Group 11 2C Edit

AWARENESS ON PREGNANCY ANXIETY AND DEPRESSION AMONG MEDICAL
STUDENTS
A Research Paper
Presented to the Faculty of the Department of Research
University of the Visayas Gullas College of Medicine
Mandaue City, Cebu, Philippines
In Partial Fulfilment of the Requirements for the Degree
Doctor of Medicine
Patel Shahid
Patil Shubham Rajaram
Suphapich Thongchuen
Jaishankar Subiksha
Umapathy Theneeswari
Ali Akbar Heba
Mamidala Bhargavi
Repalle Richie Rahul
Benjamin Sathia Satchi Josiah Thangamuthu
Saha Moumita Madan Mohan
Gosai Shubham Sharadgiri
Kumari Shrishti
Rathod Nidhi
Peddakondannagari Madhavi
Trivedi Aditya ketanbhai
NOVEMBER,2022
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APPROVAL SHEET
This research paper entitled: “AWARENESS ON PREGNANCY ANXIETY AND

DEPRESSION AMONG MEDICAL STUDENTS” prepared and submitted by Patel Shahid,
Patil Shubham Rajaram, Suphapich Thongchuen, Jaishankar Subiksha, Umapathy
Theneeswari, Ali Akbar Heba, Mamidala Bhargavi, Repalle Richie Rahul, Benjamin Sathia
Satchi Josiah Thangamuthu, Saha Moumita Madan Mohan, Gosai Shubham Sharadgiri,
Kumari Shrishti, Rathod Nidhi, Peddakondannagari Madhavi, Trivedi Aditya ketanbha in
partial fulfillment for the degree Doctor of Medicine has been examined and is recommended
for acceptance and approval for ORAL EXAMINATION.
RESEARCH COMMITTEE
Dr. Althea R. Arenejo
Chairman
Dr. Resty Picardo Dr. Ramon Del Fierro

Member Member
Mr. Rene Argenal

Adviser
===================================================
PANEL OF EXAMINERS
APPROVED by the Committee for Oral Examination with a rating of _______
Dr. Althea R. Arenejo

Chairman
Dr. Resty Picardo Dr. Ramon Del Fierro
Member Member
Mr. Rene Argenal
Adviser
Accepted and approved in partial fulfilment of the requirements for the
degree Doctor of Medicine
Passed the Proposal hearing: November 30, 2022
Passed the Oral Examination: April 21, 2023
Dr. Jose Juan Rafael G. Laico

Dean, College of medicine
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ACKNOWLEDGMENTS
In fulfilment of this research proposal, the researchers would like to extend their heartfelt
gratitude to the following:
To our advisor Mr. Rene N. Argenal, who have guide us in helping the proponents
complete their research proposal, unwavering encouragement, and insightful feedback,
that greatly enriched the quality of this study. To our esteemed panel members Dr. Althea
R. Arenajo, Dr. Ramon Del Fierro, and Dr. Resty Picardo for imparting their intelligent
views and relevant recommendations for the improvement of this study and guiding the
researchers through the research with patience and zeal. To the administration and faculty
at Gullas College of Medicine for granting access to the resources and facilities necessary
for conducting this research. To the respondents, for their time and cooperation in
answering the questionnaire, without them, this study would not have been possible. To
the friends and family of the proponents who have given their continued support and have
given the researchers the motivation they needed over the course of the study.
Most importantly, to the Heavenly Father, for continuously showering the researchers with
strength and courage when they ran out of it. This study would not be made possible
without the Lord's guidance. Above all, to God Almighty, who grants us everlasting
blessings to withstand all obstacles in our endeavours which we will understand.
THE RESEARCHERS
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ABSTRACT
This abstract investigates the awareness levels of pregnancy anxiety and depression among
female medical students of Gullas college of Medicine. A survey-based approach was
employed to assess the understanding and recognition of these mental health challenges
within the student population. Through surveys and interviews, it assesses students’
knowledge of pregnancy anxiety and depression and their associated health risks. The
findings aim to inform educational interventions to enhance awareness and better equip
future healthcare professionals to address pregnancy anxiety and depression. The sample
consisted of hundred (100) respondents randomly selected students within Gullas College
of Medicine. We used descriptive research design in this research. The instrument used was
a questionnaire, which was administered to the respondents. The research determined the
participants’ demographic profile and awareness level. The results of these findings seem
to indicate that students in the Gullas College of Medicine are aware of the harmful effects
of pregnancy anxiety and depression. Establishing targeted educational initiatives can
empower medical students to recognize, address, and mitigate pregnancy-related mental
health concerns effectively, ultimately contributing to the overall well-being of female medical
students during their reproductive years.
Keywords: Pregnancy, Anxiety, Depression, Medical students, Awareness, Healthcare
professionals, Prevention.
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TABLE OF CONTENTS
TITLE PAGE…………………………………………………………………...i
APPROVAL SHEET…………………………………….…………………….ii
ACKNOWLEDGMENT……………………………………….………………iii
ABSTRACT………………………………………..……………….…………iv
TABLE OF CONTENTS……………………………………………….……..v
CHAPTER I: INTRODUCTION
Rationale of the study…………………………………………………….….1
Theoretical Framework……………………………………………………....2
Statement of the objectives……………………………………………….…3
Statement of the hypothesis…………………………….............................4
Significance of the Study…………………………………………….............5
Definition of Terms……………………………………………………............6
CHAPTER II: REVIEW OF RELATED LITERATURE AND STUDIES….8
CHAPTER III: METHODOLOGY
Research design…….......................................................................18
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Research locale…………………………………………………………18
Research respondents…………………………………………………19
Research instrument……………………………………………………19
Data gathering…………………………………………………………...20
Ethical Considerations……………………………………………….….21
CHAPTER IV: RESULTS AND DISCUSSIONS .....................................26
CHAPTER V: SUMMARY OF FINDINGS, CONCLUSIONS AND
RECOMMENDATIONS………………………………………………………35
Summary of findings…………………………………………………....35
Conclusions……………………………………………………………..36
Recommendations……………………………………………………...38
Awareness on Pregnancy Anxiety and Pregnancy Depression…...39
REFERENCES…………………………….………………………………….40
APPENDICES…………………………………………………....…...…..….45
Sample letter.…………………………………………………………...46
Informed consent…………………………………………………….....47
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Sample Questionnaire………………………………………………….48
Gannt Chart…………………………………………………….............49
Budget……………………………………………………………………50
Grammer and Plagiarism certificate..………………………………...51
CURICULUM VITAE……………………..………………………………..…52
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LIST OF TABLES
Table number 1. Profile of the Female Respondents of Gullas College of
Medicine…………………………………………………………………….27
Table number 2. Awareness of Pregnancy Anxiety Among Gullas College of
Medicine………………………………………………………..………….28
Table number 3. Awareness of Pregnancy Depression Among Gullas College of Medicine
Students…………………………………………………………………….31
Table number 4. Correlation of awareness of perceived pregnancy
anxiety and awareness of perceived pregnancy depression…………33
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CHAPTER I
INTRODUCTION
AWARENESS ON PREGNANCY ANXIETY AND DEPRESSION AMONG MEDICAL
STUDENTS
Rationale of the study
Pregnancy is a vulnerable period which is associated with changes in
physical, behavioural, and social aspects of life. It is accompanied by sudden
mood changes and emotional disturbances like anxiety and depression that can
have deteriorating effects on their mental health, nutrition, sleep, and fetal
development. Maternal depression is one of the major contributors to pregnancy-
related morbidity and mortality. A systematic review and meta-analysis published
in the Journal of Affective Disorders in 2019 found that the prevalence of
postpartum depression worldwide was 17.7%.
This paper focuses on assessing the level of awareness of the female
medical students of Gullas college of Medicine on pregnancy-related depression
and anxiety. This is conducted through a physical distribution of a questionnaire
asking students about awareness on pregnancy-related anxiety and depression.
The medical students are future healthcare providers and will play a crucial role in
managing the health of pregnant women. Thus, it is important to understand their
knowledge, attitudes, and practices related to pregnancy anxiety and depression,
as this can impact the quality of care they provide to their patients. This study shall
make medical students more skilful and knowledgeable in their practice of
medicine while handling a female patient who had been or was pregnant. The
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awareness regarding pregnancy shall also lead to the identification of risk factors
like stress, trauma, lack of support, and relationship problems, which are also the
predecessors of perinatal depression and its related disorders. Secondly, medical
students are also at risk of experiencing pregnancy anxiety and depression
themselves since there are possibilities that they can get pregnant and face
depression due to various stressors. Therefore, understanding medical students'
awareness of pregnancy anxiety and depression can help identify potential
barriers to early detection and treatment of these conditions in pregnant women.
This study can promote positive attitudes toward help-seeking behaviour
where medical students will play an indispensable part in understanding and
provide an apt approach that can help with the diagnosis, treatment, and
management of diseases. It is, therefore, important for medical students to have a
basic foundational ground so that targeted interventions can be formulated at the
earliest. The above statistics suggest that pregnancy anxiety and depression are
significant issues for women in the Philippines and that there is a need for
healthcare providers to screen for and address these conditions in pregnant
women. Overall, through the findings of the study, we can adopt interventions to
improve medical education, awareness, and training related to maternal mental
health, support medical students' mental health and well-being, and ultimately
improve the quality of care provided to pregnant women.
Theoretical Framework
The theoretical framework for awareness of pregnancy anxiety and
depression is based on the Health Belief Model (HBM) and the Social Cognitive
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Theory (SCT). The Health Belief Model was developed by several social
psychologists, including Hochbaum, Rosenstock, Becker, and others, in the
1950s.The HBM suggests that individuals' health behaviours are based on their
beliefs about the severity of a health condition, their perceived susceptibility to the
condition, their perceived benefits of taking action to prevent or treat the condition,
and their perceived barriers to acting.
The HBM could be used to assess whether medical students perceive
pregnancy anxiety and depression as serious health problems, whether they
believe that these conditions are common among pregnant women, and whether
they perceive that taking steps to prevent or manage these conditions would be
beneficial. Social Cognitive Theory (SCT) is an interpersonal-level theory
developed by Albert Bandura in 1986. It emphasizes the role of social and
environmental factors in shaping behaviour, including the influence of peers, family
members, and healthcare providers. SCT could be used to assess whether medical
students' attitudes and behaviours related to pregnancy anxiety and depression
are influenced by their social support network, the norms and expectations of their
peers and instructors, and their interactions with pregnant women during their
clinical rotations. The combination of these two theories suggests that awareness
of pregnancy anxiety and depression is influenced by several factors, including
knowledge and beliefs about the condition, personal experiences, social support,
and access to health care. Overall, the theoretical framework suggests that
awareness of pregnancy anxiety and depression is influenced by a complex
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interplay of individual, social, and environmental factors and that promoting
awareness and access to appropriate care requires a multifaceted approach.
THEORETICAL FRAMEWORK
Figure 1. Theoretical framework for thesis AWARENESS ON PREGNANCY
ANXIETY AND DEPRESSION AMONG MEDICAL STUDENTS.
Statement of the Objectives
General Objectives:
To assess the relationship between awareness on pregnancy anxiety and
awareness on pregnancy depression among female medical students of Gullas
college of Medicine.
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Specific Objectives:
1. To determine the demographic profile of the female students of
Gullas college of medicine in terms of:
1.1 age
1.2 nationality
1.3 civil status
1.4 year level
2. To determine the level of awareness on pregnancy anxiety.
3. To determine the level of awareness on pregnancy depression.
4. To determine the relationship between awareness on pregnancy
anxiety and awareness on pregnancy depression.
5. To encourage awareness program based on the findings.
Statement of Hypothesis:
There is no significant relationship between awareness on pregnancy
anxiety and awareness on pregnancy depression.
Significance of the study:
The following are the benefits from the findings of this study:
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Female students. This study will enhance awareness of pregnancy related mental
issues like depression and help recognizing the symptoms. It also provides
effective coping strategies mitigating the impact of pregnancy-related depression
and anxiety on their wellbeing.
Medical Institutions. This study will give medical institutions idea about support
programs to address the mental needs of pregnant students, potentially enhancing
overall academic performance.
Department of Health. This study will help them in developing comprehensive
guidelines and treatment strategies for the medical students facing pregnancy
anxiety and pregnancy depression.
Researchers. This study will guide them to spark further research avenues,
potentially leading to innovation in treatment options, or targeted therapies to
manage pregnancy anxiety and pregnancy depression.
Future Researchers. This study will build a foundation for future Researchers to
encourage more in-depth investigations and potentially uncovering new aspects of
issue and ultimately contributing to collective knowledge and potential solutions in
this field.
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Definition of terms:
The following are operationally defined:
Awareness on pregnancy anxiety: It refers to an understanding of the various
emotional and psychological challenges that can arise during pregnancy, which
may lead to feelings of anxiety and stress.
Awareness on pregnancy depression: It refers to understanding the various
emotional and psychological challenges that can arise during pregnancy,
which may lead to feelings of sadness, hopelessness, and lack of interest or
pleasure in activities that the person previously enjoyed.
Age: This refers to the age range of the student population, which can vary
widely depending on the type of educational institution.
Nationality: This is typically based on a person's citizenship or country of origin.
Civil status: It refers to an individual's legal marital status, as recognized by the
government or other official authorities.
Year level: It refers to the stage or grade level that a student is currently enrolled
in within an educational institution.
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Awareness on Pregnancy anxiety and awareness on pregnancy depression
program: It is a structured set of interventions or activities designed to increase
awareness on pregnancy anxiety and pregnancy depression to support
pregnant individuals who are experiencing symptoms of anxiety and/or
depression.
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CHAPTER II
REVIEW OF RELATED LITERATURE AND STUDIES
Pregnancy anxiety and depression are common and often underdiagnosed
mental health conditions that can have significant consequences for both the
mother and child. This section has reviewed several studies that explore the
prevalence, risk factors, and consequences of pregnancy anxiety and depression,
as well as the awareness of students on these conditions.
Anxiety and depression during pregnancy are prevalent conditions, with
estimates ranging from 10% to 20% of pregnant women experiencing anxiety and
depression (Dunkel Schetter & Tanner, 2012; Gelaye et al., 2016). A study by Field
et al. (2009) found that anxiety during pregnancy was associated with adverse
birth outcomes, including preterm delivery and low birth weight.
A study by Heron et al. (2004) found that maternal anxiety during pregnancy
was associated with an increased risk of emotional and behavioural problems in
children. However, this study did not find a significant association between
maternal depression during pregnancy and child outcomes. The authors suggest
that this may be due to differences in the physiological effects of anxiety and
depression on the developing fetus.
A cross-sectional survey using the Edinburgh Postpartum Depression Scale
of 314 pregnant women attending a maternity hospital in Abeokuta North
Municipality, Nigeria, found a prevalence of gestational depression of 24.5%. A
quarter of pregnant women felt anxious or depressed. This is compared with the
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prevalence of 18.0% in pregnant women found in a regional study conducted in
Hyderabad, Pakistan, which included 1368 pregnant women with anxiety and/or
depression. The HADS in Karachi, Pakistan, reported that 70% of pregnant
women experienced anxiety and/or depression. The low incidence of anxiety and
depression in this study was partly due to different factors. This may be due to
sociocultural differences that exist within the study population.
A study by Dennis and Kingston (2014) found that pregnancy anxiety and
depression are common among pregnant women, affecting up to 20% of women
during pregnancy. Despite this high prevalence, many women are unaware of the
symptoms and risk factors associated with these conditions. Several risk factors
have been identified for pregnancy depression. These include a history of
depression, previous pregnancy complications, low social support, relationship
problems, and financial stress (Gavin et al., 2005; Lancaster et al., 2010).
Additionally, women who experience depression during pregnancy are at higher
risk of experiencing postpartum depression (Gavin et al., 2005). A study by Dunkel
Schetter and Tanner (2012) found that social support was a protective factor
against anxiety and depression during pregnancy. This study also found that
women who received social support during pregnancy had better birth outcomes
than those who did not. These findings suggest that social support may play an
important role in mitigating the negative effects of anxiety and depression during
pregnancy.
A meta-analysis by Grote et al. (2010) found that maternal depression during
pregnancy was associated with an increased risk of behavioural problems in
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children. This study also found that prenatal depression was associated with an
increased risk of ADHD, anxiety, and conduct disorders in children. These findings
suggest that the effects of prenatal depression may extend beyond the perinatal
period and have long-term consequences for children. Another study by
Andersson et al. (2004) found that antenatal depression and anxiety were
associated with an increased risk of obstetric complications, including preterm
delivery, caesarean delivery, and prolonged labour. The authors suggest that these
findings may be due to the physiological effects of stress hormones on the body
during pregnancy.
In a study by Lee et al. (2015), it was found that low levels of awareness
about pregnancy anxiety and depression among healthcare providers can
contribute to underdiagnosis and undertreatment of these conditions. The study
suggests that improving healthcare providers' awareness and knowledge of these
conditions may be an important step in improving diagnosis and treatment.
Women who experience depression during pregnancy are at higher risk for
preterm delivery, low birth weight, and small for gestational age infants (Andersson
et al., 2004; Field et al., 2009). Additionally, children born to mothers with
depression during pregnancy are at higher risk for behavioural problems, cognitive
deficits, and emotional dysregulation (Gentile, 2017).
A study conducted by Jessica Grech and her colleagues in Mater Dei
Hospital, Malta, was done to explore pregnant women's awareness, knowledge,
and attitudes about PD and identify any personal characteristics which influence
attitudes and beliefs about PD. A mixed-method cross-sectional survey design was
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chosen. An established perinatal depression monitor questionnaire was adapted
for use in the local population. A pregnant woman who attended a prenatal
appointment at Mater Dei Hospital in Malta between April and July 2019 was
recruited. Descriptive data was generated, and multivariate linear regression
models were used to assess the relative impact of sociodemographic variables on
attitudes and beliefs about PD. Of the 487 questionnaires distributed, 404
questionnaires were returned. Despite the seemingly high awareness of PD,
understanding of the term PD was limited. Samples were generally informed about
the main signs and symptoms of PD. The intentions of a person seeking first aid
generally revolved around family and friends. Attitudes towards PD and related
screening measures were generally positive. Education, pregnancy, length of
pregnancy, and marital status were identified as the main predictors of attitudes
towards PD. The findings are also of value to policymakers when evaluating the
deployment of PD screening services.
A cross-sectional online survey (n = 1,201) of adults (⩾ 18 years) in each
state and territory of Australia was conducted in early 2016. Survey questions were
based on a previous 2009 survey, with the addition of several novel items designed
to assess knowledge around both perinatal anxiety and men’s perinatal mental
health. Depression (including postpartum depression) was the most frequently
reported common health problem among women in the first year of life (52% of
spontaneous first reactions). More than 70% of the adults agreed that postpartum
depression requires special treatment, and that regular monitoring of depressive
symptoms should be performed during pregnancy and in the first year of life.
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Women identified with postpartum depression more frequently than men.
Postnatal depression was most perceived to have a biological rather than a
psychosocial etiology (34.5%). Men and women differed in their knowledge of
postpartum depression symptoms, with more women correctly identifying their
core depressive symptoms. The specific term "perinatal depression" was not
widely recognized. Although not widely recognized as a general health problem,
39% of respondents identified anxiety as a specific perinatal mental health
problem when prompted. Most Australian adults (60%) were unaware that men
could suffer from perinatal depression and anxiety.
Terri Smith et al. (2016).
A cross-sectional design conducted in a tertiary care centre in Jeddah, Saudi
Arabia, assessed the prevalence of pregnancy-related depression, anxiety, and
stress symptoms along with associated risk factors in 200 pregnant women. This
was done by calculating the DASS (depression anxiety stress score), which
estimated that more than half (54.0%) had anxiety symptoms, and only a quarter
had stress. Lebel, C.'s (2020) study stated prior history of depression is associated
with a greater risk of negative influence in pregnancy. It was found that other
factors like literacy and occupation also influenced their stress and anxiety.
Several risk factors were identified that included lack of family or spouse support,
history of C-section delivery, and mode of previous delivery. The results of the
study concluded that a significant proportion of pregnant women suffered from
psychological problems. It was recommended that improved access to mental
health support and procurement of adequate resources could be highly beneficial
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for pregnant women to adapt and cope with pregnancy-related changes. The focus
should be on improving maternal and fetal outcomes, providing knowledge, and
creating awareness to encourage women to seek professional support to improve
their mental well-being. Identification of high-risk groups is important to provide
appropriate interventions at the earliest.
A study conducted by Huizink, A. C., Mulder, E. J., & Buitelaar, J. K. (2004)
found that there was a significant correlation between pregnancy anxiety and
comorbid depression and anxiety. Specifically, women who reported high levels of
pregnancy anxiety were more likely to also report symptoms of depression and
anxiety. The study of Dunkel Schetter, C., & Tanner, L. (2012) found that pregnancy
anxiety and depression were highly interrelated, with many women experiencing both
conditions simultaneously. The authors noted that addressing both anxiety and
depression during pregnancy is important for the health and well-being of both the
mother and the child.
The study conducted by D. D. S. Rowel (2004) showed that only 42.8% had heard
of Edinburgh’s Postnatal Depression Scale. In Sri Lanka, it is recommended as an
integral postnatal screening tool in maternity care packages. This demonstrates
that, despite common knowledge, practical applications with validated
assessments are insufficient. This may explain the high prevalence of postpartum
depression in Sri Lanka and suggests an urgent need for attention. It is
emphasized that lack of knowledge of criteria is a recognized barrier to screening
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for psychiatric disorders during pregnancy and postpartum. The research showed
that care provider awareness and knowledge are sufficient. However, there must
be a shortfall in providing appropriate care or identifying target groups of women
in the healthcare chain to reduce maternal suicide-related deaths. The average
score is comparatively lower in some of the items, such as the need for specific
medical attention (57.9%), the existence of proper treatment (61.2%), higher risk
in high-risk pregnancies (64.5%), prolonged labor (66.5%), and excessively
worrying about baby's health (34.2%). The present study also shows that younger
healthcare providers showed a significantly higher proportion of having heard of
EPDS compared to older ones. Improving access and provision of CME programs
must be thoroughly considered.
A study conducted by Reyhen Ayaz et al. 2020, was conducted to know the
level of anxiety and depression in the same pregnant women before and during
the Covid-19 pandemic. This study was conducted among a total of 63 pregnant
women, and the survey was taken by questionnaire method. The mean total IDAS
II score was found to increase from 184.78±49.67 (min: 109, max: 308) to
202.57±52.90 (min: 104, max: 329) before and during the SARS-CoV-2 pandemic.
According to the BAI scores, the number of patients without anxiety (from 10 to 6)
and with mild anxiety (from 31 to 24) decreased, and patients with moderate (from
20 to 25) and severe anxiety (from 2 to 8) increased after SARS-CoV-2 infection.
Multivariate linear regression analysis revealed that obesity and relationship with
her husband are the best predictors of IDAS II scores. The result of this study
concludes the COVID-19 outbreak has a negative impact on pregnant women's
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mental health, which leads to poor birth outcomes. During the COVID-19 infection,
pregnant women's anxiety and depression symptoms increased significantly. To
prevent mental trauma during infectious disease outbreaks, healthcare
professionals should develop comprehensive treatment plans for pregnant
women, who are a highly vulnerable population.
A cross-sectional study by Kimberly McKee, Lindsay K. Admon, and Kara
Zivin estimated the prevalence of Perinatal mood and anxiety disorders and
serious mental illness among delivering women, as well as obstetric outcomes,
healthcare utilization, and delivery costs, using adjusted weighted logistics with
predictive margins and generalized linear regression models. The study included
an estimated 39,025,974 delivery hospitalizations from 2006 to 2015 in the U.S.
PMAD increased from 18.4 to 40.4 per 1000 deliveries. SMI also increased among
delivering women over time, from 4.2 to 8.1 per 1000 deliveries. Women with
PMAD and SMI experienced higher incidence of severe maternal morbidity and
mortality and increased hospital transfers, lengths of stay, and delivery-related
costs compared to other deliveries (P < .001 for all). According to the results, it
concludes that over the last decade, the prevalence of both PMAD and SMI among
delivering women increased substantially across the United States has increased
significantly and affected women had more adverse obstetric outcomes and
delivery-related costs than other deliveries.
In a review of literature by Milgrom et al. (2008), it was found that
interventions aimed at improving awareness and knowledge about pregnancy
anxiety and depression can be effective in reducing symptoms and improving
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outcomes for both mothers and babies. The study suggests that increasing
awareness of these conditions among healthcare providers, pregnant women, and
the public may be an important step in improving overall mental health outcomes
during and after pregnancy. Few studies have explored the awareness of students
on pregnancy anxiety and depression. A study by Yilmaz et al. (2019) found that
only 21% of nursing students had knowledge of the risk factors for postpartum
depression. Similarly, a study by Banerjee et al. (2018) found that only 44.6% of
medical students were aware of the prevalence of perinatal mental health
disorders.
In conclusion, pregnancy anxiety and depression are prevalent conditions
that can have significant consequences for both the mother and child. Women with
anxiety or depression during pregnancy are at higher risk for adverse birth
outcomes, and children born to mothers with anxiety or depression during
pregnancy are at higher risk for developmental problems. However, the awareness
of students on these conditions is low, indicating a need for improved education
and training on perinatal mental health.
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CHAPTER III
METHODOLOGY
Research design
This study opted for a descriptive correlational type of study. The descriptive
study design was used to collect relevant information about the awareness of
Gullas college of Medicine students on pregnancy-related depression and anxiety.
A physical survey was conducted using questionnaires related to awareness on
pregnancy anxiety and awareness on pregnancy depression among the female
participants. The survey method where the main research tool used was a
researcher-made questionnaire that was subjective to pilot testing among 100
students to establish the validity and reliability of the instrument. The main aim was
to assess the level of awareness of medical students on awareness of pregnancy
anxiety and depression.
Research Locale
The University of Visayas Gullas College of Medicine, Banilad campus in
the Philippine Central Visayas area serves as the study location which envisions
becoming a top medical school and home of globally competent and
compassionate physicians dedicated to excellence and service to communities
worldwide.
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The GCM Mission includes the following:
RESEARCH Establish and sustain a culture of ethical and scientifically sound
research among students, faculty, and non-teaching personnel.
INSTRUCTION Engage students in dynamic and effective instruction through a
conducive, collaborative, and innovative learning environment that is responsive to
the health needs of society.
EXTENSION Promote social responsibility among students, faculty, and teaching
personnel by implementing relevant health development programs geared towards
community empowerment.
VALUES Inculcate altruistic principles driven by the desire to serve others.
Research Respondents
The respondents used for this study were female medical students studying
at Gullas College of Medicine. It included all female students studying from years
one to three who were randomly selected. The survey was only limited to
participants aged 18 and above. The participants’ civil status could be anything
(single, married, or widowed). There was a total of 100 students who willingly
participated in answering the questionnaire. Consent was obtained from the
participants.
Research Instrument
The research instrument that was used to collect the data for the study was
a researcher-made questionnaire and was based on readings and some literature
about awareness on pregnancy anxiety and depression. The research
questionnaire was divided into 3 parts: Part I collects personal information of the
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respondents, which includes age, nationality, civil status, and year level. Part II
pertains to the awareness of pregnancy anxiety among GCM medical students.
There were 10 items that were asked based on different aspects of pregnancy
anxiety. Part III pertains to the awareness of pregnancy depression among GCM
medical students. There were 10 items that were asked based on different aspects
of pregnancy depression. Each item was measured using the 5-point Likert scale.
This means that the respondents were asked to specify their agreement as to:
Strongly Agree (5), Agree (4), Neutral (3), Disagree (2), and Strongly Disagree
(1).
The questionnaire was pilot tested on 20 respondents and resulted in a
reliability coefficient of 0.90, which is interpreted as an instrument with very high
reliability. The table below presents the output of the Cronbach alpha reliability
test.
Reliability Statistics:
Cronbach's Alpha
Based on
Cronbach's Alpha Standardized Items N of Items
0.90 0.90 20
Ethical Considerations
We followed and supported the Philippines' Data Privacy Law by making
every attempt to keep the participants' identities and information private. It was
also made sure that none of the volunteers were put in a position where they would
be harmed because of their involvement in either the physical or psychological
parts of the study. By protecting the confidentiality and integrity of the replies, the
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researcher ensured that the participants' privacy was safeguarded. Finally, it is
important to note that all information gathered throughout the course of this study
was solely utilized for the objectives of the research and, thus, was fully kept with
utmost care and confidentiality.
Risk-Benefit Assessment
We weighed the risks and advantages of conducting the study since it was
critical to safeguarding the participants' interests.
1. Risk. The issue of participant confidentiality being revealed was identified
as a potential risk. To ensure the secrecy of the participant's personal data and
information, we used codes for the study instruments. After the data and other
proof are compiled, they are destroyed.
2. Benefit. The result of the study can help both the individuals and the school.
The final product can be utilized to improve teaching and learning practices.
Content, Comprehension, and Documentation of Informed Consent
The participants' rights in this study were given priority. As a result, a sample
of the informed consent form confirming ethics committee approval was attached
to this study, which was provided and discussed with the participants before the
survey's conduct. The respondents' consent to participate in this study was given
voluntarily after indicating their interest and agreement to do so.
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Authorization to Access Private Information
The participants gave the researcher permission to write private and
sensitive information in the instrument. Their signature on the informed permission
form denoted the researcher's obligation to protect private and sensitive
information once it is disclosed to the researcher. The researcher and the
participants were aware that there was a danger of harm or risk to sensitive
information that emerged throughout the data collection process.
Confidentiality Procedure
The actions undertaken by the researcher to ensure privacy are as follows:
(1) classifying and differentiating data; (2) keeping a safe shelf for data storage
during the investigation; (3) inserting no identifying information or marks in the
instrument or computer; and (4) effectively eliminating identifying information after
usage.
Debriefing, Communications, and Referrals
Debriefing is the practice of soliciting feedback at the conclusion of a
research project. It is a courteous conversation between the researcher and the
participants that is done in a way that is beneficial to the participants. The
researcher in this study took time to explain why it was important to participate in
the study and what the expected outcome would be. After the data was collected,
the respondents were debriefed to avoid or minimize any psychological injury.
22
During the debriefing session, the researcher encouraged the participants to ask
questions to better understand and clarify the study's goal and avoid any
misunderstandings.
Incentives or Compensation
It is vital to highlight that there was no monetary incentive other than a
simple gift of thanks for those who helped.
Conflict of Interest
The researcher was responsible for all expenditures associated with the
study's execution. The researchers received no outside support for their research.
Furthermore, the researchers worked independently and are not linked with any
organization.
Recruitment
Participants were chosen and recruited without force, intimidation, or undue
influence, and we promised them that they have the freedom to decline or
withdraw at any moment without danger of being penalized.
23
Vulnerability Assessment
The participants in this study don’t fall into the vulnerable category since they
don’t exhibit the features of vulnerability. During the data collection, there was no
threat or hazard.
Collaborative Study Terms of References
The researchers paid for the expenditures from their own pockets. This
study may only be published by the researcher. This work may be published by
the researcher adviser if the researcher's name appears as a co-author.
Data Gathering Procedure
To realize the purpose of this study, a transmittal letter was sent to the dean
to ask permission to administer the Survey Instrument to the respondents.
Permission was granted, the researcher personally handed over the questionnaire
to the selected respondents and discussed with them the procedure in the data
gathering. The respondents were given ample time to answer the tool, at least for
one week. Retrieval of the said tool was done personally by the researcher, and
tabulation of the respondents followed. All the Data was subjected to an
appropriate statistical tool and analysed.
24
CHAPTER IV
RESULTS AND DISCUSSIONS
This section presented the results of the data during the conduct of the
study. These are presented in tables form and a discussion follows each table
highlighting the salient information about the table.
Respondents' Characteristics Frequency Percent

Age
Below 20 9 9.0
20 - 22 71 71.0
23 - 25 18 18.0
Above 25 2 2.0
Female 100 100.0

Civil Status
Single 99
99.0
Married 1 1.0
Year Level
Med 1 12
12.0
Med 2 71 71.0
Med 3 17 17.0
Nationality
African 2 2.0
Indian 96 96.0
Thai n 2 2.0
= 100
Table 1. Profile of the Female Respondents of Gullas College of Medicine
25
Table 1. denotes the demographic profile of the students where they are
categorized in terms of age, sex, civil status, year level and nationality. The data
was collected only from female respondents (total=100). It can be observed that
most female respondents fall within the age range of 20-22 years (71
respondents), followed by 23-25 years (18 respondents), below 20 years (9
respondents), and lastly, above 25 years (2 respondents). This can be since the
majority (71%) of the female students were studying in their 2nd year, and that is
the age when you are in the 2nd year. It is followed by 17% in the 3rd year and 12%
in the 1st year." 1400+ Indian students are already studying “MBBS at Gullas
College of Medicine campus. Gullas College of Medicine is the most trusted top
medical college in the Philippines by Indian medical students.”
- uvgullas.com
Items Mean Std. Deviation Interpretation

1. I am aware of the
definition of pregnancy 4.18 0.99 Agree
anxiety.
2. I am aware on the
prevalence of
pregnancy anxiety 3.93 1.01 Agree
among female
population
symptoms associated 3.63 1.10 Agree
with pregnancy anxiety 4.
I am aware about
the steps taken in the 3.31 1.06 Neutral
diagnosis of pregnancy
anxiety.
26
adverse effects of 3.91 0.98 Agree
pregnancy anxiety on
mental health.
6. I am aware of where
and whom to approach at 3.74 1.11 Agree
times of pregnancy
anxiety.
treatment regime 3.25 1.17 Neutral
proposed for
pregnancy anxiety. 8.
I am aware of the
management and 3.48 1.06 Agree
prevention of pregnancy
anxiety.
9. I am aware of the 3.60 1.02 Agree
natural ways to
overcome anxiety during
pregnancy.
pregnancy counseling
services related to
3.97 1.11 Agree
pregnancy anxiety
provided in the
Philippines.
Awareness on
3.70 0.65 Aware
Pregnancy Anxiety
Table 2. Awareness of Pregnancy Anxiety Among Gullas College of Medicine

Students
Table 2. reflects the awareness of pregnancy anxiety among Gullas college of
medicine medical students. It had 10 items on various aspects of pregnancy
anxiety which included its definition, prevalence, symptoms, diagnosis, adverse
effects, appropriate approach, treatment regime, management and prevention,
natural ways of treatment, and pregnancy anxiety-related counseling services.
27
The above table provides the general average of perceived level of awareness on
pregnancy anxiety among GCM medical students was 3.70±0.65, which is
interpreted as aware, which suggests that the students, on average, have a good
understanding of the concept of pregnancy anxiety and are aware. The mean score
of 3.70 is higher than the midpoint of the scale, which is usually set at 3. This
indicates that the students, on average, scored higher than the neutral point on the
scale, suggesting a positive perception of their level of awareness on pregnancy
anxiety.
About 8 topics were agreed on by the respondents, and 2 topics (regarding
diagnosis and treatment regime) were neutral. The item 'I am aware about the
steps taken in diagnosis of pregnancy anxiety' and the item 'I am aware of the
treatment regime proposed for pregnancy anxiety' were marked as neutral,
suggesting that they were not aware of those items. The overall interpretation of
the awareness on pregnancy anxiety was aware, which means that they are
aware of pregnancy anxiety. This can be because they are medical students and
take up relevant subjects that are taught on topics related to pregnancy anxiety
and its various aspects.
28
Items Mean Std. Deviation Interpretation
1.I am aware of the
definition of pregnancy 3.85 1.03 Agree
depression.
2.I am aware of the
early signs presented 3.70 1.10 Agree
during pregnancy
depression.
3.I am aware of the
difference between 3.34 1.25 Agree
baby blues and
pregnancy depression.
risk factors for 3.63 1.12 Agree
depression during
pregnancy.
5. I am aware about the
complications of
untreated perinatal 3.60 1.12 Agree
depression in pregnant
women.
6. I am aware of
postpartum psychosis 3.31 1.18 Neutral
and its consequences.
diagnosis of pregnancy 3.64 1.17 Agree
depression.
8. I am aware about
the management and treatment 3.39 1.01 Neutral
of pregnancy depression.
9. I am aware about the
antidepressants
and their role on alleviating 3.50 1.13 Agree
10. I am aware of the side
effects associated
with the use of 3.70 1.13 Agree
antidepressant drugs during
treatment of pregnancy
depression.
Awareness on
Pregnancy 3.57 0.83 Aware
29
Depression
Table 3. Awareness of Pregnancy Depression Among Gullas College of Medicine

Students
Table 3 gives the awareness on pregnancy depression among GCM medical students.
It had 10 items on various aspects of pregnancy depression which included definition,
early presenting signs, baby blues vs depression, risk factors, complications of
untreated pregnancy depression, postpartum psychosis and consequences, diagnosis,
management and treatment, use of antidepressant and their side effects.
As shown in table, the general average perceived level of awareness on pregnancy
depression was 3.57±0.83, which is interpreted as aware and suggests that the
students, on average, have a good understanding of the concept of pregnancy
depression. The mean score of 3.57 is higher than the midpoint of the scale, which
indicates that the students, on average, scored higher than the neutral point on the
scale, suggesting a positive perception of their level of awareness on pregnancy
depression. About 8 topics were agreed on by the respondents, and 2 topics
(management and treatment, postpartum psychosis, and its consequences) were
neutral. The item ‘I am aware of postpartum psychosis and its consequences and the
item 'I am aware about the management and treatment of pregnancy depression' were
marked as neutral, suggesting that they were not aware of those items. The overall
interpretation implies that the level of awareness on pregnancy depression was aware,
which means that they are aware of pregnancy anxiety. This can be because they are
medical students and would've come across pregnancy depression through studies.
30
Awareness on pregnancy anxiety vs
Awareness on pregnancy depression
.683**
.000
Reject the null hypothesis.
There is a significant
relationship between the variables.
Table 4. Correlation of awareness of perceived pregnancy anxiety and

awareness of perceived pregnancy depression
**. Correlation is significant at the 0.01 level (2-tailed).
Table 4 shows the Interpretation = There was a strong positive and significant
relationship between perceived awareness on pregnancy anxiety and perceived
awareness on pregnancy depression among female GCM medical students (r =
0.683 ≈ 0.70, p < 0.05)
The Person's r score of 0.70 indicated a strong positive correlation between
pregnancy anxiety and depression among GCM students. This means that as
pregnancy anxiety increases, depression also tends to increase, and vice versa.
The strength of the correlation was considered moderate because the value of r
was between 0.50 to 0.70. The direction was considered positive since the r value
was positive, and so it is concluded that if the awareness on pregnancy anxiety
increases, the awareness on pregnancy depression also increases.
The p-value of less than 0.005 indicates that the correlation between
pregnancy anxiety and depression is statistically significant at a very high level of
31
confidence. This means that we need to reject the null hypothesis since there is a
relationship and it is significant.
Therefore, based on these results, it was concluded that there was a strong
positive correlation between pregnancy anxiety and depression among GCM
students, and this correlation is statistically significant. The direction was positive,
and the strength of the correlation was moderate. This was because the concepts
of pregnancy anxiety and pregnancy depression are interrelated, and both pertain
to the mental health of pregnant women. These findings suggest that addressing
pregnancy anxiety and pregnancy depression may help to prevent or reduce
depression among pregnant women and increase awareness among female
medical students.
32
CHAPTER V
SUMMARY, CONCLUSION, AND RECOMMENDATIONS
Summary of findings
In the Philippines, the maternal mortality rate is high and is primarily due to
depression and anxiety during the postpartum period. Pregnancy is a vulnerable
period which is associated with changes in physical, behavioural, and social
aspects of life. This study tries to correlate the increasing level of awareness of
pregnancy depression and anxiety among female medical students and the
improvement of overall mental health outcomes in pregnant women. The aim of
the study was to assess the level of awareness among medical students studying
from level one to three at Gullas College of Medicine, Mandaue City, Philippines.
Using the physical distribution of questionnaires, data were collected from
100 female respondents studying in MD level one to three who voluntarily
participated. We used a researcher-made questionnaire that was developed
through a brainstorming process.
There was a total of 20 questions, with 10 each for pregnancy anxiety and
pregnancy depression. Pretesting was also done, and suggestions were taken into
consideration before forming the final questionnaire.
The questions were based on the level of awareness of pregnancy anxiety and
depression on the 5-point Likert scale. Among the female respondents, 96% were
Indian, 2% were African, and the remaining 2% were Thai.
The level of awareness on pregnancy anxiety had a mean score of 3.7 and
a standard deviation of 0.65, suggesting that they were aware. The level of
33
awareness on pregnancy depression had a mean score of 3.57 and a standard
deviation of 0.83, which also suggested that they were aware of pregnancy
depression. Results showed that there was a moderate positive and significant
relationship between pregnancy anxiety and depression among Gullas college of
Medicine students since Pearson's r score was 0.70, which is positive. The p-value
was also less than 0.005, which indicates that the correlation between pregnancy
anxiety and depression is statistically significant, and so the null hypothesis is
rejected. The findings suggest that the awareness on pregnancy anxiety and
awareness on pregnancy depression are positively correlated, and an action plan
can be drawn based on the results of the findings.
Conclusion
This study concludes that awareness of pregnancy anxiety is influenced by
awareness of pregnancy depression. From the tables, it is interpreted that there is
a positive correlation between awareness of pregnancy anxiety and awareness on
pregnancy depression. This means that if awareness on pregnancy anxiety
increases, awareness on pregnancy depression also increases. The direction is
positive, and the strength of the correlation is moderate. Medical students who
have a higher awareness of the potential health threats posed by pregnancy
anxiety and depression may be more likely to engage in behaviors that promote
early detection and prevention of these conditions. The positive correlation
between awareness of pregnancy anxiety and depression among medical
students may therefore be explained by their shared perception of the importance
34
of monitoring and addressing mental health during pregnancy. The health belief
model is justified above.
Medical students who have had more exposure to coursework, clinical
training, and discussions about perinatal mental health may be more likely to have
a heightened awareness of the prevalence and risks of pregnancy anxiety and
depression. Similarly, medical students who have interacted with patients or
colleagues who have experienced perinatal mental health issues may also be
more likely to have a shared awareness of these conditions. The positive
correlation between awareness of pregnancy anxiety and depression among
medical students may therefore be explained by the common personal and
environmental factors that promote this awareness. The social cognitive theory is
proved above.
This study can help raise awareness about depression and anxiety during
pregnancy and give an evaluation of the participant's level of understanding. An
action plan regarding the awareness on pregnancy anxiety and the awareness on
pregnancy depression program is to be submitted to the university for its
implementation.
35
Recommendations
There should be discussion on such clinical scenarios by professors while teaching
about a general topic like Pregnancy, and anxiety and depression. As a student of
medicine, one should learn these practical aspects of a common disease which she
may encounter during her practice in the future. There should be more journals or
articles posted on the web about such insufficiencies. One should share and discuss
such diseases with peers which is less known. Including discussions of clinical
scenarios related to anxiety and depression teachings can help future healthcare
providers understand the potential effects of this medication on their patients.
Aspiring healthcare professionals should learn about the practical aspects of
managing pregnancy anxiety and depression, including potential side effects and
their impact on patients' quality of life.
36
REFERENCES
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https://www.mentalhealthjournal.org/articles/anoverview-of-maternal-
anxiety-during-pregnancy (Accessed: November 28, 2022).
Anxiety during pregnancy can lead to earlier births; study finds (no date)
American Psychological Association. American Psychological
Association. Available at:
https://www.apa.org/news/press/releases/2022/09/pregnancyanxiety
(Accessed: November 28, 2022).
Khouj, M.A. et al. (2022) Prevalence of stress, anxiety, and depression
among pregnant women in Jeddah, Cureus. Available at:
https://www.cureus.com/articles/105243-prevalence-ofstress-
anxiety-and-depression-among-pregnant-women-injeddah
(Accessed: November 28, 2022).
Lebel, C. et al. (2020) Elevated depression and anxiety symptoms among
pregnant individuals during the COVID-19 pandemic, Journal of
affective disorders. U.S. National Library of Medicine. Available at:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7395614/ (Accessed:
November 28, 2022).
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RV: D.A.S.E.D. (no date) Based interventions during pregnancy: A
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2022).
Dennis, C. L., & Kingston, D. (2014). A systematic review of telephone
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course of anxiety and depression through pregnancy and the
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Rozina K, Nargis A, Carla MB, et al. Prevalence of anxiety, depression,
and associated factors among pregnant women of Hyderabad,
Pakistan. Int J Soc Psychiatry. 2009;55(5):414–424.
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Grech, Jessica & Calleja, Neville & Grech, Joseph. (2022). Pregnant
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D. D. S. Rowel, Prevalence, incidence, and correlates of postpartum
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Grote, N. K., Bridge, J. A., Gavin, A. R., Melville, J. L., Iyengar, S., &
Katon, W. J. (2010). A meta-analysis of depression during
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40
APPENDICES
41
ANNEX A
LETTER TO COLLEGE DEAN,
GULLAS COLLEGE OF MEDICINE

UNIVERSITY OF THE VISAYAS
Banilad, Mandaue City
Tel No. 346-4224 Telefax 345-2159
Date
DR. LAICO, DEAN,
GULLAS COLLEGE OF MEDICINE, UNIVERSITY OF VISAYAS
Dr. Laico, Greetings!
We are second-year medical students at the University of the Visayas' Gullas College of
Medicine, and we hope to conduct research in Cebu City, Philippines, in MARCH-APRIL
2023, on the students’ awareness on pregnancy anxiety and depression among
medical students.
Please lend your support to this project by backing our request for authorization to use
survey questionnaires to collect data on college campuses and conduct the study. Thank
you.
Sincerely,
PATEL, SHAHID
Research leader
42
ANNEX B
INFORMED CONSENT

Tel No. 346-4224 Telefax 345-2159
Informed consent for the participants in research,

AWARENESS ON PREGNANCY ANXIETY AND DEPRESSION AMONG
MEDICAL STUDENTS
Researchers:
Patel Shahid Kumari Shrishti
Patil Shubham Rajaram Rathod Nidhi
Suphapich Thongchuen Peddakondannagari Madhavi
Jaishankar Subiksha Trivedi Aditya ketanbhai
Umapathy Theneeswari
Ali Akbar Heba
Mamidala Bhargavi
Repalle Richie Rahul
Benjamin Sathia Satchi Josiah Thangamuthu
Saha Moumita Madan Mohan
Gosai Shubham Sharadgiri
43
PART 1: INFORMATION SHEET
INTRODUCTION
We are medical students of the Gullas College of Medicine who are
currently conducting a research, awareness on pregnancy anxiety and depression
among medical students. This is research which is a requirement in our course. If
you agree to be a part of the research, please sign this consent form.
PURPOSE OF RESEARCH
The aim of this research is to assess the level of awareness among medical
students regarding pregnancy anxiety and depression, recognizing the potential
impact on their well-being. By understanding their knowledge on these issues, we
hope to enhance their alertness and promote a health-conscious mindset in
addressing mental health challenges related to pregnancy.
TYPE OF RESEARCH INTERVENTION
We invite you to be a part of this study. You will be given a printed
questionnaire which will take around 15-30 minutes to fill. The top of the
questionnaire will have instructions on how to fill it.
PARTICIPATION SELECTION
We need 100 participants for this research. You are being invited to take
part in this research. Your answers to the questionnaire will contribute much to
our understanding of awareness on pregnancy anxiety and depression among
medical students voluntary participation.
44
VOLUNTARY PARTICIPATION
Your participation in this research is entirely voluntary. It is your choice whether
to participate or not. You may change your mind later and stop participating even
if you agreed earlier.
PROCEDURES
We will ask you to fill out a printed questionnaire for survey. Number of
students from each sec was selected by stratified sampling. You may answer the
questionnaire yourself. The information recorded is confidential, to mention your
name will be optional, but majorly only you ID number will identify you, and no one
else except researchers will have access to your survey.
DURATION
The questionnaire can be answered in around 15-20 minutes. After that,
your participation is finished.
RISKS
You do not have to answer any question if you don't wish to do so, and that
is also fine. You do not have to give us any reason for not responding to any
question. There are questions that need answers that might be personal or may
be confidential information by chance, or that you may feel uncomfortable talking
about some of the topics. However, we do not wish for this to happen. You do not
have to answer any question if you feel the question(s) are too personal or if talking
about them makes you uncomfortable.
BENEFITS
There will be no direct benefit to you, but your participation is likely to help
45
us find out your awareness on pregnancy anxiety and depression among medical
students, in order to make them more alert and conscious.
REIMBURSEMENT
You will not be provided any incentive to take part in the research.
CONFIDENTIALITY
We will not be sharing information about you to anyone outside of the
research team. The information that we collect from this research project will be
kept private. Any information about you will be anonymous. Only the researchers
will know what your answered. It will not be shared with or given to anyone except
the research team.
WHO TO CONTACT
If you have any questions, you can ask them now or later. If you wish to ask
questions later, you may contact any of the following:
Patel Shahid
Email ID - sayyu84@gmail.com Mobile - +918103771913
Moumita Saha
Email ID - moumitasaha6012@gmail.com Mobile- +639945936984
This proposal has been reviewed and approved by the University of the
Visayas Institutional Review Board which is a committee whose task it is to make
sure that research participants are protected from harm.
46
PART II: CERTIFICATE OF CONSENT
I have been invited to participate in research about awareness on
pregnancy anxiety and depression among medical students.
I have read the foregoing information, or it has been read to me. I have had
the opportunity to ask questions about it and any questions I have been asked to
have been answered to my satisfaction. I consent voluntarily to be a participant in
this study.
Print name of Participant: ______________
Signature of participant: ________________
Date: ____________
Statement by the researcher/person taking consent
I have accurately read out the information sheet to the potential
participant, and to the best of my ability made sure that the participant
understands that she will answer a questionnaire.
I confirm that the participant was given an opportunity to ask questions
about the study, and all the questions asked by the participant have been
answered correctly and to the best of my ability. I confirm that the individual has
not been coerced into giving consent, and the consent has been given freely and
voluntarily.
A copy of this ICF has been provided to the participant.
Print name of the Researcher/Person taking the consent
47
_____________________________________________________
Signature of the Researcher/Person taking the consent
______________________________________________________
Date
______________________________________________________
Day/Month/Year
48
ANNEXURE C
QUESTIONNAIRE

Tel No. 346-4224 Telefax 345-2159
“In the name of God, the Most Gracious, the Most Merciful”
You are being asked to participate voluntarily in this questionnaire, which will
take a few minutes. The purpose of the study is to assess the level of knowledge
regarding ED in diabetic patients among first year medical students in GULLAS
COLLEGE OF MEDICINE. Your participation is voluntary and does not entail any
rewards or cash payment for participation. We will not collect any personal
information, and only the research team will have access to the information that
you provide, which will remain anonymous. Data from all respondents will be
summarized in a study report.
Continuing to the survey section indicates your consent to participate
voluntarily. By participating in this questionnaire, you are allowing the research
team to use your data for research purposes.
Thank you,
Gullas College of Medicines, University of Visayas Supervised by
Mr. Rene N. Argenal
49
PART I – DEMOGRAPHIC PROFILE OF THE RESPONDANTS
Choose your answer by checking the appropriate options:
AGE-
• 18-21 years
• 21-23 years
• 23-25 years
• >25 years
SEX-
• MALE
• FEMALE
• OTHERS
Put a mark (∙) on the corresponding items that match your answer about your
knowledge on mental health issues using the following scale:
Range Item response

5 Strongly agree
4 Agree
3 Neutral
2 Disagree
1 Stronglydisagree
PART - II- PREGNANCY ANXIETY SURVEY
50
Strongly Disagree Neutral Agree Strongly
Disagree Agree
definition of
pregnancy anxiety.
2. I am aware on the
prevalence of
pregnancy anxiety
among
female population
symptoms associated
with pregnancy
anxiety
4. I am aware about
the steps taken in the
diagnosis of
pregnancy anxiety.
adverse effects of
pregnancy anxiety on
mental health.
6. I am aware of
where and whom to
approach at times of
pregnancy anxiety.
treatment regime
proposed for
pregnancy anxiety.
management and
prevention of
pregnancy anxiety.
51
natural ways to
overcome anxiety
during pregnancy.

pregnancy counseling
services related to
pregnancy anxiety
provided in the
Philippines.
PARTIII- PREGNANCY DEPRESSION SURVEY

Strongly Disagree Neutral Agree Strongly
Disagree Agree
definition of pregnancy
depression.
early signs presented
during pregnancy
depression.
difference between
baby blues and
risk factors for
depression during
pregnancy.
5. I am aware about
the complications of
untreated perinatal
depression in pregnant
women.
52
6. I am aware of
postpartum psychosis
and its consequences.
diagnosis of pregnancy
depression.
8. I am aware about
the management and
treatment of pregnancy
depression.
9. I am aware about
the antidepressants
and their role on
alleviating pregnancy
depression.

side effects associated
with the use of
antidepressant drugs
during treatment of
ANNEX D
Gantt chart
53
ACTIVITY OCT NOV DEC JAN 2023 FEB MAR 2023 APR
2022 2022 2022 2023 2023
GROUPING AND IDENTIFICATION OF
MEMBERS
APPROVAL OF THE RESEARCH
TOPIC
FORMULATION OF FEW PARTS OF
THE PROPOSAL
TABLE OF CONTENTS
FORMULATION OF THEORETICAL
AND CONCEPTUAL FRAMEWORK
FINALISATION OF QUESTIONNAIRE
PRETESTING OF THE
QUESTIONNAIRE
FORMULATION OF LAST PARTS OF
THE PROPOSAL
CONDUCT OF ACTUAL RESEARCH
AND DATA COLLECTION
FACILITIES AND BUDGET
DRAFT OF THE RESEARCH PAPER
CONSULTATION WITH THE
RESEARCH FACULTY
ACTUAL DEFENCE
SUBMISSION OF RESEARCH
PAPER
54
ANNEX E
Budget
Activity Quantity Cost
Proposal and defence 15 persons 18,750 pesos

charges
Printing and binding 4 copies 3000 pesos

charges
Miscellaneius charges 7000 pesos
Total cost 28,750 pesos
55
RESEARCHER’S CURRICULUM VITAE
PATEL SHAHID
Pete’s condoville
Cebu City, Cebu
Philippines-6000
Personal information
Sex: Male
Age: 20
Civil status: single
Date of Birth: 16 July 2002
Religion: Muslim
Educational Background
August 2021 – Present - University of the Visayas Gullas College of
Medicine Brgy. Banilad, Mandaue City, Cebu
October 2019 - July 2021 - Graduated, Bachelor of Science in Biology

University of the Visayas Gullas College of Medicine Brgy. Banilad,
Mandaue City, Cebu
June 2017 May 2019 – Jawahar Navodaya Vidyalaya, C.K. DAM,

District DEWAS, Madhya Pradesh INDIA
April 2015 May 2017 – Jawahar Navodaya Vidyalaya, C.K. DAM,

District DEWAS, Madhya Pradesh INDIA
56
MOUMITA SAHA
Pete’s condoville
Cebu City, Cebu
Philippines-6000
Sex: Female
Age: 21
Religion: Hindu
November 2019 - July 2021 - Graduated with a Bachelor of Science in Biology

University of the Visayas Gullas College of Medicine Brgy.
Banilad, Mandaue City, Cebu
June 2017-May 2019 – Nirmala memorial college of Science and

Commerce
June 2015-May 2017 – Gokuldham High School and junior college
57
NIDHI RATHOD
Pete’s condoville
Cebu City, Cebu
Philippines-6000
Sex: Female
Age: 21
Date of Birth: 11 April 2001
Religion: Hindu

June 2016-March 2018 – Gyanmanjari Vidyapith
June 2006-March 2016 – Saint Xavier’s school Botad
58
PATIL SHUBHAM RAJRAM
Pete’s condoville
Cebu City, Cebu
Philippines-6000
Sex: Male
Age: 20
Date of Birth: 18 January 2002
Religion: Hindu

(2017-2019)-PP Savani International School (11std - 12std)

Abrama road, mota varaccha, Surat, Gujarat, India
(2012-2016)- Genius Educational Academy (7std - 10std) Chalthan

Road, Mohini Village, Chaursiya taluka, Surat, Gujarat, India
Smita Patil Public School (1std - 6std) Dahiwad road, Shirpur, Dhule dist.,
Maharashtra, India
59
SHUBHAM GOSAI
Pete’s condoville
Cebu City, Cebu
Philippines-6000
Sex: Male
Age: 21
Date of Birth: 23 March 2001
Religion: Hindu

June 2017 - May 2019 Graduated high school – Gyanmanjari– Bhavnagar,

Gujarat India
April 2015 - May 2017. Graduated secondary school – Saint Thomas high
school – Savarkundla, Gujarat India
60
KUMARI SHRISTHI
Pete’s condoville
Cebu City, Cebu
Philippines-6000
Sex: Female
Age: 22
Religion: Hindu

June 2017- August 2019 - B.Sc. zoology Honors Graduated from JPU
University, Chhapra, Saran
June 2014 - May 2016- Graduated High School DAV centenary public school
Siwan, Bihar, India
April 2012 - May 2014- Graduated Secondary school. Sanghmitra Public

school Siwan, Bihar, India
61
TRIVEDI ADITYA KETANBHAI
Pete’s condoville
Cebu City, Cebu
Philippines-6000
Sex: Male
Age: 21
Date of Birth: 28 November 2001
Religion: Hindu

June 2017 - May 2019: Graduated from higher secondary school, tapovan
science school, Rajkot, Gujarat, India.
April 2015 - May 2017: Graduated from secondary school, Vivekanand School,
jasdan, Gujarat, India.
62
SUPHAPICH THONGCHUEN
LM dorm Banilad
Cebu City, Cebu
Philippines-6000
Sex: Female
Age: 29
Religion: Buddhism

October 2015-July 2016 Graduated from King Mongkut's Institute of

Technology Ladkrabang
October 2007-July 2012 Graduated Secondary and High School at

Navamintrachinuthit Suankularbwittayalai Samutprakarn
63
MAMIDALA BHARGAVI
Unit -5, holy famiy-2,
Cebu city 6000
Sex: Female
Age: 21
Date of Birth: 3 August 2001
Religion: Hindu
January 2020- September 2021 Saint Paul University, Philippines
June 2016- April 2018 Sri Chaitanya junior college Andhra

Pradesh, India.
June 14 – April 2016 Narayana junior college

Andhra Pradesh, India
64
HEBA ALI AKBAR
Holy Family Village-1
Mandaue City, Cebu
Philippines 6000
Personal Information
Sex: Female
Age: 21
Civil Status: Single
Date of Birth: July 19, 2001
Religion: Islam
Education Background
August 2021- Present University of the Visayas Gullas College of
Medicine. Brgy. Banilad, Mandaue City, Cebu
October 2019- July 2021 Graduated a Bachelor of Science in Biology

University of the Visayas Gullas College of Medicine. Brgy. Banilad,
Mandaue City, Cebu
2017- 2019- Graduated, High school National Model Senior Secondary

School, Coimbatore, Tamil Nadu
2012-2017 -Graduated, Secondary High School Al-Khozama

International School, Dammam, Saudi. Arabia
65
THENEESWARI UMAPATHY
608, Pete’s condoville, Damascus Road, Brgy Banilad,
Cebu City, Cebu
Philippines-6000
Sex: Female
Age: 21
Religion: Hindu
January 2021-Present: University of the Visayas Gullas College

of Medicine Brgy. Banilad, Mandaue City, Cebu
September 2019-December 2020: Graduated Bachelor of Science in Biology

University of the Visayas Gullas College of Medicine, Brgy.
June 2018- May 2019: Graduated High school Zion Mat. Hr. Sec.
School, Chennai, India
April 2106- May 2017: SSM school Chennai, India
66
PEDDAKONDANNAGARI MADHAVI
Teresita’s Dormitel
Cebu City, Cebu
Philippines-6000
Sex: Female
Age: 21
Religion: Hindu
August 2021-Present: University of the Visayas Gullas College

of Medicine Brgy. Banilad, Mandaue City, Cebu
2019-2020: Graduated Bachelor of Science in Biology, Lyceum

Northwestern University, Dagupan City, Pangasinan, Philippines
2016-2018: Graduated from High school at Sri Chaitanya junior college, Tirupati,
2015-2016: Graduated from secondary school, T.K.R. High School,

67
REPALLE RICHIE RAHUL VARDHAN
Vailoces compound
Cebu city, Cebu
Philippines 6000
Sex: Male
Age: 21
Date of Birth: 04 March, 2001
Religion: Christian
August 2021: Present. University of the Visayas Gullas College of Medicine Brgy. Banilad,
Mandaue City, Cebu
December 2018-June 2021: Graduated, Bachelor of Science in Microbiology William Carey

University Meghalaya, India
June 2016 April 2018: Graduated, High School, Sri Chaitanya junior college, Andhra
Pradesh, India
June 2014 March 2016: Graduated, Secondary School, St. Joseph

English School, Kurnool, Andhra Pradesh, India
68
SUBIKSHA JAISHANKAR
Sorilla compound
NO:16, Brgy Banilad,
Cebu City, Cebu
Philippines-6000
Sex: Female
Age: 22
Date of Birth: 13 January, 2000
Religion: Hindu
January 2021-Present: University of the Visayas Gullas College of Medicine Brgy. Banilad,
Mandaue City, Cebu
September 2019-December 2020: Graduated Bachelor of science in Biology University of

the Visayas Gullas College of Medicine,
Brgy. Banilad, Mandaue City, Cebu
June 2017-May 2018: Graduated diploma in yoga and naturopathy

Vethathiri maharishi college of yoga, Chennai, India
69
BENJAMIN SATHIA SATCHI JOSIAH THANGAMUTHU
303. Pete’s Condoville,
Talamban,
Cebu City, Cebu -6000
Philippines.
Sex: Male
Age: 21
Religion: Christian – Born again

June 2017- May 2019 - Suguna Rip V School, Coimbatore, Tamil Nadu, India.
June 2007- May 2017 – Carmel Garden Matriculation School, Coimbatore,

Tamilnadu, India.
70

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AWARENESS ON PREGNANCY ANXIETY AND DEPRESSION AMONG MEDICAL

This research paper entitled: “AWARENESS ON PREGNANCY ANXIETY AND

Dr. Resty Picardo Dr. Ramon Del Fierro

Mr. Rene Argenal

Dr. Althea R. Arenejo

Dr. Jose Juan Rafael G. Laico

gratitude to the following:

complete their research proposal, unwavering encouragement, and insightful feedback,

blessings to withstand all obstacles in our endeavours which we will understand.

female medical students of Gullas college of Medicine. A survey-based approach was

of pregnancy anxiety and depression. Establishing targeted educational initiatives can

empower medical students to recognize, address, and mitigate pregnancy-related mental

students during their reproductive years.

Keywords: Pregnancy, Anxiety, Depression, Medical students, Awareness, Healthcare

Rationale of the study…………………………………………………….….1

Statement of the objectives……………………………………………….…3

Statement of the hypothesis…………………………….............................4

Significance of the Study…………………………………………….............5

CHAPTER II: REVIEW OF RELATED LITERATURE AND STUDIES….8

CHAPTER III: METHODOLOGY

CHAPTER IV: RESULTS AND DISCUSSIONS .....................................26

CHAPTER V: SUMMARY OF FINDINGS, CONCLUSIONS AND

Awareness on Pregnancy Anxiety and Pregnancy Depression…...39

Grammer and Plagiarism certificate..………………………………...51

Table number 1. Profile of the Female Respondents of Gullas College of

Table number 2. Awareness of Pregnancy Anxiety Among Gullas College of

Table number 3. Awareness of Pregnancy Depression Among Gullas College of Medicine

Table number 4. Correlation of awareness of perceived pregnancy

anxiety and awareness of perceived pregnancy depression…………33

AWARENESS ON PREGNANCY ANXIETY AND DEPRESSION AMONG MEDICAL

Rationale of the study

Pregnancy is a vulnerable period which is associated with changes in

physical, behavioural, and social aspects of life. It is accompanied by sudden

development. Maternal depression is one of the major contributors to pregnancy-

related morbidity and mortality. A systematic review and meta-analysis published

in the Journal of Affective Disorders in 2019 found that the prevalence of

postpartum depression worldwide was 17.7%.

This paper focuses on assessing the level of awareness of the female

medical students of Gullas college of Medicine on pregnancy-related depression

and anxiety. This is conducted through a physical distribution of a questionnaire

asking students about awareness on pregnancy-related anxiety and depression.

managing the health of pregnant women. Thus, it is important to understand their

knowledge, attitudes, and practices related to pregnancy anxiety and depression,

make medical students more skilful and knowledgeable in their practice of

predecessors of perinatal depression and its related disorders. Secondly, medical

students are also at risk of experiencing pregnancy anxiety and depression

depression due to various stressors. Therefore, understanding medical students'

awareness of pregnancy anxiety and depression can help identify potential

barriers to early detection and treatment of these conditions in pregnant women.

This study can promote positive attitudes toward help-seeking behaviour

where medical students will play an indispensable part in understanding and

management of diseases. It is, therefore, important for medical students to have a

basic foundational ground so that targeted interventions can be formulated at the

healthcare providers to screen for and address these conditions in pregnant

improve medical education, awareness, and training related to maternal mental

improve the quality of care provided to pregnant women.

The theoretical framework for awareness of pregnancy anxiety and

psychologists, including Hochbaum, Rosenstock, Becker, and others, in the

and their perceived barriers to acting.

The HBM could be used to assess whether medical students perceive

pregnancy anxiety and depression as serious health problems, whether they

beneficial. Social Cognitive Theory (SCT) is an interpersonal-level theory

developed by Albert Bandura in 1986. It emphasizes the role of social and