INTRODUCTION

Hypertension is a serious public health issue that puts individuals at risk for various morbidity and mortality indicators. One of the most crucial factors in managing blood pressure and preventing complications is medication adherence which is linked to several determinants. This study explored the correlation between medication adherence among middle-aged hypertensive adults and the different domains of quality of life (QOL), which includes physical, psychological, social relationship and environment.

METHODS

This cross-sectional study involved 96 Filipino residents of Brgy. San Jose, Navotas City aged 35 to 65 years old diagnosed with hypertension and prescribed anti-hypertensive medications. Pearson’s correlation coefficient was used to calculate the correlation between different domains of QOL as well as the overall QOL score.

RESULTS

Results revealed a statistically significant but weak positive correlation between overall QOL and medication adherence (r = 0.336, p<0.001). Among the QOL domains, environmental domain had the strongest correlation with adherence (r = 0.446, p = 0.00), followed by physical health (r = 0.443, p = 0.01) and psychological well-being (r = 0.382, p = 0.01). The social relationship domain showed negligible correlation (r = 0.163, p = 0.4).

CONCLUSION

The study demonstrates that while medication adherence is modestly associated with better perceived QOL, especially in physical, psychological and environmental aspects, other factors likely influence both outcomes. These findings highlight the need for holistic, community-based interventions that address not only medication adherence but also environmental and psychosocial barriers to care in managing hypertension.

Human ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Aged: 65-79 Yrs Old ; Quality Of Life ; Public Health ; Medication Adherence ; Antihypertensive Agents ; Blood Pressure ; Interpersonal Relations

BACKGROUND AND OBJECTIVES

Technological advancements are reshaping healthcare, particularly through mobile health (mHealth) applications that aid chronic disease management. Medication tracking apps, such as Simpill, have shown potential in improving outcomes for conditions like hypertension. However, disparities in digital literacy and concerns related to technology acceptance and privacy may hinder effective use. Grounded in the principles of the Design Thinking approach, this study sought to evaluate the relationship between health-seeking behavior (HSB), perceived barriers (PB), and the perceived usability (PU) of Simpill among middle-aged hypertensive adults. The research aimed to capture not only measurable associations but also to inform future app development through a user-centered lens that prioritizes empathy and real-world usability.

METHODS

A quantitative, descriptive-correlational research design was employed to assess respondents’ HSB, PB, and PU related to Simpill. The study was guided by core phases of the Design Thinking framework, particularly empathize and define, to ensure a deep understanding of user needs and usability constraints. Data were collected using a four-part, researcher-modified questionnaire administered to 138 purposively selected middle-aged adults (30–59 years old) residing in Barangay Industrial Valley, Zone 6, Marikina City, Philippines. All participants had a confirmed diagnosis of hypertension. Correlational analyses, including Kendall’s Tau B, were conducted to examine relationships among the variables. The integration of Design Thinking informed the development and interpretation of questionnaire items, aligning them with real-world challenges experienced by the target users.

RESULTS

The study investigated the relationship between HSB, PB, and the PU of Simpill among 138 middle-aged hypertensive individuals. Most respondents were female (55.8%), aged 50–59 (47.8%), and employed in non health-related sectors (95.7%). HSB levels were gene rally high (mean = 3.23), particularly in actively seeking health information, while lower engagement was noted in routine vital sign monitoring. PB were moderate (mean = 2.06), with unfamiliarity with the application cited as a common issue. PU was also rated as moderate (mean = 2.80), although ease of use received a low score (mean = 1.99). A weak positive correlation was found between HSB and PU (Kendall’s Tau B = 0.123, p = 0.049), while a moderate negative correlation existed between PB and PU (Tau B = -0.402, p < 0.001). These findings reflect insights derived from the Design Thinking "empathize" phase, suggesting that while proactive health behaviors may modestly support app engagement, unresolved user pain points—such as poor usability and lack of familiarity—remain significant obstacles to adoption. The results underscore the importance of moving to the "ideate" and "prototype" phases, where such user insights can directly shape the redesign and improvement of mHealth tools.

CONCLUSION

The study identified a high level of health- seeking behavior, reflecting the respondents’ engagement with their health and openness to guidance, consistent with the user-empathy foundation of Design Thinking. Moderate perceived barriers highlight existing challenges in technology adaptation, particularly among those who prefer traditional methods. The moderate PU rating of Simpill, especially in terms of ease of use, suggests the app’s current design does not fully align with user capabilities or expectations. In line with Design Thinking principles, particularly user-centered innovation, the findings emphasize the need to involve users in iterative co-design processes to improve mHealth solutions. Addressing perceived barriers through enhanced digital literacy, usability testing, and interface refinement could substantially boost app acceptance and effectiveness in real-world settings.

Human ; Hypertension ; Mobile Applications ; Health Behavior ; User-centered Design

BACKGROUND AND OBJECTIVE

Self-assessment and metacognition can be practiced with an exam wrapper (EW). EW is a structured, metacognitive, and self-regulated learning strategy that involves guided self-reflection on an exam already taken to improve study habits. This research describes how internal medicine (IM) residents at two tertiary private hospitals performed in written examinations using an EW. The relationship between the residents' metacognition, the exam wrapper, and exam performance was also determined.

METHODS

This study employed a pre-experimental pre- and post-test design. The EW was constructed and tested for validity and reliability. It included (1) a description of study habits, (2) accuracy in self-efficacy perception and exam score prediction, (3) perceived reasons for exam mistakes, and (4) future study plans of residents. A complete enumeration of 24 IM residents was conducted. Respondents completed the Metacognitive Awareness Inventory (MAI) at the beginning of the study. The intervention consisted of (1) residents taking Exam 1: Gastroenterology, followed by EW; (2) Exam 2: Endocrinology and EW; then (3) Exam 3: Oncology, EW, and MAI. Scores were compared using a paired t-test or analysis of variance (ANOVA). The relationships between metacognition scores, the EW, and exam performance were determined using the Pearson correlation coefficient. The level of significance was set at p < 0.05.

RESULTS

The final EW comprises 16 items, with overall indices of content validity ratio of 0.72 and item-rated content validity of 0.8. The internal consistency coefficient is 0.65 (Kuder-Richardson 20). Nineteen out of 24 residents (79.17%) completed the study. Mean exam percentage scores were 57.97%, 42%, and 51.16% for Exams 1, 2, and 3, respectively. Exam 2 differed significantly from the other two exams (p = 0 and p = 0.04). EWs for the first two exams were not significantly different and revealed: (1) top study habits included studying right before an exam and skimming the textbook; (2) 68.42% vs. 63.16% accuracy of selfefficacy perception; (3) 26.32% vs. 31.58% accuracy of grade estimation; (4) 31.58% vs. 26.32% accuracy of error analysis; (5) most errors were due to not reading about the topic, and (6) most planned to “read more." Mean MAI scores were 36.79 ± 9.10 (pretest) and 36.05 ± 9.44 (post-test) (p = 0.81). All correlations were not statistically significant.

CONCLUSION

Residents performed poorly during exams, crammed their studies, preferred low-impact learning strategies, and lacked self-reflection skills and metacognition monitoring. Time issues related to reading or studying were common. There is no significant relationship between metacognition score and exam wrapper use or exam performance in IM residency trainees.

Human ; Metacognition ; Self-control ; Self-regulation

BACKGROUND

The Ifontok people are an ethnolinguistic group in the Mountain Province of the Philippines, for whom constructing and occupying a new house symbolizes the fulfillment of personal aspirations and reflects cultural traditions and beliefs that shape community life, worldviews, and social behavior.

OBJECTIVE

This study examined the house construction rituals of the Ifontok people and their influence on health beliefs, highlighting the interconnectedness of culture, environment, and well-being.

METHODS

A qualitative ethnographic design was employed. Six participants were interviewed between February 2021 and June 2022 until data saturation was reached. Colaizzi’s seven-step method was used for the systematic analysis of cultural experiences.

RESULTS

The Ifontok perform rituals before, during, and after house construction, as well as upon occupying a new home. Rooted in traditional beliefs, these rituals aim to ensure structural stability, invite prosperity, and safeguard holistic health. Beyond their symbolic function, the rituals serve as rites of passage that foster psychological reassurance, emotional resilience, and social cohesion. They frame health as a balance of physical, mental, and spiritual well-being, while adaptive strategies address challenges in sustaining these practices amid modern influences.

CONCLUSION

Ifontok house construction rituals integrate practical building practices, spiritual beliefs, and communal welfare. They promote mindful living, psychological well-being, and environmental awareness, offering insights for educators and healthcare practitioners working with Indigenous communities.

Human ; Health ; Ceremonial Behavior ; Rituals ; Holistic Health

OBJECTIVES

To present a rare case of recurrent urethral and intravesical foreign body insertion driven by command hallucinations in schizophrenia, to describe the surgical and psychiatric management strategies employed, and to emphasize the importance of interdisciplinary care and treatment adherence in preventing recurrence.

METHODS

Reported here is the case of a 37-year-old male with schizophrenia who presented with multiple episodes of urethral and intravesical foreign body insertion over a six-year period (2018–2025). Inserted objects included metallic wires, electrical cords, and a LED Christmas light rope, each requiring surgical removal via cystoscopy or open cystotomy. Psychiatric evaluation revealed poor adherence to antipsychotic medication, with recurrent episodes associated with command hallucinations. Psychiatric management was reinitiated with olanzapine and structured follow-up to improve treatment compliance.

RESULTS

Six documented episodes of self-inflicted urethral and intravesical trauma required repeated urologic interventions. Despite recurrent instrumentation and foreign body insertion, serial cystoscopic evaluations demonstrated preserved urethral and bladder integrity without evidence of stricture formation. The most recent episode required open cystotomy for removal of a coiled LED light rope, which was successfully extracted without complications. Following coordinated psychiatric management and improved adherence to antipsychotic therapy, the patient remained asymptomatic and free of recurrence at three months follow-up.

CONCLUSION

This case highlights the unusual preservation of urethral integrity despite recurrent traumatic self-insertion. Effective management requires sustained psychiatric stabilization, multidisciplinary collaboration, and strict treatment adherence. Integration of psychiatric and urologic care is essential to prevent recurrence and improve long-term outcomes in patients with schizophrenia-related self-inflicted genitourinary injury.

Human ; Male ; Adult: 25-44 Yrs Old ; Schizophrenia ; Cystoscopy ; Self-injurious Behavior ; Psychotic Disorders ; Antipsychotic Agents ; Olanzapine ; Constriction, Pathologic ; Hallucinations ; Urinary Bladder ; Foreign Bodies

BACKGROUND

Medication compliance contributes to preventing significant morbidities, such as stroke, among hypertensive patients.

OBJECTIVE

This study aimed to examine the factors affecting hypertensive patients' medication compliance in Sambag II, Cebu City.

METHODS

This study is an observational cross-sectional study. The study was conducted in Barangay Sambag II of Cebu City and involved 170 random, voluntary, self-reporting hypertensive patients. The Tao Yamane formula was used to determine the sample size. An interviewer-guided survey questionnaire was utilized to collect the data for the pilot study. The data were analyzed using Cronbach’s Alpha Test for internal consistency and reliability.

RESULTS

Three factors were shown to influence compliance with antihypertensive medications. These are the source of medication, access to medication, and symptoms experienced before intake of anti-hypertensive medications. A factor that significantly affects compliance is the source of medication, wherein hypertensive patients prefer medications from retail pharmacies compared to the free medications supplied by the local health center.

CONCLUSION

Residents of Sambag II, Cebu City preferred medications from retail pharmacies over the free medications provided by the local health center. Local health units may use this information to implement information drugs regarding the efficacy of medications provided by government agencies. Further studies are recommended to use subgroup analysis on factors influencing compliance and non-compliance to anti-hypertensive medicines.

Human ; Medication Compliance ; Medication Adherence ; Hypertension ; Stroke

BACKGROUND

This study explores the professional functions and experiences of male midwives in the Province of Aurora, highlighting their roles, challenges, and contributions to maternal and child healthcare in a traditionally female-dominated profession.

OBJECTIVE

This study aims to investigate the professional functions and lived experiences of male midwives in the Province of Aurora.

METHODS

This research employed a qualitative ethnographic design using semi-structured interviews to collect data. Participants were six male midwives practicing in Aurora. Data collection was conducted via mobile phone interviews from August to September 2024. A purposive sampling technique was utilized to select participants. The study adhered to ethical guidelines, receiving approval from the University of Northern Philippines Ethics Review Committee Code: 2024-251, and informed consent was obtained from all participants. Data were analyzed using qualitative content analysis. Qualitative inductive content analysis as described by Padgett was utilized to allow for data-driven analysis without pre-defined themes, making it suitable for exploring the diverse experiences of male midwives.

RESULTS

Analysis revealed six key themes: Diverse professional functions, gender bias and stereotyping, patient reluctance and shyness, cultural influences, experiences of discrimination and prejudice, and daily challenges and rewards in practice. The findings underscore the commitment of male midwives to providing quality care despite societal and professional barriers. Under the Functions theme, male midwives described their roles as not only caregivers but also as advocates for gender inclusivity in midwifery. In terms of experiences, some reported feelings of isolation and the need to prove their competence in a field dominated by women. However, they also shared empowering stories of camaraderie with female colleagues and the satisfaction derived from breaking down gender barriers.

CONCLUSION

Male midwives play a vital role in maternal and newborn healthcare, navigating challenges such as gender bias and patient hesitancy. Strengthening administrative support, promoting inclusivity, and updating policies can enhance their professional integration. Advocacy efforts from professional organizations are necessary to address workplace challenges and recognize their contributions to healthcare.

Human ; Male ; Midwifery ; Gender Bias ; Sexism ; Maternal Health ; Community ; Residence Characteristics

BACKGROUND

Long-term treatment and medication compliance are critical for managing conditions like hypertension, yet only 20% of cases are well-controlled, mainly due to socioeconomic factors. The Expanded Senior Citizens Act of 2010 offers a 20% discount on medications to improve compliance, but many seniors need to be made aware of these benefits. Evaluating satisfaction with the Act, specifically regarding its medication-related provisions, is essential for enhancing compliance and health outcomes among senior citizens.

OBJECTIVE

This study examined the association between satisfaction with the medication provisions of the Senior Citizens Act, the frequency of senior identification card usage, and medication compliance among hypertensive patients.

METHODS

We conducted a community-based cross-sectional study with 458 hypertensive senior citizens in Dasmariñas City, Cavite, Philippines. Senior citizens were randomly selected and completed a survey using a validated, self-developed questionnaire and the Hill-Bone High Blood Pressure (HB-HBP) compliance scale. We performed linear regression analysis to examine the association between their satisfaction and the use of senior citizens’ benefits on their medication compliance.

RESULTS

Senior citizens were 60-88 years old (mean 69; standard deviation [SD] 5.9). Thirty-eight percent were satisfied with the Senior Citizens Act and 49% regularly used their senior citizen card. Senior citizens scored an average of 46.82 (SD 4.96) on the HB-HBP compliance scale (possible range = 14-56), indicating high compliance. Those dissatisfied with the Senior Citizens Act were less compliant with their antihypertensive medications [B (unstandardized beta) = -1.65, 95% CI (Confidence Interval) = -2.70, -0.61]. Similarly, those who rarely or never used their senior identification cards (B = -1.54, 95% CI = -2.61, -0.48) and those who used them occasionally (B = -1.43, 95% CI = -2.57, -0.29) showed lower medication compliance compared to those who used them regularly.

CONCLUSION

Senior citizens who are satisfied with the medication provisions of the Act and regularly use their senior identification cards exhibit higher compliance with their antihypertensive medications than those with lower satisfaction and infrequent card usage. Interventions should prioritize educational sessions to inform senior citizens about the benefits of the Senior Citizens Act, including how to use their identification cards to access medication discounts effectively.

Human ; Hypertension ; Medication Adherence ; Philippines ; Satisfaction ; Personal Satisfaction

Human ; Behavior ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Diabetic Foot ; Foot Ulcer

INTRODUCTION: Social lockdowns and quarantines have been enforced in various populations to mitigate the spread of coronavirus disease 2019 (COVID-19) in the community. This study investigated the impact of COVID-19 lockdown, known as circuit breaker movement restrictions (CBMR), on physical activity (PA) and sedentary time (ST) distribution patterns among Singapore residents aged 21-65 years. METHODS: This was a cross-sectional retrospective study that utilised a 44-item questionnaire that included sections to determine PA and ST distribution patterns before and during CBMR. It also included information on sleep duration, PA preference and routine, awareness of local initiatives and perceptions on barriers towards PA during the CBMR period. RESULTS: There was an overall decrease in PA and a significant increase in physical inactivity and ST during the CBMR period. A greater proportion of participants reported sleeping for longer hours, suggesting positive adaptations in sleep habits during CBMR. Majority were unaware of online exercise initiatives and programmes offered during the CBMR period, and >50% of the respondents never used an online resource for exercise. Singapore residents seemed to prefer outdoor and facility-based venues for exercise and PA, and closure of facilities was the primary barrier for PA during the CBMR period. CONCLUSION Reduced PA and increased ST during CBMR reflect negative lifestyle adaptations and may have adverse public health implications. Increased sleep duration suggests successful coping, which may consequently lead to physical and mental health benefits. While Singapore adult residents may be flexible with certain aspects of being physically active, they seemed less adaptive to changes in type of exercise, facility and environment.
Humans ; COVID-19/epidemiology* ; Singapore/epidemiology* ; Exercise ; Adult ; Sedentary Behavior ; Cross-Sectional Studies ; Middle Aged ; Male ; Female ; Retrospective Studies ; Public Health ; Aged ; Surveys and Questionnaires ; SARS-CoV-2 ; Young Adult ; Quarantine ; Sleep