FACTORS AFFECTING COMPLIANCE TO THE TREATMENT REGIMEN

An Undergraduate Thesis

Presented to the Faculty of the School of Nursing Mindanao Sanitarium and Hospital College Brgy. San Miguel, Iligan City

In Partial Fulfillment of the Requirements for the Degree BACHELOR OF SCIENCE IN NURSING

NORHANA T. GULAM YASMINAH E. ISAAH

March 2011 APPROVAL SHEET The thesis entitled, FACTORS AFFECTING COMPLIANCE TO THE TREATMENT REGIMEN, prepared and submitted by Norhana T. Gulam and Yasminah E. Isaah in partial fulfillment of the requirements for the degree BACHELOR OF SCIENCE IN NURSING, has been examined and is hereby endorsed. ROSELYN S. PACARDO, MAN, MM, RN, RM Adviser ______________________________________________________________ PANEL OF EXAMINERS Approved by the Committee on Oral Examination with a grade of PASSED. DANILO R. ECARMA, MATCS Chairman _________________ Date Signed
STEPHANIE S. MONTE, BS Stat ROSELYN S. PACARDO, MAN, MM, RN, RM

Statistician ___________ Date Signed Date of Proposal Hearing: October 21, 2010 Date of Oral Examination: March 15, 2011

Adviser ___________ Date Signed

GTER G. GAID, MAN, RN Dean, School of Nursing _______________ Date Signed

ii

iii

DEDICATION
We dedicate this work to our parents, brothers, and sisters. Also to all loved ones who supported and inspired us in our studies. Though, there are high spots in all of our lives, and most of them come about through encouragement from YOU!

Norhana
iv

Yasminah

ACKNOWLEDGMENT The researchers would like to extend their heartfelt thanks to all those people, who in one way or the other, have contributed to the realization of this study. This paper is the result from the labor of many hands and a product of minds. Expressions of warmest gratitude are extended to the following people who have made this study possible: To Roselyn S. Pacardo,MAN, MM, RN,RM, Thesis Adviser, for her advice, support, and continuous guidance in the preparation of this study; To Stephanie S. Monte, BS Stat for her patience in helping and for her expertise in statistics; To Danilo R. Ecarma, MATCS, Panelist, for his detailed and constructive comments just to improve this paper. His kind support and guidance have been of great value in this study; To Merlin M. Espinosa, DM, MAN, RN, Research Coordinator, who offered her comments, suggestions and for constant reminders to beat the deadline to finish this undergraduate thesis; To Desiderio A. Pagdato, Jr. BSED, MAELS, Editor, for content, grammar, and style just to improve clarity and accuracy of this paper; To Noemi T. Morente, MAN, RN, Director of Nursing Service of Mindanao Sanitarium and Hospital for allowing the researchers to conduct the study at the hospital;

vi

To the respondents and their families, for being cooperative during the gathering of data and the trust given; To their parents, for the steadfast support, financially and emotionally. This study would not be made possible without you; To their friends and classmates, for their encouragement and countless assistance for the benefit of the study; and Above all, to the Almighty God, who gave the strength to hurdle the difficulties in making this study a reality.

The Researchers

vii

ABSTRACT Title Researchers School Degree Adviser Date of Defense : : : : : : FACTORS AFFECTING COMPLIANCE TO THE TREATMENT REGIMEN Norhana T. Gulam and Yasminah E. Isaah

Mindanao Sanitarium and Hospital College Bachelor of Science in Nursing Roselyn S. Pacardo, MAN, MM, RN, RM March 15, 2011

This study aimed to determine the factors affecting compliance to the treatment regimen by the clients who had their medical consultation at the Out-Patient Department, Mindanao Sanitarium and Hospital (MSH), Iligan City. The independent variables of this study are the factors affecting compliance in terms of financial, doctor-patient relationship, psychological, and physical difficulties. The intervening variable focused on the respondents profile which included the age, occupation, educational attainment, and monthly income. The dependent variable is the compliance to the treatment regimen. The study used a descriptive survey research design. A questionnaire was created as the principal instrument in gathering the data which was first validated among ten (10) clients and who were not included in the final list of respondents. A total of 50 clients from the out-patient

viii

department of MSH served as respondents of the study. The data were tested through the use of frequency, percentage, and mode. The findings of the study revealed that 21 or 42% of the respondents were aged 20-39 years old, 20 or 48 % belonged to 42- 59 years old, 18 or 45% had a monthly income of 10,000 and above, 36 or 72 % were college level/ graduates, and 25 or 50 % had no occupation. In terms of financial factors, expensive medicine was the major factor why respondents did not comply with the treatment regimen. In terms of doctor-patient relationship respondents chose the trustworthiness of the doctors as the reason of compliance to the treatment regimen. The respondents rated that they were highly motivated to follow the treatment regimen in terms of psychological factors. Lastly, in the physical difficulties factors, respondents had chosen sensory problem such as vision and hearing problems as their reasons why they did not comply with the treatment regimen. Majority of the respondents chose that doctor- patient relationship and psychological factor (43) are the two most important factors affecting compliance to the treatment regimen, followed by the financial factor (28) and physical difficulties (24) as the last factor affecting compliance to the treatment regimen.

ix

Majority of the respondents were in their early and middle adulthood, with high educational attainment, with a socio-economic status belonging to the poverty level or low middle class. The trustworthiness of the doctors, being highly motivated, expensive medicine, and sensory problems are the most common factors that would affect compliance to the treatment regimen. Patients should be aware of the effects and consequences of being non- compliant to the treatment regimen. Significant others must motivate the patients to have a positive attitude towards complying with treatment regimen and discourage beliefs and worries about the treatment consequences. Physicians should look into the importance of good communication to build a healthy relationship between patient and physician based on emotional support, giving reassurance or respect and treating patient as an equal partner in the treatment plan, and giving a detailed explanation about the disease and treatment. The nurses should continue to provide quality nursing care to the patients in order to enhance patient satisfaction, thus, improve their quality care service for the patients. Nurses should instruct patients regarding their compliance to the treatment regimen. The future researchers may conduct a similar study to determine other factors that may affect the compliance to the treatment regimen. It is also x

recommended that the future researchers will increase the number of respondents. Since the study was conducted in one hospital, a similar study can be done in other hospitals also. This study aimed to determine the factors affecting compliance to the treatment regimen by the clients who had their medical consultation at the Out-Patient Department, Mindanao Sanitarium and Hospital (MSH), Iligan City. The independent variables of this study are the factors affecting compliance in terms of financial, doctor-patient relationship, psychological, and physical difficulties. The intervening variable focused on the respondents profile which included the age, occupation, educational attainment, and monthly income. The dependent variable is the compliance to the treatment regimen. The study used a descriptive survey research design. A questionnaire was created as the principal instrument in gathering the data which was first validated among ten (10) clients and who were not included in the final list of respondents. A total of 50 clients from the out-patient department of MSH served as respondents of the study. The data were tested through the use of frequency, percentage, and mode. The findings of the study revealed that 21 or 42% of the respondents were aged 20-39 years old, 20 or 48 % belonged to 42- 59 years old, 18 or 45% had a monthly income of 10,000 and above, 36 or 72 % were college level/ graduates, and 25 or 50 % had no occupation. xi

In terms of financial factors, expensive medicine was the major factor why respondents did not comply with the treatment regimen. In terms of doctor-patient relationship respondents chose the trustworthiness of the doctors as the reason of compliance to the treatment regimen. The respondents rated that they were highly motivated to follow the treatment regimen in terms of psychological factors. Lastly, in the physical difficulties factors, respondents had chosen sensory problem such as vision and hearing problems as their reasons why they did not comply with the treatment regimen. Majority of the respondents chose that doctor- patient relationship and psychological factor (43) are the two most important factors affecting compliance to the treatment regimen, followed by the financial factor (28) and physical difficulties (24) as the last factor affecting compliance to the treatment regimen.

Majority of the respondents were in their early and middle adulthood, with high educational attainment, with a socio-economic status belonging to the poverty level or low middle class. The trustworthiness of the doctors, being highly motivated, expensive medicine, and sensory problems are the most common factors that would affect compliance to the treatment regimen.

xii

Patients should be aware of the effects and consequences of being non- compliant to the treatment regimen. Significant others must motivate the patients to have a positive attitude towards complying with treatment regimen and discourage beliefs and worries about the treatment consequences. Physicians should look into the importance of good communication to build a healthy relationship between patient and physician based on emotional support, giving reassurance or respect and treating patient as an equal partner in the treatment plan, and giving a detailed explanation about the disease and treatment. The nurses should continue to provide quality nursing care to the patients in order to enhance patient satisfaction, thus, improve their quality care service for the patients. Nurses should instruct patients regarding their compliance to the treatment regimen. The future researchers may conduct a similar study to determine other factors that may affect the compliance to the treatment regimen. It is also recommended that the future researchers will increase the number of respondents. Since the study was conducted in one hospital, a similar study can be done in other hospitals also.

xiii

TABLE OF CONTENTS Page TITLE PAGE APPROVAL SHEET DEDICATION ACKNOWLEDGMENT ABSTRACT TABLE OF CONTENTS LIST OF TABLES LIST OF FIGURES Chapter 1 THE PROBLEM AND ITS SCOPE Introduction Theoretical Framework Conceptual Framework Statement of the Problem Scope and Delimitation Definition of Terms 2 REVIEW OF RELATED LITERATURE AND STUDIES Related Literature Related Studies 3 RESEARCH METHODOLOGY Research Design Research Locale Respondents of the Study Instrument and Its Validity Sampling Technique Data Gathering Procedure Statistical Tools 4 PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA 24 24 25 25 26 26 26 28 13 14 1 2 5 9 11 11 i ii iii iv vi xi xii xiii

xiv

SUMMARY, FINDINGS, CONCLUSIONS AND RECOMMENDATIONS Summary Findings Conclusions Recommendations 38 39 40 40 42

BIBLIOGRAPHY APPENDICES Questionnaire Letter CURRICULUM VITAE

44 48 49

xv

LIST OF TABLES Table 1 2 3 4 5 6 Distribution of Respondents Profile in Terms of Age Distribution of Respondents Profile in Terms of Estimated Monthly Income Distribution of Respondents Profile in Terms of Educational Attainment Distribution of Respondents Profile in Terms of Occupation Distribution of Factors Affecting Compliance to the Treatment Regimen in Terms of Financial Factors Distribution of Factors Affecting Compliance to the Treatment Regimen in Terms of Doctor- Patient Relationship Distribution of Factors Affecting Compliance to the Treatment Regimen in Terms of Psychological Factors Distribution of Factors Affecting Compliance to the Treatment Regimen in Terms of Physical Difficulties Distribution of factor Affecting Compliance to the Treatment Regimen According to their Rank Page 28 29 30 31 32 33

7 8 9

34 35 36

xvi

LIST OF FIGURE Figure 1 Schematic Diagram of the Study Showing the Relationship between the Independent and Dependent Variables Page 8

xvii