UPCN - University of the Philippines College of Nursing

Research in UPCN

Research at the College of Nursing highlights its role in developing and advancing nursing science and in influencing policy decisions at all levels of decision-making. The faculty are actively involved in research activities based on the set research agenda of the College.

Most of the researches are funded particularly by the Philippine Council of Health Research and Development, Department of Health, and the UP Manila-National Institutes of Health.

The following are the research areas of the College:

  • Non-communicable Disease Prevention And Control
  • Care Of Older Persons And Those With Chronic Illness
  • Women’s Health And Care Of Children
  • Nursing Education
  • Community Health Nursing
  • Human Resources For Health

A. Non-communicable Disease Prevention And Control

This includes studies on identifying factors influencing compliance, service utilization, management, and effectiveness of intervention such as but not limited to smoking cessation, diabetes education, diet and physical activity strategies. This also includes mental health promotion.

The following are researches done by the faculty of the college on the area of non-communicable disease prevention and control.

Research Title

Compliance and Diabetes Management among the Faculty and Staff of the College of Nursing of UP Manila

Mejico, Merle F.

Development of a package of nursing services for the prevention and control of non-communicable disease

Tejero, Lourdes Marie S. Maderal, Vanessa Manila Tuazon, Josefina A.

Integrative Review on Hypertension among Filipinos

Dela Cruz, Felicitas Tuazon, Josefina A. Tejero, Lourdes Marie S. Santos, Marinelli

The Effects of Blood Pressure (BP) Measurement Educational Interventions on Adherence to BP Measurement Guidelines by Public Health Nurses (PHNs) 

Pagsibigan, Jesusa S.

The Development of Service Packages and Clinical Pathway Guidelines for Non-Communication Diseases

Lorenzo, Fely Marilyn E. Maderal, Vanessa Manila Poblete

The Validity and Effectiveness of an Investigator-designed Hypertension Training Program for Advanced Practice Nurses in the Philippines

Duller, Sarla F. Tating Dan Louie Renz P. Tejero, Lourdes Marie S.

The family as primary caregivers for the mentally Ill Patients in a psychiatric ward

Mejico, Merie F.

Effectiveness of eHealth Cardiac Rehabilitation for Health Outcomes of Patients with Coronary Heart Disease in China

Su, Jing Jing Paguio, Jenniffer T. Doris Sau Fung Yu

Effect of Training in Brief Advise on Smoking Cessation on Nurses’ Knowledge, Skills, Attitude and Practice

Cariaso, Josephine E.

B. Care Of Older Persons And Those With Chronic Illness

Concerns with improving support for older persons by establishing evidence on the effectiveness of intervention in the care of the elderly and identifying gaps in services among older persons.

The following are researches done by the faculty of the college on the area of care of older persons and those with chronic illness.

Fall Risk Among Urban Community Older Persons

Valera, Mary Joan Therese

Caregiver’s Burden and Context of Caregiving of Dementia Patients

Manahan, Lydia T.

A Phenomenal Journey in Compassionate Care for a Person with Dementia

Anonuevo, Cora A.

Nursing Interventions of Stoma Nurses and the Quality of Life of Patients with Fecal Ostomy (Thesis)

Batalla, Mary Grace Ann P. Balabagno, Araceli O.

Factors Affecting Adherence to Antiretroviral Therapy of Filipinos Living with HIV (Thesis)

De Torres, Ryan Q. Tuazon, Josefina A. (Thesis Adviser)

Are Health Behaviors and Risk Factors for Atherosclerotic Cardiovascular Disease Interrelated Among Older Filipinos in Underserved Communities

Flores, Jo Leah A. Cacciata, Marysol C. Hernandez, Mary Abigail A. Leyva, Erwin William A. Tuazon, Josefina A. Evangelista, Lorraine S.

Evaluation of the Effectiveness of an IAD Prevention Protocol on the Incidence of IAD among Acutely-ill Geriatric Patients in a Tertiary Hospital in Spain

Gaspar, Aldin D.

Assessing the Spiritual Well-Being of Filipino Cancer Patients: A Nursing Perspective

Tupaz, Alyssa Jenny E. Balabagno, Araceli O. (Thesis Adviser)

Health Impact of Climate Change in Older People: An Integrative Review and Implications for Nursing: Climate Change, Ageing, and Nursing

Leyva, Erwin William A. Beaman A Davidson PM

Loneliness Among Older Adults in Norway: A Longitudinal Study

Soberano, Julienne Ivan D.

Gerontology Nursing: Innovation in Education and Practice

Attitudinal outcomes of an interprofessional training program for health workers in the care of older adults in the Philippines: a longitudinal analysis

Siongco, Nakamura, Moncatar, Canila, Lorenzo, Seino

Resilience and Health-related Quality of Life of Filipino Older Persons in Flood-prone Communities

Leyva, Erwin William A. Patricia Davidson PhD RN FAAN Elizabeth Tanner PhD RN FAAN

C. Women’s Health and Care of Children

This includes studies on preconception care, postpartum care, and the first 1,000 days of the child.

The following are researches done by the faculty of the college on the area of women’s health and care of children.

The Role of Ayod Community Health Teams in Promoting Maternal and Infant Health in a Municipality in Ifugao, Philippines

Ngaya-an, Floreliz V.

Migration of Women from the Philippines: Implications for Health Care

Tejero, Lourdes Marie S.

Evaluation the Compliance of Essential Intrapartum Newborn Care Among Nurses in Selected Hospitals in Manila

Iellamo, Efrelyn A.

Culturally Congruent Health Promotion for Ifugao Women

Maternal Mortality in the Philippines: A lifecourse Perspective (Review of Data)

Peralta, Arnold B. Pacquiao, Dula F.

Patterns of Post Partum Home Visit and their Relationship with General Well-Being and Self-Efficacy of the Mother, Breast Feeding, Weight of the Infant, and Immunization (Dissertation)

Maternal and Child Health Promotion for the Ifugao in the Philippines

Ngaya-an, Floreliz V. Pacquiao, Dula F. De Torres, Ryan Q.

Promoting Parent-Adolescent Communication to Reduce Adolescent Sexual Risk Behaviours

Alvarez, Carmen Ngaya-an, Floreliz Abad, Peter James Maderal, Vanessa

Parental Role Affirmation of Parents of Children with Complex Health Needs for Home Care

Maderal, Vanessa Manila

Care Needs of Parents of Children with Cancer (Thesis)

Banayat, Aprille C. Peralta, Arnold B.

The Effectiveness of ParentUp as a Strategy to Provide Health Information among Pregnant Women and Mothers with Newborn from Low-Income Families

Iellamo, Efrelyn A. Raquedan, Regnard Raquedan, Liza

Decisional Conflict Among Parents of Children with Congenital Heart Disease: Towards Development of a Nursing Model (Dissertation)

So, Iris Chua Tuazon, Josefina A. (Dissertation Adviser)

Breastfeeding Practices and Level of Support Among Mothers in District 5 Manila

Tubera, Sophia A. Rosal, Melvin Joseph D. Stephanson, Zoe O. Tabungar, Kaezzy Ila B. Turingan, Angelo Joseph Uy, Kathleen Nicole T. Vibieda Jade Louise L. Villanueva, Mary Grace B. Ngaya-an, Floreliz V. Tuazon, Josefina A.

An Integrative Review of Home Visiting Programs for Mothers and Infants from Birth to 12 Months in Developed and Underdeveloped Countries

Ngaya-an, Floreliz V. De Torres, Ryan Q. Tejero, Ludy Marie S. Fowler, Cathrine

Strategies for Febrile Neutropenia in Children with Cancer: A Narrative Synthesis

Banayat, Aprille C.

D. Nursing Education

Studies under this area include impact evaluation of curricular programs in Nursing as well as testing effectiveness of teaching-learning methodologies.

The following are researches done by the faculty of the college on the area of nursing education.

Assessing Core Competencies and Professional Values of Faculty and Senior Nursing Students as Input to a competency-based Curriculum

Tuazon, Josefina A. Valera, Mary Joan Therese

Integration of the Promotion of safe motherhood in the nursing competency based curriculum

Peralta, Arnold B.

Teaching Learning Activities and Learning Experiences as Demonstrations of Integration of Safe Motherhood in the Nursing Competency- Based Curriculum

Status of Geriatric Nursing Education in Philippine Nursing Schools

Balabagno, Araceli O. Dela Vega, Shelley Ann F. Manahan, Lydia T. Abad, Peter James B.

Evaluation of the Implementation and Outcomes of Project RNHeals Batch 4 (Registered Nurse for Health Advancement and Local Service) in Enhancing Competencies and Employability of Entry-Level Nurses as Input to Policy and Programmatic Directions for Sustainability

Tuazon, Josefina A. Valera, Mary Joan Therese Abad, Peter James

Evaluation of a Government Deployment Project (RNHeals) for Unemployed Nurses as Input to Policy and Programmatic Directions

Evaluation of Process Recording as a Teaching/ Learning Tool in Mental Health Psychiatric Nursing Course

Student Attrition and Retention in the BSN Program as input to a Holistic Student Development Plan

Leyva , Erwin William A.

A Study on the Admission, Enrollment, Attrition and Graduation Patterns of Graduate Students accepted in the Master of Arts in Nursing & Doctor of Philosophy in Nursing in the College of Nursing

Tuazon, Josefina A. Denola, Mary Joy

Building Infra-structure for Health Education and Evidences Based Learning Programs to Promote Health Filipino Societies(I-HELP- FILIPINOS)

Tuazon, Josefina A. Hernandez, Mary Abigail Evangelista, Lorraine

Development of a Faculty Evaluation Scheme for UP College of Nursing

Peralta, Arnold B. Maderal, Vanessa

Relevance and Effectiveness of UPCN BSN Competency and Value based Curriculum towards an Outcome Based Curriculum

Peralta, Arnold B. Dones, Luz Barbara, Manahan, Lydia

Status of Interprofessional Education (IPE) Implementation in Asian Nursing Schools

Ngaya-an, Floreliz V. Peralta, Arnold B. De Torres, Ryan Q. Tuazon, Josefina A.

Technology in Open Nursing Education: Models in Teaching Nursing Research Online

Evio, Bettina

Student nurses’ level of satisfaction on the clinical learning experience in intensive care units

Formative evaluation of Philippine eHealth Strategic Framework and Plan

Bonito, Sheila R. Evio, Bettina D.

Transformative Scale UP of the “Tacloban Experiments” Post-Haiyan School of Health Sciences

Sana, EA, Atienza, Melflor A. Salvacion, Maria Lourdes Dorothy S. Peralta, Arnold B. Dones, Luz Barbara P. Paguio, Jenniffer T. Pastor, Claire D. David-Padilla, Carmencita M.

Role of the Nurse in Newborn Screening: Integrating Genetics in Nursing Education and Practice

Abad, Peter James B. Sibulo, Ma. Salve K. Sur, Aster Lynn D

Ethical Issues in Nursing Research

Tuazon, Josefina A.

Promotion of Safe Motherhood in the Nursing Competency-Based Curriculum

Peralta, Arnold B. Sana, Erlyn A.

Evaluating the Implementation of Urban Community-Oriented Health Initiatives and Activities within a Curricular Context

Hernandez, Mary Abigail A. Leyva, Erwin William A. Virtudazo, Jessa Mae P.; Dones, Luz Barbara P.

The usefulness of case studies in a Virtual Clinical Environment (VCE) multimedia courseware in nursing

Bonito, Sheila R.

Learning compassionate care: Experiences of nursing students

Su, Jing Jing Paguio, Jenniffer Torralba Masika, Golden Mwakibo Wang, Mian Redding, Sharon R.

Leadership Behavior of Dean’s of Colleges of Nursing and Faculty Job Satisfaction and Commitment

Ballena, Naressia S.

Developing the key competencies of the UP-Nurse Scientist: preliminary work to Ph.D. in Nursing curricular revision

Ngaya-an, Floreliz Paguio, Jenniffer Leyva, Erwin Peralta, Arnold Siongco, Kathryn Bonito, Sheila

Expanding the faculty capacity to help meet the increased national demand resulting from the addition of nursing informatics in the baccalaureate program: A Philippines experience

Pajarillo, Edmund J.Y. Bonito, Sheila R. Paguio, Jenniffer T. Cariaso, Josephine E.

Nursing Students’ Experience in High-fidelity Simulation-based Learning on Critically-ill Adult and Pediatric Patients

Gaspar, Aldin D. Banayat, Aprille C.

Use of Standards of Best Practice in Developing Simulation Scenarios in Nursing Education

E. Community Health Nursing

Concerns with establishing roles of the advanced practice nurses in public health nursing as well as validating indicators for community competence.

The following are researches done by the faculty of the college on the area of community health nursing.

Perceptions on Poisoning among Adult Urban Community Members

Valera, Mary Joan Therese Salvosa, Daity

Assessing Development Designing Better Indices of Poverty and Gender Equity Phase I & II

Anonuevo, Cora A. Castillo, Fatima Palaganas, Erlinda

Understanding Poverty and Gender: Narratives from the Field

Anonuevo, Cora A. Castillo, Fatima Palaganas, Erlinda Bracamonte, Nimfa

Cultural Beliefs on Disease Causation in the Philippines: Challenges and Implications in Genetic Counselling

Abad, Peter James B. Tan, M. L. Baluyot, M. M. P. Villa, A. Q. Talapian, G. L. Reyes, M. E. Laurino, M. Y.

Developing Community Based Health Program in Low Urban Settings

Leyva, Erwin William A.

Genetic Counseling in Asia: Profile of the Profession and Roles of Genetic Counselors

Abad, Peter James B. Laurino, Mercy Lee, Juliana Kejriwal, Saahil

Communication about Congenital Adrenal Hyperplasia: Perspective of Filipino Families.

Abad, Peter James B. Anonuevo, Cora & Daack-Hirsch Sandra & R. Abad Lorna & Padilla Carmencita & Laurino Mercy

Prevalence and Correlates of Depression, Anxiety, and Distress among Filipinos from Low-Income Communities in the Philippines

Flores, Jo Leah A. Hernandez, Mary Abigail Leyva, Erwin William Cacciata, Marysol Tuazon Josefina Evangelista, Lorraine

Normalizing Advanced Practice in Public Health Nursing in the Philippines: A Foucauldian Analysis

Posadas, John Joseph B. Dones, Luz Barbara P. Abad, Peter James B.

Facilitators and barriers to condom use among Filipinos: A systematic review of literature

De Torres, Ryan Q.

Fostering Partnerships between the Academe-Government and Community in the Covid-19 Pandemic Response in the Philippines

Tomanan, Kristine Joy L. Mabale, Maria Angela A. Abad, Peter James B. Bonito, Sheila R.

Building Leadership and Management Capacities of Public Health Nurses in the Philippines

Posadas, John Joseph B.

Promoting School Health Updating Urbani School Health Kit

Bonito S Iellamo E Abad PJ Hernandez MA

An Integrative Review of Interventions to Promote Culturally Congruent Care for Sexual and Gender Minorities

Competencies and Training Needs Assessment of Public Health Nurses in the Philippines

Cariaso, Josephine E. Sheila R. Bonito DrPH Luz Barbara P. Dones MPH Christiane Jannie B. Sebastian, RN

Oral Health Education Program and Competencies Among Nurses Whose Recipients are Totally Dependent Patients. (Thesis)

Ragotero, Ina G.

The Effectiveness of a Training Program for Advanced Practice Nurses in the Philippines on the Care of Patients with Primary Hypertension

Duller, Sarla F. Tating, Dan Louie Renz P. Tejero, Lourdes Marie S.

F. Human Resources for Health

Nurse-Patient Dyads: Linking Nurse and Patient Characteristics to Patient Satisfaction

The mediating role of nurse-patient dyad bonding in bringing about patient satisfaction

Development and validation of an instrument to measure nurse-patient bonding

Policy Baseline and Recommendations for Allied Health Disciplines

Lam, Hilton Y. Shelley Ann F. dela Vega, Maria Concepcion C. Cabatan, Vicente O. Medina III, Araceli O. Balabagno, Tejero, Lourdes Marie S.

Determinants of Rural Retention of Human Resources for Health

Tejero, Lourdes Marie S. Leyva, Erwin William Abad, Peter James Santos, Marinelli

Global Perspectives of Caring: An Integrative Review

Link 1   Link 2

Leyva , Erwin William A. Peralta, Arnold B. Tejero,Lourdes Marie Santos, Marinelli A.

Parental Efficacy in Nursing Practice: A Concept Analysis and Derivation

Patient Safety Culture & Perceptions on Event Reporting in the National University Hospital

Paguio, Jenniffer T. Sy, Alvin Duke R. Co, Homer U.

Work on Environment of Nurses in the Philippines: A Preliminary Study

Dones, Luz Barbara P. Paguio, Jenniffer T. Bonito, Shiela R. Balabagno, Araceli O. Pagsibigan, Jesusa S.

Paguio, Jenniffer T. Caballes, Alvin B. Co, Homer U. Sy, Alvin Duke R.

Evaluation of Readiness of the ASEAN Members for the Mobility of Nurses in these Countries

Tejero Makimoto Said Koy Tungpunkom

Safety Culture & Safety Attitudes of Nurses in the National University Hospital

Paguio, Jenniffer T. Pajarillo, Edmund J.Y.

Transnational Care Workers from the Philippines and Indonesia under the JPEPA

Añonuevo, Cora A.

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

Mariano MCO Maniego JCM Manila HLMD Mapanoo RCC Maquiran KMA Macindo JRB Tejero, Lourdes Marie S Torres, Gian Carlo S

Nursing Workforce in the Philippines

Bonito, Sheila R. Pagsibigan, Jesusa S. Balabagno, Araceli O. Serreneo, Kate Anjelyn C.

Perceived Roles and Professional Identity of Psychiatric Mental Health Nurses in selected Hospital-Based Psychiatric Settings in Metro Manila (Thesis)

Mabale, Maria Angela A. Mejico, Merle F. (Thesis Adviser)

Determinants of Anticipated Turnover of Nurses in Selected Hospitals in Metro Manila (Thesis)

Adajar, Gracielle Ruth M. Tuazon, Josefina A. (Thesis Adviser)

Determining the Required Skill Mix to deliver Primary Health care Services Across Various Rural and Urban Communities

Dones, Luz Barbara P. Abad, Peter James Medina, Vicente Cordero, Anthony

Medication Errors Among Adult Patients in Acute Care Settings: An Integrative Review

Improving Nurses Work Environments (NWE) in the Philippines

Paguio, Jenniffer T. Doris SF Yu, PhD

Capacity Needs Assessment of Primary Health Care Providers in Selected Municipalities in Cavite

Almoneda, Irma A. Bonito, Sheila R. Dones, Luz Barbara P. Tuazon, Josefina A.

A Mixed Methods Study to Evaluate the Effects of a Teamwork Enhancement and Quality Improvement Initiative on Nurses’ Work Environment

Defining Compassionate Nursing Care

Su, Jing Jing Golden Mwakibo Masika Paguio, Jenniffer Torralba Reding, Sharon R.

Systematic review of interventions to improve nurses’ work environments

Paguio, Jenniffer T. Yu, Doris SF. Su, Jing Jing.

Skill Mix in Delivering Primary Health Care Services: Context and Implications to Public Health Nursing

Dones Abad Medina III Cordero Hernandez MA

Production, Recruitment, and Retention of Health Workers in Rural Areas in the Philippines

Tejero, Lourdes Marie S. Erwin William A. Leyva, RN, MPH, PhD Peter James B. Abad, RN, MSc Diana Montorio, RN Ma. Leoant Santos, RN

Nurses in advanced roles as a strategy for equitable access to healthcare in the WHO Western Pacific region: a mixed methods study

Sue Kim Tae Wha Lee Gwang Suk Kim Eunhee Cho Yeonsoo Jang Mona Choi Seoyoung Baek David Lindsay Sally Chan Regina L. T. Lee Aimin Guo Frances Kam Yuet Wong Doris Yu Sek Ying Chair Yoko Shimpuku Sonoe Mashino Gigi Lim Sheila Bonito Michele Rumsey Amanda Neill Indrajit Hazarika

Capacity building of primary health care providers in 10+3 Southeast and East Asian Nursing Education and Research Network (SEANERN) countries

Bonito, Sheila R. Tuazon, Josefina A. Dones, Luz Barbara P.

Disaster Nursing Competencies: Nurses’ Perceived Competence and Need for Training

Developing Capacities of Professional Nurses on Disaster Risk Reduction and Management in the Philippine Nurses Association

Evio, Bettina D. Bonito, Sheila R.

Health Workforce Development in Health Emergency and Disaster Risk Management: The Need for Evidence-Based Recommendations

Kevin K. C. Hung Hung KKC Mashino S Chan EYY MacDermot MK Balsari S Ciottone GR Della Corte F Dell’Aringa MF Egawa S Evio, Bettina D. Hart A Hu H Ishii T Ragazzoni L Sasaki H Walline JH Wong CS Bhattarai HK Dalal S Kayano R Abrahams J Graham CA.

Barriers and facilitators of productivity while working from home during pandemic

Seva, Rosemary R. Tejero, Lourdes Marie S. Fadrilan-Camacho, Vivien Fe F.

Methods of Culturally Sensitive Disaster Nursing Focusing on Pacific Rim Island Countries

Tuazon, Josefina A. Miki Muratani Mihoko Uebayashi Yukiko Anzai Kame Takase Sanae Haruyama Hiroko Okuda Nahoko Harada Tuazon, Anna Cristina

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Handbook of Medical and Health Sciences in Developing Countries pp 1–22 Cite as

Nursing Education, Practice, and Research in the Philippines

  • Yaser Mohammed Al-Worafi   ORCID: orcid.org/0000-0002-5752-2913 2 , 3  
  • Living reference work entry
  • First Online: 26 March 2024

This chapter aims to discuss nursing education, practice, and research-related issues in the Philippines. Moreover, it described the achievement in education, practice, and research in the country. This chapter will describe the challenges facing education in the country and suggest the recommendations to overcome these challenges, challenges facing the practice in the country and suggest the recommendations to overcome these challenges, and challenges facing the research in the country and suggest the recommendations to overcome these challenges. Moreover, online education, practice, and research will be discussed in this chapter; facilitators for the best online education, practice, and research will be explained; and finally, the barriers to the implementation of online education, practice, and research will be discussed with the recommendations to overcome it.

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Abd Rahim, N. H., Ming, L. C., Al-Worafi, Y. M. A., & Sarker, M. M. R. (2016). A regulatory review for products containing glutathione. Archives of Pharmacy Practice, 7 (5), S57.

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Al-Meman, A., Al-Worafi, Y. M., & Saeed, M. S. (2014). Team-based learning as a new learning strategy in pharmacy college, Saudi Arabia: Students’ perceptions. Universal Journal of Pharmacy, 3 (3), 57–65.

Al-Mohamadi, A., Halboup, A. M., Ibrahim, M. I. M., Abdulghani, M., Al-Worafi, Y. M., Otham, G., et al. (2018). Medical and pharmacy students’ perceptions regarding generic medicines in Yemen. Journal of Pharmacy Practice and Community Medicine, 4 , 47–50.

Al-Qahtani, I., Almoteb, T. M., & Al-Warafi, Y. (2015). Competency of metered-dose inhaler use among Saudi community pharmacists: A simulation method study. RRJPPS, 4 (2), 37–31.

Alshahrani, S. M., Alakhali, K. M., & Al-Worafi, Y. M. (2019a). Medication errors in a health care facility in southern Saudi Arabia. Tropical Journal of Pharmaceutical Research, 18 (5), 1119–1122.

Alshahrani, S. M., Alavudeen, S. S., Alakhali, K. M., Al-Worafi, Y. M., Bahamdan, A. K., & Vigneshwaran, E. (2019b). Self-medication among King Khalid University students, Saudi Arabia. Risk Management and Healthcare Policy, 12 , 243–249.

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Alshahrani, S. M., Alakhali, K. M., Al-Worafi, Y. M., & Alshahrani, N. Z. (2020a). Awareness and use of over the counter analgesic medication: A survey in the Aseer region population, Saudi Arabia. International Journal of Advances in Applied Sciences, 7 (3), 130–134.

Alshahrani, S. M., Alzahran, M., Alakhali, K., Vigneshwaran, E., Iqbal, M. J., Khan, N. A., et al. (2020b). Association between diabetes consequences and quality of life among patients with diabetes mellitus in the Aseer province of Saudi Arabia. Open Access Macedonian. Journal of Medical Sciences, 8 (E), 325–330.

Al-Worafi, Y. M. (2013a). Pharmacy education in Yemen. American Journal of Pharmaceutical Education, 77 (3).

Al-Worafi, Y. M. (2013b). Do community pharmacists need a workshop about MDI use? Journal of Pharmacy Practice and Research, 43 (2), 165.

Al-Worafi, Y. (2013c). Towards supporting clinical pharmacy research in Arabic countries. Journal of Pharmacy Practice and Research, 43 (3), 247–248.

Al-Worafi, Y. M. (2014a). The challenges of pharmacy education in Yemen. American Journal of Pharmaceutical Education, 78 (8).

Al-Worafi, Y. M. (2014b). Pharmacy practice and its challenges in Yemen. The Australasian Medical Journal, 7 (1), 17.

Al-Worafi, Y. M. (2014c). Prescription writing errors at a tertiary care hospital in Yemen: Prevalence, types, causes and recommendations. American Journal of Pharmacy and Health Research, 2 , 134–140.

Al-Worafi, Y. M. (2014d). Comment on: “Pharmacovigilance in the Middle East”. Drug Safety, 37 (8), 651.

Al-Worafi, Y. M. A. (2015). Appropriateness of metered-dose inhaler use in the Yemeni community pharmacies. Journal of Taibah University Medical Sciences, 10 (3), 353–358.

Al-Worafi, Y. M. A. (2016). Pharmacy practice in Yemen. In Pharmacy practice in developing countries (pp. 267–287). Academic Press.

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Al-Worafi, Y. M. (2017). Pharmacoeconomics education in Yemen. Currents in Pharmacy Teaching & Learning, 9 (5), 945.

Al-Worafi, Y. M. (2018a). Knowledge, attitude and practice of yemeni physicians toward pharmacovigilance: A mixed method study. International Journal of Pharmacy and Pharmaceutical Sciences, 10 (10), 74–77.

Al-Worafi, Y. M. (2018b). Dispensing errors observed by community pharmacy dispensers in IBB–YEMEN. Asian Journal of Pharmaceutical and Clinical Research, 11 (11).

Al-Worafi, Y. M. (2018c). Evaluation of inhaler technique among patients with asthma and COPD in Yemen. Journal of Taibah University Medical Sciences, 13 (5), 488–490.

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Al-Worafi, Y. M. (2020b). Medications safety research issues. In Drug safety in developing countries (pp. 213–227). Academic Press.

Al-Worafi, Y. M. (2020c). Medications safety-related terminology. In Drug safety in developing countries (pp. 7–19). Academic Press.

Al-Worafi, Y. M. (2020d). Medications registration and marketing: Safety-related issues. In Drug safety in developing countries (pp. 21–28). Academic Press.

Al-Worafi, Y. M. (2020e). Pharmacovigilance. In Drug safety in developing countries (pp. 29–38). Academic Press.

Al-Worafi, Y. M. (2020f). Medication errors. In Drug safety in developing countries (pp. 59–71). Academic Press.

Al-Worafi, Y. M. (2020g). Adverse drug reactions. In Drug safety in developing countries (pp. 39–57). Academic Press.

Al-Worafi, Y. M. (2020h). Self-medication. In Drug safety in developing countries (pp. 73–86). Academic Press.

Al-Worafi, Y. M. (2020i). Antibiotics safety issues. In Drug safety in developing countries (pp. 87–103). Academic Press.

Al-Worafi, Y. M. (2020j). Drug-related problems. In Drug safety in developing countries (pp. 105–117). Academic Press.

Al-Worafi, Y. M. (2020k). Counterfeit and substandard medications. In Drug safety in developing countries (pp. 119–126). Academic Press.

Al-Worafi, Y. M. (2020l). Medication abuse and misuse. In Drug safety in developing countries (pp. 127–135). Academic Press.

Al-Worafi, Y. M. (2020m). Storage and disposal of medications. In Drug safety in developing countries (pp. 137–142). Academic Press.

Al-Worafi, Y. M. (2020n). Safety of medications in special population. In Drug safety in developing countries (pp. 143–162). Academic Press.

Al-Worafi, Y. M. (2020o). Herbal medicines safety issues. In Drug safety in developing countries (pp. 163–178). Academic Press.

Al-Worafi, Y. M. (2020p). Medications safety pharmacoeconomics-related issues. In Drug safety in developing countries (pp. 187–195). Academic Press.

Al-Worafi, Y. M. (2020q). Evidence-based medications safety practice. In Drug safety in developing countries (pp. 197–201). Academic Press.

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Al-Worafi, Y. (2022n). Educational games in pharmacy education. In A guide to online pharmacy education: Teaching strategies and assessment methods . CRC Press.

Al-Worafi, Y. (2022o). Web-based learning in pharmacy education. In A guide to online pharmacy education: Teaching strategies and assessment methods . CRC Press.

Al-Worafi, Y. (2022p). Mobile health technologies. In A guide to online pharmacy education: Teaching strategies and assessment methods . CRC Press.

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Al-Worafi, Y. (2022u). Assessment methods in pharmacy education: Formative assessment. In A guide to online pharmacy education: Teaching strategies and assessment methods . CRC Press.

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Al-Worafi, Y.M. (2024). Nursing Education, Practice, and Research in the Philippines. In: Al-Worafi, Y.M. (eds) Handbook of Medical and Health Sciences in Developing Countries. Springer, Cham. https://doi.org/10.1007/978-3-030-74786-2_511-1

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Quality of nursing education programme in the Philippines: faculty members perspectives

  • Stella Appiah 1  

BMC Nursing volume  19 , Article number:  110 ( 2020 ) Cite this article

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The subject of continuous improvement in the quality of nursing education programme is an extremely sensitive issue worldwide, particularly in the Philippines where a high number of trained registered nurses are exported to both developed and developing countries. The assessment of the quality of nursing education programme is usually measured using pass rates in licensure examinations by several government organizations. However, few studies have indicated that various categories of faculty members view the quality of nursing programmes differently, this study probed further and determined whether the quality of nursing education programme differs according to the profile of faculty members in Philippines colleges of higher education.

A cross-sectional survey study design was employed in this study. One hundred and eight-five (185) faculty members in fifteen (15) higher educational institutions were selected for the research using purposive-census sampling. The study was carried out from January 1 to June 30, 2017. Close-ended structured questionnaires based on study objectives were used to collect data. Frequency and percentages were used to analyse the profile of faculty members whereas weighted means from a four Likert’s scale was used to interpret the extent of perceived quality of nursing education programme.

Majority, 39 and 46% of faculty members had 1–5 years’ clinical experience and 6–10 years of teaching experience respectively. Faculty members strongly agreed with a grand weighted mean of 3.84 out of 4.00 that nursing education programme is of good quality in the Philippines and is synonyms with other universities in the world. Teaching experience of faculty members showed significant relations in the quality of mission/vision/goals/objectives ( p -value = 0.008), curriculum and instruction ( p -value = 0.038), administration of nursing programme ( p -value = 0.025), faculty development programme ( p -value = 0.003), physical structure and equipment ( p -value = 0.016), student services ( p -value = 0.017), admission of students ( p -value = 0.010) and quality assurance system ( p -value = 0.009).

Faculty members strongly perceived nursing education programme to be of good quality in this study. Teaching experience of instructors showed a significant relationship with the quality of nursing education programme in all the quality assessment indicators. However, clinical experience and job category of faculty members rather showed that the quality of nursing education programme is the same throughout all the higher educational institutions. The study implies that the teaching experience of faculty members is a strong predictor of quality of nursing education programme and employing faculty experienced in teaching is substantial for the continuous improvement of nursing education programme.

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Quality of nursing education programme is a complex topic that involves the combination of teaching and learning materials, human resources, teaching and learning processes, curriculum, teaching and clinical experiences, teacher’s attitudes and commitment that are necessary to achieve set learning expectations and produce an exceptional performance of nursing students [ 1 ]. In essence, the nursing education programme can be classified as excellent or of high quality if it can be rated high (at least 80%) in all criteria used in its assessment.

The fundamental focus of nursing education programme is to produce nursing professionals that are clinically competent and can contribute immensely to the provision of quality and safe nurse care [ 2 , 3 ]. Quality nursing education can be attained if nursing faculty obtain a balanced experienced in both theory and clinical areas. Consequently, this vast knowledge may results in nurses workforce that can apply the theory and lessons learnt in simulation laboratories into the delivery of health care in everyday living [ 4 ].

Worldwide, nurses are known to play a vital role in the rendering of health care services including many fundamental health-related services, particularly in rural areas. The increase of workforce without compromising on quality is imperative to help achieve Sustainable Development Goals (SDGs) targets that are set by the United Nations and its member countries, especially the one focused on universal health coverage [ 5 , 6 ]. Quality of nursing education programme can be viewed as a long-term contributor to attaining quality universal health coverage in the production of qualified nurses.

The assessment of the quality of nursing education programme globally has usually been based on the pass rates in licensure examinations by several government organizations [ 7 ]. Although, several quality factors such as accreditation, students’ practical exposure and profile of faculty are sometimes considered to some extent [ 8 ]. The issue of quality of nursing education programme in Philippines colleges of higher education is extremely sensitive due to the high number of trained registered nurses exported to other countries such as the United States of America, United Arab Emirates and Germany [ 9 , 10 ].

The quality of nursing education programme has been strongly associated with quality of curriculum, faculty and resources. These resources such as teaching materials and facilities are required to assist instructors in their delivery of nursing education [ 11 ]. The World Health Organization has also affirmed some standard criteria or area that quality of nursing education programme should be measured with of which faculty profile or development is included [ 12 ]. This activates the discussion into whether the quality of nursing education programme hinges on the profile of the faculty.

Aside from the challenge of quality of faculty members in nursing education programme, there are also problems of shortage of nursing instructors which usually affects the clinical teaching and learning environment and this clinical training feature of the nursing education programme results in long term detrimental effects in practising nurses if not well taught [ 13 ]. Also, other issues associated with quality of faculty members which consequently affects the quality of nursing education programme includes aging nursing faculty, less attractive faculty positions and length of education required to secure a faculty appointment [ 14 ].

According to a study conducted in Ghana, shortage of qualified instructors and insignificant upgrade of the previous infrastructure are critical issues facing the quality of nursing school and subsequently nursing education programme [ 15 ]. As far back as 27 years ago, some authors have connected the quality of nursing education in the aspect of teaching and practical gap to nursing faculty inability to assume a commanding role in clinical learning and teaching [ 16 ]. Earlier researches have related quality of nursing education to the quality of nursing instructors and this study, therefore, determined the quality of nursing education programme. This paper also found out whether the quality of nursing education programme differs according to the profile of faculty members using Philippines colleges of higher education as a case study, in addressing this, the study was based on the null hypothesis (Ho), there is no significant difference in the quality of nursing education programme by the respondents (faculty members) when grouped according to their profile.

Study design

A cross-sectional survey study design was used in this research. This was executed by employing a purposive-census sampling method to recruit one hundred and eighty-five (185) faculty instructors in fifteen (15) higher educational institutions. The use of Purposive sampling was based on the belief that the researcher’s knowledge about the population can be used to hand-pick respondents [ 17 ] and in this case HEIs. This approach did not necessarily mean HEIs known to the researcher were selected but those who met the criteria of inclusion were used for the study. Census sampling, on the other hand, is the process of taking the total population of the locale and retrieving an adequate number of respondents (faculty) as a sample of the study. The use of the two approaches complimented each other for the recruitment of the HEIs and study respondents Questionnaires centred on the aim and study objectives of the study were self-administered after the consent of participants was sought. The study was carried out with the period of January 1 – June 30, 2017.

The study was conducted in fifteen (15) private-owned higher educational institutions in the National Capital Region (NCR) of the Philippines. Ten out of fifteen of these higher educational institutions had existed for more than 45 years whilst the rest had been in existence for less than 45 years. Although 7 of these institutions were granted autonomous by a regulating body called CHED, 8 of them were still monitored by the same regulatory agency. Also, 12 of these institutions were owned by private non-sectarian organizations, however, 3 were owned by private sectarian establishments. The central government seat is in the National Capital Region and the city holds the highest number of higher education institutions which comprises those offering nursing education programme. Majority of these institutions offer health-related programmes at both undergraduate and postgraduate levels, however, the study concentrated on the nursing education programme at the undergraduate level.

Sampling procedure

An initial number of all twenty-two (22) recognized higher national institutions owned by private entities in the NCR were contacted to take part in the study, yet, a considerable number of fifteen (15) institutions approved for their school and faculty members to partake in the study. The number of faculty in the twenty-two (22) higher national institutions targeted for the study summed up to two hundred and twenty (220), nonetheless, one hundred and eighty-five (185) faculty members consisting of deans, program coordinators, and faculty instructors on full and part-time contracts consented and were recruited into the study. The made the study achieve a response rate of 84.1%.

Inclusion criteria

All teaching and clinical instructors who have spent more than 1 year in their educational institution were recruited to partake in the study.

Exclusion criteria

All other instructors who had not completed 12 months in their educational institutions were not allowed to be part of the study.

Tool for data collection

A questionnaire was specifically developed to undertake this study. In doing so, three areas were considered in the design of a close-ended questionnaire used for the study. These were; 1) aim and objectives of study 2) policies and standards of nursing schools in the Philippines and 3) World Health Organization (WHO) guidelines on quality assurance and accreditation of nursing and midwifery educational institutions in the South-East Asian countries. A four (4) Likert scale with standard questions were used to evaluate the quality of nursing education programme. The criteria for the assessment of the quality of nursing education programme included mission/vision/goals/objectives, curriculum and instruction, administration of nursing education, faculty development programme, physical structure and equipment, student services, admission of students and quality assurance system. Pretesting of the questionnaire was done in one of the accredited colleges of nursing in NCR with nineteen (19) respondents to measure the reliability of the tool before it was employed for the study. In doing so, the questionnaire was subjected to Cronbach’s alpha reliability test to determine its consistency and validity. The overall result showed .989 indicating a high consistency and reliability.

Data analysis

Information from the completed questionnaire was entered into Microsoft Excel and imported into SPSS statistical software version 22 for editing, cleaning and analysis. Frequency and percentage were employed to analyse the profile of faculty members while weighted means from a four-Likert scale was used to interpret the extent of perceived quality of nursing education programme as assessed by faculty members. The scales for assessing the quality of nursing education programme; 1.00–1.49, 1.50–2.49, 2.50–3.49 and 3.50–4.00 was interpreted as strongly disagree, disagree, agree and strongly agree respectively. One-way ANOVA was used to test for the differences in quality of nursing education programme in the eight (8) thematic areas (mission/vision/goals/objectives, curriculum and instruction, administration of nursing education, faculty development programme, physical structure and equipment, student services, admission of students and quality assurance system) concerning the profile of faculty members. A P -value of less than 0.05 was considered significant in this study.

Profile of faculty members in higher educational institutions (HEIs)

A majority, 73 (39.0%) of the 185 participants that partook in the study had 1–5 years’ clinical experience whilst few, 15 (8.0%) had 16–20 years of clinical experience. Almost half, 85 (46.0%) of respondents had taught for 6–10 years nonetheless a small number, 14 (8.0%) had 16–20 years of teaching experience. A little below two-thirds, 121 (65.0%) were doing both clinical and classroom teaching whereas very few, 8 (4.0%) were deans of the nursing department in their institutions (Table  1 ).

Quality of nursing education Programme as perceived by faculty members

At the end of the assessment of the nursing education programme, an average of the grand weighted mean of 3.84 resulted, which means participants strongly agreed that nursing programme is of good quality. However, administrators who were faculty members rated the quality of nursing education programme higher with a mean of 3.88 compared to a mean of 3.81 by faculty who were only instructors. The quality of the mission/vision/goals/objectives of the nursing education programme was appraised highest with a mean of 3.91 while the least valued was the admission of students with a mean of 3.76 (Table  2 ).

The difference in quality of nursing education Programme according to profile of faculty

Significant differences existed in the quality of mission/vision/goals/objectives ( p -value = 0.008), curriculum and instruction ( p -value = 0.038), administration of nursing programme ( p -value = 0.025), faculty development programme ( p -value = 0.003), physical structure and equipment ( p -value = 0.016), student services ( p -value = 0.017), admission of students ( p -value = 0.010) and quality assurance system ( p -value = 0.009) in relation to teaching experience of faculty members. On the contrary, the quality of mission/vision/goals/objectives, curriculum and instruction, administration of nursing education, faculty development programme, physical structure and equipment, student services, admission of students and quality assurance system did not differ significantly with regards to clinical experience and job category of faculty instructors (Table  3 ).

The excellence of nursing education programme and to a large extent nursing institution has often been linked to success in licensure exams undertaken by nursing students while other studies have associated it to the quality and shortage of nursing instructors [ 7 , 13 ]. The findings of this study also sought to unravel another concept of whether the profile of faculty in terms of clinical experience, teaching experience and job category cause significant differences in the quality of nursing education programme in the areas of mission/vision/goals/objectives, curriculum and instruction, administration of nursing education, faculty development programme, physical structure and equipment, student services, admission of students and quality assurance system.

According to this study, participants strongly agreed with a score of 3.84 out of 4.00 that quality of nursing education programme offered by institutions in the Philippines is similar to ones run by other universities. This high grading of the quality of nursing education programme may have resulted because of the majority, 39 and 46% of faculty members had 1–5 years’ clinical experience and 6–10 years of teaching experience respectively. Also, this is consistent with the requirement that nursing instructors should have at least a year each of clinical and teaching experience [ 18 , 19 ]. Again, clinical experience particularly is important to close the gap between classroom lessons and simulation classes and in the long run improves the quality of nursing education programme [ 4 ].

Besides, this study also found that about two-thirds, 65% of faculty members were both classroom and clinical instructors. This result has a direct influence on the high grading of the quality of nursing programme because is very suitable if instructors who taught a particular group of students takes them through the practical component of the course. This leads to a better delivery of the curriculum of nursing education programme according to [ 11 ], which consequently leads to a high quality of nursing education programme.

The World Health Organization emphasized vision as a key requirement for the quality of nursing education as part of the global standards for the education of professional nurses and midwives [ 12 ]. In a study on quality assurance in higher education, mission/vision/goals/objectives were rated higher as the driving force for the quality nursing education programme. This was also congruent with the finding of this study where mission/vision/goals/objective was rated highest, 3.91 out of 4.00 compared to the other quality matrix that was used in the assessment of nursing education programme.

Even though, many studies have emphasized on the importance of clinical experience on the quality of nursing education programme [ 4 ], clinical experience and type of faculty did not show a significant difference in the quality of nursing education programme in all the eight quality matrix in this study. This implies that the quality of nursing education programme will be the same throughout all the nursing colleges in the Philippines with regards to clinical experience and job category of instructors.

Conversely, teaching experience of faculty revealed a significant difference in the quality of nursing education programme in all the criteria used for monitoring the quality of nursing education programme. This underlines the importance of teaching experience in the quality of nursing education [ 20 ]. Experienced faculty members are usually needed in the development of mission/vision/goals/objectives, curriculum and instruction of a nursing programme [ 21 ]. They are also practically involved in the administration of nursing education programme and even report gaps in a curriculum where and when is necessary [ 21 , 22 ]. The nursing lecturers who have enough teaching experience had usually undergone series of faculty development programme and have the experience in advising management on the needed physical structure and equipment that are necessary for the running of quality nursing education programme [ 23 ]. Also, these faculty members have the knowledge in the calibre of students to be admitted and the type of student services that should be provided to ensure the best of nursing education. This finding on the teaching experience of faculty members discloses its importance on the quality of nursing education programme and hence worth considering in enlisting processes.

Faculty members strongly perceived nursing education programme to be of good quality in this study. Majority of these nursing instructors had sufficient years of both clinical and teaching experience. No significant difference was found in all the quality criteria of nursing education programme with regards to the profile of instructors; clinical experience and job category. However, teaching experience revealed a significant difference in the quality of nursing education programme in the area of mission/vision/goals/objectives, curriculum and instruction, administration of nursing education, faculty development programme, physical structure and equipment, student services, admission of students and quality assurance system.

Recommendation

The study, therefore, encourages management of higher educational institutions to emphasize teaching experience as one of the criteria that merit consideration for the recruitment of faculty members for a nursing education programme. This will guarantee continuous improvement of quality of nursing education programme in higher educational institutions in the Philippines and other countries.

Although Likert scale was used by study participants to measure quality of nursing education programme in all the criteria in the quality matrix used in this study, respondents may have been biased in the answering of questions concerning nursing education programme using this scale where they intentionally avoid extreme answers and choose options that are expected than the real situation the study sought to find.

Availability of data and materials

The study data and materials are in the custody of the corresponding author and can be made available on reasonable request.

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Acknowledgements

The author appreciates the management and faculty of all higher educational institutions in the Philippines for their involvement which made the conduct of the study successful.

The author self-sponsored the study.

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The sole author conceptualized, designed, analysed and interpreted the study. The author also prepared the manuscript for publication of the study. The author read and approved the final manuscript.

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The author holds a PhD in Nursing Administration from Our Lady of Fatima University, Valenzuela City, Philippines. Dr. Stella Appiah is currently a Senior Lecturer and Head of School of Nursing, Valley View University, Ghana. Her speciality is in Nursing Administration, Nursing Research Methods, Family Health Crisis Intervention, Pharmacology and Therapeutics.

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Quality of nursing education programme assessment tool. A four Likert scale questionnaire for the assessment of nursing education programme on eight thematic areas.

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Appiah, S. Quality of nursing education programme in the Philippines: faculty members perspectives. BMC Nurs 19 , 110 (2020). https://doi.org/10.1186/s12912-020-00508-9

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The philosophy of the UP College of Nursing is anchored on the belief that its major role is to strengthen the capabilities of its individual members and the society as a whole, for them to realize their aspirations. This can be achieved through relevant education, research and continuing education and community extension services. The UPCN’s core values are summarized as follows: INTEGRITY, NATIONALISM, CARING, UNIVERSALISM and EXCELLENCE (INCUE).

Mission and Vision

The UP College of Nursing is the premiere nursing school that acts as a change agent serving the health needs of the Filipino people, and provides leadership and excellence in nursing development in the “global community”.

The University of the Philippines College of Nursing (UPCN) was conceived through a thesis presented to the Division of Biological Sciences, University of Chicago, by Ms. Julita V. Sotejo, entitled, “A University School of Nursing in the University of the Philippines.” An abstract of this thesis was enthusiastically received by Filipino nurses in convention on May 9, 1946, such that a resolution supporting the proposal was passed by the Filipino Nurses Association (now Philippine Nurses Association). After dicussions and consultations with then UP President Dr. Bienvenido M. Gonzales and members of the Board of Regents ( BOR ), the latter favorably endorsed the proposal to the President of the Philippines, so that on April 9, 1948, the University of the Philippines College of Nursing came into being.

The first academic offerings of UPCN in 1948 were the baccalaureate program, Bachelor of Science in Nursing (BSN) for high school graduates, and the Post-Basic Program for nurses who graduated from the three-year Graduate in Nursing (G.N.). In 1955, the Masters program, M.A. (Nursing), was instituted as a thesis course with functional majors in administrtion, teaching and supervision, and public health. In 1968, the Masters in Nursing (MN) program, a non-thesis course focused on clinical specializations in Medical-Surgical Nursing, Maternal Child Nursing, Psychiatric Nursing and Community Health Nursing, was added to the graduate program. In response to the constantly changing times and the needs of the profession, Nursing Administration and School Health Nursing were subsequently added to the specialty fields. The doctoral program, Ph.D. (Nursing), was instituted on September 27, 1979.

In 1972, the BOR merged the Philippine General Hospital School of Nursing and the UP College of Nursing. In 1977, the Health Sciences Center was created, making it an autonomous unit of the UP System. In view of its renewed organizational structure, the College of Nursing moved out of its place at the first floor of the UP College of Law in Diliman, Quezon City and joined the rest of the health professions in Manila where it rightlfully belongs. Today, it is better known as the University of the Philippines Manila, the College of Nursing being one of its nine degree-granting units.

Thus far, since its inception in 1948, UPCN has had ten (10) deans who have all given the best years of their lives to the College, in particular, and the university, in general and continue to be the inspiration and role models of the alumni and students who make the university proud of their accomplishments and contributions to the country and the profession:

  • Dean Julita V. Sotejo - 1948-1970
  • Dean Leonor M. Aragon - 1970-1978
  • Dean Teodora A. Ignacio - 1978-1980
  • Dean Dolores M. Recio - 1980-1984
  • Dean Aurora S. Yapchiongco - 1984-1990
  • Dean Leda L. Layo-Danao - 1990-1993
  • Dean Thelma F. Corcega - 1993-1996
  • Dean Cecilia M. Laurente - 1996-2002
  • Dean Luz B. Tungpalan - 2002-2004
  • Dean Josefina A. Tuazon - 2004-Present

And, after 48 years, UP College of Nursing finally has it own building situated along Pedro Gil Street, Manila, through the efforts of Congressman Rolando Andaya, Chancellor Ernesto E. Domingo, Chancellor Perla D. Santos-Ocampo, Dr. Napoleon M. Apolinario, Dean Julita V. Sotejo, Dean Leda L. Layo-Danao and Dean Thelma F. Corcega, Dean Cecilia M. Laurente and all the alumni, friends and supporters of the College of Nursing, without whose sincere generosity and indefatigable efforts this would not have been made possible.

It was inagurated on February 26, 1997 by Cong. Rolando Andaya, President Emil Q. Javier , Chancellor Perla D. Santos-Ocampo and Dean Cecilia M. Laurente

Through the leadership of Chancelor Alfredo T. Ramirez, the Board of Regents approved the naming of the building after its founder, Sotejo Hall and this was formalized on September 4, 2000. This is the first time that a building was named after a person who was still living

The College of Nursing has been designated as World Health Organization Collaborating Center (WHOCC) for Nursing Development in Primary Health Care from March 15, 1989 - March 14, 2001 and it was re-designated as WHOCC for Leadership in Nursing Development dated January 2, 2004 - January 1, 2008.

The College of Nursing was also designated as a Center of Excellence CHED-COE by the Commission on Higher Education from 1997-2002.

College of Nursing University of the Philippines - Manila 632-5231472 / F: 5231485

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does nursing have thesis in the philippines

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does nursing have thesis in the philippines

The University of the Philippines College of Nursing (UPCN) was conceived through a thesis presented to the Division of Biological Sciences, University of Chicago, by Ms. Julita V. Sotejo, entitled, “A University School of Nursing in the University of the Philippines." The proposal was approved by the Board of Regents on April 9, 1948, as the University of the Philippines College of Nursing.

The first academic offerings of UPCN in 1948 were the baccalaureate program, Bachelor of Science in Nursing (BSN) for high school graduates, and the Post-Basic Program for nurses who graduated from the three-year Graduate in Nursing (G.N.). In 1955, the Masters program, M.A. (Nursing), was instituted as a thesis course with functional majors in administration, teaching and supervision, and public health. In 1968, the Masters in Nursing (MN) program, a non-thesis course focused on clinical specializations in Medical-Surgical Nursing, Maternal Child Nursing, Psychiatric Nursing and Community Health Nursing, was added to the graduate program. In response to the constantly changing times and the needs of the profession, Nursing Administration and School Health Nursing were subsequently added to the specialty fields. The doctoral program, Ph.D. (Nursing), was instituted on September 27, 1979.

The BOR, in its 872th meeting in 1972, made a landmark decision to merge the U.P. College of Nursing and UP-PGH School of Nursing into one unit. The approval of the merge was enacted during the 859th meeting of the BOR on April 10, 1975. Consequently, the merge was made official with the signing of E.O 545 by then Pres. Ferdinand E. Marcos on July 23, 1979.

In 1977 when the Health Sciences Center was created in Manila, the College of Nursing moved out of its place at the first floor of the UP College of Law in Diliman, Quezon City and joined the rest of the health professions in Manila. Today, the College of Nursing is one of the nine degree-granting units of UP Manila.

The College of Nursing was designated World Health Organization Collaborating Center (WHOCC) for Nursing Development in Primary Health Care from March 15, 1989 to March 14, 2001. From January 2, 2004 to January 1, 2008, it was designated WHOCC for Leadership in Nursing Development. UPCN is the first and only WHOCC for Nursing in the country and the first in the Western Pacific Region. The College of Nursing is a Center of Excellence for Nursing Education, a designation given by the Commission on Higher Education (CHED) since 1997.  

Mission-Vision

The University of the Philippines College of Nursing is the premier nursing school that acts a change agent serving the health needs of the Filipino people, and provides leadership and excellence in nursing development in the global community.

To strengthen the capabilities of its individual members and the society as a while, through relevant education, research, and continuing education and community extension services.

Core Values

Integrity -  We exercise honesty and consistency in all our professional and personal undertakings. We uphold transparency in all levels of governance. - 

Nationalism - With a strong sense of pride and history, we commit to be at the forefront in advocating for national health issues whilst considering what is good and beneficial for the Filipino people and country.

Caring -  Genuinely care for our students, faculty, staff, alumni, thus we strive to develop their highest potential by providing opportunities for their growth and development and by nurturing positive, health relationship. We are committed to respect human dignity and highest standards of care to ensure safe and quality health service delivery.

Excellence -  We make sure that we observe and apply excellence in the areas of: teaching-learning and curriculum development, research and publication, continuing education and extension services, and governance.

Leadership -  We constantly endeavor to take the lead in modelling innovations, injecting newness and improvements in nursing policies, education, and practice.

Learning -  We shall continuously improve our knowledge and skills towards professional growth, as well as enhance our systems and processes for the provision of quality service to our various publics.

Strategic Thrusts

  • Lead in the full implementation of outcome-based BSN curriculum using functional integration as framework
  • Strengthen the graduate program to prepare nurses for Advanced Practice in Nursing, clinical specialization, and preparation of nurse scientists
  • Strengthen the position of the College in building capacities of nursing education and service institutions as well as in influencing nursing policy directions in the country and the region.
  • Produce and disseminate quality research that addresses priority nursing and health-related issues and concerns in the country and the region.
  • Promote health, wellness, and welfare of the faculty, staff, and students towards improved work efficiency, productivity, and satisfaction.

Undergraduate Program

Bachelor of Science in Nursing

The BS Nursing (BSN) is a four-year outcome-based, community-oriented, and value-based program. It aims to prepare professional entry-level nurses with the necessary competencies in providing safe, quality, holistic, and compassionate nursing care to individuals, families, population groups, and the community. Through-out the program, there is emphasis in health promotion and disease prevention, as well as curative and rehabilitative interventions across levels of clientele. This is supported by instilling skills in the use of the most efficient technology and best evidence in managing clients.

Aside from preparing graduates as entry-level nursing practitioners, the program also prepares graduates as managers and researchers. There are courses that develop the leadership and management skills of students in the delivery of safe, quality client care, and continuous quality improvement of nursing care and health service. Graduates of the program are also prepared to conduct relevant research that is compliant to technical and ethical guidelines.

The learning environment in the University also prepares our graduates to use effective inter-professional collaboration, teamwork, and community partnerships toward improved health outcomes, client empowerment, and community competences.

Graduate Programs

Master of Arts (Nursing)

The primary goal of the Master of Arts (Nursing) program is to prepare qualified nurses for advanced practice and leadership in the any of the following major fields:

  • Adult Health Nursing
  • Community Health Nursing
  • Maternal and Child Nursing
  • Mental Health and Psychiatric Nursing
  • Nursing Administration

The program highlights the development of competencies of advanced practice nurses in a major field in Nursing through an increased understanding of nursing theories, research principles and methods; a broader understating of a related discipline as further base for specialization in Nursing; and through an intensive practicum in a specific field in Nursing.

Doctor of Philosophy in Nursing

The PhD in Nursing is a research-intensive degree that aims to strengthen and deepen the intellectual and scholastic capability of students in order to enhance the theory and science-based practice of Nursing. Through a dissertation, students are expected to generate new knowledge that will advance Nursing science.

Research Program

Research at the College of Nursing highlights its role in developing and advancing nursing science and in influencing policy decisions at all levels of decision-making. The faculty are actively involved in research activities based on the set research agenda of the College. Most of the researches are funded particularly by the Philippine Council of Heart Research and Development, Department of Health, and the UP Manila-National Institutes of Health.

The following are the research areas of the College:

  • Non-communicable disease prevention and control - This includes studies on identifying factors influencing compliance, service utilization, management, and effectiveness of intervention such as but not limited to smoking cessation, diabetes education, diet and physical activity strategies. This also includes mental health promotion.
  • Care of older persons and those with chronic illness - Concerns with improving support for older persons by establishing evidence on the effectiveness of intervention in the care of the elderly and identifying gaps in services among older persons.
  • Women’s health and care of children -  This includes studies on preconception care, postpartum care, and the first 1,000 days of the child.
  • Nursing education - Studies under this area include impact evaluation of curricular program in Nursing as well as testing effectiveness of teaching-learning methodologies.
  • Community health nursing - Concerns with establishing roles of the advanced practice nurses in public health nursing as well as validating indicators for community competence.
  • Human resources for health - This includes studies on retention of health workers in rural areas, skill mix in the primary care setting, and work environment of nurses.

Aside from these, the College also conducts researches under its role as a WHO Collaborating Center for Leadership in Nursing Development. Under this role the College spearheads the collection of best practice data on the implementation of inter-professional education among countries in the Western Pacific Region; as well as best practices in the role of nurses in the prevention and control of non-communicable diseases. Through these projects, the College intends to contribute to the thrusts of WHO is disseminating relevant health information on interprofessional education, and prevention and control of NCD. 

Continuing Education Programs

The College of Nursing is a continuing education provider accredited by the Philippine Professional Regulatory Board of Nursing. UPCN conducts regular, non-credit programs/courses of varying duration. These are held at different times of the year. Some of the regular seminars and workshops of the College include:

            Training-workshops on:

       a. Outcome-based BSN Curriculum Development and Instructional Designs [5-10 days]        b.Good Clinical Practice and Health Research Ethics [2 days]        c. Clinical teaching [5-10 days]        d. Health assessment [3-5 days]        e. Nursing process (e.g., care of patients with oxygenation problems, problems on psychosocial adaptation, neuromuscular problems, vulnerable            population groups in the disaster context) [3-5 days]        f.  Evidence-based nursing [3-5 days]        g. Transcultural nursing care [3-5 days]

Basic courses on:

  • Patient safety and TeamSTEPPS [1-2days]
  • Gerontology nursing [4-5 days]

Student Life

Students at the College of Nursing do not excel only in academics, but they are also involved in a number of extra-curricular activities through participation in college-based student organization.

There are student organizations and activities that shape and develop our students’ wholeness and cultivates spirit of teamwork, camaraderie, and collegiality. These organizations provide opportunity for our students to increase their social consciousness and develop their leadership potential.

  • Nursing Student Council (NSC)
  • Young Empowered Advocates of Responsive Nursing (YEARN)
  • Male Nurses’ Organization  (MNO)
  • Nursing Artists Corps (NAC)

Aside from these organizations, the student are enjoined to participate in a number of college-wide, student-initiated activities, such as:

  • Annual Tea Party- which serves as a welcome to the first year students
  • Annual Organization Fair- where various college-based and university-based organizations introduce their thrusts so first years are able to choose which organization to join
  • Nursecessism- inter-batch talent competition
  • Bakbakan- inter-college sports competition\
  • Christmas celebration activities- each batch is assigned to lead a Christmas activity, for example first years are assigned in adopt-a-ward, second years in Christmas tree making, third years for the lantern, and fourth years for the facade

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Supporting dignified dying in the Philippines

Ardith z doorenbos.

University of Washington School of Nursing, Seattle, WA 98195, USA

Carmencita Abaquin

Philippine Board of Nursing

Margot E Perrin

Linda eaton, araceli o balabagno.

University of the Philippines Manila College of Nursing

University of Washington Department of Biostatistics

University of the Philippines Open University

This study aimed to assess the appropriateness of the International Classification for Nursing Practice (ICNP) Palliative Care for Dignified Dying catalogue for palliative nursing in the Philippines.

The study recruited 230 nurses to complete the ICNP Dignified Dying survey. Participants rated ICNP nursing intervention items and identified additional interventions for promoting dignified dying.

All of the intervention items were scored on average as being at least ‘slightly important’. The three top-ranked nursing intervention categories were providing social support, maintaining privacy boundaries, and relieving psychological distress.

Conclusions

The ICNP Palliative Care for Dignified Dying catalogue lists nursing interventions that are appropriate to promoting dignity at the end of life in the Philippines.

The International Classification for Nursing Practice (ICNP) catalogue Palliative Care for Dignified Dying identifies nursing interventions specific to promoting dignified dying and supports the systematic documentation of care. It identifies the clients as patients who are dying as well as their families and significant others. The catalogue was developed after identifying nursing interventions to promote dignified dying in four countries: Ethiopia, India, Kenya, and the USA ( Doorenbos et al, 2006 ; Coenen et al, 2007 ). The aim of this study is to evaluate the validity of this catalogue for use in the Philippines.

The ICNP and the Palliative Care for Dignified Dying catalogue

The ICNP facilitates standardized nursing documentation of patient care, enabling comparison of nursing diagnoses, interventions, and outcomes internationally. It also facilitates nurses’ communication with other nurses, health professionals, and policy makers about their practice. For ease of use, the International Council of Nurses (ICN) develops catalogues that are subsets of the ICNP—specifically, nursing diagnosis, outcome, and intervention statements for selected client groups and health priorities. The ICNP catalogues allow nurses working in a specialty area (e.g. ambulatory cancer care or end-of-life care) or a focus area of nursing (e.g. pain management, urinary incontinence, or promoting adherence to treatment) to more readily integrate the ICNP into their practice.

Dignified dying has not been studied extensively, and few studies have focused on interventions to promote dignified dying ( Chochinov et al, 2006 ). To date, ways in which nurses across cultures and countries maintain human dignity at the end of life have yet to be fully explored.

The ICNP catalogue Palliative Care for Dignified Dying was guided by the dignity-conserving care model, which assists health- care providers in considering dignity from the patient’s perspective ( Chochinov, 2002 ; McClement et al, 2004 ). The model specifies three major dignity categories:

  • Illness-related concerns (factors caused by or associated with the underlying illness and requiring symptom relief)
  • Dignity-conserving repertoire (psychological and spiritual considerations for maintaining a sense of dignity during the illness experience, such as hopefulness and a sense of meaning)
  • Social dignity inventory (socially or externally mediated factors that foster a sense of dignity, such as privacy and family support).

Nursing interventions used in the Philippines have been found to accord with the dignity-conserving care model ( Ramos, 2010 ).

Nursing models of palliative care delivery in developed countries seldom translate effectively to the developing world, and extant research on palliative care that is relevant to developing countries is minimal ( Pampallona and Bollini, 2003 ; Kanavos, 2006 ; World Health Organization, 2007 ). Thus, to guide palliative care nursing practice to promote dignified dying, interventions must be examined across cultures and in developing and developed countries. The current study’s purpose is to provide an understanding of palliative care nursing interventions in the Philippines and to validate the usefulness of the ICNP Palliative Care for Dignified Dying catalogue. This is one of the first studies to survey nurses from a specific country about interventions used to promote dignified dying and to validate the ICNP catalogue. Nurses are currently being surveyed in other countries to collect additional data on the usefulness of the ICNP catalogue.

Palliative care in the Philippines

The movement toward palliative care and hospice care services in the Philippines began in the late 1980s for patients with cancer ( Wright et al, 2008 ). Malignant neoplasms are ranked as the third most common cause of mortality for Filipinos, after diseases of the heart and diseases of the vascular system ( Department of Health (DH), 2010 ). Today, hospice care services are available for terminally ill cancer patients, patients with other life-threatening illnesses, and their families ( Sharing Hospice, 2007 ). Palliative care concepts and principles are part of the curriculum in major medical and nursing schools in the Philippines, and palliative care training programmes are delivered to health providers and volunteers ( Gorospe and Bausa, 2006 ).

Key concepts to consider in understanding the Filipino perspective on death and dying include cultural values and beliefs related to religion, family, and interpersonal harmony. Religion holds a central place in the life of Filipinos ( Wright et al, 2008 ). The Philippines is a predominantly Christian nation, with Roman Catholics making up around 81% of the population ( Central Intelligence Agency, 2010 ). Miranda and colleagues ( Miranda et al, 1998 ) found that deeply religious Filipinos tended to attribute illness to reasons of God or a higher power. The predominant belief in the causes of disease was the ‘will of God’, even though individuals also believed in personal responsibility.

The family is the basic social and economic unit of Filipino kinship. Although family is important in many cultures, the central role that the family plays in the lives of its members in the Philippines is unusually significant, with family being rated the most important source of happiness ( Virola, 2010 ). In times of illness, the extended family provides support and assistance ( Wright et al, 2008 ). Important values that might affect interactions between providers and patients and families in the context of terminal illness include a strong respect for elders, a strong reliance on family as decision makers in case of illness, and strong expectations of care by the family.

Published literature on palliative care and dignified dying in the Philippines is limited. Laurente and colleagues (unpublished observations) explored the phenomenon of death and dying as experienced by adult terminal cancer patients in the Philippines and their family caregivers and nurses. The nurses perceived patients with terminal cancer to be in a state of helplessness and powerlessness. The patients and family caregivers identified two important aspects of a peaceful death: first, the presence of family support and acceptance of the burden of the patient and, second, belief in God and dying as a time to surrender self.

Interventions used to promote dignified dying for patients in the Philippines have been identified through interviews with patients (C Abaquin, unpublished observations). Nursing interventions identified by the patients included ensuring comfort, safety, and privacy; providing therapeutic touch; allowing prayer and religious music as desired; maintaining a quiet, well-ventilated, and pleasant-smelling environment; and staying with the patient. In focus group discussions, nurses stated that human dignity is maintained when a patient’s physical, psychological, and spiritual needs are met and when the patient is comfortable and clean; is able to participate in making significant decisions regarding the management of his or her illness; can focus on unfinished business; has loved ones attending to his or her needs; can openly express concerns, plans, and wishes; has good and healthy family relationships; is at peace with God; and maintains quality of life (C Abaquin, unpublished observations).

Design, participants, and setting

A cross-sectional study design was used, with a paper-and-pencil survey as the data collection method. A convenience sample of registered nurses in the Philippines with clinical care experience was recruited. A total of 250 surveys were sent out, and 230 were returned, at a response rate of 92%.

A Filipino country coordinator in the Philippines oversaw the data collection. The coordinator personally contacted heads of institutions from academe, clinical practice, and the Board of Nursing to ask whether they would be willing to have their institutions participate in the study. The study was approved by the University of Washington’s Institutional Review Board and by the participating institutions in the Philippines for the protection of human subjects.

This study was conducted at hospital, clinic, and community health-care settings. The country coordinator and a trained research assistant distributed written consent forms together with the ICNP Dignified Dying survey to nurses at regularly scheduled monthly meetings. Nurses were provided time during the monthly meeting to complete the survey, which could also be completed after the meeting and returned to the country coordinator or mailed in at a later date. The nurses were informed that the information would not be used for any purpose other than this study.

The ICNP Dignified Dying survey consists of demographic items and 105 palliative care nursing intervention items from the ICNP catalogue Palliative Care for Dignified Dying . The palliative care interventions listed in the ICNP catalogue were developed from research conducted in various countries ( Coenen et al, 2007 ). The catalogue was reviewed by palliative care nursing experts from around the world to establish face and content validity ( Doorenbos et al, 2009 ). Before being administered for the purposes of this study, the survey was further reviewed for cultural relevance by three nurses that are palliative care experts in the Philippines. Each nurse reviewed the items for clarity and relevance in the Filipino nursing context.

Participants were asked to rate each intervention on a 4-point Likert response set (1 = not at all important, 2 = slightly important, 3 = moderately important, and 4 = very important). They were also asked the following open-ended question: ‘When you care for a dying patient, what specific nursing actions do you use to promote dignified dying?’ The nurses took 45–60 minutes to complete the survey.

Data analysis

Descriptive statistics were obtained for the 230 sets of responses. An average importance rating was calculated for each of the 105 nursing intervention items using numeric codes. The items were then ranked by average importance rating. All calculations were performed using SAS 9.1.

Qualitative analysis of the open-ended item asking the nurses about the nursing actions they used to promote dignified dying in their practice was conducted using a content analysis method. The content analysis was conducted by three members of the research team and agreement on the categorization of the interventions was achieved. The actions described by the respondents were assigned to one of the three major categories of the dignity-conserving care model ( Chochinov, 2002 ). This model provided a comprehensive and empirical basis for organizing the interventions used to promote dignified dying.

The total sample was 230 nurses working in the Philippines (see Table 1 for full demographic characteristics). The mean age of the participants was 35.7±12.9 years, and the majority of the nurses (58%) had 1 to 10 years’ work experience. The majority of the participants (69%) had a Bachelor’s degree in nursing, worked full time (93%), and worked in hospitals (70%). Participating nurses cared for dying patients very often (29%), often (27%), sometimes (41%), and never (3%).

Demographic characteristics of the sample ( n =230) *

Table 2 lists the top 20 ICNP palliative care interventions to promote dignified dying, based on highest average importance rating from this study. The top ten items were:

Top 20 ICNP palliative care nursing interventions to promote dignified dying, as ranked by average importance rating of a sample of 230 nurses in the Philippines

ICNP, International Classification for Nursing Practice; SD, standard deviation.

  • Establish trust
  • Protect patient rights
  • Establish rapport
  • Maintain dignity and privacy
  • Protect confidentiality
  • Ensure continuity of care
  • Provide privacy
  • Monitor respiratory status
  • Collaborate with fluid or electrolyte therapy
  • Collaborate with physician.

All of the nursing interventions listed in the catalogue had a mean rating of over 2—that is, they were at least ‘slightly important’ in promoting dignified dying. Table 3 lists the top 10 palliative care interventions based on rankings by the subset of nurses who cared for dying patients ‘very often’ or ‘often’—the more expert nurses—and those of the nurses who cared for dying patients ‘sometimes’ or ‘never’. The top 10 interventions of the expert nurses were:

Top 10 ICNP palliative care nursing interventions to promote dignified dying as ranked by nurses with greater and lesser experience in caring for dying patients

  • Encourage rest
  • Administer pain medication.

The 230 nurses provided 155 responses to the open-ended question about specific nursing interventions used to promote dignified dying in practice. The responses were classified into the three major categories of the dignity-conserving care model ( Chochinov, 2002 ): illness-related concerns ( n =58), dignity-conserving repertoire ( n =62), and social dignity inventory ( n =35). For the open-ended responses, the five most commonly cited interventions related to psychological distress, spiritual comfort, physical distress, autonomy/control, and social support. Examples of specific interventions classified as addressing psychological distress included therapeutic communication, active listening, observing silence, decreasing emotional suffering, providing reassurance, and staying with the patient when needed.

This study found that the ICNP catalogue Palliative Care for Dignified Dying provides palliative care nursing interventions that are relevant for promoting dignified dying in the Philippines, as all interventions were rated as at least ‘slightly important’. The most important ICNP nursing interventions identified by the sample addressed establishing communication and trust with the patient, maintaining dignity and privacy, and protecting patient rights and confidentiality. Nurses who care for terminally ill patients in the Philippines deemed these interventions appropriate for dealing with patients’ states of helplessness and powerlessness. These findings are also consistent with findings that safety and privacy are important in palliative care interventions for patients in the Philippines (C Abaquin, unpublished observations).

Pain control is recognized as one of the major foci of palliative care in the Philippines ( Wright et al, 2008 ). However, in this study, only those nurses who cared for the dying ‘very often’ or ‘often’ identified ‘administer pain medication’ as one of the top ten nursing interventions, and on average they ranked this intervention as number ten. It was ranked number 20 by average importance when all participants in the study are taken together. One potential reason for these results is that fear of addiction to narcotics is a major concern of health professionals who are less expert in the field of palliative care and thus perhaps less comfortable with administering pain medication ( Galanti, 2004 ).

Four of the top 20 most important interventions were spiritual comfort interventions: ‘encourage patient to express spiritual concerns’, ‘protect religious beliefs’, ‘provide spiritual support’, and ‘provide privacy for spiritual behaviour’. These interventions to promote dignified dying are consistent with Periyakoil et al’s 2010 study of Filipino Americans, which reported that finding meaning in one’s existence and death was one of the factors influential in preserving dignity at the end of life.

Nurses who cared for dying patients ‘sometimes’ or ‘never’ prioritized spiritual comfort interventions differently than nurses who cared for dying patients ‘very often’ or ‘often’. The less experienced nurses placed three spiritual comfort interventions in the top 10, whereas nurses who cared for dying patients ‘very often’ or ‘often’ did not place any spiritual support interventions in the top 10. This might be because experienced nurses may see spiritual support as an underlying aspect of all palliative care rather than as a distinct intervention. Less experienced palliative care nurses may be more deliberate in delivering spiritual support.

The nurses who cared for dying patients ‘sometimes’ or ‘never’ also identified fluid or electrolyte therapy as the number one intervention, whereas nurses who care for dying patients ‘very often’ or ‘often’ did not identify this as a top 10 intervention. This might be because less experienced nurses may not be as clear about the differences between palliative care and acute nursing care. Experienced palliative care nurses realize that fluid and electrolyte therapy is not a goal in caring for the dying patient.

Limitations

A limitation of this study is that the data were obtained from a convenience sample of nurses and thus the findings might not be generalizable to all nurses in the Philippines. Furthermore, almost half of the participants only ‘sometimes’ cared for dying patients. Finally, how the concept of dignity at the end of life is perceived in the Philippines generally is still not well known. Research on the concept of dignity at the end of life has been conducted in other countries ( Jo and Doorenbos, 2009 ), and a greater understanding of this concept in the context of the Filipino culture would further contribute to our understanding.

Palliative care is important for promoting dignity in the dying patient. This study’s findings support the applicability of the ICNP catalogue Palliative Care for Dignified Dying for providing relevant and standardized nursing interventions for palliative care in the Philippines. The catalogue may be used as a resource in planning and managing nursing care to promote the dignity of dying patients. It would also be useful to further test the catalogue among nurses in other countries.

Acknowledgments

Support for this study was obtained in part from the International Council of Nurses, the Oncology Nursing Society, and the National Institute of Health, National Institute of Nursing Research R21NR010896 and R21NR010725.

Contributor Information

Ardith Z Doorenbos, University of Washington School of Nursing, Seattle, WA 98195, USA.

Carmencita Abaquin, Philippine Board of Nursing.

Margot E Perrin, University of Washington School of Nursing, Seattle, WA 98195, USA.

Linda Eaton, University of Washington School of Nursing, Seattle, WA 98195, USA.

Araceli O Balabagno, University of the Philippines Manila College of Nursing.

Tessa Rue, University of Washington Department of Biostatistics.

Rita Ramos, University of the Philippines Open University.

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Circulating Now From the Historical Collections of the National Library of Medicine, NIH

(Un)fit to Nurse: Efficiency and Discipline at the Philippine General Hospital, 1898–1916

Ren Capucao , MSN, RN will speak on Thursday, April 25, 2024 at 2:00 PM ET. This talk will be live-streamed globally, and archived , by NIH VideoCasting and live-streamed on the NLM YouTube Channel . Mr. Capucao is a PhD Candidate at the Bjoring Center for Nursing Historical Inquiry in the School of Nursing at the University of Virginia. Circulating Now interviewed him about his research and upcoming talk .

Circulating Now: Please tell us a little about yourself. Where are you from? What do you do? What is your typical workday like?

A formal portrait of a young Filipino man.

The quotidian flow of my “typical workday,” however, is only a recent event. At the start of my doctoral program, I worked as a guest service associate at the Virginia Museum of History and Culture . As coursework went virtual due to the COVID-19 pandemic, I determined this was the best time to undergo my first nursing position. I worked as a pediatric nurse at the Virginia Commonwealth University Health System until I received a Fulbright fellowship to conduct historical and ethnographical research at the University of the Philippines College of Nursing . My ten months abroad required many adjustments, but I learned something new about Philippine culture and myself daily. For example, I formerly feared riding motorcycles, but for the sake of affordability and getting around traffic, I came to enjoy riding motorbike taxis. Overall, I have embraced the chaos surrounding my education and self-growth as a great adventure still unfolding.

CN: What initially sparked your interest in the History of Medicine?

RC: The spark that drew me to the history of medicine ignited during my childhood. I spent a lot of time at the hospital, whether being hospitalized due to my accident-prone nature or just visiting my mother—also a nurse—at work. The fondness I developed in experiencing the healthcare environment intertwined with my favorite school subject, history. History helped me understand the cultural and intergenerational dissonance I experienced growing up under Filipino immigrant parents. I learned about my mother and her career path as a nurse, including its joys and tribulations, so my interest in the history of medicine is deeply personal. My mother’s narrative and mine are interwoven into the broader colonial history of the Filipino nurse diaspora.

My professional interest in the history of medicine took place during my master’s entry program in nursing at the University of Virginia. While learning how to be a nurse, I was also learning how to become a historian of nursing; I wanted to gain broader insight into the uneven life chances and unilateral migration patterns nurses face in the Global South. I was taken under the wing of Dr. Barbra Mann Wall, then director of the Bjoring Center for Nursing Historical Inquiry , who instilled in me a sense of curiosity and confidence to pursue doctoral studies. Since then, I have also become indebted to the mentorship of the current director, Dr. Dominique Tobbell, who has continued to help me grow and refine my scholarship. I also show gratitude to the Filipino communities I have worked alongside who continue to fuel my fervor to drive change toward decolonization and global health equity, such as the Philippine Nurses Association of America, specifically its Virginia chapter , the Filipino Nursing Diaspora Network , and the University of the Philippines College of Nursing.

Three people, two in academic regalia, posed informally indoors.

CN: Your talk, “ (Un)fit to Nurse: Efficiency and Discipline at the Philippine General Hospital, 1898–1916 ,”   explores a dramatic event in 1916 at the Philippine General Hospital. What happened?

Reproduction of a newspaper headline, subtitle: Philippine General Hospital is Scene of Tragedy, Feared blame.

RC: I myself was surprised by the events that unfolded! So, in mid-August 1916, Florentina Papa, a student nurse with exceptional record at the Philippine General Hospital (PGH), the government hospital serving the entire archipelago, committed suicide after being chastised by the American superintendent of nursing for breaking nursing’s code of conduct. Previously, she had gotten into a heated exchange with a patient on the ward who lambasted her and demeaned the professional status of nursing to servitude. She could not live with the dishonor or disrespect and chose to end her life.

On August 29, up to 150 student nurses walked out of the hospital to protest the disciplinary culture that led to Florentina’s death. Some believe politicians orchestrated the strike in the background, as on the same day the U.S. Congress enacted the Jones Law, which laid out the conditions for Philippine independence. One of these conditions was a stable government, and the strike indicated otherwise. In the student nurse’s petition to the hospital director, the most evident grievances surrounded the mandatory physical training course that began in June earlier that year and the associated punishments for absence and tardiness. On top of coursework and ward duty, all students were required to participate in calisthenics outdoors for forty-five minutes five times a week. The hospital director reasoned the course would overcome the physical weakness of Filipino nurses, whose bodies he deemed inferior to their American counterparts. He also considered the improved fitness of these nurses as a boon to the hospital’s efficiency.

A photograph of a large group of women in white uniforms posed in front of a large stone building.

In the aftermath of the two-day strike the director of civil service conducted an investigation. His report exonerated the hospital, which caused a public uproar. Shortly thereafter, the hospital director and nursing superintendent resigned, leading to the Filipinization of nursing services at the hospital. While the chain of events proves interesting, this particular moment in time must be examined within the history of PGH, a modern medical institution constructed under the American colonial government and its “benevolent” project of establishing the fitness of Filipinos for life under liberal modernity. Through this history, we can better understand the emotions, behaviors, and desires of the actors driving the development of professional nursing, the culture of discipline at the hospital, and the abledment of the Filipino nurse.

CN: The event touched many lives. In researching this subject, were you drawn to any particular event or individual’s story?

Reproduction of a newspaper headline, subtitle: Strikers seeking reinstatement while many offer help.

RC: One particular event that piqued my attention emerged from  the investigative report on the strike, which included an analysis of past issues at PGH. One of the thematic problems reported was suicides and the alleged suicide attempts of Filipino nurses within the span of three years. I learned that Florentina was not the first suicide, as another nurse had died two years prior. There were also three cases of alleged suicide attempts. Through a nursing and (dis)ability lens, the pattern of mortality, or heightened risk of death, does not appear accidental but rather intentional. To me, all of the nurses in these cases felt pressured by being unable to live up to the ableist and racialized image of the ideal nurse. The affective labor of these nurses further stimulated my curiosity about the culture of discipline at the hospital and the various subjectivities formed under the pressure of the American model of nursing. These morbid accounts must be recounted with empathy. They provide necessary interventions to rupture the linear narrative of progress lauded by benevolent colonialism, the notion of care and nursing as inherently benign, and the image of the Filipino nurse as an object of care with an unfailing body.

CN:  In your research at NLM what materials were most enlightening for you? Was there a particular document that stood out?

The first page of an article in a bound volume with a photograph of a Filipino woman in a cap and gown.

RC: For this research project, I found materials pertinent to detailing the institutional history of PGH and its training school, including the History and Description of the Philippine General Hospital: Manila, Philippine Islands, 1900 to 1911 and the 1913 and 1915 school catalogs. Furthermore, the NLM’s extensive collection of The Filipino Nurse , the professional journal of the Filipino Nurses Association (now the Philippine Nurses Association) dating back to 1926, greatly assisted me in exhuming the lived experience of Filipino nurses during the formative years of Philippine nursing. Despite the publishing start date, many of the pioneering nurses at the hospital would become leaders in the professional organization, so biographies and interviews of these nurses can be found dispersed across the journal’s issues.

Cover of a pamphlet with the Filipino Nurses' Association logo and a National Library of Medicine stamp dated 1957.

Beyond this project, one item that caught my attention was the Philippines Nurses’ Directory published by the Filipino Nurses Association. This directory, more or less, compiles a list of all known nurses from 1911 to 1941, with entries including name, alma mater, graduation year, last known address, and current employment. Overall, I’m excited about harnessing the potential of this geospatial dataset through digital mapping.

Watch on YouTube

Ren Capucao’s presentation is part of our NLM History Talks , which promote awareness and use of the National Library of Medicine and other historical collections for research, education, and public service in biomedicine, the social sciences, and the humanities. All talks are live-streamed globally, and subsequently archived, by NIH VideoCasting . Stay informed about the lecture series on Twitter at #NLMHistTalk .

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