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CHAPTER I

INTRODUCTION

Background of the Study

Diabetes mellitus is a significant health problem by itself. Among the growing number of

diabetic population, its complication is myriad. The improvement of medical treatment for this

disease and also some diabetic person may go undiagnosed; this contributes to the increasing

number of diabetic individuals developing the long-term complications of diabetes mellitus. This

just signifies that the blood glucose level has been elevated for a long time before it can be

diagnose.

It is estimated by health authorities that about one-third of diabetics are totally unaware

and undiagnosed of this disease. Blindness, congenital abnormalities, lower extremities

amputation, renal failure and the susceptibility of the diabetic individual to several kinds of

infections are the major complications of a diabetic person, especially having that disease for a

long time. It can develop at any age and susceptibility gradually increases up to age 40, and then

rapidly increases.

The fundamental problem in diabetes is the bodys inability to metabolize glucose, the

simplest form of carbohydrates, fully and continually. This is a vital process in creating body cell

energy, because glucose is the main source of nutrient giving energy to all activities happening

inside the body. The unused glucose is stored under normal conditions in the form of glycogen,

or animal starch, in the liver and muscle for later use at which time it is reconverted to glucose.

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Diabetes is not an all or nothing phenomenon. It can be mild, moderate, or severe and

can fluctuate in degree in any one individual over a long period of time, or even from day to day.

Very little is known about the reasons for these differences and changes. It is known, however,

that diabetes generally gets worse in the presence of illness particularly infections (even cold). It

is also affected adversely by hyper functioning diseases of the anterior pituitary, thyroid and

adrenal glands, by emotional and physical stress and during pregnancy.1

This disease has been known for several thousand years, because people with the disease

when untreated, may urinate copiously and frequently, the Ancient Greeks named it diabetes

(meaning siphon). In the late seventeenth century the name mellitus (meaning sweet) wasadded. In the early days, diagnosis was made by tasting the urine. The sweetness caused by the

presence of glucose in the urine; its presence distinguishes diabetes mellitus from much rarer

diabetes insipid us which is entirely different problem. 2

Since the discovery of insulin 1921, deaths attributed to diabetes have decreased

dramatically. New knowledge and techniques have made it possible to do more and more for

diabetics. Dr. Elliot Joslin, a pioneer in the treatment of diabetes, realized that the diabetic

patient needed to have a full understanding of his disease that he could take care of himself. He

contended that diabetic individuals with the chronic abnormality of a delicate and dynamic

metabolic process could not be cared for successfully solely by knowledgeable physicians. The

patient and his family had to be informed about the disease and have to make day-to-day

decisions about managing it.

1 The New Complete Medical and Health Encyclopedia, Volume Two, (Chicago: J.G, Feguson publisherCmpany), Copyright 1993

2 Ibid

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For these reasons, this study could significantly address this rather problematic situation

on misinformation relative to diabetes as a disease, and in essence establish an information base

that could alter peoples beliefs and practices towards the positive side of the health continuum

Statement of the Problem

This study was generally concerned with the health beliefs and practices among

individuals with diabetes mellitus in selected barangays of Bobon, Northern Samar. It further

determined the implications of the health beliefs and practices to the development of a health

care management program.Specifically, the study sought to answer the following questions:

1. What is the demographic profile of the respondents in terms of:1.1age,1.2gender,1.3civil status,1.4educational attainment,1.5occupation,1.6monthly salary?

2. What are the common health beliefs of the respondents in terms of:2.1diet and nutrition,2.2hygiene,2.3exercise, and2.4disease and treatment?

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3. What are the common health practices of the respondents in regards to their diabetictreatment?

4. Is there any significant relationship between the respondents profile and their healthbeliefs and health practices?

5. What implications to health care management can be drawn from the proposed programor findings of the study?

Objectives of the Study

This study attempted to present the health beliefs and practices of individuals with

diabetes mellitus in selected barangays of Bobon, Northern Samar.

It will aim:

1. To present the demographic profile of the respondents in terms of:

1.1age,1.2gender,1.3civil status,1.4 educational attainment,1.5occupation,1.6monthly salary.

2. To know the health beliefs of the respondents in terms of:

2.1diet and nutrition,2.2hygiene,

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2.3exercise, and2.4 disease and treatment.

3. To know the health practices of the respondents as regards to their diabetic treatment;

4. To determine the relationship between the respondents health practices and the health care

management, and

5. To draw implications to health care management from the proposed program or findings of

the study.

Significance of the Study

This study will provide factual information regarding one of todays most known, yet

poorly understood, disease---diabetes mellitus. The results of this study will be useful to many

individuals and institutions, such as;

Health Policy Makers. The top personnel of the Department of Health can gain

significant insights from this study on the beliefs and practices of diabetic individuals. In essence,

they may be able to formulate corrective and strengthening policies aimed at controlling the

effects of diabetes mellitus on the population in general,and at assisting diabetic individuals in

the diagnosis and treatment of this disease.

The General Public. The study will likewise inform and educate the people on the myths

and facts regarding diabetes mellitus. Consequently, the people will be able to live a healthy life

and avoid the affliction diabetes mellitus if possible.

Public Health Nurses. The data and information that will be generated by this study will

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be a useful source of knowledge in the formulation of appropriate nursing intervention protocols

designed to promote the health of diabetic individuals.

The Families of Diabetic Individuals. Moreover, the families will be educated also as to

the proper health care management for their diabetic family member, and for them to be an

effective support system for diabetic individuals.

The Diabetic Individuals. The study is an education and information campaign material

to educate diabetic individuals regarding the myths and facts of diabetes mellitus. In this regard,

they will be in a better position to care for themselves through proper health practices

specifically recommended to diabetic individuals.

The Researchers. The data and information of this study could serve as inputs in

researches involving the diagnosis and treatment of diabetes mellitus in affected individuals.

Student Nurses. The study will be an additional reference material on the existing pool of

data and information regarding diabetes mellitus. Consequently, student nurses may be able to

acquire more knowledge on this disease thereby making them more equipped, theoretically and

practically, in devising patient care for diabetic individual.

Scope and Limitations of the Study

The study primarily dealt on determining how the respondents beliefs regarding diabetes

mellitus are translated into practices, and how their beliefs and practices bears implications to

health care management for diabetic individuals. Likewise, this study will aim to enrich the

research database by including the respondents knowledge about their illness, and their

conception on the kind of treatment they receive or should receive. Moreover, the reactions of

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the diabetic individuals regarding their disease were also assessed.

Finally, the study was limited to the list of diabetic individuals taken from the record at

the Municipal Health Center of Bobon, Northern Samar as of 2010-2011, with a total population

of fifty-five individuals in the different barangays of Bobon. These fifty five persons are the

patients who had or having a check-up at the Municipal Health Center of Bobon.

Theoretical Framework

The study was fundamentally conceptualized and organized based on some theories

pertaining to beliefs and practices. They served as springboard and operational basis for this

study. This study had its theoretical foundation primarily taken from the Values Theory since it is

the operant concept underlying our beliefs.

Frank Lynch5 defines values as deep-rooted motivations of behavior. They define what is

important to us and are the bases of our choices, decisions, reactions and behavior. Men are

determined, at least in part, by their ideas of the relative value of different activities, therefore,

the quality of desirability or undesirability believed to be inherent in an idea, object, and action.

It is our values which define what is most important to us. It refers to any aspect of a situation,

event, or object that is considered good, bad, desirable and the like.

Furthermore, shared values are considered cultural values and social values are those

regarded as essential or conducive to the welfare of a given group. They constitute models of

personal behavior in social interaction and are people's conception of the desirable, their choice

of alternatives, and the direction of their attention, interest, or emphasis.6

5 Chester L. Hunt,et.al.,Sociology in the Philippine Setting; A Modular Approach,(Manila;Rex BookStore),Copyright 1987.

6Hunt,et.al.,Ibid

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The health Belief of Model postulated by Becker7 claims that health- seeking behavior is

influenced by a person's perception of a threat posed by a health problem and the value

associated with actions aimed of reducing the threat. The major components of HBM includes

perceive susceptibility, perceived severity, perceived benefits and cost, motivation, and enabling

or modifying factors. Perceived susceptibility refers to a person's perception that a health

problem is personally relevant or that a diagnosis of illness is accurate. Even when one

recognizes personal susceptibility, action will not occur unless the individual perceives the

severity to be high enough to have serious organic or social implications. Perceived benefits refer

to the patient's beliefs that a given treatment will cure the illness or help prevent it, and perceivedcosts refer to the complexity, duration and accessibility of the treatment. Motivation includes the

desire to comply with a treatment and the belief that people should do what is prescribed by

health care personnel. Among the modifying factors that have been identified are personality

variables, patient satisfaction, and socio-demographic factors.

Conceptual Framework

The researcher fundamentally assumed that diabetic individuals have varied beliefs and

notions regarding diabetes mellitus, and that they place certain values upon their belief.

Therefore, the profile of the respondents in terms of age, gender, civil status, educational

attainment, occupation and monthly salary and their beliefs and practices has implication to the

health care management.

The left schema shows the independent variable consisting of the respondents

demographic profile and their health beliefs and practices, which affects the implication of the

7 Denise F. Polit and Bernadette P. Hungler, Nursing Research;Principles and Methods, 6thEdition,(USA;Lippincott,Wilkins), Copyright 1999.

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health care management. Furthermore, this dependent variable in the right schema will have an

effect on the respondents health beliefs and practices. This could result to changes on the health

beliefs and practices that the respondents have known before the implication health care

management is done. Therefore, the health beliefs and practices of the respondents will have a

great impact to the implication of health care management and vice versa. To reinforce this

concept, a paradigm is shown below:

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Paradigm

Independent Variables Dependent Variables

Figure 1.A schematic diagram between the independent and dependent variables.

1. Demographic Profile of therespondents

1.1age;1.2gender;1.3civil status;1.4educational attainment;1.5occupation; and1.6monthly salary.

2. Health Beliefs of the Respondents2.1diet and nutrition;2.2hygiene;2.3exercise; and2.4disease and treatment.

3. Health Practices of theRespondents

Implication to

Health Care

Management

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Null Hypotheses

The following null hypotheses were tested for significance:

Ho1: The demographic profile of the respondents has no significant influence upon their health

beliefs and health practices.

Ho2: The health beliefs of the respondents have no significant influence over their health

practices.

Definition of Terms

Some important terms used in this study are herein defined conceptually and/or

operationally to facilitate appropriate understanding of their usage.

Age. Operationally, this refers to the length of time during which a diabetic individual

has live or existed.

Beliefs. Conceptually refers to probable knowledge or mental conviction; that which is

believed and accepted as true or actual. Operationally, this means the accepted knowledge of the

diabetic individuals.

Civil Status. Conceptually, this means the marital status of each individual in

relation to the marriage laws or customs of the country.8In this study, this is use as the status of

8Merriam Webster Dictionary, 2000

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the diabetic individual whether the respondent is married, single, widowed, etc.

Demographic Profile. In this study, demographic profile refers to the characteristics of

the diabetic individuals as respondents of the study with respect to the age, sex, civil status,

educational attainment and occupation.9

Diabetes Mellitus. A disease characterized by the bodys inability to metabolize glucose,

a common form of sugar, fully and continually. It is metabolic disease affecting carbohydrate,

protein, and lipid metabolism.10 Operationally, this means as the disease affecting the

researchers respondents.

Diet. Conceptually defined as the food and drink normally taken by an individual or a

group, or as prescribed course of what is to be eaten and what is not.11 Operationally, it is used as

the respondent kinds of food and drinks that he/she normally takes in from the time of diagnosis

of his/her disease.

Disease. Conceptually, it is defined as the departure from state of health caused by

interruptions or modifications of any of the vital functions and characterized by a definite train of

symptoms. 12 Operationally used as the respondents state of illness having the disease of

diabetes mellitus.

9Oxford Dictionary, Ibid10The New Complete Health and Medical Encyclopedia, op.cit.11The New Webster Dictionary of the English Language, International Edition, p. 265.12Blackwells Nursing Dictionary, Second Edition, page 186.

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Educational Attainment. The highest diploma or degree, or level of work towards a

diploma or degree, an individual has completed.13 Operationally, this means the respondents

achievement based on educational level.

Exercise. Conceptually, this means the performance of physical exertion for the purposes

of improving ones health, correcting a deformity, or developing a particular skill. 14

Operationally, this is used as the diabetic individual form of activity in terms of controlling

his/her disease.

Gender. This refers to the biological and physiological characteristics that define men

and women. 15 Operationally used as the biological and physiological characteristics of the

diabetic individual.

Health. Conceptually this means the state of complete physical, mental, and social well-

being, not merely the absence of disease or infirmity. It is also refers to the optimum level of the

functioning by individuals, families, and communities in factors such as political, behavioural,

hereditary, health care delivery system, and in the influences of social, economic, and

environmental factors.16Operationally used as the status of a diabetic individual in regards to

their optimum level of functioning whether physically, mentally or socially.

Health Beliefs. Operationally, this refers to the respondents knowledge and acceptance

of ideas, objects, or actions related to their mental and physical wellness. It may refer to the

accepted knowledge of respondents regarding diabetes mellitus.

13Merriam Webster Dictionary, Loc cit.14Blackwells Nursing Dictionary, 2nd Ed., page 221.15Merriam Webster Dictionary, Ibid.16Oxford Dictionary, 2000

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Health Care. Its defined as the services sought by people who need help for physical or

emotional problems. 17 In this study this means the care or services that are given to the

diagnosed diabetic individuals.

Health Care Management. Operationally, this means to the services render to attain the

goal on how to control the disease of these diabetic individuals.

Health Practices. Operationally, this refers to the action or actual activities of the

respondents in relation to the maintenance of their mental and physical wellness, and especially

with respect to their reactive behaviour towards diabetes mellitus. Health practices include

among others diet and nutrition, exercise and hygiene.

Health Status. As used in this study, health status refers to the condition of the diabetic

individuals with respect to the following indicators: body weight, blood sugar level, average

blood pressure, other diagnosed ailments or diseases.

Hygiene. This is conceptually defined as the condition or practice , such as cleanliness,

that is conducive to the preservation of health. 18In this study, this means the beliefs of the

respondents on the proper way to maintain cleanliness in their environment and to their selves.

Implications. Operationally, this refers to the direct effects of the respondents health

beliefs and health practices upon the health care management program for diabetic individuals. It

may involve patient education program on diabetes mellitus and how it is affected by the health

beliefs and health practices of respondents.

17Blackwells Nursing Dictionary, 2nd Ed., p. 269.18Blackwells Nursing Dictionary, 2nd Ed., page284.

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Management. Conceptually defined as to being controlled.19 Operationally used as how

diabetic individuals control their blood sugar level.

Monthly Salary. Wages received on a regular basis, Sometimes the term is used to

include other benefits, including insurance and a retirement plan.

Nutrition. Defined conceptually as the sum total of the processes by which the living

organism receives and utilizes the materials necessary for survival, growth and repair of tissues,

the creation and liberation of energy, and the elimination of waste products and of unusable

portions of the materials.20 Operationally used as the type of food and fluid a diabetic individual

take in that gives him/her the necessary components in the body to maintain his/her homeostasis

despite of having a disease.

Occupation. A persons usual or principal work or business, especially as means of

earning a living, or the activity that serves as ones regular source of livelihood.21Operationally

used as the diabetic individual work in which where the respondents sustain his/her daily living.

Treatment. This means as the medical, surgical or psychological care of a person, aimed

at relieving symptoms of a disease or injury or curing the condition. Operationally, it is the

medical and nursing service given to the diabetic population having there check-up at the

municipal health center.22

19The New Websters Dictionary of the English Language, International Edition, p. 605.20Blackwells Nursing Dictionary, 2nd Ed., p. 403.21Merriam Webster Dictionary, 200022Blackwells Nursing Dictionary, 2nd Ed., p.623.

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CHAPTER II

REVIEW OF RELATED LITERATURE AND STUDIES

Related Literature

The foregoing literature which are herein presented and reviewed has been instrumental

in the conceptualization of this study. They specifically contributed to the formulation of the

theory, statement of the problem, paradigm and hypothesis.

TYPES OF DIABETES. Diabetes occurs when the body becomes unable to handle

glucose (sugar) which builds up to dangerous levels in the blood. The problem revolves around

insulin, a pancreatic hormone that enables body cells to use glucose and thus brings down high

blood sugar levels. There are two kinds of diabetes, both of which are characterized by excessive

urination and thirst as follows:

Type I which afflicts about 5% of diabetics is often hereditary and usually begins in the

childhood or youth and is commonly called Juvenile Diabetes. Since these diabetics cannot

survive without insulin, it is now officially called as Insulin Dependent Diabetes Mellitus

(IDDM). The peak onset of type one diabetes mellitus is at age 11-13 years old and rarely

younger than 1 year and adults older than 30 years. Type II is different and often called Adult

Onset Diabetes or Non-Insulin Dependent Diabetes Mellitus (NIDDM). It afflicts millions of

people and generally hits after age 40, so as people gets older and fatter. In contrast to juvenile

diabetics, most Type II diabetes when diagnosed has plenty of insulin in their bodies.

The etiology of diabetes mellitus includes a combination of genetic and environmental

factors. The recent increase in the frequency of the disease is probably the result of trends toward

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more sedentary lifestyles, increasing consumption of high caloric foods and resultant obesity,

and increased longevity.

Studies demonstrate a strong relationship to fat, both fat in diet and fat on the body. The

disease is rare in areas of the world where fat intake is low and obesity uncommon. Most of the

time, the problem in adult onset diabetes is not a defective pancreas unable to produce sufficient

insulin but lack of sensitivity to insulin. This resistance of cells to insulin apparently relates

directly to obesity and to excess fat in the diet.23

Specific environmental factors linked to type 1 diabetes are the rubella virus where 40%

of individuals infection develops type 1 diabetes mellitus later, also the cytomegalovirus.Persistent cytomegalovirus infections appear to be relevant to the pathogenesis of some cases of

type 1 diabetes mellitus. 24

For the child or adolescent who has diabetes, there are psychosocial and cultural

considerations of compliance with medication and dietary regimen. Even if diagnosed early in

life (with learned behaviors regarding the disease parameters), the elementary school years can

be difficult for some children with diabetes. Social events such as birthday parties, field trips,

and after- school snack time, where sweet treats are the norm, serve as psychological and

physical temptation.

During adolescence, when the teen wants to fit in with a peer group, the diabetic regimen

can become difficult. It is during this time that failure to take insulin or follow dietary guidelines

becomes an issue that negatively affect present and future health. Some teens may have insulin

pumps and can more easily take extra insulin to cover foods not usually on their diet. The ability

23Aileen Ludington and Hans Diehl,Disarming Diabetes, Health and Home, (Caloocan City: PhilippinePublishing House), Vol. 35-No. 1, January-February 1994.

24Sue E. Huether and Kathyryn L. McCance, Uderstanding Pathopysiology, 3rd ed. (Library of congressCataloging in Publication Data), Copyright 2004, p.489.

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to do this helps teens feel less different from peers, but carried to excess, this practice can also

lead to problems.

In the geriatric population also represents with specific problems with regard to

maintaining a normal blood glucose level. If geriatric clients have been diabetic for most of their

life, they may choose to ignore their recommended therapy regimen because they feel it will

make little difference at this time in their lifespan. Also, elderly clients frequently display

cognitive impairment that distorts their judgement and their desire to maintain their prescribed

diet. 25

DIABETES TREATMENT. Several treatment centers have convincingly demonstratedthat Type II diabetes can normalize their blood sugar levels, often within weeks, by following a

simple diet which is very low in fat and high in fiber coupled with daily exercise. Lowering the

amount of fat, oil and grease in the diet plays a crucial role. When less fat is eaten, less fat

reaches the bloodstream. This begins as complicated process which gradually unblocks the

insulin which can then facilitate the entry of sugar from the bloodstream into the body cells.

Eating fiber-rich foods plays an important role in stabilizing blood sugar levels. Normalizing

body weight is likewise necessary to bring the blood sugar back to normal. Insulin dependent or

juvenile diabetes will need to take insulin for life unless pancreatic transplant become feasible.26

The treatment of diabetes involves the following: (a) Diet-the goal is to lessen fat intake

and increase ingestion of fiber-rich food. In obese clients the primary importance is the

restriction of total caloric intake in order to lose weight that could lead to increase insulin

sensitivity of the cells. (b) Exercise- that is at same time and same amount everyday, with a slow

25Michael Patrick Adams, et. al., Pharmacology for Nurses: A Pathophysiological Approach, 2nd ed.,(Pearson Education Soauth Asia Pte. Ltd.), Copyright 2007, pp. 683-688.

26Ludington and Diehl,, Ibid.

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and gradually increase in the exercise period. Proper diet and exercise can sometimes increase

the sensitivity of insulin receptors to the point that drug therapy is unnecessary for type 2

diabetes mellitus. (c) Oral Drugs-has a common function in lowering blood glucose levels when

taken on a regular basis. Therapy is usually initiated with single agent. If therapeutic goals are

not achieved with monotherapy, two agents are administered concurrently. Failure to achieved

normal blood glucose levels with two oral hypoglycemic agents usually indicates a need for

insulin. (c) Insulin- is more commonly used by type I diabetic client. It is necessary for both the

storage and reconversion of glucose. The desired outcome of insulin therapy is to prevent the

long-term consequences of the disorder by strictly maintaining blood glucose level within thenormal range. Several types of insulin are available, differing in their source, onset and duration

of action. Until 1980s, the source of all insulin was beef or pork pancreas. Almost all insulin

today, however, is human insulin obtained through recombinant DNA technology because it is

more effective, causes fewer allergies, and has lower incidence of resistance, which is given by

injection (subcutaneous) because it is destroyed by gastric secretions when taken orally; (d) The

Insulin Pump-development of a pump for infusion of insulin into the body offers alternatives of

treating diabetics with keto-acidosis or ketosis. The insulin pump includes a reservoir for insulin,

a peristaltic pump that impels the fluid by contracting and expanding, and a power pack to

activate the pump. 27

Stevia (stevia rebadaudiana) is a herb belonging to the sunflower family that may be

helpful to clients with diabetes. Although widely used in Japan and other Asian countries as a

sweetener, the Food and Drug Administration (FDA) has not approved it is use for this purpose

because there are concerns that substance in the herb may cause mutations. Thus, although not

27Medical and Health Encyclopedia, Ibid

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permitted as food additive, the powdered extract is readily available as a dietary supplement and

can be used in place of sugar. Its sweetening power is 300 times that of sugar but does not appear

to have negative effect on blood glucose or insulin secretion. In animal experiments, stevia

significantly elevated the glucose clearance, an effect that may be helpful to those with diabetes.

Another study done on type 2 diabetic clients showed that stevia reduces postprandial (after

eating) blood glucose levels. 28

Prolonged hyperglycemia or excess sugar in the blood, from insufficient insulin activity

can cause diabetic coma. This condition involves the increasing build up of ketone bodies, the

by-products of fat metabolism, which creates an acedotic condition (chemical imbalance in the

blood marked by excess acid). When this has been present for several days, symptoms begin to

develop that are similar to those associated with the onset of diabetes. They include excessive

urination and thirst, dry and hot skin, drowsiness and finally coma. The earliest stage of the

problem is called diabetic ketosis; a slightly later is known as diabetic acidosis.29

DIABETES INCIDENCE. The Genera-based World Health Organization (WHO)

published global estimates on the prevalence of diabetes. It described its findings as alarming

especially for developing countries and ethnic minorities in industrialized countries.

Communities in these categories have shown dramatic increases in diabetes prevalence

particularly in the eastern Mediterranean and Middle East, Southeast Asia, and Western Pacific.

In such areas, diabetes can often affect about 20 percent of the adult population, rising to 50

percent in some cases.

28Michael Patrick Adams, et. al., Pharmacology for Nurses: A Pathophysiological Approach, 2nd ed.,(Pearson Education Soauth Asia Pte. Ltd.), Copyright 2007, p. 691.

29Ibid.

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In the United States, diabetes is the third leading cause of deaths. From 1980 through

2001, the number of Americans with diabetes has more than double and increased in all age

groups. Currently, it is estimated that more than 23 million people newly diagnosed with diabetes

increase by about 1 million per year.

Diabetes has far-reaching and devastating physical, social and economic consequences,

that includes (a) being the leading cause of nontraumatic amputations, blindness in working-age

adults and end-stage renal disease,(b) diabetes as the 3rd leading cause of death due to high rate

of cardiovascular disease among people with diabetes, (c) hospitalization rates for people with

diabetes are 2.4 times greater for adults and 5.3 times greater for children than for the general

population.

Diabetes Mellitus is one of the leading causes of disability in persons over 45 years old.

Moreover, the Diabetes Foundation of the Philippines said that more than four million Filipinos

are afflicted with the disease. Diabetes mortality rate in the total population has increased by

ninety-two percent over a ten-year period from 5.1/100,000 in 1986 to 9.8/100,000 in 1995.30

The economic costs of the diabetes continue to increase because of increasing health care

costs and aging population. Half of all people who have diabetes are hospitalized each year and

severe and life-threatening complications often contribute to the increased rates of

hospitalizations. The consequences of these disease is staggering in terms of the productivity

30Frances Prescilla L. Cuevas, RN, MAN, Ed., Public Health Nursing in the Philippines, 10 th ed., p.178-194.

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loses, not withstanding the emotional and psychological havoc it brings to those who are

afflicted and their families.31

Related Studies

Ravussin and colleagues surveyed a closely related population of Pima Indians in the

remote region of North-Western Mexico. They found that individuals in this community ate a

diet lower in fat that is typically consumed in Arizona, and both men women were

physicallyactive. The men and women of Mexico weighed in the average of 50 pounds less than

the PimaIndians of Arizona. More important, diabetes was diagnosed in about 10 percent of the

Mexican Pimas compared with almost 50 percent among the Arizona Pimas. The main staples of

the Mexican Pimas are beans, corn (astorillas), and potatoes. Several essential nutrients are

lacking because of the relative absence of fruits and vegetables. Diet analysis reveals the

following: 13 percent protein, 23 percent fat, 63 percent carbohydrates, and less than 1 percent

alcohol containing five grams of fiber. This is sharp contrast to the diet of the Arizona Pimas.

The Mexican Pimas are hard workers with high level of physical activity averaging 40 hours a

week.

Interventions involving increased physical activity and a reduced fat and energy diet

slowed the progression of Type 2 diabetes in high risk population of Pima Indians.32

31Henrylito D1Tacio, What You Should Know About Diabetes, Health and Home, Vol. 37-No.1,(Kalookan City: Philippine Publishing House), January-February 1996.

32 Eric Ravussin, et. al., Effects of a Traditional Lifestyle on Obesity in Pima Indians

(http://care.diabetesjournals.org/content/17/9/1067), 1994, 10 March.

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Another study conducted by Arayakul33in 1996 investigated the reactions of tuberculosis

patients regarding their illness. The study revealed the following: (a) the respondents had no

knowledge about tuberculosis and did not see the impotence of having an x-ray examination

previous to their sickness. Among the subjects, about 90 percent were confined when the disease

was far advanced. Some patients had treatments before hospitalization and they understood the

purpose of their confinement as well as the rules and regulations of their medication and the

hospital; (b) As to cause of their illness, about 26 percent of the respondents attributed their

sickness to causative germs in the environment, and 4 percent blamed it on bad luck and ill-will

of other people; (c) As to sources of information regarding their disease, medications, andnutrition- about 61 percent were taken from physicians, 27 percent from nurses, and 10 percent

from attendant; and (d) Reactions to illness- about 96 percent were willing to accept and follow

strictly the physicians advice, hospital rules and regulations, as well as health teachings. About

72 percent of the females and 68 percent of the males were worried about additional expenses,

effects of illness on their families, jobs, friends, and their future.

A study on the health beliefs of African-Caribbean people with Type 2 diabetes was

conducted by Ken Brown and Associates 34 to gain an understanding of how health beliefs

influence the way diabetic respondent manage their illness.

Purposive samples of 16 African-Caribbean people with Type 2 diabetes were

interviewed. Participants took part in semi-structured and in-depth interviews which were audio-

33MullikaArayakul, Reactions of Tuberculosis Patients Towards Their Illness and Their Treatment as a

Basis for Patient Education Program, (Graduate Thesis, Philippine Womens University), 1996.

34 Ken Brown, Mark Avis and Michelle Hubbard, Health Beliefs of African-Caribbean People with Type 2Diabetes: A Qualitative Study, School of Nursing University of Nottingham, Nottingham UK, April 10, 2007.

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taped, recorded and transcribed. Transcripts were analyzed for emergent themes and validity was

checked by an independent researcher and through discussion with a local community group.

Participants were strongly influenced by memories of growing up in the Caribbean,

migration to the UK, and friends and families accounts of diabetes as well as their own

experiences of the illness. Knowledge and understanding of diabetes was sometimes poor. There

was some mistrust in the value of advice and treatment offered by professionals and a preference

for natural treatments. Health professional were generally praised but some interviewees felt that

the NHS did not cater properly for black people. Insulin treatments were feared and diet-

controlled or tablet-controlled diabetes was seen by some as a mild form that did not warrantserious concern.

A study conducted by H.C. Cooper, K. Booth and G. Gill focused on patients

perspectives on diabetes health care education formulated the following questions: Would

participation in an intervention program have an impact upon patients illness beliefs? Would it

lead to changes in self-care behaviour of the patients? Would it have an impact upon blood

glucose control?

A total sample size of 48 patients were required to achieve a 1% change in blood glucose

levels as measured through blood tests, and to participate in intervention program for diabetic

patients. This longitudinal study was conducted for a period of 6 months continuous health care

intervention management program to determine changes in patients perspectives on their illness.

Conclusions : While education can empower patients to take on greater responsibility for the

management of their disease, they cannot achieve long-term success without the cooperation of

health professionals who can support and facilitate achievement of patients goals; the argument

for integration of medical and social sciences into professional education so that partnerships

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with patients can be realized becomes imperative; and the responsibility for the management of

the disease resides with patients and the primary role of the health professionals becomes one of

a supporter and educator.35

Similarities and Differences

The study of Ravussin and colleagues is similar with this present study the fact that both

dealt on the prevalence of diabetes , the fundamental difference between the two studies are the

types of respondents and geographical location of the study.

Moreover, the study of Arayakul is somewhat similar with this study because the formerdealt on the reactions towards illness of a certain group of patients and how they specifically feel

towards treatment. In this regard, the present study is similarly aiming to determine reactions to

illness through an evaluation of beliefs and practices. The basic difference between the two

studies is the type of disease being investigated, the former dealt on tuberculosis while the latter

is on diabetes.

The studies of Brown and Associates and Cooper, et. al. are similar with this present

study for the reason that both dealt on diabetes as focus of research. However, the difference in

all the studies reviewed lies in their basic design and focus of evaluation. This present study

attempted to describe the relationship between health beliefs and practices and their implications

to health care management. Meanwhile the two studies reviewed have their focus on the effects

of intervention program on the health care management of diabetic patients, and the health

beliefs of Type 2 diabetic people.

35 H.C. Cooper, K. Booth and G. Gill, Patients Perspectives on Diabetes Health Care Education,(Department of Primary Care- MacMillan Nursing Practice Development Unit), Manchester University, UK.

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CHAPTER III

RESEARCH METHODOLOGY

Locale of the Study

Northern Samar is one of the 3 provinces created by virtue of Republic Act No. 4221 on

June 19, 1965. It is one of the six provinces that comprise Region VIII. It is located on the

Eastern Visayas Region of the Philippine archipelago, bounded in the north by the San Bernardo

Strait; on the west by the Samar Sea; on the south by the Eastern and Western Samar; and on the

east by the Philippine Sea.This province is subdivided into two congressional districts, 24 municipalities and 569

barangays. It ranks 35 in size among 75 provinces of the Philippines, with a total land area of 3,

498 square kilometres. This accounts for approximately 1.2% of the total land area of the country

and about 16.22% of the Region VIII.36

The capital of Northern Samar is the Municipality of Catarman situated at the northern

portion of the island. To its west is the municipality of Bobon where the researcher had

conducted their study in its selected barangays: namely; Barangay Magsaysay, Barangay Sta.

Clara, Barangay General Lucban, Barangay San Juan, Barangay Salvacion and Barangay

Dancalan. Bobon is virtually situated in the central portion of the province composed of 18

satellite barangays scattered all over its 130 square kilometre total land area. The municipality is

bounded on the north by the Pacific Ocean; on the east the municipality of Catarman; on the west

by the municipality of San Jose and on the south by the municipality of Lope de Vega.

36Provincial Government of Northern Samar, Provincial Physical Framework Plan, November, 2003, p.1.

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By income classification, Bobon is considered as fifth-class municipality. Bobon is

primarily an agricultural community with fishing and household level industries as the

secondary-tertiary means of livelihood for the people. The Municipal Health Center is situated in

the government center in the town proper and assisted by 18 Barangay Health Station. The health

personnel is composed of a Municipal Health Officer, community health nurses, community

health midwives, barangay health workers, barangay nutrition scholars, and the Municipal

Sanitary Inspector.37

The Respondents

The respondents or subjects of the study were the diabetic individuals presently residing

within the selected barangays of Bobon, Northern Samar. Based on the records of the Municipal

Health Office in Bobon as of 2010-2011 there are fifty-five diagnosed diabetic individuals who

are having their check-up in the center. These diagnosed diabetic individuals specifically

provided the needed information in the survey questionnaire.

Variables of the Study

The focus of the study was to determine the health beliefs and health practices among

individuals with diabetes mellitus in selected barangays of Bobon, Northern Samar and it's

implication to the health care management.

37Poverty Incidence Among Barangay Residents of Three Selected Barangays of Bobon, Northern Samar:Its Implication to Health Status, (Undergraduate Thesis, Colegio de San Lorenzo Ruiz de Manila), October, 2008,

page 31.

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There were two sets of variables in this study; one were the independent variables that

consisted of the demographic profile of the respondents in terms of age, gender, civil status,

educational attainment, occupation and monthly salary. The independent variables consisted of

the respondents health beliefs and health practices.

The other set of variable was the dependent variable which was the implication of health

care management of the respondents. These data were gathered through distribution of the

research instruments in a form of survey questionnaire.

Research Design

The primary objective of the study was to gather information regarding the health beliefs

and health practices of diabetic individuals, and for this reason, the descriptive method of study

was utilized. Furthermore, the study used the 3 sub-types of descriptive method: the survey

method, the documentary analysis method, and the correlational method.38 In the data gathering,

a survey questionnaire was used which was structured in relation to the statement of the problem.

The survey questionnaire was administered to the pre-identified diabetic individuals from

selected barangays of Bobon, Northern Samar.

The descriptive method of study has many advantages, both to research and to the

researcher. First, descriptive method is designed for the investigation to gather information about

present existing condition. In this way, the researchers may be able to gather relevant

information on the health beliefs and health practices of diabetic individuals. Second, descriptive

research involves the collection of data in order to test hypotheses. 39As such, the researchers

38 Consuelo G. Sevilla, et. al., Research Methods, Revised Edition, (Manila: Rex Book Store), Copyright1987

39 Ibid, pp. 95-97.

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may be able to determine whether health beliefs of diabetic individuals have bearing upon their

health practices. Third, descriptive method lends itself appropriately to investigations which

provide normative standards based on what is present. Consequently, the researchers may be able

to evaluate and compare the health beliefs and health practices of diabetic individuals against the

standard health care management for diabetes patients.

Descriptive-survey method was used to cover the entire population of diabetic individuals

in selected barangays of Bobon based on the census of the municipal health office. Surveys can

be very useful for descriptive purposes as well as in the study of relationships between variables.

This method can assist in comparing existing conditions with predetermined criteria or forevaluating the effectiveness of programs. Likewise, this may aid in testing hypothesis.

The researchers used another type of descriptive method which is the documentary

analysis or content analysis method. This study involves gathering information by examining

records and documents. The data about the respondents population was gathered by means of

analysing documents in the municipal health office.

Correlational study was also utilized in an attempt to measure a number of variables and

then compute the correlation coefficient between them, so as to find which variables are related.

This method helped to determine the relationship between the independent and dependent

variables as shown in the paradigm of this study.40

Research Instruments

The study utilized the survey questionnaire to gather data for the study, and it was

administered to the respondents through interview technique. The design of the research

40Ibid, p. 110.

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instrument was modelled after the specific questions raised by the study in the statement of the

problem section.

Part 1 of the survey questionnaire evaluated the demographic profile of the diabetic

individuals with regards to their age, gender, civil status, educational attainment, occupation and

monthly salary.

Part 2 dealt on assessing the health beliefs of the diabetic individuals.

Part 3 dealt on determining the health practices of the diabetic individuals.

Population and Sampling

The researcher determined the population of the respondents using complete enumeration

of all diagnosed diabetic individuals according to the list of the Municipal Rural Health Unit and

that these individuals were presently residing in the selected barangay of Bobon, Northern

Samar.

Validation of Research Instruments

Considering that the research instrument structured and designed by the student

researchers, it was expected that some errors in its construction were present. To remedy these

probable errors, the survey questionnaire was given to the research adviser for checking,

suggestions and comments.

The survey questionnaire was then revised according to the comments and suggestion of

the research adviser. This served as the validation process.

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Scoring and Interpretation of Data

Likerts five system management style was used to establish the health beliefs and

practices of diabetic individuals in the selected barangay of Bobon, Northern Samar.

The respondents indicated the descriptions of their age, gender, civil status, educational

attainment, occupation and monthly salary, and included also their health beliefs and health

practices.

To determine the health beliefs of the respondents, the following scale was used:

4.50 - 5.00 Strongly Agree (SA)

3.50 - 4.49 Moderately Agree (MA)

2.50 - 3.49 Moderately Disagree (MDA)

1.50 - 2.49 Strongly Disagree (SDA)

1.00 -1.49 No Comment (NC)

To determine the health practices of the respondents the following were used:

4.50 -5.00 Always (A) - when you do the item all the time

3.50 - 4.49 Almost Always (AA) - when you do the item almost all time

2.50 - 3.49 Never (N) - when you do not do the item

1.50 - 2.49 Rarely (R) - when you occasionally do the item

1.00 -1.49 No Comment (NC) - when you are undecided

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Data Gathering Procedure

The data gathering procedure involved the following steps:

STEP 1: Asking permission to the Adviser, the Dean of the College of Nursing, the

Municipal Mayor and the respondents.

STEP 2: Structuring, and validating of the survey questionnaire.

STEP 3: Finalization and mass production of the survey questionnaire.

STEP 4: Identification of the population.

STEP 5: Distribution of the survey questionnaire to the identified respondents.

STEP 6: Retrieval of the accomplished survey questionnaires from the respondents.

STEP 7: Scoring of the accomplished survey questionnaires and construction of the raw

data sheet.

STEP 8: Statistical analysis of data.

STEP 9: Tabulation and interpretation of data.

STEP 10: Preparation of the research manuscript for oral defense.

Statistical Analysis Technique

The data that were gathered by survey questionnaire were analyzed in two treatments, as

follows:

- First Statistical Treatment Statistical tools such as tally, frequent count, percentagecomputation, average or mean were used in the initial data analysis.

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Percent Computation41

P = _F_ x 100N

Where: P is the percentage of responses in relation to the total number of respondents,

F is the frequency of responses for each item in the survey questionnaire,

N is the total number of respondents.

Sample mean42X = Ex_

nWhere: X is the sample mean

Ex is the sum of sample observationn is the sample size.

Second Statistical Treatment (Correlational) to test the relationship between personal

profile and health beliefs and practices, and between health beliefs and health practices, the

following formula was used:

Chi-Square Correlational Method43 X2 = E ( fo fe ) 2

Fe

Where: X2 is the chi-square computation,

E is the summation of values,

Fo is the observed frequency,

Fe is the expected frequency.

41Antonio S, Broto, Statistical made Simple,(Manila: Melbros Printing Center).42 Ibid.43Broto, Ibid

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CHAPTER IV

PRRESENTATION, ANALYSIS, AND INTERPRETATION OF DATA

This chapter includes the assessment on the health beliefs and practices of individuals

with diabetes mellitus in selected barangays of Bobon, Northern Samar: its implications to health

care management. The data considered was on the basis of the 72.73 percent retrieval rate

obtained by the researchers and in this treatment are arranged according to the statement of the

problems on a one-on-one response scheme. Inferences and implications were included to make

such findings more in depth, meaningful and relevant.

Respondents Profile

It can be gleaned in the frequency distribution from table 1, that out of forty respondents

a greater percentage 12 or 30 percent have age ranged 51-60 years old, 10 or 25 percent were 41-

50 years old and 61-70 years old, however, the least number were 31-40 years old respectively.

From the figures it can be deduced when a person reaches at their middle age they are mostly

affected with diabetes mellitus. As shown in the same table the gender majority 22 or 55 percent

of the respondents are female as compared to the 18 or 45 percent male, likewise majority 33 or

82.5 percent married, 6 or 15 percent widowed and least 1 or 2.5 percent single. This implies that

majority of the respondents are married. As to the level of education of the respondents majority

19 or 47.5 percent were college graduate, 10 or 25 percent high school graduate and the least 5 or

12.5 percent college level and as well as elementary level. This implies that majority of the

respondents obtained a college degree program in their respective field of specialization. In terms

of occupation respondents were arranged from greater percentage a distributed as follows; 17 or

42.5 percent unemployed, 12 or 30 percent government employees, 8 or 20 percent other

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occupation and only 3 or 7.5 percent privately employed. This implies that majority of the

respondents were unemployed. As to the salary of the respondents a greater 15 of 37.5

percentage have earning Ph 7,000 and above and as well as Ph1, 000 and below. While the rest

earned from Ph3, 000 to Ph7, 000 of lesser frequency distribution. This implies that only of

relative majority earned as high from Ph7, 000 and above respectively.

Table 1Age Frequency Distribution of the Respondents

Profile of the Respondents Frequency PercentAGE: 61 70 years old

51 - 60 years old

41 - 50 years old31 40 years old

1012

108

2530

2520

Total 40 100GENDER: Male

Female1822

4555

40 100CIVIL STATUS: Single

MarriedWidowed

1336

2.582.515.0

Total 40 100EDUCATIONAL ATTAINMENT:

College graduate

College levelHigh School graduateElementary level

19

5106

47.5

12.525.015.0

Total 40 100OCCUPATION: Unemployed

Government EmployeePrivately EmployedOther occupation

171238

42.530.07.5

20.0Total 40 100

SALARY Ph 7,001 & abovePh 5,001 Ph 7,000Ph 3,001 - Ph 5,000

Ph 1,001 - Ph 3,000Ph 1,000 & below

1523

515

37.55.07.5

12.537.5

Total 40 100

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It can be gleaned in Table 2a, the mean distribution of the health beliefs and practices of

the respondents how their diet are being managed with the highest mean 4.93 that they eat food

to live, grow, to keep health and well, and to get energy for work and play. Food is made up of

different nutrients needed for growth and health. With mean 4.80 identified foods responsive to

the amount of nutrients needed in the body as influenced by age, sex, size, activity and state of

health. While the least identified as the way food is handled influences the amount of nutrients in

food, its safety, appearance and state. Likewise, all the people throughout life have the same

need of nutrients but in varying amounts. Thus, most nutrients do their work when teamed with

others nutrients. This implies that basic and primary to have good food was premised on the wayfood are handled and prepared and looking into the influences on the amount of nutrients in food,

safety, and appearance and state.

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Table 2Mean Distribution of the Health Beliefs and Health Practices the Respondents

2a DIET5 4 3 2 1

Total Mean InterpretationSA MA SDA MDA NC1. We eat food to live, grow, to keep healthy &

well, & to get energy for work and play(an pagkaon kahinahanglan nato paramabuhi, magkusog ug maging maupay anlaws ug para tagan kit sin enerhiya para saato hihimoon sa kada adlaw).

38 1 1

197

4.93 Strongly

Agree

2. Food is mad up of different nutrients neededfor growth & health (an pagkaon ay ginko-komponer sin damo nga nutrisyon nakahinahanglan para magtubo ug magkusog)

37 3

197

4.93 StronglyAgree

3. All nutrients needed by the body areavailable through food. (Natanan nganutrisyon nga panginahanglan san aton lawasin imo makukuha sa pagkaon)

28 11 1

187

4.68 StronglyAgree

4. Many kinds of food can lead to a well-balanced diet. (Damo nga klases sin pagkaonan makakahatag s aim sin maupay ug

balance nga pagkaon)

34 4 1 1

191

4.78 StronglyAgree

5. No food by itself has all the nutrients neededfor full growth and health (wara sayo la ngaklase sin pagkaon an makakahatag sa tanannga nutrisyong kinahanglan nato paramagkusog ug magupay at laws)

26 10 2 2

180

4.50 StronglyAgree

6. Each nutrient has specific uses in the body(kada sayo ng klase sin nutrisyon ay mayparticular na gamit sa aton lawas)

34 5 1

191

4.78 StronglyAgree

7. Most nutrients do their work when teamedwith other nutrients (an kadam-an san mga

nutrisyon ay nahihimo an kanra gamit kunig-papadis sa iba pa nga klase nganutrisyon)

25 10 1 2 3

175

4.38 ModeratelyAgree

8. All people throughout life have the sameneed of nutrients but in varying amounts.(Tanan nga tawo sa bug-os nya nga kinabuhiay parapareho an kinahanglana nganutrisyon pero sa iba-iba nga kadamo)

27 8 1 3

172


9. The amount of nutrients needed isinfluenced by age, sex, size, activity, &state of health (an kadamo san nutrisyon nakahinahanglan sa ato lawas ay nakadependesa edad, pagkatawo, aktibidades ug san

estado san ato lawas).

31 8 1 3

192

4.80 StronglyAgree

10. The way food is handled influences theamount of nutrients in food, its safety,appearance, and taste. (An pamaagi sanpagpreparar san pagkaon nakka-apekto sannutrisyon na ada sa pagakaon ug an kanyarasa)

24 6 3 3 4

163


Grand Mean 4.62 StronglyAgree

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It can be gleaned in 2b the mean distribution of the health beliefs on the hygiene of the

respondents. Data shows that out of ten (10) indicators it shows that the highest mean score 4.98

that one of the hygiene techniques was to have brushing the teeth after eating is a must for the

individual regardless of age and sex. Likewise, it also consider the way of preparing food,

cooking, and dinning availability of utensils that must be thorough washed before and after

eating. Henceforth, all foods must also be thoroughly washed before cooking and eating. This

implies that inasmuch the three practices is ultimately needed this must be practice appropriately

to minimize occurrences of the inadequacy for good health.

Thus, from the above health beliefs and practices the least mean score can be deduced toquantify the adequacy and inadequacy of its meaning in terms of practices. Data revealed that

waste water should be disposed in covered drainage, and sources of drinking water must be

periodically examined for the presence of water-borne microorganisms, thus, hand washing

should be done before and after eating, and more significantly all foods must be cooked thorough

at least 70 degrees centigrade temperature. This implies that with this health practices and

techniques the possibility of attaining good health would most likely to happen to individuals.

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Table 2bMean Distribution of the Health Beliefs and Health Practices of the Respondents

2b HYGIENGE / KALIMPYO

5 4 3 2 1

Tot al Mean InterpretationSA MA SDA MDA NC

1. We need to take a bath everyday(Kahinanglan ta magparigo kada adlaw) 35 5 195 4.88 StronglyAgree2. Brushing the teeth after eating is a must

(kinahanglan nato magsipilyo kadapagkatapos magkaon)

39 1

199

4.98 StronglyAgree

3. All foods must be thoroughly washedbefore cooking and eating (tanan ngapagkaon dapat hugasan sin tuhay bag-olutuon ug kaunon)

39 1

196

4.90 StronglyAgree

4. Cooking & dining utensils must bethoroughly washed before and after eating(an mga kagamitan sa pagluto ug

pagkaon dapat hugasan sin tuhay bag-o

ug pagkatapos kumaon)

38 2

198

4.95 StronglyAgree

5. Sources of drinking water must beperiodically examined for the presence ofwater-borne microorganisms (anginkukuwaan inumon nga tabig dapatpermi gin tse-tse kun may ada mikrobyo)

31 6 1 1 1

185

4.63 StronglyAgree

6. Solid wastes should be properlysegregated (an mga basurakahinahanglan paglain-lainon)

34 4 1 1

190

4.75 StronglyAgree

7. Kitchens & confort rooms must beperiodically disinfected (an kusina ug ankubeta kinahanglan pirme limpyoho)

36 2 2

190

4.75 StronglyAgree

8. Waste water should be disposed in

covered drainage (an marigsok nga tubigkahinanglan ig tapok sa kanal o luho namay takop)

28

140

4 1 4 3

170

4.25 Moderately

Agree

9. Hand washing should be done before &after eating (an paghugas kamotkahinanglan himuon bag-o ug

pagkatapos kumaon)

35 2 3

186

4.65 StronglyAgree

10. All foods must be cooked thoroughly atleast 70 degrees centigrade temperature(tanan nga pagkaon kahinahanglanlutuon sin maupay sa kalayo nga may 70degree centigrade nga kapasuon)

27 12 1

186

4.65 StronglyAgree

Total 4.50StronglyAgree

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As shown in table 2c, revealed the data and mean distribution of the health beliefs on the

exercise of the respondents. It can be gleaned from the table that three highest mean 4.85 that

they strongly agree that exercise burns cholesterol and body fats, that a person should exercise

daily by walking exercise is recommended for older individuals, thus, physical exercise should

be attuned to the status of diabetic individuals. On the other hand, the least mean identified

provide that jogging is an exercise for the young individuals. Hence, it is good to wash or take a

bath every after exercise each group has its own recommended daily exercise regimen. This

implies with the highest mean as well as its lowest mean this mark the positive health practices

that individuals should make it to happen in his/her life style.

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Table 2cMean Distribution of the Health Beliefs and Health Practices of the Respondents

2c. EXERCISE / EHERSISYO5 4 3 2 1

Total Mean InterpretationSA MA SDA MDA NC1. A person should exercise daily (an

tawo kahinahanglan mag-ehersisyokada adlaw)

32 6 1 1

186

4.65 Strongly

Agree

2. Erxercise burns cholesterol & body fats(an ehersisyo makakaiban sacholesterol ug taba sa ato lawas)

37 2 1

194

4.85 StronglyAgree

3. Each group has its own recommendeddaily exercise regimen. (kada gruposan tawa ay mayaon kanya-kanyarekomendado nga ehersisyo)

23 8 1 1 1

153


4. Jogging is an exercise for the youngindividuals (an jogging an ehersisyo naangay sa mga bata pa an eded)

16 13 4 5 3

157


5. Walking exercise is recommended for

older individuals (an paglakaw-lakaway rekomendado para sa mga mas arognga tawo)

33 4 2 2

189

4.73 Strongly

Agree

6. A person should first consult a doctorbefore exercising to determine the typeof exercise that fits for him or her (antawo dpat ngun-a magkonsulta sadoctor bag-o mag-ehersisyo paramahibaruan an angay sa iya ngaehersisyo)

23 7 3 6 1

165

4.13 StronglyAgree

7. It is good to wash or take a bath everyafter exercise (maupay na maghugasug magparigo pagkataposmagehersisyo)

17 9 8 4 2

155


8. Diabetic individuals should reduceweight through exercise (an diabeticna tawo dapat mag paiban timbang sapamaagi san pagehersisyo.

29 10 1

186

4.65 StronglyAgree

9. Physical exercise should be attuned tothe status of diabetic individuals (anpag-ehersisyo kahinahanglan tama lasa pisikal nga estado san tawo ngamay yaon diabetes)

32 7 1

189

4.73 StronglyAgree

10. Exercise helps control diabetes (anehersisyo nakakabulig para makontrolan deiabetes)

31

155

6 2 1

184

4.60 StronglyAgree

Total 4.00

Moderately

Agree

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Table 2d shows the mean distribution of the health beliefs on the disease treatment of the

respondents. Data revealed through its mean computation that three highest score 4.88

interpreted that they strongly agree that every person should be tested for their blood sugar levels

more frequently, diabetes can be controlled by proper diet and exercise, and untreated diabetes

can be fatal. This implies that when the person ill-with diabetes when not properly treated it

would cause fatal effect on his/her life as it could, so the need to meet this expectation is a

necessity of the individual. However, the least mean score revealed that diabetes can be detected

through the urine examination, diabetes caused by defect of the pancreas, and diabetes is a

curable disease. This implies that basically, an individual having diabetes should have frequent blood sugar examination, proper diet and exercise, and when not treated would cause a fatal

defect in life and perhaps cause to death.

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Table 2dMean Distribution of the Health Beliefs and Health Practices of the Respondents

2d. DISEASE TREATMENT5 4 3 2 1

Total Mean InterpretationSA MA SDA MDA NC1. Every person should be tested for their

blood sugar levels (kada tawo

kahinahanglan magpa-eksaminsa parasa lebels (kada tawo kahinahanglanmagpa-examinsa para sa lebel saasukar sa iyadugo

39 1

196

4.88 StronglyAgree

2. Diabetes caused by defects of thepancreas (an diabetes resulta sanpakakayaon depekto sa pancreas.

15 10 3 12

133

3.33 StronglyDisagree

3. Diabetes is not caused by human ill-will like sorcery or barang (andiabetes dire resulta san pag-mulay ofti-aw san tawo sugad sin barang)

25 2 5 2 6

158


4. Diabetes can be controlled by properdiet and exercise (an diabetes puydemakontrol pinaagi san tame nga pagdiet ug pageheersisyo)

36 2 2

190

4.75 StronglyAgree

5. Insulin helps in the utilization of bloodsugar (an insulin nabulig sa ato lawas

para magamit ta an asukar na ada sa atodugo)

26 8 4 2

172


6. Untreated diabetes can be fatal (andiabetes na dire ginbubulong aynakamatay)

35 3 2

189

4.73 StronglyAgree

7. Diabetes can be detected through theurine examination (an diabetes puydemahibaruan sa eksamin san ihi)

9 5 17 3 6

128

3.20 StronglyDisagree

8. Diabetes is largely hereditary (andiabetes nakukuha tikang sa mga kag-anak o kaapo-apoyan)

20 11 2 6 1

163


9. Diabetes is a curable disease (andiabetes na sakit ay nabubulong)

18 14 5 2 1166


10. Diabetes is caused by too much sugar inthe blook (an diabetes nahihimo kay sasobra ngaasukar sa ato dugo)

29 9 1 1

184

4.60 StronglyAgree

Total 4.20Moderately

Agree

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It can be gleaned in Table 3 the mean distribution of Mean Health Practices of disease

treatment of the Respondents. Data revealed that on the basis of mean computation three highest

score showed that respondents agreed they always consider ingestion of prescribed medication

based on the prescription of the doctor, regular monitoring of blood sugar, and almost always

follow doctors recommendation diet and exercise activities. This implies that following this

prescribed activities by the individual person having diabetes they will be given more chances of

minimizing the occurrence of the disease. With the least means however, diabetes can be

determine through regular examination of urine analysis, regular consultation with the doctor,

and avoiding too much ingestion of sweet foods and other carbohydrates rich food such as bread,rice, pasta, and etc. This implies that the person itself can do share in the treatment of his own

illness of being diabetic considering those suggested items by the physician such as too much

intake of food having adequate contents of sugar and that of having much carbohydrates. He

should likewise take cognizance of the proper exercise to safeguard his own health every day.

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Table 3Mean Distribution of the Health Beliefs and Health Practices of the Respondents

3. HEALTH PRACTICES5 4 3 2 1

Total Mean InterpretationA AA N R NC1. Daily exercise (adlaw-adlaw nga pag-

ehersisyo)17 17 1 5

1664.15 Almost always

2. Weight control (pagknontrol sa tamanga timbang san lawas)

16 11 6 6 1155

3.88 Almost always

3. Avoiding too much ingestion of sweetfoods and other carbohydrates richfoods such as bread, rice, pasta, etc.(paglikay sa mga pagkaon na masyadomatam-is ug damo an carabohydrates

parehas sa tinapay, luto, pasta ugibapa)

19 10 3 5 3

157

3.93 Almost always

4. Avoiding oily and fatty foods (paglikaysa mga pagkaon na damo an taba osma-asyete)

19 12 4 4 1

164

4.10 Almost always

5. Minimum necessary intake of

carbohydrates (pagkaon san tama la ngakadamo sa pagakaon namaycarbohydrates)

21 13 1 4 1

169

4.23 Almost always

6. Avoiding over-eating (paglikay sasobra nga pagkaon)

18 15 1 5 1164

4.10 Almost always

7. Ingestion of prescribed medicationbased on the prescription of the doctor(pagtumar sa bulong na ginhatag sadoctor base sa iya ginsugad ug surat)

29 10 1

188

4.70 Always

8. Following doctors recommended dietand exercise program (pag-sunod sarekomendado nga pagakon or ehersisyosan doctor)

21 13 1 5

170

4.25 Almost always

9. Regular monitoring of blood sugarlevel (regular nga pag-pa eksamin saasukar san dugo)

21 13 2 4

171

4.28 Almost always

10. Taking regular urine analysis. (regularnga pagpa-eksamin san ihi)

7 9 6 16 2123

3.08 Never

11. Regular consultation with a doctor.(regular nga pagpackeck-up ngadto sadoctor)

15 14 11

153

3.83 Almost always

Total 4.05 Almost always

Table 4 shows the chi-square test between the profile and the health beliefs and practices

of the respondents. Data revealed through its mean derived from its computation related to age,

gender, civil status, educational attainment of parents, occupation and monthly family income. It

showed that the computed chi-square value 199.67 was greater than the tabular 112.825 with 72

degrees of freedom as basis on the treatment which reject the null hypothesis of significant

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relationship as well as difference as perceived by the respondents which considerably found to be

significantly related to the respondents profile in connection with the variables indicated to the

health beliefs and practices of the respondents. This implies that health beliefs and practices

were significantly related to the profile of respondents, and this can likewise be inferred that

good health habit of the respondents would help them ease out the problem in the occurrence of

the disease respectively.

Table 4Chi-square Test of Relationship between Profile and Health Beliefs

and Practices of the Respondents

No.

Profile of the Respondents HEALTH BELIEFS AND PRACTICES

TotalO e O e O e O e O e O e O e1 10 .71 19 3.41 4.93 .06 4.88 .10 4.65 .06 4.88 3.37 4.15 .24 52.592 12 .57 5 1.95 4.93 .18 4.98 .16 4.85 .25 3.33 .04 3.88 2.30 38.973 8 .31 10 .05 4.68 .08 4.90 .11 3.83 9.25 3.95 .01 3.93 2.54 39.294 10 .02 6 1.08 4.78 .14 4.95 .17 3.93 3.78 4.75 .32 4.10 .01 38.515 18 1.01 17 .83 4.50 .38 4.63 .38 4.73 .16 4.30 .25 4.23 .40 57.396 22 4.97 12 .10 4.78 .19 4.75 .24 4.13 .34 4.73 .06 4.10 .38 55.497 1 4.33 3 1.43 4.38 1.20 4.75 1.62 3.88 .80 3.20 .29 4.70 1.94 24.918 33 19.99 8 3.15 4.30 .77 4.25 6.00 4.65 .38 4.08 .59 4.25 .65 62.539 6 2.13 15 2.09 4.80 .01 4.65 8.57 4.73 .04 4.15 2.40 4.28 1.85 43.6110 0 5.70 2 2.19 4.08 1.16 4.65 1.95 4.60 1.19 4.60 2.65 3.08 .26 23.0111 0 5.98 3 1.30 4.62 1.73 4.50 1.41 4.00 1.08 4.20 1.57 3.83 .84 24.1512 0 2.24 5 3.78 0 .95 0 .97 0 .90 0 .86 4.05 11.90 9.0513 0 3.72 15 36.76 0 1.57 0 1.61 0 1.49 0 1.43 0 1.50 15.00Total 120 51.48 115 58.12 50.78 8.42 51.89 23.29 47.98 19.72 46.17 13.84 48.55 24.81 484.5

X2cv = 199.67 df = 72 X2tab .05 = 112.825 Ho: Rejected Interpretation: Significant

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CHAPTER V

SUMMARY, CONCLUSIONS AND RECOMMENDATIONS

This study is an evaluation of the respondents health beliefs and practices being adiabetic individual in selected barangays of Bobon, Northern Samar: its implications to health

care management. The data revealed that 72.73 percent retrieval rate obtained by the researchers

and treatment was made through its arranged statement of the problems made on a one-on-one

response scheme. It deduced an inferences and implications included to make the findings more

in depth, meaningful and relevant.

Questions were posed to know the respondents profile on the basis of the statement of

the problem which study tried to find out the problem as intended by the researcher to elicit data

from them. Respondents of the study were only forty distributed to the selected barangays of

Bobon, Northern Samar. The study is evaluative design to determine the health beliefs and

practices of the respondents using the questionnaire as the primary tool in data gathering and

treated with simple statistics through frequency counts, mean and chi-square test to determine the

significant relationship and differences on the perception of the respondents. Aside from the

instrument follow-up interview was also undertaken with the following findings:

1. That out of forty respondents a greater percentage 12 or 30 percent have age ranged

51-60 years old, 10 or 25 percent were 41-50 years old and 61-70 years old, however, the least

number were 31-40 years old respectively. From the figures it can be deduced when a person

reaches at their middle age they are mostly affected with diabetes mellitus.

2. That gender of the respondents, majority 22 or 55 percent of the respondents are

female as compared to the 18 or 45 percent male, likewise majority 33 or 82.5 percent married, 6

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or 15 percent widowed and least 1 or 2.5 percent single. This implies that majority of the

respondents are married.

3. That educational Attainment of the respondents majority 19 or 47.5 percent were

college graduate, 10 or 25 percent high school graduate and the least 5 or 12.5 percent college

level and as well as elementary level. This implies that majority of the respondents obtained a

college degree program in their respective field of specialization.

4. That occupation of occupation respondents were arranged from greater percentage and

distributed as follows; 17 or 42.5 percent unemployed, 12 or 30 percent government employees,

8 or 20 percent other occupation and only 3 or 7.5 percent privately employed. This implies thatmajority of the respondents were unemployed.

5. That respondents family monthly income, greater number 15 of 37.5 percentage have

earning Ph 7,000 and above and as well as Ph1,000 and below. While the rest earned from

Ph3,000 to Ph7,000 of lesser frequency distribution. This implies that only of relative majority

earned as high from Ph7,000 and above respectively. This implies that profile of the respondents

have significant relationship with regards the health beliefs and practices for diabetics persons in

selected barangay of Bobon, Northern Samar.

6. That on the mean distribution of the health beliefs and practices of the respondents

how their diet are being managed with the highest mean 4.93 that they eat food to live, grow, to

keep health and well, and to get energy for work and play. Food is made up of different nutrients

needed for growth and health. With mean 4.80 indentified foods responsive to the amount of

nutrients needed in the body as influenced by age, sex, size, activity and state of health. While

the least identified as the way food is handled influences the amount of nutrients in food, its

safety, appearance and state. Likewise, all the people throughout life have the same need of

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nutrients but in varying amounts. Thus, most nutrients do their work when teamed with others

nutrients. This implies that basic and primary to have good food was premised on the way food

are handled and prepared and looking into the influences on the amount of nutrients in food,

safety, and appearance and state.

The hygiene of the respondents shows that out of ten (10) indicators it shows that the

highest mean score 4.98 that one of the hygiene techniques was to have brushing the teeth after

eating is a must for the individual regardless of age and sex. Likewise, it also consider the way of

preparing food, cooking, and dinning availability of utensils that must be thorough washed

before and after eating. Henceforth, all foods must also be thoroughly washed before cookingand eating. This implies that inasmuch the three practices is ultimately needed this must be

practice appropriately to minimize occurrences of the inadequacy for good health.

Thus, from the above health beliefs and practices the least mean score can be deduced to

quantify the adequacy and inadequacy of its meaning in terms of practices. Data revealed that

waste water should be disposed in covered drainage, and sources of drinking water must be

periodically examined for the presence of water-borne microorganisms, thus, hand washing

should be done before and after eating, and more significantly all foods must be cooked thorough

at least 70 degrees centigrade temperature. This implies that with this health practices and

techniques the possibility of attaining good health would most likely to happen to individuals.

Health beliefs on the exercise of the respondents three highest mean 4.85 that they

strongly agree that exercise burns cholesterol and body fats, that a person should exercise daily

by walking exercise is recommended for older individuals, thus, physical exercise should be

attuned to the status of diabetic individuals. On the other hand, the least mean identified provide

that jogging is an exercise for the young individuals. Hence, it is good to wash or take a bath

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every after exercise each group has its own recommended daily exercise regimen. This implies

with the highest mean as well as its lowest mean this mark the positive health practices that

individuals should make it to happen in his/her life style.

Health beliefs on the disease treatment of the respondents, revealed through its mean

computation that three highest score 4.88 interpreted that they strongly agree that every person

should be tested for their blood sugar levels more frequently, diabetes can be controlled by

proper diet and exercise, and untreated diabetes can be fatal. This implies that when the person

ill-with diabetes when not properly treated it would cause fatal effect on his/her life as it could,

so the need to meet this expectation is a necessity of the individual. However, the least meanscore revealed that diabetes can be detected through the urine examination, diabetes caused by

defect of the pancreas, and diabetes is a curable disease. This implies that basically, an individual

having diabetes should have frequent blood sugar examination, proper diet and exercise, and

when not treated would cause a fatal defect in life and perhaps cause to death.

Respondents agreed they always consider ingestion of prescribed medication based on

the prescription of the doctor, regular monitoring of blood sugar, and almost always follow

doctors recommendation diet and exercise activities. This implies that following this prescribed

activities by the individual person having diabetes they will be given more chances of

minimizing the occurrence of the disease. With the least means however, diabetes can be

determine through regular examination of urine analysis, regular consultation with the doctor,

and avoiding too much ingestion of sweet foods and other carbohydrates rich food such as bread,

rice, pasta, and etc. This implies that the person itself can do share in the treatment of his own

illness of being diabetic considering those suggested items by the physician such as too much

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intake of food having adequate contents of sugar and that of having much carbohydrates. He

should likewise take cognizance of the proper exercise to safeguard his own health every day.

The chi-square test between the profile and the health beliefs and practices of the respondents,

revealed through its mean derived from its computation related to age, gender, civil status,

educational attainment of parents, occupation and monthly family income. It showed that the

computed chi-square value 199.67 was greater than the tabular 112.825 with 72 degrees of

freedom as basis on the treatment which reject the null hypothesis of no significant relationship

as well as difference as perceived by the respondents which considerably found to be

significantly related to the respondents profile in connection with the variables indicated to thehealth beliefs and practices of the respondents. This implies that health beliefs and practices

were significantly related to the profile of respondents, and this can likewise be inferred that

good health habit of the respondents would help them ease out the problem in the occurrence of

the disease respectively.

CONCLUSIONS

In the light of the following findings derived from this study, the following conclusions

are hereby introduced, namely:

1. That out of forty respondents a greater percentage have age ranged 51-60 years old,

10 or 25 percent were 41-50 years old and 61-70 years old, however, the least number were 31-

40 years old respectively. From the figures it can be deduced when a person reaches at their

middle age they are mostly affected with diabetes mellitus.

2. That gender of the respondents, majority of the respondents are female as compared to

the 18 or 45 percent male, likewise majority are married, widowed and least 1 or 2.5 percent

single.

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3. That educational attainment of the respondents majority were college graduate, high

school graduate and the least are college level and as well as elementary level.

4. That occupation of occupation respondents were unemployed, government other

occupation and only few privately employed.

5. That respondents family monthly income have earning Ph 7,000 and above and as

well as Ph1,000 and below. While the rest earned from Ph3,000 to Ph7,000 of lesser frequency

distribution which implies that only of relative majority earned as high from Ph7,000 and above

which significantly diabetics persons in selected barangay of Bobon, Northern Samar.

6. That health beliefs and practices of the respondents how their diet are being managedwith the highest mean 4.93 that they eat food to live, grow, to keep health and well, and to get

energy for work and play. Food is made up of different nutrients needed for growth and health.

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