OBJECTIVES

This study explored the interplay of three Filipino cultural values—hiya (modesty/self-restraint), pakikisama (conflict-avoidance dimension of social harmony), and pakikipag-ugnayan (professional engagement, characterized by vigor, dedication, and absorption)—among Generation Z nurses in Quezon City. Specifically, it assessed their levels, examined interrelationships through correlation and path analysis, and developed a framework to illustrate their influence on nursing practice. In the Filipino context, hiya encompasses both positive dimensions, such as conscientiousness, moral accountability, and social responsibility, and constraining dimensions, including excessive self-restraint, fear of criticism, and inhibition. Pakikisama, while fostering harmony, may discourage assertiveness and limit open communication. Pakikipag-ugnayan, conceptualized here as engagement, reflects dedication, vigor, and absorption, which are vital for performance, patient safety, and workforce retention.

METHODS

A descriptive–correlational design was utilized to assess the relationships among hiya, pakikisama, and pakikipag-ugnayan. Data were gathered through a structured, self-administered questionnaire comprising validated scales for each construct, distributed in online formats to accommodate participants’ availability and work schedules. The purposive sample consisted of 115 Filipino Generation Z nurses engaged in direct patient care in various healthcare facilities in Quezon City. Data analysis involved descriptive statistics to summarize variable scores, Spearman’s rho to examine bivariate correlations, and path analysis to determine the direct and indirect effects among the variables. The results of the path analysis were used to develop a proposed framework illustrating the interplay of these cultural values in nursing practice.

RESULTS

Path analysis revealed distinct patterns in the interplay of hiya, pakikisama, and pakikipag-ugnayan among Generation Z nurses in Quezon City. Very high hiya scores (mean = 5.32) reflected both moral accountability and restraint-oriented tendencies. Despite these positive indicators, hiya showed a negative correlation with pakikipag-ugnayan, suggesting that its inhibiting side—marked by fear of criticism and avoidance of mistakes—may overshadow its constructive moral aspects. In contrast, the path analysis identified a moderate positive direct effect between hiya and pakikipag-ugnayan (β = 0.400, pCONCLUSION

Among Generation Z nurses, hiya demonstrates a dual role: while its ethical and conscientious aspects can strengthen pakikipag-ugnayan, its inhibiting side may suppress pakikipag-ugnayan. Pakikisama, operationalized as conflict avoidance and withholding dissent, emerged as a barrier to pakikipag-ugnayan by discouraging open communication. These findings informed the development of the Hiya–Pakikisama– Pakikipag-ugnayan Cultural Dynamics Framework, which illustrates how cultural values can simultaneously enable and constrain professional engagement. The framework has potential applications in nursing education and organizational practice, particularly in designing reflective learning, mentorship, and communication strategies that balance cultural sensitivity with assertiveness. Further validation across generations and healthcare settings is recommended to refine its applicability.

Human ; Weights And Measures ; Sensitivity And Specificity ; Retention (psychology) ; Education, Nursing ; Social Responsibility ; Appointments And Schedules ; Conflict (psychology)

BACKGROUND

Takayasu Arteritis (TA) is a rare, primary large-vessel vasculitis frequently leading to stenosis and less commonly, aneurysm formation. Saccular aneurysms of the aortic arch in patients with TA are fatal, have rarely been reported and represent a significant technical challenge due to the difficult anatomical location and need for protection of the cerebral circulation. Concomitant intracerebral aneurysms in patients with TA are extremely uncommon and have mostly been documented in very few case reports in literature.

CASE DISCUSSION

We present a case of a 31 year-old Filipino female with recurrent chest and neck pain radiating to the upper back. Computed tomographic (CT) angiography demonstrated a large saccular aortic arch aneurysm without branch stenosis. CTA of the cerebral circulation likewise demonstrated multiple, saccular, intra-cerebral aneurysms. She underwent hybrid thoracic arch repair with supra-aortic debranching via mini-sternotomy and proximal ligation of the left common carotid artery and staged endovascular aortic arch replacement with coil embolization of the ostial-to-proximal left subclavian artery segment. Post-operative aortogram showed optimal repair with thrombosed aneurysmal sac, optimal graft position, no endoleaks and preservation of cerebral circulation. Patient improved symptomatically post-procedure and remained symptom-free during follow-up after six months. Careful review of local literature suggests that this is the first Philippine TA case with a saccular aortic arch aneurysm successfully managed in this manner.

CONCLUSION

Saccular aortic arch aneurysms in patients with Takayasu are unusual and presence of concomitant multiple cerebral saccular aneurysms have rarely been reported in literature. This case highlighted that hybrid endovascular arch repair in patients with TA is feasible, minimally invasive and effective.

Human ; Female ; Adult: 25-44 Yrs Old ; Takayasu Arteritis ; Aneurysm, Aortic Arch ; Cerebral Aneurysm ; Intracranial Aneurysm