Informed Consent for Participation in a Research

This informed consent form is for the caregivers caring for the elderly

either at home or in a healthcare facility (home for the aged) based in Quezon

Province, of whom I am inviting to participate in a research study entitled

“The Lived Experiences of Caregivers Caring for the Elderly: A

Phenomenological Study”.

Part I: Information Sheet

Introduction

I am Ms. Siena Kathleen V. Placino, along with my thesis partner, Mr.

Joshua Rafael M. Quiñones, both Level IV Bachelor in Science in Nursing at

Manuel S. Enverga University Foundation, Lucena City. We are currently

undertaking an undergraduate research on “The Lived Experiences of

Caregivers Caring for the Elderly: A Phenomenological Study”. We respectfully

invite you to be a part of this research. Kindly read and answer the questions

and adhere to the terms and conditions regarding your participation in this

study.

Purpose of the research

This phenomenological study will focus on the overarching description

of the lived experiences of nurses and caregivers who provide elderly care at

home and in home health facility. Specifically, it hopes to:

1. Describe the challenges of caring for the elderly;

2. Determine their perceived roles while caring for the elderly;

 3. Determine how they find strength in caring for the elderly.

Type of Research Instrument

A one-on-one interview will be guided by multiple interview questions

which will be conducted to find adequate qualitative phenomenological data

from the target population of nurses and caregivers caring for the elderly and

at the same time adhere to the purpose of the study at hand.

Participant Selection

Since this study will utilize a qualitative research design, sample size is

not generally predetermined. We will be analyzing interviews as a thematic

analysis and will continue to interview until saturation. Purposive sampling

design will be used following inclusion criteria: (1) a nurse or caregiver who

has experience of direct care to elderly either at the elderly’s own home or

within a healthcare facility (home for the aged); and (2) shows willingness to

participate in the study.

Voluntary Participation

The nurses or caregivers are invited to take part in this study and their

participation will be entirely voluntary and according to your free-will. It is

their choice whether to participate or not. The choice that they will make will

have no bearing to any aspects of the personal and professional life. They

may change their mind later and withdraw their participation even if they

agreed earlier.

Procedures, Protocol, and Description of the Process

 Initially, the researcher will conduct a short introduction with regards

to the research study. The study procedures will be discussed thoroughly, the

duration of the study, as well as the risks and benefits of the study.

Afterwards, questions will be entertained in connection with the study for the

purpose of clarification. Thereafter, they will be asked to accomplish and sign

the consent form if they are willing to participate in the study in the absence

of coercion or threat. If they will voluntarily sign the consent and participate

in the study, they will be asked to participate in a one-on-one interview in

which they will answer questions relating to the purpose of the study.

Duration

This research study will take place from August 2019 until December

2019. Accomplishing the instrument will only require at least (1) one to (1 ½)

one and a half hours of interviewing the participant.

Risks

The research instrument will be asking the respondents to share some

personal experiences and self-reflection on their interactions with their

respective elderly patients/ clients. They do not have to answer any questions

in the instrument if you don’t wish to do so, and that is also fine. They do not

have to give any reason for not responding to any question.

Benefits

The benefits for participating in my study will include the opportunity

to express their personal and professional experiences in caring for elderly

patients within the workplace.

Reimbursements

They will not be provided any incentive for taking part in this research.

However, they will be given a token of appreciation as an expression of

gratefulness for being participative in the entire duration of the study.

Confidentiality

All information that will be provided in this research study will be kept

confidential and will be used only for the conduct of the research. All

information will stay put on the researcher and no other people will have

access to it except the researcher’s adviser. We assure the participants that

the research will only be used for the purpose of partial fulfillment of

requirements of NR102 (Nursing Research 2) as part of the Bachelor of

Science in Nursing program under the College of Nursing and Allied and

Health Sciences of Manuel S. Enverga University Foundation. We assure that

the name of the facility and the names of participants will not be shared in

any part of the study.

Sharing the Results

Results of the study will be explained to you and a copy of the study

will be given to the participants as per their request. Likewise, we will also

provide the elderly facilities in Quezon Province a copy of our results and

research. Confidential information will not be shared. The results of the study

will likewise not be shared on any social media platform. A copy of the study
will only be provided for our research adviser and the four (4) panelists during

our thesis defense as well as a copy for the College of Nursing and Allied

Health Sciences of Manuel S. Enverga University Foundation. The study will

not be shared outside of the College of Nursing and Allied Health Science and

Manuel S. Enverga University Foundation. Strict confidentiality of results of

the study will be maintained.

Right to Refuse

The nurses and caregivers may not participate in this research if they

do not feel comfortable to do so and refusing to participate will not affect any

aspect of their personal and professional life. They will still enjoy and have

the benefits and privileges that they have despite of not partaking in this

study. They may also withdraw their participation in this research study in

any phase or any time that they feel like uncomfortable without losing any of

their benefits and privileges.

Who to Contact

If you have any questions, you can ask me now or feel free to contact

me at 09456125117 (Globe) or 09195167952 (Smart) or e-mail me at

sienakathleen1@gmail.com and rest assured that all your concerns will be

addressed the best way I can.

This proposal has been reviewed and approved by Manuel S. Enverga

University Foundation Ethics Review Committee, which is a committee whose

task is to make sure that research participants are protected from harm.
Part II: Certificate of Consent

I have been invited to participate in the research on “The Lived

Experiences of Caregivers Caring for the Elderly: A Phenomenological Study.”

Likewise, I have read and understand the foregoing information thus; it was

read and explained to me by Ms. Siena Kathleen V. Placino and Mr. Joshua

Rafael M. Quiñones to the level of my understanding. I had the opportunity to

ask questions about this study and all questions I had asked has been

answered to my satisfaction. Therefore, I consent voluntarily to be a

participant in this study.

Printed Name and Signature of Participant: __________________________

Printed Name and Signature of Witness: _____________________________

Date: ________________________

Thumb Print of the Participant:

Statement by the Researcher/ Person taking the Consent

I have accurately read out the information sheet to the potential

respondent, and to the best of my ability made sure that the respondent

understands that the following will be done:

1. Orientation about the research process

2. Informed Consent signing

3. Participation in One-on-One Interview

I corroborate that the respondent was given an opportunity to ask

questions about the study, and all questions asked by the respondent have

been answered correctly to the best of my ability. I also confirm that the

individual has not been coerced upon giving consent, and the consent has

been given freely and voluntarily. Thus, a copy of this informed consent form

has been provided to the respondent.

Printed Name and Signature of the Researcher/Person taking the Consent:

_______________________

Date: ___________________________

_______________________

Date: ___________________________