Development of a Clinical Nursing Practice Guideline for Schizophrenia Patients with Aggressive Behaviors in the Male medical ward at Thatphanom Crown Prince Hospital

Abstract

     This study is developmental research aimed at developing and evaluating the quality of nursing practices for schizophrenia patients with aggressive behaviors in the male medical ward of Thatphanom Crown Prince Hospital. The objective is to provide professional nurses with unified guidelines for nursing schizophrenia patients with aggressive behaviors. This study applies the clinical practice guideline development framework of the National Health and Medical Research Council (NHMRC), Australia (1998), consisting of 8 steps: 1) defining the issue and its scope, 2) forming a development team, 3) setting objectives, target groups, and outcomes, 4) searching and appraising the evidence, 5) drafting the nursing practice guidelines, 6) validating the tools and guidelines, 7) piloting the nursing practices, and 8) evaluating the implementation of the nursing practices. The tools used for data collection include the nursing practice guidelines for schizophrenia patients with aggressive behaviors in the male medical ward of Thatphanom Crown Prince Hospital and a feasibility assessment of implementing these nursing practices. The data analysis of the implementation evaluation was performed by frequency and percentage. The research findings are as follows:

1. The nursing practice guidelines for schizophrenia patients with aggressive behaviors in the male medical ward of Thatphanom Crown Prince Hospital, developed from evidence-based review, comprise 4 key components: 1) initial nursing assessment, 2) assessment of mental state and severity of behavior, 3) nursing care according to the severity level, and 4) information provision and referral. These guidelines have been content-validated by five qualified professionals, achieving a total content validity index (S-CVI) of 87
2. The quality assessment of the nursing practice guidelines for schizophrenia patients with aggressive behaviors in the male medical ward of Thatphanom Crown Prince Hospital by 10 professional nurses working in the ward found that 3% of the sample group considered the guidelines appropriate and practically applicable. Regarding the ease of use of the guidelines, 87.85% of the sample group found them easy to implement, while 12.15% considered them difficult, especially in aspects related to assessing mental state and the severity of behaviors.

     The research results indicate that the nursing practice guidelines for schizophrenia patients with aggressive behaviors in the male medical ward of Thatphanom Crown Prince Hospital can be practically applied in the unit. However, additional training is necessary to enhance knowledge and skills in nursing care for patients with severe aggressive symptoms, ensuring that nurses can confidently and effectively follow the established guidelines.