BACKGROUND AND OBJECTIVE

The COVID-19 pandemic has disrupted the sports industry, resulting in the postponement of events worldwide. This posed a significant burden in the mental and emotional well-being of athletes due to uncertainties and diminished training levels. As an adaptation, bubble camps emerged as a new approach to resuming training and tournaments under stringent regulations of the COVID-19 protocols. In the national context, the University Athletic Association of the Philippines (UAAP) has adapted the bubble set-up by implementing antigen testing, RTPCR, and other health protocols as a prerequisite to bubble training. However, uncertainties in the future of sports continue to present as a psychological toll to the well-being of student-athletes despite the sense of normalcy instilled by bubble training. Existing literature on bubble training is grounded heavily on the quantitative assessments of an athlete's well-being in a bubble set-up and its effectiveness in mitigating COVID-19 transmission, thereby lacking insights that may be obtained from qualitative data. This study explored the experiences of UAAP Season 84 studentathletes in a bubble set-up by examining personal and contextual factors that impacted their well-being.

The study employed a qualitative descriptive phenomenological approach based on Seligman's WellBeing Theory. A purposeful sampling technique was used to recruit UAAP student-athletes through online dissemination of Google Forms for recruitment. Only three student-athletes from UAAP fit the eligibility criteria. Data were collected through on-site and online interviews using a semi-structured interview guide to reveal a narrative of the student-athletes' bubble training experiences, common themes, and patterns. The NVivo software program was used for data analysis, utilizing a deductive thematic approach.

The lived experiences of three UAAP studentathletes were classified into six major themes: (1) Availability and Accessibility of Services; (2) Restrictions; (3) Mental Health; (4) Fostering Relationships; (5) Support Systems; and (6) Individual Growth. Accounts of both positive and negative training perceptions and outcomes regarding the bubble set-up were noted from all student-athletes. The set-up provided studentathletes with easy access to training facilities and services, eventual development of mental fortitude and  perseverance, improved interpersonal relationships, and opportunities for individual growth. However, the restrictions, isolation, internal and external pressures, and routinary nature of the set-up contributed to the elevated levels of stress and anxiety, eventually leading to fatigue and burnout.

The study elucidates on the multi-faceted experiences of UAAP student-athletes in bubble training, underpinning the essence of the adequacy of training services and facilities, enhanced support systems, and prompt policy development that caters to improving the holistic well-being of student-athletes amidst adverse changes in the trajectory of sports.

INTRODUCTION: The survival rate for childhood cancer has increased with advances in medical care. Along with this comes the growing burden of long-term side effects of cancer treatment and cancer survivorship. Childhood cancer survivors are more likely to be sedentary and have a lower quality of life. Physical activity (PA) can promote health and well-being in childhood cancer survivors, but few studies have explored the role of parents of childhood cancer survivors (PCCS) in promoting PA. This qualitative study aims to explore the perceptions of PCCS in Singapore and the role they may have with regard to PA. METHODS: Participants were recruited through a local charity via email, social media and posters. One-hour semi-structured interviews were conducted online with seven parents. With consent, the interviews were recorded, transcribed verbatim and analysed using thematic analysis. RESULTS: Our study discussed thematically parents' accounts on (1) the barriers and enablers of PA and (2) the complications of cancer that potentially affect the levels of PA in childhood cancer survivors. Parents reported that childhood cancer negatively affects the quality of life and participation in PA. The determinants of participation in PA were multifaceted, and socioecological and health belief models were used to demonstrate how these factors were interlinked. CONCLUSION Participation in PA is influenced at an individual, family, community and societal level. The improved understanding facilitated by this research can be used to shape paediatric cancer care practices in Singapore and guide institutional or national policy interventions.
Humans ; Singapore ; Parents/psychology* ; Cancer Survivors/psychology* ; Qualitative Research ; Female ; Male ; Quality of Life ; Exercise ; Child ; Adult ; Neoplasms ; Adolescent ; Perception ; Middle Aged ; Interviews as Topic

INTRODUCTION: We aimed to understand the awareness and attitudes of elderly Southeast Asians towards telehealth services during the coronavirus disease 2019 (COVID-19) pandemic in this study. METHODS: In this qualitative study, 78 individuals from Singapore (51.3% female, mean age 73.0 ± 7.6 years) were interviewed via telephone between 13 May 2020 and 9 June 2020 during Singapore's first COVID-19 'circuit breaker'. Participants were asked to describe their understanding of telehealth, their experience of and willingness to utilise these services, and the barriers and facilitators underlying their decision. Transcripts were analysed using thematic analysis, guided by the United Theory of Acceptance Use of Technology framework. RESULTS: Of the 78 participants, 24 (30.8%) were able to describe the range of telehealth services available and 15 (19.2%) had previously utilised these services. Conversely, 14 (17.9%) participants thought that telehealth comprised solely home medication delivery and 50 (51.3%) participants did not know about telehealth. Despite the advantages offered by telehealth services, participants preferred in-person consultations due to a perceived lack of human interaction and accuracy of diagnoses, poor digital literacy and a lack of access to telehealth-capable devices. CONCLUSION Our results showed poor overall awareness of the range of telehealth services available among elderly Asian individuals, with many harbouring erroneous views regarding their use. These data suggest that public health education campaigns are needed to improve awareness of and correct negative perceptions towards telehealth services in elderly Asians.
Humans ; COVID-19/epidemiology* ; Female ; Telemedicine ; Aged ; Male ; Singapore/epidemiology* ; Qualitative Research ; Health Knowledge, Attitudes, Practice ; SARS-CoV-2 ; Aged, 80 and over ; Middle Aged ; Pandemics ; Awareness ; Asian People ; Southeast Asian People

INTRODUCTION: As the population ages, patient complexity is increasing, intensifying the demand for well-resourced, coordinated care. A deeper understanding of the factors contributing to this complexity is essential for optimising resource allocation. This study evaluates the prevalence of complex care needs in Singapore's primary care settings and identifies the factors associated with these needs. METHOD: Using a qualitative study design, we developed a patient complexity questionnaire to assess how Singapore family physicians recognise patient complexity. Sixty-nine experienced primary care physicians applied this tool to assess patient encounters, categorising each as "routine care" (RC), "medically challenging" (MC), or "complex care" (CC). We compared the care needs across these categories and used mixed-effects multinomial logistic regression to determine the independent predictors of complexity. RESULTS: Of the 4327 encounters evaluated, 15.0% were classified as CC, 18.5% as MC, and 66.4% as RC. In both CC and MC encounters, the most common medical challenges were polypharmacy (66.2% in CC, 44.9% in MC); poorly controlled chronic conditions (41.3% in CC, 24.5% in MC); and treatment interactions (34.4% in CC, 26.0% in MC). Non-medical issues frequently identified included low health literacy (32.6% in CC, 20.8% in MC); limited motivation for healthy lifestyle behaviours (27.2% in CC, 16.6% in MC); and the need for coordinated care with hospital specialists (24.7% in CC, 17.1% in MC). The top 3 independent predictors of complexity included mobility limitations requiring assistance (odds ratio [OR] for requiring wheelchair/trolley: 7.14 for CC vs RC, 95% confidence interval [CI] 4.74-10.74); longer consultation times with physicians (OR for taking >20 minutes for doctor's consultation: 3.96 for CC vs RC, 95% CI 2.86-5.48); and low socioeconomic status (OR for living in 1- or 2-room HDB flats: 2.98 for CC vs RC, 95% CI 1.74-5.13). CONCLUSION High care needs, encompassing both CC and MC encounters, were prevalent in primary care interactions. These findings highlight that relying solely on chronic disease count is insufficient to capture the full spectrum of patient complexity.
Singapore/epidemiology* ; Humans ; Primary Health Care/statistics & numerical data* ; Male ; Female ; Middle Aged ; Aged ; Adult ; Surveys and Questionnaires ; Prevalence ; Polypharmacy ; Qualitative Research ; Chronic Disease/therapy* ; Logistic Models

INTRODUCTION: Despite efforts to improve junior doctors' working conditions, burnout, distress and disillusionment persist, with implications for patient outcomes. This qualitative study analysed factors shaping the lived experiences of junior doctors in Singapore and their changes over time, thereby seeking to inform improvements to working conditions. METHOD: Thirty purposively sampled respondents who were junior doctors in Singapore between 1975 and 2022 were interviewed. Respondents were grouped into 3 cohorts: (1) junior, (2) middle and (3) senior. Employing the framework method of qualitative analysis, open coding was performed with reference to the individual, interpersonal, institutional, community and policy levels of the socioecological model (SEM). Four themes emerged: (1) inherent challenges of junior doctorship, (2) exacerbating factors, (3) alleviating factors and (4) responses of junior doctors to their experiences. Codes were reconstructed into a modified SEM, demonstrating trickle-down effects of interpersonal or structural forces on the individual doctor and pertinent factors evolving with time. RESULTS: Across cohorts, respondents echoed mental and physical challenges. While senior cohort doctors recounted higher patient-to-doctor ratios and longer working hours, junior cohort doctors cited new difficulties. These include a hostile medicolegal landscape, patients' increasingly complex needs and expectations, and higher administrative loads. Amid these difficulties, alleviating factors included good workplace relationships alongside institutional interventions. Doctors responded differently to their challenges. Some externalised difficulties through expression and advocacy; others internalised them, whether into fulfilment or distress. CONCLUSION While some facets of junior doctorship have improved with time, new challenges that warrant consideration are emerging. Junior doctors should be centred, listened to and empowered in shaping improvements to working conditions.
Singapore ; Humans ; Qualitative Research ; Medical Staff, Hospital/psychology* ; Male ; Female ; Adult ; Burnout, Professional/psychology* ; Workload/psychology* ; Attitude of Health Personnel ; Interviews as Topic ; Job Satisfaction

BACKGROUND: The STAR (Scientific, Transparent, and Applicable Rankings) working group conducts regular evaluations of Chinese guidelines and consensus statements. This study gathered insights from STAR working group members using qualitative interviews. METHODS: From March to August 2023, members of the STAR specialist committees were interviewed using semi-structured interview outline. The interviewees were selected through purpose-based sampling. Subject analysis was employed to summarize the findings. RESULTS: We conducted interviews with 37 members from 36 committees and summarized the contents into four main themes and 16 specific topics. The value of STAR in enhancing the development and selection of high-quality guidelines in China was commonly mentioned. Challenges identified included the lack of resources and suboptimal organizational structures, collaboration, and evaluation efficiency. Suggestions for the STAR tool included developing extensions for different guideline types, adjusting certain items, and better covering guideline applicability. The promotion of STAR and the consideration of an international committee for global outreach were also highlighted. CONCLUSION STAR has exerted a substantial influence on the evaluation of Chinese guidelines, and the insights gained from interviews offer valuable directions for its further enhancement.
Humans ; China ; Qualitative Research ; Practice Guidelines as Topic ; Interviews as Topic

Objective To analyze the caregiver presence needs and their influencing factors among hospitalized elderly non-surgical patients and provide a basis for formulating relevant policies.Methods A descriptive qualitative study method was adopted.Through purposive sampling,semi-structured interviews were conducted on elderly non-surgical patients and their families and medical staff in Peking Union Medical College Hospital from September to October 2023.MAXQDA 2020 and the 7-step phenomenological analysis method of Colaizzi were used to classify and code the interview contents and identify themes.Results The categories of caregiver presence needs of elderly non-surgical patients included basic living assistance needs,disease monitoring needs,psychological support needs,as well as the needs for family members to provide economic support and participate in treatment decision-making.The influencing factors included advanced age,frailty,the lack of self-care ability in patients with comorbidities,the susceptibility of patients to sudden situations during the disease exacerbation period,the increased risk of unexpected events in patients with psychological distress,and patients' concerns about social support and medical decision-making.Conclusion The caregiver presence needs of elderly non-surgical patients during hospitalization are high and influenced by multiple factors.
Humans ; Caregivers/psychology* ; Aged ; Hospitalization ; Social Support ; Male ; Qualitative Research ; Female

This integrative article explored how nurse-researchers craft and negotiate researcher identity through reflexivity. Drawing on three reflexive narratives situated across distinct practice and career contexts, including academe and military nursing, this article synthesized how personal histories, professional roles, and methodological training intersect in order to shape how one becomes a researcher. Guided by Benner's novice-to-expert lens and contemporary discussions on positionality and reflexive practice, this article's synthesis surfaced recurring themes: identity-in-motion rather than identity-as-status; persistence and vulnerability as engines of growth; insider–outsider movements and the ethical responsibilities being invited; and methodological pluralism as a value stance that links rigor with relevance and care. The narratives also illuminated how institutional cultures, resource constraints, and role expectations contour opportunities for inquiry, while reflexive writing functions as both method and pedagogy, supporting integrity, accountability, and epistemic fluency. It was argued in this article that cultivating researcher identity in nursing requires spaces that normalize doubt, foreground values, and make visible the relational, moral, and political textures of knowledge production. Implications included embedding explicit reflexivity and positionality work in curricula, mentoring, and research supervision; recognizing mixed-methods and qualitative approaches as complementary pathways to impact and to align institutional supports with nurses' dual commitments for both practice and scholarship. In this article, the process of becoming a nurse-researcher had been shown to be a continual practice of courage, reflexivity, and commitment that is by doing it, and learning it, until nurse-researchers make it.

BACKGROUND

Medication safety is a global priority, yet in the Philippines, particularly in rural hospitals, it remains underexplored. Nurses are at the frontline of safeguarding patients, often working under resource constraints.

This study explored nurses' perspectives on medication safety in rural Philippine hospitals, while focusing on systemic barriers, emotional and ethical challenges, and strategies employed to sustain safe practice.

Aqualitative design was used that employed focus group discussions (FGDs) and key informant interviews (KIIs) with staff nurses in rural hospitals. Thematic analysis was conducted to identify themes and subthemes emerging from participants' experiences.

Three themes emerged: (1) Building Responsibility and Skills (accountability, verification, documentation, and mentorship); (2) Keeping Patients Safe and Reducing Mistakes (protecting patient care, overcoming systemic barriers); and (3) Handling Emotions and Challenges in Giving Medicine (coping with guilt, moral distress, and reliance on teamwork). Findings revealed that nurses sustain safety through vigilance and accountability but are constrained by chronic understaffing, interruptions, moral distress, and limited training access.

Medication safety in rural Philippine hospitals is shaped by nurses' competence, emotional resilience, and teamwork, but remained fragile without systemic supports. Implications included equitable workforce policies, supportive errorreporting cultures, and strengthened continuing professional development opportunities. Strengthening safety also required shifting from individual responsibility to organizational and system-level accountability.

BACKGROUND

Financial hardship is a defining reality for many nursing students in the Philippines. While nursing education is viewed as a path to family upliftment, the academic burden of sustaining clinical fees, requirements, and living expenses can be overwhelming.

This study explored the lived experiences of Filipino nursing students who face financial strain, while focusing on its sources such as emotional and psychological impacts, coping and survival strategies, and academic consequences.

A descriptive qualitative design was employed to capture rich, contextualized narratives from sixteen Bachelor of Science in Nursing (BSN) students enrolled at a state university in the Bicol Region. Data was collected through semi-structured interviews and were analyzed thematically using Braun and Clarke's six-phase approach. Trustworthiness was ensured through member checking, audit trails, and reflexive journaling.

Four themes emerged: (1) Sources of Financial Strain—family income instability, solo-parent dependency, family medical expenses, and multiple dependent siblings; (2) Emotional and Psychological Impacts—hopelessness, anxiety, and depression; (3) Coping and Survival Strategies—working while studying and sacrificing rest or self-care; and (4) Academic Consequences—difficulty focusing and fear of dropping out. These findings revealed a complex interplay of economic, emotional, and cultural factors that shape students' struggle to persist.

Financial strain among Filipino nursing students extends beyond economic limitation to encompass moral obligation, emotional fatigue, and academic compromise. Universities must provide holistic support—financial, psychosocial, and institutional—to ensure that nursing students not only survive but succeed.