RESEARCH ETHICS COMMITTEE

REC Form No. 8

REGISTRATION AND APPLICATION Version No. 1
FOR ETHICS REVIEW OF Effective Date:
Page Number 1 of 3
PROTOCOL

Instruction to the Researcher: Please complete this form and ensure that you have included in
your submission the documents that you checked in (section 3. Checklist of Documents.)
I. General Information
PATIENT-CENTERED CARE OF THE LEVEL 4 NURSING STUDENTS OF
Title of Study PILAR COLLEGE OF ZAMBOANGA CITY INC.: CULTURAL COMPETENCY
IN FOCUS
REC Code Date of (mm/day/year)
(provided by Submission January 25, 2024
REC)
Type of  Initial Review Department: Higher Education
Submission
 Resubmission Program: Bachelor of Science in
Nursing
Category of  Faculty Member (specify Program): ______________________________
Researcher
 Undergraduate Student (specify Program): ________________________
 Others (please specify) ________________________________________
Name of Lead Laurente, Amirrah Mobile: 09700397241
Researcher
Contact Email:
Information laurenteamirrah10@gmail.com
Abduraji, Abdusharif O. Mobile: 09553360114
Co-researcher
(if any) Popmperada, Emelyn V. Mobile: 09770482335
Solis, Geliszel E. Mobile:09560262745
Mobile:
Mobile:
Purpose of  Academic requirement (Thesis, Faculty Requirement)
Study
 Independent research work
 Institutional collaboration (within the Pilar College only)
 Others (please specify)_________________________
Institution Pilar College of Zamboanga City Inc.
Address of R.T. Lim Boulevard, Zamboanga City
Institution
Study Site  Pilar College of Zamboanga City  Outside Pilar College
Duration of the Start date: MM/DD/YEAR No. of Study
Study
End date: MM/DD/YEAR Respondents/Participants
Has the Research undergone a technical  Yes
review?
  No

RESEARCH ETHICS COMMITTEE

REC Form No. 8
REGISTRATION AND APPLICATION Version No. 1
FOR ETHICS REVIEW OF Effective Date:
Page Number 2 of 3
PROTOCOL

Directions: The author/s or proponents are required to read the statements below and make a
check mark on the column provided.

Legend: C – Complied NC – Not Complied N/A – Not Applicable

1 UNDERLINE the vulnerable population being studied: Pregnant Women, Elderly,

Adolescents, Children, Refugees, Prisoners, Those who cannot give consent
(unconscious), Persons with mental or behavioral disorders, Persons with disability
Other; Please specify: __________________________________
C NC N/A
2 The risks and the benefits for the research participants are discussed in
the protocol
3 The protocol describes how the communities from which the
participants are to be drawn likely to benefit from the research
4 The protocol describes whether the research outcome/s is/are likely to
benefit communities beyond the research population
5 The design is free of undue inducements to participate in the research
6 The recruitment procedure includes adequate protection for the privacy
and psychosocial needs of the individuals
7 The protocol has adequate provisions to ensure the confidentiality of
participants’ data
8 The protocol provides that the participants are free not to participate for
whatever reasons or leave the research at any time without penalty
9 The protocol, when needed, ensures the availability of a counselor or a
psychologist or a spiritual adviser to provide appropriate intervention to
research participants during and after the research
10 The protocol includes the provision in handling possible adverse
reactions associated with the research (medical, physical)
11 Provisions are present in the proposal for recruiting participants
incapable of reading and signing to the written consent form (e.g.
illiterate patients). (Please explain by using extra sheet/s of paper)
12 Provisions are present in the proposal for recruiting participants
incapable of giving personal consent (e.g. because of cultural factors,
children or adolescents less than 18 years old, participants with mental
illness, etc.) and to express their decision. (Please explain by using
extra sheet/s of paper)
13 Questionnaires, diary cards, etc. are being used in the research
a. English and in the local language
 b. Written in lay language, and easily understood
c. relevant to answer the research questions
d. worded sensitively
RESEARCH ETHICS COMMITTEE
REC Form No. 8
REGISTRATION AND APPLICATION Version No. 1
FOR ETHICS REVIEW OF Effective Date:
Page Number 3 of 3
PROTOCOL

Declaration

I/We certify that I/we understand the Code for the Responsible Conduct of Research
and will abide by the research ethical principles. I/We will submit a final report of the
proposed study to the PCZC Research Ethics Office. I/We will not commence with data
collection until I/We receive an ethics review approval from the University Research
Ethics Review Committee.
____________LAURENTE, AMIRRAH___________
Name and signature of Principal Investigator

Co-Researchers

Name Signature

ABDURAJI, ABDUSHARIF O. __________________________________

POMPERADA, EMELYN V. _________________________________

SABELLANO, RUFAMAE M. __________________________________

SOLIS, GELISZEL E. ____________ __________________________________

Endorsed by/ Recommended by MARIA VICTORIA C. ALEGRE, RN

Research Adviser/ Mentor

------------To be filled by the REC------------

Completeness of Document  Complete
 Incomplete

Remarks
STAMP

Date Received MM/DD/YEAR

Received by