Objective:To determine the influence of community health nurses' social support on non-adherence with the maintenance phase of directly observed therapy (DOTS) among patients with tuberculosis (TB).Design: Prospective-cohort. Sample:One hundred purposively selected patients with TB starting with DOTS maintenance phase. Measurements:Participants answered the robotfoto and Berlin Social Support Scale (BSSS) to assess demographics and social support provided by nurses. Non-adherence was measured using the attendance record and documented in an abstraction form.Cox proportion-hazards regression determined the influence of social support provided by nurses to non-adherence. Results:With a median adherence of 3 weeks, 15% of the sample was non-adherent. The hazard of non-adherence was lower with high perceived emotional support (HR = 0.25, p = .046), perceived instrumental support (HR = 0.20, p = .044), perceived support seeking (HR = 0.27, p = .045), and received emotional support (HR = 0.45, p = .045).High received emotional support increased non-adherence (HR = 2.65, p = .039). Conclusion: Social support from nurses influenced DOTS non-adherence among patients with TB, a critical issue in the development of drug-resistance. Perceived emotional, instrumental, support seeking and received emotional support decreased the hazard of non-adherence, while received emotional support increased non-adherence. This study highlights the need to promote positive perception of instrumental support needs. Appropriate interventions should be provided to promote supportseeking skills. K E Y W O R D S community health nurses, DOTS program, perceived social support, Philippines, received social support 2 | ME THODS | Research design, subjects, and settingThis study employed a prospective-cohort design and recruited participants who were at least 18 years old, category I (newly diagnosed, smear-positive) pulmonary TB patients, about to start the maintenance phase of the DOTS program.A total of 100 purposively selected participants were included which yielded a power of 99.97% at a significance of 5% (two-tailed).This study was conducted in selected health centers from the cities of Manila, Quezon, and Marikina, Philippines. These health centers are accredited DOTS Satellite Treatment Centers of the Philippine Department of Health and provide a variety services for patients with TB. | Data measuresParticipants completed a two-part survey composed of the robotfoto and the BSSS. The robotfoto, a Dutch term denoting one's

The stress-moderated model of the influence of spirituality to depression highlights three significant points. First, there is a need to develop individualized, spiritually based interventions based on the spiritual needs of Registered Nurses. Second, policies geared towards positive spirituality in the workplace and spiritual support to nurses must be explored. Finally, nurse managers must identify the sources of occupational stress and implement stress-reducing programmes in the workplace.

No abstract

Objectives: Although the importance of home caregivers of chronic kidney disease patients has been increasingly recognized, their perceived caregiving difficulties and requisites remain underexplored. This study investigated the challenges and needs of home caregivers of hemodialysis patients in the Philippines. Methods:We utilized a mixed-method (QUAN + qual), explanatory sequential design. Data were collected from July 2017 to May 2018 from 46 home caregivers of hemodialysis patients. A three-part researcher-made survey were developed from literature search, personal values and cultural context, while some items were generated from a standardized tool that measures caregiver infrastructure and needs of those caring from frail US veterans. The tool developed gathered the participants' profile, caregiving characteristics, and related needs. The tool was validated and pretested for reliability. Fifteen participants were also interviewed to explore caregiving challenges and needs. Descriptive and χ 2 statistics were used for quantitative outcomes, while thematic analysis was employed for qualitative data.Results: Participants provided moderate assistance to patients, spending an average of 10.65 h/day and 5.08 days/week in caregiving. The most difficult caregiving circumstances were having costly expenses (78.26%); missing work (50.00%); and experiencing negative feelings (47.83%), stress (43.48%), and physical difficulties (34.78%). They also had the lowest confidence in deciding when to contact health providers (x̅ = 3.31, SD = 0.94) and finding patient care services (x̅ = 2.93, SD = 1.08).Qualitative findings further revealed caregiving needs and challenges in cost management, physical and psychological health, assumption of multiple roles, lifestyle adjustment, and reinforcement of carer knowledge, skills, and attitudes. Conclusion:Supportive strategies are needed to address the challenges encountered by home caregivers of hemodialysis patients. Findings can be utilized in developing appropriate interventions for home caregivers in low-resource settings