Proposal For Defense Group 3

1
St. Paul University Philippines

Tuguegarao City, Cagayan 3500
FACTORS AFFECTING THE HEALTH-SEEKING BEHAVIOR AND
HEALTH PRACTICES OF 3RD YEAR STUDENT NURSES OF
ST. PAUL UNIVERSITY PHILIPPINES
A Thesis Submitted to the
Faculty of School of Nursing and Allied Health Sciences
Tuguegarao City, Cagayan
In Partial Fulfillment
of the Requirements for
NCM 111: Nursing Research 1
Aquino, Kristiene Keith C.
Catsuela, Kelly G.
Lagrio, Jeremiah P.
Santos, Isabelle Arlette V.
Researchers
Mrs. Josephine Lorica, RN, DPA
Adviser
SPUP School of Nursing and Allied Health Sciences

2
Chapter 1
THE PROBLEM AND REVIEW OF RELATED LITERATURE
Introduction
Mchidi (2021, as cited in Chen, 2008) said that Nurse form
a fundamental part of the health workforce worldwide and their
contribution is essential to delivering safe care. Health care
is only safe to the extent that the person providing it is also
of good health. There is growing interest in the health of the
health care provider stemming from the realization that a
healthy population depends on a healthy workforce that leads as
an example. This has stimulated countries like China to start
programs aimed at improving their health professionals’ health.
With increasing morbidity in the health profession, the health
of the nurse must receive scrutiny by urgently seeking ways that
enhance their utilization of health services if they have to
make health seeking behavior advice to patients realistic.
Nursing student have gotten familiar with adjusting
rapidly, going through areas, and moving quickly starting with
one challenge then onto the next. Working through a pandemic has
changed all parts of our lives, and it have energetically taken
on new duties to help everyone around us with brief period to
fathom the effect of such enormous changes. And thus, as for

3
the future nurse one of the most important in everyone’s life is
their Health, 'Health' is a state of complete physical, social,
and mental wellbeing and not merely the absence of disease or
infirmity. Health is thus a level of functional efficiency of
living beings and a general condition of a person’s mind, body,
and spirit, meaning it is free from illness, injury, and pain.
Health-seeking behavior can be defined as any action
undertaken by individuals who perceive themselves to have a
health problem or to be ill for the purpose of finding an
appropriate remedy (Oberoi et al., 2016). Although there are
many studies on health-seeking behavior, there are few studies
on the health-seeking behavior of students, especially Filipino
student nurses, which is why this choice of experiment was
conducted. Culturally, Filipinos have a natural propensity of
delaying or avoiding preventative health-care steps before the
onset of an illness. Patient delay is an increasing issue for
health care providers. This study seeks to determine the factors
affecting health seeking behavior and health practices of
certain Filipino students.
Various studies about health seeking behavior have been
conducted as the years progressed. Health seeking behavior can
contribute a huge degree to the wellbeing status of each person
which incorporates various factors that influences their health.

4
The researcher knows that student nurses have an increase
knowledge about health practices since they are focus on disease
prevention and health promotion since health promotion reduce
the risk of developing chronic diseases and other morbidities.
Nurses have important role in promoting public health. The
health seeking behavior and health practices of every individual
varies on what health problems they experience and what specific
remedy they use to improve their health status. Hence, the
researcher seeks to determine the factors that affect health
behaviors and health practices of the student nurses
specifically in the Saint Paul University of Tuguegarao. To
measure the preference of the selected student nurse in
promoting their health.
Health status is an individual's relative level of wellness
and illness, considering the presence of biological or
physiological dysfunction, symptoms, and functional impairment.
Health perceptions (or perceived health status) are subjective
ratings by the affected individual of his or her health status6.
Some people perceive themselves as healthy despite suffering
from one or more chronic diseases, while others perceive
themselves as ill when no objective evidence of disease can be
found (American Thoracic Society, 2007)

5
Many factors affect health seeking behavior and health
practice of student nurses. Researchers consider reasons such as
Individual, Demographic, Sociology-economic, Health beliefs,
Institutional, Cultural in the stability of a sense of
well-being and health. Studies have shown that those with a high
perceived health status also have a better physical health
status. These people that have a high seeking behavior is
positively associated with the health problems and low health
practices.
This research is fist, of use to the future researcher as a
reference to improve their study and second, for 3rd year
Nursing Students of St. Paul University Philippines to
critically appraise their satisfaction in their functional
status of daily living. The study is conducted to identify the
different factors that influence the health-seeking behavior and
health practices. Particularly, it aims to assess the holistic
wellbeing of 3rd year Nursing Students. It provides factors to
improve the quality of health practices of 3rd year Nursing
students. Case in point, the research study determines how the
nurses seek their health and what are the ways or practices to
improve their health.
This study can advance new knowledge or new ways of
understanding by summarizing the current body of knowledge

6
related to the factors affecting health seeking behavior and
health practices among students, health information and its
influences on the students. This study will help understand and
serve as a basis to know and further address the health needs
and interventions needed among the college student being
studied. By this study it can bring new ways of understanding by
uncovering the current factors affecting health seeking behavior
and health practices especially among 3rd year student nurses of
St. Paul University to help promote better healthcare behavior
and practices which will essentially give a better health
outcome among the students. The finding of this study will
generate result that could influence nursing students to have a
positive effect and develop awareness on their health seeking
behavior and health practices which can attribute antecedents
and consequences results in promoting the status, importance,
and application of this concept in the nursing profession.
Review of Related Literature and Studies
The study explored concepts, articles and studies that are
related to the present investigation to establish clarity of
terms, to present what has been known about the variables and to
determine the gap in terms of knowledge that led to the

7
conceptualization of this research. The review is presented in
according to its level of priority. These are as follows:
Health-Seeking Behavior. This includes definition of
health-seeking behavior, and its determinants.
Health Practice. This presents the definition of Health
Practice, and its types. Strategies in promoting health.
Perceived Health Problems. This presents the definition
and the determinants.
Factors affecting Health-Seeking Behavior and Health
Practices. This includes the definition of Individual Factor,
Demographic and Socio-economic Factor, Health beliefs Factors,
and Cultural Factors.
I. Health-Seeking Behavior
Definition of Health-Seeking Behavior
The following presents varied definitions of authors on
Health-Seeking Behavior:
In a study entitled “A choice experiment of the
health-seeking behavior of a select group of Filipino nursing
students”, Health seeking is defined as any practice done by
people who believe they have a health condition or are sick to
find a suitable treatment. According to the researchers,
Filipinos have a propensity to put off or neglect preventative

8
health-care interventions before a disease manifest itself. The
aim of this research is to learn more about the health-seeking
habits of a select group of Filipino nursing students. Even
though there have been several studies on health-seeking
behavior, the researchers decided to concentrate on the
health-seeking behavior of students, specifically Filipino
nursing students. Study showed that a huge influence in terms of
health-seeking behavior is “who to consult first”. Filipino
student nurses lean towards family members to seek health advice
when signs and symptoms increase in number, severity, or
duration (De Guzman, Ho and Indunan 2020).
Understanding health seeking behaviors and determining
factors help governments to adequately allocate and manage
existing health resources. The researcher measured the health
seeking behaviors of the participant using 4 indicators
including routine medical check-ups, preferences of healthcare
facilities, admission while having health problems, and refusal
of health services while ill. The results were, 77.3% of the
participants reported to have visited health centers while they
had any health problems. More than half (51.7%) of them had a
routine medical check-up during the previous year, while 12.2%
of them had refused to seek healthcare when they felt ill during

9
the last five years. Of all, 39.1% of them reported preferring
private health services. Current smokers, having chronic
diseases, having poor perceptions on health, and spending less
on health during the last three months had about twice the odds
of having routine checkups. Higher education was shown to be a
positive predictor for the health-seeking behaviors, whereas
having self-care problems and having a moderate-income inversely
associated with seeking healthcare. Whereas the researchers
concluded that the utilization of public and private health
sectors revealed evident disparities in the socio-economic
characteristics of participants. The health-seeking behaviors
were determined by need factors including chronic disease status
and having poor health perception and by enabling factors such
as education, income, insurance status and ability to pay by
oneself. These findings highlight the need for further
nationwide studies and provide evidence for specific strategies
to reduce the socioeconomic inequalities in the use of
healthcare services (Abuduxike et. al, 2020).
Health seeking behavior refers to actions that people
resort to undertake for the purpose of finding an appropriate
remedy that can occur for both actual and potential problems.
When it occurs for actual problems, it is called illness
behavior and when it occurs for potential problems, it is called

10
health behavior. Illness behavior defines any act of going in
search of a relief to fulfil a health need. While health
behavior refers to observable actions of individuals aimed at
detecting or preventing disease and improving of wellbeing
(Babitsch et al., 2012). Though nurses, and other health
professionals are limited by a utilitarian society to seek
treatment from another health professional because this is what
they expect of their patients (Helfand, 2013), study findings
are contrary. A polish study found self-prescription was rampant
among nurses (Binkowska-Bury et al., 2013). In Nigeria, it was
found that 98.6% of the respondents had ever self-prescribed,
with 68.3% of these having had self-prescribed within the last
three months (Agaba et al., 2011). In a survey to determine
doctors’ personal choices in Hong Kong, China; 64% of the
respondents did not seek help from another physician (Chen et
al., 2008), findings that are consistent with a Nigerian study
that found that only 46.9% of the respondents consulted another
physician when last ill (Agaba et al, 2011). An Israeli study
found that though doctors had strong belief in screening tests,
only 27.5% of the respondents had undergone the tests with 55.6%
blaming it on lack of time (Peleg et al., 2013). Further, a
Baltimore study found more than half of the participants as not
having a regular meal schedule leading to poor eating habits and

11
obesity (Nahm et al., 2012). In Kenya, Taegtmeyer et al.,
(2008), found that health care providers who had had a needle
stick injury did not seek treatment because of the fear HIV
testing (Mchidi, 2012)
Health-seeking behavior has been defined as the activity
appropriate remedy [1]. Information of health seeking behavior
and health care utilization has important policy implications in
health system development. People seek help on health issues
based on several reasons and the factors which influence the
choice of treatment sources when symptoms occur include
socio-cultural factors, social networks, gender, and economic
status. Access to healthcare facilities in terms of cost of
treatment and healthcare provider attitude are also determinants
of health seeking behavior. There are indications that cost of
prescribed medicines, poor access to facilities and patient
delays affects the patronage and utilization of public health
services which increase the use of other treatment sources such
as community pharmacies, drug peddlers, herbal medicine,
religious or spiritual care organizations and students in
health-related academic disciplines (Afolabi, Daropale, and
Irinoye, 2013)

12
Health seeking behavior refers to the behavior of people
towards seeking their own health through provided health
services. The medical professionals are at a higher risk of
avoiding health seeking behavior because they believe they are
aware of the diseases and their symptoms as well as the
pharmaceutical management of the disease. The aim of this study
was to understand the healthcare seeking behavior of nurses and
doctors as well as the factors affecting it in hospitals of a
major city in a developing country. As a result, 194 doctors
(83%) had a greater access to medical facilities compared to 278
nurses (42%) (p<0.001). 176 Doctors (75%) compared to 262 nurses
(39%) were utilizing healthcare service more often (p<0.001).
Majority of the 494 nurses (74%) never visited a doctor for any
complaint over a period of one year compared to 132 doctors
(56%) (p=0.002). 234 Doctors (100%) and 662 nurses (99.7%)
equally self-medicated themselves (p=0.401). 134 Nurses (20%)
were less aware of the organization policies offered for
employee’s ill-health compared to doctors 102(44%) (p<0.001).
530 Nurses (80%) were also less aware of the significance of
regular health check-ups compared to 234 doctor (100%)
(p<0.001). Conclusions: Among the healthcare workers, doctors
have greater access to healthcare facilities. Majority of

13
nurses do not seek healthcare when they get sick.
Self-medication is common in both groups (Bana et al. 2016)
Determinants of Health-Seeking behavior
The following presents determinants of Health-Seeking
Behavior:
Understanding health-seeking behaviors and determining
factors help governments to adequately allocate and manage
existing health resources. Health-seeking behaviors were
measured using four indicators including routine medical
check-ups, preferences of healthcare facilities, admission while
having health problems, and refusal of health services while
ill. Results: About 77.3% of the participants reported to have
visited health centers while they had any health problems. More
than half (51.7%) of them had a routine medical check-up during
the previous year, while 12.2% of them had refused to seek
healthcare when they felt ill during the last five years. Of
all, 39.1% of them reported preferring private health services.
Current smokers, having chronic diseases, having poor
perceptions on health, and spending less on health during the
last three months had about twice the odds of having routine
checkups. Higher education was shown to be a positive predictor
for the health-seeking behaviors, whereas having self-care

14
problems and having a moderate-income were inversely associated
with seeking healthcare. In conclusion, the utilization of
public and private health sectors revealed a great difference in
the socio-economic characteristics of participants. The
health-seeking behaviors were determined by need factors
including chronic disease status and having poor health
perception and by enabling factors such as education, income,
insurance status and ability to pay by oneself. These findings
highlight the need for further nationwide studies and provide
evidence for specific strategies to reduce the socioeconomic
inequalities in the use of healthcare services (Abuduxike et al.
2020)
Despite high prevalence rates, little is known about health
seeking and related expenditure for chronic non-communicable
diseases in low-income countries. The researcher assessed
relevant patterns of health seeking and related out-of-pocket
expenditure in Bangladesh. Results: Eight hundred sixty-six
(12.5%) out of 6958 individuals reported at least one chronic
non-communicable disease. Of these 866 individuals, 139 (16%)
sought no care or self-care, 364 (42%) sought semi-qualified
care, and 363 (42%) sought qualified care. Multivariate analysis
confirmed that the following factors increased the likelihood of
seeking qualified care: a higher education, a major chronic

15
non-communicable disease, a higher socio-economic status, a
lower proportion of chronic household patients, and a shorter
distance between a household and a sub-district public referral
health facility. Seven hundred fifty-four (87 %) individuals
reported out-of-pocket expenditure, with drugs absorbing the
largest portion (85%) of total expenditure. On average,
qualified care seekers encountered the highest out-of-pocket
expenditure, followed by those who sought semi-qualified care
and no care, or self-care. Conclusion: The study reveals
insufficiencies in health provision for chronic conditions, with
more than half of all affected people still not seeking
qualified care, and the majority still encountering considerable
out-of-pocket expenditure. This calls for urgent measures to
secure better access to care and financial protection (Rasul et
al. 2019)
The prevalence of hypertension in India over the last 30
years is known to have increased rapidly. Hypertension is a
chronic disease that needs to be managed within its sociological
context as experienced by individuals. This study was conducted
to identify the quantitative and qualitative determinants of
healthcare-seeking behavior among hypertensive individuals in a
rural population of north India. As a result, A total of 100
participants with hypertension between 38 and 76 years of age

16
were included in the study. Out of the total study participants,
66.0% of the respondents were males and 34.0% were females.
Participants demonstrated a generalized knowledge of
hypertension and showed significant gaps and misconceptions in
their understanding of the disease and the need for seeking
expert care. There was also a lack of sense of trust in the
healthcare system. Various demographic, sociocultural, and
economic determinants of healthcare-seeking behavior in these
rural patients' services were explored. This evidence can prove
helpful in streamlining interventional programs and realigning
the existing interventions to prevent and control hypertension
in rural settings (Gupta et al. 2020)
In summary, health-seeking behavior is characterized as any
movement embraced by people who see themselves to have a medical
issue or to be sick to track down a suitable cure. The
health-seeking behaviors were determined by need factors. This
increased the likelihood of seeking qualified care. Appropriate
health seeking behavior is important to minimize complications
and improve quality of life.
II. Health Practice
Definition of Health Practice

17
Health practice means using your own non-specific
mechanisms of defense to promote health and prevent illness in
order to live a healthy life (Surdu, 2014).
Health practice is a behavior that is beneficial to one’s
physical or mental health, often linked to a high level of
discipline and self-control.
There is a growing expectation in national and
international policy and from professional bodies that nurses be
role models for healthy behaviors, the rationale being that
there is a relationship between nurses' personal health and the
adoption of healthier behaviors by patients. This may be from
patients being motivated by, and modelling, the visible healthy
lifestyle of the nurse or that nurses are more willing to
promote the health of their patients by offering public health
or health promotion advice and referring the patient to support
services (Muirreann, 2017).
Individuals with mental illness often live-in chronic
poverty, which is associated with personal health practices such
as tobacco use and poor nutrition that disrupt physical health.
The purpose of our study was to examine whether differences
exist in personal health and health practices - related to
nutrition, physical activity, smoking, alcohol consumption and
sleep - between a cohort of individuals with mental illness in

18
southwestern Ontario and the general Canadian population.
Individuals with mental illness are significantly more likely
than the general population to have a poor diet, experience poor
sleep and consume alcohol in excess. It is important for nurses,
health-care organizations, and policymakers to be aware that a
number of factors may be influencing the personal health and
health practices of individuals with mental illness and that
this population may require different health promotion
strategies to support a healthy lifestyle (Schofield et
al.,2016)
Types of Health Practices
The following research works present types of health
practices that may take effect on health-seeking behavior:
Self-Prescription/Self-Medication. This is the most common
health seeking behaviors reported by medical students in case of
illness (Sawalha, et al., 2017). Self-medication is getting and
consuming drug without the guidance of physician for either
diagnosis, treatment, or supervision of the treatment generally
involving over the counter (OTC) medications but also including
prescription-only medicines (POM), at the same time it includes
buying drugs by reutilizing/resubmitting a previous
prescription, taking medicines on advice of relative or others,

19
or consuming leftover medicines already available at home.
According to the World Health Organization, self-medication when
practiced correctly reduces the load on medical services,
reduces the time spent in waiting to see the physician, and
saves cost especially in poor countries with limited healthcare
resources (Helal, et al., 2017).
A study by Helal (2017) stressed most frequent conditions
in which the student self-medicated were cold, headache, sore
throat, intestinal colic, and lastly cramps. More than half of
students mentioned that the self-medicated drugs solved the
symptom. Other reasons for self-medication among university
students were their previous experiences, advice of family or
friends, their health problems being considered as too trivial,
time saving, nonavailability of transport, convenience, ability
to self-manage the symptoms, urgency of the problem, doctor that
was not available, and having sufficient information. Students
reported that medical education, excessive waiting time to be
seen, cost and inaccessible medical services are the most common
reasons that affect their behavior in sickness in other studies
(Sawalha, et al., 2017).
Traditional/Cultural. Traditional medical (TM)
practitioners include manghihilot (or bone setter or partera),
albularyo (herbalist), mangtatawas (diagnostician, user of

20
potassium alum), and faith healers or espiritista in most
Filipino languages, and are more popular in the rural areas.
They belong to the country’s own traditions. Also, they are
neither “part of conventional medicine” nor “fully integrated
into the dominant healthcare system”. (Ladia et al., 2018). In
the Philippines, complementary and alternative medicine was a
more cost-effective option than finding medical support from
physicians. Traditional medicine practitioners were also easier
to find in rural areas since they usually lived in the same or
neighboring barangay or village. The study showed almost 25
percent sought the services of TM practitioners like manghihilot
and albularyo. Herbal medicines and supplements were likewise
used (25%) such as sambong (Blumea balsamifera), lagundi (Vitex
negundo), banaba (Lagerstroemia speciosa), and oregano
(Plectranthus amboinicus). Almost seven percent of apparently
healthy individuals also availed of massage services (Ladia et
al., 2018).
A study by Tuliao et al (2014) surveyed college students
using pagtatanung-tanong (informally asking around), a
recommended indigenous research method for Philippine social
science research. In the Filipino American Epidemiological Study
(FACES) study, it reported Filipinos sought help for

21
psychological problems from friends, relatives, priests or
ministers, herbalists, spiritualists, and fortune-tellers.
Professional. A study in Scotland showed that most
respondents would choose to see a physician rather than a
pharmacist prescriber and some felt that their consultation with
the pharmacist could have been better (Dawood et al., 2019).
Most people can easily get access to non-prescription medicines
for short term usage and for minor illnesses and only consider
physicians’ consultation for major health problems(Chua, 2011).
In a study entitled “Assessment of health seeking behavior
and self-medication among general public in the state of Penang,
Malaysia” most people tend to visit a physician, although a
smaller percentage would consult a pharmacist when it comes to
facing any health problems. In addition, seeking for a physician
was found to be influenced by perceived the severity of illness
among people. (Dawood, et al., 2016) The recommendation of
previous physicians was a frequent factor for self-medication,
and certain people seek the advice of a physician or pharmacist
for various ways to incorporate self-treatment into their
routine. Most participants prefer to see a doctor first when
they have a health problem, however a small percentage of the
population prefers seeking a pharmacist first. Even though

22
people have the freedom to get care from whomever they choose,
it is recommended that they seek medical advice.
Strategies in Promoting Health.
Good Health is the desire of everyone, the achievement of a
good health relies upon the person's capacity to carry on with a
positive way of life. Good health is hard to be accomplished
totally as human needs cannot be totally fulfilled at some
random time. An investigation which entitled, Health
communication Strategies as Gateway to Effective Health
Promotion and Well-being, said that health promotion upholds
individual and society advancement by providing information
which improves health and enhance wellbeing. Communication
creates meaning to any data given and changing a generally
existing behavior is very difficult. However, with compelling
communication and utilization of effective strategies,
behavioral change could be achieved. Health communication
campaign directly provides education to people who are expected
to adopt or change to a healthier behavior. Health communication
galvanizes people into action promotes healthy lifestyle,
prevents diseases, and improves the health through eschewing
destructive behavior like abuse of substances (cigarette, drugs,
and alcohol), maintaining personal and environmental hygiene as

23
well as cultivating a positive and healthy sexual relationship.
In this study, it cancels a portion of the strategies received
by the health educator to impact individuals and achieve conduct
charge. Some of them incorporate health campaign,
newsletters/journals, billboard, radio/ television, and
social/internet media. Advantages of health communication
include expanding crowds' information and awareness on
health-related issues and its promotion for medical problem and
strategies were distinguished. Additionally, barriers, for
example, low health proficiency and poor communication were
recognized. It was inferred that wellbeing communication adds to
all parts of disease prevention and wellbeing promotion. Thus,
the recommendation is that health communication should be
included in all levels of health’s curriculum to enable health
educators acquire better skills to promote health and improve
well-being. (Chukumati & Obiechina et., al 2017)
A conceptual framework was presented to address a shift
from compartmentalized arrangements toward a comprehensive
frameworks approach that supports organization across orders and
areas. It was discussed in this article about the practical
tools to assist with environmental decision making, such as
Health Impact Assessments, environmental public health tracking,

24
and cumulative risk assessment. Likewise, it was distinguished
the priorities in research, practice, and training to propel the
role of public health in decision making to improve health, such
as the Health Impact Assessment, as a core competency for
environmental health practitioners. The study empowers
cross-disciplinary correspondence, research, and training that
bring the fields of preparation, transportation, and energy in
closer coordinated effort with public health to jointly propel
the frameworks way to deal with the present ecological
difficulties (Koehler, et al., 2018).
Community-level policy, systems, and environmental (PSE)
change strategies may offer an economical and sustainable
approach to chronic disease prevention. The rapidly growing
number of untested yet encouraging PSE techniques in progress
offers an exciting chance to build up practice-based proof for
this methodology. Changing Policy, System, and Environmental
features focused on physical activity and smart dieting
practices can play a key role in preventing obesity strategies
in early youth stage education settings because of their broad
reach and because they can be sustained over time. In the study
about “Implementation of policy, system and environment changes
in early childhood education settings”, it examined the
implementation and sustainability of health-promoting PSE

25
changes after facilitation of an innovative strategic planning
process in childcare settings. The article says that
distinguishing health-promoting policy, system and environment
changes that are most promptly implemented and sustained in
childcare centers can inform systems-level interventions and
resource allocation related to early childhood obesity. This
strategic planning process is a successful tool to translate
sustainable changes related to healthy eating and physical
activity, improve the quality rating of diverse childcare
centers, and promote healthy behaviors in early childhood
(Farewell, C.V., Powers, J.N., Maiurro, E. et al 2020).
Adopting a “health literacy social ecological model
(HLSEM)” may improve health or wellbeing literacy and patient
engagement. In this article entitled, “Improving low health
literacy and patient engagement: A social ecological approach,
Patient Education and Counseling”. They illustrate the five
multilevel intervention strategies for addressing low health
literacy and promoting patient engagement: accumulation,
amplification, facilitation, cascade, and convergence
strategies. The practice implications of embracing a more
extensive social ecological point of view to address low health
literacy shifts the field from considering about individual
educational interventions to how individual interventions may be

26
upheld or supported by interventions at additional levels of
influence. The potential benefit of adopting a multilevel
intervention approach is that combining interventions could
produce synergies that are greater than interventions that only
utilize one level of influence (McCormack L., Thomas V., Lewis
A., Rudd R. et al., 2017).
According to World Health Organization (WHO), specified
that reorienting health services is the responsibility for
health promotion in health services is shared among individuals,
community groups, health professionals, health service
institutions and governments. Community-based strategies are
strategies that commonly involve social and environmental change
across various contexts to avoid dysfunction and enhance
well-being across population groups in a specified local
community. The role of the health sector must move increasingly
in a health promotion direction, beyond its responsibility for
providing clinical and curative services. Health services need
to embrace an expanded mandate which is sensitive and respects
cultural needs. This mandate should support the needs of
individuals and communities for a healthier life, and open
channels between the health sector and broader social,
political, economic, and physical environmental components. In
the study entitled, “Quality improvement as a population health

27
promotion opportunity to reorient the healthcare system”, the
researchers worked directly with healthcare teams to link
cultural safety, patient-centeredness, and health equity to
other dimensions of healthcare quality and provided data from
health status reports (Kryzanows, J., Bloomquist, C.D.,
Dunn-Pierce, T. et al, 2019.
In conclusion, health practice is a behavior that is
beneficial to one’s physical or mental health, often linked to a
high level of discipline and self-control. Individuals' personal
health and health practices are influenced by a variety of
factors, which includes self-prescription/self-medication,
traditional/cultural and professional. Health practice is
influenced by the health beliefs, the types, and the strategies
in promoting health. Health communication strategies aim to
change people's knowledge, attitudes, and/or behaviors.
Strategies in promoting health is a relevant contributor in
health seeking-behavior and health practices. Community-based
strategies generally involve social and environmental change to
avoid dysfunction and enhance well-being. This information will
help identify factors affecting health seeking behavior and
health practices.

28
III. Perceived Health Problems
Definition of Perceived Health Problems
The following are definition of perceived health problems:
Perceived health status indicates people’s overall
perception of their health, including both physical and
psychological dimensions (Bonner, et al., 2017). Perceived
health refers to a person's perception of signs, diagnoses,
and performance failures that are related to a greater risk
of mortality.
Perceived health is an indicator of overall health status.
“Health” means not only the absence of disease or injury, but
also includes their overall physical, mental, and social
well-being. (Statistics Canada, 2016)
Determinants of Perceived Health Problem
The following presents determinants of perceived health
problem:
It presents a preliminary test of the conceptual model of
cognitive determinants of the perception of mental health
status. Results indicate the importance of cognitive factors
like attention, memory, and reasoning in the perception of
mental health status and support a direct causal interpretation
of model variables. Symptom checklist scores and path variables

29
were found to be the best predictors of help-seeking behavior
(Hourani et al.,2002).
Perceived health status indicates people’s overall
perception of their health, including both physical and
psychological dimensions. The aim of this study was to examine
the determinants of self-perceived health for Canadians aged 40
and older using data from the Canadian Community Health Survey
(2010). As a result, the researchers found that higher income
was significantly associated with better health status while
chronic conditions and stress were associated with worse health
status. In the 40–64 and 65+ age groups, individuals in the
highest income bracket were 4.65 and 1.94 times, respectively,
more likely to report better health than individuals in the
lowest income bracket. The difference in the level of income
associated health inequities between the two age groups point to
the need for understanding the reasons behind lower inequities
among seniors and how much the social protections provided by
the Canadian government to seniors contribute to lowering
inequities. (Bonner et al.,2017).
To sum up, perceive health problem is refers to the view of
an individual's wellbeing in general, either by the actual
individual or, on account of intermediary reaction, by the
individual reacting. Wellbeing implies the shortfall of

30
infection or injury as well as physical, mental, and social
prosperity.
IV. Factors affecting the Health-Seeking and Health Practice
There are many factors that affects an event, decision, or
situation and these are presented as follows:
Individual
Undoubtedly, physical activity and stress management have a
significant role in personal health and occupational
satisfaction of students, which consequently help them provide
better services to clients (Hosseini et al., 2015). Individual
factors that affect the Health Seeking Behavior and Health
practices are age, class section, gender, marital status,
religious belief, allowance, living arrangements, birth order.
Family/ Socio-economic
Nursing education and clinical practice can undoubtedly
increase the necessary health knowledge of nursing students but
may not change their attitudes and actual health-promoting
behaviors. The correlations were determined between various
dimensions of a health-promoting lifestyle. Students with a
higher health management score and no family conflicts were more
likely to give a positive appraisal of their health status. It
is recommended that, using multiple strategies, nursing students

31
be empowered to manage their lifestyle and make a fair appraisal
of their well-being (Chow et al., 2018).
Health Belief
Health beliefs, particularly feelings of self-efficacy,
relate to an individual's perceived ability to perform a certain
behavior. These perceptions of self-efficacy may influence
whether individuals will attempt certain behaviors and how the
behaviors will be carried out (Cukor & Kimmel, 2017)
Culture
Considering the effect of educational, cultural, and
individual factors in developing nurses’ professional values; it
is recommended to the educational and health centers to consider
value-based cares in clinical environments for the patients in
addition to considering the content of educational programs
based on ethical values in the students’ curriculum (Parandeh et
al., 2015).
Concisely, the health-seeking behavior, health practices,
and perceived health problem are influence by the individual
factors, demographic and socio-economic factor, health belief
factors, and cultural factors
The following reviews will serve as a significant
foundation for the conduct of the study. The results will

32
provide background on the variables that could be included in
the investigation. While there is many research on
health-seeking behavior, there are only few studies on the
health-seeking behavior of students, particularly Filipino which
is why this choice experiment was conducted. Therefore, the goal
of the study is to investigate factors affecting the
health-seeking behavior and health practices of 3rd year student
nurses of Saint Paul University Tuguegarao.
Conceptual Framework
Figure 1. The study will be based on the illustration below:

33
Figure 1. Paradigm of the Study
The conceptual framework presents the cause- effect between
variables of the study. As indicated in the paradigm above, the
following independent variables are: Individual Factors,
Demographic and Socio-economic Factors, Health Beliefs Factors,
and Cultural Factors that affects the Dependent Variables which
are the following: Health-Seeking behavior, Health Practice, and
Perceived Health Problem. The researchers will conduct surveys
with the use of research tools to gather data on the mentioned
inputs needed and will be analyzed and interpreted by the
researchers. The findings on the analyzed and interpreted data
will obtain baseline data regarding the factor affecting the
health seeking behavior and health practices of 3rd year student
nurse of St. Paul University Philippines.
Statement of the Problem
Generally, the study seeks to determine the factors that
affect the health seeking behaviors and health practices of BSN3
students in St. Paul University Philippines.

34
Specifically, the study seeks to answer the following
questions:
1. What are the factors present among the participants of the
study?
1.1. Individual factors
1.2. Family factors
1.3. Health beliefs/ Cultural or health traditions in
relation to health and illness
2. What are the perceived health problems of the participants?
3. What is the health seeking behavior of the participants?
4. Is there a significant relationship between the identified
factors and the health seeking behaviors of the
participants?
5. What are the health practices of the participants when they
have health problems?
6. Is there a significant relationship between the identified
factors and the health practices of the participants?
Hypothesis

35
The following hypothesis will be tested at 0.05 level of
significance:
Ho1: There is no significant relationship between the factors
when grouped according to Health-seeking behavior, Health
Practices, and Perceive Health Problem variables.
Ho2: There is no significant relationship between the identified
factors and the health practices of the participants.
Scope and Limitation
This study focuses to determine the factors affecting the
health-seeking behavior and health practices of the 3rd year
Nursing Student of St. Paul University Philippines. The
participants include 155 3rd year Nursing Students, consisting
of 118 female and 37 male ages 20-21. A Chi-square Test is use
in determining the health-seeking behavior of the participant,
Chi-square test compares the size any discrepancies between the
expected results and the actual results, given the size of the
sample and the number of variables in the relationship. To
measure the health practices Cross-sectional survey is utilized,
this research design in which you collect data from many
different individuals at a single point in time. The researchers

36
observe variables without influencing them. Next, individual
factors the SF-12 is used to test to measure assessing the
impact of health on an individual's everyday life. It is often
used as a quality-of-life measure. In demographic and
socio-economic factors descriptive-survey is being utilized to
gather data about varying health-seeking and health practices.
This data aims to know the extent to which different conditions
can be obtained. Next, health beliefs Bartlett's test is used to
test if it has an equal variance. And lastly, in Cultural factor
in-depth interview is used to obtained detailed information, its
goal is to explore in depth respondents’ point of view,
experiences, Feelings, and perspectives. The question will be
administered for 15 minutes.
Significance of the Study
This study focused on determining the health seeking
behavior and health practices of third year student nurses of
St. Paul University Philippines. Moreover, the results of this
study will be beneficial to the following:
The Students. Student will be the direct recipient of this
study specifically on determining the health seeking behavior
and health practices that can improve health outcomes. This

37
study can increase the level of awareness and knowledge of the
students specifically on the factors that affects health
wellness.
The Teachers. Teacher may use this research study to help
them in their discussion regarding health seeking behaviors and
health practices. It will be easier for them to tackle this as
for discussion as it consists of data that focus on the health
seeking behavior and health practices specifically among nursing
students.
Researchers. This study could provide learnings regarding
factors affecting the health seeking behavior and health
practices that could be applied amidst the pandemic. It will
also be beneficial not only in terms of intellectual
advancements but in preparation for a tougher and more complex
study in the future.
Future Researchers. The study presented may be used as a
reference data specially on the future researchers who will
conduct new research that is inline to the focus of the study or
undertaking similar study.
Definition of Terms

38
The following terms were defined operationally in this
study for clearer understanding of the variables under
investigation:
Behavior. It is the manner in which one acts or conducts,
particularly toward others.
Cultural factors. This is a collection of beliefs and
ideals shared by a community or group of people. It is an
individual's culture that determines how he or she acts.
Demographic factors. It refers to a characteristic of a
population. Demographic information provides data regarding
research participants and is necessary for the determination of
whether the individuals in a particular study are a
representative sample of the target population for
generalization purposes are.
Individual factors. These are the factors that contribute
to the success of the information system according to the
organizational characteristics.
Health beliefs. These are a person's culturally established
views about their health, including what they believe defines
health, the source of their sickness, and how to overcome it.

39
Health practice. It means using your own defense to promote
health and prevent illness to live a healthy life. A health
practice is a lifestyle that is favorable to one's physical or
mental health and is frequently associated with self-control and
discipline.
Health seeking behavior. Is any activity or action
appropriate remedy

40
Chapter 2
METHODOLOGY
This chapter contains the methods and procedures that were
used in the study. It includes the research design, participants
of the study, instrumentation, data gathering procedure and the
data analysis tools which were utilized to analyze the gathered
data.
Research Design
This investigation will utilize the quantitative research
approach. The quantitative approach, particularly using the
descriptive-correlational research design, is intended to
describe and correlate factors affecting the health-seeking
behavior and health practices of 3rd year student nurses of St.
Paul University Philippines. This method involves describing the
present factors including individual, family, health
beliefs/cultural factors. Describing health-seeking behavior and
describing the health practices. This study also involves
determining the relationship between health-seeking behavior and
the factors, health practices and the factors.
Participants of the Study

41
The participants involved in the study are
student-participants, from the 3rd year level of nursing student
at St. Paul University Philippines, Tuguegarao enrolled in the
second semester, academic year 2020-2021.
This table below shows the distribution of the participants
according to their sections.
Table 1. Distribution of the Participants of the Study
Section Total Population Number of

Participants
Section A 34 25
Section B 39 28
Section C 39 28
Section D 39 28
Total 151 109
There is a total population of 151 participants, composed
of 115 females and 36 males, covered in the study. In the total
population, the researchers will randomly select 109
participants, which will be distributed and divided into four
sections. A sample size of 109 participants drawn from the total
population of 151 through stratified random sampling technique.
The sample size is calculated through the online sample size
calculator (SurveyMonkey). There will be 25 students to be asked
in sections A and 28 in section B, C and D. The stratified

42
random sample is obtained using the formula: (sample
size/population size) x stratum size. The participants will be
asked about their health-seeking behavior and health practices
and factors affecting it. And the result of the survey
questionnaire will serve as a basis in determining the
relationship between the factors affecting their health seeking
behavior and health practices.
Instrumentation
To gather data, the researchers developed a tool that would
gather the factors affecting the health-seeking behavior and
health practices questionnaire and that will be used in the
study. The questionnaire was based on the tool from the study of
Mchidi (2016) Health seeking behavior among Nurses working in
Kakamega Country. It consists of 4 parts. The first part elicits
information as to the factors present among the participants of
the study, in terms of Individual, Family, Health beliefs/
Cultural or health traditions. Second part draws out data on the
perceived health problem of the participants. The third part
elicits information as to the health-seeking behavior of the
participants. And lastly the health practice, this determines

43
the health practices of the participant when they have health
problem.
The part 1 of the questionnaire has the following
sub-parts:
Individual factors. This question assesses the
participants’ profile in terms of their Age, Gender, Marital
status, Religious belief, living arrangement, and birth order
the participants respond by selecting answers and putting a
check mark on the appropriate spaces.
Family factors. This part will be gathering information
regarding the participants family household income, where the
family normally spend most money, parent’s occupation, health
insurance cover, satisfaction in terms of their health
insurance, workload, and history of illness. The participants
will be selecting answers by putting a check mark on the
appropriate spaces.
Health beliefs/ Cultural factors. This question involves 7
items which aims to assess the participants health
beliefs/cultural traditions in relation to their health and
illness. This part consists of questions regarding the
participants satisfaction with the health service they have
access, and the quality of health service. The participants

44
will be selecting answers by putting a check mark on the
appropriate spaces.
Perceived health problem questionnaire. This includes 9
items which assess what are the participants perceived health
problems. The participants will be selecting answers by putting
a check mark on the appropriate spaces.
Health-seeking Behavior questionnaire. This will be used to
assess the activity or action undertaken by the participants
regarding their health-seeking behavior.
Health practice Questionnaire. This will assess the health
practices of the participants when they have health problems.
The participants will be writing their response.
The questionnaires that were used by the researchers were
given to the research adviser for comments, suggestions, and
corrections. The result of the revision served as a basis for
its improvement and refinement of the said instruments. Thus, it
was assessed in terms of its construction, organization,
structure, and purpose. The questionnaire will be pretested to
participants with the same characteristics but in a different
locality.
Data Gathering Procedure

45
To obtain the data needed for the investigation, the following
procedures will be undertaken by the researchers.
1. The researchers will present the study for approval to a
panel of examiners and submit the revised proposal for
approval of St. Paul University Philippines (SPUP) Research
ethics Committee.
2. The researchers will frame letter of request to the dean of
nursing of St. Paul University Philippines (SPUP) and the
coordinating team of the Bachelor of Science in Nursing
(BSN) students to conduct the study.
3. Upon the approval of the letter of request, the researchers
will encode the tool in Google forms.
4. The 109 number of total participants will be identified.
There will be 109 informed consent forms that will be sent
through Google forms to ensure that the study conforms to
the ethical norms of research. Should there be any
concerns, questions, or clarification with regards to the
participation in the study, the researchers have included
their contact information such as mobile numbers, email
address, or social media accounts in the said form so the
participants could freely contact them real time while

46
answering the questionnaire. Once the participants agree to
participate, they can just access the link.
5. Upon approval of the dean, the researchers will confer with
the BSN coordinating team on the schedule of the data
gathering particularly on the online distribution of the
questionnaires through Google forms for the BSN 3 students.
The following are the details of the processes that will be
involved in obtaining the specific data:
1. Administration of the profile questionnaire. The researcher
in coordination with the student-participants agree on the
specific time and date to administer the question via
Google forms. The researchers will show directions to
ensure that the participants would understand how to answer
the questionnaire. If there will be any concerns, the
researchers will also attach contact details such as
numbers or social media lines in the said form so that the
participants could freely contact them real time while
answering the form.
The data that will be obtained from the questionnaires will be
tallied for statistical treatment.

47
Data Analysis Tools
The data that will be obtained will be tallied and treated
determining the factors affecting the health seeking behavior
and health practices of the participants, using the following
statistical tools:
Frequency and Percentage. This will be used to interpret
the profile of the participants.
Mean. This will be used to determine the participants
perceived health problem, health seeking behavior and health
practices.
Chi-square (x2) Test. This will be used to determine the
relationship between health seeking behavior and health
practices of the participants.

48
REFERENCES
Chukumati, C., & Obiechina, G. O. (2017, November). Health

communication Strategies as Gateway to Effective Health
Promotion and Well-being. Retrieved April 2021, from
https://www.imedpub.com/articles/health-communication-strat
egies-as-gateway-to-effective-health-promotionand-wellbeing
.pdf
Koehler, K., Latshaw, M., Matte, T., Kass, D., Frumkin, H., Fox,
M., Hobbs, B. F., Wills-Karp, M., & Burke, T. A. (2018).
Building Healthy Community Environments: A Public Health
Approach. Public Health Reports, 133(1_suppl), 35S-43S.
https://doi.org/10.1177/0033354918798809
Farewell, C.V., Powers, J.N., Maiurro, E. et al. Implementation
of policy, system and environment changes in early
childhood education settings. ICEP 14, 5 (2020).
https://doi.org/10.1186/s40723-020-00070-6
Lauren McCormack, Veronica Thomas, Megan A. Lewis, Rima Rudd,
(2017) Improving low health literacy and patient
engagement: A social ecological approach, Patient Education
and Counseling. Retrieved April 2021, from
https://doi.org/10.1016/j.pec.2016.07.007.
Kryzanowski, J., Bloomquist, C.D., Dunn-Pierce, T. et al.
Quality improvement as a population health promotion
opportunity to reorient the healthcare system. Can J Public
Health 110, 58–61 (2019).
https://doi.org/10.17269/s41997-018-0132-8
Rasul, F.B., Kalmus, O., Sarker, M. et al. Determinants of
health seeking behavior for chronic non-communicable
diseases and related out-of-pocket expenditure: results
from a cross-sectional survey in northern Bangladesh. J
Health Popul Nutr 38, 48 (2019).
https://doi.org/10.1186/s41043-019-0195-z
Winfred Muringi Wambui, Samuel Kimani, Eunice Odhiambo,
"Determinants of Health Seeking Behavior among Caregivers
of Infants Admitted with Acute Childhood Illnesses at
Kenyatta National Hospital, Nairobi, Kenya", International
Journal of Pediatrics, vol. 2018, Article ID 5190287, 11
pages, 2018. https://doi.org/10.1155/2018/5190287
Gupta S, Virk A, Mittal A, Agarwal B K. Patterns and
determinants of healthcare-seeking behavior among

49
hypertensive patients in a rural population of north India:

A mixed-method study. J Family Med Prim Care [serial
online] 2020 [cited 2021 Apr 15];9:2830-6. Available from:
https://www.jfmpc.com/text.asp?2020/9/6/2830/287844
Shaikh , Babar T. “Health Seeking Behaviour and Health Service
Utilization in Pakistan: Challenging the Policy Makers.”
Journal of Public Health , Advance Access Publication, 8
Dec. 2004, Retrieved from DOI: 10.1093/pubmed/fdh207
S;, Kelly M;Wills J;Sykes. “Do Nurses' Personal Health
Behaviours Impact on Their Health Promotion Practice? A
Systematic Review.” International Journal of Nursing
Studies, U.S. National Library of Medicine,
pubmed.ncbi.nlm.nih.gov/28938104/.
Schofield R;Forchui C;Montgomery P;Rudnic A;Edwards B;Meier
A;Speechley M; “Comparing Personal Health Practices:
Individuals with Mental Illness and the General Canadian
Population.” The Canadian Nurse, U.S. National Library of
Medicine, pubmed.ncbi.nlm.nih.gov/29461704/.
https://www.sciencedirect.com/science/article/abs/pii/0277953686
902091
https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-
017-0595-x#:~:text=Perceived%20health%20status%20indicates%
20people%E2%80%99s%20overall%20perception%20of,data%20from%
20the%20Canadian%20Community%20Health%20Survey%20%282010%29
.
Hosseini, M., Ashktorab, T., HosseinTaghdisi, M., Vardanjani, A.
E., & Rafiei, H. (2015). Health-promoting behaviors and
their association with certain demographic characteristics
of nursing students of Tehran City in 2013. Global Journal
of Health Science, 7(2), 264. Retrieved from
Health-Promoting Behaviors and Their Association With
Certain Demographic Characteristics of Nursing Students of
Tehran City in 2013 (nih.gov).
Chow, S. K. Y., Kin-Man, L. A. M., Shih-Hung, L. I. E., Ka-Chun,
M. A. K., Ka-Chun, M. O. N. G., Chun-Man, S. O., & Wai-Yip,
Y. U. E. N. (2018). Do demographic factors and a
health-promoting lifestyle influence the self-rated health
of college nursing students?. BMC nursing, 17(1), 1-9.
Retrieved from Do demographic factors and a
health-promoting lifestyle influence the self-rated health

50
of college nursing students? | BMC Nursing | Full Text

(biomedcentral.com).
Kim, M. J., & Yun, S. J. (2018). A convergence study on the
factors influencing nursing students' attitudes toward
standard precautions: Focusing on the health belief model.
Journal of the Korea Convergence Society, 9(6), 77-88.
Retrieved from JAKO201819352297779.pdf
(koreascience.or.kr).
Shaheen, A. M., Nassar, O. S., Amre, H. M., & Hamdan-Mansour, A.
M. (2015). Factors affecting health-promoting behaviors of
university students in Jordan. Health, 7(01), 1. Retrieved
from Factors Affecting Health-Promoting Behaviors of
University Students in Jordan (scirp.org).
Parandeh, A., Khaghanizade, M., Mohammadi, E., & Nouri, J. M.
(2015). Factors influencing development of professional
values among nursing students and instructors: a systematic
review. Global journal of health science, 7(2), 284.
Retrieved from Factors Influencing Development of
Professional Values Among Nursing Students and Instructors:
A Systematic Review (nih.gov).
Abuduxike, Gulifeiya, et al. “Health-Seeking Behaviors and Its
Determinants: A Facility-Based Cross-Sectional Study in the
Turkish Republic of Northern Cyprus.” International Journal
of Health Policy and Management, Kerman University of
Medical Sciences, 1 June 2020,
www.ijhpm.com/article_3701.html
Karwawhee, Ericson D.F., et al. “FACTORS INFLUENCING THE HEALTH
SEEKING BEHAVIOUR OF SENIOR HIGH SCHOOL STUDENTS IN THE
ASOKORE MAMPONG MUNICIPALITY OF GHANA.” Journal of Natural
Sciences Research,
www.iiste.org/Journals/index.php/JNSR/article/view/43531.
Dawood, Omar T, et al. “Assessment of Health Seeking Behaviour
and Self-Medication among General Public in the State of
Penang, Malaysia.” Pharmacy Practice, Centro De
Investigaciones y Publicaciones Farmaceuticas, 2017,
www.ncbi.nlm.nih.gov/pmc/articles/PMC5597809/.
Khajeh, Atefeh, et al. “Healthcare-Seeking Behavior and Its
Relating Factors in South of Iran.” Journal of Education
and Health Promotion, Wolters Kluwer - Medknow, 30 Sept.
2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6796318/.

51
Mak, Yim Wah, et al. “Health-Promoting Lifestyle and Quality of

Life among Chinese Nursing Students: Primary Health Care
Research & Development.” Cambridge Core, Cambridge
University Press, 6 Apr. 2018,
www.cambridge.org/core/journals/primary-health-care-researc
h-and-development/article/healthpromoting-lifestyle-and-qua
lity-of-life-among-chinese-nursing-students/7F0BD0D8C12FF28
23F8874451FBADCE4.
Bonner, W. I. A., Weiler, R., Orisatoki, R., Lu, X., Andkhoie,
M., Ramsay, D., ... & Farag, M. (2017). Determinants of
self-perceived health for Canadians aged 40 and older and
policy implications. International journal for equity in
health, 16(1), 1-9.
Perceived Health of Person. (2016, September 28). Retrieved
April 15, 2021, from
https://www150.statcan.gc.ca/n1/pub/82-229-x/2009001/status
/phx-eng.htm
Helal, R. M., & Abou-ElWafa, H. S. (2017). Self-medication in
university students from the city of Mansoura, Egypt.
Journal of environmental and public health, 2017.
Sawalha, K., Sawalha, A., Salih, E., Aldhuhori, N., Aboukalam,
N., Bakie, R., ... & Hussein, A. (2017). Health seeking
behavior among medical students in the University of
Sharjah. Journal of Pharmacy and Pharmacology, 5, 561-564.
Tuliao, A. P., & Velasquez, P. A. (2014). Revisiting the General
Help Seeking Questionnaire: Adaptation, exploratory factor
analysis, and further validation in a Filipino college
student sample. Philippine Journal of Psychology, 47(1),
1-17.
Ladia, M. A. J., Sison, O. T., Castillo-Carandang, N. T., Sy, R.
G., Llanes, E. J. B., Reganit, P. F. M., ... & Velandria,
F. V. (2018). Prevalence of and Associations for
Complementary and Alternative Medicine Use among Apparently
Healthy Individuals in the Philippine LIFECARE Cohort. Acta
Medica Philippina, 52(5).
Chua S, Sabki N. Use of nonprescription medications by the
general public in the Klang Valley. J Appl Pharm Sci.
2011;1:93.
Dawood, O. T., Hassali, M. A., Saleem, F., Ibrahim, I. R.,
Abdulameer, A. H., & Jasim, H. H. (2017). Assessment of
health seeking behaviour and self-medication among general

52
public in the state of Penang, Malaysia. Pharmacy Practice

(Granada), 15(3).
Dawood OT, Hassali MA, Saleem F. A qualitative study exploring
medicines use pattern and practice among general public in
Malaysia. Pharm Pract (Granada). 2016;14(2):740. doi:
10.18549/PharmPract.2016.02.740
Ajaegbu, O. O., & Ubochi, I. I. (2016). Health Seeking Behaviour
among Undergraduates in the Faculty of Health Sciences and
Technology, University of Nigeria Enugu Campus.
International Journal of Evaluation and Research in
Education, 5(3), 181-188.

53
Appendix A
LETTER OF PERMISSION TO THE PROGRAM COORDINATOR OF THE NURSING

DEPARTMENT
DR. ELIZABETH C. BAUA

Program Coordinator for Nursing
Dear Ma’am:
Greetings of Peace!
We, the 3rd year student nurses of this university will be

conducting a study entitled “Factors Affecting the
Health-seeking behavior and Health Practices of 3rd Year Student
Nurses of St. Paul University Philippines” as a final
requirement for our subject, NCM 111: Nursing Research 1. The
said research aims to determine the factors that affect the
health seeking behaviors and health practices of BSN3 students
enrolled in St. Paul University Philippines.
In this regard, we would like to respectfully ask your

permission to allow us to conduct our study through
administering questionnaires to the selected students,
specifically, the 3rd year student nurses of this university for
us to obtain an accurate data needed for the completion of our
research. Rest assured that the data gathered will be strictly
for research purposes only and will be kept with utmost
confidentiality.
For inquiries and clarifications, we can be reached through

via e-mail at iamkeithaquino@gmail.com. We are very willing to
answer any queries that you may have regarding our research.
Attached here with are copies of our research

questionnaire, research questions and informed consent form for
your perusal. Your approval regarding this request is highly
appreciated.
Thank you and Godspeed!

54
Respectfully yours,
(SGD) KRISTIENE KEITH C. AQUINO (SGD)KELLY G. CATSUELA
(SGD)ISABELLE ARLETTE V. SANTOS (SGD)JEREMIAH P. LAGRIO

Researchers
Noted by:
(SGD) DR. JOSEPHINE LORICA
Class Facilitator

55
Appendix B
INFORMED CONSENT FORM FOR PARTICIPATION IN RESEARCH
INFORMATION SHEET
We, the undersigned, are students of the SNAHS Department

of the St. Paul University Philippines and currently enrolled as
3rd year student nurses. We wish to invite you to participate in
this research project that we are undertaking for the completion
of our requirement for the said course. Before you participate
in this research, feel free to voice out any concerns you may
have to us. We will be very willing to answer any questions you
may have about the nature if our research.
You are being invited to take part in this research because

the study research aims to the factors that affect the health
seeking behaviors and health practices of BSN3 students in St.
Paul University Philippines and we believe that you can
contribute much to this project. Your participation in this
research is entirely voluntary. We can assure you that no
physical risks will be incurred unto you while participating in
this study. Whether or not you choose to participate will not
have any effect on your standing as student in the university.
Having been able to decide to participate in this study, you are
still free to withdraw your participation the moment that you
feel safety and privacy is at risk.
The research will make use of questionnaire as the method

of collecting data. Answering the questionnaire would last for
about 15-30 minutes. If you cannot understand a particular
question asked in the questionnaire, you are free to seek
clarifications from us. Rest assured that the personal

56
information that you entrust to us will solely be used for

research purposes only. All information that will be obtained
during the data collection process will be held confidential.
If you have any questions or concerns after answering the

questionnaire, you may contact us through our e-mail at
iamkeithaquino@gmail.com. This research project was approved by
the University Research Council (URC) and Research Area of the
University of Saint Paul University of the Philippines.
Respectfully yours,
KRISTIENE KEITH C. AQUINO KELLY G. CATSUELA
ISABELLE ARLETTE V. SANTOS JEREMIAH P. LAGRIO
Researchers
Noted by:
(SGD) DR. JOSEPHINE LORICA
Class Facilitator
(SGD) DR. ELIZABETH C. BAUA
Program Coordinator for Nursing
Approved by:
(SGD) DR. ANUNCIACION T. TALOSIG
Dean

57
School of Nursing and Allied Health Sciences

58
CERTIFICATE OF CONSENT
I have read the foregoing information and have had the

opportunity to clarify my concerns. The questions that I have
raised were answered satisfactorily. I am, therefore, giving my
voluntary consent to be a participant in this study.
Signature over printed name of Participant:

_________________________________________
Birthdate of Participant: _______________________
Date: ________________________
Statement by the Researchers:
I have accurately read out the information sheet to the

potential participant, and to the best of my ability made sure
that the participant understood the content.
I confirm that the participant was given the opportunity to

ask questions, and all the questions asked by the participant
have been answered correctly. I confirm that the individual has
not been coerced into giving consent.
Signature over printed name of Researcher:

_________________________________________
Date: ____________________________________

59
Appendix C
QUESTIONNAIRE
Instructions: Carefully read each of the following
questions before you respond by filling out the questions
or checking the box as appropriate to the best that
reflects your opinion and your knowledge. Please be
completely open and honest in your responses. Your
information will be kept confidential.
Name (Optional): _______________________ Questionnaire #:
__
Date: ________ Section: □ A □ B □ C □ D
PART I: FACTORS PRESENT AMONG THE PARTICIPANTS
A. INDIVIDUAL FACTORS.
1. What is your age IN COMPLETED
years? (Please write) ____________
2. What is your GENDER? 1  Male
(Check one box only) 2  Female

60
3. What is your MARITAL 1  Married.
STATUS? (Check one box 2  Single.
only) 3  Separated
4  Divorced
5  Widowed
4. What is your RELIGION? 1  Protestant.
(Check one box only) 2  Muslim.
3  Catholic.
4  Other (Specify)
5. What is your LIVING ARRANGEMENT? 1  Renting
(Check one box only) 2  Foster
3 Independent
Living.
4  Group home
6. What is your BIRTH ORDER? 1  1st
(Check one box only) Born.
2  Middle
Born.
3  Last
Born.
5 Only

61
child.
6 Other
(Specify)
B. FAMILY FACTORS.
7. What is your estimated monthly
HOUSEHOLD INCOME? (Please write) ___________________
8. On what do you NORMALLY SPEND 1  Food
MOST money? 2  Clothing.
(Check all that apply) 3
Healthcar
4 School
fees.
5  Leisure
6 Other (Specify)
9. What is your PARENTS OCCUPATION?
(Please write) ________ .
10. Which HEATH INSURANCE COVER do
you have? ________
(Please write)

62
11. ARE YOU SATISFIED with  No
your health insurance cover  Yes
in catering for your health
needs? (Check one box only)
12. EXPLAIN your answer
above. (Please write) _________________________________
_________________________________
_________________________________
13. On average HOW MANY HOURS 1  Less than 40 hours
do you/your family member 2  40 - 50 hours.
work per week? (Check one 3  More than 50 hours.
box)
14. On a scale of VERY LOW TO 1  Very low.
VERY HIGH, how would you 2  Low.
rate the workload that you 3  Moderate.
handle in your work now? 4  High.
(Check one box only for 5  Very high.
person who work)
15. Has any of your family 1  Yes
have ILLNESS? (Specify)
2  No

63
16. If you feel ill and had a 1  Public Facility.
CHOICE, WHERE WOULD YOU seek 2  Private facility.
treatment from? (Check one box 3 Self-treatme
only). nt.
4  Other
17. FAMILY HISORY OF ILLNESS
High blood pressure  No 2  Yes  Not sure
Relationship to the __Age of Onset
participant: __________
High cholesterol  No 2  Yes  Not sure
Heart disease or heart attack  No 2  Yes  Not sure
Stroke  No 2  Yes  Not sure

64
Diabetes/sugar disease  No 2  Yes  Not sure
Cancer  No 2  Yes  Not sure
Type/s: _______
Asthma  No 2  Yes  Not sure
Alzheimer’s disease  No 2  Yes  Not sure
Birth defects  No 2  Yes  Not sure
Type/s: ________ __Age of Onset
Vision loss/hearing loss  No 2  Yes
Relationship to the  Not sure

65
participant: __________ __Age of Onset
C. HEALTH BELIEFS/ CULTURAL.
18. Are you SATISFIED WITH THE 1  No.
HEALTH services you have 2  Yes.
ACCESS to in this County?
19. Please EXPLAIN your _________________________________
answer above. (Please _________________________________
write) _________________________________
20. Are you satisfied with the 1  No.
QUALITY OF HEALTH services 2  Yes.
that are available to you?
(Check one box only).
21. Please EXPLAIN your _________________________________
answer above. (Please _________________________________
write) _________________________________
22. What in your opinion can ________________________________
be done about THE QUALITY OF ________________________________
HEALTH SERVICE(S) that is ________________________________
accessible to you to in this ________________________________
County? (Please write). ________________________________
23. Do you believe in 1 No.
traditional healers like 2  Yes.

66
albularyo or manggamot? (Check
one box only).
24. Have you visited any 1 No.
traditional healer? (Check one 2  Yes.
box only).
PART II: PERCEIVED HEALTH POBLEMS
25. Overall, how do you rate your 1  Poor
CURRENT HEALTH? 2  Fair
(Check one box only) 3  Good
4 Very
good
5 5Excell
ent
26. In comparison to ONE YEAR AGO, 1  Worse.
how would you rate your GENERAL 2  Fairer.
HEALTH now? 3 About the
(Check one box only). same. 4 
Good.
6 5  Very good.
27. If you compare your PHYSICAL 1  Much worse than
HEALTH with other individuals of theirs.

67
your age and gender, you would 2  somewhat worse
say it is: than theirs. 3 
(Check one box only) About the same as
theirs.
4  Better than theirs.
7 Much better than
theirs.
28. Comparing your PSYCHOLOGICAL 1  Much worse than
HEALTH with other individuals of theirs.
your age and gender, you would 2  somewhat worse
say it is: than theirs. 3 
(Check one box only) About the same as
theirs.
4  Better than theirs.
8 Much better than
theirs.
29. How CONCERNED OR WORRIED about 1  Not
your health have you been in the concerned at
last 12 months? (Check one box all. 2 
only) Slightly
concerned.
9 3  Somewhat concerned.

68
4  Moderately
concerned. 5  Extremely
concerned.
30. How do you expect your HEALTH to 1  Worse.
be in two years? 2  Fairer.
(Check one box only) 3 About the
same. 4 
Good
10 5  Very good.
31. Check is this so? (Please Write) __________________________
__________________________
__________________________
__________________________
__________________________
__________________________

69
32. Do you suffer from any of 1  Diabetes
these chronic illnesses? mellitus. 2 
(Check all that apply) Hypertension.
3  HIV.
4  Mental illness.
5  Cancer (specify)
6  Rheumatism
7  Asthma
8  Epilepsy.
9Other(specify)
10  No.
33. Where do you receive 1  Private facility.
your CHRONIC DISEASE 2 Other (specify)
treatment/ management
from?
(Check one box only).
PART III: HEALTH-SEEKING BEHAVIOR
34. When receiving care from your 1  Almost
provider, HOW OFTEN ARE YOU never 2 
ASKED for your ideas when Generally

70
making a treatment plan? not 3 
(Check one box only). Sometimes
4  Most of
the time 5 
Almost always
35. In the last 12 months, have 1  No
you ever gone to 2  Yes
Hospital (JUST FOR MEDICAL
CHECKUP)?
36. If YES, what was the 1  I was worried about
reason for you to do the my health.
check-up? 2  The test was offered
(Check one box). for free.
 I wanted to be in
control of my health.
4  I know I am at risk
of disease.
5  I had been feeling
bad lately.
3  Not applicable.
37. If YES, what check-up (s) did __________________________
you undertake? (Please list all). __________________________

71
__________________________
__________________________
__________________________
__________________________
38. If YES, how did you pay for 1  Through insurance.
the said check-up? (Check one 2  The test was offered
box). for free.
4  Out of pocket.
39. If No in (35) above, what 1  I have not gotten
would be your explanation for adequate time. 2  I
this? fear finding something
(Check one box only) worse.
3  I don’t see anything
wrong with me. 4  I
can’t get the test I want
around
5  (Other, specify)
7 Money problems have
prevented me.
5 I fear my
confidentiality is not

72
guaranteed.

73
PART III: HEALTH PRACTICES
40. When is THE LAST TIME YOU were 1  Within 7 days ago.
ill (physically or mentally)? 2  7 to 30 days ago
(Check one box only) 3  > 1 month but less than
3 months ago
4  > 3 months but less than
6 months ago 5  > six
months ago.
41. What type of illness did you _____________________________
suffer in 40 _____________________________
above? (Please write) __________________________
42. How did you know what was making 1Self-diagnosis since I
you ill? (Check one box only). know the symptoms.
2 Diagnosed in the
hospital/clinic by a
doctor.
3  A colleague at work
told me the diagnosis.
4 A friend/ Neighbor
told me the diagnosis.
43. Was this ILLNESS THAT you last 1  No.
suffered 2  Yes.

74
severe? (Check one box only)
44. Did you SEEK TREATMENT THIS 1  No. (Go to question 51)
time you were ill? (Check one 2  Yes
box only)
45. IF YES, whom did you 1  Medical
consult? (Check one box doctor. 2 
only). Nurse.
3  Clinical
officer. 4 
Not
applicable.
5  Other (specify) .
46. How best can you describe the 1  Private practitioner.
practice of the 2  Public practitioner.
person you consulted above:
47. How did you decide on the person 1  His/her specialty
to consult in 2 His/ Her clinical
45 above? experience. 3  He/
(Check one box only) she is a family
friend. 4  My
spouse advised.
5  It did not matter.

75
48. Were you able to get all 1  Yes.
TREATMENT you needed this time? 2  No.
49. If no, why not? ( Please _____________________________
explain) _____________________________
_____________________________
_____________________________
________________________
50. If you DID NOT SEEK HELP IN 45 1  Nothing.
above, what did you do? 2  Took over the
(Check one box only). counter medication. 3 
Took prescription
medicine.
4  Took herbal
medicine. 5  Not
applicable.
6  Other .
51. What is the name/ type of drug _____________________________
(s) you self-medicated? (Please list _____________________________
all) _____________________________
_____________________________
________________________

76
52. What would be your reason for 1  I didn’t have time to go
not consulting a health to hospital.
professional? 2  I am comfortable
(Check all that apply only) with self-treatment. 3 
Money problems prevented
me.
4  I could not get the
service I wanted 5  Not
applicable.
6  My
confidentiality was
not guaranteed.
7  Other
(specify)

77
END OF QUESTIONNAIRE.
Thank you for participating.

Proposal For Defense Group 3

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Proposal For Defense Group 3

Uploaded by

Copyright:

Available Formats

1

St. Paul University Philippines

FACTORS AFFECTING THE HEALTH-SEEKING BEHAVIOR AND

HEALTH PRACTICES OF 3RD YEAR STUDENT NURSES OF

ST. PAUL UNIVERSITY PHILIPPINES

A Thesis Submitted to the

Faculty of School of Nursing and Allied Health Sciences

St. Paul University Philippines

Tuguegarao City, Cagayan

of the Requirements for

NCM 111: Nursing Research 1

Aquino, Kristiene Keith C.

Santos, Isabelle Arlette V.

Mrs. Josephine Lorica, RN, DPA

SPUP School of Nursing and Allied Health Sciences

THE PROBLEM AND REVIEW OF RELATED LITERATURE

Mchidi (2021, as cited in Chen, 2008) said that Nurse form

a fundamental part of the health workforce worldwide and their

contribution is essential to delivering safe care. Health care

is only safe to the extent that the person providing it is also

of good health. There is growing interest in the health of the

health care provider stemming from the realization that a

healthy population depends on a healthy workforce that leads as

an example. This has stimulated countries like China to start

programs aimed at improving their health professionals’ health.

With increasing morbidity in the health profession, the health

of the nurse must receive scrutiny by urgently seeking ways that

enhance their utilization of health services if they have to

make health seeking behavior advice to patients realistic.

Nursing student have gotten familiar with adjusting

rapidly, going through areas, and moving quickly starting with

changed all parts of our lives, and it have energetically taken

on new duties to help everyone around us with brief period to

fathom the effect of such enormous changes. And thus, as for

SPUP School of Nursing and Allied Health Sciences

the future nurse one of the most important in everyone’s life is

their Health, 'Health' is a state of complete physical, social,

and mental wellbeing and not merely the absence of disease or

infirmity. Health is thus a level of functional efficiency of

living beings and a general condition of a person’s mind, body,

and spirit, meaning it is free from illness, injury, and pain.

Health-seeking behavior can be defined as any action

undertaken by individuals who perceive themselves to have a

health problem or to be ill for the purpose of finding an

appropriate remedy (Oberoi et al., 2016). Although there are

many studies on health-seeking behavior, there are few studies

on the health-seeking behavior of students, especially Filipino

student nurses, which is why this choice of experiment was

conducted. Culturally, Filipinos have a natural propensity of

delaying or avoiding preventative health-care steps before the

onset of an illness. Patient delay is an increasing issue for

health care providers. This study seeks to determine the factors

affecting health seeking behavior and health practices of

certain Filipino students.

Various studies about health seeking behavior have been

conducted as the years progressed. Health seeking behavior can

contribute a huge degree to the wellbeing status of each person

which incorporates various factors that influences their health.

SPUP School of Nursing and Allied Health Sciences

The researcher knows that student nurses have an increase

knowledge about health practices since they are focus on disease

prevention and health promotion since health promotion reduce

the risk of developing chronic diseases and other morbidities.