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LEVEL OF AWARENESS ON ENDEMIC GOITER AMONG PATIENTS

A Thesis Presented to

Faculty of the

College of Nursing

Liceo de Cagayan University

In Partial Fulfillment

Of the Requirements for the Degree

Bachelor of Science in Nursing

Karl Ericson G. Angeles

Richelle V. Chanjueco

Christian Jed Navia

Jude Anthony Nitcha

Faith Tangcalagan

Mary Ann N. Tumulak

November, 2009


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APPROVAL SHEET

This thesis entitled LEVEL OF AWARENESS ON ENDEMIC GOITER AMONGPATIENTS prepared and submitted by Karl Ericson G. Angeles, Richelle Y.

Chanjueco, Christian Jed Navia, Jude Anthony Nicha, Faith Tangcalagan, andMary Ann N. Tumulak, in partial fulfillment of the requirement for the degree of

BACHELOR OF SCIENCE IN NURSING, has been examined and recommended foracceptance and approval for oral examination.

JOFI VALDEHUESA-MAHILUM, Ph.D

Adviser

ABSTRACT


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This study aimed to conduct an analysis of the prevailing endemic goiter patients ofBarangay Cogon, El Salvador City, Misamis Oriental. This is done by determining the level ofawareness on endemic goiter among patients hinge with its etiologies and related factors.

The subjects of the study are the 20 known goiter patients of Barangay Cogon, ElSalvador City, Misamis Oriental. The study utilized the descriptive (qualitative) survey

questionnaire of the researchers aided by the Department of Health (DOH).The findings and results of the study, and the respondents identified signs and

symptoms were significant with their awareness on the possible etiologic factors or what causesreally their disease condition.

KEYWORDS: Endemic goiter, etiologic factors

INTRODUCTION


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Iodine Deficiency Disorders (IDD) is a broad spectrum of deficiencies resulting

from inadequate or lack iodine in the diet. Goiter is an abnormal enlargement of the

thyroid gland which is usually a common manifestation of iodine deficiency. The thyroid

gland is an H-shaped gland found at the front of the neck. It controls the bodys

metabolism, development of the brain and other organs and parts of the body growth.

This gland is responsible for manufacturing and releasing a number of different

hormones, primarily thyroxine, which plays a large role in directing the bodys

metabolism and growth functions. When the thyroid gland swells, it thickens the neck

area visibly, causing tenderness or tight feeling in the neck and throat, and in some

cases, hoarseness or coughing, as well as difficulty in swallowing or breathing.

In most cases, goiter is not dangerous the major problem of having this

condition is usually appearance as many individuals may find the swelling unsightly.

However, goiter typically signals an underlying problem so that any swelling of the neck

should immediately be checked by a doctor, reminded by Dr. Rosa Allyn Sy (President

of the Philippine Society of Endocrinology and Metabolism January, 2009) during a

recent symposium to kick off the first Goiter Awareness Week

Initially, the enlargement of the thyroid gland may not be seen but can only be

felt. As it grows bigger, endemic goiter (when it affects 10 percent of the population) isgraded depending on the degree of enlargement. The following are the degree of

enlargement of endemic goiter: grade 0 Normal; Grade 1a Goiter is palpable and

not visible; Grade 1b Goiter is palpable and visible only when neck is extended; Grade

2 Goiter is visible only when neck is in normal position; Grade 3 - -Goiter is markedly

enlarged.

The Department of Health (DOH) has been designated as the lead agency in

conducting information dissemination, education and training, research and preventive

measures like the use of iodized salt to prevent goiter.

Goiter or the enlargement of the thyroid gland is considered prevalent in the

Philippines. This disease in the thyroid glands is classified as an endemic, meaning

present continuously in a community, or sporadic goiter.


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Larson (2004) noted that it tends to occur in geographical areas by soil and water

deficient in iodine. Iodine is readily available in regions with access to salt water and

also through consumption of varieties of seafood.

While goiter may affect any group, females are more commonly affected by

goiter than males because the need for thyroid hormones is particularly great during

pregnancy. This enlargement can be caused by iodine deficiency, inability of the body to

use iodine correctly, or a variety of thyroid disorders, including infection, tumors, and

autoimmune disease. Iodine-deficiency goiter can be common in regions where the

soils and foods have insufficient iodine. Preschool children, adolescent girls, pregnant

women, and the elderly are most vulnerable to goiter and other iodine-deficiency

disorders. Areas where iodine supplies are inadequate see high rates not only of goiter

but also of birth defects and retardation of both mental and physical development. While

iodine deficiency is the leading cause of goiter worldwide, it is rare cause of goiter in the

developed world (Lamberg, 1993).

Several related factors cause thyroid gland to enlarge that motivates this study to

choose Cogon, El Salvador City, Misamis Oriental as the area known to have a

considerable number of goiter cases: Iodine deficiency Iodine, which is essential for

the production of thyroid hormones, is found primarily in seawater and in the soil in

coastal areas; Pregnancy a hormone produced during pregnancy, human chorionicgonadotropin (HCG), may cause the thyroid gland to enlarge slightly; Sex because

women are more prone to thyroid disorders than men are, theyre also more likely to

develop goiters; Age being age 50 or older puts you at higher risk; Medical history a

personal or family history of autoimmune disease increases the risk.

Some inland residents however, may have goiter because of insufficient iodine

intake in their diet aside from eating a lot of goitrogenic foods, which are found in

cabbage, soybeans, peanuts, and radishes. Pregnant women and children are prone to

goiter because they are in the stage of hormonal changes. Iodine deficiency during

pregnancy results in decreased maternal and neonatal thyroid hormone secretion.

Adequate amount of thyroid hormone is crucial for brain development in the first and

second trimester of pregnancy. The most common cause in the country is iron

deficiency, but this condition is curable by mass food-supplementation with iodine.


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This brings to mind the ASIN Law which was passed in 1995 which directed the

iodization of salt and which until now has yet been fully implemented. Unfortunately,

only about 50 percent of Filipinos use iodized salt, more than twelve years after

Republic Act 8172 or ASIN Law was signed on December 20, 1995 aimed to end iodine

deficiency syndrome described as silent but tremendous nutritional problem among

Filipinos. The salt iodization program is also aimed to breed Filipinos who are healthier,

more intelligent, empowered and globally competitive (Navarro, 2005).

Dr. Gabriel Jasul Jr., PSEM director (2009) warned that if one doesnt get

enough iodine, it can lead to mental and growth retardation. In fact, serious iodine

deficiency during pregnancy may result in stillbirths, abortions and congenital

abnormalities such as cretinism, a condition characterized by severe brain damage

occurring in very early life.

Sy (2009) added that next weeks observance of goiter awareness is very

important. Theres a need to educate more Filipinos about the dangers of having goiter

and not doing anything about it. Goiter is a preventable disease and there is a need to

make sure that sufficient iodine is added into the food supply, the doctor reminded.

In addition, Dr. Josephine Carlos Palanca-Raboca, PSEM VP (2009), explained

that Goiter Awareness Week came about after President Macapagal-Arroyo signed on

December 11, 2005 Proclamation 1188, which tasked the Department of Health tocoordinate with PSEM, among other partner organizations, for the formulation of

guidelines and logistics to ensure the success of holding an annual awareness

campaign program.

However, PSEM director Dr. Leilani Mercado-Asis reminded that the events

related to the Goiter Awareness Week will continue for the rest of the year. Raising

awareness about goiter and iodine deficiency makes sense. While some deficiencies,

like lack of Vitamin A, can be corrected, if you grow up and your IQ has suffered from

iodine deficiency, its not going to be reversible (Buban, 2007).

Moreover, Larson (2004) noted that goiter can be prevented with the use of

iodized salt. However, the problem lies on the unawareness of the community people on

the need for iodized salt. What is least known among people affected with goiter

however is its occurrence especially in depressed or rural areas; Goiter control


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programs of the government often do not reach the people in hinterland barrios due to

distance, resource limitation, and lack of documentation of goiter cases. Although it is

disease, yet, in the absence of health information, lack of knowledge about the disease

condition, public health services and medicines, its risks, rate of occurrences, and

related factors can become severe and may even cause death.

The study is focused on the goiter cases of Barangay Cogon, El Salvador City

which has been noticeably identified since 2008 survey by the Barangay Nutrition

scholars, barangay health workers, midwife and rural health unit nurse (RHU).

There are a total of 2,023 projected populations and this has been noted as one

area where goiter patients are mostly found as identified by the City Health Office of

Cogon, El Salvador City affecting 4-5% of its population, all are females. Latest survey

of 2008 --- identified less than 20 cases in estimated number of households identified at

Barangay Cogon.

With this study, it is expected that people in this geographic area is aware on the

prevalence of goiter cases, and of the ways and means to prevent and treat the

disease. The study can also provide documentation of goiter cases such that health

authorities can be urged to take up measures that would eradicate goiter in the

barangay that was known to have an identified number of goiter cases. As a result, this

could serve as a link between the people in the barrio and the government as well asthe non-government organizations.

Therefore, the study is conducted to increase awareness of the community of

Barangay Cogon. The researchers choose the said barangay because of its

geographical location and prevalence of the illness.


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FRAMEWORK

The framework of the study is anchored on the framework used by the

Departmetn of Health (DOH, 2009) as it investigated the prevalence of goiter in regions

with iodine deficiency. The framework is purely qualitative survey to identify the

significant problems related to goiter which can be eradicated through the government

health programs and activities. The framework is purely qualitative survey to identify the

significant problems related to goiter which can be eradicated through the government

health programs and activities. The framework is purely a survey design; it can be

further used for hypothesis testing using the same variables. However, the framework

identifies two independent variables, the etiological factors and its signs and symptoms

and one dependent variable that is the level of understanding of the respondents toward

goiter as a dangerous disease condition if left untreated (Smeltzer, 2008).

Etiological factors of goiter are very important because they helped explain the

development of goiter and the awareness among the respondents of the factors that

really causes goiter.

The framework allows the study not merely to determine the effects of the

independent variable to the dependent criterion but also to determine the effects

between the independent variable themselves. Such scenario provides an overallpicture of the problem of individuals suffering from goiter.

For instance, the respondent verbalizes no understanding about the disease

condition, therefore he/she is considered or categorized to be in the low level of

awareness; or if the respondent identifies the factors/reasons why he/she had this

condition and identifies the signs and symptoms resulted from his/her condition,

therefore he/she can be categorized either in higher level of awareness.

In addition, the Health Belief Model (HBM) is a psychological model that attempts

to explain and predict health behaviors. This is done by focusing on the attitudes and

beliefs of individuals (GLanz et al, 2002). In this case, this model is significantly applied

to the study for the purpose of improving and determining the respondents

psychological perception or response to the disease condition. The HBM is based on

the understanding that a person will take a health-related action. The Health Belief


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Model has been applied to a broad range of health behaviors and subject populations.

Three broad areas can be identified (Conner & Norman, 1996): 1) Preventive health

behaviors, which include health-promoting (e.g. diet, exercise) and health-risk (e.g.

smoking) behaviors as well s vaccination and contraceptive practices; 2) Sick role

behaviors, which refer to compliance with recommended medical regimens, usually

following professional of illness; 3) Clinic use, which includes physician visits for a

variety of reasons (Becker, M.H. The Health Belief Model and Personal Health

Behavior. Health Education Monographs.Vol. 2 No. 4).

Research Flow

Figure 1

Figure one illustrates the research flow of the study

Respondents Demographic

Profile

Level of Awareness on

Endemic Goiter

Signs and symptoms

Etiologies

Diagnosis

Treatment

Food intake


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OBJECTIVES

The study has three main objectives namely:

1. To determine the demographic profile of the respondents;

2. To identify the etiologic factors and previous illness that contributes with theoccurrence of goiter, and;

3. To determine the level of awareness on endemic goiter among the respondents and

the etiologic factors.

SIGNIFICANCE OF THE STUDY

The Respondents. The results of the study can be used to educate and aware

the respondents how to monitor their own bodies to detect early changes in gland size

and to take acceptable preventive measures for progression of the disease and its

eventual cure through the health teachings they have acquired in the educative

strategies done by the researchers (e.g. distribution of flyers, and give additional facts

about goiter.

The Faculty of the College of Nursing of Liceo de Cagayan University. The

findings of the study, can serve as data-based added information about growth of

previously stable goiter or the onset of clinical symptoms through which new means of

evaluation can be made especially on malignant transformation (toxic or nontoxic).

The Health Workers. The result of the study will be used as data-base for goiter

cases in the barangay for follow-up programs to be initiated by the government

agencies and heath sectors Moreover, helps health personnel especially the community

and physician the appropriate interventions to be done interdependently.

The Nursing Students. With new added pieces of information, nursing students

would be able to provide an improved delivery of nursing care to goiter patients as they

practice their nursing related experiences.

The People of Barangay Cogon. As the study would document the occurrence

of goiter and the etiological factors causing it, the results would help concerned

government and non-government agencies in taking up measures in eradicating goiter

in Barangay Cogon, El Salvador City, Misamis Oriental.


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SCOPE AND LIMITATION

The study is aimed to determine the interplay of the respondents socio-economic

profile, etiological factors of goiter, and level of awareness of endemic goiter among the

respondents. Based on the existing records, there are 20 known existing cases of goiter

patients as of 2009, out of a total population of (ESC-CHO and BHC, 2009) at Barangay

Cogon, El Salvador City, Misamis Oriental; the study is focused on mainly considerable

known types caused by several etiologic factors. The study is limited only to the

selected population who are currently residing at the said barangay.


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REVIEW OF RELATED LITERATURE

Endemic Goiter

The Prevalence of Iodine Deficiency and its Correlation with Goiter Size in the Goitrous

Population of Paracelis, Mountain Province

A total of 2,253 patients underwent preliminary screening for goiter using

palpation and inspection maneuvers according to the World Health Organization

guidelines for the grading of goiter. Patients found or suspected to have goiters were

then further subjected to more thorough physical examination where the goiters were

then graded on a scale of I to IV. Of these 259 (11.49%) had goiter of varying grades

and occurring at a male: female ratio of 1:21. The goiter grade with the highest

prevalence was Grade I (64%) while the least common was Grade III (5%). Goiter

prevalence was highest in the age bracket of 31 to 40 years old. Iodine deficiency was

present in 7.8% of the population studied or 68% of the goitrous population. Iodine

deficiency occurred higher in females (66%), was most prevalent (27%) in the 31 to 40

age bracket and in goiter Grade I (64%).

This study shows that the prevalence of Iodine deficiency in the goitrous

population of Paracelis, Mt. Province remains high at 68% and that Iodine deficiency

remains to be a public health problem in the municipality.There is a correlation between Iodine deficiency and age gradually increasing

from birth, peaking at age 31 to 40 years and gradually declining thereafter. There is no

significant relationship between goiter grade and age, goiter grade and gender, iodine

deficiency and gender, and iodine deficiency and goiter grade (ORIBIO et al, 2007).

Treatment depends on the type of goiter the doctor identifies

Various types

Dr. Gabriel Jasul Jr., PSEM director and committee on advocacy chair, explained

that there are various types and causes of goiter. In countries like the Philippines,

goiter is often brought on by a lack of iodine in the diet. Iodine, which is mostly found in

fish and other seafood products, milk and fortified table salt, is essential for the


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production of thyroid hormone. The World Health Organization recommends 100

micrograms to 200 micrograms of iodine daily.

Although a minute quantity of iodine ensures an individuals iodine adequacy,

iodine deficiency remains a major public health problems in 130 developing countries,

affecting over 740 million people or 13 percent of the worlds population.

Prevalence of Endemic Goiter among Patients Admitted to General Hospitals in

Khartoum State. Salih, Osama; Nurien, A. Amel (School of Medicine, Ahfad University

for Women) Another study was carried out at Al-Zara hospital from May to July, 2007, in

an attempt to determine the prevalence of goiter and to identify the possible etiological

factors. By method of simple random selection, 100 individuals were chosen using

standardized questionnaire for data collection. The results were statistically analyzed

using SPSS. Of the total number of study population (100 patients), the prevalence rate

was higher among females than males (90% and 10%) (Magied et al, 2007).

Based on the studies on urinary iodine levels conducted by the Department of

Health (2005), most goiter cases are found in the mountainous provinces and other

remote areas of the country, where children and pregnant women are mostly affected.

One study conducted by Rechter (2001) demonstrated the prevalence of goiter in

India is associated with socio-economic conditions of the population where it oftenoccurs. In India, most of those affected are women 80% at a time, who lived far from the

cities, most often they are farmers in lands often washed out by frequent floods. Rechter

also noted that most often where there is malnutrition goiter often occur their etiological

factors equally connect to goiter prevalence. Moreover Rechter noted that literacy is

significantly associated with goiters saying that in areas where literacy is high goiter in

close to zero. Peterson (2002) conducted a study which demonstrates the livelihood of

goiter among women farmers in Africa as consisted with Rechter (2001) to be

approximately 80% which is often endemic type. Peterson noted several causes:

illiteracy, iodine deficiency, malnutrition, lack of health services and other predisposing

factors impose by culture. Peterson suggested that goiter can be prevented through

alleviation of health services and health education.


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RESULTS AND DISCUSSION

The results are shown and analyzed as presented in the bar graph (refer to

Appendix A). Figure 1 shows the level of awareness on age at most risk to have goiter.

Out of twenty respondents, 85% is highly aware on the age bracket in which goiter is at

most occurring; 10% is moderately aware and 5% is unaware. This implies that the

population knows that goiter is occurs in ages between ages 20-40 (childbearing age)

and could also possibly be present in ages 40 and above. Teenagers (aging 13-19

years old) are most likely to get goiter due to stress (Hallowell, 1998).

Figure 2 shows the level of awareness on gender at most risk to have goiter. Out

of twenty respondents, 50% is highly aware that female population is more vulnerable to

the disease than males; 35% is moderately aware; and 15% is unaware. This implies

that half of the sample population knew that women are at higher risk in acquiring goiter

since they have high stress level, childbearing and hormonal imbalances than men.

Figure 3 shows the level of awareness on civil status as factor known to cause

goiter. Out of twenty respondents, 20% is highly aware that civil status does not

contribute to the development of goiter although marriage is contrary to bearing child

but it does not have any physiologic and logical explanations that could justify such; and

80% is unaware. This implies that further explanation is to be provided to increaseawareness and acquire understanding.

Figure 4 shows the level of awareness on the occupation at most risk developing

goiter. Out of twenty respondents, only 45% is highly aware that farming is the major

and most common cause to develop goiter; 50% answered jobs on city proper which is

then categorized to moderate; and 5% is unaware and had answered fishing. Jobs on

cities might be possible but the best answer to the problem is work far from sea (a good

example is farming).

Figure 5 shows the level of awareness on educational attainment as factor to

consider in treating goiter. Out of twenty respondents, 75% is highly aware that

educational attainment is important to the treatment course of goiter since the level of

understanding on the course therapy and other well-advanced medical management in


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eradicating goiter needs expenditure to meet the demands and to sustain the needs of

the client for quality care; and 25% is totally unaware.

Figure 6 shows the level of awareness on place at most risk to develop goiter.

Out of twenty respondents, 80% is aware that on rural (e.g. mountainous areas, inland

territories) are most likely to have known considerable goiter cases both toxic and

nontoxic; and only 20% answers city proper which is second to mountainous areas; and

none answered seas which means that all respondents know the places where

identified goiter patients are mostly found.

Figure 7 shows the level of awareness on economic crisis as factor to consider in

treating goiter. Out of twenty respondents, 95% is highly aware and only 5% is unaware

that economic instability is relevant in the treatment course of goiter since medical

expenses and other prescribed medications are to be bought as part of the treatment

course therapy. That is why some who are uneducated and unemployed are most likely

to consult quack doctors instead of physicians.

Figure 8 shows the level of awareness on family size as factor to consider in

treating goiter. Out of twenty respondents, only 35% answers dili (question see

appendix B) which is categorized as highly aware; and 65% answers oo which means

that many believed that family size is one factor that triggers the development of goiter

among family members; but, usually, it does not connect and does not have anyphysiologic explanation to support the statement. Pregnancy is a factor that causes

goiter development and could possibly increase the family size but the problem is not

with the increase of family size (because some could adopt children thus increase their

family size) but rather on the number of gestation.

Figure 9 shows the level of awareness on heredity as factor at most risk to cause

goiter. Out of twenty respondents, 90% is highly aware of the hereditary factor; and 10%

is not aware. Goiter can be transmitted to offspring and is inherited.

Figure 10 shows the level of awareness on pregnancy at most risk to trigger

goiter formation. Out of twenty respondents, 45% is aware that pregnancy is one major

factor; 15% thinks that it is not; and 35% feels that they are not sure. This means that

only few understand why pregnancy is one factor; and the rest did not know.


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Figure 11 shows the level of awareness on frequency use of iodized salt. Out of

twenty respondents, 65% answers every day or at all times categorized as highly

aware; while 35% answers may be used often which is categorized as moderately

aware; and none answered never. This implies that the respondents know the essential

benefits that one could get from the use of iodine (which can be in a form of salt and

easily used).

Figure 12 shows the level of awareness on the characteristic signs and

symptoms of goiter. Out of twenty respondents, only 40% knows exactly the presenting

signs and symptoms of goiter; 5% identifies signs and symptoms they thought was

caused by goiter; and 55% identifies signs and symptoms not related to goiter.

Figure 13 shows the sick role behavior based on the Health Belief Model. The

result shows that 55% of the sample population is doing superstitious practices or is

clearly influenced by make-belief practices than scientifically based management to

treat goiter. This supports the conclusion that this happen because of the geographical

location of the respondents and the area (far from influential civilizations).


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CONCLUSION

Based on the results of the study, it is generalized that although some have high

level of awareness, still further actions from the government, non-government and

health sectors can increase the awareness programs and the need to educate the

people about goiter. There are still some who do not know about their disease and they

tend to seek attention from quack doctors which worsens the issue.

RECOMMENDATIONS

The following recommendations are necessary to increase the level of

awareness of all the respondents and the community as well:

1. For early detection and prevention of complications, sensitive thyroidstimulating

hormone (TSH or thyrotropin) assay has become the single best screening test

for Hyperthyroidism in which goiter is a presenting clinical symptom. The City

Health Unit should initiate such screening test;

2. The barangay health workers and responsible health personnel should conduct a

community health teaching activity that tackles about goiter as a symptom of

other possible underlying disease conditions;

3. The health sectors should encourage the community to use iodized salt in the

dietary intake and iodine supplementation should be given to the identified

patients, and;

4. The Republic Act 8172 or ASIN Law of 1995 should be regularly implemented

and exercised by the public annually in accordance with the law.


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BIBLIOGRAPHY

Rechter,Hegedus L, Gerber H. Multinodular goiter. In: DeGroot LJ, Jameson JL, eds.

Endocrinology. 2.2001: 15517-1528

Hallowell JG, Sterling NW, Hannon WH, et al. Iodine nutrition in the United States . Trends and

public health and Nutrition Examination Surveys l and lll ( 1971-1974 and 1988-1994). J Clin

Edocinol Metab. Oct 1998:83 (10):757-62. [ Medline]

Larson, Netterville JL, Coleman SC, Smith JC, et al. Management of substernal.2004

Lamberg BA. Iodine deficiency disorders and endemic goitre. Eur J Clin Nutr1993;47:18

Smeltzer, S. et al., Medical-Surgical Nursing Volume 2.Hyperhyroidism and goiter. Lippincott:W

illiams and Wilkins:2008

Lippincott Williams and Wilkins.Health Assessment made increadibly visual. Lippincott Williams

and Wilkins: Philadelphia, 2007

Lippincott Williams and Wilkins. Pathophysiology made incredibly visual. Lippincott Williams and

Wilkins: Philadelphia, 2007

Glanz, K., Rimer, B.K. & Lewis, F.M. (2002). Health Behavior and Health Education. Theory, Research and

Practice. San Fransisco: Wiley & Sons.

Glanz, K., Marcus Lewis, F. & Rimer, B.K. (1997). Theory at a Glance: A Guide for Health Promotion

Practice. National Institute of Health.

Conner, M. & Norman, P. (1996). Predicting Health Behavior. Search and Practice with Social Cognition

Models. Open University Press: Ballmore: Buckingham.

Websites

Oribio, R. http://www.slu.edu.ph/publications/nlrj/vol1.jsp. Iodine deficiency, goiter, Rapid Urinary Iodine Test Saint

Louis University.Bonifacio St., Baguio City, Philippines.2007

Navarro, K.L. http://www.positivenewsmedia.net/am2/publish/ Health_21/Goiter _Awareness _Week_brings_to_fore_importa

nce_of_ASIN_Law_ .shtml.Goiter Awareness Week brings to fore importance of ASIN Law implementation2005 Positive News Media Philippines

Buban, Charles E. Inquirer Doctors intensify goiter awareness. 2001-2009 INQUIRER.net,An INQUIRER Company. January, 2007

Glanz et al,http://www.etr.org/recapp/theories/hbm/Resources.htm) HEALTH BELIEF MODEL.2002, p. 52

Ahfad.http://www.accessmylibrary.com/article-1G1-185610086/prevalence-endemic-goiter-among.html. Prevalence of Endemic Goiter

among Patients Admitted to General Hospitals in Khartoum State.(Research Notes)(Clinical report). | December 01, 2007 | Magied, Ahmed Abdel
http://www.slu.edu.ph/publications/nlrj/vol1.jsphttp://www.etr.org/recapp/theories/hbm/Resources.htmhttp://www.etr.org/recapp/theories/hbm/Resources.htmhttp://www.accessmylibrary.com/article-1G1-185610086/prevalence-endemic-goiter-among.htmlhttp://www.accessmylibrary.com/article-1G1-185610086/prevalence-endemic-goiter-among.htmlhttp://www.slu.edu.ph/publications/nlrj/vol1.jsphttp://www.etr.org/recapp/theories/hbm/Resources.htmhttp://www.accessmylibrary.com/article-1G1-185610086/prevalence-endemic-goiter-among.html


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October 25, 2009

Miravel Tangcalagan, MDCity Health OfficerCity Health Office, Cagayan de Oro City

Madame:

Greetings! Peace is with you.

As part of our nursing curriculum, we, the NCM501204 nursing students of Liceo de

Cagayan University, are conducting a scientific nursing research study basicallypertaining to the highest prevalence rate of patients having goiter presently residing withBarangay Cogon, El Salvador City, Misamis Oriental. We are, hereby, askingpermission from your office to disclose to us any relevant pieces of information thatwould greatly sustain our needs for this matter.

We are looking for your full support and favourable response. Thank you very much.More power and God bless you!

Yours truly,

Ms. Mary Ann N. TumulakNursing Student, LDCU

Noted by:

Rosario R. Paclijan, RN MANResearch Coordinator

Ms. Ma. Chona V. Palomares, RN MANDean, College of Nursing, LDCU


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SURVEY QUESTIONNAIRE

PART A: SOCIO-ECONOMIC PROFILE

1. Unsa nga pangidaron ang kasagaran magka-GOITER?

a. 0-2 b. 3-12 c. 13-19 d. 20-40

e. 40- 65 d. 65 pataas

2. Kinsa ang kasagaran magka GOITER?

[ ] lalake [ ] babaye [ ] silang duwa

3. Aduna bay koneksyon/kalabtanan ang civil status sa pagbaton ogGOITER?

[ ] OO [ ] walay kalabtanan

4. Unsa nga klase nga trabaho ang kasagaran magka GOITER?

[ ] mangingisda [ ] mag-uuma [ ] trabaho sa syudad

5. Makatabang ba ang edukasyong nakab-ot sa pagtambal sa GOITER?

[ ] OO [ ] dili

6. Unsa nga klaseng lugar ang pabor sa pagbaton og GOITER?

[ ] duol sa dagat [ ] sa syudad [ ] sa bukid

7. Makaapekto ba ang kakulangon sa kwarta/ kawad-on sa trabaho sapagtambal sa adunay GOITER?

[ ] OO [ ] dili

8. Ang kadak-on sa pamilya makaapekto ba sa pagtambal sa adunayGOITER?

[ ] OO [ ] dili

PART B: ETIOLOGICAL FACTORS

1. Aduna bay kaliwat nga GOITER sa pamilya?[ ] OO [ ] wala [ ] wala kabalo

2. Ang pagmabdos usa ba kini nga dakong posibilidad nga maka goiter?

[ ] OO [ ] Dili [ ] Dili sigurado


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3. Unsa nga tubig ilimnon ang naay taas na posibilidad magka goiter?

a. [ ] Spring/tubod c. [ ]Mineral Water

b. [ ] NAWASA d. [ ] ubang kuhaanan

4. Kapila dapat mogamit og IODIZED SALT?

a. [ ] kada adlaw d. [ ] panagsakaayo

b. [ ] kanunay e. [ ] wala magamit

c. [ ] panagsa

RESPONDENT: # ___________ PIRMA:____________________

NGALAN:________________________

EDAD:________

BAYE _________ LAKE__________


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CURRICULUM VITAE

I. PERSONAL DATA

Name: Karl Ericson Angeles

Age: 20 years old

Sex: Male

Address: Cugman, Cagayan de Oro City

Date of birth: September 15, 1989

Date of place: Cagayan de Oro City

Civil Status: Single

Skills/ capabilities: Sports, singing

Companies: Liceo de Cagayan University

Level: NCM501204

II. EDUCATIONAL ATTAINMENT

LEVEL SCHOOL/ ADDRESS YEAR GRADUATED

Elementary Montessori de Oro 2001-2002

Kauswagan, Cagayan de Oro City

Secondary Xavier University High School 2005-2006

Pueblo de Oro, Cagayan de Oro City


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CURRICULUM VITAE

I. PERSONAL DATA

Name: Richelle Chanjueco

Age: 20

Sex: Female

Address: Tupaz St., Butuan City

Date of birth: December 03, 1990

Date of place: Butuan City


Skills/ capabilities: Singing, modeling


Level: NCM501204



Elementary Butuan Central Elementary School 2001-2002

AD Curato St. Butuan City

Secondary Agusan National High School 2005-2006

Butuan City


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CURRICULUM VITAE

I. PERSONAL DATA

Name: Christian Jed Navia

Age: 20

Sex: Male

Address: Lucky Village, Ambago, Butuan City


Date of place: Butuan City


Skills/ capabilities: Singing, Sports, Music artist


Level: NCM501204



Elementary Butuan Central Elementary School 2001-2002


Secondary Agusan National High School 2005-2006



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CURRICULUM VITAE

I. PERSONAL DATA

Name: Jude Anthony Nitcha

Age: 20

Sex: Male

Address: Kauswagan, Cagayan de Oro City

Date of birth: Cagayan de Oro City



Skills/ capabilities: Elocutionist, Debater


Level: NCM501204



Elementary Montessori de Oro 2001-2002

Kauswagan, Cagayan de Oro City

Secondary Xavier University High School 2005-2006

Pueblo de Oro, Cagayan de Oro City

CURRICULUM VITAE


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I. PERSONAL DATA

Name: Faith Tangcalagan

Age: 19

Sex: Female

Address: Molugan, El Salvador City

Date of birth: May 07, 1990



Skills/ capabilities: Writer, typist, journalist

Companies: Liceo de Cagayan University, Parish Youth

Council

Level: NCM501204



Elementary Miraculous Medal Academy 2001-2002

Molugan, El Salvador City

Secondary St. Joseph Academy 2005-2006

Poblacion, El Salvador City

CURRICULUM VITAE


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I. PERSONAL DATA

Name: Mary Ann Tumulak

Age: 20

Sex: Female

Address: Dipolog City, Philippines


Date of place: Dipolog City


Skills/ capabilities: journalist, movie-making, photography


Level: NCM501204



Elementary Estaka Central School 2001-2002

Dipolog City

Secondary St. Vincent College 2005-2006

Dipolog City


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final for cd burning

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