Factors Questionnaire (MRSRF), the Smartphone Addiction Scale-Short Version (SAS-SV), and the Pittsburgh Sleep Quality Index (PSQI). Binary logistic regression (BLR), Receiver Operating Characteristic (ROC) curves, and Area Under Curve (AUC) analyses were used to assess the impact of smartphone addiction on sleep quality and to identify moderating risk factors.

Results: The study found that 81.23% of nursing students experienced smartphone addiction, and 86.47% reported poor sleep quality. Sleep quality was significantly correlated with smartphone addiction (β = 0.174; p <0.001), use before bedtime (β = 1.018; p = 0.030), and duration of use after lights-off (β = 0.768; p = 0.047). Logistic regression analysis indicated that smartphone addiction (AUC = 0.872; p <0.001) and duration of use after lights-off (AUC = 0.668; p <0.001) were significant predictors of sleep quality.

Conclusion: This study found a significant correlation between smartphone addiction and poor sleep quality, as well as a negative impact of using smartphones in bed for more than 30 minutes after lights off. Nursing students with higher smartphone addiction levels, who use their devices for extended periods without blue light filters, are more likely to experience poor sleep quality. Addressing these challenges requires an integrated, multidisciplinary approach involving healthcare professionals, educators, and community stakeholders. Health promotion programs integrated into student curricula could help reduce smartphone addiction and encourage healthier sleep hygiene practices.

Background: To develop high-quality human resources with the competence required for nursing, contents of undergraduate education programs must be reviewed and enhanced. Assessments of competence levels at the time of graduation can be used to evaluate nursing education programs. International comparisons using a common assessment instrument can help identify and endorse common features, as well as highlight areas that need reform in nursing education programs from a wide range of perspectives.

Objective: To develop the Japanese version of the Nurse Professional Competence Scale Short-Form and assess its psychometric properties.

Methods: This study used a descriptive cross-sectional design to validate an instrument, conducted at eight university schools of nursing in mainland Japan. A total of 714 graduating nursing students were invited and informed about the study in mid-February 2022, with 299 students (41.88%) responding to all questions and submitting their answers via online survey forms. After item analysis, confirmatory factor analysis was conducted. Concurrent validity and internal consistency were also assessed.

Results: Respondent ages ranged from 21 to 51 years, with an average age of 22.4 ±1.97 years. Most of the respondents were female (97.99%). The mean score for the scale was 55.70 (±9.98), and the scores for the six competence areas ranged from 48.04 (±14.07) to 64.73 (±10.67). Item analysis revealed that all items met each criterion, except for Pearson's correlation coefficients for Items 34 and 35. Confirmatory factor analysis showed the CMIN/df value was 2.46, and the root mean square error of approximation value was 0.07. Concurrent validity analysis showed significant moderate correlations (r = 0.45 and 0.49, p < 0.001). The Cronbach's α values for the scale and six competence areas ranged from 0.75 to 0.95.

Conclusions: The Nurse Professional Competence Scale Short-Form Japanese version, comprising 35 items across six competence areas, demonstrated reasonably acceptable validity and reliability for use with graduating nursing students in Japan. The highest- and lowest-scoring competence areas were Value-Based Nursing Care and Medical Technical Care, respectively.

Background: Clinical decision-making is a critical competency in nursing, influencing patient safety and career satisfaction. However, the factors shaping clinical decision-making remain underexplored, particularly in Vietnam, where research on this topic is limited. Understanding these factors is essential for enhancing nursing education and clinical practice.

Objective: To assess clinical decision-making skills among nursing students, examining their relationship with students' characteristics, perceptions of the clinical environment, and grade point average (GPA).

Methods: This cross-sectional study surveyed 189 nursing students in the University of Medicine and Pharmacy at Ho Chi Minh City using an online questionnaire in June 2021. Clinical decision-making styles were assessed using the Nurses Decision-Making Instrument Revised - 2014 (NDMI-R14), and the clinical learning environment (CLE) was evaluated with the Vietnamese-CLEI. To assess differences between variables, Chi-square tests were applied, or Fisher's exact tests where appropriate. Correlation between variables was examined using Pearson's correlation coefficient for parametric data or Spearman's rank correlation for non-parametric data.

Results: The average clinical decision-making score was 68.6, with 67.7% of students demonstrating a quasi-rational decision-making style and 32.3% relying solely on analysis. Notably, no students reported exclusively intuitive decision-making. Significant negative correlations were identified between clinical decision-making scores and extracurricular activities (r = -0.20, p = 0.005), clinical learning environment (r_s (187) = -0.16, p = 0.027), and GPA (r = -0.18, p = 0.011). These findings suggest that students with higher academic performance and greater extracurricular involvement were less likely to rely on intuitive decision-making.

Conclusion: Vietnamese nursing students predominantly exhibited a quasi-rational decision-making style, combining intuition and analysis. However, students with higher GPA and extracurricular engagement showed reduced intuitive reasoning, highlighting a potential gap in their decision-making development. Nursing education programs in Vietnam should focus on fostering analytical and intuitive reasoning skills to prepare students for complex clinical environments. Further research is needed to explore the cultural, educational, and contextual factors influencing these patterns.