Capitol University Cagayan de Oro City

A Research on

THE KNOWLEDGE LEVEL AND PHYSICAL PERFORMANCE OF THE RESIDENTS OF BARANGAY BANGCUD BUKIDNON DIAGNSOSED WITH SCHISTOSOMIASIS In Partial Fulfillment of the Requirements for the Course Nursing Research Submitted by: San Gabriel, Angelica Maria D. Cabading, Ma. Edel Viera R. Marapao, Rueland Mark K. Abecia, Rose Socorro R. Sorilla, Ma. Joannie A. Ballar, Lovely G.

March 2007

Approval Sheet This research paper entitled The Knowledge Level and Physical Performance of the Residents of Barangay Bangcud Bukidnon Diagnosed with Schistosomiasis, prepared by: Abecia, Rose Socorro R., Ballar, Lovely G., Cabading, Ma. Edel Viera R., Marapao, Rueland Mark K., San Gabriel, Angelica Maria D., and Sorilla, Ma. Joannie A., in partial fulfillment of the requirements for the subject Nursing Research has been examined, accepted for Oral Examination. Dr. Expeditha Bandiola Adviser

PANEL OF EXAMINERS Approved by the committee on Oral Examination with a grade of ______.

Accepted and approved in partial fulfillment of the requirements to the subject Nursing Research. Mrs. Fidela B. Ansale, R.N, MAN Dean, College of Nursing

ACKNOWLEDGEMENT The researchers wish to express their deepest gratitude and warmest appreciation to the following people, who, in any way have contributed and inspired the researchers to the overall success of the undertaking: To Dr. Expeditha Bandiola for her guidance and support in the duration of the study. Mrs. Fidela B. Ansale, Dean of the College of Nursing, for her approval and trust. Capt. Rosa Maria Elena M. Robosa of Barangay Bangcud, for the warm accommodation and pure hospitality. To the residents of Barangay Bangcud, for their selfless cooperation and sharing their precious time. To our friends, who have been unselfishly extending their efforts and understanding. To our parents who have always been very understanding and supportive both financially and emotionally. And above all, to the Almighty God, who never cease in loving us and for the continued guidance and protection.

The Researchers

ABSTRACT 1. Title: THE KNOWLEDGE LEVEL AND PHYSICAL PERFORMANCE OF THE

RESIDENTS OF BARANGAY BANGCUD BUKIDNON DIAGNOSED WITH SCHISTOSOMIASIS 2. 25 Residents from Barangay Bangcud, Bukidnon 3. Authors: Abecia, Rose Socorro R. Ballar, Lovely G. Cabading, Ma. Edel Viera R. Marapao, Rueland Mark K. San Gabriel, Angelica Maria D. Sorilla, Ma. Joannie A. 4. Type of Document 5. Type of Publication 6. Host Institution 7. Sponsor 8. Key Words 9. Abstract 9.1 The Problem This study sought to determine the knowledge level and physical performance of the residents of Barangay Bangcud Bukidnon diagnosed with schistosomiasis. Specifically, the study aimed to know the profiles of the respondents, the knowledge level of the respondents regarding schistosomiasis, how the respondents go about with their : Nursing Research : Unpublished : Capitol University : Parents : Schistosomiasis :

activities of daily living, and what interventions can be done as nursing students based from the result of the study. Non-experimental research design was used in the study. The instrument used was a questionnaire made by the researchers. The study reveals that (a) relatively, there are more respondents (48%) fall within the adult group, 30-60 years old. Most respondents are women (13 respondents) 52%. There are fourteen married respondents and only 11 single respondents. People who acquire schistosomiasis are mostly farmers with a number of ten out of the twenty- five respondents. (b) The respondents are highly knowledgeable about the infectious agents that can cause the disease. In some instances, some of the respondents have no knowledge at all about the signs and symptoms of schistosomiasis but majority of them is highly knowledgeable about it. In preventive measures, most of the respondents are highly knowledgeable. Majority of the respondents have no knowledge at all about the medications to be taken when having schistosomiasis but still, majority of them are highly knowledgeable about alternative treatment of the disease. (c)In performance level, majority of the respondents can fairly perform their work. Mostly of the respondents have no changes in their sleeping pattern. (d) There is no significant relationship between the knowledge level and physical performance of the respondents diagnosed with schistosomiasis and their profile. The study concludes that the (a) people who acquire schistosomiasis are mostly from the adult group aged 30-60 yrs old, are married, mostly women, and those who work as farmers. (b) The respondents are highly knowledgeable about the possible infectious agents, signs and symptoms, preventive measures and treatments. (c) The respondents can perform fairly in

their activities of daily living. And with regards with their sleeping pattern, the respondents experience no change. Based on the findings, the researchers recommended the following possible research title for future use (a) the effectivity of the schistosomiasis control program at barangay Bangcud. (b) Knowledge level of school-age children diagnosed with schistosomiasis at barangay Bangcud. (c) and the residents perception towards schistosomiasis at the Matin-ao spring. Although knowledge levels surrounding transmission and prevention of schistosomiasis may thus be increased, additional research is necessary to (a) examine the retention of this knowledge over time and (b) whether and to what extent this knowledge is being used effectively by individuals in reducing risk behavior. Health education by itself cannot guarantee the control of schistosomiasis but it is a fundamental starting point around which other measures can be built to create a favorable environment for the promotion of higher levels of health consciousness and more critical thinking towards improving the quality of life of communities (http://memorias.ioc.fiocruz.br/X007.pdf).

TABLE OF CONTENTS Page Approval Sheet Acknowledgement Abstract Table of Contents List of Tables List of Figures Chapter 1 INTRODUCTION Conceptual Framework Statement of the Problem Significance of the Study Scope and Limitation of the Study Definition of Terms Chapter 2 REVIEW OF RELATED LITERATURE AND RELATED STUDIES Chapter 3 RESEARCH METHODOLOGY Research Design Research Setting Respondents Instruments i ii iii vi viii ix

Data Gathering Procedure Statistical Treatment Chapter 4 PRESENTATION OF FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS Chapter 5 SUMMARY OF FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS Findings Conclusion Recommendations Bibliography APPENDICES A. TRANSMITTAL LETTER B. QUESTIONNAIRE C. CURRICULUM VITAE

LIST OF TABLES

Table 1 2 3 4 5

Description Distribution of Respondents by Age Distribution of Respondents by Gender Distribution of Respondents by Civil Status Distribution of Respondents by Occupation Respondents Knowledge Level on the Possible Infectious Agents

Page

Respondents Knowledge Level on the Signs And symptoms

Respondents Knowledge Level on the Preventive Measures

Respondents Knowledge Level for Treatment of Schistosomiasis

Physical Performance Work

TABLE OF FIGURES

Figure 1 2

Description Schematic Diagram Map of Barangay Bangcud

Page

Chapter 1 THE PROBLEM Introduction The study is all about Schistosomiasis, a disease caused by a blood born fluke (trematode) of the genus Schistosoma. The intermediate hosts of all digenetic trematodes are snails, and schistosomes are no exception (Schistosomiasis Control Initiative, 2006). 1.9 million Filipinos are affected with this disease (Schistosomiasis Control Program). Most of which are from the Islands of Mindanao. The researchers would like to know the other factors that will trigger the disease, its mode of transmission, and the peoples knowledge regarding the case. Schistosomiasis has been in Barangay Bangcud even before we were born. By now, the endemic disease should have been eradicated, but instead, the phenomenon still goes on affecting both young and old. The residents alone believe that all populace in the said barangay has schistosomiasis. The objectives of this research are (1) to know the knowledge level of the people who has been diagnosed with the disease (2) to know how people who have been diagnosed with schistosomiasis go about to their activities requiring strength, (3) to gain additional knowledge about the said disease, (4) to impart what we know to those who has been infected with it, and (5) to educate the people to prevent from acquiring the disease. We, the researchers, believe that the disease can affect the daily lives of people who have acquired it. The researchers are convinced that by doing this research, the spread and effect of this disease will deteriorate and only few people will then be affected. Conceptual Framework

The knowledge level and physical performance of the residents of Barangay Bangcud diagnosed with schistosomiasis. The individuals primary experience and common sense are obstacles to shared and dynamic challenge. Thus, according to Bachelard (1996), health-related knowledge of individuals that is basically influenced by their socioeconomic status and fragments of scientific knowledge must be the starting point of health education actions in planning viable educational interventions that can overcome knowledge barriers. When the educational process takes into account the previous experiences and knowledge of respondents and relating them to their place of residence and day-to-day activities, and also the perception of environmental risks relating all this to scientific knowledge, it is possible to re-construct the respondents pre-existing knowledge that is necessary to facilitate new behaviors related to the control of schistosomiasis. Statement of the Problem The aim of the study is to determine the knowledge level of the respondents regarding schistosomiasis and to know how they manage their activities in daily living while acquiring the disease. Specifically, it aims to answer the following questions. 1. What is the profile of the respondents? 1.1 Age 1.2 Gender 1.3 Civil Status

Profile of the Respondents Age Gender Civil Status Occupation Interventions Health teachings Giving of leaflets Posting

Knowledge Level Activities of Daily Living

(Figure 1). Schematic diagram of the study between the Knowledge Level and Physical performance of the residence of Barangay Bangcud diagnosed with

Schistosomiasis.

1.4 Occupation 2. What is the knowledge level of the respondents regarding schistosomiasis? 2.1 Possible Infectious agents 2.2 Signs and Symptoms 2.3 Preventive Measures 2.4 Treatment 3. How do the respondents go about with their activities in terms of the following: 3.1 Work 3.2 Sleeping pattern 4. Is there a relationship between the knowledge level and the activities of daily living of the respondents diagnosed with schistosomiasis and its profile? 5. What interventions can be done as nursing students based from the result of the study? Hypothesis There is no significant relationship between the respondents profile and the knowledge level and physical performance of the respondents diagnosed with Schistosomiasis Significance of the study The study is important and significant because it will show how knowledgeable the respondents of Barangay Bangcud are regarding Schistosomiasis and how they manage their daily activities and to assess the factors which affects the performance of the respondents during the duration of the disease. Among those who will benefit from this study are the following are

The farmers. They work all day in the wet lands, and in the end they acquire the disease because of lack of knowledge and information. This study can help them understand the disease itself and how to cope up with the activities of their daily living. The children. School-age children are fond of playing in lakes, ponds, or even in a hole with water. At a young age, some of them are being infected with the disease and some may have lost their hope to live. In this way of conducting the study to their place, children then have the idea of how the disease can affect them and how they can avoid it. The neighboring barangays of Barangay Bangcud. This research paper will serve as an eye-opener so that they too will be more responsible and aware about schistosomiasis. Future researchers. research. Scope and Limitation This study is limited to twenty five (25) residents from Barangay Bangcud, Bukidon who has been diagnosed with schistosomiasis. This is done for the purpose of knowing their knowledge level and how people go about with their daily activities. The independent variables as means of differentiating their responses are also limited to age, sex, civil status, and occupation. The scope of the study is likewise limited to the possible infectious agents, signs and symptoms, preventive measures, treatment, work, and sleeping pattern. Definition of Terms The following terms are defined conceptually: Activities of Daily Living. Activities of daily living are actions/activities done by individuals This study will serve as their guide in their schistosomiasis

everyday. The ability to take part of something.

Diagnosed. Diagnosed means a person identified as having a particular disease or condition by means of a diagnosis. Knowledge Level. Knowledge level is the degree of Information contained by residents

regarding a specific topic. Physical Performance. Physical Performance is the ability of an individual to perform a certain task.

Chapter II REVIEW OF RELATED LITERATURE AND RELATED STUDIES This chapter presents a review of professional literatures and studies related to the present study.

Related Literature SCHISTOSOMIASIS; A WATER-BORNE DISEASE The Philippines is blessed with vast agriculture along with hardworking individuals that maintains the countrys bounty. Then there was Schistosomiasis, a disease making all the Filipinos hard work futile and meaningless. Schistosomiasis is a tropical disease that is caused by infestation with schistosomes (http://medical-dictionary.thefreedictionary.com/schistosomiasis). Rural areas in tropical

countries are the once mostly affected. A case of the said disease is present in Bukidnon, Philippines. People get schistosomiasis by skin contact with contaminated fresh water in which certain types of snails that carry schistosomes are living (http://www.dhpe.org/schisto.asp). Schistosoma eggs are being transmitted through their urine and stool. The egg eventually hatches and comes in contact with snails in order to survive. The parasites inside the snail multiply and are then released into the water where they can live. People who are using the contaminated water for bathing, washing, or rice cultivation have high risks of acquiring schistosomiasis since parasites can penetrate the skin through these activities. Several weeks after penetration, the growth of worms in the blood vessels and production of eggs is taking

place. These eggs travel to the bladder or intestines and are passed into the urine or stool. Not all eggs are passed in the urine or stool. Some actually stay in the body damaging and scarring vital organs. The eggs are the ones causing the visible signs and symptoms of people with schistosomiasis. Its a pity that something as precious as water is being affected resulting to loss of lives. Schistosomiasis, as with many communicable diseases, is a result of inequity and poverty. People get infected because they do not have access to safe, potable water, and maintain transmission because of the absence of proper excreta disposal systems. Infection is acquired during the course of routine domestic, agricultural or occupational duties (WHO). The Philippines, being a third-world country with impoverished rural dwellers and poor sanitary practices is a favorite site of Schistosomiasis. At risk population has been estimated at 60 million in China, 6 million in the Philippines, and a combined total of 140 000 in Cambodia and the Lao People's Democratic Republic. In China and the Philippines, schistosomiasis constitutes an occupational risk, especially for farmers and fishermen, and therefore has an impact on the economic situation and the development of rural areas. (http://www.wpro.who.int/health_topics/schistosomiasis/). The Philippines, being on the list, should not only think but as well as plan in order to stop the spread of schistosomiasis. Not only does this disease affect ones health but it also affects the economic standing of our country. As stated above, progress is made possible and maintained if the people are healthy and has the capacity to do work. Who will take care of our fields when these farmers are imprisoned with weakness and are not able to carry on?

The World Bank states, "Despite decades of effort...and $30 billion of water investment in developing countries each yearan estimated 10,000 peopledie everyday from water and excreta- related diseases. Thousands more suffer debilitating illnesses. The tragedy is that these deaths and illnesses are entirely preventable... Schistosomiasis is a problem not only in the Philippines but worldwide as well. Every effort to make things effective is only made possible if the people have the willingness to do it. No matter how much money one allots for a certain project, the peoples own practices and health would always be a factor in determining a projects success. Symptoms such as diarrhea, splenomegaly, bloody stools, weakness, enlargement of the abdomen, anemia, and inflamed liver implies that one has acquired the disease (Reyala). With the above mentioned, it is impossible for a person to carry out his daily activities especially if his job requires strength. Any disease affects different people in different ways. Some may go on to their normal lives and some may be too weak to even accomplish one thing. Schistosomiasis group worked for a significantly shorter duration of additional hours/month than control workers. This might reflect their lower capacity for work. Additional work hours also significantly decreased with increase in the severity of schistosomiasis (http://www.emro.who.int/Publications/EMHJ/0802_3/schistos.htm). The impact of

schistosomiasis is not limited to countrys economics but also on the physical development of an affected individual and his/her family and on the economic and social consequences for community development of the disease. Weakness frequently coexists with other symptoms of disease and can affect a variety of muscles, causing a wide range of disability (Brunner and Suddarth). It is then suspected

that any person who has schistosomiasis cannot go about to any functional performance until one is again in equilibrium and has the energy and ability to meet new demands.. (Brunner and Suddarth). As for treatment, ...early efforts focused on snail control in the absence of an effective drug against the disease. Discovery of praziquantel shifted control focus from the expensive snail control to a more manageable one involving case detection and treatment (http://www.ncbi.nlm.nih.gov) Schistosomiasis is one of the most important tropical diseases in the Philippines (Dr. Renato Cerdena ). It affects people of different age levels. According to him, geographic education may be used for sustainable control of schistosomiasis in the Philippines. The environment in which the snails, parasitic flukes, and human host all interact is carefully analyzed in the aim to control the persistence of schistosomiasis. REVIEW OF RELATED STUDIES Not all snails can cause schistosomiasis. Contaminated fresh water with certain types of snails that carry schistosomes are mainly the ones causing the disease. Snail-parasite interactions may be relevant to the potential coevolution between host resistance and parasite infectivity and virulence (Webster,Davies). Co-evolution, according to biology, includes the evolution of a host species and its parasites. The interaction between snail and parasites may cause grave effects to the body. Schistosomes, being the causative agent of schistosomiasis, are digenean trematodes with an indirect life cycle involving sexual reproduction in a mammalian host and an asexual

phase in a molluscan host (Schistosomiasis Research Group). In order to destroy vital organs inside the body, these parasites undergo sexual reproduction. Children under 10 years and adults were more likely to seek health care than teenagers. Also, females were more likely to visit a health facility than males of the same age groups. Socio-economic status and duration of symptoms did not appear to affect healthseeking behaviour. 'Do not have the money' (43%) and 'Not serious enough' (41%) were the commonest reasons for not visiting a clinic, reported more frequently by lower and higher socio-economic classes, respectively, for both urinary or intestinal schistosomiasis (DansoAppiah, S. J. De Vlas, K. M. Bosompem, and J. D. F. Habbema). The regular health service shows some potential in passive control of schistosomiasis as some, but far too few, people visit a health facility as first or second option. This repeated infection and long term exposure of schistosomiasis results in chronic disease causing an even greater economic drain on the public health sector. Further, the reassessment of schistosomiasis-related disability, combined with recent information on the global prevalence of schistosome infection, indicates that the true public health burden of schistosomiasis is substantially greater than previously appreciated (King et al., 2005). In Thomas K. Kristensens research programme entitled Multidisciplinary Alliance to Optimize Schistosomiasis Control and Transmission Surveillance in Sub-Saharan Africa, It is their objective to find disease control measures which are cheap and sustainable, and useable by local people in order to control bilharzia (other known as Schistosomiasis). This research programme might be beneficial not only to those living in Africa but to other tropical countries as well.

Chapter 3 METHODOLOGY This chapter contains the method used in the study which includes a.) Research design b.) Research setting c.) Sampling procedure and respondents d.) Research Instruments e.) Data gathering procedures and f.) Statistical treatment Research Design The researchers used the descriptive design. Descriptive research, also known as statistical research, describes data and characteristics about the population or phenomenon being studied. Descriptive research answers the questions: who, what, where, when and how? Although the data description is factual, accurate and systematic, the research cannot describe what caused a situation. Thus, descriptive research cannot be used to create a causal relationship, where one variable affects another. In other words, descriptive research can be said to have a low requirement for internal validity. The description is used for frequencies, averages and other statistical calculations. Often the best approach, prior to writing descriptive research, is to conduct a survey investigation. Qualitative research often has the aim of description and researchers may follow-up with examinations of wh0y the observation exists and what the implications of the findings are. (http://e.wikipedia.org/wiki/Descriptive_research) Research Setting Bangcud is one of Malaybalay Citys barangay which can be reached 10 to 20 minutes from the city proper. The place offers Matin-ao spring, a popular picnic spot, and Nasuli Spring,

with a depth ideal for diving. Barangay Bangcud has their own air strip, piggery, public cemetery, and irrigation system. The weather is relatively cool throughout the year. The average annual rainfall is 2,800 millimeters (112.5 inches). Rainfall is distributed throughout the year, though it is more intense from the months of June to October. Sampling Procedure and Respondents The respondents of this study are 25 residents of Barangay Bangcud Bukidnon who has been diagnosed with a water-borne disease called schistosomiasis. The researchers have chosen a small sample size due to lack of time in gathering data. The respondents are both males and females of different ages and occupation. Research Instrument An adapted and modified questionnaire from Maria Flavia Gazzinellis Health Education and Schistosomiasis (http://www.scielo.br/pdf/mioc/v101s1/v101s1a08.pdf) is the instrument used in this research paper. The questionnaire has undergone face validity from the research

instructor. The first page is a letter asking permission from the respondents. The questionnaire was then divided into three (3) parts. Part 1 is all about the personal data of the respondents. The second part was about the knowledge level of the respondents of barangay Bangcud diagnosed with schistosomiasis. The last part includes the physical performance of the respondents. All the choices are schistosomiasis facts based from books and internet sources. The answers are translated using the following intervals: 3.5-4 for highly knowledgeable, 2.53.4 for knowledgeable, 1.5-2.4 for fairly knowledgeable and 1-1.4 for no knowledge. Data Gathering Procedure In gathering data, various steps were carefully followed. First, the researchers inquired Schistosomiasis facts and informations to Dr. Vincent Troy Del Mundo, a doctor assigned at

the Bethel Hospital, Malaybalay City. Second, the permission to conduct the study was sought from the Dean of the College of Nursing for the approval on the request to conduct the study. After having been approved, the letter was sent to Barangay Captain Rosa Ma. Elena M. Robosa of Barangay Bangcud asking permission to conduct a research study to the residents diagnosed with schisotosomiasis in the said place. Once permitted, we, the researchers

floated our questionnaire to the respondents. After the questionnaires were answered, the researchers carefully tallied and analyzed their answers. Statistical Treatment Respondents profile in terms of their knowledge level and physical performance is presented using frequency and simple percentage. In gathering the profile of the respondents the descriptive statistics such as frequencies and percentages were used. The interval used was 3.5-4 for highly knowledgeable, 2.5-3.4 for knowledgeable, 1.5-2.4 for fairly knowledgeable and 1-1.4 for no knowledge. This interval was used to identify the knowledge level and the physical performance of the respondents in their activities of daily living.