Saludamay 2013 Issue

FOREWORD

A person is a behavioral system in which the functioning outcome is the observed behavior. Nursing contributes by facilitating effective behavioral functioning in the patient before, during, and after illness.

Nurse Dorothy E. Johnson 1980

The Nursing Process stresses the importance of efficient and effective Assessment to come up with specific Diagnoses that shall serve as basis for Nursing Interventions. The Process includes, among others keen observation and documentation of behaviors of patients so that appropriate nursing actions are implemented.

This fourth issue of the Saludamay of the AUL College of Nursing and Health Sciences features the researches of the colleges faculty and students for the last two yea rs. It includes the observations on behaviors which we hope will help in formulating possible interventions for similarly situated situations.

A member of the faculty until sy 2011-2012 , Prof. Robert Jamisola did a documentation on the Phenomenology of Male Same-Sex Practices and their Implications to Health. HIV-AIDS cases are growing among male homosexuals who are sexually active and promiscuous. We hope this study provides insights in policy formulation of the DOH and the Health Action Information Network.

A group of fourth year students also did a study on Knowledge Level on Sexually Transmitted Infections of Nursing Students in Aquinas University. It is interesting to note how much the students know of these infections so they will be able to help in health awareness campaigns of the DOH and the College.

Prof. Catherine Vargas studied the Stressors in the Workplace, Their Effects on the Faculty Members of Aquinas University of Legazpi. Insights of the study were shared to the Health Resource Ma nagement Office of the University.

Beliefs and understanding of mothers regarding the childhood immunization were researched by three fourth year students. Again, the study revealed the importance of the mothers attitudes towards immunization in the promotion of health and prevention of diseases.

We hope that these outputs contribute to the knowledge base of health information in the college, the region, and the nation.

Prof. Vicente B. Peralta, RN, MSN Dean, AUL College of Nursing and Health Sciences

PHENOMENOLOGY OF MALE SAME-SEX PRACTICES AND THEIR IMPLICATIONS ON HEALTH Robert J. Jamisola, RMT, RN, MAN The Philippines as a predominantly Christian nation favors gays in all aspects of life. Gays in the Philippines are highly tolerated amidst the machismo culture. Its a paradox between two realities making it hard for an observer to say if Filipino society really accepts or still rejects having gays in the family. Tejano (2007) classified gays in the Philippines as pa-girls, pamhin and urban gays. There are numbers of same-sex practices associated with homosexual men or in general, categorized as Men Who Have Sex with Men (MSM). For many, such practices are way beyond expected norms and place MSM at risk for contracting myriad of diseases that can be contagious and infectious, and, such practices are deemed immoral and unethical. With the main objective of delving into the phenomenon of same-sex practices and theirimplications on health, this study sought answers to the following questions: 1) What are Men Who Have Sex with Mens notions of self and identity? 2) What practices are considered homosexual in nature? 3) What are the implications on the health of those who have same-sex practices along the following dimensions: a) physical b) emotional-cognitive c) social-cultural and d) spiritual? And 4) What health care model may be recommended to Men Who Have Sex with Men?

This study was a phenomenology type of qualitative research. It made use of a guidequestion tool for the interview process for the purpose of capturing the lived same-sexexperiences and practices of the participants and the meanings things have in their experiences. It also has a purpose of delving into the reactions, feelings and insights of the participants who represent three major fields of health, education and business and who are all residing in Albay. Based on the data gathered, the study has the following salient findings: 1) Men WhoHave Sex with Mens (MSMs) early childhood experiences gave them the notion and feeling of somewhat different. The development of ones personality and identity was shaped by various factors, most important was the family. 2) Common practices that were homosexual in nature include oral intercourse, mutual oral intercourse or 69, anal intercourse, and rimming. On some occasions, MSM also engaged in fondling, kissing, necking, petting, and licking. These practices were considered sine quibus non among them. MSM may have a steady partner or a chance encounter partner only. 3) There were wide arrays of implications of same-sex practices on health. 3.a) Implications on physical health could be devastating from simple fissures and lacerations to contracting sexually transmitted infection and parasitic infection most especially if a homosexual is involved with multiple sex partners. Safe-sex considerations are routinely integrated into sexual practices but in a way that leaves a room for considerable risk factors. 3.b) Implications on emotional-cognitive health included depression that may lead to suicidal tendencies and self-inflicted pain. 3.c) Harassment, discriminations, and stereotyping were the implications on social-cultural health as homosexuality is not widely accepted although its existence is never negated. 3.d) Spiritual health was enhanced through a homosexuals strong belief in Supreme Being and integrated their religion within the context of their sexuality. 4) The resiliency of an individual to handle adversities varied depending upon their coping mechanism. Addressing the health needs of MSM to become resilient was not yet developed in the past and a health care model for them, the Jamisola MSM Health Resilient Model is recommended. Based on the findings the following conclusions were derived: 1) Men Who Have Sex with Men (MSM) had different notions about their selves and identity from being discreet, to acknowledging themselves completely as a woman, and to being openly gay. 2) Same-sex practices associated with homosexuals primarily included oral intercourse, mutual oral intercourse or 69, anal intercourse, rimming, fondling, kissing, necking, petting, and licking. 3) Implications of same-sex practices on physical health included potential risks for acquiring a wide array of STIs, sore throat, anal lacerations and fissures, and acquiring parasitic infection from bowel. Along emotional-cognitive health, depression ranks the most common among MSMs in a homosexual relationship. Complimentary relationship between a man and a woman was not satisfied by same-sex relationship. Along social-cultural health, calling of names or stereotyping such as bakla was the most common among MSM, and along spiritual health, the need to divulge and confess arise among homosexuals to integrate spirituality with their sexuality. 4) Adversities in life were common to all but may present a different perspective among homosexuals. A health model for homosexual is extremely important, most especially to those who were considered promiscuous in same-sex practices. The focus of the health model 3

should encompass the dimensions of health namely physical, emotional-cognitive, socialcultural and spiritual. In the light of the findings of the study, the following are recommended: 1) The Department of Health should consider the findings of the study and acknowledge the needs of homosexual members of the society, to support and formulate a program specially intended for MSMs, promiscuous in their homosexual encounters, practices and relationships. 2) Health practitioners and health-related professionals should ensure the delivery of services for MSMs, acknowledging their health needs and situation with wider understanding. Awareness on the implications of same-sex practices should lay down the foundation in formulating health activities and health education and information campaign materials. 3) Concept on homosexuality, gender sensitivity, and sexual orientation should become one of the thrust of a schools guidance program. Guidance program should incorporate therapeutic interventions for these homosexuals who are in a state of fear of coming-out. 4) The political parties and law makers who are within the social conservative political spectrum must recognize homosexual rights, and provide full support for self-help groups and organizations for lesbians, gays and transgenders (LGBT) with thrusts toward human rights and equality. 5) The family as major socializing agent should be made part of the schools sex education program. 6) Provisions for annual gathering of members of LGBT in the Philippines should be done to enhance the extent of awareness on major issues concerning homosexuality and related practices. 7) Understanding the situation of homosexual members of the church as part of community of faith is integral in strengthening their relationship with God.

REFERENCES Aldrich, R. & Wetherspoon, G. (2001) Whos Who in Contemporary Gay and Lesbian Story: From World War II to the Present Day. New York: Routledge American Psychiatric Association (2000). Paraphilias. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, p.576. Washington, USA. American Psychological Association. Sexual Orientation. http://www.apa.org/helpcenter/sexual-orientation.aspex Retrieved 2010 from

Anitie, S. (2007). How to Drink Sperm to Become Strong Man. The Ritual Homosexuality. Retrieved 2010 from http:// news-softpedia.com/news/ How- ToDrink-Sperm-tobecome-a-Strong-Man-67804.shtml Anonuevo, C. (2010). Qualitative Research: Inquiry Beyond Numbers. Summer Nursing Research: Qualitative and Quantitative Research Methods, Baguio City. Arksey, H., & Knight, P. (1999). Interviewing for Social Scientists. London:Sage. Bailey, C.A. (1996). A Guide to Field Research. Thousand Oaks, CA: Pine Forge. Baker, C. (2004). Behavioral genetics: An introduction to how genes and environments interact throught development to shape differences in mood, personality, and intelligence. New York: The American Association for the Advancement of Science and the Hastings Center. 5

Barry, P. (2002). Lesbian or Gay Criticism, Beginning Theory: An Introduction to Literary and Cultural Theory. Manchester University Press, pp. 139 150. Bell MD, Vila RI. Homicide in homosexual victims: a study of 67 cases from the Broward County, Florida, Medical Examiner's office (1982-1992), with special emphasis on "overkill". American Journal of Forensic Medicine and Pathology 1996;17(1):65-9. Bem, D.J. (1996). Exotic Becomes Erotic: A Developmental Theory of Sexual Orientation. Psychological Review 103, pp. 320 325 Bentz, V.M., & Shapiro, J.J. (1998). Mindful Enquiry in Social Research. Thousand Oaks, Sage. Brinkmann, S. (2004). Health Risks of Homosexual Lifestyle. Catholic Standards Times. Caelli, K. (2001). Engaging with phenomenology: Is it more of a challenge than it needs to be? Qualitative Perspective (3rd ed., pp 93-122). Sudbury, MA: Jones and Bartlett. Cameron, M.E., Schaffer, M., & Hyeoun, P. (2001). Nursing students experience of problems and use of ethical decision-making models. Nursing Ethics, pp.432-448 ethical CA:

Castro, J. (2004) Playing with Fire: Sexual Risk Behaviors and Safer Sex Practices of Young Homosexuals in the Philippines. Manila, Philippines. Castro, J. E. (2010). Christian Research Institute. Retrieved from http://www.equip.org Catholic Answers (2004). Retrieved from http:// www.catholic.com/ libraryHomosexuality.org Changingminds.org. Freuds Psychosexual Stage Theory. Retrieved 2009 from http:// changingminds.org/explanations/learning/freud_stage.htm Curran, G. (2002). Young queers getting together: moving beyond isolation and loneliness. Unpublished Doctorate Thesis. University of Melbourne, Melbourne Australia. De Guzman S. (1997). Lalaking naging babae dahil sa paniniwala; Babaeng naging lalaki dahil sa pananampalataya: Isang penomenolohikal na pag-aaral. De La Salle University, Manila, Philippines. De Los Reyes, R. (2010). Understanding Homosexuality. Catechism in Reparative Therapy. Retrieved December 3, 2010 Definition of Adversity, The Free Dictionary. Retrieved February 14, 2011 from http://www.thefreedictionary.com/adversities Depressed Man. http://hypericum.wordpress.com/2008/03/17/depression-fuels-risky-behavioringay-men-new-study-claim/ Developmental Stages of Erik Erikson. Learning Place Online. Retrieved April 2011 http://www.learningplaceonline.com/stages/organize/Erikson.htm 6 from

Diagnostic Statistical Association

Manual

of

Mental

Disorders-IV

(2000)

American

Psychiatric

Dictionary.com (2009). Definition of Homosexual. Retrieved 2009 from dictionary.com http://dictionary.reference .com/browse/homosexual Dictionary.com (2010). Definition of Implication. Retrieved 2010 from dictionary.com http://dictionary.reference.com/browse/implication Dictionary.com (2009). Definition of Phenomenology. Retrieved 2009 from http://dictionary.reference.com/browse/phenomenology dictionary.com

Diggs, J.R. (retrieved 2009). The Health Risks of Gay Sex. Corporate Resource Council Dowell, L. (2005). New Peoples Army Recognizes Same-Sex Marriage. Retrieved 2010 from www.workers.org Duterte, M. (1997). Nang Tikaman Ni Juan ang Saging ni Pedro: Isang Exploratoryong Pagaaral ng Unang Sekswal na Karanasan sa Kaparehong Kasarian. De La Salle University, Manila, Philippines. Firehammer, R. (2004). What is Wrong With Homosexuality? The Hijacking Of A Philosophy: Homosexuals vs. Ayn Rands Objectivism. Retrieved from http://www.usabig.com/autonomist/hijack/hijackhomobad.html Free Online Dictionary. http://www.thefreedictionary.com/wellbeing Garbo, J. (2001). More Young Gay Men are Contracting HIV from Steady Partners. Gayhealth Garcia, J.N. (2008). Philippine Gay Culture: Binabae to Bakla, Silahis to MSM. UP Press. City, Philippines. Global Oneness (retrieved 2011). Encyclopedia: http//www.experiencefestival.com/a/Homosexuality/id/1914216 Quezon

Homosexuality.

Greenberg, D. (1990). The Construction of Homosexuality. Masters Thesis. University of Chicago. Illinois, USA. Hammersley, M. (2000). Taking Sides in Social Research. London: Routledge Herrel, R. et al (1999). A Co-twin Study in Adult Men. Archives of General Psychiatry, pp. 867 874 Homosex Info. Retrived 2009 from http://www.homosexinfo.org/Sexuality/Sadomasochism -

Hycner, R.H. (1999). Some guidelines for the phenomenological analysis of interview data. In A. Bryman & R.G. Burgess (Eds.), Qualitative Research (Vol. 3, pp. 143- 164). London: Sage. Igna, M., Muer D. and Trinidad E. (1995) Gay Relationships: Isang pag-aaral ukol sa mga live-in na relasyon ng mga homosexual. De La Salle University, Manila, Philippines. Kvale, S. (1996). Interviews: An Introduction to Qualitative Research Interviewing. Thousand Oaks, CA: Sage Lascano, B. (2010). Special Seminar Workshop on Counseling LGBT. Kanzo Hotel Legazpi Philippines. City,

Lopez, M. (1996).The Phenomenology of Homosexual Priest. Unpublished Masters Thesis.De La Salle University, Manila, Philippines. .Man To Man Holding Hands Icon. Retrieved February, 2011 from http://www.bing.com/images/search?q=man+to+man&view=detail&id=43CE9DCE96 CFD71 07E066BCB1FAC97DC66C3B0D1&first=1&FORM=IDFRIR

Manalastas, E.J. & Mavapagal, R. (2004). What Do Filipino Gay Male College Students Want to Learn in Sex Education? Department of Psychology. Diliman, Q.C. Meals,C. (2003). The Old Question: Spit or Swallow? The Badger Herald. Wisconsin, USA. Merriam-Webster Dictionary. http://www.merriam-webster.com/dictionary/resilience Miller, W.L., & Crabtree, B.F. (1992). Primary care research: A multimethod typology and qualitative roadmap. In B.F. Crabtree & W.L. Miller (Eds.), Doing qualitative research. Research methods for primary care (Vol 3) Newbury Park, CA: Sage. Palaganas, E. (2010). Qualitative Data Analysis: Emerging from the Data. Summer Nursing Research: Qualitative and Quantitative Research Methods, Baguio City. Pinoy Big Brother Celebrity Edition 1 (2006). ABS-CBN Interactive. Manila, Philippines Polit, D. & Tatano, C. (2007). Nursing Research Generating and Assessing Evidence for Nursing Practice ( 8th edition) Lippincott, Williams and Wilkins. Richters, J. (2006). Social Construction of Sexual Practice: Setting Sexual Culture and the Body in Casual Sex Between Men. Disserrtation. Public Health and Community Medicine University of Sydney. Australia. Rimming definition by FactIndex. Retrieved December 2010 from http://www.factindex.com/r/ri/rimming.html Robertson, T.L. (1996) Gay Male Development: Hermeneutic and self psychological principal. Dissertation. California School of Professional Psychology. USA.

Sanfort, T., & de Graaf, R. (2001) Same-sex Sexual Behaviour and Psychiatric Disorders Archives of General Psychiatry, 58(1): 85-91, p. 89 Silverio, M. (2004). Youth Sex and Risk Behaviors in the Philippines. Demographic Research and Development Foundation. Sineasta Jheck Journals online (2010). J. Neil Garcias Male Homosexuality in the Philippines, A Short History. Manila, Philippines. Smith, D.W. (2008). Phenomenology. Stanford Encyclopedia of Philosophy. Retrieved 2010 TagalogLang retrieved from http://www.bing.com/ search?q=tagaloglang&form = QBRE&filt all&qs=n&sk=&sc=4-11 Tannenbaum, I. (2006). The Impact of Social Contest on the Conceptualization of Sexual Orientation: A Construct Validity Investigation. Unpublished Dissertation. Ohio State University, USA. Tejano, E. (2007). Male Homosexual Cultures of the Philippines. Yahoo Arts Entertainment

Tesioma, B. (2005). Davao Solons, Dads Frown on Gay Marriage of 2 NPA Rebels. Sun Star Welman, J.C. & Kruger, S.J. (1999). Research Methodology for the Business and Administrative Sciences. Johannesburg, South Africa: International Thompson. Wikipedia, the free encyclopedia. http://en.wikipedia.org/wiki/casual sex Retrieved 2010 from Wikipedia.

Wikipedia, the free encyclopedia. Retrieved http://en.wikipedia.org/wiki/Same-sex_relationship

2010

from

Wikipedia.

Zucchetti, L. (2009). Bianco, nero o arcobaleno? Aspettative e pregiudizi dal punto di vista delle famiglie omogenitoriali. University of Bergamo. Italy

STRESSORS IN THE WORKPLACE, THEIR EFFECTS TO THE FACULTY MEMBERS OF AQUINAS UNIVERSITY OF LEGAZPI Catherine R. Vargas, RN, MAN Work-related stress is said to be experienced when the demands from the work environment exceed the employees ability to cope with or control them (European Agency, 2000). In the teaching profession, stress is recognized as the number one health problem among teachers. It is described as the experience by a teacher of unpleasant, negative emotions, such as anger, anxiety, tension, frustration or depression, resulting from some aspect of their work as a teacher. Studies have consistently concluded that teaching is one of the most stressful occupations, and that a significant number of teachers, perhaps even a majority, are affected by work-related stress. It has been acknowledged that managing stress in the workplace is a collective effort of the individual and the organization. More so, nursing plays an immense role in assisting individuals to cope with stress and maintain or achieve wellness. This study was conducted with the primary aim of advancing recognition of teacher stress in Aquinas University. Such awareness shall be the key step in promoting a working environment that supports wellness among the faculty members by addressing stress at the individual and organizational levels. Specifically, the study strived to answer the following questions: 1) What stressors are encountered by the faculty members of Aquinas University of Legazpi in the workplace?, 2) What are the effects of these stressors along physiological and psychological aspects and job performance of the faculty members?, 3) What individual strategies can be recommended to cope with these stressors?, and 4) What administrative support can be offered to the faculty member who encountered stressors?. From the findings of the study, the

10

researcher recommended a stress management action-plan per college which outlined nursing interventions. This study utilized a descriptive-survey type of research, using a questionnaire to explore the sources of stress in the workplace along demands, management, support, role and control, working conditions and relationships; the effects of stress in terms of the physiological and psychological aspects and job performance of the respondents; the individual coping strategies and the recommended administrative support to manage encountered stress. The researcher conducted interviews to gather their actual experiences per stressor. A total of 98 faculty members served as respondents. They are teaching in the different colleges of Aquinas University of Legazpi for the Second Semester of SY 2009-2010, with at least 21 units or 24 teaching hours per week on either full-time or part-time status. Statistical treatment included frequency distribution, percentage, and weighted mean. The salient findings of the study were: 1) Sources of stress in the workplace along job demands included working on school matters in the evening or on weekends, handling too many lectures, demands and requirements in graduate studies, unreasonable deadlines and time pressures which were too often imposed and too many after school meetings. Along management, stressors were unfair practices of managers, lack of effective leader in the department, managers who could not effectively handle conflicts, a demanding and bossy immediate supervisor and fast turn over of administrator in the department. Along support, these were poor pay, lack of benefits, lack of support on faculty development, worries about job security and lack of mentors. Along role and control, stressors were new roles were required without appropriate training, required to teach outside areas of competence and training, lack of consultation in the school and lack of participation in decision-making. Along working conditions, the respondents identified far classroom locations, poor classroom ventilation, lack of facilities, too big class sizes, excessive noise levels in the working environment and poor lighting conditions as sources of stress. Along relationships, the students lack of motivation, students misbehavior in the classroom and students lack of respect for teachers were the stressors. 2) Faculty members manifested stress physiologically by often experiencing fatigue/body weakness; and psychologically by often experiencing anxiety and irritability. Accordingly, stress affected job performance as shown by poor performance and productivity though only seldom in occurrence. 3) Individual coping strategies suggested were attending stress awareness programs, discussing concerns with management, time management and priority setting, prayer, discussing concerns with co-workers, taking a day off, humor, sleep and music therapy. 4) To assist faculty members who were encountering stress, administrative support such as wellness programs, in-service trainings, stress awareness sessions and improving organizational communication were recommended. In response to the findings of the study, a stress management action-plan was designed to address the sources and effects of stress with the definitive goal of promoting wellness among the faculty members. The actionplan highlighted nursing interventions for identified effects of stress. Some of the recommended nursing interventions included encouraging healthy lifestyle (proper nutrition, adequate rest and sleep, regular exercise), assisting in relaxation techniques, positive visualization, allowing verbalization of feelings, encouraging expanding support system and advising seeking professional help when needed among others. The following conclusions were derived: 1) The faculty members of Aquinas University of Legazpi for the Second Semester of SY 2009-2010 encountered several stressors in the 11

University along the six key areas. In general, the different colleges of the University experienced similar sources of stress, though there were some stressors that were distinct to a certain college. The College of Business Administration (BA) appeared to be the college with the most number of issues and concerns in terms of the six key areas. 2) Stress of faculty members was manifested physiologically and psychologically. It also affected job performance. The colleges showed differences in manifestations of stress as well as the frequency of such manifestations with BA showing the most and frequent manifestations. 3) A critical factor in managing occupational stress was the use of individual coping strategies. Faculty members of the University recommended varied strategies in managing stress. Most likely, these recommendations were the strategies of the faculty members in effectively managing occupational stress. 4) The administration plays a significant role in stress management. The faculty members certainly required the support of the administration in managing encountered stress in the workplace. In the light of the findings and conclusions, the researcher recommends the following: At the individual level, faculty members should play an active role in managing stress by indulging in health promotional activities, undergoing regular physical and psychological examinations and having individual coping strategies for stress management, among others. At the organizational level, 1) University Administrators, specifically the Deans and the Human Resource Management Office (HRMO) to consider the findings of this study and accept that stress is an organizational issue which should be tackled. Main emphasis should be on reducing or eliminating hazards and not solely on stress management courses or training. 2) The HRMO should consider establishing an organizationally supported stress management program that would also include provisions for in-service trainings and wellness programs as recommended by the respondents as well as provision for occupational health services and counseling services for those who feel stressed, and 3) Employee unions should have a better understanding and an increased capacity in tackling stress in the University along with the other stakeholders. At the professional nurse level, their responsibility would encompass stress management initiatives at the individual and organizational levels. At the heart of this role is assisting faculty members to manage stress throughout the three levels of prevention namely: 1) Primary prevention, 2) Secondary prevention, and 3) Tertiary prevention. Nursing roles in stress management at the individual levels can best focus on promoting primary prevention through health education centered on leading a healthy lifestyle. Nursing role at the secondary and tertiary prevention is to help individuals achieve wellness and optimal level of functioning. At the center of organizational partnership in stress management comes the critical participation of the College of Nursing and Health Sciences in carrying out proactive stress management initiatives for the benefit of the faculty members including the entire workforce of the University.

12

CASE STUDY ON POST TRAUMATIC STRESS DISORDER Bryan James G. Carrillo Post Traumatic Stress Disorder (PTSD) is a form of anxiety disorder developed after a person is exposed to a traumatic and possible near death experiences which severely compromise the physical and psychological well-being of that person. PTSD sufferers exhibits three cluster of symptoms which include the re-experiencing of the traumatic event, the tendency to avoid places, people or other things that remind them of the event (avoidance) and the exquisite sensitivity to normal life experiences (hyperarousal). Eventually, the patient becomes antipathetic towards society, losses significant persons due to the withdrawal and eventually evolves into a more severe form of psychoses. Consequently, the purpose of this research is to provide an in-depth account of the life of an individual suffering from PTSD. Four problems were posed; to identify the profile of the patient, specifically age and activities of daily living; to determine the predisposing events that led to the development of PTSD; the identify existing coping mechanisms being utilized by the participant; and to enumerate and elaborate the nursing interventions that would effectively support the participant in becoming a well-adapted and functional individual. More significantly, this research would help a nurse appreciate the overwhelming duties and treatment modalities for a person aggrieved with Post Traumatic Stress Disorder. Statement of the Problem The research aims to answer the following problems: 1) What is the profile of the patient in terms of: age, and activities of daily living? 2) What are the predisposing events that led to the development of Post Traumatic Stress Disorder to the participant? 3) What are the existing coping mechanisms utilized by the patient? 4) What nursing interventions may be proposed to effectively support the participant in becoming a well-adapted and functional individual? Conceptual Framework Two nursing theorists propagated a concept that suited the management of care for a person having PTSD. Hildegard Peplaus Interpersonal Relations Theory describes a four phase phenomenon known as the nurse-patient interaction. This proved to be a valuable approach to clients who are mentally ill since it primarily addresses the functional needs of the client which is support, open communication, and a sense of being gratified. In this theory, the patient is accepted unconditionally, which is the backbone in approaching all PTSD clients. Another theory that proves to be relevant to this research is Callista Roys Adaptation theory. Her theory generally speaks of humans interacting with a changing environment and coping with the environment through bio-psychosocial adaptation mechanisms. The focus of the 13

study is on how an individual, family, group, communities, or society develop and further implement their adaptation to change. Also, a persons health status is determined by the way that individual cope to the external and internal stressors like environmental or physical trauma. Methodology The research used a therapeutic one-on-one communication and direct observation between the identified participant, key informant and researcher. The researcher stayed in the house of the participant and key informant for 4 days to observe and document the behavior of the participant. The use of a tape recorder for the interview was done to provide a veracious account of the four day immersion. The Daily Living Activities Functional Assessment was utilized as a framework for the observation and interview of the client. This provided an indepth account on the lifestyle of the patient. Datas gathered from the immersion and interviews were coded, categorized, clustered, and was provided a theme so as the discussion of the results is structural. Discussion of Results Post Traumatic Stress Disorder is imminent in the participant as she shows the distinct symptoms of avoidance, hyperarousal, and re-experiencing of the traumatic event. To better understand the situation of the client, a table showing the categories and themes is made. Summary of Categories and Themes Categories Activities of Daily Living Themes Health Perceptions Functionality Communication Self-Preservation Lack of Social Support Dysfunctional Adaptation Pattern Rape Trauma Occupational Therapy

Predisposing Events

Coping Mechanism

The participant is female, 48 years old, single, and is a plain housewife. She is diagosed with delayed chronic PTSD. The first category is activities of daily living, and it discusses the participants health perception, functionality, communication and self-preservation. Health perceptions deals with the participants awareness regarding her genera health. It discusses concepts such as present health status and ways how she maintains health, management of mood and sleep pattern aberration. Functionality discusses the participants ability to function normally. Considering that the patient has PTSD, functioning is impaired because of anxiety and the constant reliving of trauma which leads to fear and inactivity. Communication discussess the participants capacity to socialize with the external environment. Considering the fact that fear from the trauma runs the participants life, it makes it difficult for the participant to socialize with other people. Self preservation discusses the participants effort 14

to ensure and maintain personal safety. In the case of PTSD, safety is somewhat compromised as the participant is emotionally unstable, and that her actions are guided by fear and anxiety, a marker for self-inflicted harm. This would inevitably make the participant at risk for physical injuries that could have been prevented. All of the themes discusses the physical and psychological aspect of the participant. The second category is predisposing events and it discusses lack of social support, dysfunctional adaptation pattern, and rape trauma. Lack of social support is evident in the participant since throughout her life, she was neglected by significant persons. The discussion on this would revolve around her childhood history. Dysfunctional adaptation pattern denotes how the participant adapted to her losses. The resolution, if impaired, would lead to dysfunctional adaptation later in life. Lastly, rape trauma became the pinnacle which pushed the participant to become antipathetic towards society. These experiences are very troubling to almost anyone who is raped, but due to the dysfunctional pattern and lack of social support, it escalated to become Post Traumatic Stress Disorder. The themes in this category discusses the events in the participants life that contributed and somewhat drove the participant to develop PTSD. The third catgory is the coping mechanism utilized by the partcipant. The theme here is occupational therapy. In the assessment done to the participant with PTSD, the researcher has noted that the participant engages herself with cross stitching and crocheting. Needlework are classified as an art therapy and at the same time, an occupational therapy, and is considered to be a therapeutic exercise to the participant. Also, the research proposed nursing interventions that promote and maintain an effective open relationship to address the needs of the participant like emotional support, open communication and gratification. Also, specific nursing practice like providing support, safety and comfort to the patient to help decrease psychological anxiety, stress and helplessness is discussed. Recommendations To further enhance this study, the research recommends the use of Gordons Functional Assessment in the study of activities of daily living as it would cover all aspects of health in a mentally ill patient. Also, further study in the various therapies specific to PTSD client is imperative as nursing care will be based on such. Another factor that might be considered for this research is orientation on therapeutic communication and the theory of its application. Being a nurse, one cannot escape communicating with patients, especially if the patient is mentally ill. It is then imperative that the nurse must have a concrete knowledge in therapeutic communication and how it is applied in its appropriate setting.

15

References American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders: DSM-IV. Washington, DC: American Psychiatric Association Andreasen, N.C. "Acute and delayed posttraumatic stress disorders: a history and some issues."American Journal of Psychiatry 161 August 2004:1321-1323. Biology of PTSD (2008). Woodland Park, CO: PTSD Support Services http://www.ptsdsupport.net/ Carreta, C., Jaroszynski, A., Rankin, M., (2008). Nursing Care of Posttraumatic Stress Disorder after Anesthesia Awareness. Plastic Surgical Nursing (Volume 28) Dixon, R. (2008). PTSD TYPE SYMPTOMS AND CGSC CLASS 08-01, A STUDY OF FIELD GRADE OFFICERS AND IMPLICATIONS FOR THE FUTURE. Published Masteral Thesis. Domrose, C. (2008). Patients and RNs face Unprecedented Stress. Nurse Week. 30 Field, Tim. (2005). Stress injury to health trauma, PTSD. Oxfordshire, UK: The Field Foundation. http://www.bullyonline.org/stress/ptsd.htm Mental Health News. (2007) Prevalence and Correlates of Post Traumatic Stress Disorder and Chronic Severe Pain in Psychiatric Outpatients. ODell, Richard E. (2007). Do I have PTSD? Richmond, VA: The PTSD Help Network. http://www.ptsdhelp.net/index.html Tull, Matthew. (2007). Who gets PTSD? New York, NY: About.com. October 31 http://ptsd.about.com/od/prevalence/a/prevalence.htm Videbeck, Shiela L, (2004), Psychiatric and Mental Health, 2nd Edition, pg. 223-224, 290 Weathers, Frank W., Brett T. Litz, Debra S. Herman, Jennifer A. Huska, and Terrence M. Keane, 1993. The PTSD checklist (PCL): reliability, validity, and diagnostic utility. Paper presented at the Annual Meeting of International Society for Traumatic Stress Studies. San Antonio, TX. http://www.pdhealth.mil/library/downloads/PCL sychometrics.doc,

16

KNOWLEDGE LEVEL ON SEXUALLY TRANSMITTED INFECTION OF NURSING STUDENTS IN AQUINAS UNIVERSITY OF LEGAZPI Fulgar, Adrian P., Martinez, Jayvee Renz O. Marquez, Marnelli C The study identified the knowledge level of nursing students of Aquinas University of Legazpi on sexually transmitted infections. It aimed to assess what the students already knew and what they did not know about STIs. Specifically, it sought to answer the following problems: 1.What is the profile of respondents in terms of: A.) Age, B.) Gender, C.) Civil Status, D.) Religion, and E.) Year Level? 2. What is the knowledge level of the respondents with regards to sexually transmitted infection (STI) specifically on: A.) Etiology, B.) Transmission, C.) Prevention of infection, D.) Medical Management, E.) Nursing Interventions? 3. What factors affect the knowledge level of respondents on STI? 4. What are the measures that may be proposed to enhance the knowledge of the respondents on STI? Based on the data, the following findings were obtained: 1.) As to the demographic profile on age, there were 85 or 65.89% student nurses age ranged from 16 -19 while on the other hand, there were 2 or 1.55% of them were aged 28-31. On gender, student nurses were comprised of 99 or 76.74% of females and 30 0r 23.26% males. On religion, most of the student nurses with a frequency of 113 and a percentage of 87.60 were Roman Catholics while least of them with a frequency of 1 and a percentage of 0.78 were Islam, Iglesia ni Cristo and Baptist. On year level, there were 20 or 15.50% respondents in second year, 42 or 32.56% in third year and 67 or 51.94% in fourth year. 2.) Nursing students from levels 2, 3 and 4 had different knowledge level on the etiology, transmission, prevention, medical management and nursing intervention. There were 94.57% student nurses who knew that herpes simplex was one of the causes that could be found in STIs. They also knew, with a percentage of 89.92%, that gonorrhea, caused by Nisseriagonorrhea, was a sexually transmitted disease involving infection of the columnar and transitional epithelium. There were about 85.27% of student nurses who knew that cold sore or fever blister was an infection of the face or mouth caused by herpes simplex. On the other hand, 60.47% of student nurses did not know that Nisseriagonorrhea could be killed by ordinary disinfectant. In addition, there were some of them with a percentage of 31.78 did not know that the etiologic agent of HIV was HTLV-3 or retrovirus. Lastly, there were 30.23% student nurses who did not know that Treponemapallidum was the causative agent of syphilis. 2.1.). Sexually transmitted infection can be transmitted through different means. Most of the students with a percentage of 96.12 knew that AIDS could be transmitted through blood transfusion and as well as transplacental. In addition, 95.35% of them knew that having sexual activity from same gender that had one of the said STIs could increase the risk of transmission. With the same percentage, they also knew that fluids and secretions from an infected partner could facilitate transmission of infection to another partner. There were 90.70% of student nurses who knew that sexual contact included more than just sexual intercourse (vaginal and anal). On the contrary, there were 41.09% of student nurses who did not know that kissing had lesser risk in acquiring STI. Some of them, with a percentage of 22.48%, did not know that a person infected orally with herpes simplex could transmit the infection by kissing and sharing utensils. Students from levels 2, 3 and 4 with a percentage of 21.71% did not know that Gonorrhea is can be contracted sexually and from public or shared toilet seats.2.2.) Sexually transmitted infection can be prevented in different ways. Most of the student nurses with a percentage of 98.45 knew 17

that STI could be prevented. With a percentage of 96.12%, they knew that regular check-up could be a helpful way in preventing a person from acquiring such infection and their complications. In addition, they also knew that information dissemination on the said infection was one way of preventing it. Despite the different ways to teach preventions to the student nurses, they still had some concepts about prevention that they did not know. Some of the student nurses, with a percentage of 49.61 did not know that using a spermicide could help prevents STI. There was 46.51% of who did not know that sexual abstinence until marriage was the only 100% effective means of STI prevention. Lastly, 24.03% of the student nurses did not know that abstinence was the best way to prevent STI. 2.3.). There were different medical managements which could be used to diagnose STIs. Majority of the student nurses with a percentage of 97.67 knew that diagnostic tests were more useful for assessing prevalence when the test results were specific for active infection. This was followed by 93.80% of the student nurses who knew that other STIs require a blood test or sample of any unusual fluid (such as abnormal discharge from vagina or the penis for gonorrhea or Chlamydia) to be analysed in a lab to help establish a diagnosis. There were 86.82% of student nurses who knew that some STIs, such as genital herpes and HIV (which leads to AIDS) could not be cured and could only be controlled with medication. There were some concepts about medical management that student nurses did not know. There were about 44.96% of student nurses who did not know that inoculation of specimen on Thayer-Martin medium was the diagnostic exam for females infected with gonorrhea. In addition to this, there were 25.58% of student nurses who did not know that the drugs of choice for pregnant women infected with gonorrhea were ceftriaxone plus erythromycin. About 24.03% of them did not know that males infected with gonorrhea had a different diagnostic exam compared to females, which was gram-staining. 2.4.) Nursing interventions were also important in treating STIs. One of the nursing interventions that 90.70% of the student nurses knew was encouraging vaccination against STI that could be done by every health care personnel. There were also 89.92% of student nurses who knew that education and counselling of persons at risk on ways to avoid STIs through changes in sexual behaviours was one of the five major categories of the prevention and control of the infection. There were also 88.37% of the student nurses who knew that health education an effective way of imparting knowledge regarding the risk and prevention of STI. Same percentage of student nurses knew that infected persons need to learn the mode of transmission, complication and the risk for other STIs. Some of them, with a percentage of 38.76 knew that advising the infected person to keep his or her infection secret and not to report to public health department could not help the existing problem. On the contrary, few of them, with a percentage of 18.60 did not know that one of the essential nursing interventions for STI like herpes simplex was hand washing. There were also 16.28% of student nurses who did not know that advising the infected person to do abstinence from sexual intercourse until treatment has been completed could be a clinical intervention. 3.) Factors affecting knowledge level of student nurses from level 2, 3 and 4 were ranked and from the greatest to least factor that could affect the level of understanding of the students regarding STI. The primary factor which most of the students believed to affect knowledge level on STI was lack of knowledge regarding on the seriousness of the health threat of STI. Second on the rank were influences of media like television and internet and peer influences. This was followed by lack of interest and curiousness on the topic since they never have experienced sexual intercourse and never been sexually active was one of the factors. Next were parental guidance and culture influences. Then, the sixth factor was not having enough time to take the topic/issue seriously due to other reasons. Ranked seventh was educational background. Last in the rank was the subject was never been discussed in the lecture.

18

Proposed Measures Based on observations and findings, proposed measures to solve the existing problems were identified and enumerated. 1. Make pamphlets, flyers or brochures regarding STIs and distribute them to fellow student nurses. 2. Create a group or organization in the college which will promote programs against STIs and which will provide information or counselling about it. 3. Impart to the clinical instructors the insufficiencies on the knowledge of the students on STIs. 4. Conduct a mini seminar and an open-forum and make the student nurses as the primary participants. 5. Share the findings of the study to fellow student nurses, for them to become aware and to elicit their cooperation to solve the identified problems. 6. Include in the bulletin board of the college trivia about STIs. 7. Make slogan on promoting its prevention. Recommendations Based on the foregoing findings and conclusions, the following recommendations are formulated: 4BSN: 1. As part of the requirements in their subject in leadership and management, the 4th year students could conduct a seminar focusing on STIs. Through this, they could enrich their knowledge about the infection and could enlighten their minds about some misconceptions by having an open-forum with the speaker after discussing the topics. 2. Clinical Instructors should explain further and delve deeper into the topic for the students to learn not only the STIs but also their prevention, transmission, complications and nursing interventions for the venereal diseases. 3. Since most of the fourth year students spend their time in the clinical area for their duty days and completion of cases, they can have a small discussion in their group. This could be facilitated by their clinical instructors to know what the students already knew and supply their deficiency about the topics. 4. It should be cleared to them that abstinence is still the best in the prevention of teenage pregnancy and in transmission of STIs. 3BSN: 1. Clinical instructors should have a thorough discussion of STIs not only inside the room but also in the clinical area especially when they encountered person infected with the disease. 2. To enhance their knowledge, clinical instructors should give the students activities such as case studies and journal readings about STIs. To check their knowledge, clinical instructors should read the students output and address whatever concerns they have encountered as they checked the content of the writings of the students. 3. It should be clarified to them that abstinence until marriage is the most effective means not only in prevention of teenage pregnancy but also in the transmission of STIs. 2BSN: 1. Since this topic was not yet covered by their subjects or it could be one of the topics but was not fully discussed, clinical instructors should supply the inadequacies of the students not only inside the room but also in the clinical area. They should also encourage the students to attend more seminars and discussions about the topics on STIs to enhance their knowledge. 19

2. Part of gaining knowledge was research and reporting. Clinical instructors could assign a topic about STIs for every student in the class to research about and to impart knowledge to others through reporting or trivia sharing as one part of their discussions which may be related to STI and which are under their curriculum. 3. Most of the students from second year were given a chance to have a duty in the community especially in the health center of every barangay where they can utilize the materials such as brochures, pamphlets, audio-visuals and also observe the patients infected with STI who consulted in the social hygiene unit. For levels 2-4: 1. In coordination with the office of College of Nursing and Health Sciences, the college student council should conduct an annual seminar regarding STI to be able to supplement their knowledge on the said topic. 2. College of Nursing guidance counsellors should encourage the student to approach them and raise their concerns on STIs. 3. Clinical Instructors should explain further the topics on STIs, to learn the prevention, transmission, complications and nursing interventions of the venereal diseases. 4. The community should also be involved in imparting knowledge on STIs. The health centers should conduct lectures on the topic not only to the adults but also to adolescents and young adults so that they will have idea about STIs. 5. Parents of every family should guide their children in watching television and surfing the net so that any sensitive issues regarding sex and the diseases that can be acquired could be explained by them in a simple and comprehensible manner. 6. Giving flyers and pamphlets are also ways to address the lack of knowledge on STIs of nursing students. 7. Involvement of clinics not just in the vicinity of the schools but also outside the schools could also help in imparting knowledge and clarifying misconceptions through brochures, pamphlets, journals and also health teachings of the health care personnel to clients. Areas for Further Study 1. Attitude of Student Nurses in Caring of Patients Infected with Sexually Transmitted Infection in Aquinas University Hospital. 2. A Study on the Competency of Clinical Instructors of Aquinas University in Teaching Sexually Transmitted Infections to Student Nurses. 3. Effectiveness of Nursing Interventions of Aquinian Student Nurses in Patients Infected with Sexually Transmitted Infection in Aquinas University of Legazpi.

20

References Afsar, H.A. et. al. (n.d.).Community Knowledge, Attitude and Practices regarding Sexually Transmitted Infections in a Rural District of Pakistan.Retrieved from (http://www.jpma.org.pk/full_article_text.php?article_id=1979).Retrieved on September 8, 2012. American Society of Registered Nurses. (2008). Nurse Attitudes And Care For Patients With Sexually Transmitted Diseases (n.d.). Retrieved from (http://www.asrn.org/journalnursing/316-nurse-attitudes-and-care-for-patients -with-sexually-transmitteddiseases.html). Retrieved on September 8, 2012. Aral, S. et al. (2006).Sexually Transmitted Infections.Retrieved from (http://www.ncbi.nlm.nih.gov/books/NBK11734/).Retrieved on January 28, 2012.

Arao, O. S. (2007). Perceptions of the Level I Nursng Students of Aquinas University of Legazpi on Premarital Sex.Unpublished Undergraduate Thesis.Aquinas University, Legazpi City. Better Health Channel. (n.d.).Teenagers - sexual knowledge (n.d.). Retrieved from (http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Teenagers_sexual _knowledge?open).Retrieved on September 8, 2012. Boyd, D., & Bee, H. (2009). Lifespan Development. Boston, MA: Pearson Education Inc. Campogni, C (2011). A Psychological Approach to Sex Education: Is Abstinence The Answer? Castro, J. (2004). Playing with Fire: Sexual Risk Behaviors and Safer Sex Practices of Young Homosexuals in the Philippines. Manila, Philippines. Castro, J. E. (2010). Christian Research Institute. (http://www.equip.org).Retrieved on October 28, 2012. Retrieved from

Chan, C. (2005). Focus on the Filipino Youth: The Lost Generation. Retrieved from (http://pcij.org/stories/perils-of-generation-sex/). Retrieved on March 21, 2012 Cometa, S. E. A. (2005).The Roles of the Fourth Year Nursing Students in the Prevention of Sexually Transmitted Infection.Unpublished Undergraduate Thesis.Aquinas University, Legazpi City. Examiner (n.d.). A psychological approach to sex education: Is abstinence the answer? Retrieved from (http://www.examiner.com/article/a-psychological-approach-to-sex-educationis-abstinence-the-answer).Retrieved on December 1, 2011. Ferry, et al.(2001). Sexually Transmitted Infections, Sexual Behavior, and the HIV/AIDS Epidemic.Retrieved from ( http://home.uchicago.edu/~eoster/aids.pdf).Retrieved on March 21, 2012. 21

Garbo, J. (2001). More Young Gay Men are Contracting HIV from Steady PartnersGayhealth. Health Promotion Agency (2000). Promoting Health for Northern Ireland: Taking a Closer Look at Sexual Health, Northern Ireland Irishexaminer (2010).Young People 'Unwilling to Talk About STIs'.Retrieved from(http:// www.irishexaminer.com/breakingnews/ireland/young-peopleunwilling-to-talkabout-stis-450945.html).Retrieved on January 6, 2012. Jamisola, R. (2012). Phenomenology of Male Same-Sex Practices and their Implications on Health.Unpublished masteral dissertation, Aquinas University of Legazpi Professional Schools Legazpi City. Jamison, D. T. et. al (2006). Disease Control Priorities in Developing Countries, 2nd edition. Retrieved from (http://www.ncbi.nlm.nih.gov/books/NBK11734/).Retrieved on June 12, 2012. Minnesota Department of Health.(2002).Chronological History of Definitions of Sexual Health.Retrieved from (http://www.health.state.mn.us/topics/sexualhealth/definitions.html).Retrieved on September 9, 2012. Panaligan, N. (n.d.) Awareness on Risk Factors of Sexually Transmitted Infection and Sexual Risk Behaviors Among Students. Retrieved from http://reviewessays.com/Miscellaneous/Sexually-TransmittedInfection/91.html?page=1.Retrieved on March 22, 2012. Posadzki, A. (2011). Universities boost awareness about hike in sexually transmitted infections. Retrieved from (http://www.guelphmercury.com/print/article/623002).Retrieved on April 2, 2012. Read Periodicals. (2011). The Cultural Beliefs of the Vhavenda on the Causes and Transmission of Sexually Transmitted Infections (n.d.). Retrieved from (http://www.readperiodicals.com/201106/2375818511.html#ixzz24AFJJp3d).Retriev ed on September 8, 2012. Read Periodicals. (2011). Sexual Behaviour and Knowledge Regarding Sexually Tranmitted Infections Among Undergraduate Students in Durban, South Africa.Retrieved from (http://www.readperiodicals.com/201106/2375818511.html).Retrieved on September 8, 2012. Reviewessays (2010).Sexually Transmitted Infection. Retrieved from (http://reviewessays.com/Miscellaneous/Sexually-Transmitted Infection /91.html?page=13). Retrieved on February 2, 2012. 22

Steinberg, L. (2011). Adolescence (9th ed.). New York: The McGraw-Hill Companies, Inc. Stein, R. (2010). Abstinence-only Programs Might Work, Study Says. WashingtonPost. Retrieved from (http://www.washingtonpost.com/wpdyn/content/article/2010/02/01/AR201002 ). Retrieved on February 23, 2012. TheFullWiki(n.d.).Sexuality in the Philippines: Wikis. Retrieved from (http://www.thefullwiki.org/Sexuality_in_the_Philippines).Retrieved on April 3, 2012. White, J. (2008). Taking sides: Clashing views in Gender. New York, NY: Higher Education WHO (2002).Sexual and Reproductive Health.Retrieved from (http://www.who.int/reproductivehealth/topics/gender_rights/sexual_health/en/).R etrieved on January 22, 2012. (2012).Catholic Church and AIDS.Retrieved from (http://en.wikipedia.org/wiki/Catholic_Church_and_AIDS).Retrieved on September 11, 2012. (2012).Sexuality in the Philippines.Retrieved (http://en.wikipedia.org/wiki/Sexuality_in_the_Philippines).Retrieved on 2012. from July 6,

Wikipedia

Wikipedia

23

MATERNAL KNOWLEDGE AND BELIEFS TOWARDS CHILDHOOD IMMUNIZATION IN BARANGAY STA. CRUZ, LIGAO CITY Pilla, Salve Regina N. Tobongbanua, Bea R. Sarmiento, Molly L. Trianes, Kevin M. This study aimed to determine the maternal knowledge and beliefs towards childhood immunization in Barangay Sta. Cruz, Ligao City. Specifically, this study sought answers to the following questions: 1) What is the demographic profile of the mothers in terms of age, educational attainment, occupation, and monthly family income? 2) What is the level of knowledge of the respondents on childhood immunization in terms of benefits of immunization, indications and contraindications, and schedule of immunization? 3) What are the beliefs of mothers on childhood immunization? 4) What problems are encountered by the mothers during the immunization of their children? and 5) What measures may be proposed to enhance the knowledge of the mothers regarding childhood immunization? This study is a descriptive type of research concerned with the description of data and characteristics about the population. The goal is the acquisition of factual, accurate and systematic data that can be used in averages, frequencies and similar statistical calculations. Interview schedule survey method in gathering data was utilized. The study was anchored on the Dorothea Orems Self Care and Self Care Deficit Theory and Sister Callista Roys Adaptation Theory to enable the researchers to weave the facts together. The gathered data were analyzed and interpreted with the use of frequency, percentage and ranking. Based on the data gathered the following findings were elicited: 1) On the demographic profile of the respondents it was revealed that out of 30 respondents 8 or 26.66% belong to the age bracket of 26-28 years old. Majority of them were housewives, with a frequency of 26 or 86.66%, 9 or 30% were able to finish secondary level and 16 or 53.33% have 1,000-3,000 monthly family income. In view of the knowledge level of mothers on childhood immunization, the study shows that along the benefits of immunization, most of the respondents believed that immunization protects children from disease- causing agents and helps boost immunity with a frequency of 30 or 100%. Four or 13.33% of the respondents have lesser knowledge that boosters are necessary to keep a childs immunity up and for it to last longer. On the knowledge level of the respondents along the indications of immunization, it was revealed that most of the respondents knew that immunization can be given to a child who is malnourished, with a frequency of 21 or 70%. On the other hand, 25 or 83.33 % of the mothers did not know that vaccines could be given to a child with moderate fever or with temperature below 38.5oC. As to the contraindications of immunization, 27 or 90% of the respondents knew that vaccine schedules should not be restarted from the beginning even if interval between doses exceeded the recommended interval by months/ years. While, 17 or 56.66% did not know that DPT (2 nd & 3rd dose) to a child should not be given if convulsion or shock within 3 days the previous dose. Lastly, findings on the knowledge level of mothers on the schedule of immunization revealed that most of them were knowledgeable about BCG being given anytime at birth or after birth, DPT and OPV are given 3 doses with an interval of 4 weeks and anti- measles is given 9 months 24

of age both with a frequency of 29 or 96.66%. However, 5 or 16.66% of them were unaware that that first dose of Hepatitis B is given at birth. The topmost belief of the mothers on childhood immunization was that vaccines can protect children from the seven immunizable diseases with a frequency of 24 and ranked as number one followed by the indicator vaccines can enhance the knowledge of the children with 18 respondents who agreed to it but not a single one was found to believe that vaccines are not effective, ranked as last. In line with the problems encountered by mothers on childhood immunization, it was revealed that the indicator sick infant/ child was the rank one problem encountered by 25 respondents. This is followed by lack of medical supplies ranked as number two and only one respondent said that she did not encounter any problem. Several measures were proposed to enhance the knowledge of the mothers regarding childhood immunization, these are: conduct of health teachings, trainings and seminars, intensive education campaign, poster and slogan making and information dissemination by distributing pamphlets, brochures, flyers and other information materials regarding childhood immunization. Based on the findings, the following conclusions were drawn: 1) Majority of the respondents are on their early adulthood, housewives, attained secondary level of education and belong to the low income earners family. 2) The knowledge level of mothers on the benefits of immunization could be concluded that the respondents were very much aware that immunization protects children from disease- causing agents and it helps boost immunity but some of them have lesser knowledge that boosters are necessary to keep a childs immunity up and for it to last longer. On indications of immunization, most of the respondents knew that immunization can be given to a child who is malnourished, however a high percentage of mothers did not know that vaccines could be given to a child with moderate fever or with temperature below 38.5oC. As to the contraindications of immunization, majority of the respondents knew that vaccine schedules should not be restarted from the beginning even if interval between doses exceeded the recommended interval by months/ years. While, more than 50 percent of them did not know that DPT (2nd & 3rd dose) to a child should not be given if convulsion or shock within 3 days of the previous dose. Likewise, with regard the schedule of immunization, most of the mothers were aware that BCG is given anytime at birth or after birth, DPT and OPV are given 3 doses with an interval of 4 weeks and anti- measles is given at 9 months of age but few of them were unaware that that first dose of Hepatitis B is given at birth. Thorough analysis of the overall findings along the knowledge level of mothers on childhood immunization could be deduced that they are very much aware of the benefits and schedule of immunization, but there is a need for them to be further educated as to the indications and contraindications of immunization. As to the beliefs of the mothers on immunization, majority of them believed that vaccines can protect children from the seven immunizable diseases and it can enhance the knowledge of children. Not a single was found to believe that vaccines are not effective. The main problem encountered by most mothers that hindered them from submitting their children for immunization was due to sickness followed by lack of medical supplies. Several measures to enhance the knowledge of the mothers regarding childhood immunization were proposed. 25

Based on the findings and conclusions, the following were recommended: 1) Given that majority of the respondents were on their early adulthood, housewives, attained secondary level of education only and belong to the low income earners family, it is highly recommended that health care workers provide more information on responsible parenthood in relation to childhood immunization. 2) On findings that mothers are less knowledgeable in line with the indications and contraindications of immunization, health education is likewise essential. However, the health care providers responsible in educating them must be well-equipped with knowledge and skills, particularly the midwives and barangay health workers who serve as the forefronts in the promotion of health in community setting. The City Health Office should see to it that their health care providers have undergone, trainings and seminars to efficiently and competently educate the mothers pertaining immunization. 3) Since majority of the mothers believe vaccines can protect children from the seven immunizable diseases and it can enhance the knowledge of children, further knowledge regarding immunization could also be made available through distribution of Information Education Communication (IEC) materials such as pamphlets, brochures and other information materials. Posting slogans on strategic places is likewise helpful. 4) In view of the result that sick infant/child emerged as the main problem encountered by most mothers for not submitting their children to have immunization; mothers/parents classes or focus group discussion may be appropriate. Health educators should provide all the pros and cons of immunization with emphasis on the effects of immunization and should be clearly discussed to the mothers at the level they could easily comprehend. 5) All proposed measures are highly recommended to be carried out by the health care providers for effective promotion of childhood immunization, thereby increase the percentage of fully immunized children.

26

References Awodele, O. et al. (2010). The knowledge and attitude towards childhood immunization among mothers attending antenatal clinic in Lagos University Teaching Hospital, Nigeria. Retrieved December 10, 2011 from www.ajol.info/index.php/thrb/article/download/51112/43905 Balisbis, S. (2007). Implementation of maternal and child health program as perceived by the barangay health workers in the municipality of Sto. Domingo, Albay. Unpublished Master Thesis, January 5, 2012 Blanza, D. (2003). Compilation of report in community health nursing II, Bicol university college of nursing. Unpublished Master Thesis HealthCare. (2008). The benefits and risks of childhood immunization. Retrieved January 16, 2012 from www.bizymoms.com/.../benefits-of-childhood-immunization.html Ibrahim H Al-Ayed (2010). Mothers' knowledge of child health matters: Are we doing enough? Retrieved December 10, 2011 from www.jfcmonline.com/article.asp?issn=13191683;year=2010;volume=17; NazishSiddiqi et al. (2010). Mothers knowledge about EPI and its relation with age-appropriate vaccination of infants in peri-urban Karachi. Retrieved December 10, 2011 from http://www.jpma.org.pk/full_article_text.php?article_id=2393 Public health nursing in the Philippines (2007). Expanded program on immunization.pp141. January 6, 2012 Philippines (2010), Progress report on the millennium development goals. Retrieved September 13, 2012 from http://www.scribd.com/doc/58268821/ Rahul Sharma et al. (2008). Routine immunization - do people know about it? A study among caretakers of children attending pulse polio immunization in east Delhi. Retrieved January 4, 2012 from http://www.ijcm.org.in/article.asp?issn=09700218;year=2008;volume=33;issue=1;spage=31;epage=34;aulast=Sharma Reblando, S. et al. (2005). Expanded program on immunization of purok 5, BagongAbre, Legazpi City. Undergraduate thesis, January 5, 2012 Sangwan, S. & Manocha, A. (2009). Maternal knowledge and child health. Retrieved December 10, 2011 from http://www.krepublishers.com/02-Journals/JHE/JHE-25-0-000-09Web/JHE-25-1-000-2009-Abst-PDF/JHE-25-1-051-09-1463-Sangwan-S/JHE-25-1-051-091463-Sangwan-S-Tt.pdf Soma ChowdhuryBiswas, et al. (2001). Factors Affecting Childhood Immunization in Bangladesh. Retrieved January 16, 2012 from www.pide.org.pk/pdf/PDR/2001/Volume1/57-70.pdf

27

University of Iowa Hospitals and Clinics. (2005). UI Finding Speeds Up Immunization Booster Schedule. Retrieved August 26,2012 from http://www.uihealthcare.com/news/news/2005/06/27vaccinate.html

UNICEF (2008). Childrens rights: Early years. Retrieved January 23, 2012 www.unicef.org/philippines/8889_8920.html

from

UNICEF (2010). Immunization: The big www.unicef.org/immunization/index_bigpicture.html

picture

Retrieved

from

Unite for Sight (n.d.). Module 3: Teaching mothers about health education. Retrieved December 20, 2011 from http://www.uniteforsight.org/health-education/module3

28