Chapter III

METHODOLOGY
Locale of the Study
Northern Samar, Philippines is located in the Eastern

Visayas region. Its capital is Catarman and is located at

the northern portion of the island of Samar. Northern Samar

consist of 1st and 2nd district with 536 barangays, and a

total population of 637,379.

One of the barangays in Catarman which is the barangay

Aguinaldo, Northern Samar where we will conduct our

research study is consist of 108 households, with a total

population of 500 as of 2015.

Source of live hood of the resident in barangay

Aguinaldo are agriculture, palay and crop production, while

some are small business. The barangay is dominated by

Catholicism, other religions continuously existing like

Iglesia ni Cristo, Church of the Latter Day Saints, Aglipay

and Jehova’s Witness.

Research Design
 This study uses the descriptive approach. This

descriptive type of research will utilize observations in

the study. To illustrate the descriptive type of research,

(1994) will guide the researcher when he stated:

“Descriptive method of research is to gather information

about the present existing condition. The purpose of

employing this method is to describe the nature of a

situation, as it exists at the time of the study and to

explore the cause/s of particular phenomena.” The research

described in this document is based on qualitative and

quantitative method. The qualitative method permits a

flexible and iterative approach, while the quantitative

research method permits specification of dependent and

independent variables and allows for longitudinal measures

of subsequent performance of the research subject. During

data gathering the choice and design of methods are

constantly modified, based on ongoing analysis. This allows

investigation of important new issues and questions as they

arise, and allows the investigators to drop unproductive

areas of research from the original research plan.

The Variables
 The independent variable includes the profile of the

respondents in terms of age, sex, civil status, educational

attainment, and monthly income. Age is the length of time a

person has existed. Sex is the distinction of a person,

whether male or female. Civil status is any of several

distinct options that describe a person’s relationship with

significant other. Married, single, divorced, and widowed

are examples of civil status. Educational attainment refers

to the highest level of education that an individual has

completed. Monthly income refers to all remuneration

received before deduction of the employee Central Provident

Fund (CPF) contributions and personal income tax. It

comprises basic wages, overtime pay, commissions,

allowances and bonuses but exclude employer CPC

contributions. Using frequency and percentage, the profile

will be tallied and computed.

The dependent variable includes the factors affecting

the quality care among clients in regards to their medical

myths and quack practices in health care process in

District 2, Northern Samar. The prevalence of the study can

be measured with the total number of respondents who still

practice medical myths and quack practices in health care

process that could contribute in the care of clients.

Population and Sampling

The populations of families of the study are the

residents of Brgy. Aguilando Catarman, Northern Samar with

the total numbers of families 101. In our study, medical

myths and quack practices in health care process in

Barangay Aguinaldo. We use the systematic random sampling

technique is the random sampling method that requires

selecting samples based on system of intervals in a

numbered population. Also in this technique, each of the

families has an equal chance of being selected as a

subject. This interval, called the sampling interval, is

calculated by dividing the family size by the desired

sample size. 80-85 families should be the adequate sample

to evaluate the prevalence and intensity of health

practices. Thus, 80 respondents randomly selected where

included in the final same.

The Respondents
 The respondents of this study are any family members

of the family in the Barangay Aguinaldo, Catarman, Northern

Samar. A total of 80 respondents will be included in the

sample of the study to represent the whole population.

Research Instrument

The researchers design a questionnaire for the survey.

The primary aim of the questionnaire is to determine the

impact of medical myths and quack practices in health care

process in Barangay Aguinaldo. This research uses a mixture

of closed questions and more open comments in the

questionnaire. A closed question is one that has pre-coded

answers. The simplest is the dichotomous question to which

the respondent must answer yes or no. Through closed

questions, the researcher will be able to limit responses

that are within the scope of this study. For example, the

researcher intends to ask the respondents what they think

of medical myths and quack practices in general. Using a

multiple choice method, the answer of the respondents would

be within one of the limited expected answers of the

researcher. Thus the researcher design a closed question

type to remain focused on the statement of the problem and

on the main purpose of the study. However, the researcher

nevertheless extends the closed questions with the comments

option to be able to gather qualitative data for this

study. In addition, closed questions were used in the

survey because the answers are easy to analyse and are

straightforward as target respondents are mostly busy that

they do not have enough time to give attention to open

questions. Closed response questions save the respondent

having to think of possible replies. Two sets of

questionnaire will be used in this study. The first set is

a survey-questionnaire that used to gather data from 80

respondents in Barangay Aguinaldo and the other

questionnaire was used to know the perception of barangay

healthcare officials in the area. Each of the

questionnaires consists only ten questions in order to make

sure that the respondents answer all the given questions.

Validation of Research Instrument

 For the questionnaire to be valid, reliable, and

effective, a pre-test to non-sample respondents will be

conducted to validate the content of the questionnaire

whether the questions jibed with the statement of the

problem.

The survey questionnaire will be pre-tested to the

Barangay Dalakit Catarman Northern Samar, which are not

included in the study, with the same type and kind of

respondents and sampling technique that will be used.

After filling up the questionnaires, it will be

retrieved by the researcher to find out their assessment of

the questionnaire. They will then ask if all the items are

clear and unequivocal to them.

Questions and comments regarding the test question

will be entertained so as to help the researcher make the

instrument more specific and measurable.

After the validation, the researcher consults an

English critic to edit the questionnaire which revisions

stemmed from the trial done to make the instruments final

for fielding.

Data Gathering Procedure

 In this study, the collection of data is will be the

use of plain survey. Permission to conduct the study will

be obtained from the barangay officials in Barangay

Aguinaldo, Catarman Northern Samar through a communication

letter signed by all the researchers and noted by the

adviser and the dean. Once permission to conduct the study

is granted, the plain survey will be done by using a random

sampling technique. Survey form will also be administered

by the researchers and will also retrieve after the

respondents had finish answering it.

Information and response of the respondents are

processed and subjected to statistical treatment. The

findings will be extracted and analyzed based on the

processed data.

Statistical Treatment

Based on the objectives of the study, the

following statistical tools with corresponding formula have

been used to analyze the data. The statistical treatment of

data used in this study is through systematic simple

technique, sample mean test, and Z-test.

A. Systematic Sampling Technique

 The systematic sampling technique is operationally

more convenient than the simple random sampling. It also

ensure at the same time that each ™unit has equal

probability of inclusion in the sample. In this method of

sampling, the first unit is selected with the help of

random numbers and the remaining units are selected

automatically according to a predetermined pattern. It is a

type of probability sampling method in which sample members

from a larger population are selected according to a random

starting point and a fixed periodic size by the desired

sample size.

B. Sample Mean Test

The sample mean test allows to estimate what the whole

population is doing, without surveying everyone.

x̄ = ( Σ xi ) / n

Where:

x̄ = sample mean

Σ = add up

Xi = all of the x-values

n = the number of items in the sample

 C. Z-test

It is a statistical test used to determine whether

two population means are different when the variances are

known and the sample size is large. The test statistic is

assumed to have a normal distribution, and nuisance

parameters such as standard deviation should be known for

an accurate z-test to be performed.

𝑥⎺⎼𝜇
= 𝜎
√𝑛

𝑥⎺ = Sample mean
𝜇 = Population mean
𝜎 = Population standard deviation
 Chapter ll
Review of Related literature
The study aims on identifying the medical myths and quack practices in the chosen barangay and to
know its implications with health care process. In this regard, it is necessary to study related literatures
which tackle medical myths and quack practice and health care process both from the foreign and
local settings. This part of the research will provide insightful details about healthcare process, the
context of medical myths and quack practices in the Philippines and other countries and its
implications to health care process.

Foreign Studies Health care process as a discipline is concentrated on the provision of assistance to
individuals, families and communities in order to obtain, recover and maintain optimal health status
and normal body functioning. Contemporary definitions of medical profession as a science and art,
which is concentrated on quality life as understood by people and families. Thus, health care process
is not solely focused on health recovery and care but also with the provision of quality living as well.
Health care is the process of caring for, or nurturing, for an individual known as the patient. More
specifically, health care process refers to the functions and duties carried out by persons who have had
formal education and training in the art and science of health care. To promote the restoration and
maintenance of health in their clients, healthcare practitioners became more particular in enhancing
their knowledge through integrating with health and biological sciences (1993). The provision of
holistic care for other people as well as the utilization of various complementary healing modalities is
the foundation of the health care process. Health care practitioners recognize that the responsibilities
and obligations of nurses is an essential part of the healthcare community. The authority for health
care practice is fundamentally based upon a social

contract and agreement that described and explains the professional rights as well as mechanisms for
public accountability. Health organization refers to health care process as the diagnosis and treatment
of human reactions and responses to potential or actual health problems and dilemmas. Just like
medical diagnoses that aim in helping in planning, execution or implementation and assessment of
medical care, the role of the health care practitioner is to provide help in the planning, implementation
and evaluation of healthcare (1997). There are certain factors in which health care practice are being
influenced or affected. These include the notion of alternative therapies. Alternative medicine is often
defined by the modalities that it encompasses. Additionally it may be seen as denoting a group of
theories that share certain central philosophical tenets that fall broadly into the category of holism.
However it is delineated, complementary, and alternative medicines is a broad and inclusive church.
Indeed, alternative medicine is such a diverse field that even naming it presents challenges.
Alternative medicines, including medical myths and quack practices is now known as a collection of
different therapies and healing approaches which believe in the energy of the body and the idea of a
harmony and synchronization between the mind, body and spirit. Nowadays, people think that these
therapies are an “unorthodox” alongside of the clinically proven, tested and evidenced-based orthodox
medicine, but in most part of the world, these complementary and alternative medicines has continue
to become the dominant form of medical practice (2003).

Local Studies In the Philippines, the conventional medicines and Western curative methods herbal
medicines as part of health related practices had been widely used. The curative effects of these
traditional medicines were tested by traditional healers who practices quackery on their patient on try-
and-error basis. The skills and knowledge on the curative application of any quack practices and
medical myths in the country has been handed down fro generation to generation. Aside from
prescribing herbs as curative medicines (2007), the conventional healers were known to give moral
support and psychological comfort to their patients. The medical myths and quack practices in the
county were well respected and enjoy high social status among the Filipinos. Through generations of
selective process, the medical myths and quack practices that were known to be effective and efficient
in curing diseases were kept alive. However, the ineffective one was soon forgotten. When Western
medical practice, specifically drugs just started to be used in the Philippines, the Filipinos find these as
too expensive but also too scarce. Hence, the rural folks and as well as the poor people continued to
rely on medical myths and quack practices including herbal medicines which are affordable,
abundance, locally available. The western-style medical care has reached a very restricted Filipinos,
mostly in urban cities. Medical myths and quack practices have become legacy of the history of a
certain community and the number of users is fast dwindling. Public and private Hospitals that have
sprouted up in the rural areas, provinces and later in the barangays have in no small part contributed to
the dying art of traditional healing for some regions. Despite the Public Health Ministry's dynamic
campaigns to make available medical services in these regions, the services are still considered far'
from adequate and sufficient today. It is uncertain if the modern medical services will ever be
sufficient given the limited resources and trained man-power of the Philippine health organization.
The provision of expanding medical services throughout the Philippines has been doggedly followed
for several years to the manner that authorities began questioning the necessity of some barangay
hospitals considered too close to larger provincial facilities. Those people who are unable to obtain
medical services from government hospitals resort to quack practices and drugs without prescriptions
or proper advice. The health issue have been compounded as an outcome of the misguided
consumption of modern and western drugs.

Foreign Studies The health belief system about ailments and illnesses are conceptualised as being
myth-like in lieu of explaining the cure and etiology for many human diseases. There are many studies
which examined the role played by medical myths and quack practices, alternative medicines and the
likes. In one study, they have found that health belief approaches are organised in three orthogonal
aspects. These include salves for maladies, scientific explanations of disease, and sorcerybased
explanations of illness. These studies have used gender, ethnicity, and other sociodemographic
variables as
predictors of acceptance for explaining the cause of diseases, advocating steps to cure ailments, and/or
simply treating illness as some sort of spiritual intervention. In these studies, analyses of the probable
acceptance of scientific evidence refuting folk wisdom are also examined. According to a conducted
nationwide study (1993), in 1990 there is an approximately one third of the adult population of the
United States of America who used at least one unconventional medical approach to treat illness. As
noted in the study, extrapolating the per visit costs solely of supervised health care, the annual expense
is likely to approach $14 billion a year in this country. Approximately one in four individuals who sees
a medical doctor for a serious illness may be using one of quack practice and believes in medical
myth: yet over 70% of those individuals do not tell their medical doctor--a statistic that should alarm
health care professionals including practicing pharmacists and allopathic physicians. The research
concluded that medical myths, quack practices affect the health and economy of this country. An
extensive medical anthropology documents has created a rich ethnographic map of culture-specific,
conventional health beliefs and practices (1991). Beginning with Rivers "Medicine, Magic, and
Religion" (1927) to more recent documents, articles, books, and essays found in the volumes of
Medical Anthropology and Social Science and Medicine, research scholars provide fascinating
insights into different health-related belief contexts ( 1990;1992). For instance, (1989) investigated
professional and popular/traditional medical cultures, myths with Latin Americans. (1989) studied
Asian refugees resettled in the United States to identify adaptation to Western medical practices.
(1987) provided a review of literature of Spanish-American folk medical myths and theory as
practiced in the Greater Southwest, an area they defined as northwest Mexico and southwest United
States. Medical myths and quack practices are perhaps most recognized by their lack of acceptance by
conventional Western medical practice. Because of this, most of the healthcare providers do not
typically recommend or impose the use of these medicines (2004). Since only few of the healthcare
providers are accepting the conventional medical practice, the occurrence of empirical studies are very
minimal; hence, s mall number of data exist in line medical myths and quack practices (2000).
However, even though medical myths and quack practices are lacking of acceptance and testing by
professional healthcare providers, more patients are buying and spending more on utilizing medical
myths and quack practices that ever before. In the study made by Eisenberg and his colleagues in
1998, the research discovered that 42% of American adults used complementary and alternative
therapies, which reflects an increase from 34 % of adults in 1993 ( 1998). Medical myths and quack
practices are terms often used synonymously. Technically, alternative medical therapies imply the use
of treatments in place of mainstream medicine (2000) while complementary medical therapies imply
the use of treatments that are used along with more conventional medical approaches. Both of these
groups represent a large range of therapies outside the arena of conventional Western medicine.
Because a universally agreed upon classification of the various therapies as either alternative or
complementary medicine does not exist, both terms will be used in this article to describe this
collection of medical therapies. In 1997, 42 percent of the American adult population made 629
million visits to alternative health care practitioners and spent $27 billion out-of-pocket for these
services (1998). It has been estimated that in the year 2000, Americans will spend $60 billion on
complementary and alternative medical therapies (2000). This represents over a 47% increase since
1990 in total visits to alternative medical practitioners (Eisenberg et al, 1993). This increasing demand
for and purchase of alternative and complementary medical therapies by health care consumers has
been fuelled, in part, by support from some in conventional medicine. For example, a 1994 survey of
physicians found that more than 60% of the physicians surveyed recommended alternative therapies to
their patients and 23% reported incorporating these therapies into their own practices (Borkan et al,
1994). Contrary to common opinion in the health care arena, the majority of alternative medicine users
do so not because they are dissatisfied with conventional medicine, medical myths, and quack
practices but mainly because these therapies fit their own values and philosophies regarding health
and life ( 1998). Patients choose medical myths and quack practices based on their abilities to judge
the credibility of information presented by the mass media. The public seldom conducts literature
searches of medical journals. The mass media, family, and friends provide patients with lay
information from television talk shows, local newspapers, magazines, television, and by word of
mouth testimonials regarding these therapies (1998). Often patients are desperate to improve their
health and/or quality of life, accuracy of clinical information often takes a backseat to the quest for
improved health. As the public increases its use of medical myths and quack practices, it becomes
necessary for accurate sources of information on these topics to be readily available to the public. One
of the largest groups of health professionals that are in regular contact with the public are nurses, and
it seems logical to have nurses take a significant role in assisting patients in making informed
decisions regarding alternative and complementary medical therapies. To do so, nurses will need to
become well informed regarding the efficacy and safety of alternative and complementary medical
therapies. As the evidence increases, so should the awareness and recommended use among traditional
health care providers, including nurses.

A comprehensive review of the nursing literature found few articles specifically exploring nurses'
knowledge, attitudes, and use of medical myths and quack practices (1998; 1999; 2000). All of the
studies consisted of small local samples [less than 100 nurses], and surveyed specialty areas such as
oncology ( 1998; 1999) or certified nurse-midwives (2000). In the study made by (2001) entitled
“Nurses’ Perception of Complementary and Alternative Medical Therapies”, using a random sample of
1000 nurses from American Nurses Association (ANA) they have found out that the vast majority
(79%) of nurses perceived their professional preparation in the area of medical myths and quack
practices to be fair and poor. In addition, the study found out that 1 in 4 nurses obtained their
information on complementary and alternative therapies from their coursework. Recently, nurses have
recommended the inclusion of medical myths and quack practices in the baccalaureate curriculum for
nursing preparation ( 2001). Perceived effectiveness of these therapies varied from a high of 51% for
biofeedback, chiropractic care, and meditation/relaxation, to a low of 5 percent for macrobiotic diets
and 7% for body cleansing diets. It appears as though the nurses who responded were more likely to
believe in more familiar and possibly more traditional alternative and complementary medical
therapies (e.g., biofeedback and chiropractic care). This may be due to the lack of formal training in
this area and as such, the respondents were likely to be more aware of widely used therapies such as
biofeedback and chiropractic care ( 2001). In this study also, the nurses believed that therapies that
were external (e.g., chiropractic care, acupressure, healing touch, etc.) as safest. In regards to use of
medical myths and quack practices, the majority of nurses did not personally use any of the therapies.
Almost one-third of the respondents used three therapies. These same three therapies (multivitamins,
massage, and meditation/relaxation) were also among the therapies most often recommended to others
(2001). It can be said that nursing and health care practice can use holistic nursing therapies which can
be determines as complementary in nature. Study shows that medical myths and quack practices
therapies can be considered as one of the best intervention inline with health care practice and do not
exist to replace the traditional medical or nursing therapies. In this manner, when the complementary
and alternative medical therapies are being offered, there are needs and demands that should be
considered and this include the positive and negative consequences that may be faced from all the
appropriate therapeutic choices available for the patients. Herein, nurses can facilitate the combination
of complementary, alternative, and traditional therapies for an effective and efficient patient health
plan (1998).

Synthesis This review of related literature and studies discussed different studies made about the
medical myths and quack practices in both foreign and local settings. In the given studies it can be
noted that the medical myths and practices are not only prevalence in the Philippines but also in other
regions in the World. The literature also gave us some important details on how the provision of health
care process in different areas was being affected by the medical myths and quack practices in their
area. It also indicates some important issues on how medical myths and quack practices are being used
in the Philippines and the factors that pushes the people to believe in medical myths and quack
practices. Chapter 3 Research Design and Methodology

The study aims on identifying the medical myths and quack practices and its implications to health
care process. Referring to the aim and objectives set for the dissertation, the author will now
demonstrate the methodology of the means of obtaining data for analysis and coming to the
conclusion to meet the aim and objectives. Though it does show ethnic concerns to those out there,
survey-questionnaires will be tied with the primary data research collection of this study and the
secondary research will be supported through the use of the research of other scholars as mentioned in
the literature review.