“The Level of Attitude of the Students towards the Clinic Services of Holy Cross of

Agdao.”

_______________________________

A Thesis Presented to the Senior High School Faculty of

Holy Cross of Agdao

_______________________________

In Partial Fulfillment of the Requirements in

Practical Research 1

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By:

Samantha Nicole Paga-an

Roshan Dorotea Bolante

Charmine Joy Racelis

Alijah Robert Ipanag

Joshua Leto Alolod

Asi Manuel Aquino

Jan Mar Agabon

Adrian Villasis

Jerald Ruiz

March 2020
 CHAPTER 1

The Problem and Its Cope

The problem is all about the level of attitude of the students towards the

clinic services, we all know that school clinic is important nowadays because many

students needs medical services to relieve them from their sickness or any

problems; the attitude of the students may affect the services of the clinic given to

them, for example some students don’t want to be given medicine nor any

medications even though they are sick and prefer to stay in class and rest, other

students also wants to get treated in the clinic even though it is only a minor

problem.

This study is significant because it could help identify what are the

attitudes of the students towards the clinic services because students have

different attitudes, approach, taste, opinions, and insights towards the clinic

services and that’s why the researcher come with this study so that we can help

identify the different attitudes of the students towards the clinic services.

In other countries especially in the U.S, the West Virginia Assembly

promotes health services in schools to help students become healthy learners.

The mission of the West Virginia School-Based Health Assembly is ―to advance

comprehensive health care in school settings through responsive policies,

practices and partnerships‖. The organization supports sustainability and

expansion of school based health centers as an essential strategy for improving

the lives of children and optimizing their opportunities for success in school and

society. The West Virginia Assembly supports its members through advocacy,

partnership development, information and knowledge exchange, and networking

opportunities. It is a partner of the WV Primary Care Association. The Assembly is

funded by the Sisters of Saint Joseph Health and Wellness Foundation. In 2010,

the WVSBHA became an affiliate of the National Association on School-Based

Health Care.

In the Philippines, particularly in Philippine Science High School in Cagayan;

School Health Services are established at the school site to promote the health of

students through disease prevention, early case finding, referral for intervention

and remediation of specific health problems. The school health services are vitally

necessary in order to provide first aid and triage for illness and injuries, to provide

direct services for students with special needs, and to provide health counseling

and education for students, staff, and parents.

In the Davao City, particularly in Ateneo De Davao University, The clinic

provides health and medical services where students and other school personnel

are attended to when simple treatment is required. It has a full-time nurse, a part-

time physician and dentist. The nurse renders at least eight (8) hours of work

everyday. The physician and the dentist render two (2) hours of work everyday.

The school physician conducts an annual medical check-up to all students. The

school dentist also provides an annual dental check-up to all students. The health

personnel updates and maintains the cumulative medical and dental records of
students. He/She also takes precautionary measures against the spread of

communicable diseases in the school by undertaking vaccination programs when

needed.

As a conclusion, the researcher’s study aims to know the attitude of the

students towards the services of the clinic and what are the students opinion about

it and also how important our study to the students and also for the clinic, on the

other hand this study tells us how important clinic is to the students especially

those students who are ill and needs medical attention.

 Rationale of the study

The clinic is a very important asset in catering health issues, nowadays

clinics are already present in the school as a facility open to the students who
needs medical attention, clinics are equipped with different equipment that can
cater medical illnesses also medicines for the different illnesses, the services of
the clinic can affect the attitude of the student/patient on how the staff assigned in
the clinic performs his/her tasks, this is why clinics is a must to have especially in
schools so that students would have a place to feel well and be safe.

The goal of this study is to identify the level of attitude of the students
towards the school clinic services and what are the students insight about the
different services offered by the clinic.

This study is beneficial to the clinic personnel so that they can assess well
the students needs in term of health issues because they would know how to cope
with their patients likes and dislikes; also for the students because they are the
one who receives treatment and this treatment would improve and therefore they
can experience improvement in the service; the school because they would know
what their lacking is and therefore can make improvements that would make the
services of the clinic better.

This study is limited only to the services of the clinic that is offered to the
students and other facilities and services that is not related to the clinic is not
included also to determine the level of attitude of the students specifically the
grade 11 students of Holy Cross Of Agdao.
 Statement of the Research Problem

This study analyzes and evaluates the attitude of the students toward the

clinic services.

It further seeks to answer the following questions:

1. What is the profile of the respondents in terms of:

1.1. Age; and,

1.2. Gender?

2. What kind of services does the clinic give to the students in terms of:

2.1 Equipment

2.2 Medicines

3. What are the attitude of the students towards the services of the clinic in terms

of:

3.1 Medical Assistance

3.2 Medical Approach

 Review of related literature

In this section, researchers provide theories, concepts and other materials

that are related to our study. The review includes the views principles and selected

literatures regarding this topic.

According to (Franklin et al., 2006). Providing students with clinical

healthcare access onsite has been a powerful tool in maintaining and assessing

the health needs of students; however, it has been a challenge to fund access to

healthcare for all schools. For this reason, not all students in the United States

have access to health centers at their schools. As a result, students may be forced

to miss classes or school due to illnesses or injuries that require treatment outside

of the school setting .The student would have to receive treatment at a location

outside of the school, resulting in longer wait times or travel. By having a

healthcare center on site, students are able to obtain quick and efficient care for

their illness or injury, resulting in less missed class time. This lack of access to

onsite SBHCs could affect students’ academic achievement. The primary premise

of this study was to determine if there is a difference in academic performance

across schools that have access to SBHCs and those that do not have access to

SBHCs. Although some studies that have shown a link between school-related

health services and academic services, there is still no study detailing the direct
relationship between these school-related health services such as school-based

clinics and school-linked clinics on the academic performance of students.

According to (Brener et al. 2007). The importance of health in educational

outcomes has lead schools to attempt to address their students’ health needs.

Local control of schools as well as state differences in supported programs results

in heterogeneity in the types of health services schools offer, as well as in their

quality and staffing Although state mandates establish minimum student health

guidelines to which schools must attend—such as requiring certain immunizations

before enrollment, following certain procedures for medication administration, or

requiring specific health screenings be provided, schools can range from merely

complying with requirements (or even failing to minimally comply), to offering a

modest set of services, to offering an array of services in a comprehensive school-

based health center, or SBHC. Although SBHCs are relatively uncommon ( a 2006

study reports that SBHCs only exist in 6.4 percent of schools; see Brener et al.

2007), they are the most researched model for providing healthcare in schools.

Thus, any investigation into the effects of school based health provision

encounters studies of SBHCs, which are typically comprehensive clinics providing

a range of physical and mental health services.

In the study of (Allison et al. 2007), their study sates that examining SBHCs

provide evidence that school-based healthcare improves access, receipt of

services, and measures of health status. Although advocates assert that providing

health services in schools bolsters educational success, relatively little research

examines academic as opposed to health outcomes (Geierstanger et al. 2004;

Ladd 2012). More than a decade ago, a comprehensive review of research on the

link between SBHCs and academic performance found only seven empirical

studies, many of which examined multifaceted social and familial service

interventions rather than specific health service provision. These studies generally

show positive or null impacts of service presence and/or actual use . Among those

examining health services specifically, find a small advantage among students

attending schools with SBHCs in progression through school compared to a

national sample of youth; they also studied attendance and drop out rates for

SBHC students, but did not compare these rates to other groups, find mixed

results for how SBHC presence and use relates to absences and positive effects

on staying in school and eventual graduation.

According to Buttle (2007), the service existing to customers is a key

differentiator between organizations with other organizations. Health organizations

such as clinics are specially created to bump into the needs of the people in

assisting and solving many health problems. Therefore, the health surveillance

services cannot be equated with another field of services even core businesses for

all of these facilities are based on services. In the current healthcare setting,

student’s satisfaction is considered as one of the main indicators to ascertain their

service efficiency. Assessment of student’s satisfaction is a useful parameter to

predict the availability of healthcare services.

According to Gronroos (2007), quality of services is based on the perception

and appraisal of the handler. Consumers will evaluate the level of existing services

based on the ability of services to meet the requirements of consumers. As

connection, service quality is considered as an abstract and elusive nature. This

existence of invisible features, intangibility, heterogeneity, and inseparability of

production and consumption that make it unique and in terms of medicine, quality

is where health services to individual or population likely improve the health and

consistent with current knowledge professionals.

According to a study done by Bodur et al. (2014), states that the majority of

the students (about 73%) were either unsatisfied or very unsatisfied and only a

very minority (2.5%) was very satisfied. The degree of dissatisfaction was

universal and belonged to all levels of services provided by the health center

personnel. These findings were not affected by the socio-demographic

characteristics of the participants including their level of education which indicated

that the expectations of the educated university students were high. This was

irrespective of the student′s gender or nationality as well. According to the findings,

long waiting times, inadequate information was given by health personnel,

insufficient health education by nurses have been reported as important sources of

dissatisfaction in clinics.

School nurses work across multiple systems, including education, health

care, public health, insurance, and community agencies, to assure that student

needs are met (McClanahan & Weismuller, 2015). Although inadequate staffing

and time may impose barriers in school settings, leveraging community

partnerships may help ease this burden, especially when working with local health

plans, universities, or other organizations (Taras et al., 2004; Tinkelman &

Schwartz, 2004). This systematic review helps to identify effective interventions

that school nurses can employ to support students with CHCs. Many studies

addressed the positive effect of specific educational strategies for improving the

health and well-being of students with asthma, which is clearly within the school

nurse scope of practice. Of particular interest to school nurses is the demonstrated

positive effect of having a comprehensive program for managing asthma, which

includes CM (Rasberry et al., 2014).

According to (Pulcini et al., 2007). When it comes to care coordination,

school nurses are uniquely poised to facilitate communication between schools

and health-care providers, resulting in improved collaboration for medical

management, including obtaining asthma action plans.

Halterman, Riekert, et al. (2011), states that the access to SBHCs can have

significant implications for students with CHCs, particularly asthma. School nurses

are in an ideal position to provide referrals to SBHCs and other community health

providers, thus improving access to care and ensuring better chronic disease

management overall. Additionally, school nurses could benefit from developing

motivational interviewing skills, a strategy that was shown to improve asthma

symptoms in students .

(According to Donabedian (2007), defined healthcare quality as the

application of medical science and technology in a manner that maximises its

benefit to health without correspondingly increasing the risk. Donabedian

distinguishes three components of quality: technical quality, interpersonal quality,

and amenities. Technical quality relates to the effectiveness of care in producing

achievable health gain. Interpersonal quality refers to the extent of accommodation

of patient needs and preferences. Amenities include features such as the comfort

of physical surroundings and attributes of the organization of service provision.

 Theories and Concepts

The study are anchored from Social Cognitive Theory (Bandura, 1982) ,

Patient Satisfaction Theory (SusieLinder-Pelz, 1982), and Orem’s Self-Care

Theory (Orem, 1985).

Social Cognitive Theory (Bandura, 1982). According to the “Social

Cognitive Theory” it is said to focus on health promotion and disease prevention

by the means of Social Cognitive Theory. Social Cognitive theory is a theory that

emphasises that an individual’s knowledge acquisition can be directly related to

observing others by the means of social interactions and influences. Knowledge of

health risks and benefits is a stepping stone to change. If they do not have enough

knowledge about how their habits affects their health, then they wouldn’t bother to

engage themselves to health practices instead, continue their health-affecting

lifestyle habits.

This theory is related to our research because the theory focuses on health

promotion and disease prevention which is inclined to our research.

Patient Satisfaction Theory (SusieLinder-Pelz, 1982). According to the

“Patient Satisfaction Theory” it has something to do with the research study

because it reveals that satisfaction of the patient revolves around on how great the

clinic services are. It sees there that a patient’s satisfaction or dissatisfaction is

based on how the great the quality of hospital cares are. Whatever its strengths

and limitations, patient satisfaction is an indicator that should be indispensable to

the assessment of the quality of care in hospitals. According to Soloman, M.

(2013), the satisfaction must base from the nurse’s eagerness to strive in

delivering service on the schedule of his/her patient and not just the schedule that

happens to be convenient for his/ her institution. Every single employee needs to

know how to handle customer complaints and concerns for this greatly affects the

patient-nurse relationship. Poor use of language and nonverbal language cues

such as hospital employees avoiding eye contact with civilians in the hospital and

acting like they are “other” from the patients affect the patient satisfaction and

customer service. And a blame-free environment leads to improved transparency,

improved systems, and ultimately, to better results.

This theory is related to our research because patient’s satisfaction is

important to our research because the researchers will measure the attitude of the

students which determines the satisfaction of the students.

Orem’s Self-Care Theory (Orem, 1985). Accordint to the “Orem’s Self-Care

Theor”" the theory consist of three theoretical construct, including self- care, self-

care deficits, and nursing systems. The theory is based on the assumption that all

clients wish to care for themselves and should be encourage to engage in self-

care to speed their rehabilitation. A person’s self-care is seen as being influenced

by develop mental stage and life-stage-specific needs in addition to universal self-

care needs that all people have (air, water, food, elimination, activity/rest, solitude,

social interaction, hazard, prevention, and promotion of normally). Age, gender,

living conditions, socio-cultural orientation and health state modify one’s ability to

perform self-care. Self-care agency, or one’s belief that they can engage in self-

care, influence those behaviors that self-care agency is seen when a person seeks

information about self-care and desides to undertake self-care behaviors. When

clients are unable to care for themselves they have a self-care defecit and the

nurse needs to intervene to provide support until the clients can care for

themselves (Orem, 1985). Orem’s theory has been widely researched and that’s

resulted in the creation of three scales designed to measure self-care agency.

Those scales include the Denyes self-care agency scale, the Kearney and

Fleisher’s exercise self-care agency scale, and the wish to researched those skills

in more details elsewhere. A critique of orem’s theory is that not all cultures value

self-care to the same degree.

This theory is related to our research because of the three scales of the

Orem’s theory which are the self-care, self-care deficit, and nursing systems that

would incline to our study about the attitude of the students towards the clinic

services.
 Conceptual Framework

INDEPENDENT VARIABLE DEPENDENT VARIABLE

Clinic Services of Holy Cross Attitude towards the clinic

of Agdao. services.

Grade 11 students of
Holy Cross Of Agdao

Figure 1: Conceptual Framework of the study

Figure 1 shows the conceptual framework of the study from which independent variable
is the clinic services of Holy Cross of Agdao and the dependent variable is the attitude
towards the clinic services. The intervening variable is the Grade 11 students of Holy
Cross Of Agdao.

.
Hypothesis
 Definition of terms

Clinic- an establishment or hospital department where outpatients are given medical

treatment or advice, especially of a specialist nature.

Services- a system supplying a public need such as transport, communications, or

utilities.

School Based Health Clinics- generally operate as a partnership between the school

district and a community health organization, such as a community health center,

hospital, or the local health department.

Attitude- a settled way of thinking or feeling about someone or something, typically one

that is reflected in a person's behavior.

Equipment- the necessary items for a particular purpose.

Medicines- preparation used for the treatment or prevention of disease, especially a

drug or drugs taken by mouth.

Medical Assistance- financing of medical care provided to public assistance recipients.

Medical Approach- a term describing how interpersonal relationships are negotiated,

often with the connotation of positive relationship.

 CHAPTER 2

Methods

This chapter presents the description of the research process. It provides

information concerning the method that will be used in undertaking this research as well

as a justification for the use of this method. The Chapter also explains the Research

Design, Research Environment, Respondents of the study, Research Instrument, Data

gathering Procedure, and Data Analysis.

Research Design

This study will employ a quantitative approach. The research design will be used

in dealing with Utilization of School Clinic Services as a quantitative research. It will help

the researcher to know the profile of respondents, how was the school clinic services

performance towards the students, and how the school clinic totally helps the students

in medical attention. The research will be using the researcher’s made survey

questionnaire and will be validated by Ms. Janice Rios. The researchers will use

quantitative approach because it helps uncover trends in thoughts and opinions and

dive deeper into the problem. In this study, the researchers will consider the situation of

the school clinic services in Holy Cross of Agdao classes. The results will be measured
in identifying the awareness of the respondents of the school clinic services utilized by

the Senior High School Teachers of Holy Cross of Agdao.

Tools used in Techniques Output of the

Data Needed Respondents Gathering for Analyzing Study
Data Data
Profile of the Frequency
Students Count To identify the
Percentage level of attitude
100 Grade 11 of the students
The kinds of Senior High Survey towards the
services the School Questionnaire Weighted services of the
clinic gives to students of Mean clinic.
the students Holy Cross of
Agdao
Weighted
The attitude of Mean
the students
towards the
services of the
clinic

Research Environment

The research will be conducted at the Holy Cross of Agdao (formerly St.

Anthony), is a private, Catholic school in Davao City. It was founded in 1964 by the

Foreign Mission Society of Quebec (PME Fathers) to provide education to the youth of

the community. Eventually, the local Congregation of the Teresian Daughters of Mary

took over the administration starting 1986.

Respondents of the study

The participants of the study will be the Grade 11 Senior High School of Holy

Cross of Agdao. There will be 100 respondents in the study gathering 50 students each

section of the Grade 11. In this study the sampling technique used by the researchers is

the random sampling technique in order for the students to have an equal chance to be

chosen to participate in the study.

Research Instrument

The tool that will be used in this study is a survey questionnaire. The survey

questionnaire contains the profile of the respondents; the first test will have 10 items

containing questions about the attitudes and perception of the students towards the

school clinic services as a medical provider, the second test will contain 10 items

containing question about the attitudes and perception of the students towards the

clinic’s equipment and medicines as well as its efficiency.

The research instrument was validated by Ms. Janice Rios, research adviser of

Holy Cross of Agdao.

Data Gathering Procedure

The following is the process of gathering the data.

Letter for the Teachers. The researchers will send a letter to the teachers who are

involved during our survey. The researchers will ask permission to undergo survey

during their time and to secure that it will not cause time conflict to their lesson.

Letter to the school principal. The researchers will send all the letters addressed to

the school principal/directress which it asks for permission and approval to undergo a

survey to the grade 11 senior high school students of Holy Cross of Agdao.

SHS Focal Person Master List. The researchers will ask the SHS Focal Person for the

official student’s list in order for the researchers to do simple random sampling.

Distribution of the questionnaire. The researchers will coordinate to the teachers

then the questionnaires will be distributed to the students. An assigned researcher will

instruct the students on the process of answering the questionnaire.

Analyzing of Data. The researchers will tabulate the data collected from the

respondents and it will be subjected to interpretation and data analysis.

 Data Analysis

In the analysis of the data, the following statistical tools will be used:

Frequency Count Percentage and Weighted mean.

In this research, the researchers will use the Likert Scale to analyze data and to

understand the conditions behind a specific problem. Likert scale is the most widely

used approach to scale responses in survey research.

Rating Description Interpretation

Very The different kinds of services the clinic gives to the students.
4.50-5.00
Satisfied

3.50-4.49 Satisfied The different kinds of services the clinic gives to the students.

2.50-3.49 Unsatisfied The different kinds of services the clinic gives to the students.

1.50- 2.49 Very The different kinds of services the clinic gives to the students.

Unsatisfied

Rating Description Interpretation

Very The attitude of the students towards the services of the clinic.
4.50-5.00
Satisfied

3.50-4.49 Satisfied The attitude of the students towards the services of the clinic.

2.50-3.49 Unsatisfied The attitude of the students towards the services of the clinic.

1.50- 2.49 Very The attitude of the students towards the services of the clinic.

Unsatisfied