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Foundation UniversityCollege of NursingDumaguete City

KNOWLEDGE, ATTITUDE, AND PRACTICES ON COMPLEMENTARY ANDALTERNATIVE MEDICINE AND MODERN MEDICINE

IN RELATION TO HEALTH STATUS

Pangalan (Optional): _________________________ Edad: ______________

Part I: Demographic Profile

Instraksyon:

Palihog butangi og tsek ang blangko na koresponde sa inyong mga tubag

Grado na nahuman:Elementary Level ( ) Elementary Graduate ( )

High School Level ( ) High School Graduate ( ) Collage Level ( ) College Graduate ( )

Vocational Course( ) Post-Graduate( )Others, please specify: _____________

Relihiyon Roman Catholic ( )Islam ( )Christian-Protestant ( )Others, please specify: _____________

Net Family Monthly Income: 5,000.00 paubos ( )5,001.00 - < 10,000.00 ( )10,001.00 - < 15,000.00 ( )15,001.00 - < 20,000.00 ( )20,001.00 pataas ( )

Part II: Alternative Medicine

A. Knowledge

1. Unsa nga mga kultura og tradisyon nga naka impluwensiya sa imung desisyon kabahin sa panglawas? (Tseke tanan nga ma apply)

Chinese

Asian

Thai

American

Others, please specify: ___________

No Influence

2. Unsa nga relihiyon ang naka impluwensiya sa imung desisyon kabahin sa imung panglawas? (Tseke ang tanan na ma apply)

CatholicIslamChristian Protestant Jehovah’s WitnessOthers, please specify: ___________No Influence

3. Unsaon nimu pag ranko ang panglawas na kondisyon sa imung pamilya?

Excellent ( ) - Normal; walai complikado; walai ebidensyang bisan unsa na sakit; makatrabaho.Very Good ( ) – Makabuhat ra sa pang-adlaw2x nga buluhaton; naay gamayng gibati.Good ( ) – Makabuhat sa buluhaton pero naay gamayng gibati; Fair ( ) - Dili makabuhat ra sa pang-adlaw2x nga buluhatonPoor ( ) – Grabe nah, kinahanglan tambalan daun

4. How much time does it take to reach the following health care facilities or providers that are closest to your household?

( ) 1 hour ( ) 2 hours ( ) 3 hours ( ) 4 hours others, pls. specify: __________

5. Has anyone in this household been ill in the past two weeks with an acute illness? An acute illness is a condition that appears suddenly: the person did not have it immediately before becoming ill.

( ) Yes ( ) No

If No, Skip Questions 6-8

6. What type of health problems/symptoms did the sick member have during this illness?

7. How serious do you think this illness was? ( ) Very Serious ( ) Somewhat Serious ( ) Not Serious

8. At any point, did you or anybody else your behalf seek care for this illness outside the home? ( ) Yes ( ) No

9. From which of the following sources of care did the sick member receive care at any time during the illness?( ) Medical doctor (M.D., D.O.) including specialists

( ) Nurse, Nurse Practitioner, or Physician Assistant

( ) Chiropractor, Acupuncturist, or Naturopath

Others, pls. specify: _______________

B. Practice

10. Did he/she take any medicine during the acute illness, including medicines taken during hospitalization? ( ) Yes ( )No

Part B: Therapies and providers that you have used

11. Have you used complementary/alternative medicine (CAM) for: (Check all that apply)

1 □ preventing illness

2 □ treating illness

3 □ promoting health

4 □ I have never used CAM

5 □ Other________________________

12. If you answered that you have never used CAM, skip to Part C.

13. Identify the statement that best describes your health care practices:

1 □ I use CAM only

2 □ I use CAM with treatments given to me by my medical doctor

14. Which natural health products and therapies do you use or have you used in the past? (Check all that apply)

□ Acupuncture

□ Acupressure

□ Aromatherapy

□ Spiritual Healing

□ Herbal medicine

□ Massage

□ Meditation

□ Music therapy

□ Reflexology

□ Relaxation/Breathing technique

□ Shiatsu

□ Traditional Chinese Medicine

□ Therapeutic Touch

□ Vitamins and minerals

□ Yoga

□ Others please specify; ____________________

15. Identify the statement that best describes your intake of natural health products. A natural health product includes vitamins and minerals. (Check only one box)

1 □ I do not take natural health products

2 □ I take natural health products on a daily basis

3 □ I take natural health products on a weekly basis

4 □ I take natural health products on a monthly basis

5 □ I take natural health products once a year

6 □ I take natural health products less often than once a year

7 □ Other_________________________________

16. Identify the statement that best describes your level of involvement with a CAM provider. (Check only one box)

1 □ I do not see CAM providers

2 □ I see CAM providers on a daily basis

3 □ I see CAM providers on a weekly basis

4 □ I see CAM providers on a monthly basis

5 □ I see CAM providers once a year

6 □ I see CAM providers less than once a year

7 □ Other_________________________________

Part C: Your Attitude about CAM use

Listed below are a number of statements concerning your beliefs about CAM use? For each statement you should circle the number that corresponds most closely to your belief. Circle only one number. Please do not miss any statements.

Strongly Disagree

Disagree Haven’t decided

Agree Strongly agree

1 CAM providers give good information on maintaining a healthy lifestyle

1 2 3 4 5

Strongly Disagree



2 There are less side effects when taking natural remedies

1 2 3 4 5

3 CAM involves natural plant formulas which are more healthy than taking drugs given by the medical doctor

1 2` 3 4 5

4 Young adults would be more likely to use CAM if there were more CAM clinics

1 2 3 4 5

5 Young adults are more empowered when using CAM because CAM providers involve them in decisions about their health care treatments

1 2 3 4 5

6 Young adults believe that CAM builds up the body’s own defenses and promotes self-healing

1 2 3 4 5

7 The more knowledge a young adult has about CAM, the more likely he/she is to use it

1 2 3 4 5

8 Parent(s) and family can influence a young adult’s CAM use by exposing them to it

1 2 3 4 5

Strongly Disagree



9 Young adults are more likely to use CAM if their friends are using it

1 2 3 4 5

10 Young adults are more likely to use CAM if coaches and teachers discuss it with them

1 2 3 4 5

11 Young adults who believe in the physical, mental and spiritual aspects of health are more likely to use CAM

1 2 3 4 5

12 Young adults who fear the discomfort of treatments from medical doctors are more likely to use CAM

1 2 3 4 5

13 Young adults believe that taking CAM therapies is not harmful

1 2 3 4 5

Part III: Modern Medicine

Instruction:

The following questions will determine the extent of your knowledge, attitude and degree of use of modern medicine for treating various illnesses/diseases/conditions. Please indicate your answer by placing a check mark in the appropriate box.

A. Knowledge

Answer Guide:

1. Are you aware that there are modern medicines for treating various illnesses/diseases/conditions?

5 4 3 2 1

B. Attitude

Instruction:

The following question will determine the extent of your belief in the healing properties of modern medicine. Please indicate your answer by placing a check mark in the appropriate box.

Answer Guide:Scale Percentage Verbal Description5 (4.21-5) Modern medicine

is believed 81-100% of the time

Strongly Believe

4 (3.41-4.20) Modern medicine is believed 61-80% of the time

Moderately Believe


Somewhat Believe


Slightly Believe

Scale Percentage Verbal Description5 (4.21-5) Modern medicine is known

81-100% of the timeExtremely Aware

4 (3.41-4.20) Modern medicine is known 61-80% of the time

Moderately Aware


Somewhat Aware


Slightly Aware

1 (1-1.80) Modern medicine is known 0-20% of the time

Not at all Aware

1 (1-1.80) Modern medicine is believed 0-20% of the time

Don’t believe at all

Do you believe in the ability of modern medicine to cure illnesses and diseases?

5 4 3 2 1

C. Practices

Instruction:

The following question will determine the extent of your use of modern medicine. Please indicate your answer by placing a check mark in the appropriate box.

Answer Guide:Scale Percentage Verbal Description5 (4.21-5) Modern

medicine is used 81-100% of the time

All the time

4 (3.41-4.20) Modern medicine is used 61-80% of the time

Very often


Often


Sometimes

1 (1-1.80) Modern medicine is used 0-20% of the time

Never

How often do you and your family use modern medicine for the following illnesses or diseases?

Medical Conditions 5 4 3 2 1Skin infections/ allergiesCough and coldsFever

Stomach painsDiarrheaConstipationCholesterol ControlToothacheHeadacheAsthmaDyspepsia/ KabagBoils/ Hubag- HubagDisinfect woundsIntestinal wormsUrinary StonesGargle for stronger teeth and prevent cavitiesGout/Arthritis/RheumatismDiabetesHigh blood pressureDengue fever

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