"We Tried to Borrow Money, but No One Helped." Assessing the Three-Delay Model Factors Affecting the Healthcare Service Delivery among Dengue Patients during COVID-19 Surge in a Public Tertiary Hospital: A Convergent Parallel Mixed Methods Study.

Identification of delay barriers to care is essential for an effective and efficient healthcare service delivery. In this study, we described the delay in care among parents of the patients seeking treatment for dengue. We also examined the factors affecting the severity of dengue (dengue with warning signs; severe dengue). A convergent parallel design mixed-method approach using Key Informant Interviews (KII) and a survey guided by the Three-Delay Model were conducted among 24 respondents at the National Children's Hospital (NCH). Coding and thematic analysis using NVIVO and bivariable generalized linear models with a Poisson distribution and robust variance were utilized to analyze the KII transcripts and survey data, respectively. Results showed that financial constraints and previous dengue infection (first delay), mode of transportation, traffic density, and location (second delay), and hospital capacity (third delay) influenced the overall delay uncertainty in seeking care treatment for dengue infection. Furthermore, our bivariable analysis showed that travel time to NCH and place of residency, service given from previous health facilities, and parents' educational background were associated and played a role in the severity of dengue infection. Interventions focused on the identified factors contributing to delayed care should be made to avoid unwanted clinical outcomes.

Staff nurses' competency and patients' satisfaction in an accredited maternity hospital: Basis for enhancement program

This paper centers on the staff nurses' level of competency and patients' level of satisfaction. Descriptive comparative design was utilized covering 32 staff nurses and 37 maternity patients from an accredited government maternity hospital. Purposive sampling was used to select the respondents. The questionnaires that were employed came from the Department of Health's Philippine Nurse Certification Program Self Assessment Tool for Level 3 Certification in Maternal and Child Nursing. The profile of staff nurses includes gender, length of experience, and educational attainment. On the other hand, gravidity, parity, and age are the patients' profile. Informed consent was given to all respondents. Statistical tools that were used includes: frequency and percentage, mean, standard deviation, independent sample t-Test, one way analysis of variance, and Pearson's correlation. The result concluded that there was no significant difference in the staff nurses' level of competency and patients' level of satisfaction when their profiles were considered. Moreover, it can be elucidated that there was no significant relationship between the level of competency and level of satisfaction. It can be interpreted that staff nurses are highly competent and patients are highly satisfied in terms of Client Care, Management and Leadership, and Research. However, there were statements with moderately competent results namely assess degree of laceration and actively participates in the collection of data research process to improve Maternal and Child Nursing practice in work setting with a mean of 2.50 and 2.28 respectively. The researcher suggests enhancement program in the form of the following trainings: internal external suturing in coordination with Association of Nursing Service Administrators of the Philippines and Research Process in coordination with Philippine Nursing Research Society.