Job-related factors associated with depression, anxiety, and stress among healthcare workers in a Tertiary Government Hospital in Metro Manila during the COVID-19 pandemic

Background and Objectives@#Ensuring the total well-being of healthcare workers (HCWs), including their mental health and psychological well-being, is an essential aspect in the delivery of patient care and the preservation of the health workforce. This study aimed to determine the level of mental well-being and emotional state of HCWs in terms of depression, anxiety, and stress using the DASS-21 scale in a tertiary government hospital during the COVID-19 pandemic in the Philippines and to identify the job-related factors that may be associated with these outcomes.@*Methods@#This is an analytical, cross-sectional study among HCWs involved in direct patient care in a tertiary government hospital in the Philippines during the COVID-19 pandemic. Data collection was conducted from February to March 2022 through an online self-administered questionnaire, which included the Demand-Control-Support Questionnaire (DCSQ), and the 21-item Depression Anxiety Stress Scale (DASS-21). This was sent to doctors, nurses, and allied medical workers actively working in the clinical areas. All responses were collected and analyzed.@*Results@#Three hundred sixty-four healthcare workers were included in the study. Majority were single (62.62%), living with immediate family (50.82%), and working in a COVID-designated area (62.09%). High prevalence of depression (49.18%), anxiety (61.54%), and stress (30.22%) was found among the HCWs. Work in high infection/COVID-designated areas was significantly associated with anxiety and stress, and high-job demand was significantly associated with all three mental health states compared to low job-demand.@*Conclusion@#Focus should be placed on modifying the condition of high job demand among healthcare workers working in hospitals. This includes ensuring optimum staffing levels and patient to HCW ratio which avoids HCWs from being subjected to high workloads and time pressures that subsequently increase risk for stress, anxiety, and depression.

Building capacities for universal health care in the Philippines: Development and implementation of a leadership training program for public health nurses

@#Achievement of Universal Health Care (UHC) in the Philippines requires capable health workers who can navigate changes and lead in the local implementation of health system reforms. Public health nurses are in a strategic position to lead in UHC implementation as they constitute the largest cadre of health workers in the public health setting, and core concepts of UHC intersect with principles of public health nursing practice. This paper aims to describe the development and implementation of a leadership training program for public health nurses in the Philippines, in response to UHC. Document reviews of training reports and evaluations, including course site data analytics, and evaluation of the training program were done for the four cohorts of the course. The University of the Philippines Manila College of Nursing, with support from the Department of Health, responded to the increased demand of the Philippine health system for public health nurses with strong foundations and advanced skills by designing and offering a leadership development course specific to PHNs. From November 2019 to March 2022, a total of 183 participants from 17 regions completed the training. With the COVID-19 pandemic and dynamic changes in governance, the experiences of the project highlighted the need for flexibility in delivering the training program, updating module contents according to the latest developments, and improving course duration and evaluation. Barriers to course engagement and completion must be addressed for PHNs, their workplaces, clients, and the health system to benefit the most from the training.

Fostering partnerships between the academe-government and community in the COVID-19 pandemic response in the Philippines

@#This paper describes the COVID-19 response efforts through strategic partnerships of a nursing school in the Philippines. The roles of the academe through teaching as well as continuing education and community extension services programs were particularly harnessed. Existing academe-government-community partnerships were leveraged, and personal networks mobilized to provide support on risk communication, community engagement, and capacity building. Challenges and limitations encountered serve as points for improving the academe's strategies and activities. The lessons from this undertaking highlight the crucial role of nursing schools as relevant resources in COVID-19 pandemic response initiatives. Partnerships and networks built prior to the pandemic are instrumental in providing the space and opportunities for faculty and student nurses to aid in strengthening the local response. Recommendations are outlined to enhance current roles, strategies, and activities of the academe in the COVID-19 pandemic and lay future directions for Philippine nursing schools given the increasing incidence and severity of disasters in the country.

Capacity needs assessment of primary health care providers in selected municipalities in Cavite

PURPOSE@#Primary Health Care (PHC) refers to essential health care that is made accessible, acceptable and affordable to individuals and families in the community. As such, it is imperative for PHC providers to possess the necessary competencies responsive to the current health care demands. This study aims to determine the current capacity of PHC providers and their need for capability building.@*METHODS@#The study employed a quantitative descriptive design with 87 purposively-selected PHC providers and five administrators from selected rural municipalities in Cavite. It is adapted from the study, “Capacity-building of primary healthcare providers in 10+3 Southeast and East Asian Nursing Education and Research Network (SEANERN) countries”.@*RESULTS AND DISCUSSIONS@#The perceived level of knowledge of the PHC providers on the elements of PHC were all rated to be proficient. Maternal and child care received the highest score, while health education received the lowest score. The perceived level of skills of the PHC providers was also rated to be proficient. Sanitation and water received the highest score, while treatment of common diseases and injuries received the lowest score. Similar to the perceived levels of knowledge and skills, the perceived level of attitudes of the PHC providers were also proficient, with environmental sanitation having the highest score but treatment of common diseases and injuries having the lowest score. However, from the perspective of health administrators, they rated the PHC providers one level lower or needs minimal support. Training and capacity building in all elements of PHC was identified as the most needed by the PHC providers. Their most preferred method of training is workshop.@*CONCLUSIONS@#There are high perceived levels of knowledge, skills, and attitudes of the PHC providers in the elements of PHC. Despite the high scores, objective outcomes such as the MMR and immunization coverage do not reflect the proficient scores of the PHC providers. There are also other health conditions and issues such as noncommunicable diseases and injuries that need to be addressed using PHC approach. Given this, it is vital that appropriate training and adequate hiring of PHC providers be reinforced nationwide in order to meet the health goals and needs of the country.

Nursing workforce in the Philippines: Data and issues

@#<p style="text-align: justify;">This study was conducted to: (1) determine the profile of nurses in various work settings based on available databases; (2) describe the current nursing education and programs in the Philippines; and (3) identify national key issues affecting the nursing workforce. The study utilized descriptive, cross-sectional research design; and employed institutional survey, Delphi survey, and round table discussions. Results showed that the Department of Health has the current number of nurses working in hospitals and communities in the different regions, including information on age and sex distribution, employment characteristics, and type of hospital affiliations. The Professional Regulations Commission Board of Nursing has the results of the national licensure examinations. Commission on Higher Education has information on BSN curriculum and schools. Priority key issues identified are: (1) nursing leadership and nursing role clarity, (2) workplace safety and violence, and (3) shortage of nurses, (4) unjust compensation, and (5) skills mix and geographic maldistribution. PNA is thought to have a big role in helping address these key issues. </p>

Developing capacities of professional nurses on disaster risk reduction and management in the Philippine Nurses Association

@#In the years 2010-2015, the Philippines experienced a number of disasters, both natural and man-made, that killed around 1,400 and affected more than 68M people. These recent disasters highlight the need for all health workers, especially nurses to be prepared to respond to possible consequences of all types of hazards interacting with communities. Nurses who are at the forefront of health care services are counted upon to plan for and respond to emergencies and provide substantial care to individuals, families and communities. However, there is a need to review the competencies that nurses should have in emergency and disaster management to be able to carry out these roles and functions. This study describes the development of a training program, which aims to build capacity of nurses to participate actively in emergency preparedness, response and recovery efforts of hospitals and communities. Participants included nurses from hospitals and the community, and volunteer nurses. Their knowledge and skills related to disaster management were measured before and after the training. Their involvement in disaster management months after the training were recorded to demonstrate the impact of training on their professional development and in helping communities during or after a disaster. This study demonstrates how continuing education helps professionals become significant in addressing the needs of the general public and in contributing to social development.

Work environment of nurses in the Philippines: A preliminary study

@#<p style="text-align: justify;">Work environment has been described as an important factor in the job satisfaction of nurses and their quality of service provided. However, little is known of the present work environment of Filipino nurses in the country. This study used a cross-sectional design to describe work environment variables affecting Filipino nurses; determine the degree of nurses' job satisfaction;, and determine their intention to remain in their present work environment. A self-administered survey was developed by the study team and was distributed during the PNA national conference   through the Chapter Presidents. This   study discovered   that the lowest positive responses were in the Physiologic  and  Safety  Needs  but  despite  this  result,  nurses  reported  high  job satisfaction and intend to remain in their present work environment.</p>

Facing up to the challenge of Typhoon Yolanda: The Philippine Nurses Association experience

@#Considered as one of the deadliest tropical cyclones to Chave hit the country and the strongest typhoon recorded at landfall, Typhoon Yolanda (internationally known as Haiyan) swept across the Visayan region, leaving behind a devastation that mobilized national and international humanitarian efforts on a grand scale. In response to the growing global awareness for the need for disaster preparedness, the Philippine Nurses Association (PNA), through its Disaster Preparedness Committee, has been training members from different local chapters on emergency and disaster management for 1 the past four years . The training seminar aimed to capacitate the participants and, eventually through them, their respective chapter members in preparing for and managing disaster events in coordination with government agencies and international humanitarian relief efforts. The PNA Board of Governors has also approved its Emergency Response Plan and Policy outlining the communication and coordination mechanism in times of emergency and disaster. Networking and linkage with the Department of Health - Health Emergency and Management Staff has also been formalized through a Memorandum of Understanding making PNA a member of the Health cluster, Mental Health and Psychological Support Services (MHPSS) cluster and Water and Sanitation and Hygiene (WASH) cluster. When super typhoon Yolanda made its landfall and left devastation behind its path across the country, the capacity for response of the local and national government has been truly tested. PNA for its small part has also been challenged to review its preparedness efforts in terms of capacity building, policy and advocacy, as well as networking and coordination.