Establishing a Pilot Interprofessional Education (IPE) Program in a Higher Education Institution (HEI) in the Philippines

A pilot interprofessional education (IPE) program in the Philippines has been initiated in a private higher education institution by three Filipinos who were formally trained in IPE from a World Health Organization (WHO) Collaborating Centre for Research and Training on IPE. Guided by the WHO educator and curricular mechanisms on IPE and an understanding of the local context, a four-stage action plan was created for the pilot IPE program, which involved 10 health science programs. The experience from the initial implementation was challenging and required perseverance as well as inclusive leadership. Nevertheless, the program’s accomplishments such as continuous faculty training in IPE, constant communication among faculty members and students on IPE, and an inter-university collaboration to host the first-ever local IPE conference were noted. The article concludes with lessons learned from the pilot IPE program and future directions in further contributing to the growth and sustainability of IPE programs in the Philippines.

Is caring the same as nursing?

This editorial asserts that caring and nursing are not synonymous and that all practitioners of the helping and healing profession, with their humanness and disciplinary training, are experts in human and professional caring. Their distinctive disciplinary perspective on caring reflects the notion that our understanding of caring is always imperfect, and its concept is continuously co-evolving with humanity. No discipline or profession owns the restrictive privilege of caring knowledge or the sole expertise in caring expression, not even nursing

Knowledge, Practices, and Attitude of University Students towards the Prevention of Viral Respiratory Infection (COVID-19)

Background: COVID-19 has affected the educational system, particularly students of higher educational institutions. Accurate knowledge about the disease, its transmission, and preventive measures are critical for containing an outbreak. University students, the next generation of professionals, may play an imperative role in propagating key health information to society. Objectives: The study aims to assess the level of knowledge, the attitude of concern, and prevention practices among university students towards COVID-19 prevention. Methods: This descriptive study was conducted at a private higher educational institution in Central Luzon, Holy Angel University. 357 university students were recruited as study participants from the university's different departments using the purposive sampling method, and data were collected using an online self-administered questionnaire. Results: Among the 357 university students who completed the questionnaires, most were females (58.5%). The results show a good level of attitude of concern and good knowledge of clinical manifestations of COVID-19. The students' most frequently stated source of transmission is exposure to coughing and sneezing via droplets. Additionally, wearing face masks was the most reported method of protection against the infection. Conclusion: The study revealed that university students have adequate knowledge, practices, and attitude of concern towards COVID-19. To bridge the gap between current and required knowledge, it is essential to establish further professional educational campaigns to increase university students' awareness of the pandemic.

Dengue Vaccine Controversy Awareness, Vaccine Health Literacy, and Vaccine Acceptability among Mothers in Select Rural Communities

Background: Immunization is a vital public health service that reduces transmission of communicable diseases among population groups. In the Philippines, reports of adverse reaction from the dengue vaccine raised doubts about its safety and efficacy. This in turn can bring about a decline in vaccine acceptability among mothers and later on result to reduced vaccine coverage in the country. Methods: Descriptive cross-sectional correlational design were used to explicate the influence of dengue vaccine controversy awareness and vaccine health literacy on vaccine acceptability among mothers. Data were collected among 200 mothers from August – November 2018 in rural communities of Bulacan. Stepwise forward and backward multiple linear regression were done to determine the relationships between the variables of interest. Results: Majority of the mothers who participated belong to 26-35 year old age bracket and received basic education. Mothers’ functional health literacy (B=0.189, p=0.006) and critical health literacy (B=0.247, p=0.000) revealed a significant relationship to vaccine acceptability. However, the communicative health literacy (B=0.008, p=0.917) showed no significant relationship to vaccine acceptability. Moreover, the dengue vaccine controversy awareness (B=0.057, p=0.415) had no significant relationships to the mothers’ vaccine acceptability. Conclusion: Health literacy favorably influences vaccine acceptability. Likewise, awareness of controversies surrounding dengue vaccination is not a deterrent to the decision of mothers to continue submitting their children to immunization. Hence, nurses should invest more in educational interventions to promote compliance of communities to the national immunization program and engage stakeholders to support its implementation.

Keeping at-risk youth at the center: lessons learned from a community-based participatory research Photovoice project in Taiwan

Youth in the foster care and juvenile justice systems have numerous unmet health needs and long-term negative health outcomes. Photovoice is a qualitative research method in which participants produce photographs and narratives to communicate their perspectives. While Photovoice has been used in various contexts relating to at-risk youth, no known study has been conducted among youth in the foster care or juvenile justice systems. However, numerous challenges exist for the inclusion of at-risk youth in research. Thirteen youth from a group home in Taiwan for teenage boys in the foster care and juvenile justice systems participated in this yearlong study which utilized a strengths-based approach to examine resiliency, their needs, and sources of support. After receiving in-depth training, participants spent three months taking photos and writing accompanying narratives relating to the research questions. Then, via facilitated individual and group discussions, participants selected photo-narrative pairings relating to five key themes, which were then used in exhibitions for local stakeholders. This article describes nine key lessons learned to keep at-risk youth at the center of future similar research studies through protecting, representing, and empowering them: 1) consider ethical challenges, 2) identify community partners, 3) develop mutual trust with participants, 4) use symbolism, 5) have a strengths-based approach, 6) allow participants to direct the process, 7) maximize time to develop participants’ introspective skills, 8) disseminate study results widely, and 9) include participant empowerment as a key objective. Conducting research with at-risk youth is challenging but vital to identifying ways society can best support them. Photovoice remains a meaningful way for marginalized communities to articulate their needs and share their experiences and perspectives. Recognizing and addressing logistical and ethical challenges early can ultimately lead to more impactful studies for at-risk youth both individually and systemically.

Initial Reliability and Validity testing of the DESTINY Stroke and Large Vessel Screening Tool

Background: Screening is a valuable tool in emergency medicine for triaging, activation of protocols, and resource allocation. The Dallas Emergency Department Screening Tool to Identify Stroke (DESTINY) was developed to screen for all stroke subtypes, with improved sensitivity for posterior circulation stroke and large vessel occlusion (LVO). The main purpose of this study was to evaluate how reliably the tool could be taught and used by ED Nurses. Methods: This is Phase 1 of a multi-phase study to evaluate the DESTINY tool. A vascular neurologist retrospectively reviewed 409 stroke code activations between January and December of 2018. Thirty descriptive vignettes were composed: right anterior circulation stroke (n=5), left anterior circulation stroke (n=5), posterior circulation stroke (n=5), TIA and stroke mimic (n=6), non-LVO stroke (n=5), and hemorrhagic stroke (n= 4). Fifteen emergency medicine registered nurses used the DESTINY tool to screen the vignettes following the stroke education and DESTINY training module. Results: Individual Pearson Correlation Coefficients (PCC) were calculated for each nurse compared to the vascular neurologist (range: 0.43860 to 0.96966; mean: 0.8746 ± 0.1484). All individual PCC were statistically significant except for one [PCC of 0.43860 (p = 0.0153)]. Cronbach’s Alpha scores were very similar across multiple raters (standardized alpha for nurse raters: 0.9853). Omnibus test to compare DESTINY scores by stroke type demonstrated left anterior LVO and mimic/TIA stroke had few outlier observations, however, poorly differentiated hemorrhagic from ischemic stroke Conclusion: As demonstrated by high interrater reliability, the DESTINY tool can be effectively taught to ED nurses using clinical vignettes. The DESTINY tool is good at differentiating non-LVO, anterior LVO, mimics, and TIAs; while the ability to distinguish between anterior LVO/posterior LVO and ischemic/hemorrhagic stroke was sub-optimal. Utilizing the lessons learned in the early version of the DESTINY screening tool we expect that the high-reliability scores will continue to improve in future prospective studies.

Healthcare Workers Attitude and Stigma among People living withHIV/AIDS (PLHA): A Literature Review

Background: The concept of stigma and discrimination discussed in literature illuminate patient's experiences in the hands of health care providers. The review aims to assess the existing literature published in internet databases focusing on the personal perception of stigma and discrimination of health care workers as well as the patient's perception of their attitudes that may be stigmatizing and discriminatory. Methodology: A web-based search was done in the three (3) databases including EBSCOhost, Google Scholar, and PubMed. The search utilized five keywords: 'Stigma'; 'Discrimination', 'Perception', HIV/AIDS,' and 'Nurses.' Inclusion criteria includes full-text, peer-reviewed, academic journal in the English language, and published between the years 2013-2018. The studies were screened according to their relevance to the objectives of the study. The quantitative and qualitative checklist of the Standard Quality Assessment Criteria for Evaluating Primary Research Papers and Joanna Briggs Institute data extraction protocols were utilized by two interrater in the analysis of the literature. The extracted data were synthesized using a table highlighting the key findings of the studies. Results: A total of fourteen (14) titles were included in the review after evaluating its relevance to the objective and appraising its high quality. Content analysis was done and resulted in the formulation of four themes which include: (1) General Characteristics of the Literature (2) HIV/AIDS Stigma and Discrimination as perceived by health care providers; (3) Perception of health providers' attitude among HIV infected persons; and, (4) the consequences of HIV/AIDS stigma. Conclusion: The issue of HIV/AIDS stigma and discrimination is a significant component that affects patient - care provider interaction. Health care providers understand the role they play in improving the lives of their PLHA patients. Likewise, patients perceive that stigma is existent and tangible in health care facilities. HIV/AIDS stigma is a barrier between the patient and the health care team and can lead to the detriment of the patient's health outcomes and satisfaction.

Survival Analysis of Time to Retest for HIV Among Men Who Have Sex with Men from Metro Manila, Philippines: A Single-Center Prospective Study

Background: Regular HIV testing means early detection of the virus and prompt access to treatment. However, factors affecting retesting following receipt of a non-reactive test result are not yet well understood. This study aims to determine the predictors of time to repeat HIV testing among men who have sex with men (MSM) from Metro Manila, Philippines within six months following receipt of a non-reactive test result. Methods: A prospective study was implemented at a community-based HIV testing and counseling center. A total of 250 non-reactive MSM from Metro Manila and with a recent risk of acquiring HIV were the respondents. At baseline, data on socio-demographic factors were gathered; while at follow-up, repeat test status of each participant within six months after baseline was collected. Results: Two retests per 1,000 person-weeks were recorded. Mean survival time was 23.93 weeks, 95% CI: [23.18 - 24.68]. Cox proportional hazards regression demonstrated that statistically significant factors of time to retest were age (HR = 0.90, 95% CI [0.85, 0.96]) and number of tests in lifetime (HR = 1.12, 95%CI [1.06, 1.18]). Conclusion: Although the average time to return is within the recommended period of three to six months, the low return rate suggests the call for encouraging repeat HIV testing among MSM with non-reactive results and recent risk of acquiring HIV. Repeat testing has been shown to be facilitated by age and previous testing history. HIV/AIDS counselors and program administrators can aim for MSM who are older and with relatively low testing history to help meet the global target of ending the HIV/AIDS global epidemic.

Staff Nurses’ Perception of the Hemodialysis Unit as Practice Environment and Patients’ Perception of Nurse Caring Behaviors and their Level of Satisfaction

Background: Despite the concomitant rise of kidney diseases and hemodialysis services nationwide, the Philippines still lacks research on hemodialysis nursing care quality. Using nursing-sensitive indicators under the Nursing Role Effectiveness Model, this study aimed to describe hemodialysis nurses’ perception of their unit as practice environment; patients’ perception of nurse caring behaviors based on Jean Watson’s 10 Caritas Processes; patients’ level of satisfaction on nursing care; and determine the association between perceived nurse caring behaviors and satisfaction levels. Methodology: This descriptive cross-sectional study purposely selected seven free-standing hemodialysis centers in Metro Manila. Ninety-four nurses were surveyed via complete enumeration using the Practice Environment Scale of Nursing Work Index (PES-NWI) while 345 randomly selected patients answered the Caring Factor Survey-Tagalog (CFS-T) and Patient Satisfaction of Nursing Care Quality Questionnaire-Tagalog (PSNCQQ-T). Pearson’s correlation was used to analyze the gathered data. Results: The study revealed that nurses perceived their respective work unit as a favorable practice environment while hemodialysis patients perceived nurse caring behaviors as practiced to a great extent and their satisfaction with nursing care as very good. The study also revealed a significant positive correlation between the process and outcome indicators (r=0.64, p=<0.0001). Conclusion: The study reflected positive nursing-sensitive indicators in hemodialysis. However, hemodi alysis facilities should improve nurse staffing, spiritual nurse caring behavior, and facilitate a more healing environment while maintaining their current favorable qualities.