OBJECTIVES

This study aimed to describe the demographic profile, intervention sessions, goal attainment scaling (GAS), and health-related quality of life (HRQOL) of autistic children receiving speech and language therapy (SLT) in a higher educational institution in the Philippines.

Deidentified data from 18 autistic children aged 4–16 years (mean=8.2; SD=2.9) who received SLT for two months were analyzed. Their demographic profile, intervention sessions, GAS scores, and generic HRQOL scores were documented.

Most participants were school-age children (n=12; 66%) and were boys (n=14; 78%). After two months, the GAS scores of 11 participants (61%) increased by 1–2 points, whereas the scores of the remaining participants decreased (n=6; 33%) or did not change (n=1; 6%). Their mean generic HRQOL scores before and after SLT were 65.6 (SD=15.2) and 61.2 (SD=17.4), respectively.

While the GAS scores increased for most participants, their generic HRQOL scores did not show clinically significant changes after two months of SLT. This can be attributed to the few therapy sessions and short follow-up period. The findings highlight the need to provide long-term support to SLT services of autistic children in the Philippines to document more desirable quality of life outcomes.

This paper presents the development of a Time-limited Occupational Therapy (OT) Model designed to address the significant challenge of organizing the OT process within the constraints of a time-limited protocol while maintaining a client-centered approach and promoting systematic interdisciplinary care. Rooted in the authors’ clinical experiences and supported by existing literature, this challenge is compounded by multifactorial and contextual barriers within the Philippine healthcare system, including financial and resource limitations, institutional policies, and the uneven distribution of occupational therapists. Integrating the Dose-Effect (DE) and Good-Enough Level (GEL) models, this framework balances efficient treatment delivery with flexibility to meet client-specific goals. The DE Model emphasizes early improvement, while the GEL Model allows therapy to adapt dynamically to client progress. Key safeguards, such as Goal Attainment Scaling (GAS) and PostIntervention Review and Feedback based on the 5 A’s Model (Assess, Advise, Agree, Assist, Arrange), enable precise tracking of incremental progress and foster self-management through actionable feedback and goal-setting. The model comprises three main phases: evaluation, intervention, and re-evaluation, each structured by standardized measures, collaborative goal setting, and personalized intervention strategies. Interdisciplinary collaboration, informed by frameworks like the Occupational Therapy Practice Framework (OTPF-4), further enhances its adaptability across diverse clinical contexts. Demonstrating its practical application, a sample case of an 80-year-old inpatient highlights effective outcome measures and transition planning. While preliminary, this model provides a structured yet adaptable framework for delivering high-quality, outcome-driven care despite systemic constraints. Future research should prioritize empirical validation to refine the model and evaluate its long-term effectiveness in addressing the complexities of therapy delivery under resource-constrained conditions.

The Remote Home Environment Assessment (RHEA) Framework is a guide designed to help therapists conduct structured home environment assessments remotely using tools and technology. It offers an efficient and practical approach to overcoming the limitations of facility-based home assessments. The framework offers step-by-step procedures for remote home environment assessment for adult clients with physical dysfunction. It involves four major steps that focus on assessing the client’s physical environment: a) screening for selecting the most appropriate remote home environment assessment modality/ies; b) a preparatory phase that includes signing consent forms, explaining the assessment process, and previewing preliminary information; c) administration of the remote assessment; and d) consolidation of the home information. Furthermore, supplementary materials such as screening form, client and health facility consent forms, home evaluation questionnaire and checklist, and client instructions were developed to facilitate and guide the implementing therapist through the aforementioned steps. Pilot testing is recommended to gain accurate and practical insights into the RHEA Framework’s usability and effectiveness.

Occupational Therapy ; Knowledge

BACKGROUND

Since the advent of chemotherapy, cure rates for gestational trophoblastic neoplasia (GTN) have improved significantly. With increased survival, patients must cope with long-term sequelae of their treatment, including early menopause. Unlike natural menopause, treatment-induced menopause may cause a sudden and dramatic decline in estrogen, which can lead to more severe symptoms.

This study aimed to evaluate the prevalence of menopausal symptoms among young GTN survivors and to determine the impact of these symptoms on their health-related quality of life (QoL).

Ninety GTN survivors (RESULTS

A total of 90 patients were enrolled in the study with a mean age of 33.06 years. Majority (81.1%) reported at least one menopausal symptom. The most prevalent symptoms were psychological symptoms, followed by somatic, then urogenital problems. Among those with an intact uterus, 8.2% reported permanent amenorrhea. Only Stage III/IV and the presence of total hysterectomy were significantly associated with menopausal symptoms. The presence of menopausal symptoms was significantly associated with poorer health-related QoL among the respondents.

Menopausal symptoms are prevalent among young GTN survivors, and these negatively affect their health-related QoL. Emphasis should be placed on recognizing and addressing these symptoms. Adjunctive procedures, especially hysterectomy, should be carefully considered because these are significantly associated with menopausal symptoms.

BACKGROUND

With the increasing cancer burden in the country, nurses’ exposure to chemotherapy is inevitable as they belong to the workforce responsible for its preparation, administration, and disposal. These drugs are hazardous and necessitate special precautions to avoid direct exposure. Essentially, their competency must be aligned with the recommended safety guidelines to maintain quality patient outcomes while ensuring their safety.

The primary aim was to determine the competency level of Oncology nurses in terms of knowledge, skills, and attitude. The results were used to develop a training program framework for competency enhancement.

A descriptive correlational quantitative study was utilized. The study was conducted from December 2023 to February 2024 across three regions in Luzon, Philippines. The study included 203 Oncology nurses who fit the inclusion criteria. Data were collected via a four-part online questionnaire. Data were analyzed using frequency distribution, mean, standard deviation, and Pearson and Spearman correlation coefficients.

Oncology nurses exhibited excellent knowledge (x̄ = 16.18) and skills (x̄ = 3.86) but only fair attitudes (x̄ = 2.92). Knowledge correlated negatively with skills (ρs = -0.45, pCONCLUSIONS

Oncology nurses demonstrate comprehensive knowledge and accurate and efficient skills but maintain a neutral attitude toward handling chemotherapeutic drugs. These results relate to the complex interplay between the competency dimensions. There are still gaps and areas needing improvement that should be addressed and supported to align their competencies, especially along the skills and attitude dimensions. Training programs anchored on evidence-based practices and regulatory standards, and promoting a favorable practice environment are vital for their competency development.

OBJECTIVES

This study described the demographic and clinical profile, mental health problems, prevalence of psychiatric conditions, psychosocial interventions used, and outcomes of the management of mental health problems among in-patients admitted to non-psychiatry units of tertiary hospitals referred to mental health care providers; and described gender-disaggregated data related to mental health care providers and patients receiving psychosocial interventions in tertiary hospitals.

This study employed a mixed-method design, using both qualitative and quantitative methodologies following the convergence model of triangulation. The following were the data sources: (1) cross-sectional review of charts of patients referred for psychosocial problems using the ICD-10 classification; (2) a survey of mental health service providers; (3) key informant interviews of mental health service providers; and (4) focus group discussions of mental health providers. All data were collated, compared, and contrasted, then analyzed using the convergence model of triangulation design.

Among the 3,502 patients in the chart review, 1,870 (53.40%) were males. The median age was 46.08 years and 92.06% were adults. The most common diagnosis among the patients were mood disorder (744, 21.25%) and organic mental disorder (710, 20.27%). Combination treatment of psychosocial intervention and pharmacology was the most common strategy received by patients. There was a higher proportion of patients admitted to public hospitals (996, 45.27%) who received psychosocial interventions only compared to those admitted to private hospitals (235, 18.05%). There were 3,453 out of 3,502 in-patients referred for psychiatric intervention. Of these 2,420 (70%) received psychoeducation, 2,365 (68.5%), received supportive psychotherapy/counseling, 535 (15.5%) family therapy, and 286 (8.3%) behavior modification. There were more patients given psychosocial interventions 2,541 (72.56%) who were discharged with instruction to follow-up, while around one in 10 (456, 13.02%) was not instructed to do a follow-up consultation. The types of interventions across all data sources were similar.

The most common type of management for psychosocial problems of in-patients in tertiary hospitals was a combination of psychosocial intervention and pharmacotherapy. Psychoeducation, supportive psychotherapy/ counseling, and family therapy were the most often given psychosocial interventions. The patient-related reasons for the choice of interventions were patient’s medical status (diagnosis and severity of symptoms) and psychological status (psychological mindedness), while the provider-related factors influencing the choice of intervention were provider’s skills and personal preference. Moreover, resources (human and material) and service provision policies (treatment guidelines and aftercare interventions) were the most common hospital-related factors. Further prospective research to determine the associated patients, providers, and hospital factors in larger geographic and cultural settings will provide evidence for the effectiveness and outcomes of psychosocial interventions.

OBJECTIVES

The influence of weight change on the response to neoadjuvant chemotherapy (NAC) among adult Filipino patients with breast cancer remains unclear. Currently, there has been increasing evidence that weight gain during NAC is associated with increased recurrence risk and decreased survival. This study aimed to investigate this relationship and identify significant predictors of pathologic complete response (pCR), overall survival (OS) and disease-free survival (DFS).

This is a retrospective study using data from 52 female patients who received NAC for stage II or III breast cancer and had complete records of weight before and after NAC. Significant predictors of pCR such as host factors and tumor characteristics and associations between weight change and pCR, OS and DFS were examined using univariate and multivariable logistic regression analyses.

The average weight of all patients before NAC was 57.0 kg while the average weight of all patients after NAC was 59.5 kg. The average BMI of all patients before NAC was 25.8 kg/m2. In total, 29 patients (55.8%) were classified in the overweight/obese (OW/OB) group, and the rest were classified in the normal weight/underweight (NW/UW) group. The pCR rate was 51.3% in the OW/OB group versus 48.7% in the NW/UW group (p = 0.11). Initial BMI was a significant factor for achieving pCR (hazard ratio, 3.85; 95% confidence interval [CI], 1.72-8.60, p = 0.001), suggesting that a higher initial BMI was associated with an increased likelihood of achieving pCR. Initial BMI was also an independent prognostic factor for OS (p = 0.0006) and DFS (p = 0.0005). On the other hand, no significant correlation was seen between pCR rates as well as OFS and DFS (p = 0.0551) among patients whose weight changed during the course of treatment.

These findings suggest that while initial weight may significantly predict pCR rates and affect DFS and OS, weight change during treatment may not be as influential. Further research is needed to validate these findings in more diverse and larger patient populations.

OBJECTIVES

The aim of the study is to estimate the cost of breast cancer diagnosis, treatment, and management in the Philippines. Specifically, it aims to identify the resource requirements and interventions related to breast cancer diagnosis, treatment, and management, measure resource volumes (number of units), learn to value resource items (unit costs), and determine the total cost of treatment per disease stage.

The study covered nine tertiary hospitals, seven of which were government hospitals and two were private hospitals, with all tertiary hospitals providing breast cancer services and accredited by Philippine Health Insurance Corporation (PHIC or PhilHealth) for the Z-Benefit Package. Interventions and services related to breast cancer included radiographic procedures, laboratory and imaging tests, chemotherapy drugs and medications, medical and surgical supplies, surgical rates (for breast surgery), accommodation, staff time and salary/professional fees, and other procedure fees. The study conducted in 2022, examined cost prices of breast cancer interventions and services from stage 1–3B.

Purposive and convenience sampling were used based on PhilHealth accreditation and willingness of hospitals to participate in the study. The study conducted a focus group discussion with oncologists, radiologists, anesthesiologists, and other health care providers to validate the clinical guideline used and to solicit inputs to the costing design, analysis framework, and tools for data collection. Data collection of financial cost information (charge price) was conducted using a set of costing matrices filled out by the various departments of the hospitals. Costs and median rates were calculated across hospitals on diagnostics and imaging tests, surgery costs of both public and private facilities, medical treatment, and radiotherapy.

Breast MRI, Breast Panel, and Chest CT Scan are the top 3 most expensive diagnostic procedures ranging from PhP 8,102.00 to PhP 9,800.00 per procedure. Surgical procedures for breast cancer at private hospitals and public hospitals showed huge differences in costs. The cost of a cycle of chemotherapy ranges from PhP 596.70 to PhP 3,700.00 per session, while the cost of targeted therapy can cost up to PhP 46,394.21 per session. A year of hormone therapy ranges from PhP 3,276.00 with the use of Tamoxifen, and up to PhP 68,284.00 with Goserelin. Aromatase inhibitors such as Anastrozole and Letrozole cost from PhP 18,000 to PhP 36,000, respectively. Multiple cycles depending on the diagnosis are prescribed per patient and used in combination with other chemotherapy medications or other therapies such as targeted therapy and hormone therapy are usually taken daily up to 5 to 10 years. Conventional radiotherapy can cost up to PhP 88,150.00 covering 28 sessions, CT simulation, and CT planning.

This cost study provides relevant information and better perspective on benefit development for the PHIC, policy development for Department of Health on where and how to focus their support for the patient’s financial preparedness to address medical and f inancial catastrophes.

PhilHealth needs to guide the health care providers of their costing method and to develop their own integrated, interoperable, and comprehensive cost data library.

It recommends that the government allocate budget and cover for screening and assessment for earlier stage diagnosis of patients and lower health expenditure costs on cancer treatment.

BACKGROUND AND OBJECTIVE

Orthodontic brackets predispose dental biofilm accumulation causing caries and gingivitis. Chlorhexidine is an adjunct to mechanical plaque removal, but has side-effects (tooth staining, bacterial resistance) due to long term use. This study tested the efficacy of Photodynamic Therapy, which produces reactive oxygen species, to reduce Streptococcus mutans in dental biofilm on orthodontic brackets.

A 5-day S. mutans biofilm was grown on forty enamel-bracket specimens. Thirty-nine specimens were randomized to three treatment groups: A. Distilled Water; B. 0.12% Chlorhexidine (CHX); C. Photodynamic Therapy (PDT) using Toluidine Blue O (TBO) as a photosensitizer, activated by red LED (630nm). After treatment, one random specimen from each group was viewed under Environmental Scanning Electron Microscopy (ESEM); the other 12 specimens, biofilms were collected, weighed, and cultured onto BHI agar plates to determine the number of CFU/mg. For baseline evaluation, one clean and one untreated specimens were preserved for ESEM.

Based on Tukey HSD test, group A had the most S. mutans (37.0573 CFU/mg) and was significantly different (pCONCLUSION

Both Photodynamic Therapy and 0.12% Chlorhexidine showed a significant reduction of S. mutans in dental biofilm on orthodontic brackets. However, there is no significant difference between them in reducing S. mutans CFU/mg. Photodynamic therapy could be an alternative adjunctive tool to mechanical removal of plaque adhered to orthodontic brackets.