Posttraumatic Stress Symptoms, Experiences of Trauma, and Coping among Pakistani Frontline Nurses Caring for COVID-19 Patients: A Qualitative Study

This study examines the relationship between cognitive processes and job performance in teachers at the Cruz del Norte Educational Unit, focusing on attention, planning, organization, anxiety, and job stress. A mixed-method design was applied, combining quantitative and qualitative techniques such as psychometric tests, Pearson correlation, multiple regression analysis, Student’s t-test, the Delphi method, and the Ishikawa diagram. The results show that executive functions, particularly planning and organization, have a significant positive impact on job performance. Teachers with higher levels of these skills demonstrate better performance, with strong correlations (r = 0.72, p = 0.001; r = 0.65, p = 0.003). In contrast, anxiety and stress act as limiting factors. Multiple regression analysis indicates that anxiety (β = -0.4946, p < 0.0001) and stress (β = -0.3721, p < 0.001) negatively predict job performance. Additionally, job indiscipline—reflected in absenteeism and lateness—shows a strong negative correlation with performance (r = -0.74, p < 0.000). These findings highlight the importance of time management and organizational commitment, as well as the need to implement training and psychological support strategies to improve teacher performance and educational quality.

این مطالعه به بررسی رابطه بین فرایندهای شناختی و عملکرد شغلی در معلمان واحد آموزشی Cruz del Norte می‌پردازد و بر توجه، برنامه‌ریزی، سازمان‌دهی، اضطراب و استرس شغلی تمرکز دارد. از طرح پژوهشی ترکیبی استفاده شده است که تکنیک‌های کمی و کیفی مانند آزمون‌های روان‌سنجی، همبستگی پیرسون، تحلیل رگرسیون چندگانه، آزمون t استیودنت، روش دلفی و نمودار ایشیکاوا را ترکیب می‌کند. نتایج نشان می‌دهد که کارکردهای اجرایی، به‌ویژه برنامه‌ریزی و سازمان‌دهی، تأثیر مثبت معناداری بر عملکرد شغلی دارند. معلمانی که سطوح بالاتری از این مهارت‌ها را دارا هستند، عملکرد بهتری از خود نشان می‌دهند و همبستگی‌های قوی (r = ۰.۷۲, p = ۰.۰۰۱؛ r = ۰.۶۵, p = ۰.۰۰۳) مشاهده شده است. در مقابل، اضطراب و استرس به‌عنوان عوامل محدودکننده عمل می‌کنند. تحلیل رگرسیون چندگانه نشان می‌دهد که اضطراب (β = -۰.۴۹۴۶, p < ۰.۰۰۰۱) و استرس (β = -۰.۳۷۲۱, p < ۰.۰۰۱) پیش‌بینی‌کننده منفی عملکرد شغلی هستند. همچنین، بی‌انضباطی شغلی—که در غیبت و تأخیر منعکس می‌شود—همبستگی منفی قوی با عملکرد دارد (r = -۰.۷۴, p < ۰.۰۰۰). این یافته‌ها اهمیت مدیریت زمان و تعهد سازمانی و همچنین ضرورت اجرای راهبردهای آموزشی و حمایت روان‌شناختی برای بهبود عملکرد معلمان و کیفیت آموزشی را برجسته می‌کند.

This study examines the relationship between cognitive processes and job performance in teachers at the Cruz del Norte Educational Unit, focusing on attention, planning, organization, anxiety, and job stress. A mixed-method design was applied, combining quantitative and qualitative techniques such as psychometric tests, Pearson correlation, multiple regression analysis, Student’s t-test, the Delphi method, and the Ishikawa diagram. The results show that executive functions, particularly planning and organization, have a significant positive impact on job performance. Teachers with higher levels of these skills demonstrate better performance, with strong correlations (r = 0.72, p = 0.001; r = 0.65, p = 0.003). In contrast, anxiety and stress act as limiting factors. Multiple regression analysis indicates that anxiety (β = -0.4946, p < 0.0001) and stress (β = -0.3721, p < 0.001) negatively predict job performance. Additionally, job indiscipline—reflected in absenteeism and lateness—shows a strong negative correlation with performance (r = -0.74, p < 0.000). These findings highlight the importance of time management and organizational commitment, as well as the need to implement training and psychological support strategies to improve teacher performance and educational quality.

این مطالعه به بررسی رابطه بین فرایندهای شناختی و عملکرد شغلی در معلمان واحد آموزشی Cruz del Norte می‌پردازد و بر توجه، برنامه‌ریزی، سازمان‌دهی، اضطراب و استرس شغلی تمرکز دارد. از طرح پژوهشی ترکیبی استفاده شده است که تکنیک‌های کمی و کیفی مانند آزمون‌های روان‌سنجی، همبستگی پیرسون، تحلیل رگرسیون چندگانه، آزمون t استیودنت، روش دلفی و نمودار ایشیکاوا را ترکیب می‌کند. نتایج نشان می‌دهد که کارکردهای اجرایی، به‌ویژه برنامه‌ریزی و سازمان‌دهی، تأثیر مثبت معناداری بر عملکرد شغلی دارند. معلمانی که سطوح بالاتری از این مهارت‌ها را دارا هستند، عملکرد بهتری از خود نشان می‌دهند و همبستگی‌های قوی (r = ۰.۷۲, p = ۰.۰۰۱؛ r = ۰.۶۵, p = ۰.۰۰۳) مشاهده شده است. در مقابل، اضطراب و استرس به‌عنوان عوامل محدودکننده عمل می‌کنند. تحلیل رگرسیون چندگانه نشان می‌دهد که اضطراب (β = -۰.۴۹۴۶, p < ۰.۰۰۰۱) و استرس (β = -۰.۳۷۲۱, p < ۰.۰۰۱) پیش‌بینی‌کننده منفی عملکرد شغلی هستند. همچنین، بی‌انضباطی شغلی—که در غیبت و تأخیر منعکس می‌شود—همبستگی منفی قوی با عملکرد دارد (r = -۰.۷۴, p < ۰.۰۰۰). این یافته‌ها اهمیت مدیریت زمان و تعهد سازمانی و همچنین ضرورت اجرای راهبردهای آموزشی و حمایت روان‌شناختی برای بهبود عملکرد معلمان و کیفیت آموزشی را برجسته می‌کند.

Human immunodeficiency virus (HIV) infection remains a growing public health concern in the Philippines, where new infections rose by about 550% between 2010 and 2024 and diagnosis gaps persist in CALABARZON. Nurses are often the first and most sustained point of contact in HIV testing and care, yet knowledge gaps, stigmatizing attitudes, and procedure-focused training may limit their ability to provide compassionate, person-centered counseling. This study aims to develop and validate a Caring-Based HIV Counseling Training Program for Nurses in Laguna, Philippines, using a methodological research design and a modified Delphi technique. Registered nurses from selected government and private healthcare facilities in Laguna will complete a researcher-developed training-needs assessment questionnaire covering six competency domains: HIV-related knowledge; counseling and therapeutic communication; caring behaviors and person-centered practice; ethical and legal responsibilities; cultural sensitivity and stigma reduction; and linkage to prevention, treatment, care, and support. The questionnaire will undergo expert review, pilot testing, and reliability testing using Cronbach’s alpha. The needs-assessment findings, together with a review of current literature and guidelines, will inform a preliminary training program, which a multidisciplinary panel of approximately 15 to 20 experts will evaluate over successive anonymous Delphi rounds for relevance, clarity, comprehensiveness, cultural appropriateness, feasibility, and applicability. Consensus is defined in advance as at least 80% expert agreement, a median rating of at least 3.00, and an interquartile range of no more than 1.00. Content validity will be established through an Item-Level Content Validity Index of at least .78 and a Scale-Level Content Validity Index (average) of at least .90, overall agreement will be measured with Kendall’s coefficient of concordance, and the experts’ qualitative comments will undergo directed content analysis. The study is expected to produce an expert-validated, contextually relevant training program that strengthens nurses’ capacity to deliver compassionate, stigma-free HIV counseling, with its effectiveness to be tested in a future pilot or quasi-experimental study.

ABSTRACT Introduction Anxiety is central to the psychotherapy process, yet psychotherapists routinely infer a client's anxiety intensity from observable behaviour rather than from formal measurement, with no widely accepted framework to organise which observable markers indicate which levels of anxiety. This exploratory study examined how therapists make such classifications. Method Ninety‐one mental health professionals were randomly assigned to classify 41 text‐described behavioural and physiological markers using either a 5‐level or a simplified 3‐level category system, both derived from an integrated model of state anxiety in psychotherapy. Results Response distributions departed significantly from uniformity for nearly all markers in both formats, and the rank ordering of markers by intensity was highly consistent across formats, suggesting that therapists may share broad intuitions about relative marker intensity. Which markers elicited agreement, however, was far less reproducible, depending substantially on the response format. Convergence also depended on where the agreement criterion was set, declining from 90.2% to 51.2% of markers in the 3‐level format and from 63.4% to 22.0% in the 5‐level format as the criterion rose from > 0.50 to > 0.70. The 3‐level format yielded more classifiable markers at every criterion, although this advantage was not consistent across indices, whereas the 5‐level format elicited fewer ‘Insufficient to Determine’ responses. Markers placed at the highest intensity levels were classified most consistently. Discussion These findings offer preliminary groundwork for research on marker operationalisation, contextualised rating tasks and the development of training materials for psychotherapy process research.

Background: Patients with chronic kidney disease undergoing hemodialysis frequently experience physical and psychological complaints that may affect their sleep quality. Uremic pruritus, restless legs syndrome, anxiety, and post-hemodialysis fatigue are potential factors that may disrupt sleep quality. Objective: This study aimed to identify the factors influencing the sleep quality of patients with chronic kidney disease undergoing hemodialysis at Bahteramas Regional General Hospital, Southeast Sulawesi Province. Methods: This study employed a quantitative analytical approach with a cross-sectional design. The sample consisted of 83 respondents. Data were collected using the Pittsburgh Sleep Quality Index (PSQI), 5-D Itch Scale, International Restless Legs Syndrome Rating Scale (IRLS), Hospital Anxiety and Depression Scale-Anxiety (HADS-A), and a post-hemodialysis fatigue assessment instrument. Data were analyzed using the Chi-square test and binary logistic regression. Results: Bivariate analysis showed that uremic pruritus (p = 0.046), restless legs syndrome (p = 0.015), anxiety (p = 0.029), and post-hemodialysis fatigue (p = 0.049) were statistically significant factors associated with sleep quality. Simultaneously, the four variables had a statistically significant effect on sleep quality (p = 0.007), with a Nagelkerke R Square value of 0.217. In the multivariable analysis, only anxiety showed a statistically significant independent effect (p = 0.019). Conclusion: Uremic pruritus, restless legs syndrome, anxiety, and post-hemodialysis fatigue were statistically associated with sleep quality in the bivariate analysis. The four variables were jointly significant in the multivariable model, whereas only anxiety remained statistically significant after adjustment for the other variables.