Objective: The number of people with stroke increases worldwide. The stroke survivors live with disabilities and those influence their quality of life (QOL). This study was aimed to investigate the association between clinical characteristics and QOL of the older people with stroke at discharge from the hospital. Methods: This is a cross-sectional study. The participants were 113 stroke survivors aged 60 years and older admitted to the stroke unit. Quality of life was the study's outcome which measured by using the abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF). Primary clinical characteristics were measured by the National Institute of Health Stroke Scale (NIHSS), Barthel Index (BI), and Modified Rankin Scale (mRS). Potential confounding factors were age, sex, education levels, marital status, current occupation, and comorbidity (hypertension, diabetes mellitus, dyslipidemia, and heart disease). Multiple linear regression was used for data analysis. Results: The main effects of clinical outcomes were high BI Score that had a significant difference association with QOL (β = 0.312, 95% CI = 0.042, 0.296, P = 0.009), lower mRS score also had significant difference association with QOL (β = −0.371, 95%CI = −5.394, −1.162, P = 0.003) after all adjusting. Additional risk factor in this study was marital status (currently married) (β = 0.155, 95% CI = 0.226, 8.666, P = 0.039). Conclusion: Low function status and severe stroke disability as the clinical characteristics were associated with QOL in older people with stroke at hospital discharge. An additional factor was marital status (currently married).
Aim This study aimed to investigate the association between depression score and medication adherence in stroke survivor older adults. Methods The participants were 102 stroke survivor older adults. The outcome was medication adherence during a 6‐month follow‐up. The independent variable was the depression score which was assessed by the Patient Health Questionnaire‐9 (PHQ‐9). The confounding factors included sociodemographic data, clinical characteristics, number of comorbidities, and number of medications. We analyzed the association between depression and medication adherence using multiple linear regression analyses. Results The PHQ‐9 score of stroke survivor older adults at the baseline was 1.11±2.03, and at the 6‐month follow‐up was increased to 5.06±3.91. The medication adherence mean score at the outcome was 4.15±1.83. After full adjustment, the PHQ‐9 scores at baseline and 6‐month follow‐up were significantly associated with medication adherence (β = −.315, 95% CI = −.483 to −.086, p = 0.006 and β = −.270, 95% CI = −.238 to −.020, p = 0.021, respectively). Other variables that affect medication adherence during a 6‐month follow‐up included living with others and a lower number of medications. Conclusion This study revealed that lower depression scores were associated with high medication adherence in post‐stroke older adults. Additionally, living with others and a lower number of medications were associated with medication adherence. Therefore, stroke survivor older adults should be assessed for depression and given medication, and education should be used to improve mediation adherence, especially for the ones who live alone and have polypharmacy to prevent recurrent stroke.
Background: Enhancing patient safety awareness competency in nursing students is a necessity as they will be the next generation of professional nurses to take care of patients. One of the strategies is to create an innovative learning model using questioning as part of the metacognitive thinking concept. Objective: This study aimed to develop a clinical learning model to enhance patient safety awareness competency among Thai nursing students and determine its effectiveness. Methods: The study used a research and development design with two phases: (1) the development of a clinical learning model to enhance patient safety awareness competency among nursing students, and (2) the evaluation of the effectiveness of the developed clinical learning model. The evaluation was done quantitatively and qualitatively. In the quantitative strand, a quasi-experimental method using repeated measures design was used in 24 students. While in the qualitative strand, a qualitative descriptive design was employed in 24 students and three teachers. Results: In the first phase, the DUIR clinical learning model was developed, consisting of four processes: 1) Doubt (D), 2) Understanding (U), 3) Insight (I), and 4) Reflected value (R). The patient safety awareness competency included two components: managing patient safety and solving problems related to unsafe patient care. In the second phase, the model was evaluated by the students and the teachers. It revealed that nursing students’ patient safety awareness competency was very high, and the competency was statistically different before and after the learning model. Conclusion: The developed DUIR learning model using a questioning strategy is considered effective to encourage students to reflect critically on their own clinical experiences in order to achieve quality and safe care outcomes, thereby enhancing patient safety awareness for nursing students in a sustainable way. This model serves as an input for Thai nursing education and beyond.
Turnover rate of nurses in Thailand has been increasing due to excessive workload, stressful nature of the work and lack of psychological support. Therefore, the researcher has developed interventions to promote positive psychological strengths to improve retention rates among nurses. The purposes of this study were to examine retention of nurses and the effect of the program to develop positive psychological capital among professional nurses. The samples were randomly divided in two groups: experimental and control groups, consisting of 20 nurses each group. The experimental group received the program, including 16-hour class lectures, counseling and activities designed to reinforce the 5 elements of positive psychological capital: self-efficacy, hope, optimism, resilience and hardiness, while the control group did not. The study found that retention intention of nurses in the experimental group was greater than that of the control group with statistical significance
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