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SELF MEDICATION: ITS EFFECT TO THE HEALTH STATUS IN THE RESIDENTS OF THE BRGY STO.

ANGEL NORTE STA, CRUZ, LAGUNA

A Research Paper Presented to the Faculty of the College of Nursing Laguna State Polytechnic University Main Campus Sta. Cruz, Laguna

In Partial Fulfillment Of the Requirements for the Degree of Bachelor of Science in Nursing

MS. NERGELYN CARDOZA GAUNA 2012

Chapter 1

PROBLEM AND ITS BACKGROUD

Introduction Medicines are certainly meant to provide relief from ailments but their indiscriminate use can lead to serious health problems, nowadays everybody demands for fast result. When it comes to health problems or simple physical discomfort, we pop that pill without thinking its side effect. Self-medication is a term used to describe the use of drugs (including alcohol) or other self-soothing forms of behavior to treat untreated and often undiagnosed mental distress, stress and anxiety, including mental illnesses and/or psychological trauma. Self-medication is also a form of self-care, and a critical one. Products to be used for such purposes can be defined as those the average consumer can use to treat minor, self-limiting illnesses without the intervention of a prescribing, dispensing or monitoring health professional with relative assurance of its safety and effectiveness. Medications of this type are usually known as non-prescription or over-the-counter (OTC) products.

Background of the Study It has been said that self medications is always dangerous. One might be tempted to take too much of something that may be alright in smaller doses. It is much wiser to seek proper medical counsel. The free use of the drugs is the cause of much ill health today. Many of these drugs interfere with the normal physiology of the body, bringing in condition that is far worse than they were intended to relieve. Nothing is less conductive to health than to be always swallowing a pill of one sort or another. Some families are in a habit of taking some kinds of medicines from early childhood that they keep on taking until now. The researcher was stimulated to study self medications to find out what will be the effects of using Over the Counter medicines in the health status among the residents of Brgy Sto. Angel Norte Sta. Cruz, Laguna. She was stimulated to pursue this investigation because of what she observed in her locality Brgy since majority of the resident are taking over the counter medications. The researcher wanted to know what will be the advantages and disadvantages of self medications in the person using it. The researcher believes that through this study they could impart knowledge and help other people to understand about taking over the counter medications.

Theoretical Framework Duncans Model of Drug Dependence as Self-Medication. The distinction between drug use and drug abuse is critical to Duncans model. He asserts that most of the people who take illegal drugs do not meet criteria for substance abuse, let alone for dependence. The great majority exercise control and restraint over their drug use and suffer no harm from using. His model is concerned with describing why a minority (10-20%) of those who take drugs non-medically do lose control over their use and expose themselves to serious social, interpersonal and medical risks. He and Dr. Robert S. Gold have also explored the implications of his model for the primary prevention of drug abuse (Duncan & Gold, 1982 & 1983) and the tertiary prevention of the destructive consequences of drug abuse. Psychological dependence "refers to the experience of impaired control over drug use" while "physical dependence involves the development of tolerance and withdrawal symptoms upon cessation of use of the drug, as a consequence of the body's adaptation to the continued presence of a drug" (UNIDCP, 1998). In Duncans view, physical dependence is a lesser problem which occurs in addiction to some drugs, such as alcohol and opiates, but not in addiction to cocaine, heroin, etc., nor in non-drug addictions such as compulsive gambling. Duncan essentially argues that drug dependence is just another name for avoidance or escape behavior when the operant behavior being reinforced is

drug taking. Drug addicts, in his view, have found a drug which provided them with temporary escape from an ongoing state of emotional distress which might be due to a mental disorder, to stress, or to an aversive environment. Non-drug addictions, in his opinion, represent similar negatively reinforced behavior. Duncan asserts that the characteristics of dependence are all typical of operant behaviors maintained by negative reinforcement. Negative reinforcement maintains high rates of behavior. Animals that have been negatively reinforced for performing a task such as pressing a bar will often do so to the exclusion of eating, sleeping, sexual activity, etc. Avoidance behaviors are highly resistant to extinction and even when they appear to have been eliminated they tend to recur spontaneously. Thus the intensity, compulsiveness and proneness to relapse that characterize drug dependence all result, in Duncans opinion, from the fact that the behavior is maintained by negative reinforcement.

Conceptual framework The researcher conceptualized that the independent variables are the factors contribute to self medication and the dependent variable are the reason for the independent variables. The conceptual framework is illustrated in the form of paradigm below.

INDEPENDENT VARIABLES

DEPENDENT VARIABLE

DEMOGRAPHIC PROFILE: y y y y Age Gender Economic status Educational Attainment

COMPLIANCE TO SEEK MEDICAL CARE

FRAME 1

FRAME 2

The paradigm illustrates the conceptual framework of the study in the effects in the health status of the people using over the counter medicines. Frame 1- Consist of the independent variables which include the common and possible factors that contribute to self medication. Frame 2- Consist of the dependent variables consist of what the researcher wants to find out, on how the independent variables contribute to the dependent variable.

Statement of the Problem

This study aimed to determine the effects of self medication in the health status among the residents of Brgy Sto. Angel Norte Sta. Cruz, Laguna. Specifically the study sought to answer the following questions: 1) What is the demographic profile of the respondents in terms of: 1.1 Age; 1.2 Gender; 1.3 Economic status; 1.4 Educational Attainment? 2) What are the common factors that contribute to self medications? 3) Effects of self medication in the health status of the respondents in terms of: 1.1 Age; 1.2 Gender; 1.3 Economic status; 1.4 Educational Attainment? 4) Is there a significant effect of self medications in the health status of the respondents?

Hypothesis There is a significant effect of self medications in the health status of the respondents.

Significance of the Study The study which aimed to provide data on how each individual understands the possible effects of self medications in their health status. Respondents. The researcher hopes that this study will help the people who are using over the counter medicines understand the importance of health in each individual, and have information and ideas about the medicines that they take. Nursing Students. The researcher hopes that the study will help nursing students to understand and gain knowledge about self medications. Future Researchers. This research will give additional information for those who will conduct another study about the effects in the health status in self medication.

Scope and Limitations of the Study This study is composed of 50-60 respondents/persons taking an Over the counter medicines. They are randomly chosen in Brgy Sto. Angel Norte Sta. Cruz, Laguna. The target populations in the study are the person who is taking OTC medicines. The research will focus on the effects of self medication in the health status of the person. In accordance to the study, the researcher has set criteria is selecting and delegating the respondents: (1) should be residents in

Brgy Sto. Angel Norte Sta. Cruz, Laguna. The age of 18 and below or 60 and above are not included for the researcher considers the capacity of individual to answer the questionnaires; (2) a person who are using OTC medicines ,and all of them have different reasons in using OTC medicines.

Definition of terms Generally, the terms used in the study pertain to their popular connotations but there are a few terms which need clarification. There are defined in the context of their use in the study: Self medications People who are taking medication on its own decision. Effects - Result of taking medicines. Health status Condition of the people using over the counter medications Over the counter drugs - Medicines that are sold directly without the doctors prescription. Prescription- It is medicines that are safe when used under a doctors care. Health- Is a complete physical, emotional, spiritual well-being of a person. Medicine Person used to treat diseases. Gender It is sexual category of the person. Economic status It is a financial condition of the people. Educational Attainment It is a person level of learning. Compliance- Act of obedience of following to a certain law or regulation of an institution.

Chapter 2

RELATED LITERATUE AND RELATED STUDIES

Review of Literature and studies are presented in this section. They are taken from the different references such as books, journals, and other unpublished materials.

Related Literature

Age Teens are abusing some over-the-counter (OTC) drugs, such as cough and cold remedies, to get high. Many of these products are widely available and can be purchased at supermarkets, drugstores, and convenience stores. Many OTC drugs that are intended to treat headaches, sinus pressure, or cold/flu symptoms contain the active ingredient dextromethorphan (DXM) and are the ones that teens are using to get high. When taken in high doses, DXM can produce a "high" feeling and can be extremely dangerous in excessive amounts.

Up to one out of every five teenagers or 20 percent has abused prescription or over-the-counter drugs, according to research conducted by the organization Partnership for a Drug-Free America. The organization says that one in 10 teens have abused these drugs within the past year, with another (8/4/2009). Children average six to eight colds a year (Simasek & Blandino, 2007). There are more than 100 different viruses that cause this self- limiting illness, is also known as acute upper respiratory infection (URI; Kelly, 2004). Viruses that result in the common cold spread rapidly in children, who may occur because children do not wash their hands as frequently as adults; they share toys; and are more intimate with one another during casual interactions than are adults (Kelly, 2004). The average cold can last 10 to 14 days with cough, rhinorrhea (runny nose), and nasal congestion among the most bothersome symptoms reported (Gunn, Taha, Liebelt, & Serwint, 2001). The risk of overdose, incorrect dosing, and average drug events is increased in young children due to the number of colds they acquire each year, their small body size, and parents lack of clarity of the active ingredient in OTC medications, Particularly those with multiple ingredients (Markel, 2007).

Gender New research shows that long-term use of acetaminophen, sold under the brand name Tylenol -harms kidneys. This research was conducted on

1,700 women, and spanned 11 years. Overall, it showed that 10% of the women experienced a decline in their kidney function (7/27/2004). Economic Status

Related Studies Age The current study tested the hypotheses that adolescents with greater conduct problems are more likely to self-medicate, as evidenced by a greater risk for drinking on days subsequent to high negative mood, and to show negative mood-related drinking consequences. (Brown, 2004). Seventy-six respondents (54%) were aged between 20 to 39 years. The majority of he respondents (72 %) stayed within 30 minutes walking distance of a health post medical store. 59% of these respondents had taken some form of self-medication in the 6-month period preceding the study. The common reasons given for self-medication were mild illness, previous experience of treating a similar illness, and non-availability of health personnel. 70% of respondents were prescribed allopathic drugs by a nonallopathic doctor.

Gender The compounder and health assistant were common sources of medicines. Paracetamol and antimicrobials were the drugs most commonly

prescribed. A significantly higher proportion of young (<40 years) male respondents had used self-medication than other groups. More male patients used self medication compared to females, contrary to data from western reports. Economic Status In economically deprived communities, most episodes of illnesses are treated by self-medication. Due to the hilly terrain in Nepal, the poor socioeconomic status, the high cost of modern medicines and non-availability of doctors in rural areas, difficulties arise in accessing modern healthcare. In India, another south Asian country with economic and cultural similarities to Nepal, pharmacists and pharmacy attendants play an important role in fostering self-medication among the public. Combination preparations containing 'hidden' classes of drugs and food supplements or tonics of doubtful value were commonly used in India. Studies on self-medication patterns and the prevalence of non-doctor prescribing in the Pokhara valley are lacking. Over the last two years in our hospital, we have been seeing an increasing number of patients developing resistance to the commonly used antibiotics. Hence the present study was carried out in the first fortnight of August 2001 in Pokhara sub-metropolitan city and the surrounding villages, where a high prevalence of self and non-doctor prescribing was observed in the subject population.

Educational Attainment The better socioeconomic status of men in Nepal, their better earning power, and the higher educational level are probably among the reasons. However, this is difficult to reconcile with the fact that economic reasons were commonly cited for self-medication. The greater prevalence of self medication among the younger generation can be due to the better educational level (2002 Shankar).

Chapter 3

RESEARCH METHODOLOGY

This chapter presented the research design, population and sampling, research procedure, research instrument to be used in gathering data and statistical treatment of data.

Research Design The researcher used the descriptive method where in copies of a written questionnaire is the form of checklist is the main instrument they were given to the respondents in order to gather pertinent data from them regarding their reason for using over the counter medicines and the perceived effectiveness and dangers of using it.

Population and Sampling Techniques The researcher uses the purposive random sampling in which the researcher asked first the respondents if they where using over the counter medicines before giving questionnaire. Purposive sampling technique was used to identify the total number of respondents. The respondents were composed of 50- 60 selected residents in the Brgy. Sto Angel Norte Sta. Cruz, Laguna.

Research Procedure The researcher first identified the problem of the study. The researcher gathered and reviewed the applicable theories and relevant literatures and studies from books, thesis, journal, and electronic publications which are related to this study. The data and information were analyzed and summarized. The researcher\s next step is the formulation of the questionnaire. Then the researcher went ask to the Brgy Captain of the Brgy Sto. Angel Norte which was the site of the study. The questionnaires were handed out personally and the respondents were requested to answer the questions on the spot. Questionnaires were collected as soon as possible. Other records and documents were requested from the office of Brgy Sto. Angel Norte, Sta. Cruz, Laguna and Brgy Health Center.

Research Instruments Instrument used in the study are the questionnaire given by the researcher to the respondents. Questionnaire is the most common type of research instrument. A letter requesting permission to conduct the study was submitted to the office of the Dean of the College of Nursing of the Laguna State Polytechnic University Sta. Cruz, Main Campus for the approval and a letter request was given to the Brgy Captain of Brgy Sto. Angel Norte asks permission for conducting the study. The questionnaires were distributed to

the selected residents of the Brgy which is involved in the study. The researcher personally retrieved the questionnaires from the respondents.

Statistical Treatment To determine the reason of the respondents in using over the counter medicines in the Brgy. Sto Angel Norte Sta. Cruz, Laguna. Percentage of frequency was computed.

Percentage= frequency Total no. of respondents

To determine the effects of self medication in the health status of the respondents.

Total weighted mean was computed: TWM= TWS TF Where: TWM total weighted mean TWS total weighted score TF total frequency

Scale Equivalent to the weighted points 2.24 -3.0 = fast

1.67 -2.33 =moderate 1.00 -1.66 =slow

To determine the dangers in self medications percentage of frequency was also computed.

Laguna State Polytechnic University Sta. Cruz, Campus Sta. Cruz, Laguna

COLLEGE OF NURSING

Survey Questionnaire on the effects of self medications in the health status of the in the residents of Brgy Sto. Angel Norte Sta. Cruz, Laguna.

Magandang Araw po sa inyo! Ako po ay isang mag- aaral ng Laguna State Polytechnic University ng Sta. Cruz, Laguna sa larangan ng Nursing. Ito po ay naglalayon upang malaman ang inyong dahilan at kaalaman sa paggamit o paginom ng mga gamot sa inyong sariling desisyon. Ito po ay hindi isang pagsusulit kundi isang pang-akademikong pangangailngan. Maraming Salamat po!!

Pangalan(optional):________________________________ Tirahan:_________________________________________

Panuto: Lagyan ng check ( ) ang inyong sagot sa bawat katanungan. I. Demograpiya ng mga Respondents

Personal na Datus Edad ( ) 18-21 taong gulang ( ) 22-31taong gulang ( ) 32 taong gulang o higit pa y Kasarian ( ) Babae ( ) Lalaki y Antas ng pagaaral Elementarya Sekondarya Kolehiyo ( ) Nakapagtapos ( ) Di Nakapagtapos ( ) Nakapagtapos ( ) Di Nakapagtapos ( ) Nakapagtapos ( ) Di Nakapagtapos

Hindi Nakapagaral ( ) y Nagtatrabaho ( ) Oo ( ) Hindi

Panuto: Sagutan ang mga palatanungan sa abot ng inyong pagkakaunawa o makakaya. Lagyan ng check ( ) ang inyong sagot sa bawat katanungan. 5- Lubos na Sumasang Ayon 4- Sumasang Ayon 3- Hindi Tiyak o sigurado 2- Hindi Sumasang ayon 1- Lubos na Hindi Sumasang Ayon

A. MGA NAIDUDULOT NG PAGGAMIT NG GAMOT SA SARILING DESISYON 1. Nakapagdudulot ng magandang epekto sa kondisyon. 2. Hindi magandang dulot sa kondisyon/ pangit na epekto sa pakiramdam. 3. Walang naitutulong sa kondisyon. 4. Naiiwasan ang paglala ng hindi

magandang kondisyon.

Maraming salamat po sa inyong pakikiisa at naway patnubayan kayo ng Poong Maykapal

Prepared by: Nergelyn Cardoza Gauna