BACKGROUND AND OBJECTIVE

Due to disasters and calamities, the number of internally displaced persons (IDPs) in the country is steadily increasing. With their disadvantaged situation, this population is prone to experiencing powerlessness and poor health outcomes. However, there is limited information on how these communities can gain control over their health and well-being. While community empowerment is a crucial process in the health sciences, this concept remains understudied. Hence, this study aimed to explore the process of community empowerment in health and develop a theory grounded on the experiences of displaced communities.

This study utilized the classic grounded theory (CGT), primarily aimed at discovering a conceptual theory anchored on the experiences of internally displaced persons. Particularly, this GT variant sought to explicate a social process of community empowerment in health through the participants’ lenses. A total of 45 individuals from six towns of Bulacan province, Philippines were purposively recruited to participate in focus group discussions and key informant interviews. Data analysis employed the constant comparison method, which involved concept development, reduction, and refinement to derive the emerging theory from the gathered information.

he 5 C's Grounded Theory of Community Empowerment in Health depicts marginalization as the main context of internal displacement, where participants’ experiences of resource deprivation and social neglect made them vulnerable to poor health outcomes. The theory further explicates five processes involved in the empowerment of IDPs, namely: consciousness-raising, collaborating, capacity building, carrying out responsibilities, and continuing work. Particularly, the key steps involve (1) raising the community’s awareness on the importance of gaining control over their health and well-being; (2) establishing collaborative relationships within and outside communities; (3) developing competencies on various health-related domains; (4) assuming multiple roles and implementing programs; and (5) continuing efforts to train more people, sustain partnerships, and expand community involvement. These steps lead to the study’s core variable of self-sufficiency, where communities are anchored on the philosophy of communal unity (bayanihan) in managing their own health needs, promoting healthcare access, and addressing other social determinants of health. Moreover, study findings highlight the unique contribution of women, spirituality, and multisectoral engagement in facilitating the process of community empowerment.

This is one of the first few studies to explore the process of community empowerment in health, which guided the development of a theory based on the experiences of internally displaced communities. The theory emphasizes that community empowerment is an iterative and continuous process that involves interactions among community members and other stakeholders. Holistic social preparation and capacity building, together with the integration of local culture and philosophy, could support the successful transition of IDPs into their new lives. Hence, multisectoral collaboration involving government agencies, private offices, higher education institutions, healthcare facilities, and faith-based organizations is crucial in promoting the movement of IDPs from marginalization towards gaining control over their health.

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.

Human ; Grounded Theory

Background: The Coronavirus Disease (COVID-19) pandemic significantly disrupted regular health care services, mainly in the hospitals. Nurses soldiering on the battlefront of care of disaster response in the Philippines during the disease outbreak are at high risk of developing rapid-onset compassion fatigue. Notably, research is still needed to investigate the impact of compassion fatigue on various clinical areas and further develop a theory of compassion fatigue within the nursing context. Objectives: The study explored the concept of compassion as experienced by nurses directly caring for COVID-19 patients. The study further explored the experiences of nurses on compassion fatigue. Methods: This study employed qualitative methodology, specifically the constructivist grounded theory. Results: Thirty-four participants were included in the study. The narratives and voices of the nurses unfolded the following themes: (1) Acts of Compassion, (2) COVID-19 Pandemic: Nursing Challenges and Detours, (3) Nurses’ Compassion Fatigue, (4) Narratives of Opportunities: Thriving at the outset of COVID-19. All four concepts are linked to the multidimensional concept of compassion fatigue. A substantive theory, “Remon’s CF Theory in Nursing," is proposed based on the grounded experiences of nurses caring for COVID-19 patients related to compassion fatigue. Conclusion: Compassion Fatigue (CF) is a psycho-social phenomenon and occupational hazard affecting nurses directly caring for or in contact with COVID-19 patients. CF is a process that develops over time brought by prolonged enactment of compassion, the experience of empathic distress, and concurrence of organizational, contextual, and psychosocial factors. Nurses' CF can potentially affect safety and lead to poor nursing care, compromised work relations, and burnout. Nurse leaders' organizational and leadership commitment and support through up-to-date policies and continuous research on the topic are necessary to regain compassion among nurses. Likewise, reframing nurse compassion fatigue as an organizational and collective problem provides the larger perspective to further improve clinical practice and nurses’ welfare. Recommendations Nurse leaders, hospital and COVID-19 facility administrators must ensure specific policies and priorities that address issues causing and fueling nurse compassion fatigue, including frequency of exposure to traumatic events, lack of resources, and inadequate support system. The study further suggests conducting quantitative research to test the proposed theory and explore the relationship between organizational, psychosocial, and environmental context, compassion fatigue, and compassion-driven factors.
Compassion Fatigue ; Nurses ; Grounded Theory

Background: The Coronavirus Disease (COVID-19) pandemic significantly disrupted regular health care services, mainly in the hospitals. Nurses soldiering on the battlefront of care of disaster response in the Philippines during the disease outbreak are at high risk of developing rapid-onset compassion fatigue. Notably, research is still needed to investigate the impact of compassion fatigue on various clinical areas and further develop a theory of compassion fatigue within the nursing context. Objectives: The study explored the concept of compassion as experienced by nurses directly caring for COVID-19 patients. The study further explored the experiences of nurses on compassion fatigue. Methods: This study employed qualitative methodology, specifically the constructivist grounded theory. Results: Thirty-four participants were included in the study. The narratives and voices of the nurses unfolded the following themes: (1) Acts of Compassion, (2) COVID-19 Pandemic: Nursing Challenges and Detours, (3) Nurses’ Compassion Fatigue, (4) Narratives of Opportunities: Thriving at the outset of COVID-19. All four concepts are linked to the multidimensional concept of compassion fatigue. A substantive theory, “Remon’s CF Theory in Nursing," is proposed based on the grounded experiences of nurses caring for COVID-19 patients related to compassion fatigue. Conclusion: Compassion Fatigue (CF) is a psycho-social phenomenon and occupational hazard affecting nurses directly caring for or in contact with COVID-19 patients. CF is a process that develops over time brought by prolonged enactment of compassion, the experience of empathic distress, and concurrence of organizational, contextual, and psychosocial factors. Nurses' CF can potentially affect safety and lead to poor nursing care, compromised work relations, and burnout. Nurse leaders' organizational and leadership commitment and support through up-to-date policies and continuous research on the topic are necessary to regain compassion among nurses. Likewise, reframing nurse compassion fatigue as an organizational and collective problem provides the larger perspective to further improve clinical practice and nurses’ welfare. Recommendations Nurse leaders, hospital and COVID-19 facility administrators must ensure specific policies and priorities that address issues causing and fueling nurse compassion fatigue, including frequency of exposure to traumatic events, lack of resources, and inadequate support system. The study further suggests conducting quantitative research to test the proposed theory and explore the relationship between organizational, psychosocial, and environmental context, compassion fatigue, and compassion-driven factors.
Compassion Fatigue ; Nurses ; Grounded Theory

PURPOSE: The purpose of the study is to understand the experiences of career exploration among nursing students during their clinical practice and to develop a theoretical framework for the career exploration process. METHODS: From February 2 to 28, 2015, data were collected through focus group interviews from 24 participating fourth-year nursing students. The data were analyzed using grounded theory. RESULTS: The central phenomenon of 'confusion between the ideal and the reality of nursing' occurred in contexts for various reasons of choosing one's major, nurses in the ideal, a vague fear of the field, arduous nursing assignments in the field, and severe adversity in the nursing field. Nursing students tried to deal with their confusion by using interaction strategies such as pursuing the intrinsic value of nursing, finding role models, trying to project oneself, and preparing for adapting to reality. The career exploration process in clinical practice was a voyage to discover the authentic nurse of the pre-registration nurse. CONCLUSION: This result shows that nursing students were to gain confidence in their career choices by finding the value of nursing and interacting with patients. Therefore, opportunities for learning experiences about interaction with patients and various positive experiences in clinical practice should be provided for nursing students.
Career Choice ; Focus Groups ; Grounded Theory ; Humans ; Learning ; Nursing ; Nursing, Practical ; Qualitative Research ; Students, Nursing

PURPOSE: The purpose of this study is to explore what the students experienced in short filmmaking class performed to 1st grade premedical students of a medical school, and to trace educational effects of the class. METHODS: Taking a qualitative approach, the authors used semi-structured interviews to collect the data. This study employed the quota sampling method to purposefully select students to interview. Data coding and analysis were performed based on the grounded theory. The filmmaking experiences consistently described by the interviewees were labeled and reorganized into categories through the open, axial, and selective coding. RESULTS: The students experience the group filmmaking class as a participatory class. Learners also experienced the procedure of performing complicated group tasks according to detailed and scheduled processes. Participation leads to collaboration. Collaboration here is through communication and participation, not through mechanical cooperation. Students also experience various dimensions of communication. The students learned that successful performance of the group filmmaking process is enabled through consideration towards others, and experience a sense of connectedness resulting in a type of community spirit. Having fun and interest, finally, the students experience the sense of accomplishment and sharing through joint screening. CONCLUSION: Students' shared experiences and their education effects of the filmmaking class can be explained in terms of the above mentioned seven closely intertwined categories. In this class, the students were able to express emotions they would not normally express. Through this, the students were able to find the true character and new aspects of their fellow students, forming intimacy, which led to a sense of belonging and connectedness.
Clinical Coding ; Cooperative Behavior ; Education ; Education, Medical, Undergraduate ; Grounded Theory ; Humans ; Joints ; Mass Screening ; Methods ; Motion Pictures as Topic ; Schools, Medical ; Students, Medical ; Students, Premedical

PURPOSE: It is extremely difficult to apply the model learned in basic education for public health nurses (PHNs) to conduct community health assessments. The purpose of this study was to clarify the process by which community health needs can be structured through PHNs' daily practice.METHODS: Semistructured interviews were conducted in 29 PHNs, and continuous comparative analysis using a qualitative study was performed with a modified grounded theory approach.RESULTS: The participants “used their five senses to understand the relationship between the health and life of people” and “considered those who do not attend” by “learning from stakeholders.” To verify such subjective feelings sourced from vague phenomena within the communities, subjective phenomena were converted into qualitative data.CONCLUSION: The application of the findings to organizational continuous education systems may not only help appropriately improve community health assessment methods but can also help improve the evaluation of daily practice and contribute to professional human-resource development.
Community Health Nursing ; Education ; Grounded Theory ; Nurses, Public Health ; Public Health Nursing ; Public Health

PURPOSE: This qualitative study aimed to develop a substantive theory of the process of adaptation to motherhood in Central Asian-Korean immigrants to Korea.METHODS: Individual, in-depth interviews were conducted from July to September 2017, with 18 women who emigrated of Korean ethnicity from Central Asia to Korea, and took care of their baby for at least a year after their first delivery in Korea. The interviews were audio-recorded and transcribed verbatim. Data from the transcriptions were analyzed through Strauss and Corbin's grounded theory method, and data analysis was conducted simultaneously with data collection.RESULTS: As a result of categorizing the interview data through the process of open coding, 10 categories, with 31 subcategories and 102 concepts were drawn, and “growth as a Central Asian-Korean mother in an unfamiliar, historical hometown” was found to be the core category of the process of adaptation to motherhood in Central Asian-Korean immigrants to Korea.CONCLUSION: A characteristic of the process of adaptation to motherhood in Central Asian-Korean immigrants to Korea, drawn from this study, is that it differs according to the level of initiative to carry out interaction strategies, and the use of various supportive social resources. The findings indicate the need for Medicare eligibility adjustment for antenatal care, the extension of the visa renewal period during childbirth, the development of web- or mobile application-based educational programs in Russian language, and the establishment of integrated visiting healthcare services, community service resources, and policy support to enable these women to utilize various supportive social resources.
Adaptation, Psychological ; Asia ; Clinical Coding ; Data Collection ; Delivery of Health Care ; Emigrants and Immigrants ; Female ; Grounded Theory ; Humans ; Korea ; Medicare ; Methods ; Mothers ; Parturition ; Qualitative Research ; Social Welfare ; Statistics as Topic

PURPOSE: This study was conducted to explore Korean mothers' experiences of the development of parent-adolescent relationships. METHODS: The participants were 18 Korean parents of adolescents. Data were collected through in-depth interviews. The main question was, “Could you tell me about your experiences of developing a relationship with your adolescent child?” The data were analyzed using Strauss and Corbin's grounded theory methodology. RESULTS: The central phenomena of the experiences of parent-adolescent relationships among Korean mothers were “trying to reduce my expectations, but not being able to” and “having no idea where to go”. The major action/interaction strategies were “putting aside my desires and adapting to my child's needs” and “waiting and seeing at a distance”. The consequences included “appreciating myself and my child at the same time”. CONCLUSION: These findings indicate that mothers tried to adapt to their children's needs and to keep their children at a distance. Their efforts were influenced by advice from friends and family members. The findings of this study emphasize specific aspects of how Korean mothers experienced the process of developing respectful relationships with their children.
Adolescent ; Child ; Friends ; Grounded Theory ; Humans ; Mothers ; Parent-Child Relations ; Parents ; Qualitative Research