RESEARCH QUESTIONNAIRE

I. Statement of the Problem;

a. What are the profile of the respondents in terms of;
i. Age
ii. Strand
b. What is the level of awareness of the respondents regarding Herbal Medicine?
c. Health-related characteristics of respondents
d. The acquisition, recommendations, and trust in currently accessible herbal
product information

II. Instrument:

A. Profile of the Respondents

1. What is your age?
a. 15-17 years old
b. 18-20 years old
c. 21-23 years old

2. What is your Strand?

a. STEM
b. ABM
c. HUMSS
d. ICT
e. GENERAL ACADEMIC
f. HOME ECONOMICS

B. Awareness of Herbal Medicine Usage

1. Do you use herbs as an alternative to medicine?
a. Never
b. Rarely, in less than 10% of the chances when I could have.
c. Occasionally, in about 30% of the
d. chances when I could have.
e. Sometimes, in about 50% of the chances when I could have.
f. Frequently, in about 70% of the
g. chances when I could have.
h. Usually, in about 90% of the chances I could have.
i. Always

2. Have you ever recommended the use of herbal medicines?

a. Never
b. Almost never
c. Occasionally/Sometimes
 d. Almost every time
e. Every time

3. Do you think that continuing education in herbal medicines is important?

a. Strongly disagree
b. Disagree
c. Agree
d. Strongly agree

4. Have you ever recommended patients to an herbalist?

a. No, and not considered
b. No, but considered
c. Yes

5. Is it safe to use herbal medicine without the prescription of a professional doctor?

a. Never true
b. Rarely true
c. Sometimes but infrequently true
d. Neutral
e. Sometimes true
f. Usually true
g. Always true

6. Do you believe that herbal medicines are beneficial in healthcare management?

a. Very untrue of what I believe
b. Untrue of what I believe
c. Somewhat untrue of what I believe
d. Neutral
e. Somewhat true of what I believe
f. True of what I believe
g. Very true of what I believe

7. Have you ever prescribed herbs to patients for medicinal purposes?

a. No, and not considered
b. No, but considered
c. Yes

C. The association between herbal usage and responder characteristics

1. What is the state of your personal health?
a. Poor
b. Fair
c. Good
d. Very good
e. Excellent
 2. Do you suffer from a chronic illness?
a. Yes
b. No

3. If you answered yes, what type of chronic disease do you have?

a. Diabetes
b. Heart Diseases
c. Hypertension
d. Others

4. Are you familiar with natural health products?

a. Not at all familiar
b. Slightly familiar
c. Somewhat familiar
d. Moderately familiar
e. Extremely familiar

5. How frequently do you use Herbal products?

a. Daily
b. Weekly
c. Monthly
d. Yearly
e. Never

6. What kind of Herbal products have you used?

a. Vitamins/Minerals
b. Herbal remedies
c. Homeopathic medicines
d. Traditional medicines
e. Probiotics
f. Amino acids and essential fatty acids

7. Why do you use herbal remedies?

a. Maintain Health
b. Prevent Illness
c. Treat Disease
d. Supplement
e. Others

8. Do you encounter any side effects?

a. Yes
b. No
 9. What type of side effects?
a. Nausea
b. Vomiting
c. Diarrhea
d. Constipation
e. Nervousness/Anxiety
f. Dizziness
g. Skin rash
h. Others

D. The acquisition, recommendations, and trust in currently accessible herbal product

information
1. Who suggested Herbal products to you?
a. Family member
b. Friend
c. Medical Doctor
d. Pharmacist
e. Nurse
f. Dietician
g. Mass Media (TV/Radio/Newspaper)
h. Others

2. Who do you rely on for reliable information?

a. Medical Doctor
b. Pharmacist
c. Herbalist
d. Nurse
e. Dietician
f. The natural health product manufacturer
g. Family member/Friend
h. Health products store
i. Others

3. Where did you obtain Herbal Products?

a. Pharmacy
b. Herbalist
c. Health products store
d. Supermarket
e. Family member
f. Friend
g. Others