Sample Thesis (Nursing Graduate School) Template

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UNIVERSITY OF THE EAST RAMON MAGSAYSAY MEMORIAL MEDICAL CENTER, INC.

MEDITATION, PRAYER AND PRESENCE (MPP) AND ITS INFLUENCE ON

UNCERTAINTY, COPING AND ADHERENCE TO ANTIRETROVIRAL THERAPY

AMONG PERSONS LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS

A Thesis

Presented to

The Faculty of the Graduate School

University of the East

Ramon Magsaysay Memorial Medical Center, Inc.

In partial fulfillment

Of the Requirements for the Degree

Master of Science in Nursing

By

Sr. Cleofe M. Macalino, SMI, RN

2014

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This thesis hereto entitled:

MEDITATION, PRAYER AND PRESENCE (MPP) AND ITS INFLUENCE ON

UNCERTAINTY, COPING AND ADHERENCE TO ANTIRETROVIRAL THERAPY

AMONG PERSONS LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS

Prepared and submitted by Sr. Cleofe M. Macalino, in partial fulfillment of the requirements for the degree Master of Science in Nursing major in Adult Health has been examined and isrecommended for acceptance and approval for ORAL EXAMINATION.

___________________________________ WILHELMINA Z. ATOS, PhD, RN

Adviser

Approved by the committee on Oral Examination with a grade of PASS on March 22, 2014.

______________________________ GLENDA S. ARQUIZA, PhD, RN

Chair

________________________________ _______________________________ NORMA G. NASTOR, MAN, RN CARMELITA R. SALVADOR, MAed

Member Member

Accepted in partial fulfillment of the requirements for the degree of Master of Science in Nursing major in Adult Health.

_______________________________________MARIA LUISA T. UAYAN, DHSc, MSN, RN

Program Coordinator MSN/MAN

________________________________________ GEMILIANO D. ALIGUI, MD, MPH, PhD

Dean Graduate School

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ACKNOWLEDGEMENTS

For the people who have made this study possible, first of all I would like to

express my deepest gratitude to Dr. Wilhelmina Z. Atos, my thesis adviser, for her

invaluable guidance, wisdom and genuine support throughout the course of this study.

With heartfelt gratitude to Dr. Carmelita C. Divinagracia, for her encouragement,

trust and confidence in me, and most importantly for allowing me to adapt her

COMPOSURE Behavior Model in my study.

To Dean Gemiliano D. Aligui for his kind understanding and patience, to Dr. Luisa

T. Uayan, for her enthusiasm, concern and generous support, to my thesis panellists:

Dr.Glenda S. Arquiza, Mrs. Norma G. Nastor and Mrs. Carmelita R. Salvador for their

helpful suggestions and expertise, to my professors in the College of Nursing and

Graduate School who inspired and motivated me, for the knowledge shared and lessons

learned from them.

I would like to acknowledge the financial support extended to me by the

Commission on Higher Education (CHED) in the grant of a postgraduate research

scholarship through the UERM College of Nursing that provided me the necessary

financial support for this research.

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My sincerest thanks to Rev. Fr. Rodolfo Vicente Dan Cancino, MI, Director of St.

Camillus Woodwater Center for Healing and Miss Gerlita Enrera, Social Worker, for the

invaluable help and support extended to me; to Mr. Paul Darren Katigbak and Mr. Sharl

Lucero, Nurse - Research Assistants, for their time and efforts in data collection. I will

always be thankful.

I am truly grateful to all my sisters in the Philippine Delegation for their spiritual

and moral support especially to Sr. Bernadette Faustino and Sr. Liberty Elarmo; to Sr.

Asuncion Gipoleo and to my sisters of OMD community – Sr. Veronica Mondia, Sr. Fe

Santos and Sr. Teofanisa Ochavo for their loving presence, care and understanding.

To Sr. Benilda Quimio for allowing me to use the prayer “I pray you O Lord”

which she composed; for her availability and generosity in translating the questionnaires

in my study thank you so much.

To the positive community who have willingly participated in this study; for their

insightful reflections and sincerity. May this serve as one pathway that will lead them to

embark on a spiritual journey with God.

I would also like to extend my thanks to my classmates and friends in the Graduate

School for the encouragement, suggestions and companion.

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I am most grateful to my parents, my brothers Bong and Jone, and my sisters

Jeannette and Lingling especially to my mother Vicky who is always there for me; for her

selfless love and loving support.

And most importantly to God in whom I dedicate and offer this work, for the gift

of my life and my vocation, for nourishing my spirit and giving me the inner strength

that I need, and for everything that He has done for me particularly for the people who

were instruments in making this study possible with my deepest gratitude.

Sr. Cleofe M. Macalino SMI, RN

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ABSTRACT

Macalino, Cleofe M. (2014) MSN Major in Adult Health. University of the East Ramon Magsaysay Memorial Medical Center. Meditation, Prayer and Presence and its Influence on Uncertainty, Coping, and Adherence to Antiretroviral Therapy among Persons Living with

Human Immunodeficiency Virus

This study aimed to determine the influence of meditation, prayer, and presence (MPP) to

the adherence of antiretroviral therapy (ART) among the respondents. It specifically

sought to answer the following: the level of uncertainty and adherence before and after

meditation, prayer and presence, the coping styles utilized; relationship between level of

uncertainty, coping styles utilized and adherence to ART; factors that influence level of

uncertainty, coping, and adherence to ART; lastly, relationship between uncertainty and

adherence before and after MPP.

It utilized a quantitative, descriptive correlation method of study. This design is a one

group pretest – post test for single group. Sampling method utilized was non-probability

snowball sampling. Sixty (60) persons living with HIV were recruited but only 30 of

them were qualified. St. Camillus Woodwater Center for Healing was the site of the

study. The following were the tools utilized in this study Mishel Uncertainty in Illness

Scale-Community form (MUIS-C), the Jalowiec Coping Scale (JCS) and the Visual

Analogue Scale (VAS). Statistical program system software (SPSS) tool box was the

method of analysis used to obtain statistical

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data. Results shows that there was a slight decrease in the level of uncertainty and a

marked decrease in adherence before and after MPP, coping style most often used was

supportant (mean = 0.53) and coping style used as most effective was optimistic (mean =

0.13). There is a low negative correlation between uncertainty and coping. Gender and

educational background were the factors found to be significant in terms of level of

adherence. There was a significant difference among the three variables between coping

and uncertainty (p-value = 0.033), uncertainty and adherence (p-value = 0.000), coping

and adherence (p-value= 0.000) before and after MPP.

Therefore, the results showed that there is a positive correlation among the three variables

and that the intervening variables - meditation, prayer and presence can influence a

person’s perceived uncertainty, coping and degree of adherence to antiretroviral therapy.

Thus meditation prayer and presence can be used as an intervention in clinical settings as

a complementary therapy or as an adjunct to a therapy particularly for ART adherence

among persons with HIV.

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TABLE OF CONTENTS

Page

Title page i

Approval sheets ii

Acknowledgements iii

Abstract iv

Table of Contents viii

List of Tables xi

List of Figures xii

Appendices xiii

I. INTRODUCTION 1

Review of Related Literature 3

Theoretical Framework 21

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Conceptual Framework 22

Statement of the Problem 23

Definition of Terms 24

II. METHODS 27

Research Design 27

Participants 27

Sampling 27

Setting 28

Measures 29

Procedures for Meditation, Presence and Prayer 31

Data Analysis and Treatment 32

III. RESULTS 34

IV. DISCUSSION 40

A. Respondents Demographic Profile 40B. Level of Uncertainty and Adherence 41C. Coping Styles Utilized 42D. Level of Uncertainty and Coping 45E. Factors that Influence Level of Uncertainty, Coping and Adherence 46F. Meditation, Prayer and Presence, and Adherence 49

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Limitations of the Study 51

V. CHAPTER V 52

Summary of Findings 52

Conclusion 53

Recommendations 53

References 54

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List of Tables

Table 1: Demographic Profile of Respondents 34Table 2: Level of Uncertainty and Adherence to ART of

Respondents Before and After MPP 35Table 3: Coping Styles Often Utilized 35Table 4: Coping Styles Utilized as Effective 36Table 5: Correlation between Levels of Uncertainty,

Coping Styles and Adherence 36

Factors that Influence Respondents ‘Level of Uncertainty, Level of Coping and Level of Adherence 37

Table 6: Age, Gender, Educational Background, Latest CD4 37Count and Level of Coping

Table 7: Age, Gender, Educational Background, Latest CD4 37Count and Level of Uncertainty

Table 8: Age, Gender, Educational Background, Latest CD4 38Count and Level Adherence

Table 9: Significant Differences in Uncertainty and Adherence 38to ART after Meditation, Prayer and Presence

Table 10: Summary of Significant Results 39

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List of Figures

Figure 1: Schematic Presentation of Mishel’s Theory of Uncertainty 21

Figure 2: Adaptation of Merle Mishel’s Uncertainty in Illness Theory 22

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APPENDICES

A.1 “COMPOSURE BEHAVIORS” Nursing Measure Protocol (CBNMP) - Presence 65A.2 “COMPOSURE BEHAVIORS” Nursing Measure Protocol (CBNMP) –Prayer 67A.3“COMPOSURE BEHAVIORS” Nursing Measure Protocol (CBNMP) –Meditation 68B. I Pray You O Lord 71C. Mishel Uncertainty In Illness Scale – Community Form 72D. Jalowiec Coping Scales (English) 75

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Sample Thesis (Nursing Graduate School) Template