The Effects of a Participatory Nursing Care Model for Preterm Labor at Plai Phraya Hospital, Krabi Province

Abstract

Preterm birth is a major health problem associated with neonatal mortality and complications, with increasing trends observed at Plai Phraya Hospital, Krabi Province. This study aimed to compare outcomes before and after implementing a participatory nursing care model on nurses’ knowledge and skills, as well as maternal and neonatal outcomes among women with preterm labor. The sample comprised eight registered nurses and 30 pregnant women diagnosed with preterm labor, purposively selected and divided into two groups of participants including 15 before and 15 after the intervention. Research instruments included: (1) a knowledge assessment on preterm labor nursing care (CVI = 0.80; KR-20 = 0.85), (2) a nursing practice evaluation form (CVI = 0.83; Cronbach’s α = 0.87), and (3) a clinical outcomes recording form (CVI = 0.82 – 0.95). Data were analyzed using descriptive statistics and, effect size reporting, and inferential tests using Chi-square and Mann–Whitney U to compare pre-and post-intervention scores. The findings revealed that: (1) nurses’ knowledge significantly improved, with mean scores increasing from 11.80 to 20.78 (p-value < 0.01), and nursing practice in all domains improved significantly (p-value < 0.001); and (2) maternal and neonatal outcomes improved, with the preterm birth rate reduced to 40.0%, hospital readmission, an increase in successful delay of preterm labor to 60.0%, and decrease in maternal and neonatal complication  to 13.3%. Conclusion: The participatory nursing care model effectively improved nurses’ competence and maternal–neonatal outcomes. Its implementation is recommended in hospital settings to strengthen care for women at risk of preterm birth.