QUALITY OF LIFE OF PATIENTS UNDERGOING HEMODIALYSIS
AT THE RENAL UNIT OF VICENTE GULLAS
MEMORIAL HOSPITAL
Double or 1.5 spaces, spread out your texts
A Research Proposal
Presented to the Faculty of the
Department of Preventive and Social Medicine
University of Visayas – Gullas College of Medicine
Banilad, Mandaue City, Cebu, Philippines
In Partial Fulfillment of the Requirements in
Preventive and Social Medicine II
By
Group 4
Doppalapudi Yeekshith
Gadda Sreeja
Ravi Manoj
Tholiya Soumya
Yanamala Sree Koushik Reddy
Yedlapalli Srija
ERLINDA Y. POSADAS, MD, MPH
Adviser
FEBRUARY 2019. should be April 2019
ii
APPROVAL SHEET
Approval sheet should be the approval sheet after the final defense of the
completed paper.
This research study, entitled “QUALITY OF LIFE OF PATIENTS
UNDERGOING HEMODIALYSIS IN VICENTE GULLAS MEMORIAL
HOSPITAL” prepared and submitted by Doppalapudi Yeekshith, Gadda Sreeja,
Ravi Manoj, Tholiya Soumya, Yanamala Sree Koushik Reddy and Yedlapalli
Srija, in partial fulfillment of the requirements in Preventive and Social Medicine
II, is hereby recommended for acceptance and approval for Oral Examination.
Write title like writing a sentence.
Erlinda Y. Posadas, MD, MPH
Adviser
RECOMMENDED FOR APPROVAL:
Jonathan Neil V. Erasmo, MD, MPH, FPSMS
Chairman
Albert Christian A. Borbon, RMT, MD
Member
Lucilyn Shyne M. Diao, RMT, MD
Member
Shelbay G. Blanco, MD, MPH
Member
Viraliza June A. Bolok, MD
Member
APPROVED by the Committee on ORAL Examination with the grade of PASSED
on February, 16, 2019.
ACCEPTED and APPROVED in partial fulfillment of the requirements in
Preventive and Social Medicine II.
NINO ISMAEL S. PASTOR, MD, PHSAE, DRDM, FPSMID
Dean, University of Visayas- Gullas College of Medicine
FEBRUARY 16, 2019
Date of Proposal Hearing. Should be date of final defense hearing.
iii
ACKNOWLEDGEMENT
It is a great pleasure to thank several personalities who helped us to
complete this paper. We would like to express our gratitude,
To Dr. Erlinda Posadas, research advisor, who provided her time to
supervise us. She imparted her knowledge on the study that contributed greatly in
the study. Her insights and suggestions helped in the refinement of the study.
To our panelists, for correcting us and suggesting their valuable ideas to
make our research more precise.
To Dr. Shelbay Blanco, for his time, expertise, and suggestions for the
research.
To Nino Ismael Pastor, the Dean of the College, for giving us the
opportunity to conduct the study.
To the respondents, who participated in this research, their patience,
voluntariness, hospitality and their involvement brought incomparable insight and
valuable data, in attaining the success of this research.
To the researchers’ parents for the patience, understanding and support.
They have always served as a source of inspiration and motivation.
Lastly, the researchers would like to thank the Almighty God for the
guidance, wisdom and enlightenment.
The Researchers
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Abstract should be written in one paragraph only, and one page, and double
space.
Title: Quality of life of patients undergoing hemodialysis at the renal unit of
Vicente Gullas Memorial Hospital.
Authors: Doppalapudi Yeekshith, Gadda Sreeja, Ravi Manoj, Tholiya Soumya,
Yanamala Sree Koushik Reddy, Yedlapalli Srija
Objectives: To study the quality of life of patients undergoing hemodialysis at the
renal unit of Vicente Gullas Memorial Hospital.
Study Design: Descriptive method was used in this research.
Study Setting: This study will be conducted at renal unit of Vicente Gullas
Memorial Hospital, Banilad, Cebu.
Study Subjects: A total of 30 patients undergoing hemodialysis.
Intervention: The respondents of this study were patients who were undergoing
hemodialysis in the renal unit from at least three months. The researchers set
appointments with the respondents. A questionnaire administered with respect to
the convenience of each respondent.
The researchers explained and oriented the respondents, how the questionnaire
should be accomplished and respondents were given time to clarify and answer it.
Main Outcome: In the demographic profile of the patients it was observed that:
the mean age of the respondents was 53 which means that middle adults are more
in number as compared to other age groups; there were more female patients
undergoing hemodialysis than the male patients in this hospital; most of the
patients are married; most of the respondents attained college level of education;
and most of them were unemployed without any source of income. The results of
the study based on how the respondents considered the satisfaction and importance
of the three domains is the following: the Physical function of the respondents was
found to be moderately satisfied and moderately important; the Emotional function
of the respondents was found to be moderately satisfied and very important; the
Socio-economic function of the respondents was found to be moderately satisfied
and moderately significant.
Keywords
v
TABLE OF CONTENTS
TITLE PAGE
Page
i
APPROVAL SHEET
ii
ACKNOWLEDGEMENT
iii
ABSTRACT
iv
LIST OF TABLES
LIST OF FIGURES
LIST OF APPENDICES
TABLE OF CONTENTS
v
List of Tables -
vii
List of Figures
viii
CHAPTER
I
II
INTRODUCTION
Rationale
1
Statement of the Problem
2
Objectives
2
Significance of the Study
3
Scope and Delimitations
4
Limitations
4
Definition of Terms
5
REVIEW OF RELATED LITERATURE
Review of Related Literature
6
Conceptual Framework
11
vi
III
METHODOLOGY
Research Design
12
Research Environment
12
Research Subjects
13
Research Instruments
13
Research Procedures
15
Ethical Considerations
16
IV
RESULTS AND DISCUSSION
23
V
SUMMARY, CONCLUSION AND
31
RECOMMENDATIONS
REFERENCES
33
APPENDICES- Write in the LIST OF APPENDICES
A
Letter to Medical Director
35
B
Informed Consent
36
C
Questionnaire
40
D
Statistical Data
45
E
Photos
54
F
Gantt chart
55
G
Budget
57
CURRICULUM VITAE
58
vii
LIST OF TABLES
Table
Title
Page
1
How satisfied a dialysis patient is in his /her
health, family, friends and achievements in life.
14
2
How important dialysis is in the patient’s
health, family, friends and achievements in life.
15
viii
LIST OF FIGURES
Figure
Title
Page
1 Conceptual framework of the study
11
2 Age of patients undergoing hemodialysis
23
3 Sex of the patients undergoing hemodialysis
24
4 Civil Status of the patients undergoing hemodialysis
24
5 Educational Status of the patients undergoing hemodialysis 25
6 Employment Status of the patients undergoing hemodialysis 25
7 Income of the patients undergoing hemodialysis
26
8 Satisfaction to Physical Function
26
9 Satisfaction to Emotional Function
27
10 Satisfaction to Socioeconomic Function
27
11 Importance of Physical Function
28
12 Importance of Emotional Function
29
13 Importance of Socioeconomic Functioning
29
LIST OF APPENDICES
LIST OF PLATES
These are the list of pictures. Plate number and title of the plate.
ix
1
CHAPTER I
INTRODUCTION
Rationale
End stage renal failure is a chronic disease that exerts a great negative
impact on patients’ health-related quality of life (QOL) mainly due to the
accompanied impairment or to the imposed limitations in almost all domains of
their daily lives. Hemodialysis consists a complex procedure for patients that
require frequent hospital or dialysis centers visits, mainly three times a week, thus
implying substantial changes in the normal way of patients’ living. Assessment of
health-related quality of life is a predictive indicator of the outcome of the disease
as well as a valuable research tool in assessing the effectiveness of therapeutic
intervention, patients’ survival and hospitalizations (Gerasimoula, Lefkothea,
Maria, Victoria, Paraskevi, & Maria, 2015).
A significant part of the treatment process is the maintenance and/or
recovery of independent functioning in daily life. In chronic diseases, QOL
depends on disease type, time from onset, symptom intensity, treatment options,
treatment side effects, limitations resulting from the disease, the patient's age and
self-care capabilities. Patients treated with hemodialysis are a special group of
chronically ill, who are at risk of frequent hospitalizations and multiple disorders
due to the renal dysfunction and to the hemodialysis treatment itself. A better QOL
contributes to a longer lifespan and better response to treatment. To improve the
acceptance of their health, dialysis patients should receive comprehensive care,
including treatment, diet, motor rehabilitation and psychological counseling,
2
which improve their wellbeing and illness acceptance (Jankowska-Polańska,
Uchmanowicz, Wysocka, Uchmanowicz, Lomper, Andrzej, 2017).
Patients who have dialysis for survival live with a great deal of uncertainty
about the future. They do not deal only with treatment-related complications such
as left ventricular hypertrophy, arthrosclerosis and hyperparathyroidism, but also
with the changes in their perception of their own self-worth. The major
psychological and physiological stresses experienced by patients on dialysis are
pain, restriction of fluids, itching, discomfort, limitations in physical activity,
fatigue, weaknesses, high cost of care, feelings of inadequacy, and negative moods,
Therefore, a dialysis schedule can significantly interfere with both professional and
personal lifestyles. These factors may contribute to the diminished QOL reported
by patients on regular dialysis (Ayoub, & Hijjazi, 2013).
Statement of the Problem
How is the quality of life of patients undergoing hemodialysis?
Objectives
General Objectives
The study will be conducted to determine the quality of life of patients
undergoing hemodialysis at Vicente Gullas Memorial Hospital.
Specific Objectives
Specifically the study will seek the answers to the following questions:
1.
To determine the demographic profile of patients undergoing
hemodialysis in Vicente Gullas Memorial Hospital:
1.1
Age
3
2.
1.2
Sex
1.3
Civil Status
1.4
Educational Status
1.5
Employment Status
1.6
Income
What is the quality of life of the patients in terms of satisfaction and
importance on the following domains:
2.1
Physical function
2.2
Emotional function
2.3
Socio- economic function
Significance of the Study
For the Health Care Providers
The study will serve as an instrument for feedback for health care providers on
the concerns of patients undergoing hemodialysis so that they will be able to
develop new methods and improve strategies for a holistic plan of care of the
patients.
For the Patients of hemodialysis
This study will allow the patients to understand results and develop proper
coping mechanisms that will contribute to develop a deeper comprehension of the
procedure and a more positive outlook towards his/her condition.
For the Researchers
4
The outcome of this research activity will contribute to knowledge production.
The purpose of this research is to gain better understandings of perspective on
quality of life of patients undergoing hemodialysis.
For the Medical Students, Faculty, School, Future workers:
This research will serve as a significant endeavor for the students; faculty and
future workers for it will serve as a source of information. This study will also help
identify the most suitable approach in the planning of health care in clients
undergoing hemodialysis.
Scope and Delimitations. Use past tense.
The researchers will try to gather patients undergoing hemodialysis, of different
age groups and different family incomes at Vicente Gullas Memorial Hospital
dialysis center in Banilad, Cebu city. The researchers will use Quality of Life Index
Version III questionnaire by Ferran and Powers to assess their quality of life.
Initially researchers will set appointments with the patients at the hospital that they
were already acquainted with, referrals will be made with the hospital
administration, and 30 respondents will be gathered. They will give questionnaires
and explain them how to answer it. The respondents will be given convenient time.
Limitations
Limitations of the study include the following: (a) willingness and cooperation
of the patients undergoing hemodialysis. (b) Level of understanding of the patients.
(c) Patience of the respondents. (d) The availability of the research respondents.
(e) Only a limited number of respondents can be involved to participate in the study
due to time constraints. (f) The study will only be focused on Vicente Gullas
Memorial Hospital and the other hospitals will not be included.
5
Definition of Terms
1. Respondents: Male/female, 20-60 years old, caregivers of the patients
undergoing hemodialysis chosen by snowball sampling. Your respondents
are the patients, not the caregivers.
2. Quality of Life Index Dialysis version III: The tool used in the study to
measure the quality of life.
3. Quality of life: The standard of health, comfort, satisfaction and happiness
experienced by the caregivers computed using Quality of Life Index
Version III questionnaire by Ferran and Powers.
4. Physical function: The special action or physiologic property of the
physical characteristics of human body hindered or impeded by a certain
condition which is measured by Quality of Life Index Dialysis Version III.
5. Emotional function: It assumes emotional characters or functions
impeded or hindered by a certain condition which may often lead to
complex bodily changes.
6. Socioeconomic function: This pertains to the individual’s interaction to
those people, group or the society around them and those matters regarding
financial constraints that would affect patient’s condition.
6
CHAPTER II
REVIEW OF RELATED LITERATURE
The quality of life (QOL) has emerged as an important parameter for
evaluating the quality of health-care for patients with renal failure. The literature
suggests that many factors impact QOL. In a study conducted, on Quality of life in
dialysis patients from the United Arab Emirates, a descriptive comparative survey
design was used to study 161 dialysis patients. The participants completed the 36Item Short Form Health Survey (SF-36) and the QOL index dialysis version tool.
Comparative analyses of the results for both tools were done using descriptive
statistics. Multiple linear regression analysis determines the effect of the variables
on the QOL scores. The questionnaires return rate was 93%. The overall QOL for
dialysis patients was rated low when self-assessed using the SF-36 (58.9)
compared to QOL index (77.2). The multiple regression analysis revealed that
having a chronic illness had the strongest impact on the total scores of both tools.
The comparison between the statistically significant variables for both samples
revealed contradictory results from the two tools used. This meant that the two
tools measured QOL differently (Abdelbasit, Ayoub and Hijjazi , 2013).
Effects on social and emotional status of the patient:
Quality of life is one of the parameters to check the improvement of
hemodialysis treatment among hemodialysis patients. Those patients will be
dealing with this treatment in long term if this treatment is the only way for them
to replace their kidney function and this thing will affect their quality of life. In a
study of Quality of Life among Patients Undergoing Hemodialysis in Penang,
7
Malaysia, to evaluate the quality of life patients on hemodialysis using kidney
disease quality of life-short term 24 (KDQoL-SF24) Malaysian Version. Cohort
observational study was conducted in this study. The study included 78
hemodialysis patients in HD center Penang, Malaysia. There were 9 components
which had the lower of the mean and standard deviation (SD) than the standard
form; work status (15.01 ± 35.57), cognitive function (75.66 ± 13.75), quality of
life social interaction (76.32 ± 16.11), sleep (55.86 ± 15.30), social support
(59.61 ± 22.08), patient satisfaction (43.24 ± 15.32), physical functioning
(50.06 ± 42.81),
general
health
(29.62 ± 25.56),
and
role
emotional
(54.27 ± 49.92). In this HD center, the group of patient’s age who had the lower
mean ± SD from the KDQoL-SF Manual Standard were the first and the sixth
groups of patient’s age (≤20 and 61–70). The study conducted in HD center,
Penang, Malaysia showed that the scoring of work status, cognitive function,
quality of social interaction, sleep, social support, patient satisfaction, physical
functioning, general health, and role emotional were low than standard form
(Ramatillah, Sulaiman, Khan, & Meng, 2017).
Assessment of quality of life (QOL) of patients with end-stage renal disease
has become increasingly important, both in order to evaluate the influence of the
disease on patients and the type of renal replacement therapy they require. In the
study, Assessment of quality of life in patients undergoing hemodialysis using
WHOQOL-BREF questionnaire: a multicenter study, following QOL scores were
recorded:
environmental
domain
(53.17±15.59),
psychological
domain
(51.23±18.61), social domain (49.86±21.64), and physical domain (45.93±16.90).
Older age was associated with a better QOL score in the social domain (p=0.005),
8
and employed patients scored better in the environmental domain (p=0.019).
Unemployed patients and those of the Terai/ Madhesi ethnic group had
significantly low scores in overall perception of health (p<0.05) as compared to
other groups. Low-income status and increased duration on hemodialysis were
found to be the only independent negative predictors of QOL in patients with
hemodialysis (p<0.05). Patients with chronic kidney disease on dialysis had overall
low QOL scores in all four domains. Age, ethnicity, employment status, income,
and duration on hemodialysis affected one or more domains of QOL in such
patients. Low-income status and increased duration on hemodialysis were the only
independent negative predictors of QOL of patients on maintenance hemodialysis
(Joshi, Subedi , Poudel, Ghimire, Panta , Sigdel, 2017).
QOL in the environment and social relationships domains:
In a study on, Quality of Life in Patients Undergoing Hemodialysis or
Peritoneal Dialysis Treatment, Patient-reported assessments included: WHOQOLBREF inventory of World Health Organization, General Health Questionnaire
(GHQ-28) of Goldberg, State-Trait Anxiety Inνentory, Center for Epidemiologic
Studies Depression Scale (CES-D) and Multidimensional Health Locus of Control
(MHLC). Results indicated that HD patients reported lower QoL in the
environment and social relationships domains. More symptoms were also reported
in the GHQ-28 subscales of anxiety/insomnia and severe depression. This
measurement includes sleep problems and suicidal thoughts. The findings confirm
the differences between the two treatment modalities, indicating that HD patients
have poorer QoL in several aspects of their environment and their social
relationships. Both groups reported elevated depression. However, HD patients
9
reported more suicidal thoughts and sleep problems com- pared to PD patients
(Theofilou, Paraskevi, 2011).
Chronic Renal Failure (CRF) is a chronic disease, which has a negative
impact on the quality of patients’ life. The study of factors affecting the quality of
life of these patients is necessary to investigate the impact of the disease in a
biological, psychological and social level. In a study conducted on Quality of Life
of Patients Undergoing Hemodialysis, the purpose of this research study was to
investigate the satisfaction of patients undergoing chronic hemodialysis and their
perceptions of their quality of life. Material and Method: The study sample
consisted of patients undergoing chronic hemodialysis at a Dialysis Unit in Athens.
The study lasted from January 2016 to March 2016. To measure the health related
quality of patients’ life, the Greek version of the questionnaire WHOQOL-BREF
of the World Health Organization was used. The completion of the questionnaires
was made by the method of the structured interview. A total of 70 questionnaires
were completed. Results: According to the study results, most of the patients
considered the quality of their life as good (48.6%), while the 8.5% described it as
bad or very bad. The lowest satisfaction rates associated with issues of physical
health and independence with mean (12.89 ± 2.23) and the highest with social
relations (14.68 ± 1.50). Conclusion: The effect of Chronic Renal Failure on the
physical, psychological and social background of patients on dialysis is an essential
factor in creating a tailor-made holistic treatment program, adjusted to the specific
needs of each patient (Georgia, Garofyllou Martha, Kelesi - Gerogianni, GeorgiaTsaras, Konstantinos Fasoi, Georgia- Evridiki, Kaba- Areti, Stavropoulou, 2017).
Effects on physical and social domains:
10
In another study of factors associated with the quality of life of patients
undergoing hemodialysis, to identify factors associated with the quality of
life/spirituality, religion and personal beliefs of patients with chronic kidney
disease undergoing hemodialysis. It was correlational cross-sectional study. The
following instruments were applied through individual interviews: the WHOQOLBref, the WHOQOL-SRPB, along with a questionnaire to characterize the
participants. The sample consisted of 110 participants with chronic kidney disease
undergoing hemodialysis. Descriptive analysis was performed along with
univariate and multiple logistic regressions to identify associated factors. Low
level of albumin was mainly associated with the “physical” and “social
relationships” domains of the WHOQOL-BREF. Participants without an
occupation presented the greatest compromise in the domains “Connectedness to
a spiritual being or force” and “Awe”. In the domain “spiritual strength”,
participants worth an occupation presented higher chances of low quality of life.
The factors associated with the domains of quality of life of patients with chronic
kidney disease undergoing hemodialysis were: occupation, marital status, sex,
education, religion, levels of hematocrit and albumin, and overall health
(Gesualdo, Dutra, Menezes, Costa, Rusa, Gabriela, Napoleão, Alves, Figueiredo,
Moralez, Melhado, Ramos, & Orlandi, Fabiana de Souza., 2017).
Conceptual framework
11
Fix your diagram
Age
Sex
Civil Status
Educational Status
Employment Status
Income
QUALITY OF
LIFE
OF PATIENTS
UNDERGOING
HEMODIALYSIS
Physical function
Emotional function
Socio- economic function
Fig. 1.
Conceptual framework of the study
12
CHAPTER III
RESEARCH METHODOLOGY
Research Design
The descriptive method was used in this research. This method observes,
describes and documents aspects of a situation as it naturally occurs and serves as
a starting point for generation of hypothesis theory development. (Polit, 2008)
The study used a survey done through a self-administered questionnaire,
Quality of Life Index Dialysis Version III by Ferran and Powers, provided to the
respondents to gather information on the satisfaction and importance of their
physical, emotional and socioeconomic function in regard to Quality of Life. The
questionnaires were designed to allow standardization and uniformity in their
response.
Research Environment.
The primary research setting for this study was Metro Cebu, located on the
island of Cebu in Central Visayas region of the Philippines. Cebu has experienced
socioeconomic changes as well as substantial population growth in the past several
decades. Metro Cebu is the second largest metropolitan area in the Philippines,
with a population of 922,611 individuals (PSA, 2016).
The increasing demand for dialysis clinics in the Philippines brought about
by the growing number of patients that need to undergo hemodialysis prompted a
company to open a US standard dialysis clinic in Cebu. The market for dialysis
centers in the Philippines has not reached its saturation point simply because more
and more people are diagnosed of diabetes and hypertension thus requiring them
to undergo hemodialysis.
13
This study was conducted in Banilad, Mandaue City, Cebu, specifically at
the Vicente Gullas Memorial Hospital Dialysis Center. The VGMHDC serves 15
surrounding municipalities and has a team of doctors, nurses and nursing
technicians who are responsible for the dialysis process and for maintaining the
health status of the patient during the session.
Research Subjects
This is a descriptive study, with a quantitative approach. The initial sample
consisted of 30-40 patients undergoing hemodialysis enrolled in the Vicente Gullas
Memorial Hospital, Banilad, Cebu city. To be eligible, a patient had to be on
maintenance hemodialysis therapy for more than 3 months, regardless of age or
sex.
Patients who did not accept voluntarily to sign the Informed Consent form
(IC) were excluded, as well as people with mental disorders, or those who, at the
time of data collection showed a decreased level of consciousness. Also, patients
who did not attend the dialysis unit during the stipulated period for data collection
were excluded. Once applied the inclusion criteria, the final sample was maintained
of 30 subjects.
Research Instruments
Initially it involved preparation of the setting for the study. Personal
interview with the patients was scheduled at the study settings. As data collection
instruments, two instruments were used: a questionnaire focused on sociodemographic profile of the participants and other for the analysis of quality of life,
which is divided into two parts (part I and part II). The instrument used in gathering
is the Quality of Life Index Dialysis Version III by Ferran and Powers. The
14
instrument was composed of questions that were simplified into simple words and
terms for respondents to understand. The instrument had its own translation into
the Filipino language so that to aid in the understanding of the respondents. If both
languages are not comprehended, English and Filipino, by the respondent then the
researchers clarified the questions for the respondent. The researchers from a
similar study that used the same questionnaire by Ferran and Powers adopted these
translations. It was tested by a pilot study to investigate the feasibility and clarity
of the tool and its translation.
i) The questionnaire includes patient's background:
Age, sex, work status, marital status, level of education, of the patients.
ii) Quality of life questionnaire: Each questionnaire consists of 34 items which
are categorized into three domains, which are physical function and limitation
(question no. 1,2,3,7,10,13,16,19,28,31,34), emotional function and limitation
(question no. 5,8,9,11,12,14,15,17,18,20,23,25,26,29,32), and socioeconomic
function and limitation (question no. 4,6,21,22,24,27,30,33) which all determine
the Quality of Life of the dialysis patient. The researchers used two part
questionnaire, Part I evaluated how satisfies a dialysis patients in his/ her health,
family, friends and achievements in life and Part II assessed how important dialysis
is in the patient’s health, family, friends and achievements in life.Do not cut your
table, all tables should be in single space. Title of table should be single space.
Table1. How satisfied a dialysis patient is in his /her health, family, friends
and achievements in life. The answers are rated as follows:
Numerical Rating
Interpretation
15
1
Very Dissatisfied
2
Moderately Dissatisfied
3
Average
4
Moderately satisfied
5
Very satisfied
Table 2. How important dialysis is in the patient’s health, family, friends and
achievements in life.
Numerical Rating
Interpretation
1
Very unimportant
2
Moderately unimportant
3
Average
4
Moderately Important
5
Very Important
In the research questionnaire the researchers particularly stipulated on the
instructions that their answers were neither right nor wrong. That this questionnaire
was conducted for the purpose of gathering reliable information in the event a
realistic research is made.
Research procedure
The researchers included patients undergoing long-term hemodialysis
treatment at Vicente Gullas Memorial Hospital Dialysis Center in Banilad, Cebu
City. Initially researchers set appointments with the patients at the hospital that
they were already acquainted with, since in this study as we utilized the simple
random technique of sampling, referrals were made accordingly with the hospital
16
administration, therefore 30-40 respondents in total were gathered. The survey of
the questionnaire was conducted at different times in the dialysis center with
respect to the convenience of each respondent.
Before the administration of the questionnaire, the researchers let the
respondents sign an informed consent and explained to them the content of the
questionnaires, after which they were given time to answer and make clarifications.
The time given for filling the questionnaire sheet to the respondents was around 30
minutes.
Data Analysis
Descriptive statistics was employed in this study to describe the data
gathered on the patient’s socio-demographic profile and the quality of life of the
patients specifically based on the following three domains: physical function,
emotional function, and socioeconomic function included in the questionnaires and
their corresponding interpretation.
The descriptive measures used the frequency counts and the percentage
for the analysis of the respondents’ personal profile and their scorings on the
scoring templates among the three domains of the quality of life of the patients.
Ethical consideration. Use past tense
The researchers will exercise three basic principles, namely, beneficence,
respect and justice. The researchers will treat the respondents with beneficence,
that is, the researchers will minimize harm and maximize benefits for them. They
will also be given respect for human dignity by the researchers, which include the
right to self-determination and right to full disclosure. Third, the researchers
17
uphold justice, which includes the respondents’ right to fair treatment and their
right to privacy.
A. Content, Comprehension and Documentation of Informed Consent
Participant Status. All of the respondents who will voluntarily join in the study
will be interviewed using a researcher-made questionnaire. It will be only a onetime collection, which will last for about 15 to 30 minutes. All the data that they
will provide will be used for research purposes only to help the researchers find
out the quality of life of patients undergoing hemodialysis.
Study Goals. The respondents will be told that the goal of this study is to determine
the quality of life of patients undergoing hemodialysis.
Type of Data. The respondents will be told that data will be gathered which is
quantitative.
Procedures. The researcher will be meeting with director of the dialysis unit and
explains the aim and process of the study. Then, the researchers will look for
prospective respondents, if a respondent fits the inclusion criteria, she/he will be
selected. An informed consent will be given to her, it will be read and explained
thoroughly by one of the researchers. The researchers will answer any questions
by the respondent. Patient’s verbal consent will be obtained. If the respondent has
fully agreed and voluntarily consented to be part of the research, they will be given
a researcher-made survey questionnaire. It will be answered in about 15 to 30
minutes. After the respondent answers the questionnaire, the researchers will
clarify if there’s anything vague or not understood about the questionnaire, if
there’s none, the researchers will thank the respondent and assure them that all
their answers will be kept confidential. Complete confidentiality of any obtained
18
information will be ensured. The researcher will also assure the administration that
the conduction of the study will not affect the work in the study settings.
Nature of Commitment. Single-data collection will be used in the study. It will
consist last for about 15-30 minutes.
Sponsorship. The respondents will be told that this research is an academic
requirement for the course Preventive and Social Medicine in the University of the
Visayas-Gullas College of Medicine.
Participant’s Selection. The study population will be 30-40 hemodialysis
patients. Inclusion criteria included, (1) ages 20 years to 60 years old, (2) resident
of the Cebu city for at least five months prior to the study, (3) mentally sound, (4)
willing to participate in the study. Exclusion criteria include (1) Illiterate (unable
to study the questionnaire) (2) persons who are not willing to participate in the
study. The respondents shall be selected by simple random sampling during
hospital visitations by the researchers in Vicente Gullas Memorial Hospital
Dialysis Center. The hemodialysis patient who will meet the criteria shall be
interviewed and those who agree to participate in the study will be enrolled. The
respondents will be asked to sign the informed consent after being thoroughly
explained by the researchers.
Recruitment. The respondents will be asked to sign the informed consent before
answering the questionnaire. The participation of the respondents will be strictly
voluntary. The respondents will be told that they have the right to terminate their
participation at any point of the study.
19
Collaborative Study Terms of Reference. There was a state of agreement, which
the researchers and faculty advisers signed to ensure that the data collected by
the researchers would only be used for the publication.
Risks. The respondent will be told that she /he is free to choose whether to answer
or not some statements in the questionnaire that he/she feels uncomfortable. The
researchers will stop the questions if they feel that the respondents show emotional
distress may it be verbal or non-verbal cues.
Potential Risk. The patients will be told that some of the statements in the
questionnaire may be too personal for them, they may opt to skip the questions and
they won’t be asked why. They have the choice to withdraw if they feel that it is
their loss of privacy and loss of time. They can deny answering the questionnaire
if they are physically weak and not willing to participate.
Benefits. The respondents will be told that there will be no direct benefit to them
but their participation will help the researchers find out the quality of life of the
hemodialysis patients in Cebu city. This study will help them indirectly in
increasing knowledge
about themselves or their conditions. They will get a
chance to escape from normal routine, being part of a study. They will have
satisfaction that information they provide may help others with similar problems
or conditions.
Potential benefits. The respondents will be told that the results of this study will
improve the functioning of hemodialysis patients in a manner most similar to
healthy persons, the renal replacement therapy should consider patients’ individual
needs and expectations, i.e., guarantee flexible hours of work or study and of
20
receiving dialysis. In addition, patients treated with hemodialysis should receive
psychological care, in particular those demonstrating emotional problems, in order
to achieve better results in therapy and improve their QoL. Therefore, it is
recommended to pay more attention to the needs of patients and provide adequate
social, economic, physical and psychological support for them.
Alternatives. There are no alternative procedures or treatments that may be
advantageous to the respondents in this study.
Incentives and compensation. The respondents will be told that they will not be
provided with any incentives and compensation in this research study.
Confidentiality Pledge. The respondents will be assured that privacy will be
protected at all times and that all information that they will give will be kept private
and only the researchers will be able to access it. Anonymity will be preserved.
The provisions of the Data Privacy Act 2012 will be observed in the conduct of the
study.
Confidentiality Procedures. The respondents will be told that the questionnaires
will not have their names, instead will have an identification (ID) number, which
will identify them in a separate list with their names.
This list and the
questionnaires that they will answer will be secured by one of the researches in a
locked cabinet and made accessible only to the other researchers who will sign
confidentiality pledges. The answered questionnaire will be stored and given to the
UV-IRB office for strict confidentiality. Data will be encoded in a room where no
other individuals aside from the researchers can visualize the laptop monitor or the
questionnaires.
21
Authorization to Access Private Information. The laptop will be secured with a
password and all electronic documents will be secured with a password that only
the researchers can access.
Voluntary Consent. The respondents will be told that their participation is strictly
voluntary and that failure to volunteer will not result in any penalty or loss of
benefits.
Right to withdraw and withhold information. The respondents will be told that
they have the right to terminate their participation at any point of the study and
there will no penalty or loss of benefit with regards to their decision. The
respondents have the right to choose what information will be included in the
study.
Contact Information. If the respondents have any questions the respondents can
ask at anytime of the study. They will be told that this proposal has been reviewed
and approved by the University of the Visayas Institutional Review Board, which
is a committee whose task it is to make sure that research participants are protected
from harm. Address: University of the Visayas- Institutional Review Board Office,
5th
floor
Inday
Pining
Building
Colon
St.,
Cebu
City
Email:
uvirb2017@gmail.com Tel: 2537401 local 116.
If they wish to ask any questions later, they may contact: Tholiya Soumya. Email:
soumyatinu.st@gmail.com, Cell phone number: 09491938389.
B. Debriefing, Communications and Referrals. If the respondents have
questions while they answer the questionnaire, the researchers will be gracious and
polite in answering their questions, and show sensitivity to cultural and linguistic
diversity. Researchers will offer debriefing sessions after data collection is
22
completed to permit respondents to ask questions or air complaints. Debriefing is
especially important when the data collection has been stressful.
When the
respondents finish answering the questionnaires, the researchers will let them know
that their participation was appreciated. If respondents need to be referred to
appropriate health, social or psychological services, the researchers will do so.
C. Conflict of Interest. The respondents will be told that there will be no direct
monetary or material gain and non-monetary compensation to them, that there will
be no conflict of interest or situations in which financial or other personal
considerations can compromise or bias professional judgment or objectivity.
D. Treatment of Vulnerable Groups. Respondents in the study do not belong to
the vulnerable population
23
CHAPTER IV
RESULTS AND DISCUSSION
This chapter presents the data gathered, their analyses and discussion in the
light of the objectives of the study.
Specifically, this includes the following: demographic profile of the
patients undergoing hemodialysis; the quality of life with the use of the three
domains namely physical, emotional and socio-economic function.
Demographic Profile of the Respondents
The following graphs present the data gathered on:
Fig. 2. Age of patients undergoing hemodialysis
The mean age of the respondents is 53. There were six (20%) young adults,
thirteen (43.4%) middle adults and eleven (36.7%) elderly. It was observed that
patients with middle age were more in number as compared with young adults and
elderly.
24
Fig. 3. Sex of the patients undergoing hemodialysis
There were 14 (46.7%) male respondents and 16 (53.3%) female respondents.
Fig. 4. Civil Status of the patients undergoing hemodialysis
Most of the respondents were married. There were 5 (16.75%) who were
single, 21 (70%) were married, 1 (3.3%) was divorced, 1 (3.3%) was separated and
2 (6.7%) were widowed.
25
Fig. 5. Educational Status of the patients undergoing hemodialysis
Most of the respondents attained college level. There were 3 (10%) who
attained elementary level, 9 (30%) reached high school, 13 (43.3%) reached
college level and 5 (16.7%) had post graduate studies.
Fig. 6. Employment Status of the patients undergoing hemodialysis
26
Most of the respondents were unemployed. There were 8 (26.7%)
respondents who were employed, 4 (13.3%) were self-employed, 17 (56.7%) were
unemployed and 1 (3.3%) did not specify.
Fig 7. Income of the patients undergoing hemodialysis
Most of the respondents have no source of income. There were 15 (50%)
respondents who have no income, 1 (3.3%) had low income, 3 (10%) had lower
middle income, 8 (26.7%) had middle income and 3 (10%) had upper middle
income.
Fig. 8. Satisfaction to Physical Function
27
Satisfaction to physical functioning was measured through selected items
of the questionnaire (Part 1) that fits the construct. There were 4 (13.3%) who were
moderately dissatisfied, 10 (33.3%) rated average, 12 (40%) were moderately
satisfied and 4 (13.3%) were very satisfied. Most of the respondents were
moderately satisfied with their physical functioning.
Fig.9. Satisfaction to Emotional Function
Satisfaction to emotional functioning was measured through selected items
of the questionnaire (Part 1) that fits the construct. There was 1 (3.3%) who was
moderately dissatisfied, 5 (16.7%) rated average, 18 (60%) were moderately
satisfied and 6 (20%) were very satisfied. Most of the respondents were moderately
satisfied with their emotional functioning.
Fig. 10. Satisfaction to Socioeconomic Function
28
Satisfaction to socioeconomic functioning was measured through selected
items of the questionnaire (Part 1) that fits the construct. There was 1 (3.3%) who
was moderately dissatisfied, 6 (20%) rated average, 14 (46.7) were moderately
satisfied and 9 were very satisfied. Most of the respondents were moderately
satisfied with their socioeconomic functioning.
Fig. 11. Importance of Physical Function
Importance of physical functioning was measured through selected items
of the questionnaire (Part 2) that fits the construct. There were 5 (16.7%) who rated
as average, 13 (43.3%) rated as moderately important and 12 (40%) rated as very
important. Most of the respondents rated physical functioning as moderately
important.
29
Fig.12. Importance of Emotional Function
Importance of emotional functioning was measured through selected items
of the questionnaire (Part 2) that fits the construct. There was 1 (3.3%) who rated
as average, 13 (43.3%) rated as moderately important and 16 (53.3%) rated as very
important. Most respondents rated emotional functioning as very important.
Fig. 13. Importance of Socioeconomic Functioning
Importance of socioeconomic functioning was measured through selected
items of the questionnaire (Part 2) that fits the construct. There were 2 (6.7%) who
30
rated as average, 16 (53.3%) rated as moderately important and 12 (40%) rated as
very important. Most respondents rated socioeconomic functioning as moderately
important.
Discuss your findings in relation to your review of literature.
31
CHAPTER V
SUMMARY, CONCLUSIONS AND RECOMMENDATIONS
Summary
In the demographic profile of the patients it was observed that: the mean
age of the respondents was 53 which means that middle adults are more in number
as compared to other age groups; there were more female patients undergoing
hemodialysis than the male patients in this hospital; most of the patients are
married; most of the respondents attained college level of education; and most of
them were unemployed without any source of income. The results of the study
based on how the respondents considered the satisfaction and importance of the
three domains is the following: the Physical function of the respondents was found
to be moderately satisfied and moderately important; the Emotional function of the
respondents was found to be moderately satisfied and very important; the Socioeconomic function of the respondents was found to be moderately satisfied and
moderately significant.
Conclusion
In the light of the findings revealed in the study, the following conclusions
we arrived at:
Majority of our respondents undergoing hemodialysis are within the age
bracket of 48-57 years old and majority are female respondents with the average
rate of 53%. Based on the result, the researchers came up with this conclusion
about the quality of life of patients undergoing hemodialysis in the following
domain: (a) Physical function: the respondents find it moderately satisfied and
moderately important; (b) Emotional function: the respondents find it moderately
32
satisfied and very important; (c) Socioeconomic function : the respondents find it
moderately satisfied and moderately important.
However, despite the data gathered in this study, the researchers have
concluded that the data collected are not sufficient enough to appropriately
measure the quality of life of patients undergoing hemodialysis because of
inadequate number of respondents.
Recommendations
In the view of the results of the research study conducted, the researchers
arrived at the following recommendations, as follows:
That a similar study be conducted with enough time to (a) acquire more
respondents (b) come up with more comprehensive interpretation and analysis of
the tool used by interpreting each questions under each domain according to
satisfaction and importance and (c) determine the relationships of their
demographic profiles to each domain.
That health care provider is able to assess the patients quality of life and
plan out a multidisciplinary approach specifically addressing attention to the
satisfaction and importance of these domains.
33
REFERENCES
Ayoub, A. M., & Hijjazi, K. H. (2013). Quality of life in dialysis patients from the
United Arab Emirates. Journal of family & community medicine, 20(2),
106-12.
Retrieved
from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3748644/ on February 20,
2019.
Beata Jankowska-Polańska, Izabella Uchmanowicz, Agata Wysocka, Bartosz
Uchmanowicz, Katarzyna Lomper, Andrzej M. Fal; Factors affecting the
quality of life of chronic dialysis patients, European Journal of Public
Health, Volume 27, Issue 2, 1 April 2017, Pages 262–267. Retrieved
from https://doi.org/10.1093/eurpub/ckw193 on February 19, 2019.
Georgia, Garofyllou Martha, Kelesi - Gerogianni, Georgia- Tsaras, Konstantinos
Fasoi, Georgia- Evridiki, Kaba- Areti, Stavropoulou- 2017/01/12 Quality
of Life of Patients Undergoing Hemodialysis Retrieved from
https://www.researchgate.net/publication/312247482_Quality_of_Life_of
_Patients_Undergoing_Hemodialysis on February 21,2019.
Gerasimoula, K., Lefkothea, L., Maria, L., Victoria, A., Paraskevi, T., & Maria, P.
(2015). QUALITY OF LIFE IN HEMODIALYSIS PATIENTS. Materia
socio-medica, 27(5), 305-9.
Ramatillah, D. L., Syed Sulaiman, S. A., Khan, A. H., & Meng, O. L. (2017).
Quality of Life among Patients Undergoing Hemodialysis in Penang,
Malaysia. Journal of pharmacy & bioallied sciences, 9(4), 229-238.
Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5810072/
on February 19, 2019.
Gesualdo, Gabriela Dutra, Menezes, Ana Laura Costa, Rusa, Suzana Gabriela,
Napoleão, Anamaria Alves, Figueiredo, Rosely Moralez de, Melhado,
Vivian Ramos, & Orlandi, Fabiana de Souza. (2017). FACTORS
ASSOCIATED WITH THE QUALITY OF LIFE OF PATIENTS
UNDERGOING
HEMODIALYSIS. Texto
&
Contexto
Enfermagem, 26(2), e05600015. Epub July 10, 2017. Retrieved from
https://dx.doi.org/10.1590/0104-07072017005600015 on February 20,
2019.
Joshi U, Subedi R, Poudel P, Ghimire PR, Panta S, Sigdel MR. Received 9 March
2017. DOI Retrieved from https://doi.org/10.2147/IJNRD.S136522 on
February 19, 2019.
Theofilou, Paraskevi- Quality of Life in Patients Undergoing Hemodialysis or
34
Peritoneal
Dialysis
Treatment
2011.
Retrieved
from
https://www.researchgate.net/publication/51542520_Quality_of_Life_in_
Patients_Undergoing_Hemodialysis_or_Peritoneal_Dialysis_Treatment
on February 20, 2019.
35
APPENDIX A
LETTER TO MEDICAL DIRECTOR
36
APPENDIX B
INFORMED CONSENT
Gullas College of Medicine
UNIVERSITY OF THE VISAYAS
Banilad, Mandaue City, Cebu, Philippines
Tel No. 346-4224 Telefax 345-2159
Informed Consent Form for participants in the research, QUALITY OF
LIFE OF PATIENTS UNDERGOING HEMODIALYSIS AT THE RENAL
UNIT OF VICENTE GULLAS MEMORIAL HOSPITAL
Researchers: Doppalapudi Yeekshith
Gadda Sreeja
Ravi Manoj
Tholiya Soumya
Yanamala Sree Koushik Reddy
Yedlapalli Srija
Second Year Students
Gullas College of Medicine
Part I: Information Sheet
Introduction
We are medical students of the Gullas College of Medicine who are currently
conducting a research, “QUALITY OF LIFE OF PATIENTS UNDERGOING
HEMODIALYSIS AT THE RENAL UNIT OF VICENTE GULLAS
MEMORIAL HOSPITAL.” This is a research, which is a requirement in our
course.
I am going to give you information and invite you to be part of this research.
We will go through the information and the consent form. If there is anything that
you do not understand, please ask me to explain. If you agree to be a part of the
research, please sign this consent form.
Purpose of the research
End stage renal failure is a chronic disease that exerts a great negative impact
on patients’ health-related quality of life (QOL) mainly due to the accompanied
impairment or to the imposed limitations in almost all domains of their daily lives.
37
Hemodialysis consists a complex procedure for patients that require frequent
hospital or dialysis centers visits, mainly three times a week, thus implying
substantial changes in the normal way of patients’ living. Assessment of healthrelated quality of life is a predictive indicator of the outcome of the disease as well
as a valuable research tool in assessing the effectiveness of therapeutic
intervention, patients’ survival and hospitalizations
With this we are conducting a study to determine the quality of life of patients
undergoing hemodialysis. Health-related QOL refers to cognitive understanding of
the impact of the disease or the treatment on ones’ health and his overall QOL and
includes physical, mental and social dimensions. Health-related QOL is clearly
affected by individuals’ ideas, life experiences, personality and expectations.
Health-related QOL is a predictive indicator of the disease outcomes and a valuable
research tool to evaluate the effectiveness of therapeutic interventions, the patient
survival, hospitalization, and health policies.
Type of Research Intervention
We invite you to be a part of this study. We will give you a questionnaire to
answer, which will take you about 30 minutes to answer. We will explain to you
the questions as you go along in answering.
Participant Selection
We are in need of 30-40 participants for this research. You are being invited to
take part in this research because you are a patient who is undergoing hemodialysis
at Vicente Gullas Memorial Hospital. Your answers to the questionnaire will
contribute much to our understanding of quality of life of a patient undergoing
hemodialysis.
Voluntary Participation
Your participation in this research is entirely voluntary. It is your choice
whether to participate or not. If you choose not to participate nothing will change.
You may change your mind later and stop participating even if you agreed earlier.
Procedures
We will ask you to fill out a survey, which will be provided by me and collected
by me. You may answer the questionnaire yourself, or it can be read to you and
you can say out loud the answer you want me to write down.
If you do not wish to answer any of the questions included in the survey, you may
skip them and move on to the next question. The information recorded is
confidential, your name is not being included on the forms, only a number will
identify you, and no one else except me and my research group members with
access to the information will have access to your survey.
Duration
38
The questionnaire can be answered in less than 30 minutes. Afterwards, your
participation is finished.
Risks
You do not have to answer any question if you don't wish to do so, and that is
also fine. You do not have to give us any reason for not responding to any question.
If you find any question offensive or if it is invading your privacy, you can skip it.
If you are physically feeling weak, and willing to answer the questionnaire, you
can deny answering it.
There are questions that need answers which are personal or are confidential
information by chance, or that you may feel uncomfortable talking about some of
the topics. However, we do not wish for this to happen. You do not have to answer
any question if you feel the question(s) are too personal or if talking about them
makes you uncomfortable.
Benefits
There will be no direct benefit to you, but your participation is likely to help us
find out your knowledge. This study will help you indirectly in increasing
knowledge about yourself or your conditions. You will get a chance to escape
from normal routine, being part of a study. You will have satisfaction that
information you provide may help others with similar problems or conditions.
Reimbursements
You will not be provided any incentive to take part in the research.
Confidentiality
We will not be sharing information about you to anyone outside of the research
team. The information that we collect from this research project will be kept private.
It will not be shared with or given to anyone except the research team.
Who to Contact
If you have any questions, you can ask them now or later. If you wish to ask
questions later, you may contact any of the following: Tholiya Soumya. Email:
soumyatinu.st@gmail.com Cell phone number: 09491938389.
This proposal will be reviewed and approved by the University of the Visayas
Institutional Review Board, Location: 5th floor Inday Pining Building Contact
Number: 253-7401 local 116 and the email: uvirb2017@gmail.com, which is a
committee whose task it is to make sure that research participants are protected
from harm.
39
Part II: Certificate of Consent
I have been invited to participate in research about QUALITY OF LIFE OF
PATIENTS UNDERGOING HEMODIALYSIS AT THE RENAL UNIT OF
VICENTE GULLAS MEMORIAL HOSPITAL.
I have read the foregoing information, or it has been read to me. I have had the
opportunity to ask questions about it and any questions have been answered to my
satisfaction. I consent voluntarily to be a participant in this study.
Print Name of Participant__________________
Signature of Participant ___________________
Date ___________________________
(Day/month/year)
Statement by the researcher/person taking consent,
I have accurately read out the information sheet to the potential participant, and
to the best of my ability made sure that the participant understands that she will
answer a questionnaire.
I confirm that the participant was given an opportunity to ask questions about
the study, and all the questions asked by the participant have been answered
correctly and to the best of my ability. I confirm that the individual has not been
coerced into giving consent, and the consent has been given freely and voluntarily.
A copy of this ICF has been provided to the participant.
Print Name of Researcher/person taking the consent ________________________
Signature
of
Researcher
/person
taking
the
consent
__________________________
Date ___________________________
(Day/month/year)
40
APPENDIX C
QUESTIONNAIRE
QUALITY OF LIFE OF PATIENTS UNDERGOING HEMODIALYSIS AT
THE RENAL UNIT OF VICENTE GULLAS MEMORIAL HOSPITAL
Researchers: Doppalapudi Yeekshith
Gadda Sreeja
Ravi Manoj
Tholiya Soumya
Yanamala Sree Koushik Reddy
Yedlapalli Srija
Adviser:
Erlinda Y. Posadas, M.D.
How to Fill in the Questionnaire:
This questionnaire asks you about different aspects of your life as a dialysis
patient. Please think about your experience as a patient within the last two weeks
and please tick the box that applies next to each statement. There are no right or
wrong answers; we are just interested in what life is like for you as a hemodialysis
patient.
Socio-demographic profile
1. Age _____
2. Gender
_____ Male
_____ Female
3. Civil status
_____ Single
_____ Married (legally or has a common-law partner)
_____ Divorced
_____ Separated
_____ Widow
Educational attainment
_____ Never went to school
_____Elementary graduate or undergraduate
_____High School graduate or undergraduate
41
_____College graduate or undergraduate
_____Post graduate
6. Occupational status
____ Employed. If employed, state the occupation: _______________
____ Self employed
____ Unemployed
____ Others
7. Monthly Income
_____ No income
_____ Lower: lower than P 5,000 a month
_____ Lower middle – P 5,000 to 10,000
_____ Middle – P 10,000 to 20,000
_____ Upper middle – P 20,000 to 50,000
_____ Upper – more than 50,000
PART1. For each of the following, please choose the answer that best describes
how satisfied you are with that area of your life. Please mark your answer by
Very
Satisfied
1
1
2
2
3
3
4
4
5
5
1
2
3
4
5
1
1
2
2
3
3
4
4
5
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
Average
Moderately
Satisfied
1. Your health?
2. The likelihood that you will get a
kidney transplant?
3. Your family’s health? (Brothers,
sisters, parents)
4. Your health care?
5. The amount of control you have over
your life?
6. Your children and their support to
your health state?
7. The amount of energy you have for
everyday activities?
8. Knowing that the chances of living for
as long as you like is now partly
dependent on Dialysis?
9. Your family’s happiness?
Moderately
Dissatisfied
HOW SATISFIED YOU ARE WITH
REGARDS TO
Very
Dissatisfied
circling the number. There are no right or wrong answers.
42
10. Your ability to take care of yourself
without help?
11. The emotional support you get from
your family.
12. Your relationship with your spouse,
lover, partner?
13. The changes you have had to make
in your life because of kidney failure
such as diet and the need for dialysis?
14. The emotional support you get from
people other than your family?
15. The support your friends are giving
you.
16. Your sex life?
17. Being able to cope with your
everyday worries?
18. Your neighbourhood support and
concern?
19. The ability to take care of family
responsibilities?
20. Your feelings on your chances of a
happy future?
21. Your home, apartment, or the place
your live?
22. How useful you are to others?
23. Your peace of mind?
24. Your job (if employed)?
25. Your life in general?
26. Your faith in God?
27. Not having a job (if unemployed,
retired or disabled)?
28. Your personal appearance at
present?
29. Your achievements of personal
goals?
30. Your education?
31. Yourself in general?
32. Your happiness in general?
33. How well you can take care of your
financial needs?
34. Being able to do the things you do
for fun?
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
1
2
2
3
3
4
4
5
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
1
1
1
1
1
2
2
2
2
2
2
3
3
3
3
3
3
4
4
4
4
4
4
5
5
5
5
5
5
1
2
3
4
5
1
2
3
4
5
1
1
1
1
2
2
2
2
3
3
3
3
4
4
4
4
5
5
5
5
1
2
3
4
5
43
PART 2
Moderately
Unimportant
Moderately
Important
Very
Important
1. Your health?
1
2
3
4
5
2. The likelihood that you will get a
kidney transplant?
3. Your family’s health? (Brothers,
sisters, parents)
4. Your health care?
5. The amount of control you have over
your life?
6. Your children and their support to
your health state?
7. The amount of energy you have for
everyday activities?
8. Knowing that the chances of living for
as long as you like is now partly
dependent on Dialysis?
9. Your family’s happiness?
10. Your ability to take care of yourself
without help?
11. The emotional support you get from
your family.
12. Your relationship with your spouse,
lover, partner?
13. The changes you have had to make
in your life because of kidney failure
such as diet and the need for dialysis?
14. The emotional support you get from
people other than your family?
15. The support your friends are giving
you.
16. Your sex life?
17. Being able to cope with your
everyday worries?
18. Your neighbourhood support and
concern?
19. The ability to take care of family
responsibilities?
20. Your feelings on your chances of a
happy future?
1
2
3
4
5
1
2
3
4
5
1
1
2
2
3
3
4
4
5
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
1
2
2
3
3
4
4
5
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
1
2
2
3
3
4
4
5
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
Average
Very
Unimportant
RATE ITS IMPORTANCE IN YOUR LIFE
44
21. Your home, apartment, or the place
your live?
22. How useful you are to others?
23. Your peace of mind?
24. Your job (if employed)?
25. Your life in general?
26. Your faith in God?
27. Not having a job (if unemployed,
retired or disabled)?
28. Your personal appearance at
present?
29. Your achievements of personal
goals?
30. Your education?
31. Yourself in general?
32. Your happiness in general?
33. How well you can take care of your
financial needs?
34. Being able to do the things you do
for fun?
1
2
3
4
5
1
1
1
1
1
1
2
2
2
2
2
2
3
3
3
3
3
3
4
4
4
4
4
4
5
5
5
5
5
5
1
2
3
4
5
1
2
3
4
5
1
1
1
1
2
2
2
2
3
3
3
3
4
4
4
4
5
5
5
5
1
2
3
4
5
45
APPENDIX D
STATISTICAL DATA
SPSS Statistical Software Raw Output
Statistics
Age
Valid
Age Category
30
30
0
0
Mean
52.6667
2.1667
Median
55.0000
2.0000
47.00a
2.00
15.25266
.74664
Range
56.00
2.00
Minimum
23.00
1.00
Maximum
79.00
3.00
1580.00
65.00
N
Missing
Mode
Std. Deviation
Sum
a. Multiple modes exist. The smallest value is
shown
Age
Frequency
Percent
Valid Percent
Cumulative
Percent
23.00
1
3.3
3.3
3.3
27.00
1
3.3
3.3
6.7
28.00
1
3.3
3.3
10.0
29.00
1
3.3
3.3
13.3
32.00
1
3.3
3.3
16.7
33.00
1
3.3
3.3
20.0
38.00
1
3.3
3.3
23.3
47.00
2
6.7
6.7
30.0
48.00
1
3.3
3.3
33.3
50.00
2
6.7
6.7
40.0
Valid
46
52.00
2
6.7
6.7
46.7
55.00
2
6.7
6.7
53.3
56.00
1
3.3
3.3
56.7
58.00
1
3.3
3.3
60.0
59.00
1
3.3
3.3
63.3
60.00
1
3.3
3.3
66.7
61.00
2
6.7
6.7
73.3
63.00
2
6.7
6.7
80.0
67.00
1
3.3
3.3
83.3
68.00
1
3.3
3.3
86.7
70.00
1
3.3
3.3
90.0
71.00
1
3.3
3.3
93.3
78.00
1
3.3
3.3
96.7
79.00
1
3.3
3.3
100.0
Total
30
100.0
100.0
Age Category
Frequency
Percent
Valid Percent
Cumulative
Percent
Young Adult
6
20.0
20.0
20.0
Middle Adult
13
43.3
43.3
63.3
Elderly
11
36.7
36.7
100.0
Total
30
100.0
100.0
Valid
Statistics
Sex
Valid
30
N
Missing
0
Mean
1.5333
Median
2.0000
Mode
Std. Deviation
2.00
.50742
Range
1.00
Minimum
1.00
47
Maximum
2.00
Sum
46.00
Sex
Frequency
Percent
Valid Percent
Cumulative
Percent
Valid
Male
14
46.7
46.7
46.7
Female
16
53.3
53.3
100.0
Total
30
100.0
100.0
Statistics
Sex
Valid
30
N
Missing
0
Mean
1.5333
Median
2.0000
Mode
2.00
Std. Deviation
.50742
Range
1.00
Minimum
1.00
Maximum
2.00
Sum
46.00
Sex
Frequency
Percent
Valid Percent
Cumulative
Percent
Valid
Male
14
46.7
46.7
46.7
Female
16
53.3
53.3
100.0
Total
30
100.0
100.0
Statistics
Civil Status
Valid
30
N
Missing
0
48
Mean
2.1333
Median
2.0000
Mode
2.00
Std. Deviation
.97320
Range
4.00
Minimum
1.00
Maximum
5.00
Sum
64.00
Civil Status
Frequency
Percent
Valid Percent
Cumulative
Percent
Single
5
16.7
16.7
16.7
Married
21
70.0
70.0
86.7
Divorced
1
3.3
3.3
90.0
Separated
1
3.3
3.3
93.3
Widowed
2
6.7
6.7
100.0
30
100.0
100.0
Valid
Total
Statistics
Educational Status
Valid
30
N
Missing
0
Mean
3.6667
Median
4.0000
Mode
Std. Deviation
4.00
.88409
Range
3.00
Minimum
2.00
Maximum
5.00
Sum
110.00
Educational Status
Frequency
Percent
Valid Percent
Cumulative
Percent
49
Valid
Elementary
3
10.0
10.0
10.0
High School
9
30.0
30.0
40.0
13
43.3
43.3
83.3
5
16.7
16.7
100.0
30
100.0
100.0
College
Post Graduate
Total
Statistics
Employment
Monthly Income
Status
Valid
30
30
0
0
Mean
2.3667
2.4333
Median
3.0000
1.5000
3.00
1.00
.92786
1.56873
Range
3.00
4.00
Minimum
1.00
1.00
Maximum
4.00
5.00
71.00
73.00
N
Missing
Mode
Std. Deviation
Sum
Employment Status
Frequency
Percent
Valid Percent
Cumulative
Percent
Valid
Employed
8
26.7
26.7
26.7
Self-employed
4
13.3
13.3
40.0
17
56.7
56.7
96.7
1
3.3
3.3
100.0
30
100.0
100.0
Unemployed
Others
Total
Monthly Income
Frequency
Percent
Valid Percent
Cumulative
Percent
None
15
50.0
50.0
50.0
Lower
1
3.3
3.3
53.3
Valid
50
Lower Middle
3
10.0
10.0
63.3
Middle
8
26.7
26.7
90.0
Upper Middle
3
10.0
10.0
100.0
30
100.0
100.0
Total
Statistics
Satisfaction (Physical Function)
Valid
30
N
Missing
0
Mean
3.5333
Median
4.0000
Mode
4.00
Std. Deviation
.89955
Range
3.00
Minimum
2.00
Maximum
5.00
Sum
106.00
Satisfaction (Physical Function)
Frequency
Percent
Valid Percent
Cumulative
Percent
Moderately Dissatisfied
Valid
4
13.3
13.3
13.3
Average
10
33.3
33.3
46.7
Moderately Satisfied
12
40.0
40.0
86.7
4
13.3
13.3
100.0
30
100.0
100.0
Very Satisfied
Total
Statistics
Satisfaction (Emotional
Function)
Valid
30
N
Missing
0
Mean
3.9667
Median
4.0000
Mode
Std. Deviation
4.00
.71840
51
Range
3.00
Minimum
2.00
Maximum
5.00
Sum
119.00
Satisfaction (Emotional Function)
Frequency
Percent
Valid Percent
Cumulative
Percent
Valid
Moderately Dissatisfied
1
3.3
3.3
3.3
Average
5
16.7
16.7
20.0
18
60.0
60.0
80.0
6
20.0
20.0
100.0
30
100.0
100.0
Moderately Satisfied
Very Satisfied
Total
Statistics
Satisfaction (Socioeconomic)
Valid
30
N
Missing
0
Mean
4.0333
Median
4.0000
Mode
4.00
Std. Deviation
.80872
Range
3.00
Minimum
2.00
Maximum
5.00
Sum
121.00
Satisfaction (Socioeconomic)
Frequency
Percent
Valid Percent
Cumulative
Percent
Moderately Dissatisfied
1
3.3
3.3
3.3
Average
6
20.0
20.0
23.3
14
46.7
46.7
70.0
9
30.0
30.0
100.0
Valid
Moderately Satisfied
Very Satisfied
52
Total
30
100.0
100.0
Statistics
Importance
Importance
Importance
(Physical
(Emotional
(Socioeconomic
Function)
Function)
Function)
Valid
30
30
30
0
0
0
Mean
4.2333
4.5000
4.3333
Median
4.0000
5.0000
4.0000
4.00
5.00
4.00
.72793
.57235
.60648
Range
2.00
2.00
2.00
Minimum
3.00
3.00
3.00
Maximum
5.00
5.00
5.00
127.00
135.00
130.00
N
Missing
Mode
Std. Deviation
Sum
Importance (Physical Function)
Frequency
Percent
Valid Percent
Cumulative
Percent
Average
5
16.7
16.7
16.7
Moderately Important
13
43.3
43.3
60.0
Very Important
12
40.0
40.0
100.0
Total
30
100.0
100.0
Valid
Importance (Emotional Function)
Frequency
Percent
Valid Percent
Cumulative
Percent
Average
1
3.3
3.3
3.3
Moderately Important
13
43.3
43.3
46.7
Very Important
16
53.3
53.3
100.0
Total
30
100.0
100.0
Valid
Importance (Socioeconomic Function)
53
Frequency
Percent
Valid Percent
Cumulative
Percent
Average
2
6.7
6.7
6.7
Moderately Important
16
53.3
53.3
60.0
Very Important
12
40.0
40.0
100.0
Total
30
100.0
100.0
Valid
54
Label each picture as: Plate number and title of the plate. Put below the
picture.
APPENDIX E
PHOTOS
55
APPENDIX F
GANTT CHART
Oct
2016
Nov
2016
Dec
2016
Jan
2017
Feb
2017
Mar
2017
Apr
2017
May
2017
June
2017
Research
Activities
1 2 3 4 12 3 4 1 2 3 4 1 2 34 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1. Formation of
group
2. Formulation of
research title
3.Submission of
the title
4. Assignment of
adviser
5. Drafting of
research protocol
6. Submission of
research protocol
to adviser
7. Correction of
the research
protocol
8. Printing of the
research protocol
56
9. Research
proposal Hearing
10. Incorporation
of corrections to
protocol paper
11.Submission of
research protocol
to IRB
12.Data collection
progress
13. Statistical
analysis of data
14. Data
interperetation
15.Submission of
research paper to
adviser
16. Correction of
research paper
17.Submission of
research paper for
oral defense
18. Oral Defense
19.Incorporation of
corrections to
research paper
20.Submission of
research paper to
coordinator
21.Hard bound of
research paper
22.Submission of
research paper to
library
57
APPENDIX G
BUDGET SUMMARY
Expenses
Cost
Photocopies
PHP 2000.00
Short folders and Fasteners
PHP 150.00
Bond Papers
PHP 500.00
IRB Fee
PHP 1500.00
Statistical Evaluation Fee
PHP 2000.00
Other Expenses
PHP 500.00
Total
PHP 6650.00
58
CURRICULUM VITAE
Personal Background
Name
: Doppalapudi Yeekshith
Date of Birth
: Aug-04-1998
Place of Birth
: Andhra Pradesh, India
Father’s Name
: Ammaiah Choudary
Mother’s Name
:Uma Maheshwari
Address
: Santo Nino Village, Banilad
E-mail address
: yeekshithdoppalapudi06@gmail.com
Educational Background
Elementary school
: Loyola Public School
Address
: Andhra Pradesh, India
Inclusive dates
: 2003-2010
Secondary school
: Loyola Public School
Address
: Andhra Pradesh, India
Inclusive dates
: 2010-2013
High school
: Sree Chaitanya Junior College
Address
: Andhra Pradesh, India
59
Inclusive dates
: 2013-2015
Tertiary school
: Cebu Doctor’s University
Address
: North Reclamation Area, Mandaue City, Cebu,
Philippines
Present School
:University of the Visayas- Gullas College Of Medicine
Address
:Banilad, Mandaue City, Cebu, Philippines
Previous Research Study:
Identification of macroinvertebrates present in Sapangdaku River, Barangay
Sapangdaku, Cebu City: Basis for determining the rivers’ ecological health.
Personal background
Name
:Gadda Sreeja
Date of Birth
: 04, November, 1995
Place of Birth
:Warangal, India
Father’s Name
:Dr.Gadda Kamal yadav
Mother’s Name
:Gadda Lalitha
Address
: Subhadarshini Residency, Naimnagar,
Hanamkonda, Warangal
Email- Address
:gaddasreeja8487@gmail.com
Educational Background
Elementary school
: Tejaswi High school
60
Address
:Telangana, India
Secondary school
:Tejaswi High school
Address
:Telangana, India
High school
:Sri Chaithanya Junior College
Address
: Hyderabad, Telangana, India
Tertiary school
:Cagayan State University
Address
: Cagayan, Tuguegarao City, Philippines.
Present school
Medicine
: University of the Visayas- Gullas College Of
Address
:Banilad, Mandaue City, Cebu, Philippines
Previous Research Study:
Wound healing property of Euphorbia hirta on Albino rats.
Personal Background
Name
: Ravi Manoj
Date of Birth
: 04 may 1997
Place of Birth
: Chennai, India
Father’s Name
: Ravi.M
Mother’s Name
: Mohana
sundari
Address
: Nasipit , Upper Talamban, Cebu
E-mail address
: manoj451998@gmail.com
Educational Background
Elementary school
: Velammal future school
Address
: Chennai , India
61
Secondary school
: Velammal future school
Address
: Chennai , India
High school
: Velammal Mat .he. sec. school
Address
: Chennai , India
Inclusive dates
: 2012-2014
Tertiary school
: Manila Central University
Address
: Manila, Philippines
Present School
:University of the Visays- Gullas College Of Medicine
Address
:Banilad, Mandaue City, Cebu, Philippines
Awards/ Honours received :
Hockey District runner up
Road cycling district runner up
Personal Background
Name
: Tholiya Soumya
Date of Birth
: Aug-04-1997
Place of Birth
: Andhra Pradesh, India
Father’s Name
: Suraj Bhan Tholiya
Mother’s Name
: Purna Tholiya
Address
: Holy Family Village 2, Banilad
E-mail address
: soumyatinu.st@gmail.com
Educational Background
Elementary school
: Divine Dale International School
Address
: Gurgaon, Haryana
62
Inclusive dates
: 2002-2009
Secondary school
: Shaheed Amar Singh Public School
Address
: Gurgaon, Haryana
Inclusive dates
: 2009-2012
High school
: Shaheed Amar Singh Public School
Address
: Gurgaon, Haryana
Inclusive dates
: 2012-2014
Tertiary school
: Cebu Doctors’ University
Address
: North Reclamation Area, Mandaue City, Cebu,
Philippines
Present School
:University of the Visayas- Gullas College Of Medicine
Address
:Banilad, Mandaue City, Cebu, Philippines
Previous Research Study: Larvicidal effects of Citrofortunella Microcarpa
(Lemonsito) peel extract on Aedes mosquito.
Personal Background
Name
:Yanamala Sree Koushik Reddy
Date Of Birth
:08,August,1996
Place of Birth
:Proddatur
Father’s Name
:Lakshmi Reddy
Mother’s Name
:Vijaya Bharathi
Address
:YMR Colony ,Proddatur
E-mail address
:koushikreddy.sri@gmail.com
Educational Background
63
Elementary School :Gautam High School
Address
:Andhra Pradesh
Secondary School
:Gautam High School
Address
:Andhra Pradesh
High School
:Sri Chaitanya kalasala
Address
:Andhra Pradesh
Tertiary School
:Cebu Doctors’ University
Address
:North Reclamation Area, Mandaue City, Cebu, Philippines
Present School
:University of the Visayas- Gullas College Of Medicine
Address
:Banilad, Mandaue City, Cebu, Philippines
Awards/Honours receiver :
State level swimmer
Previous Research Study:
The effect of Moringa oleifera (Malunggay) leaf extract on the growth of
Staphylococcus aureus.
Personal background
Name.
: Yedlapalli Srija
Address.
: Khammam District, Telangana, India
Email address
: yedlapallisrija12@gmail.com
Educational Background
Elementary school
: SFS high school
Address
: Khammam District, Telangana, India
Secondary school.
: Triveni talent school
Address
:Khammam District, Telangana, India
64
Secondary school
:Sri Chaitanya junior college
Address
: Vijayawada, India
Teritiary school
:Cebu Doctors University
Address
: North Reclamation Area,
Mandaue City, Cebu, Philippines
Present School
:University of the Visayas- Gullas
College Of Medicine
Address
:Banilad, Mandaue City, Cebu, Philippines
Awards/honours Received:
Won first prize in dance at school level competition
Previous Research Study:
Prevalence and incidence rate of tuberculosis from the year 2012 to 2017 in
Mandaue city.
Erlinda Y. Posadas
Address
Contact numbers
Date of birth
Place of birth:
Civil status:
Citizenship
Languages spoken
Email address
Education
: 54 Osmena Blvd., Capitol Site, Cebu City
: + 63-32-253-6426 (residence)
+ 63-933-249-1112 (mobile)
: December 4, 1963
: Cebu City
: Married
: Filipino
: English, Filipino, Cebuano, Chinese
: erlindaposadas@yahoo.com
65
Currently enrolled in the Master in Health Professions Education (MHPEd)
Blended Learning Mode, National Teacher Training Center for the Health
Professions, University of the Philippines Manila
Master of Public Health
University of the Philippines – Open University, Los Banos
2002 – 2005
Doctor of Medicine
Cebu Institute of Medicine, Cebu City
1988 – 1992
Number four in the graduating class
Post-graduate internship, Vicente Sotto Memorial Medical Center
Most Outstanding Intern Awardee
1992 – 1993
Passed the Licensure Examination for Physicians
August 1993
Master of Science in Biology (units)
University of San Carlos, Cebu City
1985 – 1988
Bachelor of Science in Biology
University of San Carlos, Cebu City
1980 – 1984
Magna cum laude
Secondary and primary education: Sacred Heart School – Hijas de Jesus
Cebu City
1970 – 1980
Valedictorian
Working experience
2007 – present
Assistant professor, University of the Visayas, Gullas College of Medicine
Department of Preventive and Social Medicine. Teaches epidemiology and basic
biostatistics in second year.
Department of Pharmacology and Therapeutics. Handles lectures on
complementary and alternative medicine, second year.
Department of Research, chairman, May 2018 – present. Research instructor
and adviser for first and second years.
66
2007 – present
Assistant professor 6, Cebu Institute of Medicine, Cebu City.
Community medicine coordinator, Department of Family and Community
Medicine.
1993 – 1999; 2003 - present
Program physician, Visayas Primary Healthcare Services, Inc.
1993 – present
Medical officer, Department of Social Welfare and Development, Area
Vocational Rehabilitation Center II, Labangon, Cebu City
Memberships in Professional Organizations
Member of the Capacity Building Committee of the Central Visayas Consortium
for
Health Research and Development
Cebu Medical Society
Philippine Medical Association
Philippine Academic Society of Community Medicine
Community Medicine Practitioners and Advocates Association, Inc.
Community Medicine Development Foundation, Inc.
Publications
1. Rojas, K. G. B., Maybuena, G. N., Posadas, E. Y., Quisumbing, L. C., and
Ybañez, A. P. (2016). Wives’ roles among alcoholic partners in the Philippine
context. University of the Visayas Journal of Research, 10 (1).
2. Vidal, A.R., Alfeche, P.O. Quisil, S.J.C., Posadas, E.Y., Quisumbing, L.C.,
Ybanez, A.P., (2017). Knowledge of HIV and AIDS among call center agents in
Cebu City, Philippines. University of the Visayas Journal of Research, 11 (1).