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Chapter I Newborn Screening Awareness and Acceptability among Selected Mothers at Candelaria Municipal Hospital: An Assessment

Introduction Newborn Screening is a simple method to find out if your baby has congenital metabolic disorder that may lead to retardation and even death. It is a preventive health service that should be available to all neonates. Newborn Screening no longer refers to the screening test itself, but encompasses the entire element essential to all neonates to have access to a screening system that has optimal quality and performance. (DOH, 2006). According to World Health Organization (WHO) figures, about two million babies are born in the Philippines every year, and not all are aware, however, that 33,000 babies are at risk of life threatening disorders that could cause mental retardation and even death. Over 99% of parents agree for their baby to have the NBS test and overall about 1 out of every 1000 babies tested (0.1%) will be diagnosed with a condition as a result of having NBS (WHO, 2007). In response to growing concerns over the health of children, newborn screening for congenital disorders began in the United States in 1961, when Dr. Robert Guthrie designed an assay for the pre-symptomatic identification of patients with Phenylketonuria (PKU) using dried blood absorbed into special filter paper. Newborn screening has since been a routine component of quality newborn care in the United States with newborn coverage of about 100%. The test involves prickling the baby’s heel to obtain a small blood sample, which is then sent to a special laboratory for the testing. The test is best done within 24

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hours, or at least 48 hours after a baby is born. Even though each disease by itself is rare, all together these diseases affect 1 in 1500 babies. If untreated, they can lead to health problems, such as poor growth or mental retardation (London, 2007). This form of testing is known as screening because it involves testing a whole population - in this case, newborn babies. All babies are tested even if they do not have any obvious signs of a condition that affects their metabolism, endocrine and blood (Stewart, 2007). In order to provide optimum level of health for the children and infants, different researches and programs were inducted to promote development. In July 2000, the

Philippine NBS Project was cited for outstanding health research by the Philippine Council for Health Research and Development. In October 2000, the NBS Project had already screened 135,000 babies, 53 of which were confirmed to have one of the disorders included in the program. But perhaps the most dramatic achievement, by far, of the Philippine NSB Project is the approval into law on April 7, 2004; Republic 9288, entitled, “AN ACT PROMULGATING A COMPREHENSIVE POLICY AND A NATIONAL SYSTEM FOR ENSURING NEWBORN SCREENING”. This Newborn Screening Act of 2004 ensures that every newborn in the Philippines is given the opportunity to be offered newborn screening. It is the policy of the state to protect and promote the right to health of the people, including the rights of children to survival and full and healthy development as normal individuals. In pursuit of such policy, the State shall institutionalize a national newborn screening system that is comprehensive, integrative and sustainable, and will facilitate collaboration among government and non-

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government agencies at the national and local levels, the private sector, families and communities, professional health organization, academic institutions and non-

governmental organization. The National Newborn Screening System shall ensure that every baby born in the Philippines is offered the opportunity to undergo newborn screening and thus be spared from heritable conditions that can lead to mental retardation and death if undetected and untreated. (McKinney, 2007) The implementation of this law has found renewed impetus through an earlier Proclamation No. 540, signed by former President Gloria Macapagal Arroyo on January 20, 2004, declaring the 1st week of October of each year “National Newborn Screening Week.” However, the greatest challenge remains: making newborn screening available to all Filipino babies. A critical point of concern is the lack of public awareness about the benefits of newborn screening. Moreover, and perhaps because of low awareness, there appears to be some resistance from mothers to the idea of subjecting babies to the screening procedure. Even the law acknowledges that NBS may not be acceptable to some parents, as evidenced by Article 3, Section 7 of the Newborn Screening Act, thus: Sec. 7. Refusal to be Tested – a parent or legal guardian may refuse testing on the grounds of religious beliefs, but shall acknowledge in writing their understanding that refusal for testing places their at risk for undiagnosed heritable conditions. A copy of this refusal documentation shall be made part of the newborn screening database. Indeed, the goal of NBS to become program for major disease prevention in the Philippines has yet to be realized. This is where public support is required so that our policymakers and health administrators can be compelled to integrate this technology as part of the Filipino health routine.

the underlying factors that promote the acceptability of Newborn Screening among Filipino mothers. Availability and accessibility of the program c. specifically among selected mothers in Candelaria Quezon who had just delivered their babies at the Candelaria Municipal Hospital (CMH). Socio-economic Status e. Maternal History 2. The following specific problems were sought to be addressed: 1. only 45% of them are subjecting their infants to Newborn Screening. Nature of the screening program b. Educational status d.NEWBORN SCRENING AWARENESS…… 4 It is this challenge that has prodded the researchers to conduct a study on the determinants of NBS awareness and acceptability. albeit on a limited scale. What is the level of awareness of the respondents about NBS in terms of: a. Civil status c. What is the level of acceptance of the respondents on Newborn Screening? . The researchers have chosen to conduct their study at Candelaria Municipal Hospital as they have found out that out of the average of 101 pregnant mothers who give birth on the hospital. Significance of NBS program 3. Age b. What are the characteristics of selected respondent-mothers in terms of: a. Statement of The Problem The study aimed to assess the awareness regarding Newborn Screening and also.

The philosophy behind the model is that the best people to care for the child is the family with the help from various professional staff. What are the variables that affect the acceptance of the respondents on Newborn Screening? 5. There should therefore be a partnership between parents and caregivers. Community Health Nursing THEORETICAL FRAMEWORK The Casey Model of Nursing (1988) comprises the five concepts of child.NEWBORN SCRENING AWARENESS…… 5 4. Program Development c. Health Education b. pregnant women are the ones responsible on . specifically the mothers beforehand. the role of the nurse is that of guidance not decision maker. In relation to the study. co-creating of rhythmical patterns in exchange with the environment. In connection to the study. on the benefits of having the Newborn Screening done on their child. Parse believed that each choice opens certain opportunities while closing others since each individual makes his or her choices. This includes the responsibility of the nurses to undergo the child into Newborn Screening to evaluate the possible abnormalities that may occur to the child as well as to educate the parents. environment and the nurse. family. health. Moreover. What are the implications of this study to the following : a. Philosophy represents the unity and relationship between the nurse and the family to achieve the best health condition of the child as possible. it was also based on the Theory of Human Becoming by Rosemarie Rizzo Parse (1995). It emphasizes free choice of personal meaning in relating value priorities.

NEWBORN SCRENING AWARENESS…… 6 deciding whether to subject or not to subject their child on Newborn Screening. The nurse will only serve as a guide for women in gathering correct information on newborn screening and during their decision making concerning the screening of their child. Conceptual Paradigm .

Figure 1. NBS Awareness and Acceptability among Mothers .NEWBORN SCRENING AWARENESS…… 7 • • • Profile Nature of the Screening Program Availavility and Accesibiity of the • Analysis of the Program • Enhanced Awareness and Acceptance of the newborn screening by mothers.

the Inputs included are Social Influence. Together. Education refers to the mother’s knowledge regarding NBS which may affect her acceptance of the certain procedure. nutrition. and confidentiality and privacy implemented in the hospital. sanitation and better health care is primarily the mother’s responsibility. she may decide to accept the procedure to be done on her child and this may mean early detection of conditions present on the child which may suggest prompt treatment accordingly. family influence & decision making pattern. In the diagram shown above. and is also satisfied with the services offered by a certain institution. which refers to the Economic Problems or fear of the mother to be discriminated when results of such NBS is achieved.NEWBORN SCRENING AWARENESS…… 8 The purpose of this study is to assess NBS awareness and its acceptability among selected mothers --. If a mother is knowledgeable or aware about the different advantages given by the NBS on the infant. child survival intervention through immunization. Meanwhile. values & norms of a person. competence of provider. screening. and is financially capable of having the procedure done so. delivery of the result. Socioeconomic Status would be the financial capability of the mother. Culture and Religion would be referring to Role of traditional healers. Services on the Hospital refers to Method and quality of testing. Moreover. all these factors may affect the perception and acceptance of the mothers regarding NBS. and all these depend heavily on her capacity .whether they submit or not their child on Newborn Screening. education. Educational Status of the mothers was also considered for their level of understanding regarding the program would affect their acceptance of it.

As the NBS program looks toward the future. 2. Assumptions For purposes of this study. Newborn screening is a must for babies after giving birth. efforts to make operations sustainable instead of reliant on grants from donors. by political activities--the NBS program may have to develop strategies to address women’s roles from vantage points outside the clinic. and decision about how many services to provide and to whom. Provide knowledge to the parents will let them ensure that they recognize their responsibilities in promoting their child’s right to health and full development. Scope and Delimitation of the Study The result of this study have been obtained from direct interviews and analysis of the checklist questionnaires that were distributed among respondents. by living conditions in their home and communities. . who constitute a sample size of 30 selected mothers who had delivered their babies at the Candelaria Municipal Hospital within the period February 2012 to March 2012 which was the time of collection samples. it will face several challenges: the need to publicize and market its services and programs to gain a larger client base. the researchers have moved along the following assumptions: 1.NEWBORN SCRENING AWARENESS…… 9 Because child’s health is affected by factors other than physiology by family relationship.

but also information on the program itself. or friends. To the nurses. The researchers have remained mindful of the general observation that a key component of the Newborn Screening acceptability is the provision of not only Newborn Screening services. for it will make them more knowledgeable or if they are not aware. to impact on the following sectors/areas: To the respondents. . For the nursing profession.NEWBORN SCRENING AWARENESS…… 10 Care was also undertaken to determine ---whether by herself or with the influence of other members of the family. particularly since provision of law mandate the availability of this procedure to all Newborn children. for it will provide them awareness about the important role nurses play in NBS promotion and the provision of health information and will help them gain confidence towards health education through repeated interaction with the mothers. it will serve as basis for formulating more programs to implement in order that all children will undergo the Newborn Screening program. Significance of the Study This study aimed to assess the potential of full implementation. The researchers expected this study. therefore. give them full knowledge of the importance and benefits of NBS as the researchers communicate and conduct interviews with them.

Acceptability: The level of acceptability of the given situation that also includes satisfaction of what is required and what is the standard. Newborn screening (NBS): It is a simple procedure to find out if your baby has a rare metabolic disorder. to feel.tuning and/or amendment. Newborn: It means a child from complete delivery up to 30 days of life. you cannot be certain that he will not develop negative outcomes caused by these metabolic . either operationally or contextually. Candelaria Municipal Hospital: This is a secondary hospital located at Candelaria Quezon where in the researchers would conduct their study on selected mothers regarding NBS awareness and acceptability. objects or sensory patterns. it will inquire them to have immediate feedback about the provision of the NBS law that may require fine. Mother: It refers to a female parent who nurtures and rears her newborn child. to afford the readers a clearer understanding of the study and its results: Awareness: It is the state or ability to perceive. Definition of Terms The researchers have defined the following terms. sense data can be confirmed by an observer without necessarily implying understanding. In this level of consciousness. Although your baby may look healthy at birth. or to be conscious of events.NEWBORN SCRENING AWARENESS…… 11 For the Policymakers.

residual dried blood spots also have many potential uses in public health and bioemedical research (Olson. infectious or auditory disorders. If the disorders are left untreated. In addition. Screening is performed on blood samples that have been collected shortly after birth and dried on a filter paper. metabolic. Individual states may store these extra samples for use in the quality control of current test and the development of new tests. hematologic. extra samples are collected in the form of multiple blood spots on a standardized form. These children generally appear normal at birth but have an inherent condition that will lead to disability or death without intervention. Related Literature Newborn Screening (NBS) programs identify children who are born with serious genetic. 2010) According to DOH (2011) Newborn screening (NBS) is a public health program aimed at the early identification of infants who are affected by certain . This gave the researchers full understanding of the subject being investigated and studied. Chapter II Review of Literature and Related Studies This chapter contains literature and prior studies related to the researchers’ study which may help in lending context and enrich the discussion of the subject matter. they may lead to physical disabilities. and even death. To ensure that the specimen can be reevaluated if warranted by the initial screening result.NEWBORN SCRENING AWARENESS…… 12 disorders. mental retardation.

Galactosemia. The DOH Advisory Committee on Newborn Screening has approved a maximum allowable fee of P50 for the collection of the sample. Newborn Screening Promotion. Five conditions are currently screened: Congenital Hypothyroidism. If babies are delivered at home. According to Department of Health (DOH) 2011. and Glucose-6-Phosphate Dehydrogenase Deficiency. Education on newborn screening should be included during the pre-admission process. Phenylketonuria.NEWBORN SCRENING AWARENESS…… 13 genetic/metabolic/infectious conditions. Newborn screening is available in participating health institutions (hospitals. lying-ins. From 1996 to December 2010. NBS test costs only Php. mortality. and associated disabilities in affected infants. Congenital Adrenal Hyperplasia. Rural Health Units and Health Centers). The baby’s pediatrician. According to ACOG (2003) Parent education about newborn screening should start well before the time of delivery and labor. family physician.UP Manila (2010). or other health care provider should introduce information about newborn screening to parents during the third trimester. According to National Institutes of Health. NBS in the Philippines started in June 1996 and was integrated into the public health delivery system with the enactment of the Newborn Screening Act of 2004 (Republic Act 9288). the program has saved 45 283 patients. Early identification and timely intervention can lead to significant reduction of morbidity. 500 at a very reasonable price. babies may be brought to the nearest institution offering newborn screening. Community health agencies for pregnant women should .

Treatment consists of a daily dose of thyroid hormone (thyroxine) by mouth. Because the treatment is simple. nearly all of the developed world practices newborn screening to detect and treat congenital hypothyroidism in the first weeks of life. Obstetrician-gynecologists can continue to work to improve the health of their patients by informing expectant families of the newborn screening process. or adults. the enzymes needed for further metabolism of . effective. severe congenital hypothyroidism can lead to growth failure and permanent mental retardation. while even more have mild or partial degrees. In individuals with galactosemia. Approximately 1 in 4000 newborn infants has a severe deficiency of thyroid function. Approximately 95% of cases of CAH are due to 21-hydroxylase deficiency. and inexpensive. GAL (Galactosemia) . Most of these conditions involve excessive or deficient production of sex steroids and can alter development of primary or secondary sex characteristics in some affected infants. the following are the common diseases found in newborn screening test: CH (Congenital hypothyroidism) . According to Nieto (2009).NEWBORN SCRENING AWARENESS…… 14 also include this education.is a condition of thyroid hormone deficiency present at birth. CAH (Congenital adrenal hyperplasia) . Lactose in food (such as dairy products) is broken down by the body into glucose and galactose. children.refers to any of several autosomal recessive diseases resulting from mutations of genes for enzymes mediating the biochemical steps of production of cortisol from cholesterol by the adrenal glands (steroidogenesis). If untreated for several months after birth.is a rare genetic metabolic disorder which affects an individual's ability to properly metabolize the sugar galactose.

phenylalanine accumulates and is converted into phenylpyruvate (also known as phenylketone).is an autosomal recessive genetic disorder characterized by a deficiency in the enzyme phenylalanine hydroxylase (PAH). which is detected in the urine. renal failure. PAH is found on chromosome number 12. G6PD Deficiency .NEWBORN SCRENING AWARENESS…… 15 galactose are severely diminished or missing entirely. The heel prick may cause brief discomfort to your newborn. and brain damage. cataracts.Left untreated. When PAH is deficient. mortality in infants with galactosemia is about 75%. but holding or feeding them during collection will help. Screening is quick and safe. There is a very small risk . PKU (Phenylketonuria) . This enzyme is necessary to metabolize the amino acid phenylalanine to the amino acid tyrosine. resulting in hepatomegaly (an enlarged liver). leading to progressive mental retardation and seizures. leading to toxic levels of galactose to build up in the blood. this condition can cause problems with brain development. However.is an X-linked recessive hereditary disease characterized by abnormally low levels of the glucose-6-phosphate dehydrogenase enzyme (abbreviated G6PD or G6PDH). It is a metabolic enzyme involved in the pentose phosphate pathway. There is no cure. A diet low in phenylalanine and high in tyrosine can be a very effective treatment. PKU is one of the few genetic diseases that can be controlled by diet. Without treatment. Damage done is irreversible so early detection is crucial. especially important in red blood cell metabolism. cirrhosis.

irreparable damage can occur – damage such as mental retardation or. 2007) .health. A positive screen means that the baby is at increased risk of having one of the disorders being screened. it is being followed up by series of medication. death. (London.gov. This program is essential nowadays because it is a procedure that determines whether the infant has a congenital defect or anomaly. because once newborn screening procedure is being done and the result has been revealed that the infant is positive for any of the congenital disorders/anomalies.vic. but if the infant did not undergo the procedure and has any of the congenital defects present at birth. Newborn screening results are available within seven to fourteen (7 .com) According to Newborn Screening Reference Center (2012). she may be asked to sign a paper stating that she refused to have her baby tested for these very serious disorders (www. but using gloves and cleaning the heel beforehand will minimize this risk . As a parent.au).14) working days after the newborn screening samples are received in the NSC. it would be a life-long burden not only for the family but especially for the child. in countless instances. Newborn screening (NBS) is important because a baby with one of these illnesses will appear perfectly healthy and by the time symptoms are visible. A negative screen means that the result of the test indicates extremely low risk of having any of the disorders being screened. If she refuses to have the test done. one may refuse newborn screening for her baby only if her religious beliefs and practices do not allow this testing. A mother should always be aware of her infant’s condition.NEWBORN SCRENING AWARENESS…… 16 of infection because we are making a small break in the skin.aaroncyuntalan.Newborn Screening for the health of your baby (www.

NEWBORN SCRENING AWARENESS…… 17 Greater education for mothers contributes to new skills. Paderes. 2005). To the extent that more-educated mothers make healthier choices for themselves during pregnancy. whose family income was less than $5. had a life-expectancy at all ages that was about 25 percent longer than those in the bottom 5 percent. According to Deaton (2003) Richer. (March 2005) her findings based on her research at Tayabas Community Hospital in Tayabas Quezon. the respondents.000. people whose family income in 1980 was greater than $50. less-educated people. Comparison between Selected Primiparas and Multiparas in the level of Awareness regarding Newborn Screening at Quezon Medical Center. For instance. Related Studies Local According to Toletino MJ. education will have a direct effect on the health of the child at birth (Miller and Rodgers.000. hygiene. knowledge obtained during a mother’s education can affect choices about antenatal care and about children’s nutrition. respondents where highly aware of . better-educated people live longer than poorer. According to Ayrette E. putting them in the top 5 percent of incomes. (March 2008) based on his findings in his research. beliefs. According to calculations from the National Longitudinal Mortality Survey which tracks the mortality of people originally interviewed in the CPS and other surveys. and health care. Multiparas are aware and the Primiparas were unaware of it. and choices about sound health and nutritional practices that directly influence the proximate determinants of child health.

Lucena City. could from the basis for this education approach. most frequently after delivery (73%) and in the third trimester (60%). procedure of newborn screening despite the false or negative statement about newborn screening. According to Marquez KJ (January 2008). Professional societies and state health professional should work together to encourage parent and provider education. 117 entitled: Recommendation for Effective Newborn Screening Communication: Results of focus group with parents and experts that recommended prenatal and primary care providers be involved in educating about newborn screening. the respondents were highly aware with regard to newborn screening. Pediatrics Vol. such as those we developed. According to Dr N J Kerruish. Department of Women’s and Children’s Health Information and consent for newborn screening: practices and attitudes of service providers (2008) 93% of LMC in New Zealand report giving parents information concerning NBS. The majority (85%) . her findings based on her research at Lucena Medical Mission Group of Hospital and Health Cooperative.NEWBORN SCRENING AWARENESS…… 18 the facts. Usesfriendly patient provider educational materials. Foreign According to the study published on May 2006. It is concluded that postpartum mothers delivered their babies in private hospital were aware on newborn screening test and concluded also that state needs to improve communication in promoting newborn screening test in public hospitals.

Ph. Research Associate Professor in the Division of General Pediatrics at the University of Michigan Health System and the study's lead author. Waisbren. Ph.D. Despite this a significant minority of LMC (23%) reported considering that NBS should be mandatory. according to new U-M research published in the February issue of the journal Pediatrics. paradoxically most (89%) still believed that some form of parental consent should be obtained. Research about decision aids and informed consent may . Feb 2010). Ph.NEWBORN SCRENING AWARENESS…… 19 of LMC currently obtain some form of consent (verbal or written) for NBS from parents and consider this to be the ideal approach (94%).A . of those who believed testing should not be mandatory. — outweigh the costs of a false positive. Research specifically about uptake has little relevance while newborn screening is fully integrated with routine maternity care and refusal rates are negligible.. Donna Rusinak. (Science Daily. setting have resulted in favorable costeffective ratios for screening for this illness but did not include primary data for quality of life effects for a false positive screen. only a small proportion (10%) would accept parental refusal without question .D .S.Chung Yin Kong. "Our results show that newborn screening remains costeffective after accounting for the measured loss in quality of life associated with a false positive screen" (Benefits Outweigh Risks Associated with Newborn Screening for Disorder. and Susan L.D Benefits Outweigh Risks Associated With Newborn Screening for Disorder Feb2010 ). it states that the need for education about the role and limitations of screening and the meaning of test results. Of those in our survey who believed that NBS should be mandatory."Published studies of expanded newborn screening in a U. What is known about communication with parents about newborn bloodspot screening? (2003)." says Lisa Prosser. B.

Most programs (n=36) believe that parents should be informed about newborn screening as a part of prenatal care. and 32 of these have information available in multiple languages. whether this is for screening itself. (2005) states that fifty programs provide standardized information about screening. informing parents of the right to refuse screening (n=13). . only one provides the consent form in a language other than English. Hospitals and birthing centers are required by many programs to educate families. and documenting refusal on institutionally developed forms (n=9) (Kemper AR et al. Five require documented informed consent.Informing parents about newborn screening 2005). the reporting of results. Oliver -What is known about communication with parents about newborn bloodspot screening? May2003). none has rules or regulations requiring this. . or the storage of bloodspots for clinical reasons or research (Stewart. obtaining informed consent (n=5). including providing information (n=12). however.NEWBORN SCRENING AWARENESS…… 20 become more relevant with the offer of more screening programmes and the need to seek informed consent. Kemper AR et al.

Research Locale . data collection. 1998) Descriptive Method was regarded as the most appropriate method to be used. sample.NEWBORN SCRENING AWARENESS…… 21 Chapter III Research Methodology This chapter tackles on how the researchers approached the topic as well as how the instrument materialized and how it was be distributed to obtain the necessary information. measurements. data processing and analysis. The researchers utilized the descriptive method of research through quota sampling technique. In quota sampling the selection of the sample is made by the interviewer. It also describes the methodology used in this study by identifying the steps used in this research process and is consisting of research design. Research Design This study which is entitled “Newborn Screening Awareness and Acceptability among Selected Mothers of Candelaria Municipal Hospital”. Descriptive research is a design which aims to “describe the nature of a situation as it exist at the time of the study and to explore the cause of particular phenomena. (Ardales. who has been given quotas to fill from specified sub-groups of the population. setting. seeks to assess the level of understanding of the mothers regarding Newborn Screening and their level of acceptance of the procedure.

was chosen by the researchers as the locale of their study. which was used to assess the awareness and acceptability of NBS among selected mothers who delivered their babies in Candelaria Municipal Hospital.NEWBORN SCRENING AWARENESS…… 22 Candelaria Municipal Hospital in Candelaria Quezon. The Research Subjects There were more than 100 documented cases of delivery at Candelaria Municipal per month. The locale is near the town proper. the number chosen by the researchers or allocated by the researchers will be enough to represent the general population of the respondents taking into consideration the percentage of marginal error. Data Gathering Tool The survey instrument is a self-made questionnaire. . An allocated number of respondents were chosen as subjects to partake in the study. Thirty percent (30%) of the delivery rate per month was selected from this total population. The research population who served as the sources of data was made up of mothers who were present on the hospital during the conduction of this study and has a newborn child subjected or not subjected to newborn screening. with 30 questionnaires to be distributed. The questionnaires were distributed to those mothers who were present during the period of data gathering.

Filipino. The instrument was pre-tested on eight (8) mothers in a selected facility to determine readability and understanding by respondents. Data Gathering Procedure Personal or face-to-face surveys were conducted among the respondents. Chief Nurse of the hospital and to the Head Nurse of the OB-Gyne department to gain permission on conducting the said study. the questionnaire was submitted to an experienced research adviser who was asked to evaluate the items for clarity and appropriateness. Researchers decided to paraphrase the original instrument designed for this study into the national language. After gathering some data.NEWBORN SCRENING AWARENESS…… 23 Specifically. Instrumentation The researchers gathered data that supported the study awareness and acceptability in Newborn Screening. The confidentiality of each participant’s responses was assured during the interview. and most were accepted with few revisions. a simple survey will be employed. articles and even in different websites. The data were gathered in different sources such as. The researchers provided formal letters of communication for the Medical Director. thus assuring that responses are immediately gathered after each interview. To establish content validity of the instrument. books. to assure wider comprehension among respondents. the researchers .

Affects. From English language. monthly income and maternal history. 2 . It consists of three (3) parts: Nature of Screening. Responses to items on second part are made on the following scale: 1 .Doesn’t Affect. 2 . the following are the scale of the fourth part: 1 . so as the fourth part which is composed of nine (9) questions regarding Factors that Influences Acceptance of Newborn Screening. 4 – Fully Aware. The third part of the questionnaire contains seven (7) item questions about the Level of Acceptance on Newborn Screening.Unaware. Meanwhile. educational attainment. The researcher came up with 3 and 4 points scale for questions with varying degrees of responses. 3 .NEWBORN SCRENING AWARENESS…… 24 formulated a survey type of questionnaire based on its sub-problems. 3 . The following are the scale of the third part: 1 . Availability and Accessibility of the Program and Significance of Newborn Screening Program. The first part of the questionnaire is the checklist about respondents’ demographic profile which was composed of age. the questions were translated to Filipino language for easy understanding of the respondents.Unacceptable. The second part of the questionnaire is regarding Level of Awareness regarding Newborn screening. Data Processing . 2 – Not so Aware. 3 – Aware.Acceptable. civil status.Highly Acceptable.Highly Affects. The researchers also conducted a pilot testing to selected mothers to make sure that the questions were appropriate to the respondents so that the researchers would collect the proper data.

the Level of Acceptance of Newborn Screening and Variables that Affect the Acceptance of Mothers on Newborn Screening). Availability and Accessibility of the program & Significance of Newborn Screening. Nature of Screening. The percentage conversion can also be used by converting frequencies into percentage using the formula. Frequency – Percentage Distribution To answer the sub-problem `1(demographic profile of the respondents). the . 3 and 4 (respondents’ awareness regarding Newborn Screening.NEWBORN SCRENING AWARENESS…… 25 1. the researchers utilized simple statistical method such as frequency ranking technique. Weighted Arithmetic Mean To answer sub-problem 2. P = f/n x 100 Where the formula stands for: P = percentage equivalent f = the frequencies of similar responses n = is referable to the number of respondents involved in the study 2. The frequency method is the simplest method that can be obtained by getting the frequencies of similar responses and ranking them according to the frequency obtained.

The Likert Scale depended on the response from the questionnaire given to the respondents.NEWBORN SCRENING AWARENESS…… 26 researcher used the Likert Scale in the analysis of the central tendencies of the data that they gathered. The formula for the mean weight is. X = __∑wf___ n Whereas: X = weighted mean summation of weighted frequency total number of population ∑wf = n= MEAN AND DESCRIPTIVE MEANING USED IN THE STUDY Table I. The mean weight was highly commendable for interpreting data that have varying degrees responses. The researchers knew that the Likert Scale is the most appropriate method in the statistical treatment of their data measuring the degree of agreement of the respondents. Measure probability or measure of central tendencies of responses was also utilized in the course of treatment of the data gathered. 4-point Scale Table for Verbal Description of Level of Awareness Regarding Newborn Screening .

35 2.67 1.00 Qualitative Description Unacceptable Acceptable Highly Acceptable Table III.00 Qualitative Description Unaware Not so Aware Aware Fully Aware Table II.75 1.25 3.67 1.00 – 1.00 – 1.76 – 2. 3-point Scale for Verbal Description of Variables that Affect the Acceptability of the Respondents on Newborn Screening Weighted Mean 1 2 3 Range of Weighted Mean 1.00 – 1.36 – 3.51 – 3.NEWBORN SCRENING AWARENESS…… 27 Weighted Mean 1 2 3 4 Range of Weighted Mean 1.50 2.00 Qualitative Description Doesn’t Affect Affects Highly Affects For a thorough understanding of the collected data from the respondents.26 .4.36 – 3.68 – 2.35 2.68 – 2. data were presented into graphs and tables. 3-point Scale for Verbal Description of Level of Acceptance of Newborn Screening Weighted Mean 1 2 3 Range of Weighted Mean 1. Data processing is important for nursing researcher .

its nature. The second category provides the findings about questions under: Level of Awareness regarding Newborn Screening. 2. Level of Acceptance on Newborn Screening. Analysis. The following are tables and chart that corresponds to the questions result. and acceptability. To identify the mothers awareness regarding newborn screening. and Interpretation of Data This chapter presents findings of the study based on the mother’s awareness and acceptability of Newborn Screening with the following objectives: 1. Factors that Influences Acceptance of Newborn Screening. The data were presented in numerical as well as text . Chapter IV Presentation. 3. Civil Status. and Maternal History. The first category shows the different charts of respondents profile according to Age. Educational Attainment. Monthly Income. availability and accessibility. To assess the mother’s level of acceptance of newborn screening.NEWBORN SCRENING AWARENESS…… 28 because this is a process of interpreting such gathered data in order to come up with the result of the study. To assess mothers perception of different factors affecting the acceptance of NBS procedure.

The sample was composed of 30 selected mothers who had just delivered their babies in CMH. the researchers were able to distribute thirty questionnaires and all of them were able to answer it. With the participation of the admitted mothers in Candelaria Municipal Hospital.33 34 above FIGURE 2.NEWBORN SCRENING AWARENESS…… 29 terms.24 25 . Part I.27 27% 37% 28 . Demographic Profile of the Respondents Ag e 3% 10% 3% 3% 17% Below 18 19 .21 22 .30 31 . and the tables consisted of the demonstrated scores. descriptive statistics and collective data. This figure . Percentage distribution of the Respondents According to Age Figure 2 presents the data of the respondents in terms of their age.

10% (3 mothers) were within the age range of 28-30. 2005) Civil S tatus Single 47% 53% Married Figure 3. These data indicates that most mothers are in their stage of Young Adulthood.NEWBORN SCRENING AWARENESS…… 30 shows that 37% (11 mothers) of the total respondents were within the age range of 22-24 while 27% (8 mothers) were within the age range of 25-27 years old. And only 3% (1 mother) of the respondents are in ages 18 and below. (Taylor. wherein they are of more focus on accomplishing maternal tasks and is getting ready for developing the ability to manage a home and assume responsibilities for her child. 31 to 33 and 34 and above. Percentage distribution of the Respondents According to Civil Status . 17% (5 mothers) were within the age range of 19-21years old.

This chart shows that majority of the respondents are single with the average of 53% (16 mothers). 47% (14 mothers) were married. there two single parents for every ten adults in the country. It is of course not only through pre-marital sex or divorce that spouses are often left alone with a child. Meanwhile. single parenting is becoming a rapidly rising trend in the society.net (2011). The cause of single parenting stretch much wider than that. mothers who are married possess much sense of their own maternal competency in performing care for their infants and children. Studies in the US alone indicate that there are four single parents to every ten parents. Also. This is because married mothers are frequently more experienced in decision making concerning the health of their children.NEWBORN SCRENING AWARENESS…… 31 In figure 3 the data is according to the respondent’s civil status. Single parents are said to be less knowledgeable than those mothers who are married when it comes to attending the needs of their children. As cited in Single Parent Center. Educational Attainm ent 10% 20% 3% 7% 7% Elementary Undergraduate Elementary Graduate High School Undergraduate High School Graduate College Undergraduate 53% College Graduate .

were able to finish elementary. hygiene. beliefs. 20% (6 mothers) were college undergraduate. knowledge obtained during a mother’s education can affect choices about antenatal care and about children’s nutrition. It only indicates that most of the respondents are high school graduates that are engaged to the study. It shows that 53% (16 mothers) of the total respondents were able to finish high school. 10% (3 mothers) were able to finish college. and only 3% (1 mother) were elementary undergraduate. education will have a direct effect on the health of the child at birth (Miller and Rodgers. For instance. To the extent that more-educated mothers make healthier choices for themselves during pregnancy. . Greater education for mothers contributes to new skills. 2005). Percentage distribution of the Respondents According to Educational Attainment ` In figure 4 the data of the respondents are presented in terms of educational attainment. and health care. The level of education of the mothers can greatly affect her understanding of Newborn Screening as her knowledge of it depends on how high her educational attainment was.NEWBORN SCRENING AWARENESS…… 32 Figure 4. and choices about sound health and nutritional practices that directly influence the proximate determinants of child health. This data illustrates the maturity of the mothers specifically in understanding child care. 7% (2 mothers). 7% (2 mothers) were high school undergraduate.

001 .10. Percentage distribution respondents According to Monthly Income In Figure 5.000 15.001-10.000 10.001 .000 25.25.001 .000 per.000 below 5.000 above Figure 5.15.NEWBORN SCRENING AWARENESS…… 33 MonthlyIncom e 0% 17% 37% 3% 0% 5. the data of the respondents in terms of monthly income are presented. It shows that 43% (13 mothers) have a monthly income of 5. On the other .20.001 .000 43% 20.

000 to 20.000 per month and eventually they can afford to subject their child to NBS.000. 3% ( 1 mother) has a monthly income of 20.15.000. Parity 17% 6% 7% 43% 27% 1 2 3 4 5 G ravida 6% 17% 27 % 7% 1 4 3% 2 3 4 5 A B . better-educated people live longer than poorer. whose family income was less than $5. and none of them have monthly income of 25. 37% (11 mothers) have a monthly income of 5. had a life-expectancy at all ages that was about 25 percent longer than those in the bottom 5 percent. people whose family income in 1980 was greater than $50. According to calculations from the National Longitudinal Mortality Survey which tracks the mortality of people originally interviewed in the CPS and other surveys.000 -25.000 to 10. Mothers with higher socioeconomic status are considered to be more knowledgeable and has higher level of educational attainment. putting them in the top 5 percent of incomes. less-educated people. According to Deaton (2003) Richer. It only shows that most of the respondents earn 5.000-15.000.000.000 and below.000.000 and above.NEWBORN SCRENING AWARENESS…… 34 hand. 17% (5 mothers) have a monthly income of 10.

3.A STATEMENT a. 6. The attending physician or the birth attendant is responsible in explaining the screening test results to the parents. Multiparas are aware and the Primiparas were unaware of it. Nature of Screening 1.8 3. This chart shows that majority of the respondents are primiparas with an average of 43% (13 mothers). Newborn Screening is a program of the Department of Health. Newborn Screening is a simple procedure to find out if your baby has a rare metabolic disorder. 4.53 Aware Aware Aware Aware Aware Aware Aware 7 3 4 2 5 1 8 . Newborn Screening Tests are done through UA 1 NA 2 A 3 FA 4 N WM VD Rank 2 1 1 1 2 1 4 8 4 7 2 4 4 4 17 18 16 20 18 15 16 3 7 6 7 6 10 6 3 0 30 3 0 30 3 0 30 3 2. 7. 6% (2 mothers) have 4 children. Newborn screening is safe. 2. Meanwhile. the respondents. 17% (5 mothers) have 3 children. primiparas had gain knowledge about newborn screening. Table IV.07 2.83 3. Newborn Screening test aids in early detection of five congenital metabolic diseases of the newborn.03 2. because the health care provider provides information about the test before giving birth to their first child.57 2. Percentage distribution of the Respondents According to Maternal History In figure 6 the data of the respondents are presented in terms of their maternal history. Level of awareness of the respondents about NBS Table IV.98 2. 5. 7% (2 mothers) have 5 children. 27% (8 mothers) have 2 children. Comparison between Selected Primiparas and Multiparas in the level of Awareness regarding Newborn Screening at Quezon Medical Center. The baby must undergo NBS after 24 hours but not later than three (3) days of his/her birth. (March 2008) based on his findings in his research. But nowadays. According to Toletino MJ.NEWBORN SCRENING AWARENESS…… 35 Figure 6.

0 3 0 36 2 6 19 3 2.53. Newborn screening is a simple procedure.03 which falls also on Aware.vic. Obtaining the least mean is the item Newborn Screening Tests are done through heel prick method to get blood samples with Aware and the score of 2.98 (Aware). obtaining a mean of 3.gov. It is also shown in the table that the second with the highest mean is the awareness that Newborn Screening test aids in early detection of five congenital metabolic diseases of the newborn with 3. where the scale of 1 means Unaware while the scale of 4 refers to Fully Aware. The first subcategory is concerned with the Nature of the Screening.NEWBORN SCRENING AWARENESS…… heel prick method to get blood samples. As cited in www. Using the heel prick method. a few . As shown in the table.health. but using gloves and cleaning the heel beforehand will minimize this risk. Mothers are aware of the procedure but it has the least mean as shown on the table above. This table is divided into three subcategories. and as cited in.au.63 Aware 6 Legend: WM VD R - Weighted Mean Verbal Description Rank Table IV shows that the Level of Awareness of the Respondents about Newborn Screening. There is a very small risk of infection because we are making a small break in the skin. Screening is quick and safe. The blood samples will be sent in the Newborn Screening Laboratory and the result will be released 7 to 14 working days after newborn screening sample is received in the NBS center. 8. majority of the respondents are aware that Newborn screening is safe. but holding or feeding them during collection will help. The third item with the highest mean is Newborn Screening is a program of the Department of Health with 2.07. The heel prick may cause brief discomfort to your newborn.

43. 3 2. rural health units and health centers). 4 3. The NBS program is within financial capability of the family.17 Aware Not so Aware Aware 2 3 1 Legend: WM VD R - Weighted Mean Verbal Description Rank The second subcategory of Table IV is about the Availability and Accessibility of the Program.17 While. Newborn Screening is available in participating Newborn Screening facilities (hospital. 1 3 8 3 18 11 14 6 7 12 30 30 30 2. B UA 1 NA 2 A 3 FA 4 STATEMENT N WM VD Rank b. The facilities providing NBS are within accessible locations.43 3. . Newborn Screening is available in participating Newborn Screening facilities (hospital. Availability and Accessibility of the Program 1. Majority of the respondents are aware of NBS program is within financial capability of the family which obtained the mean of 3. The scale of 1 means Unaware while the scale of 4 means Fully Aware.7 2.7 and the mothers are not so aware of The facilities providing NBS are within accessible locations with the average of 2.NEWBORN SCRENING AWARENESS…… 37 drops are taken from the baby's heel and blotted on 1 a special absorbent filter card. lying-ins. rural health units and health centers) which obtains 2. Table IV. The blood is dry 3 to for 4 hours and sent to the Newborn Screening Laboratory. lying-ins.

there is a chance of excellent prognosis and the baby may be spared from lifelong impairment and can enjoy normal life.13. Significance of Newborn Screening 1 NA 2 A 3 FA 4 N WM VD Rank 1. lying-ins. UA STATEMENT c. 500 at a very reasonable price. NBS test costs only Php. It helps in detecting the metabolic disorders of an infant so that it would not lead to further deterioration of the child’s health status.73 Aware 3 2 3 17 8 30 2.9 Aware 2 1 9 17 3 30 2. 4. 1 1 19 9 30 3. babies may be brought to the nearest institution offering newborn screening. With a mean of 2.67 Aware 4 Legend: VD R - WM Weighted Mean Verbal Description Rank The third subcategory of Table IV is about the Significance of Newborn Screening. Rural Health Units and Health Centers). If my baby is not screened. Newborn Screening Promotion. According to National Institutes of Health. it could lead to severe mental retardation and even death. When diagnosed early of disorders. the respondents are aware that if the child was diagnosed early of having one of the . 2. Majority of the respondents are aware that Newborn Screening test is important to ensure the infant’s good health condition obtaining a mean of 3.UP Manila (2010). If babies are delivered at home. Table IVC.13 Aware 1 2 5 18 5 30 2.NEWBORN SCRENING AWARENESS…… 38 According to Department of Health (DOH) 2011. The DOH Advisory Committee on Newborn Screening has approved a maximum allowable fee of P50 for the collection of the sample – Newborn Screening Promotion.9. Newborn screening is available in participating health institutions (hospitals. 3. Newborn Screening test is important to ensure the infant’s good health condition.

This program is essential nowadays because it is a procedure that determines whether the infant has a congenital defect or anomaly. The respondents are aware with the least mean of 2. A mother should always be aware of her infant’s condition. it could lead to severe mental retardation and even death. Newborn screening (NBS) is important because a baby with one of these illnesses will appear perfectly healthy and by the time symptoms are visible.67 that If their baby is not screened. 2007) . irreparable damage can occur – damage such as mental retardation or. in countless instances. (London. death. but if the infant did not undergo the procedure and has any of the congenital defects present at birth. there is a chance of excellent prognosis and the baby may be spared from lifelong impairment and can enjoy normal life.NEWBORN SCRENING AWARENESS…… 39 disorders. because once newborn screening procedure is being done and the result has been revealed that the infant is positive for any of the congenital disorders/anomalies. it would be a life-long burden not only for the family but especially for the child. it is being followed up by series of medication.

37. The hospital emphasizes promotion of NBS based on the policies and standards of the institution with a mean of 2. while the scale of 5 refers to Highly Acceptable. with a mean . obtaining the mean of 2. As shown in the table. Level of acceptance on Newborn Screening Statement 1.37 2. I am financially capable to have my child undergo NBS. 2. It shows that in the hospital setting.63.1 2 2. where the scale of 1 Unacceptable. 4. I would like to subject my child for NBS.NEWBORN SCRENING AWARENESS…… 40 Table V. 3.33 2. The hospital emphasizes promotion of NBS based on the policies and standards of the institution. 7.63 VD Acceptable Acceptable Acceptable Highly Acceptable Highly Acceptable Acceptable Acceptable RANK 5 7 3 1 1 2 1 0 23 22 16 11 6 6 13 19 1 2 3 15 14 15 14 14 6 30 30 30 2. I understood everything that the nurse/ hospital worker/ doctor told me about NBS test. 6. I would like to subject my child for newborn screening UA 1 A 2 HA 3 N 30 30 30 30 WM 2. On the other hand. I am prepared to whatever results the NBS test may give.27 2. since my first child had undergone to this test too.1 2 4 6 Legend: WM VD R - Weighted Mean Verbal Description Rank Table V shows the Level of Acceptance on newborn screening. majority of the respondents highly accepts that NBS is not against their cultural and religious beliefs. NBS is not against my cultural and religious beliefs 5.

500 at a very reasonable price. NBS test costs only Php.NEWBORN SCRENING AWARENESS…… 41 of 2.edu.UP Manila (2010). you may be asked to sign a paper stating that you refused to have your baby tested for these very serious disorders. obtaining the least mean in the item I am financially capable to have my child undergo NBS with a score of 2.slh. The DOH Advisory Committee on Newborn Screening has approved a maximum allowable fee of P50 for the collection of the sample – Newborn Screening Promotion.wisc. Newborn Screening Promotion. As cited in www. Moreover. . If you refuse to have the test done. respondents accept and would like to subject their child for NBS. Most mothers accept the fact that they are financially capable of subjecting their child to the test. you may refuse newborn screening for your baby only if your religious beliefs and practices do not allow this testing. as a parent.33. since their first child had undergone to this test too. According to National Institutes of Health.

4.43 1.77. Variables that Influence the Acceptability of Newborn Screening among Respondents DA Statement 1.63 1.77 VD Highly Affects Affects Affects Affects Affects Affects Affects Highly Affects Affects Rank 1 5 4 7 3 8. The provider of information regarding Newborn Screening.63 1.43.77 1. Financial Capability to undergo Newborn Screening.5 Legend: WM VD R - Weighted Mean Verbal Description Rank As shown in the table majority of the mothers responds that Highly Affects their Newborn Screening Acceptance Personal experience of health and illness as well as parenting with a mean of 2. However. 2.83 2. Policies/ Standard Procedures Set by the Hospital.9 2 1. the least item are the Financial Capability to undergo Newborn Screening and The possibility for a positive result of the test with both a mean of 1. 5. 6. Personal experience of health and illness as well as parenting. 3. Influence of friends and other people.77 1. Religious and Cultural belief of my family. The possibility for a positive result of the test.9 2 1. 8. Interest and knowledge in health matters. 7.8 2.5 6 2 8.77 WM 2.63 and Policies/ Standard Procedures Set by the Hospital obtaining a mean of 2.13 1.8 2. 1 0 6 6 7 5 7 5 2 8 A 2 11 9 6 8 6 9 15 9 5 HA 3 19 15 18 15 19 14 10 19 17 N 2. . 9.13 1. Quality of Services rendered under the NBS program.83 2.NEWBORN SCRENING AWARENESS…… 42 Table VIII.43 1.

could from the basis for this education. Community health agencies for pregnant women should also include this education. The American College of Obstetrics and Gynecology (ACOG) Committee on Genetics Opinion Number 27. or other health care provider should introduce information about newborn screening to parents during the third trimester. Uses. . Professional societies and state health professional should work together to encourage parent and provider education. 117 entitled: Recommendation for Effective Newborn Screening Communication: Results of focus group with parents and experts that recommended prenatal and primary care providers be involved in educating about newborn screening. family physician." According to the study published on line on May 2006.NEWBORN SCRENING AWARENESS…… 43 Parent education about newborn screening should start well before the time of delivery and labor.friendly patient provider educational materials. such as those we developed. Pediatrics Vol. October 2003 states: "Obstetrician-gynecologists can continue to work to improve the health of their patients by informing expectant families of the newborn screening process. Education on newborn screening should be included during the pre-admission process. The baby’s pediatrician.

Limitations of the study are discussed along with recommendation for further research. The method used to conduct the study has been taken into account. Summary This study was conducted within Candelaria Municipal Hospital in Candelaria Quezon. the “Newborn Screening Awareness and Acceptability among Selected Mothers at Candelaria Municipal Hospital: An Assessment”. Participant completed the questionnaire in the said hospital and returned the questionnaires immediately after answering. There are 30 respondents who filled up every questionnaire. which aims to seek out. Conclusion. formulated conclusion and recommendation offered. The descriptive method of research was utilized and self-made questionnaire served as the principal data gathering instrument.NEWBORN SCRENING AWARENESS…… 44 Chapter V Summary. The purpose of this study was to: . The results of the questionnaire were tabulated and interpreted from which the findings and conclusion were drawn. The study was conducted in the month of February 2011. And Recommendation This chapter presents the summary of the study. A discussion of the significance of the findings that included the implication to in and on for nursing profession will follow with respect to education for mothers about Newborn Screening Program.

16 (53%) out of 30 are single.mothers are of age 22-24. Assess the mother’s awareness of the factors that affects Newborn Screening. 3. Assess the mother’s level of awareness of the Newborn Screening Program. Identify mother’s acceptance of the Program. School (7%).NEWBORN SCRENING AWARENESS…… 45 1.2 Majority of the respondent.001.1 A total of thirty (30) respondents were chosen for this study.4 Most of the respondents finished High School (53%). analyzed and interpreted in Chapter IV: 1.000 which constitutes 43% of the sample population. Married respondents numbered 14 with 47% of the sample.10.5 Majority of the sample has a monthly income of 5. Demographic Profile of the Respondents 1. 10% are able to finish college. Elementary (3%) 1. 1. 7% are able to finish Elementary . . The following are the summary of findings of the study based from all the data presented. 1. 1.3 When grouped according to Civil Status. 2.

2 Majority of the respondents are aware that The NBS program is within financial capability of the family which obtained the mean of 3. two children (27%). four child (7%).07 while the least obtained the mean of 2.3 Majority of the mothers are aware of Newborn Screening test is important to ensure the infant’s good health condition with an average weighted mean of 3. three chid (17%). with an average weighted mean of 2.17. 2. .6 Majority of the respondents are primigravidas with 43%. 2. obtaining a mean of 3. Level of Awareness regarding Newborn Screening 2.13.NEWBORN SCRENING AWARENESS…… 46 1. 43 2. and multigravidas are composed of. one child. It shows that mothers are aware of The facilities providing NBS are within accessible locations. it could lead to severe mental retardation and even death with an average weighted mean of 2.67. five child (7%).53 which is the item Newborn Screening Tests are done through heel prick method to get blood samples. It shows that mother’s aware of the statement If my baby is not screened.1 Majority of the respondents are aware that Newborn screening is safe.

the least item are the Financial Capability to undergo Newborn Screening and The possibility for a positive result of the test with both a mean of 1.77. .NEWBORN SCRENING AWARENESS…… 47 3. Level of Acceptance on Newborn Screening 3. However.1 Majority of the respondents Highly Accepts the item NBS is tweighted mean of 2.63 and Policies/ Standard Procedures Set by the Hospital obtaining a mean of 2.67.43.1 Majority of the mothers responds that it Highly Affects their Newborn Screening Acceptance in Personal experience of health and illness as well as parenting with a mean of 2. 4. While the respondents only Accepts the item I am financially capable to have my child undergo NBS with a least mean of 2. Variables that Influences Acceptance of Newborn Screening 4.

The respondents earns 5. .most of the mothers are Single and High School graduate.000 monthly and most of them are primapara. Respondents are aware that the Newborn Screening is safe. The respondents are also aware that Newborn Screening test aids in early detection of five congenital metabolic diseases of the newborn and that Newborn Screening is a program of Department of Health. . they arrived at the following conclusions: 1. Majority of the respondents are ages 22-24. 3.000 to 10. The respondents are less aware that the facilities providing NBS are within accessible locations while the respondents are much aware that The NBS program is within financial capability of the family and Newborn Screening is available in participating Newborn Screening Facilities.NEWBORN SCRENING AWARENESS…… 48 Conclusion Based from the results of the researchers’ data gathering. 2. They have little knowledge that Newborn Screening Tests are done through heel prick method to get blood samples.

NEWBORN SCRENING AWARENESS……

49

4. The respondents are aware that Newborn Screening test is important to

ensure the infant’s good health condition. The mother respondents are also aware that When diagnosed early disorders, there is a chance of excellent prognosis and the baby may be spared from lifelong impairment and can enjoy normal life and it also helps in detecting the metabolic disorders of an infant so that it would not lead to further deterioration of the child’s health status. The respondents are least aware that If their baby is not screened, it could lead to severe mental retardation and even death.`
5. Mothers highly accept that the hospital emphasizes promotion of NBS

based on the policies and standards of the institution and that NBS is not against their cultural and religious beliefs. the respondents would like to subject their child for NBS, since their first child had undergone to this test too. I am financially capable to have my child undergo to this test is the least acceptable for the respondents. 6. Mothers responded that all factors affect their acceptance of Newborn Screening for their child which includes Personal Experience of health and illness as well as parenting, Interest and knowledge in health matters, Influence of friends and other people, Religious and Cultural belief of my family, The provider of information regarding Newborn

NEWBORN SCRENING AWARENESS……

50

Screening, Financial Capability to undergo Newborn Screening, Quality of Services rendered under the NBS program, Policies/ Standard Procedures Set by the Hospital and The possibility for a positive result of the test.
7. Mothers responded that Personal Experience of health and illness as

well as parenting and Policies/Standard Procedures set by hospital highly affects them in accepting Newborn Screening. The respondents also responded that The provider of information regarding NBS and the rest of the tatements affects them in accepting the test. The Financial capability to undergo NBS least affect to the respondents.
Recommendations:

Based on conclusions mentioned above, the researchers of this study hereby recommend the following:
1. Implement an effective health education plan for the mothers who are

about to give birth in order to raise their awareness towards NBS.
a. The level of current support and training for health professionals in

health education needs to be considered. This includes those professionals directly involved with implementation of the NBS

NEWBORN SCRENING AWARENESS……

51

programme, those providing information and education as well as NBS programme staff.
b. Student nurses should also take part on educating the pregnant

mothers in the OB ward in order to make sure that they are given enough information on what NBS is for.
2. Certain programs must be formulated to provide reinforcement NBS

among mothers.
a. For the hospital, the institution must plan to implement a program

that will conduct a seminar to pregnant woman before their delivery to strengthen the health education of Newborn Screening.
b. Also, further policy development regarding best practice in the

timing and distribution of information about NBS should be required. 3. The area of Community Health Nursing must also be given priority. a. For the midwives of the community, they should have formal education plan for the mothers regarding the different congenital disorders which will be taught to them during prenatal visit in order for them to gain knowledge and understanding of how NBS could help towards early detection of these disorders.

4. . It would provide them basis if they still have to implement more programs or improve their strategies on health education. Provide some leaflets for pregnant mothers containing information regarding NBS procedure and its importance so that mothers may read it and learn at home if they don’t have enough time to go to the Barangay Health Center.NEWBORN SCRENING AWARENESS…… 52 b. Future studies should be done on the effectiveness of the health education plan and programs implemented on the communities and the particular hospital studied.

C. Steve. Marticia (2007).NEWBORN SCRENING AWARENESS…… 53 REFERENCES Books • Olson. The National Academic Press. Maternal and Child Nursing Care (3rd Edition).. Washington. • London. D.C. Washington D. Heather. • Stewart. (2010) Challenges and Opportunities in Using Residual Newborn Screening Samples for Translational Research. (2007) Maternal & Child Nursing Care (2nd Edition) Journals .

Angus (2003) Health. Fant KE. Clark SJ. Oliver (May 2003). 26.. 44. (2005) Informing parents about newborn screening. What is known about communication with parents about newborn bloodspot screening? • The American College of Obstetrics and Gynecology (ACOG) Committee on Genetics Opinion Number 27. • • Deatus. 132-134 • Kemper AR. October 2003 . pp. Hastings Cent Rep. 32–31 • Stewart. Vol. Kemper AR. Level of Awareness on Newborn Screening of Selected Mothers in Tayabas Quezon. (2005) Completeness and complexity of information available to parents from newborn screening programs.NEWBORN SCRENING AWARENESS…… 54 • Ayrette E. Clark SJ. (March 2005). Paderes. Income and Inequality. Pediatrics. Fant KE. (2008) Expanding newborn screening: process. • Jane Miller and Yana Rodgers (2005) Mother’s Education and Children’s Nutritional Status: New Evidence from Cambodia. policy. and priorities. Public Health Nurs.pp. • Moyer VA.

html .gov. Republic of the Philippines.doh. Comparison between Selected Primiparas and Multiparas in the level of Awareness regarding Newborn Screening at Quezon Medical Center. Republic of the Philippines (2011 October) Where is Newborn Screening available Retrieved February 2012.gov. April 07). (March 2008). • Pediatrics Vol.net/statutes/repacts/ra2004/ra_9288_2004. from http://www.ph/node/766 • Depertment of Health. Republic of the Philippines (2011 October) Newborn Screening Retrieved Feb 2012.lawphil.NEWBORN SCRENING AWARENESS…… 55 • Toletino MJ. 117 entitled: Recommendation for Effective Newborn Screening Communications Electronic Sources • Department of Health. Congress of the Philippines Retrieved January 2012. from http://www. from http://www.ph/content/newborn-screening • The LawPhil Project Arellano Foundation (2004.doh.

vic.NEWBORN SCRENING AWARENESS…… 56 • N Dickson (2008.UP Manila (2010) Newborn Screening Promotion https://sites. Retrived January 2012.bmj.gov. January 24) Information and consent for newborn screening: practices and attitudes of service providers.au/nbs/downloads/nbs_dl.health.com/content/34/9/648.google.abstract • National Institutes of Health .pdf . from http://jme.com/site/vylhphilippines/vylhadvocacies/newbornscreening-promotion/basic-information-on-newborn-screening from • Newborn Screening for the Health of your baby 2011 http://www.

NEWBORN SCRENING AWARENESS…… 57 APPENDICES APPENDIX A Calayan Educational foundation Incorporated College of Nursing Lucena City Date: .

Thank you very much. Jieneth Angoy Emiliano Suayan BSN – IV Approved By: Mr. may we request from your good office for permission to conduct the aforementioned study. In connection with this. Rest assured that all findings will be treated with utmost confidentiality. Red – V. Imperial Dean. MHA.. Quezon THRU: Mrs. Hoping for your favorable consideration. Nelson J. Myrnalita Trinidad RN. MAT Research Professor Noted By: Dr. Hugo. An Assessment as a requirement for the course Bachelor f Science in Nursing. OB Head Nurse Candelaria Municipal Hospital Candelaria. PHSAE Chief of Hospital Candelaria Municipal Hospital Candelaria. Quezon Dear Sir/Madamme: Good day! We are senior nursing students of Calayan Educational Foundation Incorporated and we will be conducting a study entitled Newborn Screening Awareness and Acceptability of Selected Mothers In Candelaria Municipal Hospital. Mirando MD. College of Nursing APPENDIX B CALAYAN EDUCATIONAL FOUNDATION INC.Maria Theresa S. Lucena City . Grace S.NEWBORN SCRENING AWARENESS…… 58 Dr. Respectfully yours.

NEWBORN SCRENING AWARENESS…… 59 Petsa:__________ Sa mga kinauukulan. Jieneth Angoy Emiliano Suayan Mga Mananaliksik Endorsed By: Mrs. Hinihingi po naming ang inyong partisipasyon para sa pag-aaral na ito.. Maaasahan po ninyong ang mga impormasyong makukuha mula sa inyo ay mapapanatiling pribado. Hugo. Maraming salamat po. Sonia A. Lubos na gumagalang. Ang layunin po ng pag-aaral na ito ay upang malaman ang mga salik na nakaiimpluwensya upang ipa-newborn screening o hindi ipa-newborn screening ng mga nanay ang kanilang mga sanggol pagkatapos ipanganak. Delantar. Kami po ay nagsasagawa ng aming pananaliksik na pinamagatang “NEWBORN SCREENING AWARENESS AND ACCEPTABILITY OF SELECTED MOTHERS IN CANDELARIA MUNICIPAL HOSPITAL: AN ASSESSMENT”. Nelson J. MAN Tagapayo Ni-notahan ni: Mr. MAT Research Professor APPENDIX C QUESTIONNAIRE .

001 and above E. Age: _____ B. Level of Awareness regarding Newborn Screening . of Deliveries Part II. Monthly Income ____ 5.000 and below ____ 5. of Pregnancies ____ No. Maternal History ____ No.001 – 15.001 – 20. Civil Status: _____ Single _____ Married C. Educational Attainment Graduate Elementary High Schoool College Not Applicable Undergraduate D.000 ____ 20.NEWBORN SCRENING AWARENESS…… 60 Part I: Demographic Profile Direction: Check ( / ) or fill up the spaces provided according to your responses. A.000 ____ 25.000 ____ 15.000 ____ 10.001 – 10.001 – 25.

my child undergo NBS. IThe blood samples will my sent infor NBS. 3. Availability and Accessibility of the Program 1. 6. If my baby is not screened. rural health units and health centers). NBS is not against my cultural andscreening beliefs is received in emphasizes promotion of NBS based on the 5. It helps in detecting the metabolic disorders of an infant so that it would not lead to further deterioration of the child’s health status. LEVEL OF ACCEPTANCE ON NEWBORN SCREENING Direction: Read each item carefully. B. I am prepared to whatever results the NBS test may give. would like to subject be child the Newborn Screening Laboratory this test too. Indicate your answer by putting a check ( / ) on the box which corresponds to your answer guided by the following: Scale: 4 Fully Aware 3 Aware 2 Not so Aware 1 Unaware Part III. Significance of Newborn Screening Program 1. child had undergone toand the result will be released 7 to 14 working days after newborn religious sample 4.NEWBORN SCRENING AWARENESS…… 61 Direction: Read each item carefully. Newbornlike to subject my child for newborn screening I would Screening facilities (hospital. doctor toldScreening Tests test. 3 2 1 . INewborn screening is safe the nurse/ hospital worker/ 6. since my first 3. it could lead to severe mental retardation and even death. 4. lying-ins. am financially capable to have 8. 3. Indicate your answer by putting a check ( / ) which corresponds to your answer guided by the following: Scale: 3 2 1 Highly Acceptable Acceptable Unacceptable Statement 1. When diagnosed early of disorders. The hospitalthe NBS center. The facilities providing NBS are within accessible locations. Imethod to get blood samples. there is a chance of excellent prognosis and the baby may be spared from lifelong impairment and can enjoy normal life. understood everything that 7. The NBS program is within financial capability of the family. C.done through heel prick Newborn me about NBS are 2. 2. 2. policies and standards of the institution. Newborn Screening is available in participating 7. Newborn Screening test is important to ensure the infant’s good health condition.

Indicate your answer by putting a check ( / ) which under the box that corresponds to your answer guided by the following: Scale: 3 2 1 Highly Affects Affects Doesn’t Affect 2 1 Statement 3 That factors that affects my acceptability of Newborn Screening includes: 1. 7. 6. 9. Variables that Influences Acceptance of Newborn Screening Direction: Read each item carefully. Policies/ Standard Procedures Set by the Hospital. . Interest and knowledge in health matters.NEWBORN SCRENING AWARENESS…… 62 Part IV. Quality of Services rendered under the NBS program. Financial Capability to undergo Newborn Screening. 4. Personal experience of health and illness as well as parenting. The provider of information regarding Newborn Screening. 5. 2. 3. 8. Religious and Cultural belief of my family. Influence of friends and other people. The possibility for a positive result of the test.

Antas ng Edukasyon Natapos Hindi Natapos Elementarya Secondarya Kolehiyo D.NEWBORN SCRENING AWARENESS…… 63 APPENDIX D PALATANUNGAN Unang Bahagi: DEMOGRAPHIC PROFILE Direksyon: Lagyan ng tsek ( / ) o isulat ang sagot sa patlang na naayon sa iyong tugon. A.000 ____ 15.000 ____ 25.000 pababa ____ 5.001 – 15.001 – 20.000 ____ 10.001 – 10. Buwanang Kita ____ 5.000 ____ 20.001 – 25. Estado Sibil: _____ Hindi Kasal _____ Kasal C. Edad: _____ B.001 pataas .

Gabay: 1 Hindi Alam 2 Hindi Gaanong Alam 3 Alam 4 Alam na Alam . Maternal History ____ Bilang ng pagbubuntis ____ Bilang ng Panganganak Ikalawang Bahagi.NEWBORN SCRENING AWARENESS…… 64 E. ANTAS NG KAALAMAN TUNKOL SA NEWBORN SCREENING Direksyon: Basahin ng mabuti ang bawat katanungan. Lagyan ng tsek ( / ) ang kahon na ayon sa iyong sagot.

2. Nakatutulong ito na malaman ang sakit sa metabolismo ng bata upang nang sa gayon ay hindi na ito makasira pa sa kalusugan ng sanggol. 2. Ang programa ng NBS ay abot kaya ng bawat pamilya. 6. B. Kahalagahan ng Newborn Screening Program 1. kung ang sanggol ay mayroong alinman sa limang sakit sa metabolismo. Ang mgaahensya na nagbibigay ng NBS test ay madali at malapit na puntahan. Ang Newborn Screening ay naglalayong malaman ng mas maaga. Ang Newborn Screening ay ginagawa sa pamamagitan ng pagtusok sa sakong ng bata upang makakuha ng sample ng dugo. Ang sample ng dugo ay ipadadala sa Newborn Screening Laboratory at ang resulta ay makukuha pagkatapos ng 7 hanggang 14 araw pagktanggap ng sample. Ang Newborn Screening ay isang program ng Department of Health (DOH). Pagsasagawa ng NBS 1. 4.NEWBORN SCRENING AWARENESS…… A. Ang sanggol ay dapat sumailalim sa NBS pagkatapos ng 24 oras ngunit hindi lalagpas ng tatlong (3) araw pagkapanganak. Kapag nalaman ng maaga ang sakit ng sanggol. rural health unit at health center. Ang NBS test ay makikita sa iba't ibang mga pasilidad tulad ng ospital. 3. 1. Ang NBS ay importante para masigurado ang mabuting kondisyon ng sanggol. Ang doktor o kumadrona ay ang responsable sa pagpapaliwanag ng resulta ng newborn screening sa mga magulang. . 3. 3. Availability and Accessibility of the Program 1. maaari itong humantong sa kapansanan sa pag-iisip at maging sa pagkamatay ng sanggol. Ang NBS ay isang simpleng pamamaraan Mga Pahayag 1 2 3 65 `4 upang malaman kung ang bagong panganak na sanggol ay nagtataglay ng mga bihirang sakit sa metabolismo. 2. lying-in. 5. 2. Kapag ang sanggol ay hindi na-screen. 4. may tsansa na mgkaroon ng magandang prognosis at ang sanggol ay maaaring makaligtas sa mga kapansanan at magkaroon ng normal na buhay. Ang Newborn screening ay ligtas. C.

Ako ay handa sa kahit ano mang maging resulta ng NBS. 4.. ANTAS NG PAGTANGGAP SA NEWBORN SCREENING. Binibigyang-diin ng hospital ang NBS base sa mga patakaran ng institusyon. 5. Direksyon: Basahin ng mabuti ang bawat katanungan. .NEWBORN SCRENING AWARENESS…… 66 Ikatlong Bahagi. 2. Gusto kong sumailalim sa NBS ang aking sanggol. Gusto kong ipanewborn screening ang aking anak tulad ng aking naunang anak. MGA PAHAYAG Naintidihan ko lahat ng sinabi ng nurse/doctor tungkol sa NBS. Ako ay may pinansyal na kakayahan upang ipanewborn screening ang aking anak. 7. Ang aking relihiyon at kultura ay hindi hadlang sa NBS. 3. Lagyan ang tskek ( / ) ang kahon na ayon sa iyong sagot. Scale: 1 2 3 – – – Hindi Tanggap Tanggap Tanggap na Tanggap 1 2 3 1. 6.

Tagapagbigay ng Impormasyon Tungkol sa NBS.NEWBORN SCRENING AWARENESS…… 67 Ikaapat na Bahagi. . Pinansyal na kakayahan upang ipa-newborn screening ang aking anak. Kalidad ng Serbisyo na ibinibigay ng programa ng NBS 8. Ang posibilidan ng positibong resulta para sa NBS. Relihiyon at kultura ng aking pamilya 5. Patakaran ng Ospital 9. Scale: 1 Hindi Nakakaapekto 2 Nakakaapekto 3 Higit na Nakakaapekto Mga Pahayag 1 2 3 Ang mga salik na nakaiimpluwensya sa aking pagtanggap sa newborn screening ay ang mga sumusunod: 1. Interes at kaalaman sa kalusugan 3. MGA SALIK NA NAKAKAIMPLUWANSYA SA PAGTANGGAP NG NBS Direksyon: Basahin ng mabuti ang bawat katanungan. Lagyan ang tskek ( / ) ang kahon na ayon sa iyong sagot. 6. Personal na karanasan ng pagkakaroon ng karamdaman at pagiging magulang 2. Impluwensya ng mga kaibigan at ng ibang tao 4. 7.

com Contact Number: 09084102958 Personal Information Civil Status: Single Religion: Roman Catholic Nationality: Filipino Date of Birth: May 16. ANGOY HOME ADDRESS: Blk. Pagbilao Quezon Email Address: jieneth16@yahoo. Krisanta Village. 1991 Place of Birth: Lucena City Educational Background Tertiary CALAYAN EDUCATIONAL FPUNDATION INC Red-V Lucena City Bachelor of Science in Nursing 2012 .NEWBORN SCRENING AWARENESS…… 68 CURRICULUM VITAE NAME: JIENETH T. 9 Lot 11.

NEWBORN SCRENING AWARENESS…… 69 Secondary SAINT PHILOMENA SCHOOL Gulang-gulang Lucena City 2007 Primary SACRED HEART COLLEGE Lucena City 2003 Seminars Attended Certificate of Attendance “Disaster Management” Certificate Attendance “Basic Life Support” First Aid 2012 2011 2009 .

NEWBORN SCRENING AWARENESS…… 70 CURRICULUM VITAE NAME: EMILIANO M. Quezon Educational Background Tertiary . SUAYAN HOME ADDRESS: Kinatihan I. 1989 Place of Birth: Candelaria. Candelaria. Quezon Email Address: emilsuayan@ymail.com Contact Number: 09478812208 Personal Information Civil Status: Single Religion: Roman Catholic Nationality: Filipino Date of Birth: September 11.

NEWBORN SCRENING AWARENESS…… 71 CALAYAN EDUCATIONAL FPUNDATION INC Red-V Lucana City Bachelor of Science in Nursing Secondary LADY MEDIATRIX INSTITUTE Candelaria. Quezon 2002 Seminars Attended Certificate of Attendance “Disaster Management” Certificate Attendence “Basic Life Support” First Aid 2012 2011 2008 . Quezon 2012 2006 Primary KINATIHAN I ELEMENTARY SCHOOL Candelaria.