This paper attempts to capture how the principles of Participatory Action Research (PAR) were put into life in the integrated reproductive health (RH) programme in the Cordilleras, Northern Philippines. Document review and interviews of program staff were utilized to learn from the field and data were derived from participatory methods such as Group and Team Dynamic Methods, Interviewing and Dialogue Methods, Sampling Methods, and Visualization and Diagramming Methods. Results show that Community Needs Assessment (CNA) as a baseline for integrated planning of programme partners, laid a PAR framework for the entire development process. With the guidance of the integrated RH framework, the CNA ensured relevant and correct interpretation and analysis of data which then led to meaningful plans, actions and partnership, having gained the acceptance of communities. Community structures - People's Organizations with Health Committees that oversee income generating projects and RH education activities in the barangays (villages), were strengthened; partnerships with the Barangays Councils (BC) and the Barangay Health Stations (BHS) are continually enhanced to make policy formulation and service delivery more responsive to RH needs. Through this, the community was presented as a powerful unit of identity that builds on the strengths and resources of the community. The experience revealed that co-learning and capacity building can be promoted, and knowledge generation and intervention is integrated. The experience also emphasized the local relevance of public health problems (RH in this case) and the multiple determinants of health and disease including biomedical, social, economic, and physical environmental factors. To the researchers, it has been an inspiring and empowering experience to grow and learn with the people.

Human ; Male ; Female

PURPOSE:This research explored the voices of nurses in contemporary times and unraveled nurses' situations for the purpose of generating a substantive theory to guide and refine nursing practice.
METHOD:The  grounded  theory  methodology  of  qualitative  research  was  utilized patterned mainly in the works of Glaser and Strauss. Criterion sampling was used in the selection of 31 participants and the basis for selection was employment in the hospital, academe, and community and being part of different levels of management (nurses from top, middle, first, and staff levels). Theoretical sampling also informed the final list of study informants and was conducted by snowballing that consisted of 10  participants.  The  data  gathering  procedures  included  the  combination  of interviews, observations, and document and literature analysis.
FINDINGS:The study revealed three major themes: (1)nursing as a profession,(2)Nightingale in the 21st century:life of a nurse in today's context,and (3)the challenges and opportunities to quality of nursing care.
CONCLUSION:Nursing   is   dynamic,   complex,   diverse,   expanding   and   highly contextualized. Nursing is a field that grows with time and nurses are adaptive to the widening demands of their profession. The goal of nursing remains a Nightingale's pledge  and  an  endeavor  amidst  nurses'  constant  battle  between  motivations  and challenges.  The  Integrated  Systems  Approach  to  Nursing  Care  model  was developed to be used as a framework for sound decision-making in nursing practice.Nursing,  nightingale  and  beyond  is  a  picture  of  struggles,  success,  and  potential solutions to the predicaments surrounding the nursing profession.
CLINICAL RELEVANCE:The  study  has  potential  to  help  health  managers  and  policy implementers in providing assistance to nurses in enhancing their knowledge and skills, increasing their emotional and psychological resilience and in revitalizing their commitment to the nursing profession.It may also aid in  the  reconsideration  of institutional policies and set-ups toward collaborative and enabling work environment. In addition, it may serve as a guide in creating proactive health governance, in facilitating nurses' work motivation  and  retention  through  the  due  implementation  of nursing law and other statures for the welfare of health workers, in providing additional plantilla position for nurses in the country, and in increasing funding for health programs to create more learning and practice environment for nurses. Lastly, the utilization of the theory  can  be  used  in  developing  a  more  responsive  nursing practice.

Human ; Male ; Female ; Middle Aged ; Adult ; Motivation ; Organizational Policy ; Resilience, Psychological ; Goals ; Nurses ; Workplace ; Qualitative Research ; Models, Nursing ; Decision Making

The outbreak of COVID-19 triggered various responses from nations in an effort to control its spread. This review aimed to assess the responses of China, South Korea, Japan, Singapore, and the Philippines, and identify effective strategies to address the pandemic's incidence and mortality rate. Using a descriptive review of existing literature, their responses were evaluated using the World Health Organization (WHO) Strategic Preparedness and Response Plan (SPRP) and the Sendai Framework for Disaster Risk Reduction (SFDRR), which outline long-term objectives of reducing viral transmission, and reducing disaster risks and losses respectively. The countries studied were able to engage and mobilize communities; find, test, and isolate cases; provide clinical care, and maintain essential health services. However, countries differ in implementation, mainly due to their varying Social Determinants of Health (SDH) and disparities in resources. The countries' common goal was to control COVID-19 and return to economic normalcy. This study showed that effective strategies in handling the pandemic contain the following aspects: 1) strategic preparedness by drawing from past experiences, 2) tactical restructuring of the healthcare system, 3) effective resource mobilization and management, and 4) effective use of communication and technology to engage with the public. The SFDRR global targets were clear long-term goals for countries to base their pandemic responses on. This could equip the countries with the right tools and policies for future disasters, including a pandemic. Glaring issues on countries' SDH should also be foremostly addressed. Economic inequality, communication gaps, and issues on governance are primary factors that hinder the effective management of the pandemic for countries. Policy makers and social development workers, including nurses, need to adopt a holistic framework in analyzing situations confronting their work such as disasters.
COVID-19 ; Disease Outbreaks

Performance in the eight Nurse Licensure Examinations from December 2006 to December 2010 was analyzed to describe how graduates of colleges of nursing nationwide performed in the tests and to determine the factors that correlate with the examinees' scores. The study included all the graduates of colleges of nursing who participated in the eight Nurse Licensure Examinations. Data were collected through a review of secondary data from the Professional Regulation Commission - the passing percentage and average rating of schools, testing centers in the subjects tested and type of examinees. The variables from each NLE were categorized into Examinee variables, Institutional variables, and Program and Other variables. Based on the NLE results, the study concluded that those who took the examination for the first time (first timers) performed better, had higher passing percentage and significantly higher average rating than repeaters in all the NLEs. Among the repeaters, those who took the examination for at most two times showed higher passing percentage and average rating. Examinees from accredited schools also had higher passing percentage and average rating than examinees from non-accredited schools. Those from government-owned schools showed higher passing percentage in all NLEs and significantly higher average ratings in six (6) out of the eight (8) NLEs than examinees from non-government-owned schools. The study found that the accredited and government-owned schools had higher passing percentage and average rating compared to non-accredited and non-government-owned schools. Significant differences were found in the passing percentage and average rating of the examinees across regions and testing centers. Of the five subjects tested, the examinees performed best in Nursing Practice I and III. Their lowest passing percentage and average rating was in Nursing Practice IV. Number of examinees per school appeared not to have affected nor influenced either the passing percentage or average rating of schools in the eight (8) NLEs. The study reveals significant findings that correlate the performance of graduates of Philippine colleges of nursing in the 8 NLEs with selected variables and these findings may provide a better understanding of the issues and problems concerning the performance of examinees in the NLE.

Human ; Male ; Female ; Nursing ; Nurses ; Licensure, Nursing ; Accreditation

This research endeavored to explore, describe and document the saga of experienced nurse administrators to come up with reflective learning in nursing leadership and management. A qualitative phenomenological approach was utilized, specifically descriptive and interpretative methods of Husserl and Heidegger. Purposive sampling and referral were employed to select eight participants from the three fields of nursing administration(academe, hospital, and community) within Luzon, Philippines. An in-depth interview about the participants' experiences in nursing and nursing administration, together with a review of historical narratives and personal accounts were engaged to generate data. The interviews were transcribed verbatim and were analyzed following hermeneutic interpretive phenomenology. An integrated analysis of literature showed parallel descriptions of participants' responses and the context of historical accounts and events in nursing in the Philippines. Four main themes have emerged in the saga of Seasoned Nurse Administrators (SNAs): 1) Nurse administrators' responses according to the need and context of nursing in their times; 2) Nursing foundations and training are geared towards the values of nursing as a service profession, 3) The pathways towards becoming a nurse administrator are marked with competence in the roles undertaken and living the passion for service; 4) SNAs facing challenges are towards the improvement of life conditions, excellence in their profession, and setting advocacies to elevate the nursing profession in the country in the 21st century. A conceptual model was formulated in understanding the paths towards a seasoned nurse administrator.
Nurse Administrators ; Learning

Spirituality is a multifaceted concept with varied definitions. In the nursing literature, it is commonly described based on its significance in the lives of individuals. Exploring the perspectives of nurses, nursing students, and patients regarding spirituality and spiritual care is crucial to gain a sound understanding of how these concepts impact the nursing profession. This literature review explored the perspectives on spirituality and spiritual care of four population groups: nurse educators, nursing students, clinical nurses, and patients. A literature search was done using worldwide databases. The 84 articles included dealt with the perceptions of nurse educators, nursing students, clinical nurses, and patients regarding spirituality and spiritual care.

The four main categories of perspectives from the nurse educators, nursing students, nurse clinicians, and patients yielded ten sub-categories: (a) meaning of spirituality and spiritual care, (b) role of spirituality and spiritual care in nursing practice, (c) role of nursing education in developing spirituality and spiritual care competence of nursing students, (d) manner of integrating spirituality and spiritual care in nursing curriculum, (e) methods of teaching spirituality and spiritual care, (f) manner of spiritual care delivery, (g) barriers and challenges to the teaching and learning of spirituality and spiritual care, (h) barriers and challenges to spiritual care delivery, (i) ways of enhancing nurse educators' competence in curricular integration and teaching spirituality and spiritual care, and (j) ways of enhancing nurses' competence in spiritual care delivery.

Nurse educators, nursing students, clinical nurses, and patients presented similar and diverse perspectives, but they all recognized the significance of spirituality and spiritual care in the profession. The information derived from this study can contribute to the existing knowledge base and spur strategies at individual and institutional levels to enhance teaching and learning of the concepts, improve practice, and promote holistic care.

Human ; Nursing ; Students, Nursing ; Patients ; Spirituality

PURPOSE: The disparity between conducting research and putting it into practice has remains a global healthcare issue, with less than 50% of nurses utilizing research. This study aims to determine the level and relationship between Evidence-based practice (EBP) competency, current EBP beliefs and research utilization among nurses. DESIGN AND METHOD: This quantitative study utilized a descriptive-correlational design and mediation analysis. A purposive sampling was used to select six Christian Health Association of Ghana (CHAG) hospitals. Simple random sampling was used to recruit 544 nurses from the six CHAG hospitals. The study utilized mean and standard deviation, Pearson Correlation, ANOVA, and GLS mediation analysis. The researcher obtained ethical approval from the Saint Louis University Research Ethics committee and, the institutional review board of the CHAG. FINDINGS: The results showed that nurses had a low level of EBP competency (M=2.27, SD= 0.255), strong positive EBP beliefs (M=2.58, SD=0.322) and low research utilization (M=2.57, SD=0.300). There was a moderately significant positive relationship between EBP competency and research utilization (r= .431, p= .000), EBP competency and EBP beliefs (r= .327, p= .000) and EBP beliefs and research utilization (r= .306, p= .000). There is no significant difference in terms of EBP competency and research utilization when EBP training attendance was considered. Nurses with 1-2 years of experience had a higher level of EBP competency. Theatre nurses had a higher level of EBP competency, however, emergency nurses had a lower level of research utilization than nurses in the surgical unit. EBP beliefs mediated the relationship (B= 0.0604, z= 3.99, p < .001) between EBP competency and research utilization. CONCLUSIONS Nurses in CHAG hospitals have a limited ability to implement the EBP process. The respondent perceived the value of EBP in nursing practice to be significant and has the confidence to implement the EBP process. The nurses' respondents use of research in nursing practice is limited due to the organizational barriers in CHAG institutions in Ghana. Based on the findings, it is recommended for nurse administrators and policy makers to prioritize the provision of adequate resources, support, EBP policies and targeted training programs to facilitate a culture of evidence-based practice and research utilization in CHAG institutions. By improving EBP competency and promoting research utilization, nurses can enhance the quality and safety of patient care.
Evidence-based practice ; Competencies

This study on the tobacco-growing communities in the Northern part of the Philippines unveiled the stark reality of child labor among poor families in rural villages. These children found the tasks of the industry as normal and obligatory. They were made to earn their own money for school, food, and other basic needs such as clothes and personal belongings. This study aimed to give perspective on a child worker's life from their own lens, humanizing the face behind child labor. It unveiled issues, feelings, and deep-seated longings of typical children in tobacco-growing communities: wanting sustenance for their education despite the risks involved, easing their family's burden, finishing studies and preferring work over play. The study also looked at possible mechanisms towards addressing the issue of child labor, which include nurses and social development workers advocating for access to government instruments and raising awareness on the matter.
Tobacco ; Nurses

As qualitative researchers, we are actively involved in the research process. We accept the fact that we are the main instrument, thus are part of the social world we aim to understand. It entails self-awareness and as Parahoo (2006) posits, reflexivity, as a process, is an introspection on the role of subjectivity in the research that entails a continuous process of reflection by researchers on their values. It is also a process of recognizing, examining, and understanding how their “social background, location, and assumptions affect their research practice” Hesse-Biber, 2007, p.17). Reflexivity, as the abundant literature would indicate, is an elusive term, it is commonly used interchangeably with reflectivity, and even with critical reflection. In this paper, an attempt was made to rediscover how reflexivity has been utilized in various perspectives to define its position and role in the conduct of robust qualitative research. In the process, we would like to share and solicit perspectives on reflexivity as a process and as an output. This was done thru a review of literature and the integration and highlighting of reflexivity/reflexivities of various researchers arising from the various research that we have been involved with such as: the six-country multi-disciplinary team lead by the Ottawa University based in Canada that undertook participatory research across Asia, Africa, and the Pacific to learn how poverty can be defined and measured; the five-country multi-disciplinary team, led by the Australian National University, Australia; and various local interdisciplinary researches. These researches were conducted over three years or more, some in various stages using focused group interviews, key informant interviews, observations, ladder ranking using photographs, record reviews, surveys, and photovoice. We also included documented reflexivities of colleagues with whom we have worked with in various capacities. We analyzed these documents vis-à-vis the concern of the qualitative researcher to unravel how their personhood intersects with their experiences in the field. Indeed, revisiting reflexivity and research methods enlightens the rigor in traversing the pathways of knowledge generation in qualitative research.
Research Design ; Ethics

Glass ceiling is the unseen barrier that prohibits women and minorities in achieving a higher potential in the workplace. This barrier influences the well-being and prosperity of women and minorities resulting to career stagnation and inability to earn a higher income. Despite the abundance of literature on the issue, there is a dearth of comprehensive information that examines the organizational, cultural, and individual factors that contribute to the glass ceiling phenomenon in the healthcare industry. The main goal of this study is to do a full scoping review to find and map all the existing healthcare settings that contribute to the glass ceiling effect. A total of 28,184 hits resulted in the search of the published and grey literature. Nine articles passed the full-text review and were further reviewed. Data were synthesized and interpreted to determine the experiences of nurses about the glass ceiling phenomenon. Findings: Gender discrimination, bias, and stereotyping prevent nurses from learning executive summary skills, maintain the gender wage gap, and lead to unequal treatment of women and men in the health workforce; structural and systemic barriers within healthcare organizations can restrict their access to these higher-level positions; underrepresentation of women in leadership roles leads to lack of mentors; and lack of work-life balance due to limited flexible work arrangements.
Sexism ; Gender Equity ; Nurses