Princess of Naradhiwas University Journal

Effectiveness of a Massive Open Online Course in Paediatric Nursing for Undergraduate Nursing Students

Siriporn Vetcho — 2026-08-18

Background and Objective Massive Open Online Courses (MOOCs) represent a flexible and accessible mode of learning, with a strong emphasis on learner-centered approaches. ThaiMOOC is Thailand’s national MOOC platform that provides open online courses for higher education and lifelong learning. This study aimed to evaluate the effectiveness of the ThaiMOOC-based paediatric nursing course in enhancing knowledge, learning behaviours, and satisfaction among undergraduate nursing students from networked institutions.

Methods A quasi-experimental one-group pretest–posttest design was employed with a sample of 210 nursing students from five institutions. This course consisted of 14 modules with a total learning time of nine hours. The intervention was delivered through the ThaiMOOC online learning platform. The research instruments included a demographic questionnaire, a knowledge assessment test, a learning behavior questionnaire, and a satisfaction questionnaire. Data were analyzed using descriptive statistics and a paired t-test.

Result The finding revealed that students’ knowledge scores significantly increased from pretest (M = 22.06, S.D. = 7.667) to posttest (M = 36.12, S.D. = 5.213), p < .001. Learning behaviours were reported at a “frequent” level (M = 4.12, S.D. = 0.519), while satisfaction with both course content and course design was rated as “very high” (M = 4.19, S.D. = 0.272).

Conclusion and Recommendations The ThaiMOOC-based paediatric nursing course was associated with significant improvements in nursing students’ knowledge, learning behaviours, and satisfaction, demonstrating the value of well-designed MOOC instruction in nursing education. By structuring learning into smaller modules and adopting a learner-centred approach, it can effectively promote flexible learning and support educational equity.

Caregiver Factors Influencing the Emergency Department Length of Stay of Older Adults with Acute Ischemic Stroke

Keerati Nitipuwadol — 2026-08-18

Background and Objectives Caregivers play a crucial role in deciding to transfer patients with symptoms of acute ischemic stroke for treatment within 4.5 hours or 270 minutes. This study aimed to investigate 1) the emergency department length of stay of older adults with prodromal symptoms of acute ischemic stroke, and 2) caregiver factors influencing the emergency department length of stay of older adults with acute ischemic stroke.

Methods Predictive research. The sample consisted of 100 caregivers or individuals who brought older adults to the emergency department. Data were collected at the emergency department and stroke ward of a central hospital in Samut Sakhon Province. The instruments used for data collection included 1) a general information questionnaire, 2) a knowledge questionnaire about stroke prodromal symptoms, 3) a disease severity perception assessment, 4) a symptom management questionnaire, and 5) a hospital arrival method questionnaire. These instruments had validated content validity with scores of 1.00, .96, .90, .94, and 1.00, respectively. The reliability analysis of questionnaires number 2, 3, 4, and 5 yielded scores of .70, .63, .94, and 1.00, respectively. Data were analyzed using descriptive statistics and multiple regression analysis.

Results The emergency department length of stay for older adults with acute ischemic stroke was 399 minutes. Factors related to knowledge about the prodromal symptoms of acute ischemic stroke and the management of symptoms by caregivers or transporters influenced the emergency department length of stay by 14.5% (adjusted R² = .14, p<.001).

Conclusion and Recommendation The study results provide foundational information for educating caregivers or individuals who encounter elderly patients suspected of having acute ischemic stroke about the prodromal symptoms and symptom management, ensuring that the elderly patients receive timely treatment in the emergency department.

Predicting Factors of Executive Function Development among Preschoolers in Orhanages

Pennapa Phummai — 2026-08-18

Background and Objectives Executive function development is a fundamental foundation for learning, emotional regulation, and behavioral control in children. Preschool children with well-developed executive functions can engage in analytical thinking, planning, problem-solving, impulse control, and social adaptation in the future. This study aimed to examine factors predicting executive function development among preschool children living in orphanages.

Methods This study employed a predictive correlational research design. The simple random sampling of 85 preschool children aged 3- 6 years residing in three government orphanages in Bangkok and its surrounding areas. Samples were selected using a multistage random sampling. The research instruments consisted of four questionnaires: a general information; Child’s Sleeping Habits: Thai version (abridged version); a preschool language development; and the Executive Function Development for Early Childhood. The second and fourth questionnaires demonstrated Cronbach’s alpha reliability coefficients of 0.78 and 0.96, respectively. The language development questionnaires showed a sensitivity of 41.70% and a specificity of 75.50%. Data were analyzed using descriptive statistics and stepwise multiple regression analysis.

Results The overall executive function development of preschool children in orphanages was at a moderate level, with a mean score of 81.61 (S.D. = 25.20, range = 14-127) and a mean T-score of 51. Gender was identified as only significant predictor, explaining 33.40% of the variance in executive function development (R² = .334, p < .001). Boys showed significantly lower executive function development than girls (β = -.578, p < .001).

Conclusion and Recommendations Gender significantly predicts executive function development among preschool children living in orphanages. Pediatric nurses and child caregivers are encouraged to develop appropriate strategies to enhance executive function skills, particularly among boys.

Development of a Health Literacy Management Model to Delay Kidney Deterioration in Patients with Type 2 Diabetes with Complications of Chronic Kidney Disease stage 3 in the Wang Wiset District Network, Trang Province

Jiravadee Sinchai — 2026-08-18

Background and Objectives Diabetes is a chronic disease caused by abnormalities in the production or response to the body's insulin hormone, leading to inefficient use of sugar and high blood sugar levels and resulting in chronic kidney complications. Health literacy is therefore a factor that can delay kidney deterioration in diabetic patients and reduce blood sugar levels. This research and development aimed to create a health literacy management model designed to delay kidney deterioration and evaluate the effectiveness of this model in patients with type 2 diabetes who have chronic kidney disease stage 3 complications within the Wang Wiset district network in Trang Province.

Methods The research was conducted using a research and development approach from March 2024 to May 2025 at the chronic diabetes and chronic kidney disease clinic, Wang Wiset Hospital, Trang Province. The sample consisted of 30 patients with type 2 diabetes with complications of chronic kidney disease stage 3. The research process included four phases: 1) Situational analysis and problem identification, 2) Development of a health literacy management model, 3) Implementation of the model for managing health literacy, and 4) Evaluation of the outcomes of using the health literacy management model. Research tools included in-depth interviews, feasibility questionnaires for the model, health literacy questionnaires for patients with diabetes, and satisfaction questionnaire for service providers using the health literacy management model. The research tools were validated by five experts. Data were analyzed using descriptive statistics, T-test, and content analysis.

Results Research results revealed that 1) the situational analysis identified the existing healthcare service model as reactive, lacking a complete interdisciplinary team. The sample group exhibited inappropriate behavioral outcomes, and their kidney filtration rates and blood sugar levels could not be controlled within the standard parameters. 2) The development of a health literacy management model to delay kidney deterioration utilized health literacy theory, and 3) the evaluation of the outcomes of using the health literacy management model to delay kidney deterioration showed that the average estimated glomerular filtration rate (eGFR) (M = 51.03, S.D. = 12.40) increased before using the health literacy management model (M = 44.95, S.D. = 7.91) and the average blood sugar level (HbA1c) (M = 7.15, S.D. = 0.93) decreased before using the health literacy management model (M = 7.83, S.D. = 1.39) significantly (p<0.05).

Conclusion and Recommendation This research indicates that the developed health literacy management model to delay kidney deterioration in patients with type 2 diabetes can effectively enhance nursing quality and clinical outcomes.

Factors Associated with Serum 25-Hydroxyvitamin D Levels in Muslim Women in Narathiwat Province: A Cross-Sectional Analytical Study

Davis Muhammaddawood WamaeWamae — 2026-08-21

Background and Objectives This analytical cross-sectional study aimed to compare serum 25-hydroxyvitamin D [25(OH)D] levels between Muslim women who wear a headscarf and those who do not in Narathiwat Province, Thailand, while analyzing factors associated with vitamin D levels after controlling for physiological confounders.

Methods A total of 100 female participants were equally divided into two groups: headscarf-wearing (n=50) and non-headscarf-wearing (n=50). Serum vitamin D levels were measured as total serum 25(OH)D using Chemiluminescent Microparticle Immunoassay (CMIA) at an ISO 15189:2012-certified laboratory. Data were analyzed using descriptive statistics, independent t-test, multiple linear regression, and logistic regression analysis.

Results The mean vitamin D level in the headscarf group (18.92 ± 7.34 ng/mL) was significantly lower than that in the non-headscarf group (25.22 ± 8.77 ng/mL) (p < 0.001), with a large effect size (Cohen’s d = 0.776). Multiple linear regression revealed that headscarf wearing was the only statistically significant predictor of vitamin D levels (B = -6.05, 95% CI: -9.16 to -2.95, p < 0.001), after adjusting for age, BMI, and eGFR (R² = 0.231). Furthermore, logistic regression showed that headscarf-wearing women had 7.16 times higher odds of vitamin D deficiency (95 % CI: 2.72 –18.90, p < 0.001). None of the headscarf-wearing participants achieved the optimal vitamin D level (≥ 40 ng/mL)

Conclusion and Recommendation The findings of this study indicated that Headscarf wearing is a significant independent predictor of lower serum vitamin D levels. Clothing-related physical barriers reduce UVB-exposed skin surface area, substantially limiting cutaneous vitamin D synthesis. These findings support targeted vitamin D screening and supplementation strategies for this high-risk population, while respecting their cultural and religious practices. Future studies should incorporate quantitative sun exposure assessment, dietary vitamin D intake, and genetic polymorphisms to more comprehensively explain the remaining variance.