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.

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.

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.

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.

Background and Objective: In the Philippines, patients are constrained from accessing their own records, restricting their ability to freely choose who to seek care from. To address this, the study makes a case for the development of the health smart card in the Philippines, an integrative tool unique to each citizen carrying their lifetime medical record. Methods: The prototype is developed using no-code programming technology and validated through a series of focus group discussions and stakeholder consultations with patients (n=4), healthcare administrators (n=4), and hospital personnel (n=13). It was then revised based on the collected insights and recommendations. Results: Findings report that the current facility-centric model utilizing paper records constrains patients’ access to their records due to long wait times, slow turnaround periods, constant intra- and inter-hospital transfers, and even charging of fees to acquire a copy of their own data. The health smart card alternative was widely accepted by the participants, particularly for its contribution to increasing data accessibility, patient empowerment, and advancing patient data ownership. Nevertheless, several considerations for the upscale implementation of the health smart card emerged, including creating an interoperable environment through harmonizing standards and capacity-building programs, and ensuring data security through robust cybersecurity measures. Issues on scalability and funding of the project were also raised, centering on the critical role of the government in stepping up as regulator and potential funder. Concerns over potential abuse, dataveillance, and the digital divide are tackled, highlighting the need to account for socioeconomic factors to ensure that no one is left behind in the implementation. Conclusion The study makes a case for the development and adoption of a health smart card to address the inaccessibility of records to patients. The study concludes by recommending the conduct of a pilot implementation to comprehensively demonstrate and analyze the features of the proposed scheme.
health smart card ; patient empowerment ; patient participation ; Philippines

Macaque is a common animal model in drug safety assessment. Its behavior reflects its health condition before and after drug administration, which can effectively reveal the side effects of drugs. At present, researchers usually rely on artificial methods to observe the behavior of macaque, which cannot achieve uninterrupted 24-hour monitoring. Therefore, it is urgent to develop a system to realize 24-hour observation and recognition of macaque behavior. In order to solve this problem, this paper constructs a video dataset containing nine kinds of macaque behaviors (MBVD-9), and proposes a network called Transformer-augmented SlowFast for macaque behavior recognition (TAS-MBR) based on this dataset. Specifically, the TAS-MBR network converts the red, green and blue (RGB) color mode frame input by its fast branches into residual frames on the basis of SlowFast network and introduces the Transformer module after the convolution operation to obtain sports information more effectively. The results show that the average classification accuracy of TAS-MBR network for macaque behavior is 94.53%, which is significantly improved compared with the original SlowFast network, proving the effectiveness and superiority of the proposed method in macaque behavior recognition. This work provides a new idea for the continuous observation and recognition of the behavior of macaque, and lays the technical foundation for the calculation of monkey behaviors before and after medication in drug safety evaluation.
Animals ; Electric Power Supplies ; Macaca ; Recognition, Psychology

Leukemia is a common, multiple and dangerous blood disease, whose early diagnosis and treatment are very important. At present, the diagnosis of leukemia heavily relies on morphological examination of blood cell images by pathologists, which is tedious and time-consuming. Meanwhile, the diagnostic results are highly subjective, which may lead to misdiagnosis and missed diagnosis. To address the gap above, we proposed an improved Vision Transformer model for blood cell recognition. First, a faster R-CNN network was used to locate and extract individual blood cell slices from original images. Then, we split the single-cell image into multiple image patches and put them into the encoder layer for feature extraction. Based on the self-attention mechanism of the Transformer, we proposed a sparse attention module which could focus on the discriminative parts of blood cell images and improve the fine-grained feature representation ability of the model. Finally, a contrastive loss function was adopted to further increase the inter-class difference and intra-class consistency of the extracted features. Experimental results showed that the proposed module outperformed the other approaches and significantly improved the accuracy to 91.96% on the Munich single-cell morphological dataset of leukocytes, which is expected to provide a reference for physicians' clinical diagnosis.
Humans ; Blood Cells ; Leukocytes ; Leukemia ; Electric Power Supplies ; Recognition, Psychology

PURPOSE: The purpose of this study was to identify factors related to family health and develop a prediction model with an ability to explain family health in families of patients with schizophrenia.METHODS: A hypothesized model with twelve pathway forms was developed based on literature review. Family stress and social stigma were included as two exogenous variables; whereas family resilience, family empowerment, self-esteem, community integration, and family health were included as endogenous variables. Data were collected using a self-report questionnaire from 206 families of patients with schizophrenia living in Republic of Korea. Data were analyzed with PASW/WIN 18.0 and AMOS 18.0 programs.RESULTS: Social stigma had a negatively indirect and total effect on family health. Family resilience, self-esteem, and community integration had positive and direct and overall effects on family health.CONCLUSION: A prediction model for families of patients with schizophrenia is proposed and social stigma, family resilience, self-esteem, and community integration are presented as predicting factors for family health. Nursing interventions and support programs should be developed to overcome social stigma and improve family resilience, self-esteem, and community integration.
Community Integration ; Family Health ; Humans ; Nursing ; Power (Psychology) ; Republic of Korea ; Schizophrenia ; Social Stigma

OBJECTIVES: The present study aimed to compare the quality of life of elderly menopause living in urban/rural areas of Abadeh, Iran. METHODS: This descriptive and cross-sectional study was conducted on 312 urban and 68 rural elderly population using the two-stage (systematic random classification) and objective-based sampling methods. Data were collected by Leiden-Padua questionnaire for assessment of quality of life in elderly menopause. SPSS software (version 21) and descriptive-analytical tests were used for data analysis. RESULTS: The results showed that the overall quality of life was 37.5 and 34.2 in rural and urban areas, respectively, and no statistically significant difference was observed between them. However, there was statistically significant difference in the mean score of depression and anxiety, cognitive function, social function, life satisfaction, and sexual activity in urban and rural elderly menopause (P < 0.001). CONCLUSIONS: It seems necessary to pay more attention to the elderly menopause to improve their quality of life and consider proper planning for their empowerment and coping skills training.
Adaptation, Psychological ; Aged ; Anxiety ; Cognition ; Cross-Sectional Studies ; Depression ; Female ; Humans ; Iran ; Menopause ; Power (Psychology) ; Quality of Life ; Rural Population ; Sexual Behavior ; Statistics as Topic ; Urban Population

PURPOSE: The purpose of this study was to explore the effects of head nurses' authentic leadership and empowerment on job satisfaction, and nursing performance of nurses and to identify the mediating effect of empowerment in the relationships of head nurses' authentic leadership, with nurses' job satisfaction, and nursing performance. METHODS: The sample for this study was 149 nurses from 2 general hospitals located in Busan. Data were collected using self-administered questionnaires and the SPSS/WIN 23.0 program was used for analysis. Mediation analysis was performed according to the Baron and Kenny method and Sobel test. RESULTS: Head nurses' authentic leadership showed positive correlations with empowerment, job satisfaction, and nursing performance. Empowerment showed partial mediating effects in the relationship between head nurses' authentic leadership and nurses job satisfaction, and a perfect mediating effect in the relationship between head nurses' authentic leadership and the performance of nursing. CONCLUSION: The results indicate that it is necessary to develop strategies and applications to enhance nurses' empowerment for improved job satisfaction and nursing performance.
Busan ; Head ; Hospitals, General ; Job Satisfaction ; Leadership ; Methods ; Negotiating ; Nursing ; Power (Psychology) ; Work Performance

PURPOSE: The objective of this study was to verify a mediating effect of followership in the relationship of organizational citizenship behavior and nurse managers' empowering leadership as perceived by nurses. METHODS: The study was a descriptive research involving 222 nurses working on nursing units in a university hospital. Data were analyzed using independent t-test, one way ANOVA, Mann-Whitney U, Scheffé test, Pearson correlation coefficients, and simple and multiple regression techniques with the SPSS 23.0 program. Mediation analysis was performed according to the Baron and Kenny method and Sobel test. RESULTS: Nurse managers' empowering leadership and followership showed a positive correlation (r=.22, p=.001), and a significantly positive correlation with organizational citizenship behavior (r=.32, p<.001). Also, followership and organizational citizenship behavior showed a positive correlation (r=.52, p<.001). The results of the study verified that nurses' followership had a mediating effect on organizational citizenship behavior in nurse unit managers' empowering leadership, a positive effect on organizational citizenship behavior and ultimately an increase in organizational achievement. CONCLUSION: Nurse managers need to be aware of the importance of empowering leadership, and endeavor to enhance it further. As for the organizational level, support to strengthen empowering leadership is required.
Humans ; Leadership ; Methods ; Negotiating ; Nurse Administrators ; Nursing ; Power (Psychology)

PURPOSE: This research was conducted to identify the effects of providing support programs to families of elderly with dementia on family empowerment and attitudes toward dementia. METHODS: A nonequivalent control group pre- and post-test design was used. Participants were 49 family caregivers, experimental (24) and control (25), recruited from families through a dementia support center in Y district. This program implemented Haearim, a support program for family caregivers of demented elders developed by the National Institute of Dementia in 2016. Outcome measures were empowerment and attitudes toward to dementia. Data were analyzed with a χ2-test, independent t-test, Fisher's exact probability test, paired t-test, and repeated measures ANOVA with SPSS/PC version 20.0. RESULTS: Family empowerment (F=6.84, p=.002) and family caregivers' attitudes (F=16.48, p < .001) toward dementia in the experimental group improved significantly more than that of the control group after intervention. CONCLUSION: Results indicate that support programs for families of elderly with dementia are effective in positively changing empowerment and attitudes toward dementia among family caregivers.
Aged ; Caregivers ; Dementia ; Humans ; Outcome Assessment (Health Care) ; Power (Psychology)

OBJECTIVES: The aim of this study was to assess community participation in Dengue virus control measures, and community satisfaction in the Dengue surveillance workers (DSWs) performance in Semarang municipality after 3 years of empowerment.METHODS: A cross-sectional survey involved 1,018 selected participants from 12 groups of social roles in 141 villages in Semarang municipality, Indonesia. A direct interview was performed using a structured questionnaire to evaluate the acceptance, and satisfaction of the community towards the DSWs. The data were analyzed descriptively.RESULTS: The majority of the members of the community considered that the DSWs play an important role in reducing Dengue cases, and vectors of the Dengue virus, as well as increasing the community participation in Dengue control measures. The survey showed that DSWs performance, attitudes, and abilities regarding their main tasks were perceived to be good.CONCLUSION: Overall, people in Semarang municipality were satisfied with the performance of the DSWs, and considered them important enough to be maintained and strengthened in the future so that Dengue could be controlled. This new policy needs to be disseminated to other regions that may encounter the problems associated with Dengue virus.
Consumer Participation ; Cross-Sectional Studies ; Dengue Virus ; Dengue ; Indonesia ; Power (Psychology) ; Public Health