Surgical Patient Preoperative Readiness: Translation into French, Cultural Adaptation for Switzerland and Cross-Sectional Exploratory Study in a Tertiary Hospital.

PURPOSE: Preoperative evaluation of elective surgery patients traditionally focuses on somatic and organizational aspects of the situation. Patient feelings of readiness, called preoperative readiness (PR), impacts postoperative outcomes, and yet is rarely evaluated. The Preoperative Assessment Tool (PART) is a validated and reliable 15-item questionnaire available in Filipino and English. A reliable tool is essential for evaluating PR within the Swiss health context to offer optimized and comprehensive perioperative care. The aim of this study was to both translate into French and adapt culturally the Preoperative Assessment Tool for Switzerland's francophone population, and to explore patient PR in the preoperative consultation within a Swiss tertiary hospital. DESIGN: A mixed design with methodologic phases and descriptive study. METHODS: A mixed design in two phases with a methodologic phase with (1) translation and (2) cultural adaptation for Romandie of the PART, following Wild's 10 steps methodology (n = 11) and (3) a cross-sectional exploratory descriptive study with pilot testing of the translated version in a general elective preoperative consultation in a tertiary hospital in Romandie (N = 88). FINDINGS: Translation and cultural adaptations are well accepted and understood by the participants (n = 9/11), modifications are accepted by the authors and deemed adequate by the participants (n = 11/11). Time of completion is short (m = 69.06 seconds) and adapted to clinical context. The translated version has a Cronbach (α = 0.85) comparable to the original validated scale (α = 0.86). CONCLUSIONS: The translation and cultural adaptation for Switzerland of the PART was achieved, and PR was explored. Further psychometric testing of the PART-FrenCH must be conducted to assess fully the tool before its use in a clinical setting. Including PR in preoperative evaluations could enhance patient-centered approaches and lead to improvement in the quality of care.

A home environment-moderated model of the influence of ergonomics on individual work performance among Filipino nurse educators working from home during the COVID-19 pandemic: An interaction moderation analysis using structural equation model.

AIM: To determine the influence of ergonomics on individual work performance of nurse educators working at home during the COVID-19 pandemic and to develop a model of the moderating effect of home environment. DESIGN: Cross-sectional, predictive-correlational design. METHODS: Utilizing interaction moderation and structural equation modeling, 214 consecutively-selected educators from nursing schools in the Greater Manila Area, Philippines completed a four-part online survey. RESULTS: Physical, cognitive, and organizational ergonomics positively influenced individual work performance. Home environment had a linear, positive moderation on the effects of physical and cognitive ergonomics on individual work performance but had a negative moderating effect with organizational ergonomics. CONCLUSION: The moderated model underscored the positive effects of ergonomics and the moderating effect of home environment on the individual work performance of nurse educators working at home during the COVID-19 pandemic, and this knowledge can be used in developing appropriate programs, strategies, and policies. IMPACT: The moderated model highlights the need for policies and programs, training and education, and organizational evaluation geared towards promoting healthy workplace and work-life balance among nurse educators transitioning to remote work and online teaching. PATIENT OR PUBLIC CONTRIBUTION: Eligible participants contributed in the data collection with the survey responses.

Social connectedness and health-related quality of life among patients with cancer undergoing chemotherapy: A mixed method approach using structural equation modelling and photo-elicitation.

OBJECTIVE: To develop and test the model of association of social connectedness and health-related quality of life (HRQoL) among patients with cancer undergoing chemotherapy and to describe their social connectedness through photo-elicitation. BACKGROUND: Social connectedness has been empirically associated with several well-being outcomes. However, little is known on the association of social connectedness among patients with cancer undergoing chemotherapy. METHODS: Employing a mixed-methods design following the good reporting of a mixed methods study guideline, the quantitative approach involved 230 consecutively-selected patients with cancer undergoing chemotherapy who answered a three-part survey. From these patients, six informants participated in the photo-elicitation and key informant interview sessions. Gathered data were quantitatively analyzed using structural equation modelling and qualitatively processed using polytextual thematic analysis. RESULTS AND FINDINGS: Social connectedness had a positive influence on social well-being (ß = .22, p = .008) and emotional well-being (ß = .20, p = .023); however, it had a negative effect on functional well-being (ß = -.20, p = .007). The overall model revealed good model indices: χ2 /df = .82, RMSEA = .01, GFI = 1.00. Qualitative analysis culled from photo-elicitation uncovered five interconnected themes yielding the Honeycomb model of social connectedness which was composed of correspondence, cohesion, constitution, convergence and corroboration. CONCLUSION: HRQoL among patients with cancer undergoing chemotherapy is a multi-factorial health construct affected by social connectedness. The presented model emphasises the importance of social connectedness and paves way for the development of appropriate strategies to promote social connectedness among patients with cancer undergoing chemotherapy. RELEVANCE TO CLINICAL PRACTICE: The findings provide impetus in the modification and development of appropriate practices, policies and strategies in promoting social connectedness. These approaches are geared towards patient-family empowerment and health education techniques to ascertain that assistance from significant others is provided without limiting the patient's autonomy or independence.

Adaptation of the pain management self-efficacy questionnaire into Turkish.

OBJECTIVES: The aim of this study is to examine the Turkish validity and reliability of the Pain Management Self-Efficacy Ques-tionnaire (PMSEQ). METHODS: The study was carried out descriptively and methodologically between September and December 2018 with 214 nurses and 248 nursing students. The data were collected using the descriptive characteristics form and the PMSEQ. RESULTS: Cronbach's alpha internal consistency coefficient was 0.90 in the total scale. In repeated measurements to test time reliability, there was no statistically significant difference between the two measurements (t=0.320, p=0.751), and there were a high power and positively highly significant relationship (r=0.997, p<0.001). CONCLUSION: Turkish version of the PMSEQ can be used as a valid and reliable scale in assessing the self-efficacy of clinical nurses and nursing students in pain management.

Exploring the challenges and needs of home caregivers of hemodialysis patients in the Philippines: A mixed methods study.

OBJECTIVES: Although the importance of home caregivers of chronic kidney disease patients has been increasingly recognized, their perceived caregiving difficulties and requisites remain underexplored. This study investigated the challenges and needs of home caregivers of hemodialysis patients in the Philippines. METHODS: We utilized a mixed-method (QUAN + qual), explanatory sequential design. Data were collected from July 2017 to May 2018 from 46 home caregivers of hemodialysis patients. A three-part researcher-made survey were developed from literature search, personal values and cultural context, while some items were generated from a standardized tool that measures caregiver infrastructure and needs of those caring from frail US veterans. The tool developed gathered the participants' profile, caregiving characteristics, and related needs. The tool was validated and pretested for reliability. Fifteen participants were also interviewed to explore caregiving challenges and needs. Descriptive and χ2 statistics were used for quantitative outcomes, while thematic analysis was employed for qualitative data. RESULTS: Participants provided moderate assistance to patients, spending an average of 10.65 h/day and 5.08 days/week in caregiving. The most difficult caregiving circumstances were having costly expenses (78.26%); missing work (50.00%); and experiencing negative feelings (47.83%), stress (43.48%), and physical difficulties (34.78%). They also had the lowest confidence in deciding when to contact health providers (x̅ = 3.31, SD = 0.94) and finding patient care services (x̅ = 2.93, SD = 1.08). Qualitative findings further revealed caregiving needs and challenges in cost management, physical and psychological health, assumption of multiple roles, lifestyle adjustment, and reinforcement of carer knowledge, skills, and attitudes. CONCLUSION: Supportive strategies are needed to address the challenges encountered by home caregivers of hemodialysis patients. Findings can be utilized in developing appropriate interventions for home caregivers in low-resource settings where home caregiving and healthcare system issues, such as lack of access to resources and social support, are prevalent.

Social support from nurses and non-adherence with directly observed therapy (DOTS) maintenance phase among patients with tuberculosis in Metro Manila, Philippines.

OBJECTIVE: To determine the influence of community health nurses' social support on non-adherence with the maintenance phase of directly observed therapy (DOTS) among patients with tuberculosis (TB). DESIGN: Prospective-cohort. SAMPLE: One hundred purposively selected patients with TB starting with DOTS maintenance phase. MEASUREMENTS: Participants answered the robotfoto and Berlin Social Support Scale (BSSS) to assess demographics and social support provided by nurses. Non-adherence was measured using the attendance record and documented in an abstraction form. Cox proportion-hazards regression determined the influence of social support provided by nurses to non-adherence. RESULTS: With a median adherence of 3 weeks, 15% of the sample was non-adherent. The hazard of non-adherence was lower with high perceived emotional support (HR = 0.25, p = .046), perceived instrumental support (HR = 0.20, p = .044), perceived support seeking (HR = 0.27, p = .045), and received emotional support (HR = 0.45, p = .045). High received emotional support increased non-adherence (HR = 2.65, p = .039). CONCLUSION: Social support from nurses influenced DOTS non-adherence among patients with TB, a critical issue in the development of drug-resistance. Perceived emotional, instrumental, support seeking and received emotional support decreased the hazard of non-adherence, while received emotional support increased non-adherence. This study highlights the need to promote positive perception of instrumental support needs. Appropriate interventions should be provided to promote support-seeking skills.

Cross-Cultural Validation Into Filipino of the Consumer Assessment of Health-Care Providers and Systems Surgical Care Survey (S-CAHPS).

Surgical experience is increasingly being recognized; however, Consumer Assessment of Health-Care Providers and Systems Surgical Care Survey (S-CAHPS), the tool for surgical experience, is available in English and Spanish only. To measure surgical experience among Filipinos, a culturally appropriate version should be validated. This study culturally adapted the S-CAHPS into Filipino. A five-step cross-cultural validation study was conducted. Language experts conducted forward translation, back translation, and panel reconciliation. Pretesting included content validation and pretesting of the Filipino S-CAHPS. Field testing involved 55 purposively selected postoperative patients who completed a 3-part survey from March to July 2018. The English S-CAHPS was reduced to 34 items to account cultural variations, yielding an item content validity index (I-CV) of 1.00. One-sample t test and Bland-Altman plots showed good linguistic equivalence. Correlation coefficients were ≥0.30, suggestive of good conceptual equivalence. Cronbach's alpha values were 0.83 and 0.85 indicative of good reliability. The Filipino S-CAHPS showed acceptable psychometric properties. It is a valid and culturally appropriate instrument to measure surgical experience among Filipinos which can be utilized for quality improvement measures on both practice and policy levels.

Psychometric Properties of the Filipino Version of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS): A Cross-Cultural Validation Study.

Albeit the importance of patient experience, most questionnaires are only available in English. To understand the hospital experience of Filipino patients, a psychometrically sound instrument in Filipino is warranted. This study culturally adapted and validated the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) into Filipino. A 5-step cross-cultural validation process was conducted. Forward translation, back-translation, and panel reconciliation involved 7 language experts. Pretesting included content validation and pretesting of the Filipino HCAHPS, while field testing involved 64 purposively selected hospitalized patients who completed a 4-part survey from July to December 2018. Content, linguistic, and conceptual equivalence and internal consistency were statistically appraised. Content validation yielded a scale content validity index/average of 1.00. Comparative analysis and Bland-Altman plots indicated good linguistic equivalence. All correlation coefficients were ≥.30, denoting good conceptual equivalence. Cronbach's α for both versions of HCAHPS were ≥0.80, suggestive of good internal consistency. The Filipino HCAHPS is a psychometrically sound and culturally appropriate tool to measure patient experience among Filipinos. This understanding can be utilized for quality improvements on both practice and policy levels.

A conjoint analysis of the communication preferences of registered nurses towards mechanically ventilated patients.

BACKGROUND: The nurse-patient communication is a dyadic process involving the transmission and recognition of information and feelings. However, communication difficulty is a common phenomenon among mechanically ventilated patients which causes distress among patients and may compromise the quality of patient care that nurses provide. AIM: To explicate the communication preferences of registered nurses towards mechanically ventilated patients. DESIGN: Cross-sectional, choice-based conjoint analysis METHODS: From August to November 2017, 201 purposively selected registered nurses with prior experience in caring for mechanically ventilated patients were surveyed and ranked 12 choice bundles with four selected attributes of the communication process. RESULTS: Family participation was the most important attribute (40.40%) while communication initiator was the least important attribute (15.44%). Registered nurses prefer to communicate with mechanically ventilated patients if family members are involved (utility = 1.03), if conventional communication equipment are used (utility = 0.24), if open-ended questions are asked (utility = 0.13), and if nurses are the communication initiator (utility = 0.22). CONCLUSION: The model of communication preferences highlights the importance of involving the family in the communication process and can inform family-centered policies for mechanically ventilated patients. Unit policies on the use of conventional communication equipment should be considered to maximize the nurse-patient communication and potentially improve patient care.

Occupational determinants of compassion satisfaction and compassion fatigue among Filipino registered nurses.

AIMS AND OBJECTIVES: To determine the prevalence and to identify the occupational determinants of compassion satisfaction and compassion fatigue among general medical-surgical registered nurses. BACKGROUND: Compassion fatigue and compassion satisfaction are caring concepts that have been explored among nurses in specialised hospital units. However, there is paucity of studies exploring the occupational determinants among general medical-surgical registered nurses. DESIGN: Cross-sectional. METHODS: From August-November 2017, 121 consecutively selected general medical-surgical registered Nurses from five hospitals completed a four-part survey packet composed of the participant information sheet, the Professional Quality of Life Version 5, the McCloskey-Mueller Satisfaction Scale and the Eden Warmth Survey-Employee Questionnaire. Stepwise-forward multiple linear regression was employed to identify the occupational determinants of compassion fatigue and compassion satisfaction. The STROBE checklist was followed in reporting this study (see Appendix S1). RESULTS: The prevalence of moderate to high levels of compassion satisfaction was 90.09% while burnout and secondary stress, the facets of compassion fatigue, had a prevalence of 74.38% and 83.47%, respectively. Among the identified occupational determinants, only job satisfaction and nurse colleague relationship positively influenced compassion satisfaction. In contrary, although higher monthly income positively influenced both dimensions of compassion fatigue, nurse colleague relationship had the strongest negative effect. CONCLUSION: Among the occupational determinants of compassion fatigue and compassion satisfaction, nurse colleague relationship had the strongest influence. This result highlights the importance of positive nurse colleague relationships and paves way for the development and initiation of appropriate strategies. RELEVANCE TO CLINICAL PRACTICE: The findings of this study paves way for the development of institutional policies and individualised programmes geared towards building rapport and communication among registered nurses assigned in general medical-surgical units. Likewise, the high prevalence of compassion fatigue needs further exploration to develop appropriate measures to mitigate its development among general medical-surgical nurses.

A conjoint analysis of the acute and critical care experiential learning preferences of Baccalaureate student nurses.

With the increasing need for competent nurses specializing in acute and critical care, educators must consider the needs and preferences of students in designing experiential learning programs. This cross-sectional, choice-based conjoint analysis determined the acute and critical care experiential learning preferences of student nurses. From March to July 2016, 213 randomly-selected student nurses from a higher education institution in Manila, Philippines were surveyed and ranked 20 choice bundles with 5 selected attributes of the experiential learning program. Results showed that duration of unit exposure (48.73%) and group structure (7.46%) were the most and least valued attributes, respectively. Additionally, student nurses prefer an experiential learning program that lasts for 1 week (21 h) per unit (utility = 0.93), has a stay-in instructor (utility = 0.30), encourages full student involvement (utility = 1.08), deploys 2-3 students per group (utility = 0.09), and provides both single program and on-going unit orientation (utility = 0.52). Part-worth utilities of duration of unit exposure (t = 3.65, p = 0.0001) and group structure (t = 3.46, p = 0.001) differed between gender. With a model explaining the acute and critical care experiential learning preferences of student nurses, nursing institutions can restructure their clinical placement to maximize positive learning.

Fluid distribution timetable on adherence to fluid restriction of patients with end-stage renal disease undergoing haemodialysis: Single-blind, Randomized-Controlled Pilot Study.

AIM: To determine the effects of a fluid distribution timetable on adherence to fluid restriction of patients with end-stage renal disease undergoing haemodialysis. BACKGROUND: Fluid restriction is necessary among patients with chronic kidney disease. However, treatment adherence remains a challenge. DESIGN: Single-blind, randomized-controlled pilot study. METHODS: From September - December 2016, 24 consecutively-selected patients with end-stage renal disease from a single dialysis clinic were randomly assigned using computer-generated sequences of randomly permuted blocks stratified according to gender to receive the fluid distribution timetable or standard care. Adherence to fluid restriction was measured using two indicators-thirst and interdialytic weight gain- and were compared using One-way RM-MANOVA and MANCOVA. Secondary outcomes included baseline patient demographic and clinical characteristics and were compared according to treatment allocation. Both groups were followed-up for 4 weeks, assessing outcome measures during the second haemodialysis session for each week. RESULTS: At baseline, the demographic and clinical characteristics and indicators of adherence to fluid restriction were comparable between the two groups. Thirst scores, however, were statistically lower in the treatment group than the control group on the fourth week follow-up. There was also a remarkable decrease from baseline thirst and interdialytic weight gain scores in the treatment group, with partial eta-squared of 0.43 and 0.39, respectively. CONCLUSION: The fluid distribution timetable was an effective adjunct treatment strategy in promoting adherence to fluid restriction. However, since this is just a pilot study, further investigation must be conducted to determine the effects of fluid distribution timetable. TRIAL REGISTRATION: NCT03582592.

Effectiveness of a community-based health programme on the blood pressure control, adherence and knowledge of adults with hypertension: A PRECEDE-PROCEED model approach.

AIMS AND OBJECTIVES: To determine the effectiveness of a community-based health programme grounded on the PRECEDE-PROCEED model, on the knowledge, adherence and blood pressure control of community-dwelling adults with hypertension. BACKGROUND: Hypertension has consistently been a leading cause of morbidity and mortality in different countries and has continuously increased in prevalence. Albeit manageable with lifestyle modification and anti-hypertensive medications, adequate knowledge and poor adherence to these treatment regimens are issues that have led to poor blood pressure control. DESIGN: Quasi-experimental, one-group pretest-post-test design. METHODS: The PRECEDE-PROCEED model was used to develop and evaluate the effectiveness of the community-based health programme. From August to October 2017, a total of 50 community-dwelling adults with hypertension participated in the programme which included blood pressure monitoring, targeted health educations, motivational interviews, individualised lifestyle modification plans and house-to-house visits. Knowledge, adherence and blood pressure were assessed at the start and at the end of the 2-month programme. Gathered data were analysed using descriptive statistics and RM-MANOVA. The TREND checklist was followed in reporting this study (See Appendix S1). RESULTS: After 2 months, the mean adherence, systolic blood pressure and diastolic blood pressure significantly improved, attributing more than 25% of the change. Although knowledge scores were significantly higher after the programme, it only accounted 9% of the improvement. CONCLUSION: This study provides evidence on the effectiveness of a community-based health programme grounded on the PRECEDE-PROCEED model on the knowledge, adherence and blood pressure control of community-dwelling adults with hypertension. RELEVANCE TO CLINICAL PRACTICE: The community-based health programme is beneficial to community-dwelling adults with hypertension in promoting knowledge and adherence to treatment regimen and improving BP control. This study also provides a framework for developing new or enhancing existing programmes on hypertension in the Philippines.

Characteristics of a critical care clinical placement programme affecting critical care nursing competency of baccalaureate nursing students: A structural equation modelling.

AIM AND OBJECTIVES: To evaluate and determine the characteristics of a critical care clinical placement programme affecting the critical care nursing competency of baccalaureate nursing students. BACKGROUND: The increase in global demand for competent critical care services and human resources translates to an educational focus in preparing students for their eventual role as critical care health professionals. Albeit clinical placement in critical care units can promote competency, evidence supporting such claim remains inadequate. DESIGN: Cross-sectional, descriptive correlational design. METHOD: Employing structural equation modelling, 236 randomly selected baccalaureate nursing students from a clinically intensive university in the Philippines were recruited from January-March 2016. A three-part online survey, composed of the robotfoto, Critical Care Nursing Rotation Evaluation Questionnaire, and Intensive and Critical Care Nursing Competence Scale, was completed. The STROBE checklist was followed in reporting this study. RESULTS: Five characteristics of clinical placement were extracted as follows: sufficient clinical exposure, adequate area orientation, supportive clinical instructor, diversified medical cases and supplemental learning resources. Four characteristics affected critical care nursing competency and built a good model (χ2 /df = 1.52; comparative fit index = 0.94; parsimonious normal fit index = 0.77; root mean square error of approximation = 0.047). Adequate area orientation had the most diverse influence on all competency domains, while supportive clinical instructor had the strongest positive influence on critical care nursing skill (ß = 0.30, p = 0.005). CONCLUSION: The model highlights the characteristics of a critical care clinical placement programme which influences critical care nursing competency among nursing students. It emphasised the importance of a supportive clinical instructor and adequate area orientation in promoting critical care nursing skills and values and attitude. RELEVANCE TO CLINICAL PRACTICE: The proposed model highlights the role of clinical instructors and appropriate orientation which provides impetus in improving the clinical placement design to maximise competency development.

Moderating effect of occupational stress on spirituality and depression of Registered Nurses in tertiary hospital: A structural equation model.

AIM: The aim of this study was to determine the influence of spirituality to depression and to determine the moderating effect of occupational stress among Registered Nurses. BACKGROUND: Depression is a major contributor to the global burden of disease and it is influenced by several factors. Spirituality can be a protective factor against depression. However, it remains underexplored among nurses who experience several precipitating factors of depression, including occupational stress. DESIGN: Cross-sectional, predictive-correlational study. METHODS: From August - December 2017, 242 purposively selected nurses from selected tertiary hospitals completed a four-part survey packet composed of the "robotfoto," Spirituality Assessment Scale, Expanded Nursing Stress Scale, and Beck's Depression Inventory-II. Structural equation modelling analysed the influence of spirituality to depression, while multigroup analysis determined the moderating effect of occupational stress. RESULTS: "Personal faith, spiritual contentment, and religious practice" negatively influenced depression, generating a good model. Occupational stress significantly moderated the influence of spirituality to depression, with a significant inverse U-shaped effect for both "personal faith" and "religious practice" and a non-significant decreasing effect for "spiritual contentment". CONCLUSION: The stress-moderated model of the influence of spirituality to depression highlights three significant points. First, there is a need to develop individualized, spiritually based interventions based on the spiritual needs of Registered Nurses. Second, policies geared towards positive spirituality in the workplace and spiritual support to nurses must be explored. Finally, nurse managers must identify the sources of occupational stress and implement stress-reducing programmes in the workplace.

Scale Development and Psychometric Evaluation of the Preoperative Assessment of Readiness Tool.

PURPOSE: Technology has greatly advanced surgical capacity; however, the patient's perspective of surgical readiness remains unexplored. There is also a paucity of psychometrically sound instruments quantifying surgical readiness. Hence, this study developed and psychometrically evaluated the Preoperative Assessment of Readiness Tool (PART). DESIGN: A methodological study. METHODS: An initial 25-item questionnaire was developed after preliminary interviews and literature review. Psychometrics included content and construct validity and internal consistency. PART was tested on 210 purposively selected preoperative patients and preliminary factor analyses examined two random halves of the sample. FINDINGS: The questionnaire was reduced to 21 items after content validation and was further reduced to 15 items after preliminary factor analyses. Final factor analysis extracted two factors: quality information acquisition and supportive interpersonal care assimilation. Scale reliability was 0.97 with acceptable subscale reliability. CONCLUSIONS: The 15-item Preoperative Assessment of Readiness Tool demonstrated satisfactory psychometrics in assessing perceived surgical readiness. Nonetheless, further analysis is warranted to guarantee robust cross-cultural and cross-geographical comparisons.

Developing and testing a model of quality of life among chronically-ill, community-dwelling older adults: A structural equation model.

PURPOSE: Although healthy ageing aims for better quality of life, the inability of older adults to adequately care for themselves and their health impair the realization of such objective. Moreover, in a collectivist community like the Philippines, the family, community, and Transcendent are inseparable in promoting quality of life. This study developed and tested a model of quality of life (QoL) among chronically-ill, community-dwelling older adults. MATERIALS AND METHODS: From August to November 2017, a cross-sectional study of 304 chronically-ill, community-dwelling older adults from selected rural communities in the Philippines was conducted. Respondents completed a five-part survey packet composed of the socio-demographic profile, modified Older People's Quality of Life, Spirituality Assessment Scale, Hypertension Self-Care Profile, and Diabetes Self-Management Questionnaire. RESULTS: Socio-demographics, community satisfaction, spirituality, and disease self-management accounted 29.00% of QoL, generating a good model (χ2/df = 1.44, RMSEA = 0.038, and PNFI = 0.64). Spirituality (ß = 0.34, p < 0.01) was the strongest predictor of QoL, while community satisfaction had both direct (ß = 0.26, p < 0.01) and indirect (ß = 0.08, p < 0.01) effects. Disease self-management directly (ß = 0.15, p = 0.016) influenced QoL. In contrast, longer chronicity and larger family size impair QoL. CONCLUSION: Quality of life among chronically-ill, community-dwelling older adults is a multi-faceted health construct influenced by socio-demographics, disease self-management, community satisfaction, and spirituality. The presented model highlights the positive effect of disease self-management, community satisfaction, and spirituality which can be utilized in developing appropriate community-based geriatric strategies, policies, and programs. Further, forming collaborative groups with socially-active community elderly and community-based self-care programs can be ventured to address the needs of older adults.

Development and psychometric appraisal of the Pain Management Self-Efficacy Questionnaire.

AIM: The aim of this study was to develop and psychometrically evaluate the Pain Management Self-Efficacy Questionnaire. BACKGROUND: Pain management competence and confidence are important in rendering safe and effective patient care. However, there is a lack of psychometrically sound instruments measuring pain management self-efficacy. DESIGN: Triphasic, prospective psychometric study. METHOD: A 55-item Pain Management Self-Efficacy Questionnaire was initially developed after extensive theoretical and literature review. The questionnaire was evaluated by content experts for content validity and a consensus was achieved after two iterations. After pretesting, the Pain Management Self-Efficacy Questionnaire was distributed to 420 randomly selected pre-graduate student nurses and registered nurses from a nursing institution and a tertiary hospital. Data collection was conducted from January 2015 - 2016. Assessment parameters included basic item analysis, reliability analysis, floor and ceiling effects and construct validity using factor analysis and "known groups" technique. Replication analyses scrutinized two random halves of the sample. RESULTS: The initial 55-item questionnaire was reduced to 42 items after two iterations of validation. After preliminary factor analyses, the Pain Management Self-Efficacy Questionnaire was reduced to 21 items. Final factor analysis produced a three-factor model: Comprehensive, Evaluative and Supplemental Pain Management Self-Efficacy. Construct validation using Kruskal-Wallis and Mann-Whitney tests showed group differences according to years of clinical experience and receipt of pain management training. CONCLUSION: The 21-item Pain Management Self-Efficacy Questionnaire demonstrated satisfactory psychometric properties and can be used to measure pain management self-efficacy among nurses. Nevertheless, further psychometric validation is warranted accounting differences in culture and clinical practices.

Social media use profile, social skills, and nurse-patient interaction among Registered Nurses in tertiary hospitals: A structural equation model analysis.

BACKGROUND: Social media has become increasingly important over the past decades and has been integrated in various environments, including the healthcare setting. Yet, the influence of social media use on the social skills and nurse-patient interaction of nurses is an area in nursing that requires further studies. This study determined the interrelationships among social media use profile, social skills, and nurse-patient interaction of Registered Nurses in tertiary hospitals. METHODS: Employing structural equation modeling, a descriptive-correlational study was conducted among 212 consecutively-selected nurses from two tertiary hospitals. Consenting respondents completed a two-part survey composed of the respondent profile sheet and the Social Skills Inventory. The respondent profile sheet assessed demographic profile and social media use profile in terms of the mode, frequency, and duration of utilization. Three trained team members observed each nurse-patient dyad and completed the Nurse-Patient Bonding Instrument. RESULTS: A good fit model illustrated the negative effects of frequent social media use to patient openness (ß = -0.18, p < 0.05) and engagement (ß = -0.11, p ≤ 0.05). Longer use of social media on a daily basis, however, positively affected both dimensions of social skills. Accessing social media platforms using non-handheld devices showed the most influential positive effects to social skills and nurse-patient interaction. Additionally, although verbal social skills positively affected most dimensions of nurse-patient interaction, non-verbal social skills negatively influenced patient engagement (ß = -0.19, p = 0.019) and nurse openness (ß = -0.38, p ≤ 0.05). CONCLUSION: The structural model illustrates the effects of using social media on the social skills and nurse-patient interaction of nurses and emphasizes the need for implementing institutional policies on the judicious use and application of social media in the workplace. Further, social skills development programs geared toward having a balanced social skill must be implemented.

Assessment of Research Capacity Among Nursing Faculty in a Clinical Intensive University in The Philippines.

BACKGROUND: Many nursing studies are conducted in the United States, Europe, and Australia, where only a fourth of the world's population resides. There is a need to promote nursing research in Asia to enhance the contextual relevance of their evidence-based nursing interventions. A first step toward this goal is to determine the perceived research capacity among nursing faculty in academic settings in the Philippines. METHODS: This study described the perceived research capacity among nursing faculty of the University of Santo Tomas - College of Nursing, Manila, Philippines. The study used a survey that contained four sections: subject demographics; knowledge and skill on research designs and research process; research involvement, services, and incentives; and factors affecting research involvement. Chi-square test of homogeneity and MANOVA analyzed the gathered data. RESULTS: Findings showed that the faculty perceived themselves as knowledgeable and skillful in conducting research. However, current teaching assignments hindered their capacity to conduct research. University-sponsored incentives and college-based research services had also remained underutilized despite their availability. Overall, heavy teaching load was the greatest hindrance to research endeavors. CONCLUSION: Actions must be taken to reconfigure effort allocations with careful consideration of existing university and institutional bylaws.