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thesis consent

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This informed consent form is for college students who are currently enrolled this academic year 2020 -2021 in
Mindanao State University-Main Campus Marawi City and who I am inviting to participate in research entitled
“COVID-19: The Five Dimensions of Mental Well-Being among College Students in MSU-Main Campus Marawi
City”.
Name of Researcher: Norolhudah S. Edres
Name of Institution: Mindanao State University - College of Health Sciences
Name of Thesis Adviser: Dr. Ashley A. Bangcola, RN, MAN
Name of Research: COVID-19: The Five Dimensions of Well-Being among College Students in MSU-Main
Campus Marawi City
Part I. Information Sheet
Purpose of the research
The aim of this study is to explore the relationships among the different dimensions of mental well -being and
physical well-being among college students in the context of the COVID-19 pandemic. I believe that you, as
one of the students of MSU-Main Campus, can help in this research by sharing your experiences and feelings
during this time of health crisis. I want to know how this pandemic brought effect to the mental well-beings and
physical well-being of the students.
Type of Research Intervention
This research will involve your participation in answering a survey questionnaire prepared by the researche r.
The questionnaire that you will be answering is composed of Part I. Demographic Profile of Respondent, Part
II. Emotional Well-Being, Social Well-Being, Psychological Well-Being, Spiritual Well-Being and lastly Part III.
Physical Well-Being (General Perceived Health) it will take about five (5) to ten (10) minutes to finish
answering the survey questionnaire.
Participant Selection
You are being invited to take part in this research because you are qualified in the inclusion criteria of this
study as the inclusion criteria in this study are those students of MSU-Main Campus Marawi City, currently
enrolled this academic year 2020-2021, attained an age at least 16 years old, and willing to participate in this
study. I believe that your experiences can contribute much to this research.
Voluntary Participation
Your participation in this research is entirely voluntary. It is your choice whether to participate or not. The
choice that you make will have no bearing on your job or on any work-related evaluations or reports. You may
change your mind later and stop participating even if you agreed earlier.
Procedures
I am asking you to help us learn more about your experiences and feelings during this time of health crisis with
regards to your mental and physical status. I am inviting you to take part in this research project. If you accept,
you will be asked to participate in answering a survey questionnaire prepared by the researcher.
I will send you the survey questionnaire thru your email address then I will wait f or your response. If you do not
wish to answer any of the questions, you may say so. The information will be gather is confidential, and no one
else except my researcher adviser, Dr. Ashley A. Bangcola will access to the information documented.
Duration
The research takes place in just one day for about five (5) to ten (10) minutes to finish answering the survey
questionnaire.
Risks
I am asking you to share with us some very personal and confidential information, and you may feel
uncomfortable talking about some of the topics. You do not have to answer any question or take part in the
survey 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, or for refusing to take part in answering this survey.
Benefits
There will be no direct benefit to you, but your participation is likely to help us find out more about how this
pandemic brought effect to the mental well-beings and physical well-being to the students.
Reimbursements
You will not be provided any incentive to take part in the research.
Confidentiality
The information that the researcher will obtain from this study will be shared in a conference and will be
published for academic purposes. Rest assured that your name will not be connect ed with any information you
reveal to maintain confidentiality and privacy. I will not be sharing information about you to anyone outside of
the research team. The information that I will collect from this research project will be kept private. Any
information about you will have a number on it instead of your name. Only the researchers will know what your
number is and we will lock that information up with a lock and key.
Sharing the Results
Nothing that you tell us today will be shared with anybody outside the research team, and nothing will be
attributed to you by name. The knowledge that we get from this research will be shared in conference and will
be published for academic purposes only with strict confidence of the participant profile.
Right to Refuse or Withdraw
You do not have to take part in this research if you do not wish to do so, and choosing to participate will not
affect you in any way. You may stop participating in the survey at any time that you wish without you being
affected. I will give you an opportunity at the end of the survey to review your remarks, and you can ask to
modify or remove portions of those, if you do not agree with my notes or if I did not understand you correctly.
Who to Contact
If you have any questions, you can ask me now or later. If you wish to ask questions later, you may contact me
through:
Norolhudah S. Edres
09184796190
edres.ns97@s.msumain.edu.ph
Part II. Certificate of Consent
Do you give your consent to participate in this survey? *
I have read and understood the information in this form. I have been encouraged to ask questions
and all of my questions have been answered to my satisfaction. I will answer the questions
appropriately and to the best of my ability. I have also been informed that I can withdraw from the
study at anytime. By checking this box, I voluntarily agree to participate in this study.
I do not give my consent voluntarily to participate in this study.
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