The role of the nurse practitioner (NP) has been successfully implemented globally including in some Southeast Asian countries. However, the Philippines has yet to enact this expanded role, not with standing being faced with the common factors influencing the evolution of the NP role indicated in the literature. With the proposed repeal of the current Philippine Nursing Law to include Advanced Practice Nursing, this study aimed to determine the knowledge and attitudes of nurses and physicians in the Philippines on the NP role. Sixty-six participants (41 nurses and 25 physicians) completed the survey on the knowledge and attitude on the NP role, conducted in two tertiary-level hospitals in Manila. Nurses have statistically higher scores on items regarding general understanding of the NP role, and on the difference of the NP from senior nurses. However, the difference of overall survey scores on the knowledge and attitude on the NP role between nurses and physicians was statistically non-significant. These results support the need to raise awareness on the role of the NPs by educating nurses, physicians, and other healthcare professionals in the Philippine setting.
Advanced practice nursing ; nurse practitioner ; knowledge ; attitudes

This research endeavored to explore the concept of nursing in the Philippines from the perspectives of Ilocano nurses to develop a nursing description based on the Filipino nurses' perceptions of nursing practice that will contribute to the richness of the concept of nursing in the Philippines. The participants of the study included 16 practicing nurses in Region I (Ilocos Region) who were identified through purposive sampling based on the inclusion criteria. Using phenomenology research design, the researcher utilized in-depth semi-structured individual interviews to gather the data from 2015-2016. Collaizi's method was used in data analysis. Ethical clearance was granted by the SLUREC with certification number 2014-013. The findings of the study revealed four (4) major themes, which are: 1) Mangtaraken or Caring, 2) Mangpasantak or Nurturing, 3) Mangipateg or Valuing, and 4) Mangsalimetmet or Preserving. Ilocano nurses explicate the concept of nursing in the Philippines as mangtaraken, which is described as the art, science, and discipline of caring; mangpasantak, which is to nurture an individual; mangipateg, which pertains to valuing the individual, family, and community; and mangsalimetmet, which refers to the preservation of the profession, culture, and knowledge generation. The findings revealed that the meaning of nursing is culture-based which is deeply rooted in their traits as Ilocanos.
Humans ; Students, Nursing ; Surveys and Questionnaires

PURPOSE: Scholarly works have reported about the nurses' salary and its impact on job satisfaction, nurse turnover, retention, work condition, and provision of nursing care. However, studies are either focused on the nurses in government hospitals or nurses working outside the country. Thus, the study aims to explore and describe the lived experience of nurses employed in private hospitals in Albay province, the Philippines, and explicate the need for better pay. DESIGN: The study used a qualitative design, specifically a descriptive phenomenology approach. METHODS: Purposive sampling and in-depth interviews were conducted among seventeen (17) nurse informants. The audio-recorded interviews were transcribed verbatim and analyzed following the seven-stage process as described by Colaizzi (1978) for data coding and identifying themes. The same process of analysis performed among the responses or data gathered through electronic communication platforms. FINDINGS: Four themes and nine sub-themes were identified. The first theme is 'Over but under,' which includes three sub-themes: (1) Over-worked, underpaid working conditions, (2) Finding an additional source of income as a result of low-wages, (3) More nurses are produced, but less are staying in the country, (4) Required by law in the country but not permitted by low salary. The second theme is 'Same but different,' which includes three sub-themes: (1) The Nursing profession is akin to others, yet uncompensated, (2) Work demands are comparable to government hospitals. The third theme is 'Caring but uncared-for,' which includes two sub-themes: (1) Psychologically upsetting, (2) Stimulates nurses transition. The fourth theme is 'Selfless foresight,' which include only one sub-theme (1) Increasing the salary attracts nurses to stay in the country. CONCLLUSION AND RECOMMENDATIONS: The study results showed that nurses in private hospitals need better remuneration as they experience poor work conditions. Also, it described a low salary that impacts the nurses' workload, their physical and mental health, their socio-economic being, their ability to avail professional development, the retention or turnover, and the provision of nursing care. The study findings suggest data triangulation of the study in some other private hospitals outside the region and explore strategies for increasing nurses' retention and satisfaction. Nonetheless, these efforts will robust the empirical data about the need for better pay among nurses in the private sector.
Job Satisfaction ; Personnel Turnover ; Hospitals, Private ; Salaries and Fringe Benefits

BACKGROUND: In ensuring access to maternal health services, various strategies toward safer health practices and improved health service delivery are important ingredients to eliminate avoidable maternal deaths. A recent household survey showed that access to antenatal care (ANC) (89%) and facility-based delivery (FBD) (82.4%) in the Eastern Visayas region is significantly high, despite the extensive damage to over 500 health facilities caused by Typhoon Haiyan in November 2013. Postpartum care (PPC), however, was relatively low (37.4%). As these findings needed further elaboration, a qualitative study using focus groups was conducted. METHOD: The focus groups method was utilized to elicit responses from the mothers, BHWs, and midwives to explain what contributed to the high ANC visits, high FBD, and low PPC. Sixteen focus groups were conducted in the local dialect (Waray and Cebuano), and all discussions were audio recorded. Focus groups data were transcribed and subsequently translated to English text, then reviewed and validated by socio-linguistic academics from the region. Other data sources included debriefing session reports and expanded field notes. Nvivo 10 software was used in the coding process and data management. The data analysis referred to the principles of thematic analysis. RESULTS: The findings showed that incentives in the form of free maternal services and cash grants drive mothers to go to the health facility for antenatal care and facility-based deliveries. The free services were provided by PhilHealth (the country's social health insurance), while cash grants were awarded through the government's conditional cash transfer program and other community partners. Mothers were provided with some financial risk protection through these financial incentives. The disincentives came in the form of local ordinances, which prohibited home births. Penalties included fines for both mother and birth attendant when the mother was found to deliver outside the health facility. The unintended stigma, shame, and fear that developed in response to these ordinances also deterred home births. The significantly low use of PPC services in the health facility was attributed to the lack of advices given to mothers regarding the need for follow up care after delivery. It is also noted that there are no incentives for PPC, which may contribute to its low rates. The role of the community health workers and midwives were to inform and educate the mothers on these incentives and disincentives. However, these incentives and disincentives are extrinsic motivators and are deemed insufficient to provide long-term impact. CONCLUSION AND RECOMMENDATIONS. The implementation of the incentives and disincentives in Eastern Visayas has increased rates of ANC and FBD. The presence of these in the current environment has initially facilitated behavior change, shifting home births to facility births. However, we argue that financial incentives, with a lack of intrinsic motivation, may be insufficient to sustain long-term impact. Disincentives, in the form of local ordinances, forced mothers instead to seek care in facilities. Such an approach may eventually become less effective over time. Incentives and disincentives are both demand-side factors, and to sustain change, concurrent improvements in the supply end need to be implemented. The capacity of facilities to absorb the increased demand should be in place to provide positive experiences for mothers in the health facilities.
Pregnancy ; Female ; Prenatal Care ; Postnatal Care ; Postpartum Period

The Cordillera is home to indigenous pregnancy and childcare practices. This study describes the Ibaloy traditional health practices of which little are known. It seeks to contribute to the literature about indigenous pregnancy and childcare practices. This two-year ethnographic study was conducted in Mangagew, Poblacion, Bokod, Benguet. Data was gathered through field observations and interviews with mothers, elders, and traditional birth attendants. The findings showed that Ibaloys are strongly connected to their traditional beliefs and possess strong family and community support for pregnant women and their children. Most of the traditional beliefs and practices of caring are still observed, alongside modern healthcare principles and practices. There are myriad of factors that influence Ibaloy health care decisions apart from their traditional beliefs and practices. Achieving health for these vulnerable groups requires multi-sectoral linkages and active community participation. The result of this research serves as a basis for culturally appropriate evidence-based care for both the Ibaloys and similar groups, and as reference for the Ibaloys’ slowly fading traditional beliefs and practices
Female ; Pregnancy ; Child Care ; Child Health ; Delivery of Health Care

This descriptive correlational study determined the level of hope and spiritual wellbeing among Filipino caregivers of terminally-ill cancer patients, and the relationship of hope and spiritual wellbeing to various patient and caregiver characteristics. The study involved 50 caregivers of terminally-ill-cancer patients, mostly belonging to 51-60 age group (42%) with mean age of 44 years (SD=15), mostly females (72%), married (62%), Roman Catholic (90%), high school graduates (50%), spouses of patients (28%), with an average of 18.36 hours of caregiving in a day for an average duration of 21.4 months. The hope and spirituality scores of caregivers were 3.24 (SD=0.28) and 3.25 (SD=0.46) respectively. Caregivers had high self-efficacy (3.29) but low social support (1.72). Patient's age was moderately correlated with caregiver's hope (r=0.3; p=0.03). Caregiver's educational attainment was significantly associated with hope (p<0.01) and spiritual wellbeing (p<0.01). Caregiver's self-efficacy was moderately correlated with their spiritual wellbeing (r=0.46, p<0.01). Caregiver's hopes were (1) for their patients to get well and recover from their illness, (2) to have strong spiritual faith and be healed with God's help (3) to be hopeful and positive, (4) hope for longer life, (5) resumption of family relations, and (6) free of pain and other discomforts. Caregivers' thoughts on spiritual wellbeing were to have: (1) stronger faith, (2) being prayerful, and (3) being positive. Compared to other studies, Filipino caregivers had lower hope scores, but higher spiritual wellbeing scores. Nursing interventions promoting hope and spiritual wellbeing should be conducted in patients' room, clinic appointments, or during home visits. Nursing care promoting hope and spiritual wellbeing should be part of patients' activities for daily living.
Humans ; Female ; Adult ; Caregivers ; Spirituality ; Family Relations ; Spouses ; Self Efficacy ; Catholicism ; Patients' ; Rooms ; House Calls ; Terminally Ill ; Hope ; Marriage ; Spiritual Therapies ; Social Support ; Neoplasms ; Pain ; Schools

PURPOSE: With continuous positive airway pressure (CPAP) being the treatment of choice for Obstructive Sleep Apnea (OSA), adherence rates to CPAP are still low without a clear consensus of causes. The Self-Determination Theory (SDT) is a general theory of human motivation that emphasizes the extent to which behaviors are relatively autonomous based on the psychological needs that are critical to supporting the process of internalization and the development of optimal motivation. This study sought to determine whether the implementation of an SDT-based intervention is effective in improving: (1) perceived competence, (2) treatment self-regulation, (3) CPAP treatment adherence, and (4) Apnea–hypopnea index (AHI) of OSA patients. METHODS. Using a true experimental pretest-posttest design, 30 purposively selected participants were randomly allocated to experimental and control groups. The SDT-based intervention included group sessions, individual sessions, and follow up phone calls in three weeks. Written permission to conduct the study was obtained from the Institutional Review Board of the University of the East - Ramon Magsaysay Memorial Medical Center, Inc. (UERMMMCI) and the Lung Center of the Philippines. Participation was voluntary and all participants had the right to refuse or discontinue their participation at any time during the study. Data were analyzed using two way repeated-measures ANOVA, student's T-test, and chi-square. RESULTS AND CONCLUSION: The participants in the experimental group have increased adherence rates from Time 1 (60%) to Time 2 (92.9%) and Time 3 (85.7%). Although, when compared to the control group, no significant difference was noted across the different periods of measurement (p=0.70810, p=0870, p=0.2403). There were higher proportions of patients who eventually became adherent in the experimental group compared to the control group immediately after and 5 weeks after the intervention (p=0.0001). The experimental group had significantly better improvement in AHI compared to the control group immediately after (p=0.0152) and 5 weeks after the intervention (p=0.0022). Considering the importance of CPAP adherence in effectively treating OSA, measures to improve adherence such as SDT-based intervention could be usefully incorporated into OSA patients' treatment plans.
Continuous Positive Airway Pressure ; Personal Autonomy ; Sleep Apnea, Obstructive

PURPOSE: The partners of cancer patients commonly provide the needs of cancer patients along cancer trajectory except for patients with gynecological cancer. In developing countries including Indonesia, who have strong family bonding, the family of cancer patients are involved more intensely in providing cancer care. This situation may bring the cancer patients' families experience the burden and decrease their quality of life. Therefore, assessing the family's supportive needs are as important as patient supportive needs. There are more gynecological cancer survivors in Indonesia; however, little is recognized about partners' supportive needs due to lack of validated assessment tools to measure it. This study aimed to translate, culturally adapted and test the validity and reliability of the CaSPUN questionnaire among partner of Indonesia gynecological cancer patients. DESIGN: First, the procedures of forward-backward translation and modification of the CaSPUN were conducted to ensure cultural adaptation. Second, using convenience sampling with 295 partners of gynecological cancer patients, we tested the construct validity and internal consistency of the CaSPUN-Indonesia Version (CaSPUN-I). We conducted Exploratory Factor Analysis to explore the factor structure of CaSPUN-I and Cronbach Alpha to confirm internal consistency reliability. RESULTS: The CaSPUN were modified to make more understandable and culturally appropriate in the Indonesian context. Five factors were extracted from EFA in the CaSPUN-I with factor loadings of items between 0.41 and 0.85. The Cronbach's alpha coefficient for the CaSPUN-I ranged from 0.96-0.97. CONCLUSION: The CaSPUN Indonesia version presents acceptable validity and reliability for assessing supportive care needs among families of Indonesian gynecological cancer patients. The CaSPUN-I can be used by healthcare providers to assess and design the supportive care program for family of Indonesia gynecological cancer patients.
Cancer Survivors ; Needs Assessment ; Cross-Cultural Comparison ; Indonesia

PURPOSE OF THE STUDY: This study aimed to investigate the knowledge, attitudes, and practices regarding post-operative pain management among nurses working in the surgical units in Kandy, Sri Lanka. DESIGN: The study was based on quantitative method, specifically descriptive design. Samples were selected using the probability sampling technique of simple random sampling. The sample size obtained was 200 nurses using 95% confidence level and a 4% margin of error for a population of 300 nurses in the research setting. METHODS: A self-administered questionnaire was chosen as a data collection method, and this questionnaire contained 36 questions under four sub-topics. A box was kept in the matron office in the surgical section to collect the questionnaire. The data were analyzed using descriptive analysis with percentages. FINDINGS: According to the research findings, 66% (132) were knowledgeable about the meaning of post-operative pain management. Post-operative pain management was identified by 74% (148) of the respondents, and 26% (52) correctly indicated that the most accurate judge of post-operative pain is the patients' self-report. When considering the attitudes, 66% (132) of the participants agreed that post-operative patients show discomfort before receiving the next analgesics. Among the participants, 60% (120) of nurses worried that patients would become addicted to analgesics that they give, while 20% (40) disagreed, and 2% strongly disagreed. 54% (108) of the nurses stated that patients were kept under close observation and the pain was monitored regularly, while 46% (92) expressed that patient is kept in a comfortable position. To manage post-operative pain, 80% (160) used non-pharmacological methods while 20% (40) did not. CONSLUSIONS: The findings of this study identified problems such as inadequate knowledge, and inappropriate attitudes and practices regarding postoperative pain management.
Pain, Postoperative ; Knowledge

PURPOSE: Since the outbreak of the unprecedented COVID-19 health crisis, Filipino nurses are one of the vital health workers in fighting its devastation in the Philippines. The study aimed to describe the lived-experiences of Filipino next generation nurses as frontliners in the midst of COVID-19 pandemic. DESIGN: The paper espoused the qualitative research design of inquiry exclusively Husserlian descriptive phenomenology. Study participants were selected using non-probability, purposive sampling design. The sample (N=19) was consisted of Filipino nurses with less than 10 years of practice experience, referred to as next-generation nurses, who function as frontline healthcare workers in healthcare settings, both male and female. The study was conducted in the national capital region (NCR), which has the most COVID-19 cases in the country. Due to the community quarantine imposed by the national government, the corpus of data was collected through virtual semi-structured interviews and from the participants' testimonies posted in social-media. METHOD: An adaptation of Colaizzi's empirical phenomenological research approach was utilized to obtain an in-depth understanding and analysis of study participants' experiences. FINDINGS: The profound, life-changing experiences of a select group of Filipino next- generation nurses were unified in three interesting themes, namely,: acclimatization to the challenges of the novel clinical situation, affirmation of the spirit of resiliency, and actualization of the valued calling. CONCLUSION: The contagion has demanded a new way of working, and these nurses have risen to the challenge, and demonstrated how capable they are at responding to new situations and uncertainty. Despite facing dire challenges, they demonstrate the spirit of resiliency. This health crisis enables them to impart the value of the nursing vocation. As they navigate this unprecedented contagion, their experiences and status could likely alter at different phases of the pandemic. Hence, the provision of long-term and holistic support for them is necessary to preserve their welfare.
COVID-19 ; Pandemics ; Family Characteristics