An Investigation into Consumer Attitudes and Perception towards Self-Medication in Pakistan in light of the Cultural Dimension of Uncertainty

Avoidance

Submitted by Khawaja Saleem Ahmed (1058138) Fatima Haider (1058117) Yousuf Zahid (1058156) Asma Zuberi (1058108)

For the course Research Project EMBA 66 (6)

Submitted to Faryal Salman on Thursday, February 14, 2013 Faculty of Management Sciences, SZABIST

Shaheed Zulfikar Ali Bhutto Institute of Science & Technology (SZABIST) – Karachi

Table of Contents
Acknowledgement ........................................................................................................................................ 4 Abstract ......................................................................................................................................................... 5 1. INTRODUCTION ................................................................................................................................ 6 1.1 Background of the Study............................................................................................................... 6

1.2 Problem Statement .............................................................................................................................. 7 1.3 Research Gap ...................................................................................................................................... 8 1.4 Research Objectives ............................................................................................................................ 9 1.5 Research Questions ........................................................................................................................... 10 1.6 Theoretical Framework ..................................................................................................................... 11 1.7 Significance and Scope of the Study................................................................................................. 12 1.8 Limitations of the Study.................................................................................................................... 13 2. LITERATURE REVIEW ................................................................................................................... 14 2.1 Self-Medication: Definition .............................................................................................................. 14 2.2 Self-Medication: Spread and Frequency ........................................................................................... 14 2.3 Self-Medication: Reasons and Ailments Treated.............................................................................. 15 2.4 Self-Medication: Consumer Behavior .............................................................................................. 15 2.5 Self-Medication: Effect of Population Spread, Income and Literacy ............................................... 16 2.6 Self-Medication: Perception of Risk ................................................................................................. 17 2.7 The National Cultural Dimensions of Hofstede ................................................................................ 18 2.8 Pakistan: The Cultural Dimension of Uncertainty Avoidance .......................................................... 19 2.9 Hofstede: Criticism ........................................................................................................................... 20 3. RESEARCH METHODOLOGY ........................................................................................................ 21 3.1 Research Design................................................................................................................................ 21 3.1.1 Qualitative Research .................................................................................................................. 21 3.1.1.1 Focus Group ........................................................................................................................... 21 3.1.2 Quantitative Research ................................................................................................................ 23 3.1.2.1 Desk Research ......................................................................................................................... 23 3.1.2.2 Survey and Questionnaire Design........................................................................................... 23

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3.2 Sampling Procedure and Design ....................................................................................................... 25 3.2.1 Sampling Frame ......................................................................................................................... 25 3.2.2 Sampling Size and Selection ...................................................................................................... 25 3.3 Field Work for the Survey ................................................................................................................ 27 3.4 Research Hypothesis ......................................................................................................................... 28 4. DATA ANALYSIS ............................................................................................................................. 29 4.1 Reliability Analysis ........................................................................................................................... 29 4.2 Instrument Validity ........................................................................................................................... 31 4.3 Demographics ................................................................................................................................... 32 4.3.1 Frequency Tables ....................................................................................................................... 32 4.3.2 Bar Charts .................................................................................................................................. 35 4.4 Behavioral Analysis .......................................................................................................................... 39 4.5 Confirmatory Factor Analysis........................................................................................................... 41 4.6 Pearson’s Correlation Matrix ............................................................................................................ 45 4.7 Hypothesis Testing............................................................................................................................ 46 5. CONCLUSION AND RECOMMENDATIONS .................................................................................... 49 5.1 Conclusion ........................................................................................................................................ 49 5.2 Recommendations ............................................................................................................................. 51 AREAS OF FURTHER STUDY ................................................................................................................ 52 BIBLIOGRAPHY ....................................................................................................................................... 53 APPENDIX ................................................................................................................................................. 57 a. b. Focus Group Guide ......................................................................................................................... 57 Survey Questionnaire ...................................................................................................................... 61

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Asad Subzwari for taking out time and assisting the authors during coding and data entry of the survey on the software of SPSS 17 and PASW Statistics 18.Acknowledgement The authors of the study express a sincere gratitude to Ms. A profound appreciation also goes out to all our classmates who had been instrumental in extending support in their respective organizations for collection of data through the survey questionnaire. Special thanks are conveyed to Mr. Faryal Salman for providing guidance throughout the semester and especially on the continuous improvement of data collection and its compilation. 4 .

Analysis of data obtained from specially designed questionnaire had been fed into statistical software to acquire descriptive statistics together with confirmatory factor loading and correlation matrix analysis. The empirical findings showed that the consumers are risk averse but will be willing to practice self-medication based upon the specific situation they may face in life or due to operational variables which they may be exposed to at any given time e. cost of medicine being too high or unavailability of time to wait at a doctor’s clinic. Studies in Pakistan have been undertaken on self-medication but not in juxtaposition with any cultural dimension. The study had been conducted in Karachi and a sample size of 200 had been utilized for the purpose. Future researches on different cultural dimensions of Hofstede vis-à-vis selfmedication and for other risk-taking and risk-averse behavior can be conducted in light of this research.Abstract The purpose of the research study is to investigate the perception and attitudes of consumers towards self-medication in light of Hofstede’s cultural dimension of uncertainty avoidance. the consumer may engage into self-medication based upon good past experience or group influence.g. Additionally. 5 .

Regardless of the reasons. attempting to cheat in exams. it is a human behavior which requires to be studied in order to determine the factors which play a role in developing perception and attitudes among people.1 Background of the Study The people of Pakistan have been observed to take risks. procrastinating at workplace despite being aware of work deadlines and visiting public places during times of public unrest and turmoil. providing children at home with computer and internet facilities and then not keeping a check and control over their activities. Self-medication is not only common in Pakistan but all over the world as well and it is practiced due to a large number of reasons. swimming at the seaside without knowing how to swim. reasons which encourage people to avoid consulting the physician. talking on the cell phone while driving. in every walk of life. INTRODUCTION 1.1. knowingly and unknowingly. The authors in light of their everyday observation have seen countless people take a risk while undertaking a specific action. This is where perceptions of people come into interplay. violating traffic signals on the red light. consider the people who take risks while riding motorcycles without helmets. The list of such activities in which an apparent risk-taking behavior is observed is endless but then risk is a subjective term and what is considered to be a risk for one person may not be so for another. Without contemplating on the reasons as to why people have developed such attitudes. The authors of the study have attempted to narrow the focus on the apparent risk-taking behavior of people in the act of self-medication. making an expensive lease-based investment but without a plan of how future payments will be made. 6 . These actions arise from an attitude that the people have created due to a wide range of reasons.

7 . indulge in treatment of ailments through self-medication without seeking professional advice from doctors. This contradiction is the essence of the problem because on one hand.1. Pakistanis refrain from taking risks and on the other.2 Problem Statement According to the cultural dimension of uncertainty avoidance put forth by Hofstede (geerthofstede. the act of self-medication as per common knowledge and based upon general scientific evidence is a risk-taking behavior. the people of Pakistan have been found as risk-averse and with a considerably high uncertainty avoidance index.com). On the contrary.

8 .1. a) Has the society’s risking-taking attribute changed and evolved over the years? b) Is the society still risk-averse and had the original research missed out key aspects which had failed to show the larger picture? c) Do other cultural dimensions of Hofstede influence or have started to influence the uncertainty avoidance index of Pakistanis? d) Is it just a perception or a fact that self-medication is dominantly practiced amongst the educated people? e) Is the consumer behavior of self-medication influenced by personality characteristics of an individual and by formal/informal reference groups? The research being undertaken will eventually benefit to understand and identify the hidden reasons of this specific consumer behavior and bring to light possible other aspects besides Hofstede’s theory when it comes to declaring the Pakistani society as high on uncertainty avoidance. 1984).3 Research Gap The research conducted in Pakistan almost thirty years ago (Hofstede & Bond. had established the basis of the society as high on uncertainty avoidance but the authors intend to conduct a study because of some apparent gaps that have been identified in the research.

At the same time.4 Research Objectives The primary objective of the study is to learn how consumers develop perceptions and form an attitude towards the act of self-medication and whether consumers take this risk willingly or unknowingly. the study will also assist in the determination and analysis of reasons behind this act in contrast with the cultural dimension of uncertainty avoidance.1. 9 .

1. why do the people in Pakistan practice selfmedication? c) Which attributes contribute in forming an attitude towards the specific consumer behavior of self-medication? d) If and whether socio-economic factors play a role in motivating people to practice self-medication? 10 .5 Research Questions The core research questions arising as a result from the research objectives and the research gap are: a) How do the people in Pakistan perceive risk when it comes to management of health matters? b) Despite being a risk-averse nation.

1. Figure 1. This postulation has been clarified in the theoretical framework which incorporates the research hypothesis in light of the uncertainty avoidance index and the different variables. This means that people take a risk even after knowing the fact that it is a risk.6 Theoretical Framework The practice of self-medicating students has reached a significantly high percentage despite the fact that the majority of students understand that self-medication practice is incorrect (Zafar et al.. The theoretical framework 11 . 2008).

7 Significance and Scope of the Study The research study strives to identify reasons by means of which consumers develop an inclination towards risk-averse or risk-taking behavior in the practice of self-medication based upon the perceptions that are developed leading to attitude formation. In order to conduct the research.1. specific units have been considered and which constitute of male and female adults hailing from different income groups and belonging to different age segments. These units are students and working individuals both in terms of profession. 12 . tactical measures by all concerned stake holders will ensure that a larger strategy is formulated which also incorporates the aspect of imparting awareness on self-medication towards the people. Findings of the study will possibly pave the way for managerial implications in terms of identifying ways and means of implementing stringent pharmacy regulations. stabilizing the cost of medicines and sustaining the quality of health care otherwise a strong probability exists that consumers will continue to jeopardize individual and family health care through self-medication practices. Subsequently.

additional in-depth research is required which may bring to light hidden variables that act as trigger points when it comes to understanding consumer behavior and the cultural dimensions of Pakistan. The drawn sample size is however not sufficient as it may not represent the total population of the city and the other principle urban hubs of the country.8 Limitations of the Study The study is restricted to the research of consumer behavior on self-medication only with a focus on Karachi that represents the major urban areas of Pakistan. this dimension also has not been taken into consideration. 13 . Personalities also play a role and which motivates a person to develop an attitude and behave in a particular manner. Other factors that have not been considered in the study include elements of religion and locus of control by means of which people govern their lives in Pakistan.1. The other cultural dimensions of Hofstede besides uncertainty avoidance have not been considered and which may establish an-interplay among all the dimensions in order to analyze consumer perception and attitude. Based upon the lines of the study undertaken. An element of bias may also exist in the replies received by the respondents due to individual perception and attitude towards the personal subject of health care.

14 . 2005).. up to 68% in European countries (Bretagne et al. 2006)..1 Self-Medication: Definition The act treating an ailment either for diagnosis or prescription.. 2012). 2004) Self-medication as an act is spread all over the world and has considerably high rates of occurrence. 2.. however. 2002).. 2002). The developing countries have an even higher rate (Shankar et al.. In Pakistan. India has 31% (Deshpande & Tiwari. 1997) whereas Nepal has a prevalence rate of 59% (Shankar et al. 1995). LITERATURE REVIEW 2. during sickness will choose and consume a drug for self-treatment (WHO. 2004). just a few undertakings have come to light which elucidate the spread of self-medication but which have nonetheless confirmed a high rate of 51% spread in the country (Haider & Thaver. Self-medication is a widespread international occurrence and it has been around since ages because human beings have a natural disposition to reduce and eradicate health related issues with some medicine (Baig. sharing and recommending drugs with friends. using old prescriptions to acquire medicines. up to 92% in Kuwait (Abahussain et al. 1997) The methods of self-medication are several and include purchase of drugs without a doctor’s prescription.2. consuming in-stock medicines at home or workplace and exchanging. family members and colleagues (Filho et al.2 Self-Medication: Spread and Frequency The impulsive use of medicines based upon self-conceived notions and through influencing references has been a matter of all-round concern (Filho et al. Self-medication has been recognized at the highest level as well and the World Health Organization has pronounced the act as one where a person. 1998). by purchasing and consuming medicines without consulting an authorized doctor is called self-medication (Montastruc et al..

1%). it was discovered that up to 76% students have engaged in the act of self-medication (Zafar et al. 2006). most notable among which were the past experience of respondents with similar health indications (50. anti-allergics (44. it is assumed that non-medical students do not engage in the practice of selfmedication in comparison with medical students due to the possession of limited knowledge of medicines but the research findings proved otherwise.4%) or acquired from class mates and friends (9. Traditionally. 2007). It had also been reported in the study that more than one-third (43.3%). The study disclosed a number of reasons based upon which students self-medicate.. 2007). In contrast. fever relieving medicines (65. 2.5%).4 Self-Medication: Consumer Behavior Self-medication is practiced by students in all academic disciplines and its commonness is more or less equal among medical and non-medical students (Zafar et al.3 Self-Medication: Reasons and Ailments Treated In a research that had been undertaken among Karachi-based university students. Accordingly.2%).1%) and the perception itself of the petty nature of the problem (48. 15 . Ailments for which the students practiced self-medication included headaches (72. the respondents consumed medicines for relief and which fell into the category of painkillers (88.4%). another research shows an exceptionally higher rate of self-medication among medical students and professionals (James et al.3%).1%) and antibiotics (35..7%).3%) students who had approached a physician had later modified the dosage of the prescribed medicine on their own accord. These drugs had been mostly purchased from pharmacies (64.6%) or/and consumed from available medicines stored at home (64.2. fever (55.2%) and common cold (65.

2010. 16 ..2%) with a monthly income of less than Rs. Another study presented interesting facts which proved the common knowledge that illiterate people abide by basic rules more than literate people. 10. 2012). The households in urban and rural areas together constitute 64. 2.. The research also showed that respondents (76. 1995) Such consumer attitudes are developed through perception that is reinforced by gaining good experience through repeated acts of selfmedication but it is negative in outlook and identifies that people. 2006). Results from a research puts skilled labor over unskilled labor (by 21%) when it comes to practicing self-medication (Baig.6%) earning a monthly income of above Rs. Henry et al.5 Self-Medication: Effect of Population Spread. rules that govern specific situations in life.3%) with drugs had been the primary reason for selfmedication (Haider & Thaver.A study that had been carried out on women and specifically mothers in Pakistan brought to light that positive past experience (61. Income and Literacy Self-medication in Pakistan is practiced more in the urban as compared to rural areas and that its prevalence ratio goes up with the gradual increase in literacy levels (Baig.2% in terms of presence of contemporary medicines at home with urban household leading within the percentage (Hussain et al. The results of the study revealed that literate people have a greater tendency to selfmedicate in comparison with illiterates (Klemenc-Ketis et al. despite being educated remain ignorant of possible problems that may arise through self-medication.000 self-medicated more than those (57. 2012).000 per month. 2011).. 10.

the specific consumer behavior of borrowing and sharing of medicines prescribed by physicians is recognized as a risk factor by the health and medical field stakeholders exclusively in medication errors which subsequently result in adverse drug events (Runciman et al. that despite majority of the students (89%) understood the reason of consulting a doctor before consuming antibiotics. This specific patient behavior negatively affects the quality use of medicine (Bolton et al. 45% nonetheless continued the practice of self-medication (Buke et al. 2002) and that there is a risk of underestimating the impact of this behavior on the incidence of adverse drug events which include drug-drug interactions. 2006)... Within the research it had been noted that 87. According to the Australian Council for Safety and Quality in Health Care. it was discovered that the frequency of self-medication had been as high as 76 percent (Zafar et al.4% of the respondents were aware of the risks to health through self-medication..6 Self-Medication: Perception of Risk A research study discovered that in Pakistan.. 2009). In another study conducted at two medical and two non-medical universities. a very low proportion of university students consult a physician for ailments and that the reason for not consulting a doctor includes a number of factors besides the issue of cost of treatment. 2003)..2. The respondents had accepted the fact that selfmedication is harmful and this shows the aspect of absence of knowledge. 2008). 2005). The study shows that the risk and hazard perception of the students towards self-medication is considered as inconsequential (Mumtaz et al. 17 . A similar result had also come to light in a research carried out in Turkey where it was found out. poisoning and the development of antibiotic resistant strains of pathogens (Ellis.

In a study conducted in United States of America. The scrutiny of differences in culture is carried out by a number of different models and from which the most-well renowned is Hofstede’s National Cultural Dimensions. 1984).2. 2012). There is a definite influence of cultural dimensions on the behavior of a person at the time of an illness and upon the subsequent consumption of drugs (Deschepper et al. 2008). it was found that African-Americans consume medicines for symptoms like headaches. Hofstede defines culture as “the collective programming of the mind that distinguishes the members of one human group from another” (Hofstede & Bond.. 1984). The awareness of health and its management in contemporary times by ordinary people is a result of the difference between culture and language. 2002). the factors which encourage a person to indulge in self-medication are still not clear and the risks arising from this practice continue to bring forth serious dangers to health (Baig. 2008). the following of people of each other will increase the possibilities of perceiving the social environment and sharing of a subjective culture all from the same or a similar window (Hofstede & Bond.. Based upon moderating variables such as education. 18 . nosebleeds and hallucinations by taking decisions based upon culturally-informed experiences (Schoenberg and Drew. and the socioeconomic ranks together with the capacity of a person to comprehend and act on a doctor’s advice which depends upon cultural beliefs on the broad subject of health (Shaw et al.7 The National Cultural Dimensions of Hofstede Despite being common in all segments of society.

2. the people in Pakistan possess an emotional need for rules even if these rules do not seem to work (geert-hofstede. have an emotional need for rules. 1997). on the uncertainty avoidance index. “It means that Pakistanis adhere to specific codes of belief. unknown. political instability and increasing stagflation in Pakistan. Pakistan is categorized as high in uncertainty avoidance or where people have a high preference for avoiding uncertainty. 2011). ambiguous or unstructured situations. it is interesting to note that the findings on uncertainty avoidance index are amidst terrorist attacks. observe punctuality as a norm and individual motivation is driven by security” (geert-hofstede. From the study. In other words. 19 . uncertain or unstructured situations. the results showed that the Pakistani society by and large does not feel threatened by uncertainty. According to Hofstede.com). With a score of 70. 2011). give importance to time. ambiguous. the people of Pakistan feel threatened by unknown. However.com).. have an urge to work hard. On the other hand. all kinds of drugs are available at a chemist without prescription.com). This fact proves Hofstede’s point but the medicines at these pharmacies are being sold because there are customers who will purchase them. and calls for more research into this phenomenon (Shah & Amjad. It is a two-way intentional violation of the governing rule for a pharmacy to function (Strum et al. rules and regulations exist in Pakistan to govern the functioning of a pharmacy but in Karachi alone. in a study on the cultural diversity in Pakistan (Shah & Amjad.8 Pakistan: The Cultural Dimension of Uncertainty Avoidance Hofstede has labeled the people of Pakistan as risk averse in the cultural dimension of uncertainty avoidance (geert-hofstede. resist innovation at times. are intolerant of unorthodox behavior and ideas.

the purpose of this study is to learn how consumers develop perceptions and form an attitude towards the act of self-medication and whether consumers take this risk willingly or unknowingly. Therefore. 20 . their level of awareness and the factors which trigger the specific act of selfmedication. This study also undertakes to discover the behavior of consumers in Pakistan. (Graves. 1999). culture is not necessarily bounded by national borders therefore entire nations cannot be the valid unit of analysis (McSweeney..2.9 Hofstede: Criticism Hofstede’s cultural dimensions have been criticized as not being a valid instrument to determine cultural differences because of the almost thirty years that have lapsed since 1984 and the study is far too obsolete and could not be implemented in contemporary times of fast evolving environment. Hofstede’s research had been conducted on the data collected from one company in different countries and a the findings of one company in each country could not be implemented on the entire nation to determine cultural dimensions. convergence and globalization (Shariq et al. The argument includes Hofstede’s variables varying in sensitivity from one culture to another (Schwartz. A number of researchers have put forth compelling argument against Hofstede. 1988). 2000). Olie. 1986. which skewed the results (Dorfman & Howell. the original study by Hofstede had been based on an assessment of individuals and then applied in large on the overall community. 2011). 1995).

write and record the feedback received from a specific group of people who are selected as per pre-defined criteria. The focus group participants are managed by a moderator who asks questions and probes deeper to obtain a true understanding of the replies provided by the participants (Prince and Davies. conduct. households and corporate professionals. Quantitative and qualitative research methodologies have been implemented in order to explain the contradiction in actual consumer behavior towards the risk-bearing act of selfmedication and the risk-averse label suggested on the people of Pakistan in light of the cultural dimension of uncertainty avoidance as formulated by Hofstede.1.1 Qualitative Research 3..1.3. a focus group had been conducted to obtain a better understanding of opinions and attitudes of consumer behavior towards the act of self-medication in light of the underlying cultural dimension variable. The research design for the study will subsequently assist in bringing forth an analysis that will allow suggesting logical recommendations. 2001). A focus group is used as a tool to manage. For the undertaken research. The discussion guide for the focus group consisted of unstructured questions according to the information needed to extract responses through a conversation.1.1 Research Design The development of the study is based on applied research with an approach encompassing cross-sectional and snap-shot research parameters. RESEARCH METHODOLOGY 3. 21 . 3. students.1 Focus Group The focus group analysis had been designed and implemented in order to assess the perception and attitude of the three identified respondent clusters viz.

The sample size for the focus group constituted of seven individuals and which represented educated and different socio-economic classes specifically hailing from the clusters of corporate sector, household and students. The overall age group was between 20-35 years with average house hold income of Rs. 100,000 per month. The major findings which came forth elucidated that the participants have practiced selfmedication due to five main reasons viz., (a.) time constraints (b.) avoiding the queue time at a clinic/hospital (c.) non-accessibility to a qualified physician (d.) negligence of doctors in terms of imparting service as per general perception (d.) non-availability of quality doctors at the time when treatment of an ailment had been required. According to participants’ perspective, self-medication is a risk towards health by which various negative consequences can occur and which often leads to serious complications in the form of side effects and even causing death. The participants opined that factors exist which can motivate an individual to take a calculated or blind risk in terms of self-medication and in life in general. These factors interplay with an individual’s personality based upon aspects of recognition in society, a powerful external locus of control and group influence. The participants also disclosed that they will avoid an uncertain situation as and where logically possible. The focus group findings disclosed that homogeneity in approach existed among the three respondent clusters towards the act of self-medication. Accordingly, the outcome of the focus group determined the constructs for the quantitative survey.

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3.1.2 Quantitative Research 3.1.2.1 Desk Research

Research in Pakistan has been undertaken in the past on self-medication but not in light of the cultural dimension of uncertainty avoidance. With regard to the act of self-medication, consumer behavior including consumer knowledge, perception and attitude has either not been measured in depth or has been missed out altogether. A thorough study of different literature has been conducted to develop an understanding of the consumer behavior in this study and to ascertain if the Pakistani people are genuinely risk averse as declared by Hofstede. Secondary data has been collected from different data bases of trustworthy and genuine research journals of medicine, consumer behavior, psychology and sociology.

3.1.2.2 Survey and Questionnaire Design

In terms of applied research, a self-monitored questionnaire based survey has been deployed in light of a cross-sectional study in Karachi. The survey has been designed to measure the consumer perception and attitude in terms of behavioral intention, uncertainty avoidance, perceived risk and risk aversive behavior towards self-medication. The questionnaire has been designed to provide simplicity, understandability and comprehensiveness for the respondent and for the ease in post survey proceedings. The structure of the statements in the survey had been supported by the likert scale had been developed to determine the strength of opinion of the respondents. The scale had been balanced in terms of favorable and unfavorable responses and was non-comparative in nature.

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According to the conceptual model of the undertaken research, uncertainty avoidance serves as the independent variable and the consumer attitude and behavior as the dependent variables. The underlying operational elements of medicine cost, waiting time for treatment, consumer’s awareness, external legal environment, consumer’s locus of control and physician’s service quality shaped up the questionnaire statements and which also included constructs to ascertain the influence of reference groups on consumer behavior. In the questionnaire, specific constructs also carried the rank-order scale to measure ailments most commonly treated through self-medication the situations which encourage a consumer to opt for self-medication. The profile of the respondent had also been developed based upon scales requesting for data pertaining to gender, age group, education, employment status and household income.

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The principle criterion for selecting the sample was based on probability of stratified random sampling. 3.1 Sampling Frame The focus group findings brought to light that there is no significant difference in opinion among the three clusters of corporate. the sample of respondents had been chosen from the corporate sector and university students.2 Sampling Size and Selection The sample size constituted of 200 educated respondents residing in different localities of Karachi.2. Therefore. 25 . For the respondents. household and student representatives. 2000).2. the city of Karachi had been selected because of its universal influence on other cities of Pakistan and thereby it would depict an appropriate representation of the major urban areas. the contact persons had been advised to pre-qualify the respondents on behalf of the authors vis-à-vis willingness of the respondents to participate neutrally in the survey and by considering the ability of a respondent to comprehend the importance of the research survey and articulate the replies accordingly.3. The respondents had been selected on a chance-basis from the population of those available at the point of contact at the time of approach. marital status and gender. corporate position.2 Sampling Procedure and Design 3. At the private firms and university. This is type of sampling technique is where every individual has an equal and known chance of being selected (Sekaran. Homogeneity within these clusters may exist but the respondent background within the clusters will lead to heterogeneity due to diversity in income and age groups.

AKUH. Habib Metro. Multinet and Ibrahim Fibers. HBL.The respondents from the students’ cluster had been approached in the BBA and MBA programs of Shaheed Zulfiqar Ali Bhutto Institute of Science and Technology whereas the working professionals (as respondents) had been approached in a number of private companies which included MCB. 26 . Habib Public School. Bayer.

Research quality had been assured by maintaining a Chinese wall (wikipedia.3. It took 16 days from first contact till the receipt of completed survey forms.3 Field Work for the Survey The authors of the study had approached the private firms in two teams by contacting the resource individuals and obtaining necessary permission.org) during all communication to ensure that the element of bias is kept at the lowest possible level. 27 .

H0: The behavioral intention is significantly correlated to risk aversive behavior H1: The behavioral intention is not significantly correlated to risk aversive behavior d. H0: The behavioral intention is significantly correlated to uncertainty avoidance H1: The behavioral intention is not significantly correlated to uncertainty avoidance b. the people may be high or low on the uncertainty avoidance index which reflects on the specific (positive or negative) attitudes that are developed and which will eventually initiate or avoid the consumer behavior towards self-medication. H0: The perceived risk is significantly correlated to risk aversive behavior H1: The perceived risk is not significantly correlated to risk aversive behavior 28 . H0: The uncertainty avoidance is significantly correlated to perceived risk H1: The uncertainty avoidance is not significantly correlated to perceived risk e. H0: The uncertainty avoidance is significantly correlated to risk aversive behavior H1: Uncertainty avoidance is not significantly correlated to risk aversive behavior f. H0: The behavioral intention is significantly correlated to perceived risk H1: The behavioral intention is not significantly correlated to perceived risk c. As a result. Risk is perceived by self-medicating people in individual capacities and which leads the people to be either risk-averse or risk-takers.3. The following hypotheses were generated: a.4 Research Hypothesis The study puts forth specific hypothesis for empirical testing in light of the research objectives and with the help of secondary data and insights from focus group.

DATA ANALYSIS The data collected from field survey of the study had been analyzed by means of four specific tests through SPSS 17 and PASW Statistics 18 software. The four constructs of the research study presented acceptable reliability figures of 0.1 Reliability Analysis The internal consistency of a test is expressed between 0 and 1 (Cronbach. instrument validity. 1951). As the credibility estimate increases. The tests included the reliability analysis. 29 . The internal consistency measures the statements under each of the variables with respect to reliability i. 2011). 1994). if the constructs are reliable enough to measure what is intended to be measured. The Cronbach is a measurement of the credibility of a result and locates and assigns errors at specific respondent instead of on the researcher (Tavakol and Dennick. the fraction of the test score which may be derived from a mistake should decrease (Nunnally and Bernstein. Subsequently. 4.4. factor analysis and correlation matrix. the hypothesis put forth will be concluded.5 and greater Cronbach’s alpha and depicted in the tables on the following page.e.

813 Cronbach's Alpha Based on Standardized Items .775 Cronbach's Alpha Based on Standardized Items .Behavioral Intention Cronbach's Alpha .646 N of Items 5 Perceived Risk Cronbach's Alpha .643 Cronbach's Alpha Based on Standardized Items .775 N of Items 12 Uncertainty Avoidance Cronbach's Alpha .818 N of Items 5 Risk Aversive Behavior Cronbach's Alpha .825 N of Items 7 30 .824 Cronbach's Alpha Based on Standardized Items .

These constructs cumulatively accentuate the different research studies undertaken in Pakistan and internationally on self-medication.2 Instrument Validity The instrument for conducting research has to be checked for validity before implementation. perceived risk and risk aversive behavior. risk aversive behavior. cultural dimension of uncertainty avoidance. the authors customized the original questionnaire to accommodate the four constructs of behavioral intention. For the specific requirement of the research. 31 .org). Face validity had also been acquired from course advisor to the extent that the said constructs and scales will amicably fulfill the purpose of measuring the needful. The questionnaire deployed for the research had been replicated from that administered on self-medication with antibiotics from an international study (plosone. and consumer behavior. uncertainty avoidance.4.

5 100.5 100.0 Marital Status Frequency Valid Single Married Total 135 65 200 Percent 67.5 32.5 100. (a) gender (b) marital status (c) age group (d) education (e) employment status (f) household income. Six basic demographic dimensions had been used in the survey instrument.0 Valid Percent 66.4.0 Valid Percent 67.3.5 100.0 99.5 100.0 Cumulative Percent 67. 4.0 Cumulative Percent 66. viz.1 Frequency Tables Gender Frequency Valid Male Female 3 Total 132 67 1 200 Percent 66.0 33.5 100.0 33.5 .5 .0 32 .3 Demographics The survey questionnaire constituted of items related to identify the basic demographic structure of the respondents.5 32.

Age Group Frequency Valid 18-20 21-26 27-32 33-38 39-34 45-50 50-55 Total 25 93 48 21 9 3 1 200 Percent 12.0 Cumulative Percent 12.5 .0 10.0 10.5 43.0 Valid Percent 18.0 100.5 62.5 59.0 Valid Percent 12.0 100.5 4.0 Cumulative Percent 18.5 98.5 4.5 1.5 24.5 43.5 1.5 100.5 100.5 46.0 83.5 .0 33 .5 46.0 99.0 93.5 38.5 100.5 24.0 Education Frequency Valid undergraduate Graduate Post Graduate Total 37 87 76 200 Percent 18.0 100.5 38.

Employment Status Frequency Valid employed self employed unemployed 5 Total 96 18 85 1 200 Percent 48.0 Cumulative Percent 2.5 23.0 9.0 30.5 100.0 Valid Percent 2.0 49.0 100.0 57.5 .0 99.0 6.0 Cumulative Percent 48.0 100.0 42. 50k-74k 75k-99k 100k-124k 125k-149k 150k+ Total 5 47 46 60 12 30 200 Percent 2.5 100.0 Valid Percent 48.0 34 .0 85.0 30.5 26.0 100.5 100.5 23.0 15.0 9.5 23.0 42.0 6.5 .0 79.5 23.0 Household Income Frequency Valid 0 Rs.0 15.

4.2 Bar Charts 35 .3.

36 .

37 .

The unemployment percentage was 42.3. diverse readings came to light.000 and Rs.5%. 38% postgraduates and 18.5% and 12. 38 . Rs.000. 75. On the household income front. followed by 27-32 years group at 24%. 23% and 30% respectively.000 per month household income groups were represented by 23. 50.5% respondents were graduates. Most notable was the 15% representation from the Rs.e. 150.5% hailed from the age group of 21-26 years.5% were married and 32. Nearly half the respondents were employed at 48%.000124. Rs.5% and the reason for this high ratio was the fact that close to a hundred respondents had been students in their final semester.4.3 Findings The demographic results of the study presented 66% male and 33% female respondents and out of the total sample size 67. Majority of the respondents i. With regard to education.000 plus income bracket.000-74. 100.5% undergraduates. 43. Age groups of 33-38 and up to 20 years old represented 10.5% respectively. 46.5% single.000-99.

4. the situations under which they are motivated to selfmedicated and the ailments for which they engage into this practice.4 Behavioral Analysis The research had also incorporated two specific items to identify the behavior of respondents in terms of self-medication i. The lack of trust on the competency and quality of a doctor constituted 10% whereas the most significant reason stood out as the easy of availability of medicines at a chemist without having to show a doctor’s prescription at 29%. Another 21% self-medicate to avoid the waiting time at a doctor’s clinic or a health-care facility. The empirical findings brought to light that 19% of the respondents practice self-medication in order to save the fee of a doctor.e. A notable 21% of the respondents engage into self-medication because going over to the doctor is considered as a hassle. Legend: B1: Save doctor’s fee B3: Lack of trust on doctor B5: Hassle going to the doctor B2: Avoid waiting at the doctor’s clinic B4: Ease of availability of medicines 39 .

nasal congestion (10%) and ordinary fever (9%). the practice of self-medication is considerably low. nausea and diarrhea had represented less than 10% each. cough and sore throat (11% each). the percentages were low which show the behavioral trend that consumers will prefer to visit a doctor. The most common ailments for which consumers self-medicate include cold (18%). headaches (13%). depression. Lack of sleep.The other questions asked from respondents regarding the ailments for which they usually self-medicate presented the fact that for perceived to-be minor ailments. For serious ailments. 40 . self-medication practice is high among consumers whereas for ailments which are perceived to be serious or complex in nature.

perceived risk and risk aversive behavior. In factor analysis.5 then it is not appropriate (Dr. The final solution had been constructed and based upon the criteria that each factor must possess a minimum of three item loadings greater than 0. This has been done due to the reason that perceptions cannot be accurate. factor analysis had been conducted separately. The following tables present the communalities derived from factor analysis. A KMO close to 1.4. uncertainty avoidance. 41 .3 and that any item loading on more than one factor subject to acquiring the final solution. For all the four constructs i.5 Confirmatory Factor Analysis Reducing from a large to an achievable choice of factors is factor analysis (Zikmund. KMO identifies the specific item which has to be discarded in factor loading.3 as the baseline against each variable of the construct has been considered.0 indicates a factor analysis and if it is less than 0. Komata). perceived risk and risk aversive behavior.5 on the other hand would have been considered if the findings had been healthier. will be placed only in the factor on which it loads most highly. behavioral intention. all variables are grouped together in order to display the capability of individual items to depict a specific construct. 2002). uncertainty avoidance. Since the data is based upon perceptions therefore for the constructs of behavioral intention. the score of 0.e. A score of 0. The Kaisr-Meyer-Olkin (KMO) measures the adequacy of the sample and presents an index (between 0 and 1) of the proportion of variants among the variables that might be common variant.

624 . 42 .515 Findings: For the construct of behavioral intention.000 1. if a doctor's prescription doesn't make me feel better I switch to any economical medicine brand if the one prescribed by the doctor is expensive If I run-out of medicine prescribed by the doctor.Behavioral Intention Initial If I am cured by a medicine through self-medication then I will not visit a doctor I take advice for self-medication from the chemist Based upon my past experience with medicines.400 .578 1.550 .000 1. The KMO had been determined at 0.676 .000 . I self-medicate on my own I use medicines based upon the references provided by my family and friends I favorably recommend medicines to family and friends which made me better I switch to another medicine on my own.605 .000 1.562 .000 .000 1.592 1. twelve items had been loaded and all were accepted.695 .000 1.606 1.000 1.782 whereas the approximate chi-square came out to be 658. I switch to another alternative medicine available at home I switch to any other alternative medicine if side-effects are experienced from the doctor’s prescribed medicine I discontinue using a medicine without consulting the doctor I discontinue using a medicine on my own after the symptoms disappear I discontinue using a medicine after it runs out 1.653 .000 1.000 1.054.000 .000 Extraction .

553 . 43 .000 Extraction .678 and with a chi-square of 140.000 1.603 .000 Extraction . Perceived Risk Initial I always read the medicine pack/label even if the medicine has been prescribed by the doctor I always read the medicine information sheet (inside the pack) even if the medicine has been prescribed by the doctor I always follow the doctor's instructions while taking medicine I always discontinue using medicine after consulting the doctor Rules and regulations should be strictly implemented so that chemists sell medicines only through a doctor's prescription 1.735 . KMO was derived at 0.000 1.Uncertainty Avoidance Initial Through self-medication.603 .653 1.700 1. The KMO came out to be 0. the risk that I take is high There may be side-effects from the medicines I use through self-medication I may suffer harmful side-effects if I take an over/under dose of a medicine I may suffer from severe allergic reactions from the medicine I use through self-medication People practice self-medication because medicines are freely available (without prescription) 1.000 1.999.000 1.576 .000 .803 approximately.000 1.000 .378 Findings: Five items were loaded for the construct of uncertainty avoidance and all had been accepted.000 1.800 and the approximate chi-square was 344.598 .689 Findings: The perceived risk construct was loaded for a total number of five items and all of them had been accepted.

492 .000 1.Risk Aversive Behavior Initial I ensure that I always take medicines that are prescribed by the doctor When I take a medicine.395 Findings: The construct of risk aversive behavior had a total of seven items that had been loaded and all were accepted.608 . I ensure that no health risks are involved I don’t want to be unsure about the medicines I take I would be rather safe than sorry I only change medicine if my doctor tells me to do so I always take the exact dosage of medicine as prescribed by the doctor I always check the expiry date on medicine before consuming them 1.000 1.000 1.823 and with an approximate chi-square of 439.000 Extraction .582 .388 .000 1. Accordingly.382. 44 .500 .466 . the KMO came out to be 0.000 1.000 1.

no correlation) and 1.213 ** .6 Pearson’s Correlation Matrix The correlation matrix of Pearson has been used to identify the correlation between no less than continuous factors.000 200 -.002 200 .e.87962 .418 ** . 45 . In most cases.8 are thought to be high. Descriptive Statistics Mean Behavioral Intention Uncertainty Avoidance Perceived Risk Risk Aversive Behavior 2.8858 3.000 200 200 **. however. (2-tailed) N 200 -.01 level (2-tailed).00 (i.3890 3. (2-tailed) N Perceived Risk Pearson Correlation Sig.65836 .4. correlations about 0.001 200 -.79652 .000 200 . absolute best correlation). (2-tailed) N Uncertainty Avoidance Pearson Correlation Sig.4270 3.00 (i.282 ** . The worth of the correlation may fall between 0. The different components corresponding to team size should resolve whether or not the correlation is important.443 ** 1 .e. Correlation is significant at the 0.000 200 . (2-tailed) N Risk Aversive Behavior Pearson Correlation Sig. Deviation .269 ** 1 200 .73327 N 200 200 200 200 Correlations Risk Behavioral Intention Behavioral Intention Pearson Correlation Sig.233 ** Uncertainty Avoidance Perceived Risk Aversive Behavior 1 1 200 .7136 Std.

b. It is believed that the consumer behavior towards selfmedication is triggered with the uncertainty avoidance index. How a consumer perceives risk and whether it leads to a risk-taking or riskaversive behavior towards self-medication are linked together.7 Hypothesis Testing In light of Pearson’s Correlation Matrix. Risk perception of a consumer could be either experiential or influenced by a group reference thereby increasing or decreasing the confidence and motivation to engage or refrain from selfmedication. As a situational need of a person comes to light it may diminish the high uncertainty avoidance index and the consumer will likely to be engaged in self-medication.4.233). 46 . The two variables are correlated significantly and negative in its empirical outcome (-0. a. The consumer with a high uncertainty avoidance index will act in a safe manner and not take the risk to engage into self-medication and had the uncertainty avoidance been low then the consumer’s behavior would have been more towards a risk-taking attitude. H0: The behavioral intention is significantly correlated to uncertainty avoidance H1: The behavioral intention is not significantly correlated to uncertainty avoidance Null hypothesis is accepted and believed that the two variables have some association in the population. the hypothesis could now be concluded. It is believed that the consumer will act depending upon how risk is perceived. H0: The behavioral intention is significantly correlated to perceived risk H1: The behavioral intention is not significantly correlated to perceived risk Null hypothesis is accepted and believed that the two variables have some association in the population.269). The two variables are correlated significantly and correlate together due to the negative finding (-0.

the uncertainty avoidance index of consumers will also remain high and vice versa that is if the consumer perceives that there is no risk in the act of selfmedication then a low uncertainty avoidance index will be observed. 47 . d. The two variables are correlated significantly but are negative in nature (0.282) and therefore the perception of risk will vary on the risk-aversive and risk-taking continuum.c. It is believed that the intent of a consumer to behave towards self-medication is directly linked with the risk aversive behavior.213). H0: The behavioral intention is significantly correlated to risk aversive behavior H1: The behavioral intention is not significantly correlated to risk aversive behavior Null hypothesis is accepted and believed that the two variables have some association in the population. It is believed that with high perception of risk. This correlation acts inversely due to its positivity (0. The two variables are correlated significantly. H0: The uncertainty avoidance is significantly correlated to perceived risk H1: The uncertainty avoidance is not significantly correlated to perceived risk Null hypothesis is accepted and believed that the two variables have some association in the population. This situation may also be influenced upon a person. A consumer will refrain from taking risk if the perception has been developed to avoid risk unless a specific situation arises which demands a person to practice self-medication.

48 . H0: The uncertainty avoidance is significantly correlated to risk aversive behavior H1: Uncertainty avoidance is not significantly correlated to risk aversive behavior Null hypothesis is accepted and believed that the two variables have some association in the population. It is believed that consumers in accordance with their perception of risk behave in a risk aversive manner when it comes to selfmedication.443) and therefore as uncertainty goes up or down.418) in nature they move inversely. the higher will be the risk-aversive behavior and vice-versa. H0: The perceived risk is significantly correlated to risk aversive behavior H1: The perceived risk is not significantly correlated to risk aversive behavior Null hypothesis is accepted and believed that the two variables have some association in the population. Therefore the higher the perception of risk. The two variables are correlated significantly but due to positive (0. If the consumers perceive that there exists a risk then they will avoid the act of self-medication. The two variables are correlated significantly but the finding is positive in nature (0. It is believed that consumers at the time of being risk aversive towards self-medication display a high uncertainty avoidance index.e. f. the risk-aversive behavior increases or decreases accordingly.

uncertainty avoidance. the people refrain from self-medicating because they are aware of the risks attached. Cost of medicines. competency of doctors and long waiting queues all play a role independently and together in motivating a person to self-medicate. at the same time they also engage into the practice of selfmedication due to (1) they lack complete knowledge about adverse drug reactions and (2) they justify their act by citing reasons which in their specific state of affairs holds true.1 Conclusion The basic purpose of this research study was to gauge the perception and attitude of consumers towards self-medication in light of the cultural dimension of uncertainty avoidance. who are employed and earning respectable income engage into this act (Klemenc-Ketis et al. In a nutshell. 2010. On one hand. CONCLUSION AND RECOMMENDATIONS 5. The locus of control is also directly linked with the religious beliefs of a person. perceived risk and risk aversive behavior. with regard to self-medication. But the study could not acquire a respondent base from a lower socio-economic class which could further justify that people from this group either do not self-medicate or do it nominally because of their strong affinity towards rules and regulations (Klemenc-Ketis et al. 2011).. This contradiction brings to light the elements of locus of control which according to research studies in case of Pakistanis is external (Shah & Amjad.. The demographic findings from the research bring to light the fact that educated people earning average and above average income though are risk-averse but are inclined towards self-medication as per situations which they face in their lives and that have been identified above. Henry et al. 2006).. the people operate their behavior with a two-prong strategy. 2010. This fact establishes the rationale that people with education. Regardless of the fact that the act of self-medication is considered as a risk-taking behavior. 49 . Henry et al.5. (Shah & Amjad. as evident from the focus group finding and acceptance of all null hypotheses. 2006). the assertion put forth by Hofstede that Pakistanis are risk-averse people due to a high index of uncertainty avoidance index is true. 2011) This aspect however demands a separate study.. In addition to this an investigation was made to discover the relationship between the four survey constructs of behavioral intent.

The universal fact remain that consumers develop a perception and then form an attitude leading either towards the act of self-medication or refraining from it. The establishment of risk perception comes into action from operational variables which surround a consumer e. Subsequently. That the government regulations have not been implemented is one aspect but the consumers themselves have totally disregarded the rule. unawareness of the danger involved. where Pakistan’s uncertainty avoidance index states that people have an affinity towards rules and regulations then these same people at their own free accord purchase all types of medicines from a pharmacy. in case of minor ailments such as sore throat and cough) is witnessed. situation-based and experience-based risk-taking behavior is displayed. The risk consumers take towards self-medication is both willing and unknowingly. the consumers do not perceive the act of self-medication itself to be one that involves risk. therefore attitude formation takes place and selective risk-aversive behavior (e. in case of serious ailments such as diarrhea and sleeping disorder) and risktaking behavior (e.g. 50 . both of which encourages them to consider the self-medication issue as too petty. Additionally.From the literature that had been reviewed and the empirical findings it also came to light that the consumers are aware of the risks attached with self-medication but they still pursue the practice basically because of a positive past experience and the influence of credible reference groups. etc. It’s a matter of how the risk is perceived to be. cost of medicine. At the same time.g. competency of physicians. Socio-economic factors play a role and so specific situations upon which a person may not have any control. The risk-taking attribute of the society may have changed over the years if a general observatory glance is given over the people but just as in selective ethics which a person may practice. the empirical findings of the research also concluded and accepted the null hypotheses that had been derived initially. lack of regulations. in a similar way.g.

Things can be done to reduce self-medication in any country and it can also be done in third world countries like Pakistan. consumer perception and attitude has to be checked not only for different product and service categories. Another solution could be the reduction in price of medicines and to revisit the overall health care cost in Pakistan. which can identify risktaking consumer behavior but also on the platform of social sciences and coupling it with all the cultural dimensions of Hofstede and not only uncertainty avoidance. is the number one thing which pharmaceutical companies.2 Recommendations The primary understanding is that self-medication is not in benefit of a consumer unless it is an over-the-counter medicine like paracetamol which can be sold and purchased without the prescription of a physician. in light of the logical criticism of Hofstede.5. will the actual uncertainty avoidance index by identified. Finally. the ministry of health and other stake holders need to plan and initiate. Stringent implementation of pharmacy regulations is also long overdue. after comparing multiple dimensions which a person is exposed to and experiences in life in general. 51 . Educate. Only then.

52 .AREAS OF FURTHER STUDY At this time on an academic level. all cultural dimensions put forth by Hofstede have to be measured parallel and not only uncertainty avoidance because these dimensions possess an interplay and based upon which consumers behave towards different objective and subjective elements. Additionally. the authors have attempted to define the effects of perception and attitude on consumer behavior towards self-medication. both of which are strongly and deeply rooted in the Pakistani society and serve as a bench mark towards countless deeds and acts by the people from all walks of life. The unanswered question of ‘why they do it’ could be comprehended in totality if the dimensions of locus of control and religion are taken into account.

(2009). Birkin J. 11.BIBLIOGRAPHY 1. Filho L. Baig S. Haaijer-RuskampFM . Frances Printer. and J. 1997. Mullan. Abahussain E. Scicluna EA. Graves. Self-medication-a growing concern. Deschepper R. W. Pak. Indian J Med Sci. SAR consortium (2007) Attitudes. Self-reported medication use among adolescents in Kuwait. 3. 4. Bambui Project: a qualitative approach to self-medication. P. Thaver IH (1995). National Cultural Dimensions. 51: 93-6. 2009.Diagnosis and Change: Auditing and changing the culture of organizations. P. J. Australian Family Physician. Coefficient alpha and the internal structure of tests. Lundborg CS. 1951. Nicholls PJ. Lima-Costa MF. 14: 161-4. Howell (1988). 6. Available at: http://www. J. 8." Advances in International Comparative Management 3: 127-150.com/countries. J. Antonio I. J. Med PrincPract 2005. 53 .19(4): 513-521. 816-819. 9. 45 (11): 297-298. Professional Med J Aug 2012. 2013) 10. Deshpande SG. (1986). 38(10). Cad SaudePublica 2004. GEERT-HOSFTEDE. Cronbach.geerthofstede.. Corporate Culture . Matowe LK. Uchoa E. London. beliefs and knowledge concerning antibiotic use and self-medication: a comparative 5. 2. Ellis. Psychometrika 16:297–334. Med. Dorfman. Self medication practices.html (Accessed on January 2.20:1661-9. Haider S. Assoc. L. Monnet DL. "Dimensions of National Culture and Effective Leadership Patterns: Hofstede revisited. Tiwari R. D. Prescription medication borrowing and sharing: risk factors and management. Self medication or self care: implication for primary health care strategies. 7..

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27. M (2001) "Moderator teams: an extension to focus group methodology". 2:2:331-344 30. N. 2012) 55 . H. Articulating Silence: experiential certitude and biomedical controversies over hypertension symptomatology. J AntimicrobChemother1997. Schwartz. 16:1234-43. 28. Partha P. Runciman WB. Smits AJ et al.207 – 216 25. Amjad. "A Theory of Cultural Values and Some Implications for Work " Applied Psychology 48(1): 23-47. Tavakol.wikipedia. (1999). Available at: http://www. U. Dr.plosone. self-medication and patterns of resistance in Karachi. Sekaran. Available at: http://www. Mediterranean Center of social and Educational Research 2011. Roughead EE. Shankar PR.3:17-23. & Drew. Shenoy N.23.org/selfmedication (Accessed on December 19. et al. 31. S. Western Nepal: a questionary-based study.M. Prince. R. Qualitative Market Research: An International Journal.” International Journal of Medical Education. 4 Iss: 4. 26. 458-475. 39:543–547. 2:53-55 33. File S1: Questionnaire for selfmedication with antibiotics.org (Accessed on January 22. Medical Anthropology Quarterly. M. Pakistan. pp. 29. Self-Medication. Self-medication and non-doctor prescription practices in PokharaVaelley. 16(4). Int J Qual Health Care 2003.. Adverse drug events and medication errors in Australia. M. (2000). WIKIPEDIA. (2011) “Making sense of Cronbach’s alpha. 15 Suppl 1: i49-i59. BMC FamPract 2002. and Davies. Schoenberg. PEER REVIEWED OPEN ACCESS JOURNAL. E. Sturm AW. Pharmacoepidemiol and Drug Safety. Cultural Diversity in Pakistan: National vs Provincial. Research methods for business. and Dennick. M. 32. Semple SJ. European study. S. Vol. van der Pol R. Inc. (2002). Shah.E. 2013) 24. New York: John Wiley & Sons. Over-the-counter availability of antimicrobial agents.

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o) 57 . We would like to record the focus group so that we can make sure to capture the thoughts. We hope to learn about consumer behavior in Pakistan.000 Rs.000-74. 75. opinions. Gender: Age Group: Education: Employment Status: Household Income: Male 21-26 Female 27-32 Marital Status: 33-38 Graduate 39-44 Single Married 55+ 45-50 50-55 Intermediate Employed Masters Unemployed Rs. their level of awareness and the factors which trigger the specific act of self-medication. 125. Please check the boxes below to the best of your knowledge and to show that you agree to participate in this focus group. 150.o) ___ Children (13-17 y. and ideas we hear from the group.000-149. We are very interested to hear your valuable opinions.000 Rs. 100.000 + Family Members: ___ Adults ___ Children (up to 12 y. We will ask participants to respect each other’s confidentiality. You may refuse to answer any question or withdraw from the study at anytime.APPENDIX a.000 Self-Employed Rs. Focus Group Guide Thank you for agreeing to participate. The information you give us is completely confidential. 50. and we will not associate your name with anything you say in the focus group.000-124. The purpose of this study is to learn how consumers develop perceptions and form an attitude towards the act of self-medication and whether consumers take this risk willingly or unknowingly. No names will be attached to the focus group and the audio file will be destroyed as soon as they are transcribed.000 Rs.000-99.

Explain that focus groups are being used more and more often in consumer research. This allows us to develop the statements for the subsequent survey questionnaire. b) Not trying to achieve consensus. Ask the group if anyone has participated in a focus group before. we’re gathering information. and send the Consent Form around to the group. take notes or use the white board to express your thoughts.The focus group session will last for 60 minutes approximately and during which you should feel free to sit and walk. d) The reason for this focus group is that we can get more in-depth information from a smaller group of people. Introducing the focus group with a review on: a) Who we are and what we’re trying to do? b) What will be done with this information? c) Why we asked you to participate? Explanation of the process. c) No virtue in long lists: we’re looking for priorities. Beginning the Focus Group Session Welcome and introduce yourself and the note-taker. 58 . About focus groups a) We learn from you (positive and negative).

hobbies & family) Discussion begins. Use the probes to make sure that all issues are addressed. born where. working where and as. c) Stay with the group and please don’t have side conversations.Ground Rules a) Everyone should participate. g) Participant Introductions (name. CNG. d) Turn off cell phones. e) Turn on Audio Recording f) Ask the group if there are any questions before we get started. in your life? h) Why do people take risks? (helmet. smoking) 59 . overhead bridge. swimming. and address those questions. Focus Group Questions a) What are your thoughts about self-medication? (Your feelings and approach) Why and how? b) Which ailments do you think individual typically opt for self-medication? c) Which drugs are usually brought for self-medication purpose? d) Do you think it’s a risk or is it safe to self-medicate? e) Why do people prefer self-medication? (if people are in the habit to do so) f) Who’s opinion matters in using drugs? g) How do you perceive risks in general. but move on when you feel you are starting to hear repetitive information. b) Information provided in the focus group must be kept confidential. make sure to give people time to think before answering the questions and don’t move too quickly.

self-concept and confidence c) Belief in your self d) Belief in fate and destiny e) Experiential perception f) Family traditions g) Knowledge based decisions That concludes our focus group.Underlying variables: a) Situation faced before self-medication b) Ailment treated c) Decision to do so – past experience and/or under influence d) Medicines consumed e) Cost f) Time Probes for Discussion: a) Personal satisfaction b) Ego. Thank you for coming and sharing your thoughts and opinions with us. If you believe that you have missed a certain point or fact which you wanted to share then please note it down on the sheet provided so that it may assist in compilation of the research. 60 .

b. Survey Questionnaire 61 .

62 .

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