1.Perceived professional identity and role stress among midwifery students in South Central Mindanao: A cross-sectional study.
Elizabeth S. LIBA ; Charlie C. FALGUERA ; Mandy Roie A. ATENDIDO
Acta Medica Philippina 2026;60(8):69-76
BACKGROUND
Professional identity plays a significant role in alleviating role stress among healthcare professionals. However, these two factors are poorly explored in the midwifery profession.
OBJECTIVETo determine the perceived level of professional identity and role stress and the relationship between them among midwifery students.
METHODSA cross-sectional study design was employed involving 379 midwifery students from SOCCSKSARGEN Region, Mindanao. Participants were selected through purposive sampling. Macleod Clark Professional Identity Scale (MCPIS-9) and twelve-item Role Stress Scale (RSS) were used in gathering the data. Spearman rho, point-biserial correlation, and F-test were used for data analysis.
RESULTSThe students’ mean score in professional identity was high (4.07, SD=0.46) while the mean score of the overall role stress was low (2.47, SD=0.51). There was a positive and significant relationship between age (rs=0.207, P=CONCLUSION
Midwifery students’ perceived level of professional identity was high, while their level of role stress was quite low. Age, year level, and marital status were significantly correlated with their levels of professional identity and role stress. Moreover, students with a higher level of professional identity may report low levels of role ambiguity, role overload, role conflict, and overall role stress.
Midwifery ; Students ; Role ; Cross-sectional Studies
2.Nutritional status of children 0-59 months old and household enrollment in the Pantawid Pamilyang Pilipino Program (4Ps) in a rural municipality in Leyte: A cross-sectional study.
Angelita C. Jaya ; Hannah Grace D. Pugong ; Daryne Aya H. Bolla ; Edelmer B. Azcueta ; Charlie C. Falguera
Acta Medica Philippina 2026;60(5):7-16
BACKGROUND
Child malnutrition is a prevailing global public health concern especially in low- and middle-income countries. Conditional cash transfer (CCT) programs were implemented to help address this problem.
OBJECTIVETo determine the relationship between the nutritional status among 0-59 months old children and household enrollment in a Philippine CCT program, Pantawid Pamilyang Pilipino Program (4Ps).
METHODSA cross-sectional study was employed to 392 children and mothers/primary caregivers in a rural municipality in Leyte. Stratified random sampling technique was used in selecting the participants. Anthropometric characteristics were measured for these 392 children and were classified as 4Ps and non-4Ps members. Chi-square test was used to determine the relationship between the variables of interest.
RESULTS4Ps household beneficiaries had mothers/primary caregivers who were older and had fewer years of education. The 4Ps beneficiary households had more household members and had lower average monthly income compared to the non-beneficiaries. No significant differences were found between the 4Ps beneficiary and non-beneficiary households in terms of the household hunger scale, the mean age of the children, and the sex distribution of the children included in the study. Specific profile components were found to be correlated to the children’s nutritional status. The age of the children was significantly associated to their length/height-for-age (L/HFA) wherein stunting was noted to occur among children older than 12 months of age. Maternal education was significantly associated to the weight-for-age (WFA) of the children. Children who were underweight had mothers/primary caregivers with fewer years of education. No significant correlation was found between the child’s sex, age of the mother/primary caregiver, household size, average monthly household income, and household hunger scale and the children’s nutritional status Lastly, there was no significant correlation between 4Ps household enrollment and the WFA and L/HFA status of the children. 4Ps household enrollment was, however, significantly correlated to the weight-for-length/height (WFL/H) or wasting status of the children.
CONCLUSIONThe 4Ps program has the potential to enhance the nutritional outcomes of children hence the need to maximize its gains. In addition, the relationship of different sociodemographic variables with the children’s nutritional status reflects the complexity and multidimensionality of childhood malnutrition, implying the need for a holistic and multistakeholder approach in addressing the problem.
Human ; Infant Newborn: First 28 Days After Birth ; Infant: 1-23 Months ; Child Preschool: 2-5 Yrs Old ; Child Nutrition Disorders ; Nutritional Status ; Philippines
3.Perceived professional identity and role stress among midwifery students in South Central Mindanao: A cross-sectional study.
Elizabeth S. LIBA ; Charlie C. FALGUERA ; Mandy Roie A. ATENDIDO
Acta Medica Philippina 2026;60(8):69-76
BACKGROUND
Professional identity plays a significant role in alleviating role stress among healthcare professionals. However, these two factors are poorly explored in the midwifery profession.
OBJECTIVETo determine the perceived level of professional identity and role stress and the relationship between them among midwifery students.
METHODSA cross-sectional study design was employed involving 379 midwifery students from SOCCSKSARGEN Region, Mindanao. Participants were selected through purposive sampling. Macleod Clark Professional Identity Scale (MCPIS-9) and twelve-item Role Stress Scale (RSS) were used in gathering the data. Spearman rho, point-biserial correlation, and F-test were used for data analysis.
RESULTSThe students’ mean score in professional identity was high (4.07, SD=0.46) while the mean score of the overall role stress was low (2.47, SD=0.51). There was a positive and significant relationship between age (rs=0.207, P=CONCLUSION
Midwifery students’ perceived level of professional identity was high, while their level of role stress was quite low. Age, year level, and marital status were significantly correlated with their levels of professional identity and role stress. Moreover, students with a higher level of professional identity may report low levels of role ambiguity, role overload, role conflict, and overall role stress.
Midwifery ; Students ; Role ; Cross-sectional Studies
4.Post-pandemic implications of the nursing students' clinical learning environment and its relationship to academic grit, self-esteem, and caring behaviors: A cross-sectional study
Charlie C. Falguera ; Janet Alexis A. De los santos ; Carmen N. Firmo ; Paulo Batidor
Acta Medica Philippina 2025;59(Early Access 2025):1-10
BACKGROUND
The clinical learning environment (CLE) significantly influenced the nursing students' learning experience. While clinical learning is the heart of nursing education, certain non-academic factors might be influenced by CLE. Consequently, CLE may be affected during a health crisis like the COVID-19 pandemic.
OBJECTIVETo determine the relationship between nursing students’ CLE and their academic grit, self-esteem, and caring behaviors in the Central Philippines.
METHODSA descriptive cross-sectional study was conducted involving 462 nursing students enrolled during the COVID-19 pandemic. A purposive sampling technique was used to select the participants. Four self-report questionnaires were adopted to gather the data: a 42-item Clinical Learning Environment Inventory (CLEI) scale, short-form Grit (Grit-S) scale, Rosenberg’s Self-Esteem (RSE) scale, and Caring Behavior Inventory (CBI-24) scale. Spearman rho and rank-biserial correlation tools were used to analyze the data.
RESULTSThe results indicated that the clinical learning environment was positively associated with academic grit, selfesteem, and caring behavior. Some profiles of the participants, such as age, sex, year level, type of school, leadership experiences, clinical setting experience, and willingness to be a nurse, were significantly associated with the clinical learning environment, academic grit, self-esteem, and/or caring behavior.
CONCLUSIONSStudents’ CLE influences their academic grit, self-esteem, and caring behavior. That is, students who reported a more positive perception of CLE, the higher their academic grit, self-esteem, and caring behaviors. Furthermore, some students’ profile characteristics influence CLE, academic grit, self-esteem, and caring behavior. Enhancing CLE while promoting grit, self-esteem, and caring behaviors of nursing students affiliated with hospitals or any clinical learning settings and promoting alternative means of meeting CLE competencies when face-to-face interactions are restricted during a health crisis are recommended.
Human ; Clinical Practicum ; Preceptorship ; Mental Health ; Education, Nursing
5.Public health nurses' provision of primary healthcare services in the context of universal health care.
Mary Cris T. ROMBAOA ; Charlie C. FALGUERA ; Danica V. DELIMA ; Mandy Roie A. ATENDIDO
Philippine Journal of Health Research and Development 2025;29(4):26-33
BACKGROUND
Public health nurses (PHNs) are a significant cadre of the primary healthcare workforce working toward achieving universal health care (UHC). Exploring their work activities is integral to understanding how UHC is implemented better.
OBJECTIVESTo describe and explore the work activities, roles, and functions of the PHNs in rendering primary care services in the context of UHC.
METHODSKey informant interviews were conducted with 12 PHNs in Tarlac Province who were working with permanent status in their respective rural health units (RHUs) for at least 1 year. They were selected through selection criteria. Data were recorded, transcribed, and subjected to thematic analysis.
RESULTSData analysis led to the emergence of 4 themes and 11 subthemes. The four themes were: (a) evolving scope and nature of work, (b) work challenges and barriers toward UHC implementation, (c) UHC outcomes, impact, and insights, and (d) communication and health promotion.
CONCLUSIONSThe study underscores the importance of exploring the PHNs’ roles and functions, as it offers a window on how they fulfill their duties toward achieving the goals of UHC. From the viewpoint of the interviewed PHNs, several elements and issues need to be addressed. Consequently, some positive impact on their work activities and functions emerged. Their nature of work brought them professional development and fulfillment as they render primary care and value-driven services despite the challenges and struggles they encountered in public health.
Human ; Primary Health Care ; Nurses, Public Health ; Universal Health Care
6.Teamwork, moral sensitivity, and work engagement among employees in a government higher education institution.
Daisy N. DELOS REYES ; Charlie C. FALGUERA ; Ana Blesilda A. ATENDIDO
Philippine Journal of Health Research and Development 2025;29(4):63-71
BACKGROUND
Although higher education institutions (HEIs) are expected to contribute much in the larger communities, it cannot be denied that the employees have the qualities and characteristics with genuine interest to help the institution, other individuals, and the communities surrounding them. Studying teamwork, moral sensitivity, and work engagement is essential in determining how they affected with the organizational management, training of students, and achieving the goals of the college.
OBJECTIVESThe objective of this study was to determine the level of teamwork, moral sensitivity, and work engagement and the relationship between them among faculty members, school administrators, and supporting staff in a government HEI in the Philippines.
METHODSA cross-sectional design was employed involving 49 employees in a government HEI. Three self-report scales were used in gathering the data: TeamSTEPPS Teamwork Perceptions Questionnaire, Ethical Sensitivity Scale, and Utrecht Work Engagement Scale. Data were analyzed using Spearman’s rho correlations, point biserial correlations, and eta correlations.
RESULTSParticipants reported high levels of perceived teamwork, moral sensitivity, and work engagement. Marital status was significantly and positively correlated with moral sensitivity and work engagement, whereas employment status was significantly and positively correlated with teamwork and moral sensitivity. Moreover, moral sensitivity was significantly and positively correlated with teamwork and work engagement.
CONCLUSIONSCollege employees who reported high levels of moral sensitivity are associated with high levels of teamwork and work engagement. Strategies to maintain and enhance teamwork, moral sensitivity, and work engagement are recommended through various activities such as team-building workshops, staff development, and/or leadership trainings.
Human ; Work Engagement
7.Readiness, perception, and attitude toward interprofessional education among students in a stepladder and community-based health science tertiary institution: A cross-sectional study
Ruvi Ann D. Tan-linugao ; Charlie C. Falguera
Acta Medica Philippina 2025;59(9):90-97
BACKGROUND
Interprofessional education (IPE) is a kind of education that fosters an environment of teamwork and collaboration among various healthcare professionals, such as midwives, nurses, and doctors. Identifying midwifery, nursing, and medical students’ IPE readiness, perception, and attitude is critical to formally and effectively implement IPE programs in the curriculum.
OBJECTIVEThis study determined the readiness, perception, and attitude for IPE and the relationships between them, including the personal characteristics of the Midwifery, Nursing, and Doctor of Medicine students enrolled in a stepladder and community-based health science tertiary institution in the Philippines.
METHODSA descriptive cross-sectional design was employed involving 166 students selected through a stratified random sampling technique who were drawn from the three health programs. The Readiness for Interprofessional Learning Scale (RIPLS), Interdisciplinary Education Perception Scale (IEPS), and Interprofessional Attitude Scale (IPAS) were used to assess students’ readiness, perception, and attitude toward IPE, respectively. Pearson’s r-moment correlation, t-test, and one-way ANOVA were used to determine correlations between the variables.
RESULTSHigh scores were demonstrated on the students’ readiness, perception, and attitude toward IPE. A significant correlation was found between prior exposure and readiness to IPE. Further, a significant and positive correlation was found between the students’ readiness, perception, and attitude toward IPE. Preparing students for interdisciplinary learning may promote positive perceptions and attitudes.
CONCLUSIONSMidwifery, nursing, and medical students had a high readiness, perception, and attitude toward IPE. IPE readiness, perception, and attitude were correlated to one another. The study recommends formally incorporating IPE in the stepladder and community-based curriculum, such as embedding IPE concepts and competencies in the program specifications.
Interprofessional Education ; Midwifery ; Nursing ; Medicine
8.Anxiety, depression and resilience among primary care nurses working in the Rural Health Units of Samar Province during the COVID-19 pandemic
Oscar B. De paz jr. ; Charlie C. Falguera ; Abigail L. Brillantes ; Kiara F. Balo ; Veigner V. Cabugayan ; Rosemarie T. Del monte ; Beverly T. Pimentel ; Ethel C. Valones
Acta Medica Philippina 2025;59(9):98-106
BACKGROUND AND OBJECTIVE
Primary care nurses serve as the gatekeeper of the health system. They could be psychologically affected in times of health crisis such as the COVID-19 pandemic. This study aimed to assess their perceived anxiety, depression, and resilience while working in the rural health units in Samar Province.
METHODSA cross-sectional design was employed involving 188 primary care nurses who were working in rural health units (RHUs) in Samar province. They were selected through stratified random sampling technique. Anxiety and depression levels were assessed using the 21-item Depression Anxiety Stress Scale (DASS-21). Resilience level was assessed using 18-item Resilience Scale. Pearson’s r moment correlation and logistic regression analysis were used to determine associated factors with mental health.
RESULTSTwenty (20) nurses experienced anxiety and five of them reported depression. Work experience is associated with depression [Exp(B) = 3.753; 95% CI (1.121 – 12.563)]. Overall, nurses reported high resilience level. Anxiety and depression are significantly and negatively associated with resilience.
CONCLUSIONPrimary care nurses experience depression and anxiety during COVID-19 pandemic. Work experience is associated to their levels of depression. Moreover, nurses reported high levels of resilience. The higher the levels of anxiety and depression, the lower is their resilience.
Anxiety ; Depression ; Resilience, Psychological
9.Post-pandemic implications of the nursing students' clinical learning environment and its relationship to academic grit, self-esteem, and caring behaviors: A cross-sectional study.
Charlie C. FALGUERA ; Janet Alexis A. DE LOS SANTOS ; Carmen N. FIRMO ; Paulo BATIDOR
Acta Medica Philippina 2025;59(18):71-80
BACKGROUND
The clinical learning environment (CLE) significantly influenced the nursing students' learning experience. While clinical learning is the heart of nursing education, certain non-academic factors might be influenced by CLE. Consequently, CLE may be affected during a health crisis like the COVID-19 pandemic.
OBJECTIVETo determine the relationship between nursing students’ CLE and their academic grit, self-esteem, and caring behaviors in the Central Philippines.
METHODSA descriptive cross-sectional study was conducted involving 462 nursing students enrolled during the COVID-19 pandemic. A purposive sampling technique was used to select the participants. Four self-report questionnaires were adopted to gather the data: a 42-item Clinical Learning Environment Inventory (CLEI) scale, short-form Grit (Grit-S) scale, Rosenberg’s Self-Esteem (RSE) scale, and Caring Behavior Inventory (CBI-24) scale. Spearman rho and rank-biserial correlation tools were used to analyze the data.
RESULTSThe results indicated that the clinical learning environment was positively associated with academic grit, selfesteem, and caring behavior. Some profiles of the participants, such as age, sex, year level, type of school, leadership experiences, clinical setting experience, and willingness to be a nurse, were significantly associated with the clinical learning environment, academic grit, self-esteem, and/or caring behavior.
CONCLUSIONSStudents’ CLE influences their academic grit, self-esteem, and caring behavior. That is, students who reported a more positive perception of CLE, the higher their academic grit, self-esteem, and caring behaviors. Furthermore, some students’ profile characteristics influence CLE, academic grit, self-esteem, and caring behavior. Enhancing CLE while promoting grit, self-esteem, and caring behaviors of nursing students affiliated with hospitals or any clinical learning settings and promoting alternative means of meeting CLE competencies when face-to-face interactions are restricted during a health crisis are recommended.
Human ; Clinical Practicum ; Preceptorship ; Mental Health ; Education, Nursing
10.Perceived emotional and cognitive reactions to tobacco graphic health warning labels among nonsmoking senior high school students in Leyte.
Gail G. PILLERO ; Cedrick James A. SABULAO ; Rachelle Joy S. AGUEDAN ; Cristina C. PICARDAL ; Oscar B. DE PAZ ; Adelaida G. ROSALDO ; Charlie C. FALGUERA
Philippine Journal of Health Research and Development 2025;29(3):45-52
BACKGROUND
The Philippines implemented a law on the inclusion of graphic health warning (GHW) labels in cigarette packs to increase awareness about the health effects of smoking, to quit smoking, or to deter potential users from engaging in cigarettes. Investigating its impact on senior high school (SHS) students may provide insights into enhancing and reinforcing the law to achieve its purpose at the adolescent developmental stage.
OBJECTIVESThe objective of this study was to determine the perceived emotional and cognitive reactions as well as the perceived health risks of GHWs among nonsmoking SHS students in Leyte and their relationship to their level of exposure.
METHODOLOGYA cross-sectional design was employed involving 247 students from public high schools in Pastrana, Leyte, who were selected through stratified random sampling. A self-report questionnaire was used to gather the data. Spearman’s rho correlation coefficient was used to test the hypothesis.
RESULTSThe majority of the participants reported positive perceptions of GHW labels. Moreover, the majority of them have seen GHW at least once a week on cigarette packs and evoked variable agreement about the high arousal and low arousal negative emotion, but have positive cognitive reactions. They have a strong agreement on the perceived health risks posed by cigarette smoking through GHWs. There was a positive and significant correlation between the level of exposure and the perceived health risks of smoking through the GHWs.
CONCLUSIONAdolescent learners reported variable agreement on emotional reactions, but had positive cognitive reactions to tobacco GHW labels. They also have reported that GHWs in cigarette packs provide positive visual information on the health effects and other consequences of smoking. Those who have frequent exposure to the GHWs of the cigarette packs were more likely to report knowledge and information on the health risks of smoking. Thus, the GHWs on cigarette packs are still necessary to decrease the new smoker rate, especially among adolescents. Policy implications toward the continuous development of GHWS are offered.
Human ; Tobacco ; Tobacco Products ; Smoking ; Jurisprudence ; Adolescent


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