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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Acknowledgement The authors of the study express a sincere gratitude to Ms. Faryal Salman for providing guidance throughout the semester and especially on the continuous improvement of data collection and its compilation. 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. Special thanks are conveyed to Mr. 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. 4 .

5 . 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. 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. Additionally.g. 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 consumer may engage into self-medication based upon good past experience or group influence. Studies in Pakistan have been undertaken on self-medication but not in juxtaposition with any cultural dimension. cost of medicine being too high or unavailability of time to wait at a doctor’s clinic.

The authors in light of their everyday observation have seen countless people take a risk while undertaking a specific action. talking on the cell phone while driving. Regardless of the reasons. attempting to cheat in exams.1. in every walk of life. procrastinating at workplace despite being aware of work deadlines and visiting public places during times of public unrest and turmoil. reasons which encourage people to avoid consulting the physician. making an expensive lease-based investment but without a plan of how future payments will be made. 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. knowingly and unknowingly. 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. providing children at home with computer and internet facilities and then not keeping a check and control over their activities. swimming at the seaside without knowing how to swim. This is where perceptions of people come into interplay. 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.1 Background of the Study The people of Pakistan have been observed to take risks. Without contemplating on the reasons as to why people have developed such attitudes. violating traffic signals on the red light. INTRODUCTION 1. 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. 6 . These actions arise from an attitude that the people have created due to a wide range of reasons. consider the people who take risks while riding motorcycles without helmets.

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

1. 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. 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. 8 .3 Research Gap The research conducted in Pakistan almost thirty years ago (Hofstede & Bond. 1984).

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.1. At the same time. the study will also assist in the determination and analysis of reasons behind this act in contrast with the cultural dimension of uncertainty avoidance. 9 .

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.

.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. Figure 1.1. This means that people take a risk even after knowing the fact that it is a risk. 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. The theoretical framework 11 . 2008).

In order to conduct the research.1. 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.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. 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. These units are students and working individuals both in terms of profession. specific units have been considered and which constitute of male and female adults hailing from different income groups and belonging to different age segments.

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. 13 . 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. 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. 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. this dimension also has not been taken into consideration. Personalities also play a role and which motivates a person to develop an attitude and behave in a particular manner. 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.1. 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.

The developing countries have an even higher rate (Shankar et al.. during sickness will choose and consume a drug for self-treatment (WHO. 1997) The methods of self-medication are several and include purchase of drugs without a doctor’s prescription. using old prescriptions to acquire medicines. 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. 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. 1995). by purchasing and consuming medicines without consulting an authorized doctor is called self-medication (Montastruc et al. LITERATURE REVIEW 2. 2006)...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. 2012). 2005). however. 2004). family members and colleagues (Filho et al. 2002). 2004) Self-medication as an act is spread all over the world and has considerably high rates of occurrence. In Pakistan..2... 14 . 1997) whereas Nepal has a prevalence rate of 59% (Shankar et al.. 2. up to 68% in European countries (Bretagne et al. 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. up to 92% in Kuwait (Abahussain et al. consuming in-stock medicines at home or workplace and exchanging. sharing and recommending drugs with friends.1 Self-Medication: Definition The act treating an ailment either for diagnosis or prescription. 2002). 1998). India has 31% (Deshpande & Tiwari.

another research shows an exceptionally higher rate of self-medication among medical students and professionals (James et al. 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.6%) or/and consumed from available medicines stored at home (64. the respondents consumed medicines for relief and which fell into the category of painkillers (88.2%) and common cold (65. most notable among which were the past experience of respondents with similar health indications (50.1%).7%). anti-allergics (44. The study disclosed a number of reasons based upon which students self-medicate.. 2. Accordingly.4%) or acquired from class mates and friends (9. It had also been reported in the study that more than one-third (43.1%) and the perception itself of the petty nature of the problem (48..3 Self-Medication: Reasons and Ailments Treated In a research that had been undertaken among Karachi-based university students.5%).3%). In contrast.2%).2. Ailments for which the students practiced self-medication included headaches (72.3%) 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 (64.4%). 2006). 2007). 2007).3%). Traditionally. it was discovered that up to 76% students have engaged in the act of self-medication (Zafar et al. fever (55.1%) and antibiotics (35. 15 . fever relieving medicines (65.4 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.

despite being educated remain ignorant of possible problems that may arise through self-medication. 2011). The results of the study revealed that literate people have a greater tendency to selfmedicate in comparison with illiterates (Klemenc-Ketis et al.000 per month.A study that had been carried out on women and specifically mothers in Pakistan brought to light that positive past experience (61. 16 . 2012). Henry et al. 2006). Another study presented interesting facts which proved the common knowledge that illiterate people abide by basic rules more than literate people. rules that govern specific situations in life. 2010. 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 research also showed that respondents (76.6%) earning a monthly income of above Rs. 2.000 self-medicated more than those (57. The households in urban and rural areas together constitute 64.. 2012)..3%) with drugs had been the primary reason for selfmedication (Haider & Thaver.2%) with a monthly income of less than Rs. 10.5 Self-Medication: Effect of Population Spread. 10. Results from a research puts skilled labor over unskilled labor (by 21%) when it comes to practicing self-medication (Baig. 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.

The study shows that the risk and hazard perception of the students towards self-medication is considered as inconsequential (Mumtaz et al. 2009).. 17 . The respondents had accepted the fact that selfmedication is harmful and this shows the aspect of absence of knowledge.. poisoning and the development of antibiotic resistant strains of pathogens (Ellis. 2006). This specific patient behavior negatively affects the quality use of medicine (Bolton 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. 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.. it was discovered that the frequency of self-medication had been as high as 76 percent (Zafar et al.2. According to the Australian Council for Safety and Quality in Health Care. In another study conducted at two medical and two non-medical universities. 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. Within the research it had been noted that 87... 2008). A similar result had also come to light in a research carried out in Turkey where it was found out. that despite majority of the students (89%) understood the reason of consulting a doctor before consuming antibiotics. 45% nonetheless continued the practice of self-medication (Buke et al. 2003). 2005). 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.

The awareness of health and its management in contemporary times by ordinary people is a result of the difference between culture and language. 1984). 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. 1984). 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. 2012). it was found that African-Americans consume medicines for symptoms like headaches. 18 .. 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. In a study conducted in United States of America. 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.7 The National Cultural Dimensions of Hofstede Despite being common in all segments of society.2. 2008). Hofstede defines culture as “the collective programming of the mind that distinguishes the members of one human group from another” (Hofstede & Bond. Based upon moderating variables such as education.. 2008). 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. nosebleeds and hallucinations by taking decisions based upon culturally-informed experiences (Schoenberg and Drew.

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

Therefore. 1995). 20 . convergence and globalization (Shariq et al. 1999). This study also undertakes to discover the behavior of consumers in Pakistan. 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. 2011). A number of researchers have put forth compelling argument against Hofstede. 1988). 1986. Olie. 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.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. their level of awareness and the factors which trigger the specific act of selfmedication. culture is not necessarily bounded by national borders therefore entire nations cannot be the valid unit of analysis (McSweeney. the original study by Hofstede had been based on an assessment of individuals and then applied in large on the overall community. The argument includes Hofstede’s variables varying in sensitivity from one culture to another (Schwartz.2. 2000).. (Graves. which skewed the results (Dorfman & Howell.

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. 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. conduct. 21 .1 Research Design The development of the study is based on applied research with an approach encompassing cross-sectional and snap-shot research parameters. households and corporate professionals.1. The discussion guide for the focus group consisted of unstructured questions according to the information needed to extract responses through a conversation. students. 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.1.1. 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. write and record the feedback received from a specific group of people who are selected as per pre-defined criteria.. For the undertaken research. RESEARCH METHODOLOGY 3.3. 3.1 Qualitative Research 3. 2001). A focus group is used as a tool to manage. The research design for the study will subsequently assist in bringing forth an analysis that will allow suggesting logical recommendations.

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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3. household and student representatives. This is type of sampling technique is where every individual has an equal and known chance of being selected (Sekaran. 3.2 Sampling Size and Selection The sample size constituted of 200 educated respondents residing in different localities of Karachi. 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. Therefore. 2000).2. 25 .1 Sampling Frame The focus group findings brought to light that there is no significant difference in opinion among the three clusters of corporate.2 Sampling Procedure and Design 3. the sample of respondents had been chosen from the corporate sector and university students. corporate position. 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 principle criterion for selecting the sample was based on probability of stratified random sampling.2. 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. For the respondents. 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. At the private firms and university. marital status and gender.

Multinet and Ibrahim Fibers. 26 . AKUH. Bayer. Habib Metro. Habib Public School.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. HBL.

27 .org) during all communication to ensure that the element of bias is kept at the lowest possible level.3.3 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. It took 16 days from first contact till the receipt of completed survey forms. Research quality had been assured by maintaining a Chinese wall (wikipedia.

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 behavioral intention is significantly correlated to uncertainty avoidance H1: The behavioral intention is not significantly correlated to uncertainty avoidance b. H0: The uncertainty avoidance is significantly correlated to perceived risk H1: The uncertainty avoidance is not significantly correlated to perceived risk e. Risk is perceived by self-medicating people in individual capacities and which leads the people to be either risk-averse or risk-takers. As a result.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.3. 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. The following hypotheses were generated: a. 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. H0: The behavioral intention is significantly correlated to risk aversive behavior H1: The behavioral intention is not significantly correlated to risk aversive behavior d.

the hypothesis put forth will be concluded. The four constructs of the research study presented acceptable reliability figures of 0. factor analysis and correlation matrix. The tests included the reliability analysis. 2011). instrument validity.1 Reliability Analysis The internal consistency of a test is expressed between 0 and 1 (Cronbach. 29 . if the constructs are reliable enough to measure what is intended to be measured. 1951). 1994). As the credibility estimate increases. 4. Subsequently. 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 internal consistency measures the statements under each of the variables with respect to reliability i.4. 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.e.5 and greater Cronbach’s alpha and depicted in the tables on the following page.

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

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

5 .0 Valid Percent 67.5 100.0 Valid Percent 66.5 32.5 32.5 .0 33.5 100.3. (a) gender (b) marital status (c) age group (d) education (e) employment status (f) household income.1 Frequency Tables Gender Frequency Valid Male Female 3 Total 132 67 1 200 Percent 66.5 100.0 32 .5 100. 4.5 100.0 Cumulative Percent 66.5 100.0 99.0 Marital Status Frequency Valid Single Married Total 135 65 200 Percent 67.4.0 Cumulative Percent 67. viz.3 Demographics The survey questionnaire constituted of items related to identify the basic demographic structure of the respondents. Six basic demographic dimensions had been used in the survey instrument.0 33.

5 59.0 83.5 100.0 Valid Percent 18.0 10.5 43.5 1.5 .0 93.0 Valid Percent 12.0 100.5 43.0 100.5 62.5 46.0 33 .5 38.5 4.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 Education Frequency Valid undergraduate Graduate Post Graduate Total 37 87 76 200 Percent 18.5 .5 1.5 38.0 100.0 10.0 99.5 24.5 24.5 100.5 100.5 46.0 Cumulative Percent 12.5 4.5 98.0 Cumulative Percent 18.

0 100.0 30.0 42.Employment Status Frequency Valid employed self employed unemployed 5 Total 96 18 85 1 200 Percent 48.0 Cumulative Percent 48.5 23.5 100.5 23.5 26.0 49. 50k-74k 75k-99k 100k-124k 125k-149k 150k+ Total 5 47 46 60 12 30 200 Percent 2.0 9.0 34 .5 100.5 23.5 .0 6.0 Cumulative Percent 2.0 Valid Percent 48.0 100.0 42.0 85.0 30.0 99.5 23.5 .5 100.0 100.0 9.0 15.0 57.0 15.0 6.0 Valid Percent 2.0 79.0 Household Income Frequency Valid 0 Rs.

2 Bar Charts 35 .4.3.

36 .

37 .

5% respondents were graduates.5%. 100.000.5% and 12. followed by 27-32 years group at 24%.5% hailed from the age group of 21-26 years. On the household income front. The unemployment percentage was 42. 150.3 Findings The demographic results of the study presented 66% male and 33% female respondents and out of the total sample size 67.000-99.5% single.3. Age groups of 33-38 and up to 20 years old represented 10.000124.5% respectively. Most notable was the 15% representation from the Rs.e. 50. Rs. 38 .000 plus income bracket. With regard to education.000-74. 46. 38% postgraduates and 18.5% undergraduates. Nearly half the respondents were employed at 48%. 43.4.000 and Rs. 23% and 30% respectively. Majority of the respondents i.5% were married and 32.5% and the reason for this high ratio was the fact that close to a hundred respondents had been students in their final semester.000 per month household income groups were represented by 23. 75. diverse readings came to light. Rs.

The empirical findings brought to light that 19% of the respondents practice self-medication in order to save the fee of a doctor.e. Another 21% self-medicate to avoid the waiting time at a doctor’s clinic or a health-care facility. 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%. A notable 21% of the respondents engage into self-medication because going over to the doctor is considered as a hassle.4. 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 . 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 most common ailments for which consumers self-medicate include cold (18%). the practice of self-medication is considerably low.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. depression. nausea and diarrhea had represented less than 10% each. nasal congestion (10%) and ordinary fever (9%). headaches (13%). the percentages were low which show the behavioral trend that consumers will prefer to visit a doctor. 40 . Lack of sleep. cough and sore throat (11% each). self-medication practice is high among consumers whereas for ailments which are perceived to be serious or complex in nature. For serious ailments.

behavioral intention.5 then it is not appropriate (Dr. 41 . A KMO close to 1.3 as the baseline against each variable of the construct has been considered. perceived risk and risk aversive behavior.e. This has been done due to the reason that perceptions cannot be accurate.3 and that any item loading on more than one factor subject to acquiring the final solution. Since the data is based upon perceptions therefore for the constructs of behavioral intention. KMO identifies the specific item which has to be discarded in factor loading. the score of 0.5 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. uncertainty avoidance. The following tables present the communalities derived from factor analysis. 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. Komata). In factor analysis. all variables are grouped together in order to display the capability of individual items to depict a specific construct. A score of 0.0 indicates a factor analysis and if it is less than 0. perceived risk and risk aversive behavior. 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. For all the four constructs i. uncertainty avoidance.4. 2002).5 Confirmatory Factor Analysis Reducing from a large to an achievable choice of factors is factor analysis (Zikmund. factor analysis had been conducted separately.

606 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.000 1. The KMO had been determined at 0.400 .782 whereas the approximate chi-square came out to be 658. 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.592 1.624 .000 1.515 Findings: For the construct of behavioral intention.000 1.000 Extraction .000 1. twelve items had been loaded and all were accepted.000 1.676 . 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 1.605 .000 . 42 .695 .000 1.550 .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.653 .054.562 .000 .000 .000 1.578 1.000 1.

603 .000 .000 1.000 1.689 Findings: The perceived risk construct was loaded for a total number of five items and all of them had been accepted. 43 . The KMO came out to be 0.000 1.999.000 Extraction .700 1.000 1.378 Findings: Five items were loaded for the construct of uncertainty avoidance and all had been accepted.000 1.576 .603 .803 approximately.000 Extraction .678 and with a chi-square of 140.653 1.735 . KMO was derived at 0. 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 1.800 and the approximate chi-square was 344.Uncertainty Avoidance Initial Through self-medication. 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 .598 .553 .000 1.

582 .492 .388 .823 and with an approximate chi-square of 439.000 1.608 . 44 .000 1.000 1.500 . the KMO came out to be 0.Risk Aversive Behavior Initial I ensure that I always take medicines that are prescribed by the doctor When I take a medicine.000 1.382.395 Findings: The construct of risk aversive behavior had a total of seven items that had been loaded and all were accepted.000 1.000 Extraction . 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. Accordingly.466 .000 1.

233 ** Uncertainty Avoidance Perceived Risk Aversive Behavior 1 1 200 .000 200 200 **. absolute best correlation).4270 3.8858 3.3890 3. 45 . Descriptive Statistics Mean Behavioral Intention Uncertainty Avoidance Perceived Risk Risk Aversive Behavior 2. Correlation is significant at the 0.4.000 200 . The worth of the correlation may fall between 0. correlations about 0.001 200 -.002 200 .443 ** 1 . (2-tailed) N Uncertainty Avoidance Pearson Correlation Sig.282 ** .00 (i.000 200 .65836 . however.418 ** .6 Pearson’s Correlation Matrix The correlation matrix of Pearson has been used to identify the correlation between no less than continuous factors. (2-tailed) N Perceived Risk Pearson Correlation Sig. The different components corresponding to team size should resolve whether or not the correlation is important. Deviation .7136 Std.01 level (2-tailed).269 ** 1 200 .8 are thought to be high.00 (i.73327 N 200 200 200 200 Correlations Risk Behavioral Intention Behavioral Intention Pearson Correlation Sig. (2-tailed) N Risk Aversive Behavior Pearson Correlation Sig.87962 .e. In most cases.000 200 -.79652 .e. no correlation) and 1. (2-tailed) N 200 -.213 ** .

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. 46 . The two variables are correlated significantly and negative in its empirical outcome (-0.233). b. 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. The two variables are correlated significantly and correlate together due to the negative finding (-0. 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.7 Hypothesis Testing In light of Pearson’s Correlation Matrix. It is believed that the consumer behavior towards selfmedication is triggered with the uncertainty avoidance index.269). It is believed that the consumer will act depending upon how risk is perceived. a. 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. 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. How a consumer perceives risk and whether it leads to a risk-taking or riskaversive behavior towards self-medication are linked together. the hypothesis could now be concluded.4.

d. It is believed that the intent of a consumer to behave towards self-medication is directly linked with the risk aversive behavior.282) and therefore the perception of risk will vary on the risk-aversive and risk-taking continuum. 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. The two variables are correlated significantly but are negative in nature (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 . 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.c. It is believed that with high perception of risk. The two variables are correlated significantly. This correlation acts inversely due to its positivity (0.213). This situation may also be influenced upon a person. 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.

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. The two variables are correlated significantly but due to positive (0. Therefore the higher the perception of risk.e. f. the risk-aversive behavior increases or decreases accordingly. It is believed that consumers in accordance with their perception of risk behave in a risk aversive manner when it comes to selfmedication. It is believed that consumers at the time of being risk aversive towards self-medication display a high uncertainty avoidance index. the higher will be the risk-aversive behavior and vice-versa. The two variables are correlated significantly but the finding is positive in nature (0.418) in nature they move inversely.443) and therefore as uncertainty goes up or down. 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. 48 . If the consumers perceive that there exists a risk then they will avoid the act of self-medication.

Regardless of the fact that the act of self-medication is considered as a risk-taking behavior. The locus of control is also directly linked with the religious beliefs of a person. 2006). 2006). competency of doctors and long waiting queues all play a role independently and together in motivating a person to self-medicate. This fact establishes the rationale that people with education. the assertion put forth by Hofstede that Pakistanis are risk-averse people due to a high index of uncertainty avoidance index is true. Henry et al. 2010. On one hand. Henry et al. Cost of medicines. In addition to this an investigation was made to discover the relationship between the four survey constructs of behavioral intent. 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. 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. 2010. who are employed and earning respectable income engage into this act (Klemenc-Ketis et al. uncertainty avoidance. as evident from the focus group finding and acceptance of all null hypotheses.. the people refrain from self-medicating because they are aware of the risks attached.. 2011). 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. (Shah & Amjad. This contradiction brings to light the elements of locus of control which according to research studies in case of Pakistanis is external (Shah & Amjad. In a nutshell. the people operate their behavior with a two-prong strategy...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.5. CONCLUSION AND RECOMMENDATIONS 5. 49 . 2011) This aspect however demands a separate study. with regard to self-medication. perceived risk and risk aversive behavior.

The establishment of risk perception comes into action from operational variables which surround a consumer e. Additionally.g. lack of regulations. competency of physicians. The risk consumers take towards self-medication is both willing and unknowingly. cost of medicine. 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. situation-based and experience-based risk-taking behavior is displayed. the empirical findings of the research also concluded and accepted the null hypotheses that had been derived initially. both of which encourages them to consider the self-medication issue as too petty. It’s a matter of how the risk is perceived to be. 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. At the same time.g. Subsequently.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.g. the consumers do not perceive the act of self-medication itself to be one that involves risk. 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. etc. That the government regulations have not been implemented is one aspect but the consumers themselves have totally disregarded the rule. 50 . in case of serious ailments such as diarrhea and sleeping disorder) and risktaking behavior (e. unawareness of the danger involved. Socio-economic factors play a role and so specific situations upon which a person may not have any control. in a similar way. in case of minor ailments such as sore throat and cough) is witnessed. therefore attitude formation takes place and selective risk-aversive behavior (e.

Another solution could be the reduction in price of medicines and to revisit the overall health care cost in Pakistan.5. Stringent implementation of pharmacy regulations is also long overdue. Things can be done to reduce self-medication in any country and it can also be done in third world countries like Pakistan. in light of the logical criticism of Hofstede. Finally. will the actual uncertainty avoidance index by identified. Educate. 51 . is the number one thing which pharmaceutical companies. after comparing multiple dimensions which a person is exposed to and experiences in life in general.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. consumer perception and attitude has to be checked not only for different product and service categories. the ministry of health and other stake holders need to plan and initiate. 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. Only then.

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.AREAS OF FURTHER STUDY At this time on an academic level. 52 . Additionally. 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. the authors have attempted to define the effects of perception and attitude on consumer behavior towards self-medication.

Filho L. Pak. Med PrincPract 2005. Australian Family Physician.19(4): 513-521. L. 45 (11): 297-298. beliefs and knowledge concerning antibiotic use and self-medication: a comparative 5. (2009). Self-medication-a growing concern. Self medication practices. 11.geerthofstede. and J. 1951. 8. P. 2.BIBLIOGRAPHY 1.Diagnosis and Change: Auditing and changing the culture of organizations. Self medication or self care: implication for primary health care strategies.20:1661-9. 9. Mullan. "Dimensions of National Culture and Effective Leadership Patterns: Hofstede revisited.. 816-819. Deshpande SG. J. Assoc. Monnet DL. Matowe LK. Professional Med J Aug 2012. Coefficient alpha and the internal structure of tests. 4. National Cultural Dimensions. Self-reported medication use among adolescents in Kuwait. Lundborg CS. Bambui Project: a qualitative approach to self-medication. Psychometrika 16:297–334.com/countries. Dorfman. GEERT-HOSFTEDE. Lima-Costa MF. Frances Printer. Deschepper R. J. Graves. Ellis. Howell (1988). Available at: http://www. London. P. J. 51: 93-6. Baig S. Uchoa E. Antonio I. 1997. D. Cronbach. 2013) 10. Cad SaudePublica 2004. Med. Prescription medication borrowing and sharing: risk factors and management. SAR consortium (2007) Attitudes. 53 . 14: 161-4.html (Accessed on January 2. Haider S. Tiwari R. 38(10). (1986). 7. 3. Corporate Culture . Birkin J. Abahussain E. 2009. Thaver IH (1995). W. Haaijer-RuskampFM . 6. Nicholls PJ. Indian J Med Sci. Scicluna EA.. J." Advances in International Comparative Management 3: 127-150.

Waseem M. J. McSweeney B. J. Bagheri H. Kersnik. Psychometric Theory (3rd ed... A technique for the measurement of attitudes. C. J. Health Policy Plan. 21. Malik. R.ncl. New York: McGraw-Hill. 46(1): p. 3: 3234. 54 . I. S. Olie. Montastruc JL. Dr. Rev. New York: Columbia University Press. Likert. Nunnally. Grmec S.12. Salway S.. 23-29. 13. James. Bond MH (1988). 18: 261–269. Harzing and V. Riaz H (2010). 52: 105-110 20. R. The Confucius connection: From cultural roots to economic growth. Pharmacovigilance of selfmedication. F. Lapeyre MM (1997). Klemenc-Ketis. medicine use and self medication in rural and urban Pakistan. Southern Med. 55: 89-118. Z.).uk/iss/statistics/docs/factoranalysis. (1931).ac. Kometa. Hofstede's model of national cultural differences and their consequences: a triumph of faith – a failure of analysis. Psychology. The 'Culture' Factor in Personnel and Organization Policies. International Human Resource Management: An integrated approach. 22. H. (1995). Human Relations 2002. & Bernstein. Influence of medical training on self medication by students. Mumtaz Z. Hameed A. Exploring health seeking behaviour. 19. Umer N (2003). 16. "How to perform and interpret factor analysis using SPSS” Data Retrieved from: http://www. Hussain S. London. R. H.. Critical Care 2010 14:R56. Therapie. et al. A. Geraud T. International Journal of Clinical Pharmacology and Therapeutics. Sage Publications: 124-143. 14.. Gender-based barriers to Primary health care provision in Pakistan: the experience of female providers. 2008. 2013 17. Hofstede G. (1994). 15. The effect of carbon dioxide on near-death experiences in out-of-hospital cardiac arrest survivors: a prospective observational study.. Archives of 18.php Date: January 15.

WIKIPEDIA. 28. et al. pp. U. Available at: http://www. European study. M. 27. (2002).wikipedia. Articulating Silence: experiential certitude and biomedical controversies over hypertension symptomatology. (2011) “Making sense of Cronbach’s alpha. Self-medication and non-doctor prescription practices in PokharaVaelley.org/selfmedication (Accessed on December 19. Qualitative Market Research: An International Journal. 39:543–547. Sturm AW.” International Journal of Medical Education. 4 Iss: 4. Mediterranean Center of social and Educational Research 2011. Inc. M (2001) "Moderator teams: an extension to focus group methodology". BMC FamPract 2002. Sekaran. Western Nepal: a questionary-based study. Over-the-counter availability of antimicrobial agents. Available at: http://www. Int J Qual Health Care 2003. Tavakol. PEER REVIEWED OPEN ACCESS JOURNAL. M. Research methods for business. N. Runciman WB. Shenoy N. and Dennick. 15 Suppl 1: i49-i59. R. Pakistan. "A Theory of Cultural Values and Some Implications for Work " Applied Psychology 48(1): 23-47. Schoenberg. (1999). Cultural Diversity in Pakistan: National vs Provincial. 32. 31. S. H. van der Pol R. Vol. E. Prince. 2:53-55 33.3:17-23. 26. 2013) 24. New York: John Wiley & Sons.23. 458-475. Smits AJ et al. self-medication and patterns of resistance in Karachi. Medical Anthropology Quarterly.org (Accessed on January 22. Partha P. S. Dr. Shah. M.207 – 216 25. 16:1234-43. and Davies.. (2000). 29. Amjad.E. 16(4). & Drew.M. 2:2:331-344 30.plosone. J AntimicrobChemother1997. Adverse drug events and medication errors in Australia. Shankar PR. Semple SJ. 2012) 55 . Schwartz. Roughead EE. File S1: Questionnaire for selfmedication with antibiotics. Pharmacoepidemiol and Drug Safety. Self-Medication.

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100. You may refuse to answer any question or withdraw from the study at anytime. 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.000 Rs. 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. 125. 150.o) ___ Children (13-17 y. We hope to learn about consumer behavior in Pakistan. We are very interested to hear your valuable opinions. Please check the boxes below to the best of your knowledge and to show that you agree to participate in this focus group. The information you give us is completely confidential.000-99.000-124.000-74. and ideas we hear from the group. opinions.000-149.000 Rs.APPENDIX a. and we will not associate your name with anything you say in the focus group. We would like to record the focus group so that we can make sure to capture the thoughts.000 Rs. their level of awareness and the factors which trigger the specific act of self-medication.o) 57 . 50.000 Self-Employed Rs. We will ask participants to respect each other’s confidentiality.000 + Family Members: ___ Adults ___ Children (up to 12 y. 75. Focus Group Guide Thank you for agreeing to participate. No names will be attached to the focus group and the audio file will be destroyed as soon as they are transcribed.

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

working where and as. smoking) 59 . born where. b) Information provided in the focus group must be kept confidential. c) Stay with the group and please don’t have side conversations. but move on when you feel you are starting to hear repetitive information. Use the probes to make sure that all issues are addressed. g) Participant Introductions (name. 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. CNG. in your life? h) Why do people take risks? (helmet. d) Turn off cell phones. e) Turn on Audio Recording f) Ask the group if there are any questions before we get started. swimming. make sure to give people time to think before answering the questions and don’t move too quickly. hobbies & family) Discussion begins. overhead bridge.Ground Rules a) Everyone should participate.

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. 60 . 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.

b. Survey Questionnaire 61 .

62 .

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