Health-related Assessment of Geriatric Residents

in Laura and Villa Beatriz, Old Balara, Quezon City

Community Diagnosis Protocol ver.2/5.28.2019

PREVENTIVE AND COMMUNITY MEDICINE

Investigators:
PEREZ, Ma. Lucila M.
MACABULOS, Edmyr M.
SOLANO, Sigfredo M.
TAPIA, Carolina L.

Geriatric Health Assessment_DPCM 1

I. Introduction

One of the most critical issues in the improvement of health status of a community is the presence
of up-to-date and unbiased information. A well-conducted community diagnosis describing both the
community demographics, health status and the factors affecting its residents’ health will serve as the
cornerstone for formulating health strategies and programs of intervention to improve overall health in the
target population by providing a focus for both community involvement and allocation of support.

The use of a community diagnosis is vital in addressing the factors for morbidity and mortality due
to communicable and non-communicable diseases. On the national level, majority of the country’s deaths
result from cardiovascular disease, cancer, diabetes, and chronic respiratory disease. The prevalence of
such diseases is increased among high risk populations like the elderly. As a result, comprehensive geriatric
assessment for the elderly population has been increasingly implemented in community settings.
Assessment of the elderly requires a multidimensional approach, evaluating factors such as functional
ability, physical health, cognition and mental health, and socio-environmental circumstances; and in
combination with interventional actions, it could prevent functional decline, nursing home or hospital
admission and mortality. To the best of our knowledge, no community diagnosis among the elderly has
been done in Barangay Old Balara.

Significance of the Study

This project aims to determine the current health status of the elderly residents of Sitio Laura and
Villa Beatriz, Barangay Old Balara. The results of this study will provide the basis for identifying the health
concerns of the elderly and determine potential solutions to the identified problems. The proponents of the
study plan to use the results to come up with health projects with the community to address identified health-
related issues.

Review of Related Literature

Statistics in Southeast Asia

In Southeast Asia, both non-communicable diseases (NCDs) and communicable diseases are
major public health issues. NCDs alone have caused 7.9 million deaths, with cardiovascular diseases
ranked as the first followed by chronic respiratory diseases, cancer, and diabetes [33]. Communicable
diseases, on the other hand, have caused 40% of 14 million deaths annually in this region [34]. Southeast
Asia contributes a large portion to the burden of communicable diseases globally: 64% for measles, 36%
for tuberculosis, 33% for upper respiratory infections, 52% for dengue, and 28% for diarrheal diseases [35].

Communicable and Non-Communicable Diseases in the Philippines

In the Philippines, leading causes of mortality which are due to non-communicable diseases,
include, but are not limited to, diseases of the heart, diseases of the vascular system, malignant neoplasms,
pneumonia, tuberculosis, chronic obstructive, and diabetes mellitus. [21]. In 2008, 57% of mortality resulting
from NCDs was due to cardiovascular disease, cancer, diabetes, and chronic respiratory disease [22].
Diseases of the heart remained to be the number one cause of mortality over several years, wherein most
deaths were among the elderly aged 70 and above [24]. In 2016, total deaths due to NCDs increased to

Geriatric Health Assessment_DPCM 2

67% [23]. Non-communicable diseases also cause serious morbidity, such as hypertension, which ranks
third of out the ten leading causes of morbidity in 2014 [24].

On the other hand, communicable diseases such as pneumonia and tuberculosis of all forms, rank
fourth and eighth out of the ten leading causes of mortality, respectively. Due to improved sanitation, better
access to healthcare, and technological advancements, mortality resulting from infectious diseases have
decreased over several years yet remain to be a domestic health problem despite its decline. As for
morbidity, respiratory and other forms of tuberculosis are included in the ten leading causes, alongside
dengue fever, influenza, urinary tract infection, acute watery diarrhea, and acute respiratory infection [24].
Among high risk populations such as the elderly, the prevalence of tuberculosis is high. According to WHO,
there were about 260,000 incident cases locally in 2011 alone with 28,000 dying in a single year [25]. In
addition, the elderly population is also at increased risk of contracting pneumonia [26].

In the elderly, cardiovascular diseases are the leading cause of death, followed by pneumonia,
neoplasms, tuberculosis, chronic obstructive pulmonary diseases, diabetes mellitus, ulcers, accidents,
kidney diseases, and septicemia [27]

Health-Seeking Behavior

In the study of De Guzman et al (2014), as one becomes well-advanced in years, there is a decline
in health-seeking behavior due to several reasons, some of which are: embarrassment, social stigma,
neglect, past experiences with doctors, attitudes of family members, inaccessibility due to logistical
hindrances, cost of medical bills, and perception of symptoms. Usually, the elderly would only seek consult
when they experience severe pain, dizziness, or debilitation. They would rather choose to self-medicate
with commercially available medications and herbal medications, thereby delaying proper intervention.

Socio-economic capacity is an important determinant for health-seeking behavior, as most Filipinos

need to pay out of their pockets to receive medical care, in the absence of personal health insurance. This
alone serves as a tremendous roadblock for many, especially the urban poor, who face challenges every
day in acquiring even the most meager amounts of money [29]. Accessibility of health facilities is an
important determinant of health-seeking behavior, young and old alike.

Geriatric Assessment

Geriatric Assessment is used to evaluate an older person’s functional ability, physical health,
cognition and mental health, and socio-environmental circumstances and is usually initiated when potential
problems are identified by the physician, with emphasis on the functional capacity and quality of life.

In a study by van Rijn et al., geriatric assessment was used to determine the prevalence of geriatric
conditions in community-dwelling elderly persons at increased risk of functional decline. The study
demonstrated that the use of geriatric assessment in the said population could detect many geriatric
conditions. Problems such as hypertension, constipation and alcohol or substance misuse were not
frequently recognized as relevant problems, while pain and incontinence were recognized the most; this
may be attributed to elderly persons simply accepting some conditions as part of normal ageing. Such
problems were perhaps already treated, or some conditions were not perceived as appropriate problems
to discuss with their doctors [2].

In a cross-sectional study by Cigolle et al. which aimed to investigate the prevalence of geriatric
conditions and their association with dependency in activities of daily living showed that some conditions

Geriatric Health Assessment_DPCM 3

were as prevalent as common chronic diseases, such as heart disease and diabetes and the association
between geriatric conditions and dependency in activities of daily living was strong and significant [4].

Approach in the Assessment of the Elderly

Well-validated tools and survey tools to evaluate activities of daily living, hearing, fecal and urinary
incontinence, balance, and cognition are important parts of geriatric assessment [1]. Since a more
comprehensive method is needed for assessment of the elderly, a multidimensional approach is usually
employed in studies. Aspects evaluated commonly include Functional Ability, Physical Health,
Cognition and Mental Health, and Socio-environmental Circumstances.

Functional Ability is the person’s ability to perform tasks required for living. It is important to
identify leading causes of morbidity and mortality in the population to aid in the assessment of physical
health and in turn, a person’s functional ability. Aside from the leading causes of morbidity and mortality
among the elderly such as cardiovascular and respiratory diseases that causes functional impairment,
special attention must also be made towards weakening of special sensory functions such as vision
and hearing as these can cause considerable disability. Frailty must also be considered as it is linked
to increased mortality, morbidity, and falls risk.
In the assessment of a geriatric patient, two (2) key division of functional ability are utilized, namely
Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). The Katz ADL scale
and Lawton IADL scale are commonly used to evaluate functional ability. Deficits that were determined
using these scales may signal need for more in-depth evaluation of socio-environmental circumstance
and need for additional assistance [1].

Physical Health assessment of a geriatric patient incorporates conventional medical history which
includes the main problem, current illness, past and current medical problems, family and social history,
demographic data, and review of systems. However, approach should include nutrition, vision, hearing,
fecal and urinary continence, balance and fall prevention, osteoporosis, and polypharmacy [1].

Since a normal physiologic decline is expected as a person ages, intricate screening of non-age-
related decline in function should be initiated such that timely interventions can be performed. In
addition, nutritional assessment is also important since inadequate micronutrient intake is common
among the elderly that predisposes them to deficiencies, hence the need for use of nutritional
checklists. Common visual and hearing impairment can be screened during history taking and physical
examination. Urinary incontinence may be associated with other conditions and has important medical
and psychosocial implications. Screening with the question, “Do you have a strong and sudden urge to
void that makes you leak before reaching the toilet?” is best asked to screen for this condition. At the
same time, balance impairment in the geriatric population often manifests as falls and fall-related
injuries. A useful tool to assess fall risk is the Tinetti Balance and Gait Evaluation which includes
observing the patient get up from a chair without using his or her arms, walking 10 feet, turning around,
walking back, and then returning to a seated position with the entire process taking less than 16
seconds. Connected to this, osteoporosis may predispose in low-impact or spontaneous fragility
fractures leading to falls hence the condition should be diagnosed clinically or radiographically.
Polypharmacy should be avoided in the geriatric patient as this often results in confusion and may even
lead to overdosing as they are often forgetful and tend to confuse their medications.

Cognition and Mental Health. Mental health issues are among the most prevalent health
problems of the elderly and are an important source of distress for patients and caregivers [11]. Mental

Geriatric Health Assessment_DPCM 4

 health conditions are largely untreated in the elderly population as health assessments are
concentrated on the physical condition of the patient.

Dementia is one of the most common issue that affects cognition among the elderly. The
prevalence of dementia in the Philippines was found to be at 10.6%, the most prevalent form being
Alzheimer’s disease at 85.5% [7]. Screening tests such as the Mini Cognitive Assessment Instrument
is preferred test due to its speed, convenience, and accuracy, as well as the fact that it does not require
fluency in English.

Aside from cognition, depression is also a concern among the elderly. Locally, it was found that
31% of an elderly population in Quiapo, Manila was found to be depressed. However, symptoms of
depression were infrequent among the Filipino geriatric population of the selected community [8]. This
implies that depression is harder to detect in this population as they do not present with overt symptoms.
More important, geriatric depression can cause major disability as individuals affected by it have
difficulty carrying out ADLs and IADLs, increasing their dependency on others as well as healthcare
systems [8]. A simple two-question screening tool (“During the past month, have you been bothered by
feelings of sadness, depression, or hopelessness?” and “Have you often been bothered by a lack of
interest or pleasure in doing things?”) is found to be effective in screening for depression. The test is
deemed negative if the respondents respond “no” to the aforementioned questions.

Socioenvironmental Circumstances include social interaction network, available support

resources, special needs, and environmental safety which all should also be assessed since
determining the most suitable living arrangements for older patients is an important function of the
geriatric assessment [1].

Objectives

General Objective: The study aims to determine the health and environmental conditions of the elderly
residents aged >60 years old in Laura St. and Villa Beatriz, Old Balara, Quezon City

Specific Objectives:

● To determine the percentage distribution of elderly residents of Old Balara, Quezon City according
to the following social demographic characteristics:
○ Sex/Gender
○ Marital Status
○ Socio-economic status
○ Educational attainment
○ Occupation
○ Living arrangement
● To determine the percentage distribution of elderly residents of Old Balara, Quezon City with the
following health practices:
○ physical activity practice
○ smoking practice and exposure
○ alcohol beverage drinking practice
○ polypharmacy
● To determine the percentage distribution of elderly residents of Old Balara, Quezon City with the
following health conditions:
○ Hypertension

Geriatric Health Assessment_DPCM 5

 ○ Diabetes
○ Heart Disease
○ Pneumonia
○ Tuberculosis
○ Bronchial Asthma
○ Liver Disease
○ Kidney Disease
○ Arthritis
○ Malignancies
○ Visual difficulties
○ Hearing difficulties
○ Others Conditions: Balance impairment and fractures, Urinary and Fecal Incontinence,
Depressive symptoms
● To determine the index of independence of elderly residents of Old Balara, Quezon City to do
normal routine or activities of daily living and the instrumental activities of daily living (ADL) without
assistance using the scores obtained from Katz Index of Independence in Activities of Daily Living
and Lawton Instrumental Activities of Daily Living Scale
● To determine the percentage distribution of elderly residents of Old Balara, Quezon City according
to their perception of healthcare resources depending on:
○ Availability
○ Accessibility
○ Affordability
● To determine the percentage distribution of elderly residents of Old Balara, Quezon City according
to their health resources and health-seeking behaviors.

Scope and Limitations

This study will be conducted from July to December 2019 and will include only the population of
the elderly (60 years of age and above)who are residents of Sitio Laura and Villa Beatriz, Area 1 of Old
Balara, Quezon City during the dates of data collection. The study will not involve physical examination,
laboratory tests or cognitive assessments to validate the health conditions of the population.

Operational Definition of Terms

Elderly Individuals belonging to the age group 60 years and over

Socioeconomic Status A household’s income per annum, categorized into clusters modified
according to monthly income[13], as follows:

Income class Monthly Income Range

Poor <5,000

Low Income 5000 - 15,780

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 Lower Middle Income 15,781 - 31,560

Middle Class 31,561 - 78,900

Upper Middle Income 78,901 - 118,350

Upper income 118,351 - 157,800

Rich >157,800

Household A social unit consisting of a person living alone or a group of persons who
sleep in the same housing unit and have a common arrangement in the
preparation and consumption of food13

Educational Attainment Measured with respect to the highest education program completed and may
be classified into levels as follows[13]:

Level Education Program

1 Elementary

2 High School

3 College

4 Post Graduate / Vocational

Occupation The specific activity with a market value that an individual continually
pursues or pursued or obtained to obtain consistent and steady income[18]

Level of Independence Measure of the degree of the elderly’s capacity to do normal routine or
activities of daily living by themselves, assessed via modified questions from
Barthel Index such as if they could do the following activities: grooming, toilet
use, dressing, mobility, climbing stairs and bathing by themselves, with
assistance, or none at all. [17]

The following interpretation scale will be applied:

Geriatric Health Assessment_DPCM 7

 Number of Activities Interpretation

0-3 Maximally Dependent

4-6 Moderately Dependent

7-9 Minimally Dependent

10-12 Independent

Health practices EXERCISE OR PHYSICAL ACTIVITY: physical activity that includes leisure
time physical activity, transportation, occupational (if still working), household
chores, play, games, sports or planned exercise, in the context of daily, family,
and community activities. Elderly should have at least 150 minutes of
moderate-intensity aerobic physical activity throughout the week or do at least
75 minutes of vigorous-intensity aerobic physical activity throughout the week
or an equivalent combination of moderate- and vigorous-intensity activity.[19]

SMOKING PRACTICE and EXPOSURE: smoking of one or more

manufactured or tobacco products, with the following classification:

Current Smoker is defined as an adult who has smoked 100 cigarettes in

his/her lifetime and who currently smokes cigarettes, and may further be
classified into two:

Every day smoker is an adult who has smoked 100 cigarettes in his/her
lifetime, and who now smokes every day

Someday smoker is an adult who has smoked 100 cigarettes in his/her

lifetime, and who smokes now but does not smoke every day

Former Smoker is an adult who has smoked 100 cigarettes in his/her lifetime,
but who had quit smoking for at least 28 days

Never Smoker an adult who has never smoked, or who has smoked less than
100 cigarettes in his or her lifetime.

Smoking Exposure is the exposure to a member of the household.

DRINKING: intake of any alcoholic beverage during an individual’s lifetime

and may be classified as:

Note: 1 drink is equivalent to 350 ml beer bottle or 2 shot glasses of gin

Lifetime Abstainer Fewer than 12 drinks in a lifetime

Geriatric Health Assessment_DPCM 8

 Former drinker Former infrequent drinker - fewer than 12
drinks in any 1 year and no drinks in past
year
Former regular drinker - at least 12 drinks in
any one year but no drinks in past year

Current drinker Current light drinker - at least 12 drinks in the

past year but 3 drinks or fewer per week, on
average over the past year

Current moderate drinker - more than 3

drinks but no more than 7 drinks per week for
women and more than 3 drinks but no more
than 14 drinks per week for men, on average
over the past year

Current heavier drinker - more than 7 drinks

per week for women; more than 14 drinks per
week for men, on average over the past year

Healthcare resources All materials, personnel, facilities, funds, and anything that can be used to
access or provide health care and services. [20]

II. Methodology

Study design

The study will employ a descriptive cross-sectional design through a face-to-face interview of
eligible respondents from Sitio Laura and Villa Beatriz, Area 1, Barangay Old Balara, Quezon City.

Setting

The survey will be conducted in Laura Street and Villa Beatriz, Barangay Matandang Balara,
Quezon City, Philippines. This city was selected because it is: (1) a highly urbanized city, and (2) one of
the largest and most populated cities in the National Capital Region accounting for 12.8 percent of the
Philippine population, which posted a total population of 2,936,000 persons in 2015. Matandang Balara
(also known as Barangay Old Balara) has a population of 71,022 individuals and is the one of the most
populated barangays of Quezon City, with an elderly population of 3,600 (with 288 in Laura Street and 225
in Villa Beatriz).

Geriatric Health Assessment_DPCM 9

 Spot Maps

Figure 1. The area coverage of the study, which is located in Area 1 of Old Balara, Quezon City

Figure 2. Area-1 of Old Balara.

Subjects

Target Population

The target population of the study are the elderly residents of Barangay Old Balara, Quezon City.

Inclusion Criteria

● Elderly residents of Laura street and Villa Beatriz, Barangay Old Balara, Quezon City who have
lived in the area for at least 6 months

Geriatric Health Assessment_DPCM 10

 ● Comatosed or incoherent patients will still be included if with primary care giver > 18 years old

Exclusion Criteria

● Individual / caregiver who refuses to participate

Sampling and Sample Size

Complete enumeration method will be employed for the study. A spot map will be used to facilitate
the recruitment of eligible subjects. All houses in the spot map will be included in the interview proper. The
household will be included in the study if it includes an elderly, who should be present during the time of
interview. If the elderly in the household was not available or is not capable of undergoing interview, a family
member over 18 years old who is present and is knowledgeable of the elderly’s health, finances and other
issues can be interviewed. There are 500 elderly residents estimated in the study area.

Data Collection

Relevant Variables

The following variables of the elderly subjects will be determined through the survey:
demographics, socioeconomic and environmental aspects, health-related practices and status, health
seeking behavior, health resources and the level of independence.

Data Collection Tool

A questionnaire was formulated based on the American Academy of Family Physician

questionnaire. It focuses on the physico-psychosocial status of the elderly population of Brgy. Old Balara
[2]. The questionnaire[11] consists of 8 parts and has a total of 45 questions, with a total of 8 pages. The
first 5 parts determined the percentage distribution of elderly residents of Old Balara, Quezon City according
to their demographics, socioeconomic and environmental aspects, health-related practices and status,
health seeking behavior, health resources. The last 2 determine functional capacity and is composed of the
Katz Index of Independence in Activities of Daily Living and Lawton Instrumental Activities of Daily Living
Scale. There are 8 questions on demographics, 5 questions on socioeconomic aspects, 4 questions on
environmental aspects, 3 questions on health practices, 3 questions on health and illness , 7 questions on
health seeking behavior and health resources.

Content validity of the questionnaire will be assessed by selected officers of the local Elderly Club
and a Geriatrician. The Filipino-translated interview schedule will be used for the data collection proper.
Pre-testing will be done among 30 elderly in a neighboring area of the study site.

Survey Procedure

House to house interviews of the elderly will be employed for data collection. The questionnaire will
be read by an interviewer. All eligible elderly in one household will be interviewed. If the respondent is out
of the house at the time of the interview, a scheduled date and time will be agreed on by the interviewer
and representative of the household at that time wherein the elderly in that house shall be available. If this
elderly family member will not be available on 3 separate occasions for the interview, then he/she will no
longer be included in the sample population.

Data Collection Team

Geriatric Health Assessment_DPCM 11

One data collection team will be assigned per week day (Monday to Friday) for a total of five (5) data
collection teams. A team will be composed of one (1) CHP, one (1) junior intern and one (1) senior intern.

Training of Field Interviewer

The Community Health Promoters (CHP) will be tapped to be the field interviewers and undergo training
on how to conduct the interview. A prepared script will be provided to ensure standardization of interview
schedule.

Data Collection Strategy

The duration of data collection is expected to occur over the course of one month. Data collection
will be done on weekdays (Monday to Friday) from 1:00 to 5:00 PM. During each visit, the research team
member will conduct the face-to-face interview.

A spot map will be sketched based on the previously existing spot map of Laura street and Villa
Beatriz made by the local barangay with use of Google Map’s Satellite View and Street View with the
exclusion of areas in Laura street and Beatriz street designated for demolition. The entire Sitio Laura and
Villa Beatriz will be divided into five clusters. A total of 10 to 15 households in one cluster will be visited per
sampling day. Data will be collected from Cluster 1 then Cluster 2 and so on. The spot map with cluster
groups will be made upon approval of the study.

Each housing structure will be counted as one dwelling unit. All eligible elderly from each dwelling
unit who fulfilled the criteria and is willing to join the study will be interviewed. An identifier sticker will be
placed on the door after testing to avoid multiple visits in the household.

Control of Biases

Refusal or Non-Response Bias

This bias will be controlled by maximizing participation rates by ensuring that the participants are
in their place of residence during the time of data collection. The data collection will be scheduled during
the weekdays. Residents who were not at home during the time of data collection will be interviewed at
another pre-agreed time when they are ensured to be available.

Reporting bias (Hawthorne Effect)

This bias will be controlled by explaining the importance and benefit of providing truthful answers,
and assuring the respondents that they will be anonymous and will not be identified in any way during the
consolidation and presentation of the research findings.

Observer/ Interviewer Bias

This bias was controlled by using a standardized interview schedule. The data collection team who
will perform the interview will undergo training and a script will be provided to ensure standardization of
interviews.

Measurement Bias

Geriatric Health Assessment_DPCM 12

 This bias was controlled by constructing precise operational definitions to prevent generalized
definitions and to avoid confusion of concepts that were used in the study. The interview schedule designed
and to be used in the study was: (1) comprehensively structured involving multiple and varied
measurements capable of accurately measuring parameters and characteristics of interest (e.g. level of
independence, health practices) of the study population; (2) comprehensible for respondents at any age
above 60 and regardless of educational background; and (3) objective and will not include open ended
questions.

Ethical Considerations

The protocol will be submitted to the SLMCCM Research Ethics Committee for approval.

Written informed consent will be obtained from the respondents who will be allowed to read and
understand the informed consent. Minimal risk is expected from participation in the study. Participation is
voluntary and they can withdraw anytime. For elderly who are incapable of writing their signature, their
thumb print will be used to signify consent. For those who are mentally impaired and unable to give an
informed consent, the elderly’s condition will be properly documented and a legally acceptable
representative (LAR) will be asked to give the informed consent who is >18 years old and is knowledgeable
of the elderly’s condition.

Measures such as coding of the responses and safekeeping of the records and interview files will
be also done to preserve the respondent’s privacy and confidentiality. Furthermore, permission to use
recording instruments such as voice recorders, video cameras or cellphones or other similar electronic
recording devices will be obtained. The recordings will be stored in a secure online cloud storage account
with password and will be erased after the data has been summarized. Code numbers will be assigned to
the respondents in order to allow the researchers to analyze the data. All forms will be stored in a locked
cabinet and will only be accessed by the people involved in the research. Data will be stored for 5 years
and destroyed afterwards.

Statistical Analysis

Data Processing

Completeness, accuracy and consistency of data will be ensured by checking the answer sheet at
the end of every interview. The collected data from the completely filled out answer sheet will be encoded
in a Master Table. Each participant will be assigned an identification number and names will not be written
in the answer sheet and master table to secure anonymity. The dummy tables that will be used for this
study are shown in the Appendix.

Data Analysis

The data gathered from the questionnaires will be plotted in a graph or presented in tabular form
showing frequency distribution of health and environmental conditions of the elderly in Old Balara, Quezon
City categorized as:

Social demographic characteristics (sex, marital status, socio-economic status, educational

attainment, educational attainment, occupation, living arrangement), health practices (physical activity
practice, smoking practice and alcohol beverage drinking practice), health conditions (hypertension,
diabetes, heart disease, pneumonia, tuberculosis, bronchial asthma, liver disease, kidney disease, arthritis,
malignancies, visual difficulties, hearing difficulties and others), index of independence (ADLs and IADLs),

Geriatric Health Assessment_DPCM 13

healthcare resources ( availability, accessibility, affordability), health-seeking behaviors, and Philhealth
members.

Reporting and Dissemination

The findings of the community diagnosis will then be reported to Office of Senior Citizens Affairs
(OSCA), the barangay local Elderly Club and other community stakeholders upon completion of the study.

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Lu, Christopher Emmanuel D. V. Ma & Calvin Rei L. Macrohon (2014) Health-Seeking Preferences
of Elderly Filipinos in the Community via Conjoint Analysis, Educational Gerontology, 40:11, 801-
815, DOI: 10.1080/03601277.2014.882110
29. Islam M, Montgomery M, Taneja S. Urban Health and Care-Seeking Behavior: A Case Study of
Slums in India and the Philippines. United States Agency for International Development. 2006.
30. Geriatric Functional Assessment. University of Michigan Medical School, Division of Geriatric
Medicine, Department of Internal Medicine. 2003.
31. Briggs R, McDonough A, Ellis G, Bennett K, O’Neill D, Robinson D.Comprehensive Geriatric
Assessment for community-dwelling, high-risk, frail, older people.Cochrane Database of
Systematic Reviews 2017, Issue 6. Art. No.: CD012705.DOI: 10.1002/14651858.CD012705.
32. Lionakis N, Mendrinos D, Sanidas E, Favatas G, Georgopoulou M. Hypertension in the elderly.
World J Cardiol. 2012;4(5):135-47.
33. Narain J.P., Garg R., Fric A. Non-communicable diseases in the South-East Asia region: Burden,
strategies and opportunities. Natl. Med. J. India. 2011;24:280–287.
34. Narain JP, Shah NK. Communicable diseases in South-East Asia: call for papers. Bull World Health
Organ. 2008;86(9):660.
35. Gupta I, Guin P. Communicable diseases in the South-East Asia Region of the World Health
Organization: towards a more effective response. Bulletin of the World Health Organization
2010;88:199-205. doi: 10.2471/BLT.09.065540.

Geriatric Health Assessment_DPCM 15

IV. APPENDIX

INFORMATION SHEET AND CONSENT FORM

Title of Research: Health-related Assessment of Geriatric Residents in Laura and Villa Beatriz,
Old Balara, Quezon City
Study Investigators: PEREZ, Ma. Lucila M., MACABULOS, Edmyr M., SOLANO, Sigfredo M., TAPIA, Carolina L.

What is this project about?

This research is designed to help the researchers evaluate the health condition and health-related
experiences of the elderly residents of Area 1 Barangay Old Balara.

What will you have to do?

You were selected to be part of the study because you are 60 years old or older and a resident of Laura or
Villa Beatriz, Old Balara. You will be asked a series of questions about your living experience and health
information . There are no wrong answers, just different opinions. If you do not feel comfortable answering
a question or do not have an answer, just let us know. We are interested in your perspective as a community
member of Old Balara; so please keep that in mind during the discussion.

We estimate that it will take 30 - 45 minutes of your time to complete the interview. Your participation in the
interview will be one-time only. During this discussion we will be recording on paper your answers on paper.
We may also be video- or audio-recording our talk to make sure we do not miss anything, if you have no
objections. Only those doing the research will listen and see the recording. You can ask for the recorder to
be turned off at any time during the interview.

Are there any benefits?

Although there are no direct benefits to you in participating, you will be assisting us in our
study by providing us with important community opinions and facts. We hope that the information we learn
will be used to improve services for you and members of your community

What are the risks?

There are no known risks of participating in this study. You may feel uncomfortable talking about specific
topics, such as problems or needs in your community. You can skip any questions that make you feel
uncomfortable

Geriatric Health Assessment_DPCM 16

What are the costs?

The only cost to you is the time spent participating in this interview. There will be no compensation for
your participation but, you will be given a small token in appreciation of your help.

How do we assure Confidentiality?

Any information given will be used only for summarizing our findings and not linked to identify you. The
video-audio recordings will be stored in a secure online cloud storage account with password and will be
erased after the data has been summarized.

Identifying information will not be linked in any way with the information collected in interviews. In our
records, we will assign a code number to each participant to ensure identifying information cannot be linked
to that person. You may refuse to provide contact information.

The data from our research may be shared with the Old Balara Local Health Center and Sons of Charity
Formation Center Clinic, or others but without your identifying data.

Can I refuse to participate?

Your participation is voluntary and is up to you. If you don't want to join, it will not stop your getting services
now and in the future. If you agree to participate now, you are free to change your mind anytime snd stop
taking part in this study.

Who is leading this project? How can I get in touch with them?

This is a study conducted by the doctors of the St Lukes Medical Center College of Medicine in cooperation
with the Sons of Charity, a France-based Catholic Organization.

If you have any questions, please contact:

Dr. Ma. Lucila M Perez; cell phone no. 09209238551 or by visiting our study members in our clinic at
Sons of Charity Community Chapel or

Dr. ___________________; cell phone no.: __________of the Research Ethics Committee, St Luke’s
Medical Center College of Medicine

Geriatric Health Assessment_DPCM 17

Participant Informed Consent Certificate:

I have been invited to participate in this research entitled “Health-related Assessment of Geriatric
Residents in Laura and Villa Beatriz, Old Balara, Quezon City”.

I have read or it has been read to me, and I understood the said information given to me. I am
aware that I will be asked to answer questions about my health and other health-related
information. I have had the opportunity to ask questions about it and any questions I have
asked were answered to my satisfaction.

I consent voluntarily to participate in this study.

__________________________________ ___________
Name and Signature of Participant/LAR Date

__________________________________ ___________.
Name and Signature of Independent Witness Date

(IF SUBJECT IS ILLITERATE) Thumbprint of Participant

I have explained the study to the participant and given him a copy of the Informed Consent
Form.

__________________________________ ___________
Name and Signature of Person who Obtained Date
the consent

Geriatric Health Assessment_DPCM 18

IMPORMASYON TUNGKOL SA PAG-AARAL AT ANG BATID NA PAHINTULOT

Pamagat ng Pananaliksik: Health-related Geriatric Assessment of Residents in Laura and Villa

Beatriz, Old Balara, Quezon City
Mga mananliksik: PEREZ, Ma. Lucila M., BAUTISTA, Paul Vincent C., MACABULOS, Edmyr M., SOLANO,
Sigfredo M., TAPIA, Carolina L.

Ano ang proyektong ito?

Ang community diagnosis ay isang pananaliksik na pinag-aaralan ang kalagayan pangkalususgan at
karanasan ng mga nakatatandang residente ng Barangay Old Balara.

Ano ang inyong kailangang gawin?

Kayo ay napili dahil kayo ay 60 taon gulang o higit pa at nakatira sa Laura o Villa Beatriz, Old Balara. Kayo
ay tatanungin ng ilang mga katanungan ukol sa ibat-ibang aspeto ng pamumuhay at kalusugan niyo, kung
saan walang maling sagot, iba-iba lang na opinyon. Kung kayo ay hindi kumportable na sumagot sa kahit
aling tanong o kung ayaw nyo sumagot sa isang tanong sa aming panayam. maaring magbigay-alam.
Interesado kami sa iyong pananaw bilang isang miyembto ng Old Balara.

Mga 30 – 45 na minute ang kakailanganin upang matapos ang interbyu. Ang pagkuha ng inyong
panayam ay gagawin lamang nang isang beses. Isusulat ang inyong mga kasagutan sa isang papel.
Kung bibigyang-pahintulot at walang magiging pagtutol, maaring irekord gamit ang isang video o audio na
digital recorder ang pag-uusap upang masigurado na kumpleto ang sagot na malilikom mula sa inyo.
Tanging mga tagapag-saliksik ang makakarinig at makakakita ng mga recording. Maaring hingin na
patayin ang recorder sa kahit anong bahagi ng panayam

Ano ang mga benepisyo na inyong makukuha?

Walang magiging direktang benepisyo sa inyo sa pagsali sa pag-aaral na ito. Ngunit ang inyong paglahok
ay mahalaga sa paglakap ng mga impormasyon ukol sa inyong komunidad. Ninanais ng mga mananaliksik
na ang mga impormasyong ito ay makakatulong upang mapabuti ang mga serbisyo sa inyong komunidad.

Ano ang mga panganib na inyong makukuha?

Ang pananaliksik na ito ay walang kaakibat na panganib sa mga magiging kalahok nito. Maari na hindi kayo
kumportable na pag-usapan ang mga problema o pangangailangan ng komunidad. Puede naman hindi
sagutin kahit anong tanong kung kayo ay hindi komportable.

Kailangan bang maghanda ng salapi?

Ang gastos nyo lamang ay ang oras na ginugol sa pagsagot ng mga tanong. Walang magiging bayad ang
partisipasyon nyo pero, kayo ay makakatanggap ng tanda ng pasasalamat mula sa amin.

Geriatric Health Assessment_DPCM 19

Paano manatili na kompidensyal ang mga impormasyon na inyong ibabahagi?
Ano man na impormasyon na binigay nyo ay gagamitin lang sa pagsusuri na ito at hindi malalaman ang
pagkakakilanlan mo. Ang mga recording ay pansamantalang itatago sa isang online na imbakan (sa
cloud) na meron password. Ang mga impormasyong ito ay pagsasama-samahin at pagkatapos ay amin
ding buburahin.

Ang mga impormasyong makakatukoy sa inyo ay hindi makakabit sa impormasyon na nakalap sa usapan
natin Ang mga mananaliksik ay gagamit ng mga numero o code bilang pagkakakilanlan sa yo sa halip na
pangalan nyo para masiguro na hindi malaman ang pagkakilanlan mo. Maaari din na tumanggi kayo
magbigay ng impormasyon na pakipag-ugnayan sa iyo.

Maaari na mabahagi sa Old Balara health center at Sons of Charity Formation Center Clinic, o sa iba pa
ang mga resulta ng pag-aaral na ito pero hindi malalaman ang pagkakakilanlan mo.

Maaari ba ako tumanggi?

Ang iyong pagsali dito ay kusang-loob at boluntaryo. Kung ayaw nyo sumali, hindi ito magiging hadlang sa
mga serbisyo na nakukuha ngayon at sa hinaharap. Kung ikaw ay pumayag ngayon, puede nyo baguhin
ang isip mo kahit kalian at ihinto ang pakikilahok sa anumang oras..

Sino ang pumapatnubay ng proyektong ito? Paano ko sila maaring makausap?

Ang pananaliksik ay ginagawa ng mga doctor ng St. Luke’s Medical Center College of Medicine at ng Sons
of Charity, na isang organisasyong Katoliko na mula sa France.

Kung mayroon mga katanungan, maaaring makipag-ugnayan kay:

Dr. Ma. Lucila M Perez; cell phone no. 09209238551 o bumisita sa Sons of Charity Community Chapel o
kay Dr. Edmyr M. Macabulos; cell phone no.: __________ng Research Ethics Committee, St Lukes
Medical Center College of Medicine.

Geriatric Health Assessment_DPCM 20

Batid na Pagsang-ayon ng Kalahok:

Ako ay naimbitahan na sumali sa pagsusuri na ang pamagat ay

Nabasa ko o binasa sa akin at naiintindihan ko ang mga impormasyon patungkol sa

pagsusuri. Alam ko na ako ay papasagutin ng mga tanong tungkol sa aking kalusugan at iba
pang impormasyon na meron kaugnayan sa kalusugan. Nabigyan ako ng pagkakataon na
magtanong at nasagutan ito ng maayos.

Binibigay ko ang pagsang-ayon ko ng kusang-loog na sumali sa pagsusuri na ito.

__________________________________ ___________
Pangalan at Lagda ng kalahok/LAR Petsa

__________________________________ ___________.
Pangalan at Lagda ng Saksi Petsa
(KAPAG HINDI NAKAKABASA O PIRMA Thumbprint ng Kalahok
ANG KALAHOK)

Napaliwanag ko sa kalahok ang pag-aaral na ito at nabigyan sya ng kopya ng Batid na

Pagsang-ayon na kasulatan.

__________________________________ ___________

Pangalan at Lagda ng Taong Kumuha ng Petsa

pagsang-ayon

Geriatric Health Assessment_DPCM 21

 GANTT CHART

2019

June July August September October November December

Activities

Approval of Protocol to
TRC and SLMCCM-REC

Spot Mapping

Questionnaire Pretesting
and Revisions, Script
Making

Finalizing Actual Data

Collection
Strategies/Schedule
(Training of Data
Collectors)

Acquisition of Budget

Formation of Teams,
Coordination with Elderly
Club, Local Health
Center and OSCA

Production of
Questionnaire and
Acquire Other Materials

Data Collection

Data Processing

Data Analysis

Writing and finalizing of

report

Geriatric Health Assessment_DPCM 22

BUDGET

Item Quantity Unit Price Total Price

Personnel
1. Field Interviewers 5 x 3 months 500.00 7500.00
2. Statistician 1 x 1 month 10000.00 10000.00
3. Research
Assistant (part-time) 1 x 6 months 10000.00 60000.00
SUBTOTAL: 77500.00
Supplies
Supplies
1. House Stickers 500 10.00 5000.00
2. Clip Boards 7 100.00 700.00
3. Ballpens 25 10.00 250.00
4. Logbook 1 100.00 100.00
5. Brown Envelope 550 10.00 5500.00
6. Ecobag 10 50.00 500.00
Photocopy/Printing of
1. Questionnaires 9 x 500 1.00 4500.00
2. Consent Forms 6 x 500 1.00 3000.00
SUBTOTAL: P19550.00
Training of Field Interviewers
1. Training Kit 7 150.00 1050.00
2. Training Manual
copies 7 60.00 420.00
SUBTOTAL: P1470.00
Uniforms
T-Shirt
1. White Color 5 200.00 1000.00
2. Blue Green 5 200.00 1000.00
Color
Identification (ID)
1. Lanyard 5 100.00 500.00
2. ID Holder 5 50.00 250.00
Cap (White) 5 100.00 500.00
SUBTOTAL: 3250.00
Miscellaneous
Snacks for Interviewees 500 25.00 12500.00
Token (Face Towels) 500 25.00 12500.00
Communications Cost
1. Study Cell phone 1 2000.00 2000.00
2. Cell phone load 7 x 3 months 200.00 4200.00
SUBTOTAL: 31,200.00
Contingency (10.0%) 13000.00
TOTAL: P 146,020.00

Geriatric Health Assessment_DPCM 23

Geriatric Health Assessment_DPCM 24