CHAPTER I
INTRODUCTION
The Problem and Its Background
The fast rising of elderly population around the globe
correspondingly means an expansion of cohesive issues that should
be answered. For the same instance that elderly person gives a
great impact to the community, there needs should be given
appropriate rendition of care and extensive understanding. The
issue that the elderly are facing is amplified and interrelated.
Our elderly should not be seen as a burden to our society. In
fact, they still can be productive citizens in their own little
ways.
As the world becomes smaller through the use of high
technology that makes it easy for travel and communication, the
importance of a more global perspective and the differences in
aging across the globe is hardly needed. Most of the countries
around the globe are experiencing a demographic transition
towards aging population. As for our country, the Philippines’
population as of the year 2012 in terms of people ages15-64 years
is 61.1% (for the male 31,103,967 and for the female 31,097,203)
and for the elderly ages 65 years and above is on 4.3% (for male
1,876,805 and for female is 2,471,644)(Philippines Demographic
Profile 2012 CIA World Factbook, July 19, 2012). In such case
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that is also prevalent to the Municipality of Catarman, Northern
Samar were in the aging population is approximately more than 600
elderly in the whole population among the 23 town proper
barangay.
Older adults collectively experience a wide array of
perceptions coming from younger society. Perceptions about older
adults vary from one to another. Family caregivers of adults also
often faced with problems as to the living options. Decision
making for older adults may be viewed by some as declining, thus
ignoring their autonomy to decide for themselves. This only shows
our responsibility and the obligation not to neglect the idea of
improving the perception of the family caregivers with regards to
the elderly because it will affect the kind of care rendered to
them.
Thus, the researchers, as future nurses equipped with the
knowledge about the care of the elderly, are inquisitive on how
the family caregivers a present perceived the elderly.
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Statement of the Problem
General Problem
This study will seek to find out the Perceptions of
Family caregivers about the biologic and psychosocial aspects of
the Elderly in Municipality of Catarman, Northern Samar.
Specific Problems
Specifically, it will seek to answer the following
questions:
1. What is the demographic profile of the family caregiver
of the elderly in terms of:
A. Age
B. Sex
C. Educational attainment
D. Relationship with elderly
E. Length of Service as caregiver
2. What are the perceptions of family caregivers in terms of
the biologic and psychosocial aspects of the elderly?
3. What is the significant relationship of the demographic
profile of the family caregivers to their perception
about the elderly in terms of their biologic and
psychosocial aspects?
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Objectives of the Study
This study aims at finding out the perception of Family
Caregivers about the elderly in the Municipality of Catarman,
Northern Samar.
Specifically, this study aims to:
1. Determine the demographic profile of the family
caregivers of the elderly in terms of age, sex,
educational attainment, relationship with elderly and
length of service as caregiver.
2. Determine the perceptions of the family caregivers about
the elderly in terms of their biologic and psychosocial
aspects.
3. Determine the relationship of the demographic profile of
the family caregivers to their perception of about the
elderly.
Significance of the Study
The findings of this study will make the family caregivers
aware about the new trends in rendering appropriate care to the
elderly persons.
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Basically, the following group of individuals and
institution will be benefited by this study;
Elderly. This study will help the elderly to know about the
perceptions of family caregivers towards them.
Family Caregivers. This study will help the family to
understand the importance of caring elderly client.
Nursing Students. The result of this study will make them
aware of the ideas to the perception of the family caregivers
towards the elderly.
Colleges of Nursing. The result of the study will help the
colleges to recognize as to what proper learning or proper
teaching to expound the perception of future nurses about
elderly.
Researchers. The result of this study will help the
researcher identify and evaluate which among of the factors
mentioned affect most the perception of family caregivers to the
elderly.
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Scope and Limitation
This study will focus on the Perception of selected family
caregivers about the elderly. It will cover the twenty-three (23)
town proper barangay out of the 46 mainland Barangays of the
municipality of Catarman Northern Samar.
Considering the financial and time constraints in conducting
of this study, the respondent will be choosen from the above the
(23) urban barangays, located in the town proper, namely: Acacia,
Airport Village, Bangkerohan, Baybay, Cabayhan, Cag-abaca,
Calachuchi, Cal-igang, Casoy, Cawayan, Dalakit, Ipil-ipil, Jose
Abad Santos, Jose P. Rizal, Lapu-lapu, Mabini, Mabolo, Molave,
Narra, Sampaguita, Santol, Talisay and Yakal. The researchers
also consider the easy accessibility of the respondents in
conducting the study. Hence, as a study of perceptions the
reliability of the finding depends on the veracity of the
subjects response and the level of willingness of the respondents
to participate in the study.
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Hypothesis
There is no significant relationship between the demographic
profiles of the family caregivers to their perception about
the elderly.
Theoretical Framework of the Study
This study makes use of a core theory and several theories
related to it which will serve as strong bases to make this study
realistic.
Toughy and Jett Theories of aging served as bases for this
study. It was suggested that some cognitive functions in old age
decline people regardless of age can continue to learn. The
cognitive skills that remain stable are attention span, language
skills, communication skills, comprehension and discourse and
visual perception. Some of the skills that decline with age are
verbal fluency logical analysis, selective attention object
naming and complex vision spatial skills. (Toughy and Jett 2010)
According to Toughy and Jett older adults who have higher
cognitive function are the ones that have the highest social
interaction. Older people continue to learn from their
experiences and understand new situations (Toughy and Jett
2010).It also tackles the four types of aging which includes
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chronological age, biological age, psychological age, and social
age these ages may not be the same on a person. Chronological age
is the number of years a person has lived. Biological age is the
predicted by the person’s physical condition and how well vital
organ systems are functioning. Psychological age is expressed
through a person’s ability and control of memory, learning
capacity, skills, emotions, and judgment, Social Age is measured
by age graded behaviors that conform to an expected status and
role within a particular culture or society.
It was anchored on Phillips’ Family Caregiving Dynamics
model. The concept of the model include both interactional
context factors, such as the caregiver’s role expectations and
expectations of the care recipient, and situational context
factors, such as the care recipient’s abilities. It also includes
the perceptions that the caregiver and care recipient have about
the situation such as the caregiver burden. This model provides
framework for understanding poor caregiving, with attention to
many factors, including the prior relationship history of the
caregiver and the care recipient. (Phillips, Brewer, & Torres de
Ardon, 2001)
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Conceptual Framework of the Study
We know for a fact that as the age of a person increases,
the biologic and psychosocial aspects of a person has to be
considered significant. These changes could greatly affect the
public’s perception most especially to the perceptions of the
family caregivers. This study will conceptualize on the
assumption that factors such as age, sex, educational attainment,
length of service and relationship with elderly have a
relationship to the perceptions of the family caregivers about
the elderly.
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Paradigm of the Study
Independent Variables Dependent Variables
Prp
Figure1. The diagram shows the relationship between the
independent and the dependent variables.
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Profile of a respondent family caregiver in terms of:
Age Sex Educational
attainment Relationship with
elderly Length of service
Family Caregivers Perception in terms
of:a. biologic
aspectb. psychosocial
aspect
Definition of Terms
Elderly. It is conceptually defined rather old especially being
past middle age.
In this study, it refers to the characteristics of later
life of a person.
Family Caregiver. It is conceptually defined as a person who
provides direct care (as for children, elderly people, or the
chronically ill).
In this study, it refers to the Family caregivers of the
elderly.
Perception. It is conceptually defined as Awareness of the
elements of the environment through physical sensation or
physical sensation interpreted in the light of experience.
Furthermore, it is any insight or intuitive judgment that
implies discernment with truth or fact. This includes the
beliefs, views, of a certain person about the elderly as measured
by the Self-Assessment on beliefs about the Elderly
Questionnaire.
In this study, it refers to the insight of the Family
caregivers towards the elderly.
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Chapter II
Review of Literature
Related literature
The aging process is of course a biological reality which
has its own dynamic, largely beyond human control. However, it is
also subject to the constructions by which each society makes
sense of old age. In the developed world, chronological time
plays a paramount role. The age of 60 or 65, roughly equivalent
to retirement ages in most developed countries is said to be the
beginning of old age. In many parts of the developing world,
chronological time has little or no importance in the meaning of
old age. Other socially constructed meanings of age are more
significant such as the roles assigned to older people; in some
cases it is the loss of roles accompanying physical decline which
is significant in defining old age. Thus, in contrast to the
chronological milestones which mark life stages in the developed
world, old age in many developing countries is seen to begin at
the point when active contribution is no longer possible."
(Gorman, 2002)
Unlike child care, which typically involves finding services
primarily for healthy children who live with the employee, elder
care requires a set of services to respond to a wide range of
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often unpredictable medical, emotional, physical and financial
possibilities. These services are frequently required to be
delivered some distance from the employee. Elder care takes many
forms, including providing meals, transportation to medical
appointments, food shopping, financial assistance, assisting with
housework or providing emotional support. When elder-care needs
occur, they tend to be unpredictable and involve many unknowns.
These needs often cause anxiety about things such as the ability
to find and pay for immediate care or ways to take preventative
measures like withholding car keys away from an elderly parent.
Employees with elder-care responsibility are often called upon to
assist in making costly financial decisions around issues of
long-term care. In many cases, they have very little information
and little confidence in their ability to get comprehensive
information on public and private benefits, service and financial
options, and risks of needing extensive care overtime. Adult
children usually want to respect the autonomy and decision-making
capability of their older adult relatives. However, most people
are not proactive when it comes to elder care and critically
important discussions about “what to do if” rarely take place in
advance. (Rose and Burut, 2006; pg.62)
The American Journal of Nursing (AJN) recognizes that
nurses today will care more adults over 65 than any other patient
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population. Caring for older adults requires specific expertise,
knowledge and skills that the majority of nurses did not learn in
school, and or which less than one percent have has specialized
training or certification.
During the last decade and primarily because of the aging
population and the dual-focus workforce, the time one adult
spends caring for another adult has emerged as a workplace issue.
Finding and coordinating elder-care services is no easy task,
especially for an employed caregiver. The study overwork in
America: when the way we work becomes too much (families and work
institute 2004) found that employees with elder-care
responsibilities tend to be more overworked than employers
without these responsibilities.
Caring for elderly patients can be a double-edged sword. On
the one hand, it is a demonstration of concern for the person
involved, but on the other, the paramount feeling when a patient
cannot no longer do the things for themselves that they used to
do is uselessness, which leads to sadness, laziness and self-
loathing. Patients may eat more and start to gain weight, and
actually decline in health. If that is the case, then there is no
better time for these individuals to get off that couch and start
moving.
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This only shows that elderly persons are much dependent with
the tender loving care that their health care providers are
rendering thru them. But since that few programs were implemented
locally, concerning the necessities that our government should
have. This study also tackles about the insights and perspective
of each caregiver family member to an elderly person that belongs
to their family.
Related Studies
The study of Christina Englert, MA, Center for Language &
Cognition, University of Groningen (Sept. 2008 )“Elderly people
talking: The production of Elderly Identity in Interaction”
examined how the identities of elderly people are socially
constructed and marked in interaction by means of linguistic
practices and how this can be influenced by the conversational
setting. The aim of this research is to give a general idea of
the range of communicative activities of elderly by means of a
communication profile. The aim is to describe, from an
interactional perspective, relevant linguistic practices and
communicative activities that are characteristic and constitutive
for a certain number of typical communicative situations and
genres where elderly participate.
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In every culture life circumstances change for an aging
individual and there are typical experiences in the areas of
social situations and relationships (e.g. retirement, health
condition, widowhood, loss of driver’s license, moving to a
retirement home). The processing of all these changes and
experiences are not only carried out cognitively but also
communicatively: they shape the linguistic, communicative
behaviour of elderly people. The communicative milieu (e.g.,
neighbourhood, family, shopping places, healthcare settings) of
elderly people can be characterized by regular, more or less
standardized, stable social relationships with a shared history,
specific communicative repertoires and more or less normative
rules that govern the interaction.
Previous Conversation Analytic studies of the discourse of
elderly tend to focus on interactions taking place in care-giving
institutions or home-help contexts between the elderly and their
care-givers during care activities (cf. Backhaus, 2010;
Engbersen, 2009; Heinemann, 2006; Lindström, 2005)
According to the study conducted by Caroline G. Lee, the
Role of an Aged Care Nurse Practitioner (ACNP) is well recognised
internationally however, in Australia the implementation of this
advanced role is still in its infancy with few gerontological
nursing experts registered as nurse practitioners (NP). This
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single Victorian Facility 2002 study was the first to describe
the clinical & social benefits or otherwise of ACNP interventions
in an Australian context.
This study aimed to establish clinical or other outcomes
that a Gerontological Nurse Practitioner (ACNP’s) could achieve
for older persons in an Australian residential aged, care
facility.
In summary, this study identified interventions an ACNP
could undertake & therefore the role they could play in an
Australian residential aged care facility, given the national
legislation governing all aspects of an aged care facility. This
study demonstrated that the role was feasible and achieved
positive resident outcomes despite the factors that impeded its
introduction.
The study about Nurses’ Perceptions and Support of Elderly
Loneliness in Nursing Homes (Edith Mutafungwa Degree Programme in
Nursing Thesis, February 2009.) The purpose of the study is to
find out how nurses perceive elderly loneliness. A qualitative
research method was used in the study. The thesis topic
originated from the project “Experiences of Loneliness”, which
was innovated by Espoo City. The data was collected from
Taavinkoti (nursing home) based in Espoo from November to
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December 2008. Consent and information letters were sent to
nurses prior to their participation in the study.
In addition, nurses described that the absence of family
members in an elder’s life plays a significant role in an
individual’s loneliness. The study showed the supporting methods
offered by nurses were nursing assistance, psychological support,
physical support and social participation.
According to the study of Maria Linda S. Agus, MAN about the
perception of public health Nurses & family caregivers of the
elderly in Catarman Northern Samar, the findings of the study
with regards to the profile data specifically age as one of the
variables is that most of the respondents both from the CHN &
family members belonged to the aged bracket of 32-37 & which 35-
39 years old respectively, is under the early adult stage.
Chapter III
Methodology
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Locale of the Study
Catarman is a first class municipality in the province of
Northern Samar. It is the capital and largest town by land area
and population in Northern Samar. According to the 2010 census,
it has a population of 84,833 in 12, 437 household making it the
most populous municipality in Eastern Visayas. It has an area of
464.23km2 (179.32 sq. mi). It is also the commercial,
educational, financial, political, and socio-cultural and
government center of the province. It lies on the northern part
of Samar Island and southeast of the Philippine capital, Manila.
It is bounded to the east by Mondragon, to the west by Bobon, to
the south by Lope de Vega, and to the north by the San Bernardino
Strait. The municipality is skirt-shaped. On the Pacific coast
are flat lowlands with the interior characterized by outlying low
hills. Mt. Puyao in Barangay Liberty is the highest peak in the
area.
Catarman representatively standing for the business region
of Northern Samar is in the process of renewing its image as a
poor and underdeveloped area in the 1980s. Due to its direct
topographic contact to Luzon the area serves now as a trading
center in Northern Samar with increasing volume of trade and
commerce annually.
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At present, Catarman town proper have 23 urban mainland
barangays, these are Acacia, Airport Village, Bangkerohan,
Baybay, Cabayhan, Cag-abaca, Calachuchi, Cal-igang, Casoy,
Cawayan, Dalakit, Ipil-ipil, Jose Abad Santos, Jose P. Rizal,
Lapu-lapu, Mabini, Mabolo, Molave, Narra, Sampaguita, Santol,
Talisay, Yakal. The town also currently has five public health
nurses.
Research design
This study will utilize the descriptive correlational survey
method of investigation to determine the perception of the public
health nurses and family caregivers about the elderly.
Correlational design is used in this study to determine the
relationship of the demographic profile of the respondents which
are the public health nurses and family caregivers to their
perception about the elderly.
Research Respondents
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The identified respondents of this study are categorize into
two (2): the first group composes the selected family caregivers
of the elderly and the second group are the five Public Health
Nurses of the Municipality of Catarman, Northern Samar.
Research Variables and their Measures
The variables that will be use in this study are quantified
in the following manner:
Age. This refers to the number of years that the family
caregivers has lived from birth up to present.
Gender. It refers to the characteristics which determine whether
both of the family caregivers are male or female.
Educational attainment. It refers to the highest level of
education attained by family caregivers.
Length of service. It refers to the family caregivers’ number of
years in service with the elderly.
Relationship with the elderly. It refers to the blood relation of
the selected family caregiver with the elderly.
Research Instrument
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The researcher will make use of a standardized tool adopted
and modified from a study entitled “Community Health Nurses and
Family Members’ Perceptions of the Elderly in the Province of
Northern Samar, Proposed Health Teaching Plan” (Agus,1996).
Modification made was inclusion of relationship of the family
caregiver to the elderly as one of the variables.
Part I of the questionnaire will determine the demographic
profiles of the family caregivers.
Part II of this instrument will measure the family
caregivers’ perception about the biological and psychosocial
aspect of the elderly. It consists of nine biological perceptions
and twelve psychosocial perceptions about the elderly.
It will be completed by placing a check mark on the
appropriate column- SA if they Strongly Agree; A if they Agree; U
if they are Undecided; D if they Disagree and SD if they Strongly
Disagree.
Sampling Technique
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This study will utilize the Slovin’s formula to determine
the sample size. In order for the barangays to have an equal
representation, proportionate sampling will be done after getting
the sample size in every barangay. The researchers will pick from
a bowl with name of the families with elderly per barangay and
the names that will be picked will be taken as the respondents.
This technique will be used based on the belief that researchers’
knowledge about the population can be used to hand-pick sample
members to which in this study are the family caregivers.
Date Gathering Procedure
Prior to the study, letters of request to conduct the study
will be sent out to the Municipal Health Officer of the Rural
Health Unit of the selected Municipality which is Catarman,
Northern Samar. The researchers will personally distribute the
questionnaires to the family caregivers and retrieve them
immediately on the very day they will be administered. Collection
of data from the family caregivers will be done through
structured interview schedule.
Scoring and Interpretation of Data
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The following scoring and interpretation will be employed in
this study.
A. Demographic Profile of family caregivers will utilize
frequency count and percentages:
a) Age
The age of family caregivers will be categorized
based from the psychosocial theory of Erik Erikson’s
which are as follows:
Young Adulthood (18-25 years old)
Middle Adulthood (25-60 years old)
b) Gender
The gender of family caregivers will be categorized
as male or female.
c) Educational Attainment
The educational attainment of the family caregivers
will be categorized as:
Elementary
High School
College level
College Graduate
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Others, please specify
e.) Length of Service
The length of service of family caregivers will be
categorized as:
31-35 years
26-30 years
21-25 years
16-20 years
11-15 years
6-10 years
1-5 years
f.) Relationship with Elderly
The relationship with the elderly of the family
caregivers will be categorized as:
Daughter/Son
Grandchild
Niece/Nephew
Son/daughter in Law
Husband/wife
Relatives
B. Self-Assessment on Perceptions of the Elderly
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The researchers will base the scoring and
interpretation of the study from the adopted and modified
questionnaire. It will be interpreted through item per item
analysis.
The responses of family caregivers will be scored as
follows:
Range INTERPRETATION
Quantitative
Interpretation
Qualitative Interpretation
4.20 – 5.00 Very Positive The respondents perceive the
elderly as holistically functional
individual of the society.
3.40 – 4.19 Positive The respondents perceives elderly
as functional individual yet has
their own limitation
2.60 – 3.39 Undecided The respondents cannot decide on
the abilities of the elderly as
functional human being
1.80 – 2.59 Negative The respondents perceives the
elderly as individual with
decreased functional ability
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1.00 – 1.79 Very Negative The respondents perceives the
elderly who has absence of
functional ability
Interpretation of the result will be done by assigning
descriptive interpretation for every response. For the negatively
stated items which include item numbers: 1,2,3,4,5,6,7,8,7,11,12
interpretation will be “very positive” to a strongly agree
response; “positive to an agree response; “undecided” to an
undecided response; “negative” to a disagree response and “very
negative” to a strongly disagree response. For the positively
stated items which include 9,10,13,14,15,16,17 interpretation
will be “very positive” to a strongly disagree response;
“positive” to disagree response; “undecided” to an undecided
response; “negative” to an agree response and “very negative” to
a strongly agree response.
Statistical Treatment of Data
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The study was analyzed statistically based on the presented
data gathered during our survey on every family caregiver in the
province of Northern Samar.
These are the statistical tool used in or study.
1. Frequency and personal distribution
Percent (%) = f x100N
Where:
P = Percent (%)
f = frequency/response
N = total # of case
100constant factor
2. Mean
a. The mean was used in analysing the status of
implementation of the data gathered in the survey to
measure the overall reaction of several variables
The formula is:
x=∑fxN
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Where:
X = mean
∑fx = summation of frequency
N = total number of respondents
3. The Multiple Regression Analysis to be use to determine the
relationship of demographic profile of the family caregivers
to their perception about the elderly.
The Multiple Regression Analysis
The Multiple Regression Analysis is used in
predictions. The dependent variable can be predicted given
several independent variables. For instance, we can make
better predictions of the performance of newly hired
teachers if we consider not only their education but also
their years of experience, personality, and other variables
that may influence performance.
Many mathematical formulas can serve to express
relationship among more than two variables, but the most
commonly used in statistics are linear equations.
y = b0 + b1 x1 + b2x2= ... + bnxn
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where:
y = the dependent variable to be predicted
x1x2...xn = the known independent variables that may
influence y
b0b1b2..bn = numerical constants which must be determined from
observed data
For instance, when there are two independent variables
x1 and x2 and we want to fit the equation, the equation
model:
y = b0 + b1x1 + b2x2
we must solve the three normal equations:
Σy = nb0 + Σx1b1 + Σx2b2
Σx1y = Σx1b0 + Σx 21b1 + Σx1x2b2
Σx2 = Σx2b0 + Σx1x2b1 + Σ x 22 b2
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