BACKGROUND

Caregiving for survivors of stroke often leads to significant stress, impacting caregivers’ health and well-being. This study aims to explore the occupational engagement and coping strategies of family caregivers in a community rehabilitation setting, focusing on the physical, emotional, and financial challenges they face.

A qualitative descriptive phenomenological approach was used, employing in-depth interviews with eight family caregivers of stroke survivors. Participants were recruited from a rehabilitation center in a central urban area in Cebu, Philippines. Thematic analysis was conducted to identify recurring patterns and key themes in the caregivers’ experiences.

Three main themes emerged from the analysis: (1) Navigating Caregiving and Life: Impact on Occupational Engagement, (2) Ripple Effect: The Strain of Emotional and Physical Demands, and (3) Navigating New Normals: Coping Strategies to Manage Caregiving Stress. Caregivers reported disruptions in daily routines, significant emotional and physical strain, and financial burdens. Coping strategies varied from adaptive techniques, such as seeking social support, to maladaptive behaviors like smoking.

Caregivers experience significant challenges in maintaining their occupational engagement due to the demands of caregiving. This highlights the need for targeted interventions, such as pre-discharge education, financial support, and access to community-based programs, to improve caregiver well-being and enhance their ability to manage caregiving stress.

BACKGROUND AND OBJECTIVE

Within a decentralized health system, barangay health workers (BHWs) are often the first point of contact for Filipinos seeking care. Despite their importance, BHWs are neglected in the health value chain. The study seeks to examine the lived experiences of BHWs, particularly their journey in navigating their roles within the community and the health system that encompasses their day-to-day realities, challenges, motivations, and the meanings they derive from their work.

The study draws on seven focus group discussions (FGDs) with BHWs (n=50), residents (n=7), and local government officials and health workers (n=7) of San Miguel, Bulacan. The qualitative data collected were analyzed using thematic analysis.

Findings show that BHWs perform many roles, which are not limited to health and are dependent on orders from their superiors. Guidelines are vague in appointing BHWs, with personal connections valued more than technical qualifications. Their accreditation is hardly conferred any significance. There is also a lack of formal and structured training. The informality of these processes leads to an absence of quality assurance on rendered health services. The non-provision of incentives and benefits stipulated in RA 7883 also places their health and lives at risk. Furthermore, BHW’s commitment to serve is used to excuse the inadequacy of their compensation and excessive workload.

BHWs take on diverse roles, from community organizers to healthcare providers, and are confronted with significant challenges encompassing politicization, inadequate training, and insufficient compensation. The study concludes with policy recommendations to improve the conditions of the neglected BHWs, with particular attention to coordinating, capacitating, compensating, career pathing, and connecting them to the health system.

BACKGROUND

Community Health Workers (CHWs) play a vital role in addressing community healthcare needs, yet little is known about their psychosocial status and job satisfaction. This study aimed to describe the psychosocial status and job satisfaction of CHWs, and examine the factors associated with their job satisfaction.

A cross-sectional study was conducted among 440 CHWs aged 25-60 years working in urban and rural areas of Batangas, Philippines. Linear regression models were used to examine the association between psychosocial factors and job satisfaction. Other factors associated with job satisfaction were also examined.

Despite 90.0% of CHWs reporting high perceived stress and 52.1% experiencing high depressive symptoms, they demonstrated relatively high job satisfaction (mean [standard deviation]= 80.05 [17.56]; range= 0-100) and high perceived social support (mean [standard deviation]= 25.09 [2.93]; range= 10-30). Among psychosocial factors, only perceived social support was associated with job satisfaction (unstandardized beta [B] 0.93; 95% confidence interval [CI] 0.44, 1.41). Other factors associated with job satisfaction include fixed working hours (B 4.71; 95% CI 0.49, 8.94), work amenities (B 7.37; 95% Cl 0.03, 14.72), ≥21 years of work experience (B 5.64; 95% CI 0.35, 10.93), and working in rural areas (B 5.88; 95% CI 2.77, 8.99).

Psychological factors such as perceived stress and depressive symptoms were not found to be associated with job satisfaction among CHWs. However, factors such as greater perceived social support, fixed working hours, work amenities, longer work experience, and working in rural areas were identified as contributors to higher levels of job satisfaction among CHWs.

OBJECTIVE

To investigate factors influencing adherence of caregivers to prescribed out-patient management of children with cerebral palsy (CP).

This prospective cohort study enrolled 106 children with CP and their caregivers seen at the Philippine General Hospital (PGH) from July 1, 2018 to April 30, 2019 to investigate the association of patient profile, caregiver profile, accessibility of treatment center, and type of therapy, to adherence to out-patient management.

Atotal of 106 pediatric patients with CPand their caregivers participated in the study with no dropouts observed. Adherence to therapy was defined as completion of patient of at least 50% of the prescribed therapy sessions or completion of at least one set of therapy. Adherence was significantly increased when patients were referred to: (1) physical therapy (OR=34.5, CI 7.21 to 167, pCONCLUSION

Caregiver's adherence to out-patient rehabilitation program was seen to be significantly influenced by the type of therapy the patient with CPwas referred to undergo (i.e., PT, OT, SLT).

OBJECTIVES

This study aimed to determine the relationship between self-assessed environmental factors, organizational commitment, and turnover intention among frontline nurse managers of internationally accredited private hospitals in Metro Manila from February to March 2024.

A descriptive correlational study among frontline nurse managers of internationally accredited private hospitals in Metro Manila utilizing total enumeration sampling was employed. Data were obtained using three adopted instruments namely: Nurse Leader Environmental Support Survey (NLESS), Three-Component Model (TCM) Employee Commitment Survey, and the Expanded Multidimensional Turnover Intention Scale (EMTIS). Data analysis was done using descriptive and inferential methods.

A total of 195 frontline nurse manager respondents participated in this study with a response rate of 97%. The study reported environmental factors overall mean score of 7.41 generally interpreted as “Always Supportive” and organizational commitment mean score of 3.45 inferred that frontline nurse managers have “Strong Commitment” to their organization. On the other hand, frontline nurse managers reported “Low Turnover Intention” to their organization, with an overall mean score of 2.52. Furthermore, multiple regression analysis revealed that environmental factors and organizational commitment collectively predicted 34.2% of the variance in turnover intention (R²=0.342, F=50.0, p=CONCLUSION

The results of the study found a strong positive correlation between environmental factors, organizational commitment, and turnover intention. Higher levels of both environmental factors and organizational commitment were linked to reduced turnover intention. Furthermore, multiple linear regression analysis showed that both environmental factors and organizational commitment were significant predictors of turnover intention.

BACKGROUND AND OBJECTIVE

The primary determinant for patient referral by general dental practitioners (GDPs) to periodontists differs based on the country of practice. Moreover, previous research has revealed that GDP preferences for managing periodontal patients, actual number of referrals, and the overall decision-making process have evolved over time. Understanding the periodontal referral pattern of Filipino GDPs could help identify factors that promote or inhibit referral to periodontists. These factors may in turn be used as basis for the formulation of periodontal referral guidelines for use by GDPs in the Philippines. Therefore, this study aimed to determine the factors that affect the referral patterns of Filipino GDPs to periodontists, with GDPs practicing in the City of Manila as the representative population.

A descriptive cross-sectional study design with the use of a self-administered survey was utilized for this study. Participants were 75 licensed dentists practicing in the City of Manila who were members of the Philippine Dental Association-Manila Dental Chapter. The questionnaire collected information on sociodemographic characteristics of the participants, periodontal referral pattern, and the factors considered by the participants when referring patients to a periodontist. Descriptive statistics (frequency and percentage) were used to report the study’s findings.

Majority (92%) indicated that they regularly referred patients with periodontal disease to periodontists, with a personal estimate of up to 20 periodontal case referrals monthly by 81.3% of the participants and >20 referrals for 10.7%. The clinical factors considered as most important when referring to a periodontist were the type of periodontal disease (81.3% of the participants), periodontitis severity (74.7%), and the presence of a complex medical history 61.3%). Among the nonclinical factors, the most influential were the following: uncooperative patient (32% of the participants), perceived personal skill (24%), postgraduate training of the periodontist (21.3%), and the patient’s financial capacity (13.3%).

Multiple factors affect the decision of general dental practitioners in the City of Manila when referring patients to a periodontist. Majority are influenced by clinical factors such as the type and severity of periodontal disease and the systemic condition of the patient. Although considered to a much lesser degree compared to clinical factors, the top nonclinical factors that Manila GDPs base their referral decisions include the assessment that a patient is uncooperative and the perceived adequacy of personal skills in managing periodontal patients.

Objectives: The present study explored the experiences of caregivers raising a child with perinatal HIV infection through a narrative inquiry approach. It uncovered how caregivers learned about their children’s diagnosis, the challenges that they experience in raising their children, and how they cope with the ordeal caused by HIV infection. Methods: A total of ten participants joined the study – five caregivers participated in the key informant interviews (KIIs), with their respective child diagnosed to have perinatal HIV infection joining the focus group discussion (FGD) (n=5). Semi-structured individual interviews were carried out to examine in-depth narratives from the caregivers. We thoroughly analyzed the verbatim interview transcripts using reflexive thematic analysis (RTA) by the six-phase process outlined by Braun and Clarke (2019). NVivo 12 was utilized in the process of data analysis. The transcribed data were uploaded, coded, and analyzed individually. The software helped the organization and expression of the codes and themes. Result: In this study, three major themes and four sub-themes in each theme were generated: a) becoming known: the journey towards testing and treatment, which includes reasons for testing, cause of acquiring HIV, reactions, and treatment, b) passing through challenging times, which cover preparing the child to understand illness, child's awareness and understanding of illness, physical health, and discrimination, and c) receiving essential support which includes an understanding of illness, building hope, needs received, and sources of support. Conclusions Caregivers with children living with HIV face challenges such as preparing the illness to be known and understood by their child, managing the child’s physical health, and discriminating against others. However, they can live healthy and meaningful lives if they are given comprehensive support from the government, access to quality healthcare and education, and psychosocial interventions. The government and private sectors must make efforts to promote physical, emotional, and mental health care underpinning the well-being of caregivers and children with HIV. The retention of the programs offered by certain organizations (e.g., testing and treatment needs, nutritional and basic needs support, educational supply, and livelihood program for caregivers) and the increase in the number of psychoeducational and support group activities were suggested to significantly help in addressing the concerns of both caregivers and their child with perinatal HIV infection.
HIV ; Caregivers

Objectives: Community health workers (CHWs) fill in the insufficiency of health professionals in low-income countries. The CHWs’ roles include health education of their constituents whose health they likewise take care. This study aimed to describe the concept and understanding of diabetes among CHWs in the Philippines. Methods: Fifty female CHWs currently working in rural and urban areas participated in six focus group discussions with guidance from Kleinman’s eight questions. With the written informed consent of the participants, discussions were recorded and transcribed by the Research Assistant. A multi-disciplinary team manually analyzed the data. Disagreements were discussed among them and the physicians provided clinical analyses and explanations on the results. Quotations of an important point of view were also presented. Pseudonyms were utilized to uphold anonymity. Results: CHWs were aged 32 to 72 years; older participants reside in rural areas. Majority were married, housekeepers, and high school graduates. Some CHWs and their family were suffering from diabetes or dyabetis, the disease of the rich according to them. Its causes were food and lifestyle, and believed to be hereditary. Complications lead to death. Amputation was feared the most. Diabetes is incurable. Persons with diabetes should take maintenance medicines, and seek physicians’ and family’s help. Together with the patient, the family must decide on its management. Balanced diet, healthy lifestyle, maintenance medicines, food supplements, and herbal plants were perceived treatments. The internist should lower blood sugar level as well as prolong life span. Proper diet and regular check-up prevent diabetes. Conclusions CHWs’ concept and understanding of diabetes reflect some of the biomedical causes, effects, treatment, and prevention of diabetes as well as its social determinants. The efficacy and safety of herbal plants in the treatment of diabetes, however, should be further studied. Training on diabetes care should be provided to address their fears of amputation, insulin injection, and complications.
Community Health Workers ; Philippines

Background and Objective: Within a decentralized health system, barangay health workers (BHWs) are often the first point of contact for Filipinos seeking care. Despite their importance, BHWs are neglected in the health value chain. The study seeks to examine the lived experiences of BHWs, particularly their journey in navigating their roles within the community and the health system that encompasses their day-to-day realities, challenges, motivations, and the meanings they derive from their work. Methods: The study draws on seven focus group discussions (FGDs) with BHWs (n=50), residents (n=7), and local government officials and health workers (n=7) of San Miguel, Bulacan. The qualitative data collected were analyzed using thematic analysis. Results: Findings show that BHWs perform many roles, which are not limited to health and are dependent on orders from their superiors. Guidelines are vague in appointing BHWs, with personal connections valued more than technical qualifications. Their accreditation is hardly conferred any significance. There is also a lack of formal and structured training. The informality of these processes leads to an absence of quality assurance on rendered health services. The non-provision of incentives and benefits stipulated in RA 7883 also places their health and lives at risk. Furthermore, BHW’s commitment to serve is used to excuse the inadequacy of their compensation and excessive workload. Conclusion BHWs take on diverse roles, from community organizers to healthcare providers, and are confronted with significant challenges encompassing politicization, inadequate training, and insufficient compensation. The study concludes with policy recommendations to improve the conditions of the neglected BHWs, with particular attention to coordinating, capacitating, compensating, career pathing, and connecting them to the health system.
community health workers ; universal health care ; Philippines

Objectives: This study aimed to determine the relationship between self-assessed environmental factors, organizational commitment, and turnover intention among frontline nurse managers of internationally accredited private hospitals in Metro Manila from February to March 2024. Methods: A descriptive correlational study among frontline nurse managers of internationally accredited private hospitals in Metro Manila utilizing total enumeration sampling was employed. Data were obtained using three adopted instruments namely: Nurse Leader Environmental Support Survey (NLESS), Three-Component Model (TCM) Employee Commitment Survey, and the Expanded Multidimensional Turnover Intention Scale (EMTIS). Data analysis was done using descriptive and inferential methods. Results: A total of 195 frontline nurse manager respondents participated in this study with a response rate of 97%. The study reported environmental factors overall mean score of 7.41 generally interpreted as “Always Supportive” and organizational commitment mean score of 3.45 inferred that frontline nurse managers have “Strong Commitment” to their organization. On the other hand, frontline nurse managers reported “Low Turnover Intention” to their organization, with an overall mean score of 2.52. Furthermore, multiple regression analysis revealed that environmental factors and organizational commitment collectively predicted 34.2% of the variance in turnover intention (R² = 0.342, F = 50.0, p = < 0.001). The environmental factors emerged as a very influential predictor of turnover intention as indicated by β = 0.545, p= < 0.001. Conclusion The results of the study found a strong positive correlation between environmental factors, organizational commitment, and turnover intention. Higher levels of both environmental factors and organizational commitment were linked to reduced turnover intention. Furthermore, multiple linear regression analysis showed that both environmental factors and organizational commitment were significant predictors of turnover intention.
nurse manager ; nurse administrators