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Per- and polyfiuoroalkyl substances (PFAS) on paper packaging resist water and oil to effectively contain food and beverages. However, previous studies have established correlations between PFAS and several diseases including COVID-19, cancers, and obesity. The goal of this collaborative research between the Philippines and Singapore is to set a baseline for PFAS levels in local packaging with the intended outcome of further increasing awareness on these contaminants in Southeast Asia, providing a starting point for migration experiments and risk assessments on PFAS in commercially-available food contact materials and articles, and initiating policy developments on these substances in the Philippines. In this study, 15 different types of PFAS were analyzed in selected paper packaging used by major quick service restaurants (QSRs) in Metro Manila. Using liquid chromatography-mass spectrometry (LC-MS), PFAS was detected in 100% of the samples with a total PFAS concentration range of 8.20-97.7 ng PFAS/100 cm². The highest amount of PFAS compound measured across all samples was PF-3,7-DMOA (89.8 ng/100 cm²). PFAS compounds regulated in European packaging such as PFHpA, PFOA, PFNA and PFDA were also detected in all samples but at trace levels. Paper wrappers for rice and small burgers were found to have the highest total PFAS of 97.7 ng PFAS/100 cm². This value translates to approximately 65.1 ng F/100 cm² which is way below 10,000 ng F/100 cm², the currently existing limit for PFAS in packaging set by the Danish Ministry of Environment and Food. While each packaging may be deemed safe compared to regulation, the compounded effects brought by use of multiple packaging, and high frequency and long-term exposures require further investigation. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to develop a model to help parents cope with decisional conflict. Background: Parents of children with congenital heart defect experience decisional conflict when they are uncertain about treatment decisions for their child, which may lead to delay in seeking care or distress over the decision made. Design: Correlational design with model building and data triangulation was used. Methods: Data were collected through surveys and interviews with a consecutive sample of 221 parent respondents from June to December 2018. Structural equation modelling and qualitative data analysis were used. Results: Lower decisional conflict was seen in parents with higher income, more nurse support and physician risk communication. Time delay for surgery was correlated with the child's age, social service coverage, and social support. Decisional conflict mediated the influence of income, nurse support and physician risk communication on satisfaction with decision. Based on model fit parameters, the emerging model is a good and parsimonious model of decisional conflict. The overall theme, 'Deciding for Surgery: What Matters Most', described the processes parents went through in making treatment decisions. Conclusion: Nurses may help parents feel more certain, less conflicted, and more satisfied with their decision by addressing factors including knowledge gaps, personal values, available support, and resource access. Summary statement: What is already known about this topic? Decisional conflict occurs when parents are uncertain of the best action for their child because treatment options entail risks for undesirable outcomes, value compromise, unclear prognosis, or anticipated regret over the decision.Professional support, information, and communication are vital to parents' decision‐making process.Child, parent, and support factors may influence parent treatment decisions in varied paediatric conditions. What this paper adds? Child's age at the time of decision‐making had an effect on the delay in surgery. However, assisting parents to weigh their options and focus on personal values allowed them to make their treatment decision.Low income, costly health services, and bureaucratic processes impeded the timely availment of surgery. Healthcare reforms that provide a system of government funding, streamlined health structure, and social insurance may be looked into.Family support weighed in on the parents' decision to delay surgery for fear of blame or guilt. Providing relevant information enabled parents to make a choice and stand by their decision regardless of the outcome. The implications of this paper: Modelling provides a framework to identify which factors are more important and how they interact to affect decision‐making. It may be used as an approach to find solutions to clinical problems for groups with different diagnoses.Though nursing support, information, and communication are essential, a more holistic family nursing care approach may be considered to assist parents to make appropriate treatment decisions for their child.Familiarity with the healthcare system may equip nurses to aid parents in processing available healthcare funding and dealing with financial uncertainty affecting decisions for their child's treatment. [ABSTRACT FROM AUTHOR]

The Philippines is a source of labor for many countries. Roughly 10 million overseas Filipinos are working and living outside of the Philippines. This paper examines the association between sociodemographic characteristics (sex, age, educational level, and income) and self-rated physical and mental health, access to healthcare, and health habits among immigrant Filipinos living in Santa Cruz de Tenerife, Spain. Through convenience sampling, Filipino migrants (n = 103) aged 18 years and above participated in the online survey between October 2022 and March 2023. The data were analyzed using descriptive statistical analysis and chi-square. Almost all respondents self-rated their health as excellent and very good. Female respondents are more affected by mental health. Most are enrolled in the Universal Health System of Spain (public insurance). There is more utilization of private health insurance among respondents aged 60 years and above and high-wage earners. Cigarette smoking and alcohol drinking are associated with males. More than half of the respondents perform weekly exercise occasionally or never. These findings suggest a potential need for targeted interventions with an emphasis on the practice of preventive health and the promotion of healthy lifestyles, especially among financially disadvantaged migrants with lesser health access. [ABSTRACT FROM AUTHOR]

The development of efficient and reliable online assessments has become increasingly important in the digital era. We developed a 10-min online word reading assessment of global English based on the existing paper-and-pencil version of our English silent word reading test. The test includes two parts, namely, random word recognition and contextual word reading. A total of 889 participants (437 children and 392 adults; 62.7% female) took part in the study. They were from various regions including mainland China, Hong Kong SAR, Macau SAR, Poland, the United States, and the Philippines. Reliability and validity analyses on various demographics samples (by age and country/region of origin) demonstrated that the WordSword Test is highly reliable and valid (e.g., the correlation of this test with other English reading measures were above.80). Education level was positively correlated with test performance, while the correlations between age and test performance were not consistent. Ninety-seven children participants also took the paper-and-pencil version of the WordSword Test. The correlation between performances on the online and paper-and-pencil versions of the test was.879, one year apart. With more children and adults taking the WordSword Test, we ultimately hope to establish norms by area, grade level, and age. [ABSTRACT FROM AUTHOR]

One of the most commonly used tools by clinicians to identify cases of anxiety and depression in medically ill patients is the Hospital Anxiety and Depression Scale, or the HADS Filipino version. However, there were some "gray areas" with its use, particularly for those who are in the non-psychiatric setting. Some translated items may pertain to something else which could influence patients' responses. Furthermore, local studies showed differences in the conception, understanding, and expression of depression unique to Filipino culture and could be potentially missed during the assessment. This paper determined the validity and reliability of the Anxiety and Depression Symptom Assessment Guide or ADSA to a sample of 91 adult cardiac Filipino patients in the in-patient setting. In addition to the 29-item ADSA tool that was generated from HADS, the review of literature and other sources was also reviewed by experts from two rounds of Delphi Survey. It was written in a yes-or-no format and available in both English and Filipino versions. The tool was tested for internal consistency, intra-class and inter-item reliability. Another test used was criterion-based validity utilizing HADS to identify cases of anxiety and depression. The results showed that ADSA is highly reliable with Cronbach's alpha of 0.97, poor-to-moderate intra-class correlation (0.670 for anxiety, 0.440 for depression), and consistent/acceptable interitem correlation (0.528 for anxiety, 0.382). Both HADS and ADSA were positively correlated with correlation coefficients of 0.667 and 0.391 (p-value<0.5) for anxiety and depression respectively. Using a cut-off score of 5, ADSA has moderate sensitivity and specificity of 72.5% and 78.4% for anxiety, and 66.7% and 64.3% for depression. Further research is needed to strengthen ADSA's validity by increasing the sample size and the multi-center sites. [ABSTRACT FROM AUTHOR]

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Aims: Challenges in the nurse practice environment greatly affect nurse work outcomes. This study investigated the relationship between nurse practice environment and work outcomes in the Philippines. Methods: This cross‐sectional survey involved 549 hospital nurses in the Philippines in 2018. The nurse practice environment was measured using the Practice Environment Scale of the Nursing Work Index (PES‐NWI). Four self‐report scales were used to measure work outcomes: job satisfaction, job burnout, job stress and nurse‐assessed quality of care. Multiple linear regression analysis was used to analyse the data. Results: Significant relationships were found between nurse and organizational characteristics and nurse practice environment. Further, multivariate regression analysis revealed that the nurse practice environment had a significant and positive relationship with perceived quality of care and a significant and negative relationship with job burnout and job stress. Conclusion: A favourable work environment significantly reduced job burnout and job stress and improved the quality of patient care. With considerable migration abroad, a favourable nurse practice environment may engage a better nurse workforce in the country and subsequently reduce migration. Managers must focus on developing good nurse practice environments that will improve professional work outcomes and quality patient care. SUMMARY STATEMENT: What is already known about the topic? The nurse practice environment in hospital settings comprises nurse participation in hospital affairs; nurse foundation for quality care; nurse manager ability, leadership and support for nurses; staffing and resource adequacy; and collegial nurse–physician relations.For many years, substantial numbers of Filipino nurses have migrated abroad seeking a better practice environment with better professional and personal development opportunities. What this paper adds? Similar to many international studies, the data analysis supports certain elements of the nurse practice environment being significantly related to better work outcomes.Collegial nurse–physician relations and nurse participation in hospital affairs were negatively related to nurse level of job burnout. Staffing and resource adequacy and the overall perceptions the of nurse practice environment were negatively related to both job burnout and job stress.Overall, the nurse practice environment was predicted by personal characteristics (years of nursing and highest educational attainment) as well as organizational factors (location of work, type of hospital and hospital bed capacity).A favourable nurse practice environment affects the quality of patient care; however, it had no relationship with job satisfaction among nurses. The implications of this paper: A favourable nurse practice environment may result in reduced job stress and job burnout among nurses. Considering the substantial migration of Filipino nurses abroad, improving the nurse practice environment and associated work outcomes may be used as a strategy to encourage Filipino nurses to remain in the country to work and serve sick and needy Filipinos.Health‐care managers must consider professional and organizational factors that improve the work environment for nurses. Promoting professional advancement and career development for nurses may enhance the nurse practice environment.The challenges of an unfavourable nurse practice environment need to be addressed through coordinated efforts of government agencies, policymakers, nurse organizations and hospital administrators. [ABSTRACT FROM AUTHOR]

Summary: Social workers are expected to challenge the exclusion and oppression of marginalised populations which requires the critical interrogation of prejudicial views, discriminatory attitudes, and oppressive practices. In this regard, social work practitioners need to be vigilant of their own attitudes toward the people they serve. This is relevant to social work practice with sexual minorities. This paper presents the results of a mixed-methods study informed by a critical theoretical frame that explored Vietnamese social work practitioners' attitudes toward sexual minorities. The findings presented in this article were drawn from a survey of 292 social work practitioners based in Hanoi, Vietnam and 12 semi-structured interviews with volunteers recruited from the pool of survey participants. Findings: The findings suggest that practitioners who participated in this study held relatively positive attitudes toward people who identify as lesbian or gay. However, those who had what could be considered moderate to positive attitudes were not necessarily free from prejudicial and discriminatory views, particularly when it came to certain matters such as those relating to their own families and work with young children. Applications: The discussion of the findings illustrate the relevance of the broader social context to Vietnamese social work practitioners' attitudes toward sexual minorities. It highlights the potent influence of dominant ideologies in shaping prejudicial views and attitudes and points to the need for practice at a broader level targeting Vietnamese society and culture as a whole. [ABSTRACT FROM AUTHOR]

Dengue is a global health issue and is also regarded as one of the major public health concerns in the Philippines. Presented in this paper is the application of a geographic information system (GIS) in mapping dengue cases in Baguio City. A descriptive research design was utilized and mapped dengue cases were reconciled with environmental correlates such as land cover, housing information (independent, mixed, or interconnected), hydrology (water bodies and canals), urbanization level (urban or rural), elevation, soil, and land surface temperature. Moreover, demographic factors and practices were utilized for further analysis. Results show that interconnected housing, urbanization, land surface temperature, hydrology, and population density are predictors of dengue cases in Baguio City with the predictive power of 0.3810 (strong), 0.3426 (strong), 0.2509 (medium), 0.1675 (medium), and 0.1323 (medium), respectively. In the context of dengue, several data gaps in health information systems exist. Although the Manual of Procedures for the Philippine Integrated Disease Surveillance and Response (PIDSR) published by the Department of Health (DOH) of 2014 provides a detailed guide in the management and surveillance of communicable disease, the use of GIS was noted to be unspecified. Using GIS provides the possibility of harmonizing several data sets to better inform policymakers. [ABSTRACT FROM AUTHOR]

Objectives: explore thoughts and feelings of children on COVID-19, find out how they cope, and what they did during lockdown. It was total lockdown in Luzon, Philippines, April 2020 – when survey was conducted; pre-tested open-end questionnaire was administered to children who answered either by paper and pen, or through social media, with parents' cooperation. Participants: 200 boys and girls, 6-12 years old, public and private schools in NCR-Luzon. Results: Participants heard COVID-19, pandemic and lock down from media and family; described as deadly, dangerous, contagious, world-wide, death-causing virus; about 90% expressed sadness, fear, boredom, anger, disappointments and difficult time; employed self-enhanced coping mechanisms, and engaged in hobbies and interests to assuage thoughts and feelings; family appeared as saving grace. Recommendations: develop strategies to assist children during critical events; studies – find out effects of pandemic on participants' health; visit participants after two years to find out reminiscence of pandemic experience. [ABSTRACT FROM AUTHOR]

The global COVID-19 crisis disrupted education systems around the world. With the call for vaccination as a crucial step toward educational recovery, it is important to study the intentions of teachers to vaccinate against COVID-19. Thus, this article aimed to examine the intentions of Filipino teachers to vaccinate against COVID-19. A sample of 1070 K to 12 teachers from Mindanao, Philippines participated in the online survey. The collected data were analyzed using descriptive and inferential statistics. The results showed that a large majority of the teachers are uncertain about whether they will vaccinate against COVID-19 or not. When looking into the underlying reasons, they expressed that they do not have enough knowledge about the vaccine and are concerned about its potential side effects. The results further revealed that gender, monthly income, and educational attainment were significantly associated with the intention to vaccinate against COVID-19. Lastly, it was found out that a low level of barriers significantly predicted the intention of the teachers to vaccinate against COVID-19. Considering these results, this paper underscores the need for concerned authorities to strategically focus on addressing the persistence of hesitancy by campaigning for vaccine literacy and information resilience so that teachers will vaccinate when appropriate. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore the quality of social relationships of older Filipino church members by determining their perceptions of support and non-support in their social network.Design/methodology/approach A qualitative research approach with semi-structured interviews was utilized. A purposive sample of six Filipino older adults (ages 60-89) were invited and agreed to participate in the study.Findings The themes found in the study confirmed the types of support outlined in social convoy theory. Several unique nuances in the types of support and non-support between the interactions of older adult Filipinos with people very close to them, somewhat close to them, and merely acquainted with them were identified. The themes of support include instrumental support, emotional care, social connectedness, and companionship during engagement in activities. Themes characterising lack of support include disrespect and lack of understanding, constraining one’s actions, helplessness in responding to the other’s needs, non-dependability and non-reliability, difficulty in maintaining social connections, making it difficult to play a desired or expected role.Research limitations/implications The study’s limitations are the small sample size, the quality of support explored only through nominating two members of each level of closeness in the older adults’ social convoy, sample size adequacy to reach data saturation, and the lack of data on support reciprocity that may influence the respondents’ perceptions of support and non-support.Practical implications The findings of the paper point to possible interventions to improve social support for the older population. The road map for those interested in developing interventions should also put some emphasis on older adults’ needs in their continued societal engagement. Interventions may involve facilitating role transitions and providing social support systems attuned to the needs of the elderly.Social implications The authors speculate that this lack of support experienced by the older adults relates to the loss of societal roles, especially as this relates to their identity, meaning, and changes in social interactions within their communities. It is therefore important that interventions be planned to provide structures for older adults’ transitions in their re-engagement in society and into the work-force, thereby reducing this sense of role ambiguity and providing them with more positive identities in their communities.Originality/value The results suggest another form of support distinct from the emotional and instrumental support elaborated in previous work. This support is identified as companionship from within the social network that allows older adults to sustain engagement in meaningful activities. The study’s results further suggest a lack of clarity in societal roles, i.e. a sense of role ambiguity, which older adults may experience in the transitioning from adulthood to later adulthood. [ABSTRACT FROM AUTHOR]

Aims: Educating women regarding breast cancer and increasing breast self‐examination uptake continues to remain a major challenge despite the intensive campaigns. An innovative, cost‐effective and easily customised intervention is needed especially in under‐resourced and hard to reach communities. This paper is a report examining the effects of mobile text messaging on women's knowledge of breast cancer and BSE, BSE self‐efficacy and frequency of BSE. Methods: A randomised controlled trial design was used. The study sample consisted of 128 women of reproductive age (WRA) (64 in the experimental group and 64 in the control group) from two communities in the Philippines during the months of August to October 2018. Three to five short messages were sent to the participants in the experimental group daily for one month while the control group did not receive the messages. Results: Women who received mobile text messages had higher knowledge of breast cancer (F = 21.756, p = 0.001) and breast self‐examination (F = 6.776, p = 0.010) than the control group. However, no significant improvements were seen in the BSE self‐efficacy (F = 1.446, p = 0.232) and frequency of BSE (F = 3.374, p = 0.69). Conclusion: Mobile text messaging significantly improved the knowledge on breast cancer and breast self‐examination among women; however, it did not affect their breast self‐examination self‐efficacy and frequency. Mobile text messaging can be a viable tool that can be used by healthcare workers in order to educate women regarding breast cancer and breast self‐examination. [ABSTRACT FROM AUTHOR]

Background: The abundance of easy and accessible information and the rapid development of social networking sites (SNSs) have proven that the world is small and within reach. The great implication of this interconnectivity is attributable to the change in the learning and sharing environment, which for the most part is something that classrooms are lacking. Considering the potential implications of SNSs in nursing education reveals the benefits of SNSs in allowing students to communicate and interact with a wider audience and beyond the classroom. The aim of this study is to identify the extent of SNS utilization, the perceived benefits of SNSs and the potential of SNSs for improving the study habits of nursing students in five countries (Israel, Iraq, Oman, the Philippines and Turkey). Methods: This study is a quantitative cross-sectional study that determined the relationship between the utilization of SNSs, the perceived benefits of SNSs, and the potential of SNSs for improving the study habits of nursing students in the five participating countries (Israel, Iraq, Oman, the Philippines, and Turkey). This paper is based on carefully analysing the survey responses of a sample of 1137 students from an online hosting site. The online instrument focuses on the extent of the utilization and benefits of SNSs according to their accessibility, usability, efficiency and reliability. Results: Based on the Pearson correlation coefficient (r) our findings, reveal a significant positive correlation between the extent of a possible improvement in study habits and the extent of SNS utilization in terms of the four domains, namely, accessibility (r = 0.246), usability (r = 0.377), reliability (r = 0.287) and efficiency (r = 0.387). Conclusion: It can be concluded that there is a significant positive correlation between students' study habits and the extent of SNS utilization, meaning that the more students devote themselves to their study habits, the higher the level of SNS utilization. The use of SNSs by nursing students has positive and negative implications, and there is greater potential for further improving approaches to nursing education through the adaptation of curricula based on the proper utilization of SNSs. [ABSTRACT FROM AUTHOR]

Background and Purpose: Cultural competence is significant in addressing the health needs of vulnerable populations. This study conducted psychometric testing of a cultural competency instrument in the Philippines. Methods: Brislin's translation and a cross-sectional online design were used. Exploratory factor analysis (EFA) with varimax rotation examined construct validity of the 23-item scale among 157 adult LGBTQ+ residents. The scale revealed overall reliability (α =.85) including two subscales (α =.87, α =.81, and α =.61). The EFA yielded three theoretical factorial solutions. Conclusion: The Filipino version of the instrument demonstrated reliability and validity. Measuring clients' perceptions of provider and organizational cultural competency can improve the utilization of healthcare in Filipino LGBTQ+ communities. Future research will examine the dimensional structures of the instrument among expanded LGBTQ+ communities. [ABSTRACT FROM AUTHOR]

Aim To explore how and why mobile instant messaging applications are used by Filipino nurses as part of their work. Methods Guided by the uses and gratifications theory, in-depth interviews with 20 staff nurses working in 9 hospitals (ie, 4 private and 5 public hospitals) in the Philippines were conducted in July 2015. Interview data were analysed through a phenomenological perspective to thematic analysis. Results Results show that mobile instant messaging applications such as Facebook Messenger and Viber were mostly used by staff nurses and these were accessed using their own smartphones. Thematic analysis indicates that they were used to meet staff nurses' need for information exchange, socialization, and catharsis. Moreover, user interactions vary depending on members within a chat group. For instance, communication via mobile instant messaging applications are much formal when superiors are included in a chat group. Conclusion In general, the results show that mobile instant messaging applications are routinely used by Filipino staff nurses not only for clinical purposes (ie, information exchange) but also for non-clinical purposes (ie, socialization and catharsis). This paper ends with several practical and theoretical implications including future research directions. [ABSTRACT FROM AUTHOR]

Background: Stress in relation to academic studies is identified to be one of the reasons behind suicide cases in higher education institutions around the world. Locally, there is none to less studies that explored this area among nursing students. As stress is inevitable in nursing students' Related Learning Experience (RLE), recognizing the stressors that affect their quality of RLE is necessary. Purpose: This study aimed to investigate the stressors and coping strategies that nursing students commonly use in managing stress during their RLE and their relationship to each other. Methods: A descriptive correlational research design with total enumeration sampling was employed. A pilot-tested questionnaire was used to gather data from 191 junior and senior nursing students from two nursing schools in Iligan City. Weighted mean, standard deviation, percentages, and Spearman rho were used to analyze the data. Results: The findings show that the "Clinical Instructor" (Mean=3.01) is perceived to cause higher stress among all the intrapersonal and interpersonal stressors identified. Students highly utilize both intrapersonal (Self-Concept Mean=3.75) and interpersonal strategies (Role Function Mean=4.13, Interdependence Mean=3.46) to cope with stress. When students' clinical "skill confusion" increases, they tend to work less with others (r=-0.259, p=0.000). When "staff nurses" cause them less stress, their use of positive "self-concept" decreases as well (r=0.152, p=0.035). Furthermore, when students are stressed with their "Duty-mates," they rely more on "physiological" coping mechanisms (r=0.160, p=0.027). When their "clinical instructor" causes them stress, they cope less with "physiological" (r=-0.237, p=0.001) and "interdependence" strategies (r=-0.317, p=0.000). Conclusion: Among all the stressors, clinical instructor causes more stress to the students. The students' perceived stressors affect their effective use of intra and interpersonal coping strategies. Nurse educators, nursing schools and regulating bodies can consider these results in designing a holistic curriculum and helping students manage stress healthily. [ABSTRACT FROM AUTHOR]

Aims: To describe sources of health information and health‐seeking behaviours of adults (aged ≥18) living in medically underserved communities in the Philippines. Design: This is a secondary, quantitative analysis from a cross‐sectional parent study. Participants completed a 10‐item, self‐report survey on their sources of health information, healthcare providers sought for health and wellness and health‐seeking behaviours when ill. Responses were evaluated across two age groups (<60 vs. ≥60 years) and genders using generalized linear mixed models. Results: Surveys were completed by 1202 participants in rural settings (64.6% female, mean age 49.5 ± 17.6). Friends and/or family were their key source of health information (59.6%), followed by traditional media (37%) and healthcare professionals (12.2%). For health promotion, participants went to healthcare professionals (60.9%), informal healthcare providers (17.2%) or others (7.2%). When ill, they visited a healthcare professional 69.1% of the time, self‐medicated (43.9%), prayed (39.5%) or sought treatment from a rural health clinic (31.5%). We also found differences in health‐seeking behaviours based on age and gender. Conclusions: Our findings highlight the need to organize programs that explicitly deliver accurate health information and adequate care for wellness and illness. Study findings emphasize the importance of integrating family, friends, media and healthcare professionals, including public health nurses, to deliver evidence‐based health information, health promotion and sufficient treatment to medically underserved Filipinos. Implications: New knowledge provides valuable information to healthcare providers, including public health nurses, in addressing health disparities among medically underserved Filipinos. Impact: This study addresses the current knowledge gap in a medically vulnerable population. Healthcare professionals are not the primary sources of health information. Approximately one‐third of participants do not seek them for health promotion or treatment even when ill, exacerbating health inequities. More work is necessary to support initiatives in low‐ and middle‐income countries such as the Philippines to reduce health disparities. Reporting Method: We adhered to the reporting guidelines of STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) for cross‐sectional studies. Patient or Public Contribution: There was no patient or public contribution as our study design and methodology do not make this necessary. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic is impacting individuals and society's physical and mental health. Despite the lack of any definite and effective therapeutic regimen, public health measures such as quarantine and isolation have been instituted to contain this pandemic. However, these mitigating measures have also raised issues regarding isolated patients' mental and psychological well-being. Several stakeholders were engaged in this approach, including the university, the local health office, the tertiary hospital, and the local communities. This intervention addresses concerns regarding the health status of isolated individuals due to COVID-19 infection, making the program available to anyone who agrees to participate. This was done through telehealth services delivered via phone calls and SMS. The university provided technical support and telehealth manpower through medical students. The local health unit manages the isolation facilities, while the referral hospital offers specialty care for isolated patients through teleconsultation. Finally, the local community is the one that reintegrates discharged patients into their communities. Three hundred forty-four (344) participants were provided seven sessions on telehealth education and tracking of their COVID-19 prescribed practices and mental health. The mean age of the patients was 37 years; half were females, and 15% had comorbidities. Regarding their mental health status, the level of depression dropped from 6% to 1% (p<0.0001), the level of anxiety dropped from 12% to 2% (p<0.0001), and the level of stress dropped from 3% to 0% (p<0.0001) from the first day of admission to 2 weeks after discharge. Moreover, a general trend of statistically significant increase in various practices was noted: wearing face masks, physical distancing, disinfecting frequently held objects, hand hygiene, and self-monitoring for COVID-19 symptoms. Those with progressing symptoms of COVID-19 were referred immediately to the referral hospital. There were also no reports of complications of co-morbidities during their stay in the isolation facilities or social isolation upon community reintegration. The study concludes that telehealth services have the potential to address many challenges in providing continuous healthcare services to isolated patients until they are reintegrated into their community. Furthermore, a whole-of-society approach is necessary to provide holistic care to patients affected by the pandemic. [ABSTRACT FROM AUTHOR]

As one migrates from an area of low to high incidence of breast cancer their personal risk of developing breast cancer increases. This is however not equally distributed across all races and ethnicities. This paper specifically examines Filipino migrants. A literature review was conducted to summarize breast cancer incidence, screening practices and trends in treatment amongst Filipino migrants. In addition, a retrospective cohort study was conducted specifically examining the age in which Filipino women were diagnosed with breast cancer compared to Asian and Caucasian counterparts. Filipino women are diagnosed with breast cancer at a statistically significant younger age (53.2) compared to their Asian (55.1) and Caucasian (58.4) counterparts. In addition, they are at an increased risk of developing more aggressive breast cancer with noteworthy disparities in the care they are receiving. The evidence suggest this group is worthy of special focus when diagnosing and treating breast cancer. [ABSTRACT FROM AUTHOR]

Aims: To determine which stressor has the highest occurrence and what stressors are related to nurse outcomes, such as job satisfaction, perceived quality of care, and turnover intention. Background: Numerous stressors have been identified in nursing practice, but it is unclear if specific stressors are related to nurse outcomes. Design The study used a cross‐sectional and descriptive‐correlational research design. Methods: In July and August 2017, survey data were collected from 427 staff nurses employed in a large tertiary‐level private hospital in Metro Manila, Philippines. The Nursing Stress Scale was used to measure stress frequency. Structural equation modelling was used to determine the relationship of stressors and nurse outcomes. Results: Exploratory and confirmatory factor analyses indicate nine Nursing Stress Scale factors. Workload is the most frequent stressor. Moreover, workload was negatively related to job satisfaction and perceived quality of care. Workload and conflict with nurses were positively related to turnover intention. Conclusions: The Nursing Stress Scale has a different factor structure based on a survey of nurses in the Philippines. Only workload and conflict with nurses were related to specific nurse outcomes. Nurse managers should identify and mitigate stressors experienced by nurses since these can lead to turnover and poor quality of care. SUMMARY STATEMENT: What is already known about this topic? Nursing is one of the most stressful health care occupations.Stress is related to job satisfaction, perceived quality of care, and turnover intention.The Nursing Stress Scale is a widely used tool to measure stress in nursing practice. What this paper adds? Stress due to too many non‐bedside nursing tasks is the highest reported item level stressor.Among several stressors, only workload was related to job satisfaction, perceived quality of care, and turnover intention.Instead of the original seven‐factor model, results of factor analyses suggest that the Nursing Stress Scale fits a nine‐factor model. The implications of this paper: Nurse managers should mitigate stressors experienced by nurses to improve job satisfaction.One way to reduce nurse turnover could be to reduce nurses' workload.The quality of care provided to patients by nurses may improve by reducing workload. [ABSTRACT FROM AUTHOR]

Background: Nursing, as a profession, is a facet where job satisfaction and performance matter. In the changing landscape of nursing practice in the Philippines and the aftermath of the COVID-19 pandemic, it is imperative to revisit and to perform an empirical investigation of the current state of nurses' job satisfaction and performance in the hospital setting. This study aimed to describe the job satisfaction and performance among staff nurses in private and government hospitals in Baguio City. Design: Using a quantitative descriptive cross-sectional survey design, a sample of 313 randomly selected staff nurses working in two private and two government hospitals in Baguio City were surveyed from March to April 2023, using a questionnaire. This study's protocol was approved by two ethics committees, namely the Saint Louis University Research Ethics Committee and the BGHMC REC. Nominal data was analyzed using the SPSS trial version employing frequencies, percentages, and the Chi-square test. Findings: There are more staff nurses in both private and government hospitals who reported satisfactory job satisfaction levels (276 nurses, 87.9%) and had good job performance (303 nurses, 96.5%) in all domains. However, results show that there are more nurses (209 nurses, 90.7% ) in government hospitals who are satisfied with their jobs than in private hospital nurses (67 nurses, 80.1%) in the domains Intra-practice Partnership/Collegiality (p=0.010); Challenge/Autonomy (p=0.001); Professional, Social and Community Interaction (p=0.010); Professional Growth (p=0.036); Time (p=0.009); and Benefits (p=0.045). In terms of job performance, more government nurses at 97.3% (224 nurses) rated a higher self-appraisal of job performance. In comparison, only 94.8% (79 nurses) of private staff nurses appraised themselves as having good performance. No significant differences were found in the domains of job performance, namely leadership, teaching, planning, communications, and professional development, except in critical care. In "Critical care," which showed significance, the results suggest that more nurses in government hospitals perceive higher job performance, revealing a significant difference (p=0.011) in the "critical care" domain, indicating that a higher proportion of nurses in government hospitals demonstrate superior performance in this area. Conclusion: Through this study, it was learned that nurses in both private and government hospitals generally experience high job satisfaction and performance, reflecting a fulfilled workforce and indicating commendable competency among the staff nurses. However, more nurses in government hospitals report high satisfaction and perceived performance in critical care compared to those in private hospitals. Thus, the findings of this study can contribute to and serve as a rationale for policy-making regarding creating a positive work environment, proper management and leadership, creation of training and skill development for critical care, providing opportunities for professional growth, and conducting regular evaluation and feedback----- all geared towards a satisfied and productive workforce. [ABSTRACT FROM AUTHOR]

Aim: To determine the reliability of the Philippine nurse licensure examination (PNLE) results from 2010 to 2019. Background: The PNLE first-time pass rate (FTPR) is a major criterion used to evaluate nursing program quality. There is wide variability in PNLE results ranging from 0% to 100% across nursing schools. There are no published studies to investigate the reliability of the PNLE. Methods: A retrospective correlational research design was used to determine the reliability of PNLE. Secondary data analysis of 517 nursing schools' PNLE FTPR results was conducted. Descriptive statistics described trends in PNLE results over 10 years. Spearman correlation was used to determine PNLE reliability. Findings: The PNLE FTPR increased from 2010 to 2019. More than half of Philippine nursing schools have low PNLE performance. Combined annual PNLE results, that is, adding May/June and November/December results, provided a more accurate measure of reliability. Conclusion: The PNLE is a reliable measurement tool to evaluate nursing program outcomes. Regulatory bodies should use caution in using PNLE results as a criterion in assessing nursing program quality. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to assess the prevalence of, and determined the factors associated with self-reported symptoms of suicide attempts and psychosocial distress among female victims of intimate partner violence (IPV). Design/methodology/approach - Using cross-sectional data from 13,594 women aged 15-49 years from the 2008 Philippines Demographic and Health Surveys, the authors measured univariate prevalence, conducted bivariate and multivariate analyses using logistic regression models to examine the associations between outcomes, exposures, and potential explanatory variables. Findings - In total, 47 and 8 per cent of the women reported psychological distress, and suicide attempts following IPV, respectively. Physical and psychological IPV occurred in 7 per cent of the women, respectively, whilst sexual IPV occurred in 5 per cent of the women. Multivariate analyses showed significant association between physical and psychological IPV and suicide attempt, as well as psychological distress. Research limitations/implications - This study extends the knowledge about the interaction between IPV, suicide attempts, and psychological distress by redirecting the attention to more systemic expressions of the excess burden of IPV among abused women. Practical implications - It highlights the significance of screening for the presence of, and accumulated effect of IPV exposures as a risk factor for suicide attempt and psychological distress. Social implications - Since IPV is a product of gendered norms and power relations, the extent to which exposure to IPV results in poor mental health outcomes is determined by the interplay between societal gender norms and attitudes, poverty, and psychological distress. Originality/value - Given that most of the literature on the association between traumatic events, psychosocial stress, and suicidality derive from high-income countries, they do not reflect cultural differences within the context of low-middle-income countries like the Philippines, or be generalizable to the low-middle-income countries. [ABSTRACT FROM AUTHOR]

Job satisfaction is a frequently studied topic among scholars, but only few have taken into account the job satisfaction of older workers. This study aims to develop a model that describes the mediating effect of happiness on job satisfaction specifically on a select group of aging Filipino workers. This paper utilized structural equation modeling (SEM) for its data analysis to test what impact happiness has on job satisfaction. Three hundred aging Filipino workers, both from public and private organizations in the Philippines, took part in this study by completing a five-part research tool that consists of aRobotfoto(a Dutch term that describes a photo-like picture drawn by police to describe a suspect from a witness's illustration) and adopted questionnaires for physical and mental well-being, employee recognition, happiness, and job satisfaction. The structural equation model revealed that physical and mental well-being and employee recognition significantly affect—and are predictors of—happiness. Moreover, it was found that happiness has an impact on the job satisfaction of older workers. Findings generated in this study cater relevant ideas in developing programs and practices for the aging workforce in the field of Human Resource Management. [ABSTRACT FROM AUTHOR]

Aim: Nurses play an essential role in improving health‐related knowledge and self‐efficacy of patients through health education. This study aimed to investigate the effects of message‐framed informational videos on diabetes management knowledge and self‐efficacy in patients with type 2 diabetes. Methods: A quasi‐experimental pretest and posttest design with two experimental and one standard care comparison groups was carried out to examine the effects of the message‐framed videos. The two message‐framed informational videos were developed to provide health teachings about diabetes self‐care. The knowledge and self‐efficacy of the two video groups and lecture comparison group were measured before and after the intervention using valid and reliable instruments established by the authors. Results: After the intervention, the knowledge and self‐efficacy of the two experimental groups were significantly higher than the comparison group. No significant difference was found in the knowledge scores between the two experimental groups, but a significant difference was noted in the average increase in their self‐efficacy. Conclusion: Message‐framed informational videos can be effective in increasing the diabetes management knowledge and self‐efficacy, and a gain‐framed rather than loss‐framed approach can be superior in increasing self‐efficacy. SUMMARY STATEMENT: What is already known about this topic? The use of an informational video in providing health education to patients improves retention of information.Message framing may be used to provide health‐related information effectively regarding gains and losses of behavioural changes among patients. The majority of the literature has focused on the moderating effects of self‐efficacy on message framing.There is a dearth in message framing research in the nursing literature particularly in a patient setting with high risk for actual health problems like type 2 diabetes. Limited work has reported the magnitude of the effect of message‐framed videos on self‐efficacy. What this paper adds? Gain‐ and loss‐framed informational videos, created to provide health teachings about diabetes self‐care management, significantly increased the diabetes management knowledge of older adults with type 2 diabetes.Both message‐framed informational videos achieved a modest increase in diabetes management self‐efficacy of older adults with type 2 diabetes, but the gain‐framed messages were more effective than the loss‐framed ones. The implications of this paper: Nurses can use message‐framed informational videos to increase the diabetes management knowledge and self‐efficacy in patients with type 2 diabetes during health teaching. [ABSTRACT FROM AUTHOR]

Aims: This paper is a report examining the level of professional autonomy as well as its predictors and outcomes among practicing nurses in the Philippines. Methods: This study adopted a descriptive, cross‐sectional research design. One hundred sixty‐six (n = 166) nurses participated in the study or a response rate of 83% during the months of January 2017 to May 2017. Seven self‐reported scales were used for this study: the Nurse Autonomy Scale, Job Stress Scale, Burnout Measure Scale, Job Satisfaction Index, Organizational Commitment Questionnaire, Turnover Intention Inventory Scale, and the Six Dimension Scale of Nursing Performance. Inferential and descriptive statistics were used to analyse the collected data. Results: Nurses demonstrated moderate levels of professional autonomy with education and hospital bed capacity as strong predictors. Regression analysis showed positive effects of professional autonomy on nurses' job outcomes such as organizational commitment, job satisfaction, and work performance. Conclusion: Consistent to international studies, nurses in the Philippines demonstrated moderate levels of professional autonomy. Nurses who had higher levels of autonomy tended to be high performing, satisfied, and committed in their jobs. Organizational efforts are critically important to foster autonomy in practicing nurses through adequate support, education, training, and developed policies. What is already known about the topic? Professional autonomy is an essential aspect of a positive work environment and is attributed to enhanced outcomes in patients, nurses, and organizations.The literature has identified several factors (individual and organizational) that influence nurses' ability to gaining professional autonomy.In the Philippines, the extent to which practicing nurses act, function, and practice independently according to their professional nursing role remains unexplored.What this paper adds? Results showed moderate professional autonomy among Philippine nurses with education and hospital bed capacity as important predictors.Higher perceptions of professional autonomy were linked to enhanced organizational commitment, job satisfaction, and work performance.The implications of this paper: Nursing leaders and managers are strategically positioned to enhance autonomy in practicing nurses through provision of adequate resources, organizational support, and developed policies.Professional enrichment through continuing education, training, and provision of adequate mentorship and coaching are essential to promote autonomy in nurses.By strengthening the concepts of nursing autonomy and professionalism in the curriculum, nursing education can play an essential role in preparing future nurses. [ABSTRACT FROM AUTHOR]

Forensic science plays a crucial role in the pursuit of justice, particularly through the identification of physical evidence found at crime scenes, such as human fingerprints and handprints. This study aimed to develop formulae for determining living stature using the handprint anthropometry of Tagalog people, an indigenous ethnic group in the Philippines. A total of 360 Tagalog volunteers, comprising 180 men and 180 women, were recruited. This study excluded subjects who had finger and hand-related diseases, injuries, or were under the age of 18. The materials used were a stadiometer for height measurement, a digital vernier caliper for handprint measurements, and a handprint kit to collect handprints. Five length measurements were collected for each handprint. The length measurement spanned the distance from the middle wrist crease to the tips of each of the five fingers. The data were analyzed statistically using regression analysis (p<0.05) in IBM SPSS Statistics for Windows, version 26.0 (IBM Corp., Armonk, N.Y., USA). The analysis results produced equations for determining stature using all the length measurements of the handprints. The study involved the calculation of correlation coefficients (r values) and standard deviations using the stature and handprint lengths of individuals of both genders. The results are presented in the form of tables and figures. The study concluded with the development of regression equations that may be utilized for determining stature based on various handprint length measurements of the Tagalog people. This study represents the first-ever anthropological study conducted on the Philippine Tagalog population within the scope of this research subject matter. The formulae can be applied to actual crime scenes for the purpose of personal identification. [ABSTRACT FROM AUTHOR]

Bacoor City, Cavite, is one of the Philippines' largest mussels producers. Thus, determining the changes in the microbiological and physico-chemical attributes of the mussels along its supply chain is essential to ensure the safety and quality of this commodity. Mussel samples were subjected to a time-distribution study to identify the presence of foodborne pathogens and to determine the changes in pH and drip loss. A high prevalence of pathogenic bacteria such as Escherichia coli, Salmonella, and Vibrio spp. was detected in the mussel culture sites. Microbiological counts and detection showed increased aerobic plate count (APC) along the supply chain, higher than the standard limits. The total coliform still conformed to the required range while E. coli levels increased along the supply chain, exceeding acceptable levels for raw consumption. For the presence of pathogenic bacteria in the different points of the supply chain, results revealed that enteric bacteria E. coli and Salmonella were present. Furthermore, pathogenic strains of Vibrio such as V. parahaemolyticus, V. cholerae, and V. alginolyticus were detected. The study emphasizes the need for improved post-harvest practices, including proper temperature control and packaging, to maintain the quality and safety of green mussels. Additionally, efforts to mitigate bacterial contamination in the culture areas and implement effective depuration processes are necessary to ensure consumer safety. [ABSTRACT FROM AUTHOR]

Patient-centered care (PCC) is the prevailing model of care globally. However, most research on PCC has been conducted in Westernized countries or has focused on only two facets of PCC: decision-making and information exchange. Our study examined how culture influences patients' preferences for five facets of PCC, including communication, decision-making, empathy, individualized focus, and relationship. Participants (N = 2071) from Hong Kong, the Philippines, Australia, and the U.S.A. completed an online survey assessing their preferences for exchange of information, autonomy in decision-making, expression and validation of their emotions, focus on them as an individual, and the doctor-patient relationship. Participants from all four countries had similar preferences for empathy and shared decision-making. For other facets of PCC, participants in the Philippines and Australia expressed somewhat similar preferences, as did those in the U.S.A. and Hong Kong, challenging East–West stereotypes. Participants in the Philippines placed greater value on relationships, whereas Australians valued more autonomy. Participants in Hong Kong more commonly preferred doctor-directed care, with less importance placed on the relationship. Responses from U.S.A. participants were surprising, as they ranked the need for individualized care and two-way flow of information as least important. Empathy, information exchange, and shared decision-making are values shared across countries, while preferences for how the information is shared, and the importance of the doctor-patient relationship differ. [ABSTRACT FROM AUTHOR]

To assess the association of early onset of smoking and use of other addictive substances with nicotine dependence, the extent of substance use, and the probability of relapse in drug treatment and rehabilitation centers. Self-reported data were collected from July to September 2019 from 632 inpatients at five drug treatment facilities in the Philippines. The Addiction Severity Index (5th edition) and the Fagerström Test for Nicotine Dependence were used to assess the inpatients' drug and alcohol use and nicotine dependence severity, respectively. Of a group of smokers who started smoking before the age of 10 years old, 54.3% were nicotine dependent current smokers and 9.89% were low to moderate nicotine dependent smokers. There were 82.61% male responders and 76% of the females started using drugs and alcohol before the age of 14. Other drug use eventually increased, yielding odds ratio of 26.5 and 28.9 in the past 30 days and lifetime, respectively, with 95% confidence interval of 10.8–64.9 and 11.5–72.9, indicating significant (p <.05) differences. This study advises policymakers to focus more on educating and disseminating information about the early onset of nicotine, which paves the way to nicotine dependence and other drug use problems eventually. This present study suggests a follow-up intervention and an aftercare therapy solely for nicotine dependents with substance use disorder in the prevention of relapse after treatment. [ABSTRACT FROM AUTHOR]

Information on fortifiable food consumption is essential to design, monitor and evaluate fortification programmes, yet detailed methods like 24‐h recalls (24HRs) that provide such data are rarely conducted. Simplified questionnaire‐based methods exist but their validity compared with 24HRs has not been shown. We compared two simplified methods (i.e., a household food acquisition and purchase questionnaire [FAPQ] and a 7‐day semiquantitative food frequency questionnaire [SQ‐FFQ]) against 24HRs for estimating fortifiable food consumption. We assessed the consumption of fortifiable wheat flour and oil using a FAPQ and, for wheat flour only, a 7‐day SQ‐FFQ and compared the results against 24HRs. The participants included children 12−18 months (n = 123) and their mothers 18−49 years selected for a study assessing child vitamin A intake and status in Mandaluyong City, Philippines. For fortifiable wheat flour, the FAPQ estimated considerably lower mean intakes compared to 24HRs for children and mothers (2.2 vs. 14.1 g/day and 5.1 vs. 42.3 g/day, respectively), while the SQ‐FFQ estimated slightly higher mean intakes (15.7 vs. 14.1 g/day and 51.5 vs. 42.3 g/day, respectively). For fortifiable oil, the FAPQ estimated considerably higher mean intakes compared to 24HRs for children and mothers (4.6 vs. 1.8 g/day and 12.5 vs. 6.1 g/day, respectively). The SQ‐FFQ, but not the FAPQ, generated useful information on fortifiable food consumption that can inform fortification programme design and monitoring decisions in the absence of more detailed individual‐level data. Potential adaptations to improve the FAPQ, such as additional questions on foods prepared away from home and usage patterns, merit further research. Key messages: Fortifiable (i.e., industrially processed) food consumption data are essential to design, monitor and evaluate fortification programmes, yet 24‐h recalls (24HRs) that provide such data are rarely conducted.Simplified methods, such as targeted food acquisition and purchase questionnaires (FAPQs) and semiquantitative food frequency questionnaires (SQ‐FFQs), exist but their validity compared to 24HRs has not been shown.Among Filipino children 12−18 months and their mothers, the SQ‐FFQ generated useful information on fortifiable wheat flour consumption while the FAPQ systematically underestimated wheat flour and overestimated oil.Further research could strengthen the FAPQ to better capture foods prepared away from home and usage patterns. [ABSTRACT FROM AUTHOR]

Introduction: Many Asian immigrants, including Filipino Americans (FilAms), experience psychological distress (PD) due to the challenges in adjusting to their new country and culture. This descriptive comparative study aimed to compare FilAms and Filipinos concerning their levels of PD, sources of stress, and use of health-promotion strategies. Methods: Data from 89 FilAms and 95 Filipinos living in urban cities, obtained from the I-HELP-FILIPINOS database, measuring cardiometabolic risks, mental health, and environmental stressors in 2017, including PD, were examined. Results: The mean age of all participants (N = 184) was 44.2 ± 22.8 years old. Both groups rated their health as good to excellent, although Filipinos were significantly more likely to be distressed (p <.001). Filipinos were also more likely to ascribe stress to employment (48.3% vs. 68.2%, p =.006) and finances (28.1% vs. 52.6%, p <.001) than FilAms. Discussion: While both groups shared comparative perspectives on health, FilAms reported lower PD than Filipinos. The most significant source of stress was the country of residence. We recommend tailoring interventions to each local context's unique social and environmental circumstances. [ABSTRACT FROM AUTHOR]

Child maltreatment is a serious problem affecting millions of children. Research on self-reporting of child maltreatment has shown a difference in reporting between caregivers and children. Increased understanding of this has implications for further evaluations of parenting programmes and assessment of violence and maltreatment. The purpose of this study was to explore caregiver-child reporting discrepancies on child maltreatment and emotional health before and after piloting of the International Child Development Program (ICDP) in the Philippines. Data was collected from caregivers and their children before and after caregiver participation in ICDP. Participants were selected from the Pantawid Pamilyang Pilipino Program in Leyte by Save the Children. Caregivers and children completed a questionnaire with some adapted items from the Conflict Tactics Scale Parent–Child version (CTSPC), some relevant complementary items on psychological aggression and items from the emotional problems subscale from the Strength and Difficulties Questionnaire (SDQ). Matching items, subscales and total count scores were compared using paired t-tests in STATA 14. Forty-six caregivers and 43 children aged from 5–13 years participated at baseline, and 44 caregivers and 42 children at endline. At baseline, children reported significantly more maltreatment than their caregivers. The groups reported similarly at baseline and endline on the items from the subscale on emotional problems. Both children and caregivers had lower scores on our harsh discipline scale at endline, indicating improved parenting strategies after the intervention. These results indicate a difference in reporting of child maltreatment between caregivers and children, with higher rates reported by the children before the intervention, but not after. This is important because it illustrates child and caregiver perspectives on maltreatment, and how they can differ. As such, our findings point towards a positive effect of ICDP on parenting. [ABSTRACT FROM AUTHOR]

Service workers are expected to maintain high‐quality service delivery despite customer mistreatment—the poor‐quality treatment of service workers by customers—which can be demeaning and threatening to self‐esteem. Although service work is increasingly delivered by middle‐aged and older workers, very little is known about how employees across the age range navigate abuse from customers on the job. Does advancing age help or hinder service performance in reaction to customer mistreatment? Drawing on strength and vulnerability integration theory, we proposed that age paradoxically both helps and hinders performance after customer mistreatment, albeit at different stages. We tested our proposed model in a two‐sample field investigation of service workers and their supervisors using a time‐lagged, dyadic design. Results showed that age heightens the experience of self‐esteem threat but, nevertheless, dampens reactions to self‐esteem threat, leading to divergent effects on performance at different stages. Implications for age and service work, as well as aging and the sense of self, are discussed. [ABSTRACT FROM AUTHOR]

The study aimed to assess the spiritual nursing care competencies of BSN students in Region 1 through the utilization of a descriptive-correlational research design involving the 424 Levels 2 - 4 BSN students and 125 clinical instructors from 14 selected higher education institutions. Data were gathered through questionnaires and were analyzed using frequency percentage, mean, and Pearson Correlation Coefficient. Findings revealed that the extent of the spiritual nursing care competencies of BSN students in Region 1 is moderate (spiritual nursing knowledge: x2 = 11.18; spiritual values: x2 = 3.77; and spiritual nursing skills: x2 = 2.76). There is a very weak positive, statistically significant correlation between the students' year level and spiritual values (r = 0.135, SD = 0.63, p < 0.01) and spiritual nursing skills (r = 0.153, SD = 0.62, p < 0.01). Furthermore, a very weak inverse significant relationship was revealed between the school category (r = -0.113, SD = 0.62, p < 0.05) and the level of accreditation (r = -0.101, SD = 0.62, p < 0.05) to their spiritual nursing skills. The BSN students in Region 1 are reasonably competent in rendering spiritual nursing care. Their year level, school category, and school accreditation are important factors to better spiritual nursing skills. As they advance in the year level, they are likely to assimilate spiritual values that are indispensable in delivering spiritual nursing care. However, amidst this favorable competence, clinical instructors still see the students as work in progress, capable of excelling. Thus, the utilization of the training module, which is an output of this endeavor, can help the nurse educators mold BSN students to advance their spiritual nursing care competence. [ABSTRACT FROM AUTHOR]

Inclusion of evidence-based practice (EBP) in entry-level physical therapy (PT) curricula is meant to develop the necessary competencies for better EBP uptake in clinical practice. This study aimed to: 1) determine the practice, knowledge, and values for EBP of the graduates of an entry-level PT curriculum with EBP education; 2) compare graduates' EBP practice profile to their EBP knowledge and values; and 3) explore their views on their EBP education and how EBP education influenced their practice. A convergent parallel design was used to gather quantitative and qualitative data. The Evidence-based Practice Profile - 2 (EBP2) questionnaire was used for quantitative data. Focus group discussions and open-ended questions in the EBP2 were sources for qualitative data. Seventy-seven completed the questionnaire and eight participated in focus group discussions. Participants scored highest for Relevance domain (standardized mean = 75.3) and lowest for Practice (standardized mean = 45.5). Three themes, 'Positive impact of EBP education,' 'Realities of PT clinical practice, and 'Strategies to improve EBP education' were derived. Data integration confirmed findings that graduates have good knowledge, value for, and confidence in doing EBP Findings suggest that early EBP education led to adequate knowledge, confidence, and positive attitudes, but practice barriers hinder EBP uptake. The medical model of service delivery was identified as a factor that influences EBP use. There is a need to revisit the EBP education program to complement real-world demands. [ABSTRACT FROM AUTHOR]

Background: Traditional, complementary and alternative medicine (TCAM) is used to treat a broad range of conditions. In low- and middle-income countries (LMICs), TCAM use is particularly common among those with low socio-economic status. To better understand the patterns and impact of TCAM use on the management of non-communicable diseases in these populations, this study examines the prevalence and characteristics of TCAM use for hypertension, its determinants, and its association with hypertension management outcomes and wellbeing among low-income adults in two Southeast Asian countries at different levels of economic and health system development, Malaysia and the Philippines. Methods: We analysed cross-sectional data from 946 randomly selected adults diagnosed with hypertension from low-income rural and urban communities in Malaysia (n = 495) and the Philippines (n = 451). We compared the prevalence, characteristics and household expenditure on TCAM use between countries and used multi-level, mixed-effects regression to estimate associations between TCAM use and its determinants, and five hypertension management outcomes and wellbeing. Results: The prevalence of TCAM use to manage hypertension was higher in the Philippines than in Malaysia (18.8% vs 8.8%, p < 0.001). Biologically-based modalities, e.g. herbal remedies, were the most common type of TCAM used in both countries, mainly as a complement, rather than an alternative to conventional treatment. Households allocated around 10% of health spending to TCAM in both countries. Belief that TCAM is effective for hypertension was a positive predictor of TCAM use, while belief in conventional medicine was a negative predictor. TCAM use was not strongly associated with current use of medications for hypertension, self-reported medication adherence, blood pressure level and control, or wellbeing in either country. Conclusions: A small, but significant, proportion of individuals living in low-income communities in Malaysia and the Philippines use TCAM to manage their hypertension, despite a general lack of evidence on efficacy and safety of commonly used TCAM modalities. Recognising that their patients may be using TCAM to manage hypertension will enable health care providers to deliver safer, more patient-centred care. [ABSTRACT FROM AUTHOR]

Background and purpose: Social engagement is an important active aging strategy to promote older adults' mental health. The purposes of this study were to compare social engagement in older populations around the world and explore associations with mental health outcomes. Materials and methods: An international cross‐sectional survey was conducted from 2017 to 2019. Data were retrieved from The International Social Survey Programme for a secondary data analysis across 30 countries. This study applied the Taxonomy of Social Activities and its six levels as operational definitions for a consistent concept of social engagement for international comparisons. Results: In total, 9403 older adults with a mean age of 72.85 ± 6.40 years responded. The highest levels of older adults' social engagement were found in Switzerland, Thailand, and New Zealand. Older adults of a higher age, with a lower educational level, who were permanently sick or disabled, who had no partner, who were widowed or whose civil partner had died, who lived alone, and who had lower self‐placement in society had significantly lower social engagement than did their counterparts. In the regression model, older adults' social engagement positively predicted general health, self‐accomplishment, and life satisfaction, but negatively predicted loneliness and depression. Conclusions: In aging societies worldwide, encouraging older adults' social engagement would be beneficial to promote mental health. Implications for nursing practice and health policies: Community professional nurses can develop strategies of social engagement based on the needs and sociodemographic factors of older adults to improve their mental health. Developing efficient strategies and local policies by learning from successful experiences in other countries is important to promote social engagement in aging societies. [ABSTRACT FROM AUTHOR]

Purpose: Although cerebrovascular accident is a leading cause of mortality in the Philippines, there has never been a national survey of stroke client descriptors and rehabilitation practices. This paper reports on data from the audit of stroke care for inpatients in hospitals serviced by physiatrists. Method: Audit was done of the medical records of stroke clients admitted to hospitals with rehabilitation units. Performance indicators for timely referral to rehabilitation were applied. Results: A total of 1683 records were audited. The majority of clients had cerebral infarct followed by cerebral haemorrhage. The median length of stay was 7 days; stay was lengthier for haemorrhagic strokes. Only 54.1% of the clients were referred to rehabilitation, with a median delay of 3 days between admission and referral to rehabilitation. 25.4% of the clients had early referral to rehabilitation. 39.2% of the 1397 clients were referred to rehabilitation earlier than 2 days before discharge. Conclusion: This Filipino study provides valuable information on stroke types and prevalence, demographics and rehabilitation practices. Despite the prevalence of post-stroke rehabilitation, it has been underutilised in the management of stroke. [ABSTRACT FROM AUTHOR]

Purpose: Work–family conflict (WFC) is an important issue in nursing administration and management that is associated with reduced work effectiveness and patient safety issues. To date, very few studies have attempted to explain the mechanisms underlying these relationships. The aim of this study was to determine the influence of work–family conflict (WFC) on patient safety outcomes and job engagement via the intermediary role of transformational leadership (TL). Design: Cross‐sectional study. Methods: Seven hundred fifty‐four nurses from 10 acute care hospitals in the Philippines were included in this cross‐sectional study. Findings: A higher perception of WFC was associated with increased adverse events, reduced quality of care and decreased job engagement. WFC was indirectly associated with quality of care, adverse events and job engagement through the intermediary of TL. Conclusions: The results of this study underscore the important role of nurse managers' TL in sustaining work–family balance and, in turn, improving patient safety outcomes and enhancing job engagement among nurses. Clinical relevance: Institutional measures to foster patient safety outcomes and sustain the nursing workforce should involve enhancing nurse managers' leadership behaviors through theory‐driven interventions, periodic leadership assessment, and implementation of leadership development activities. WFC may be addressed by creating empowering work conditions, providing adequate coaching and mentorship to nurses, and implementing work–family friendly policies in the workplace. [ABSTRACT FROM AUTHOR]

Early Detection and Intervention (EDI) is a system of services that promote development in the critical early years of childhood. It serves as an invaluable support to achieve Inclusive Education (IE). With limited literature regarding perspectives from public schools regarding EDI, this research engages the stakeholders from public schools of Filipino Children with Disability (CWD) to describe outcomes of EDI. Three focus group discussions participated in by 21 public school teachers and three key informant interviews of four school administrators from three cities in Metro Manila, namely Taguig, Paranaque, and Pateros, were conducted. Through comparative analysis using NVivo 11, three major themes emerged: (1) child outcomes seen in the skills and occupational performance of CWD; (2) systemic outcomes experienced in the surrounding context, encompassing the family, school and community, and (3) factors affecting EDI outcomes. Results suggest the need to have concrete strategic action to address system bottlenecks in EDI, imperative for successful IE. The importance of the environment where CWD partake in should be addressed for inclusion, equally important with addressing the capabilities of the CWD. Healthcare practitioners should take the initiative in advocating for coordination of medical and educational professionals to facilitate meaningful participation of CWD in education. [ABSTRACT FROM AUTHOR]

This study explores the relationship between income generation, increasing substance dependence, and the risk of relapse among drug treatment inpatients after their primary drug treatment in the Philippines. We collected 632 patients' data using a survey questionnaire at five drug treatment facilities – two each in Metro Manila (Luzon), Cebu and Iloilo (Visayas), and Davao City (Mindanao) – representing the Philippines' three principal geographical regions, from July to September 2019. Participants who reported substance dependence were distributed as follows: 20 (42.55%) high nicotine dependent users, 49 (41.88%) alcohol users, 51 (39.53%) methamphetamine users, and 35 (52.24%) cannabis or marijuana users. All were found among poor- to low-income earners. The adjusted odds ratios for the past-30-day substance use were calculated from occupations (formal, informal) of men and women using multiple logistic regression, and the results were: AOR = 7.96, 95% CI = 4.61–13.73 and AOR = 3.96, 95% CI = 1.69–9.24, respectively, with p <.005. Policymakers should facilitate economic interventions (livelihood/training skills) and prevention programs to address drug relapse among low- to poor-income earners admitted to rehabilitation centers for primary drug treatment (six months). [ABSTRACT FROM AUTHOR]

Effective tuberculosis (TB) treatment has existed for more than 50 years, but TB remains a leading cause of death worldwide and in the Philippines, in part because symptomatic individuals delay or avoid seeking care. Through qualitative interviews in Pampanga, Philippines, we investigated barriers to care-seeking using a behavioural science lens. We found barriers to TB care-seeking to be shaped by: (1) ambiguous symptoms; (2) association of TB risk with lifestyle and habits; (3) expectations of stigma, discrimination, and isolation; (4) short-term costs and long-term financial burden of TB; and (5) visibility of care in public sector facilities. Findings suggest that these barriers are deeply intertwined and that, typically, it is a combination of barriers that holds back a particular symptomatic individual from seeking care, as the barriers influence implicit trade-offs related to health, social, and financial consequences of having TB or another serious illness and of seeking care or not seeking care. The findings suggest avenues for more effectively reaching those with symptoms and their family members to encourage care-seeking by elevating the perceived benefits and putting perceived costs in proper perspective. [ABSTRACT FROM AUTHOR]

Introduction: Routine and timely testing for human immunodeficiency virus (HIV) is a gateway towards early treatment. Identifying key factors that drive repeat testing can inform interventions to promote regular HIV testing. Using the Reasoned Action Approach (RAA, as per Fishbein & Ajzen, 2010) as model, this study determined the predictors of repeat voluntary counseling and testing (VCT) for HIV after three to six months following receipt of a non-reactive test result among men who have sex with men (MSM) at risk of HIV infection. Material and methods: A prospective study was implemented at a community-based HIV testing and treatment center in Metro Manila, Philippines. At baseline, participants answered a self-administered questionnaire to measure re-test intention and its determinants. Their repeat status was identified at follow-up. Two-hundred and fifty MSM who received a non-reactive HIV test result were recruited for the study. Results: Behavioral attitude (β = 0.20, p < 0.001), injunctive norms (β = 0.15, p < 0.01), and perceived behavioral control (β = 0.46, p < 0.001) significantly predicted repeat VCT intention and provided 37% of variance explained. Descriptive norms did not significantly predict re-test intention. Intention to re-test (β = 0.10, p = 0.02) significantly predicted actual re-test status, and provided a 3% variance in actual repeat test status. Conclusions: The RAA was partially confirmed. Interventions that influence perceived control of MSM over repeat VCT are recommended. [ABSTRACT FROM AUTHOR]

Background: Several studies have demonstrated the significance of assertiveness in the nursing profession. However, there is a lacuna in the literature regarding the level of workplace assertiveness of Filipino nurses. Purpose: This study determined the workplace assertiveness towards nursing colleagues, nursing management personnel, medical doctors, and other members of the health team among hospital staff nurses. Methods: The data in this cross-sectional study were collected from randomly selected staff nurses (n=223) involving two tertiary hospitals in the Philippines using the Workplace Assertive Behavior Questionnaire. Descriptive statistics and tests for differences were used to analyze the data. Results: Results showed that staff nurses had moderate workplace assertiveness. They were less assertive towards the nursing management personnel, and were less likely to provide constructive criticisms and say no to requests. Assertiveness significantly varied based on employment status (p=.001), age (p=.046), years of nursing work experience (p=.037), and years in the present organization (p=.022). A sense of responsibility to patients was the main facilitator while reprimand and fear of repercussions from the nursing management personnel were the major barriers to assertive behaviors. Conclusion: Personal and work environmental factors can inhibit or support assertiveness. This study highlighted some gaps in Filipino staff nurses' assertiveness at work. Nursing management plays a pivotal role in nurses' assertiveness. Efforts should be made to address the barriers and improve the assertiveness of staff nurses. [ABSTRACT FROM AUTHOR]

Legal protections for people living with HIV (PLHIV) are important for protecting human rights, yet little research has examined how laws translate into awareness and understanding for key populations. The Philippines has recently revised their legal protections for PLHIV in response to its growing HIV epidemic, where HIV-positive gay, bisexual and other men who have sex with men bear the majority of cases. We present findings from interviews with 21 HIV-positive gay, bisexual and other men who have sex with men in Manila, Philippines regarding awareness, understanding, and needs regarding HIV-specific legal protections at the time just before new revisions to the omnibus HIV law were passed. Overall, there was no standardized way participants became aware of legal protections; few became aware through healthcare providers, while most learned through online resources, social media, and advocacy organizations. However, even after learning about HIV-specific legal protections, many found the law too complex to understand or did not understand how to use such protections. This led participants to preemptively take action to avoid HIV-related discrimination, even if they were protected by law. Participants demonstrated a strong desire for interventions and policies to improve legal awareness and understanding for PLHIV, government officials, and private businesses. This research demonstrates the value of increasing awareness and understanding in policy-specific interventions designed to improve quality of life for PLHIV. Interventions centered around legal protections are currently underdeveloped, providing a strong opportunity to integrate such interventions in existing practice or as stand-alone tools to decrease perceived stigmatization. [ABSTRACT FROM AUTHOR]