AIM

This study explored the developmental process of self-advocacy among nurses and proposed a conceptual framework, The Nurse Becoming Model of Self-Advocacy, to contribute to middle-range theory development.

METHODS

A constructivist grounded theory design guided this study. Data was gathered from 29 nurses through in-depth individual and group interviews across academe, hospitals, and professional organizations in Region I and the Cordillera Administrative Region. Theoretical and disconfirming sampling was used to refine categories. Data was analyzed using constant comparative methods.

FINDINGS

Self-advocacy emerged as a developmental trajectory comprising four interrelated stages: self-preservation, selfdevelopment, self-actualization, and self-transcendence. Novice nurses often relied on protective strategies such as silence and conformity, while experienced nurses engaged in assertiveness, credibility-building, leadership, and collective advocacy. Nurses emphasized that self-advocacy extended beyond the individual to encompass patients, the profession, and society, while highlighting its relational and collective nature.

CONCLUSION

Self-advocacy is a dynamic process and core dimension of professional identity. It evolves through stages of growth, integrating self-care, competence, engagement, and transcendence. Supporting self-advocacy through education, mentoring, reflective practice, and enabling organizational structures enhance nurses' well-being and strengthens their capacity to advocate for patients, advance the profession, and contribute to societal transformation. The Nurse Becoming Model of Self-Advocacy offers a transferable framework to guide nursing research, education, and policy toward empowerment and resilience.

Human ; Nursing ; Grounded Theory ; Empowerment ; Leadership ; Resilience ; Resilience, Psychological

BACKGROUND

Organizational commitment strengthens care delivery and system responsiveness, yet high turnover and workforce exhaustion threaten healthcare stability. Understanding factors that sustain commitment is especially critical during crises such as the COVID-19 pandemic.

AIM

This study examined how nurses' attitudes toward their practice environment predict organizational commitment at King Abdullah Medical City (KAMC), Makkah, Saudi Arabia.

DESIGN

Across-sectional predictive correlational design was used.

METHODS

Data was collected from 275 staff nurses between October and November 2020 using convenience sampling. Attitudes toward the practice environment were assessed with the Practice Environment Scale of the Nursing Work Index (PESNWI), while organizational commitment was measured using the Revised Three-Component Model Employee Commitment Survey. Descriptive statistics, Pearson's correlations, and multiple regression were conducted in SPSS version 21.

RESULTS

Nurses reported positive work attitudes, with the highest ratings for nursing care and interdisciplinary relationships, followed by management and leadership, and the lowest for adequate resources. Organizational commitment was moderate across affective, normative, and continuance domains. Regression analyses identified nursing care and interdisciplinary relationships as the most consistent predictor across all domains of commitment, including affective (p < .001), normative (p = .047), continuance (p = .004), and overall organizational commitment (p < .001). Adequate resources significantly predicted affective (p = .014) and overall commitment (p = .050), while management and leadership predicted normative commitment (p = .016).

CONCLUSION

Nurses' perceptions of their practice environment significantly shape organizational commitment during crisis conditions. Interdisciplinary collaboration consistently emerged as the strongest predictor, underscoring the value of teamwork and nurse–physician partnerships. Adequate staffing and resources also reinforced commitment, particularly in sustaining affective bonds. These findings underscored that supportive practice environments, through collaboration, adequate resources, and participatory leadership, enhance nurses' autonomy and sense of meaningful work, which in turn strengthen organizational commitment, retention, and resilience during crises.

Human ; Nurses ; Nursing ; Workforce ; Health Resources ; Covid-19 ; Work ; Leadership ; Environment ; Saudi Arabia

Self-efficacy is central to effective academic nursing leadership since it influences decision-making, resilience, and organizational outcomes. This phenomenological study described the essence of leadership self-efficacy among nurse leaders in Philippine higher education institutions. Using Colaizzi's method, data was collected through semi-structured interviews (n=10) and one focus-group discussion (n = 8). Analysis yielded three interwoven essences: (1) Personal Capacities of a SelfEfficacious Leader (decisiveness, resilience, reflective composure), (2) Relational–Communicative Doing of Leadership (ethical consistency, collaboration, mentoring), and (3) Professional–Organizational Grounding (resource navigation, quality assurance, continuous learning). Recognition indicators of achieved self-efficacy included sustained goal attainment, composed decision-making, entrustment by stakeholders, reduced self-doubt, and ethical consistency. Findings suggested that academic nurse leaders' self-efficacy is a multi-dimensional structure rather than a linear developmental process. Implications were offered for leadership preparation, mentoring, and appraisal.

Human ; Nursing ; Leadership ; Education, Continuing ; Philippines

This reflexivity paper explores the evolving identity of a nurse leader turned researcher, tracing a journey along “the road less travelled” in nursing. It examines how personal history, professional experiences, and sociocultural contexts shape the researcher's positionality and influence the pursuit of knowledge. Anchored in critical, feminist, and interpretivist paradigms, the paper underscores reflexivity as both an ethical stance and a transformative process that connects power, purpose, and praxis. Reflective practice bridges experience and empirical knowledge (Sherwood & Webb, 2024). Through self-analysis, the author illuminates how lived experiences, leadership practice, and gendered perspectives inform inquiry, ultimately advancing a vision of nursing research that is self-aware, socially responsive, and justice-oriented.

Human ; Nursing Research ; Leadership

BACKGROUND

Leadership and leadership development are increasingly recognized as essential aspects of the medical profession today; however, these are not expressly taught and reinforced in current medical education, with many students having to learn on their own time or while already on the job.

OBJECTIVE

This study aimed to determine the perceptions of graduates of the UST Faculty of Medicine and Surgery (Class of 2023) on leadership in the medical profession and leadership development within the basic medical curriculum.

METHODS

A cross-sectional study using descriptive analysis was done using responses to a web-based questionnaire regarding participants’ perceptions of medical leadership, its incorporation into the basic medical curriculum, and self-assessment of specific leadership competencies.

RESULTS

Two hundred three (203) individuals participated in the study, 83% of whom reported having prior leadership experience. 75% of participants strongly agreed that leadership is relevant in the medical profession, and only 27% strongly agreed that leadership development is adequately incorporated into the medical curriculum. Participants rated themselves highest in emotional self-awareness and adaptability for the intrapersonal domain, and in empathy, organizational awareness, and teamwork for the interpersonal domain. There was a statistically significant positive correlation between perceptions regarding adequacy of incorporation of leadership development into medical education and participants’ mean scores in interpersonal leadership competencies. The top three gaps in leadership development identified by participants were lack of interest from the medical student, lack of time to incorporate leadership development in the medical curriculum, and lack of adequate exposure to leadership development in regular learning activities.

CONCLUSION

The study was able to determine the perceptions of recent medical graduates regarding leadership in the context of medicine and leadership development in the current basic medical curriculum. It has also ascertained how they viewed themselves regarding specific leadership competencies, particularly communication and interpersonal relations. The contexts provided by the students gave a more nuanced view of what leadership is like for them, both in the classroom and hospital setting.

Human ; Leadership ; Education

BACKGROUND AND OBJECTIVE

Public health nurses (PHNs) are vital in the local implementation of the provisions of the Universal Healthcare (UHC) Act of 2019. However, they need adequate competencies in health systems approach to successfully implement the provisions of the law. In response to this, a leadership development course for public health nurses (LDC-PHN), anchored on the building blocks of health systems, was developed and implemented. This paper aims to describe the extent to which training participants have applied the competencies acquired from the LDC-PHN as manifested by the workplace application of their capstone projects.

METHODS

Following Kirkpatrick’s Model of Evaluation, we used a multi-method study design to evaluate the extent of the participants’ workplace application of acquired competencies. Sources of data included the Workplace Application Plan (WAP) accomplished by each participant, a questionnaire to determine the perceived implementation status of the participants’ capstone project, interviews, and focus group discussions (FGDs) conducted with selected participants and their supervisors, and observation visits. Data were collected from May to December 2022. Data from the semi- structured interviews and FGDs were analyzed through content analysis, while the participants’ perceived status of their capstone project implementation was summarized as frequencies.

RESULTS

Majority of the participants (61.9%) reported partial implementation of their capstone project while 16.77% reported full implementation. Capstone project implementation was facilitated by the support received from their supervisors and local chief executives. Barriers identified included the demands of the COVID-19 pandemic and the challenges imposed by the events before and after the 2022 Philippine National elections. Major themes emerged from the interviews conducted among participants and their supervisors. The workplace application of the training program outcomes, based on participants’ perspectives, yielded increased capacity to lead and innovate, improved ability to advocate for capstone project implementation, transferability of acquired skill sets, and improved population outcomes. From supervisors’ perspectives, workplace application of training program outcomes include increased ability of PHNs to deliver health services, and visible enhancement of leadership and supervision skills among PHNs.

CONCLUSION

Given ample support and opportunities, and despite the barriers and challenges they faced, LDC-PHN participants, in general, utilized and applied the competencies they gained from the course in their actual work setting. Course graduates participated in health systems strengthening at various capacities by acting upon their capstone projects that addressed UHC challenges within their particular work settings.

Leadership ; Universal Health Care ; Nurses, Community Health ; Community Health Nurses ; Nurse' ; s Role

BACKGROUND AND OBJECTIVE

Public health nurses (PHNs) perform more than the provision of direct care to clients. They are also expected to perform roles as leaders, managers, and collaborators in different settings, especially in areas where there are no physicians. Their continuous professional development must be facilitated to empower them to lead the delivery of health programs and services in pursuit of universal healthcare. This study aims to determine the perceived competencies of public health nurses and describe their training needs.

METHODS

A descriptive, cross-sectional study was utilized, where an online survey was administered to PHNs across the Philippines to determine their self-perceived competencies and training needs based on the eight domains of core competencies of public health professionals. Descriptive statistics was used to summarize the data.

RESULTS

A total of 330 PHNs answered the survey. The results showed that at baseline, PHNs perceived themselves to be competent (from most to least) in the following: communication, analytical/assessment, community dimensions of practice, policy development/ program planning, leadership and systems thinking, cultural competency skills, public health science, and financial planning and management. In terms of training needs, the enablers mentioned include a supportive work environment that can provide a work schedule that is inclusive of time for professional development and work-life balance; a learning environment where colleagues and supervisors support the need for training and innovation; strong internet connection; and enough equipment to participate and submit deliverables for courses taken.

CONCLUSION

Filipino public health nurses perceived themselves to be competent in the areas of communication and community practice, but less competent in public health science, and financial planning and management. Future capacity-building programs must be designed to meet this demand. Furthermore, to make training programs truly responsive to the needs of nurses, steps must be taken to promote capacity-building enablers.

Human ; Universal Health Care ; Nursing ; Leadership ; Policy Development ; Public Health Nursing

BACKGROUND AND OBJECTIVE

Midwives play a vital role in the attainment of Sustainable Development Goals related to the health and well-being of mothers and newborns. Strengthening the leadership and management capacities of midwives is pivotal to the fulfillment of their mandate beyond assisting in birth and delivery. The study explores the perspectives of midwives about professional education and practice, which are aimed to serve as bases for developing a leadership course for midwives to enhance their roles in public health.

METHODS

The study employed a descriptive-qualitative design. Using a semi-structured questionnaire, online focus group discussions (FGDs) with midwives from the academe, professional organization, and clinical practice were conducted. Through directed content analysis, the gathered information was analyzed to include the participants’ insights on midwifery competencies, teaching methods and assessment strategies, supplementary courses and training, and factors affecting midwifery practice.

RESULTS

A total of eleven (11) participants contributed to the FGDs, which included midwives from the academe (dean, faculty), professional organization (board member of the Professional Regulation Commission), and clinical practice (public and private institutions). Notably, participants shared their perspectives regarding the similarities/differences in the terminal competencies of midwifery programs. The demands of outcomes-based education, coupled by the shift to online learning due to the pandemic, pushed the need for modifications in program delivery for the students. Results highlighted the need for supplementary courses and capacity building on leadership and management, research, and interprofessional collaboration. Midwives shared factors that affect their professional practice, which include insufficient training, inadequate manpower, and differences in expectations/standards in task performance.

CONCLUSION

The findings indicate the need to develop capacity-building courses for midwives to enhance their contribution towards universal health care. The results of this study also highlight the importance of understanding and improving the competencies of midwives across the building blocks of the health system, which include health service delivery, human resources for health, health information systems, health financing, health governance, and health regulation. Notably, key concepts recommended for the Leadership Development Course for Midwives include: leadership and management, research, and interprofessional collaboration.

Leadership ; Universal Health Care ; Midwives ; Midwifery ; Sustainable Development ; Sustainable Development Goals

Background: The leader-follower (L-F) relationship in the nursing sector is an important aspect in the delivery of healthcare.While studies that primarily focus on the nurse leader have yielded very important contributions, it is also necessary to look at how the followers see their relationship with the leader, in the context of the practices and culture of their environment. Purpose: This study aimed to identify factors that affect the quality of nurse leader-follower relationships and propose a model for fostering high-quality L-F relationships among nurses. Design and method: The study utilized a descriptive qualitative design using a deductive, semantic thematic analytical approach. Semi-structured in-depth interviews were conducted among 11 staff nurses from different tertiary hospitals in Metro Manila. Data analysis and interpretation were performed using Braun, Clarke and Hayfield's thematic analysis. Results: Analysis showed that 19 factors, which influence the quality of leader-follower relationships among nurses, can be categorized into context factors, follower characteristics, and leadership characteristics. These factors gave rise to a model for highquality nurse leader-follower relationships. At the core of the model is the leader and followers, who both possess characteristics perceived to be the main factors in building high-quality relationships. The relationship takes place in the context of professional nursing practice, organizational context and work unit context. These three spheres of context are specific to nursing services in hospitals. Conclusion The model highlights the characteristics of leaders and followers needed in high-quality nurse leader-follower relationships and the context in which they operate. It could be useful in guiding the staff development programs for nurses, as well as, improvements in the work environment.
Leadership

PURPOSE: The purpose of this study was to define and clarify the concept of political competence for nurses.METHODS: A hybrid model method was used to investigate the dimensions, attributes, and definitions of the concept. In the theoretical stage of the study, literature on nursing, politics, and other discipline were reviewed. In the fieldwork stage, individual in-depth interviews and focus groups interviews were conducted with politically seasoned experts or activists who had an understanding of the concept of political competence for extensive descriptions in nursing and field of health care.RESULTS: The concept of political competence was represented in four dimensions as political knowledge, political efficacy, political interaction, and political activity. In the political knowledge dimension, there were three attributes, namely, political knowledge, political information and systematic analysis ability. The political efficacy dimension had three attributes of internal political efficacy, external political efficacy, and self-pride of nursing profession. The political interaction dimension had three attributes of organizations and community service, networking, and persuasive power. The political activity dimension had six attributes of political leadership, political expression, assertive behavior, political advocacy, political participation, and policy intervention.CONCLUSION: This concept development might provide a basic understanding of developing a measurement tool and for constructing a theory promoting nurses' political competence.
Concept Formation ; Delivery of Health Care ; Focus Groups ; Leadership ; Mental Competency ; Methods ; Nursing ; Politics ; Professional Competence ; Seasons ; Social Welfare