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Determinants of herbal medication utilization.

INTRODUCTION

Health is one of the dimensions that should be looked into as an important factor for life and survival. Today, health is compromised because of the changes that are occurring like the food we are eating, the technologies that are arising and, our activities of daily living. These factors tend to affect our lifestyle and our future disposition. These factors contribute and affect every decision we make in relation to the dimensions of life. One dimension that is affected by these factors is the dimension of health. Health is one of the most important dimensions in life that is greatly affected by the changes that are occurring. One of these alternative ways of treating the symptoms of the underlying disease is through the usage of plants and herbal medications. Some of these herbal medications have not yet been approved by the Department of Health (DOH). Some of these herbal medications are just being used by people because of specific beliefs or because of the influence of their relatives, neighbors, and peers.

This study identifies reasons why people utilize herbal medications in treating diseases even without consulting the physicians. We would also want to know why they are more than willing to take the risk in letting their kids take in herbal medications even if these medications have no approved therapeutic claims.

FRAMEWORK

The structure of this study is based on Leininger's Culture Care Theory. Leininger underlines the meaning. The roots of the theory are in clinical nursing practice: Leininger discovered that patients from diverse cultures valued care more than the nurses did. Gradually, Leininger became convinced about the need for a theoretical framework to the dimensions of life. In her Culture Care Theory, Leininger states that caring is the essence of nursing and unique to nursing. Care always occurs in a cultural context. Culture is viewed as a framework to solve human problems. In that sense, culture is universal. It is also diverse, as Leininger refers culture to the specific pattern of behavior which distinguishes any society from others.

Alternative medications vary from one culture to another. Some cultures may prefer certain medications than other cultures. The study uses Madeline Leininger's Transcultural theory. She mentioned in her theory that nursing approach varies from culture to culture. Some cultures may prefer certain interventions that others don't. In this study, we use Leiningers theory because some cultures may use herbal medications and some may not. Some believe that certain effects are seen when these herbal medications are used.

OBJECTIVES OF THE STUDY

The study was conducted to identify the determinants why people practice the usage of alternative medications. Specifically, this study sought to answer the following objectives:

1. To describe the profile of the respondents; and,

2. To identify the determinants of herbal medicine utilization.

Hypothesis

People in the community resort to the use of herbal medications because of these reasons: herbal medications are cheap, safe and have lesser side effects.

Scope and Delimitation

The study involved 30 respondents each from selected communities of Cebu City, namely: Labangon, Mabolo, Buhisan & Busay. There were 15 respondents who utilize herbal medications and 15 respondents who did not utilize herbal medications from each community. The study included adult both male and female with ages 18 and above living in the selected communities.

FRAMEWORK

The reasons why people resort to complementary medicine are both rational and emotional factors. Relying upon recommendations of their family and friends, holistic treatment, mild treatment, dissatisfaction of conventional medicine, fewer side effects and/or lower costs are the few reasons given by adult complementary and alternative medicines (CAM) patients (Wapf and Busato, 2007). These beliefs and practices include the preference of consumers for natural therapies; the belief that herbal drugs are free from side effects; the belief that herbal medicines might be of effective benefit in the treatment of certain diseases where conventional therapies and medicines have proven to be inadequate; tendency towards self-medication and the belief that they can save money more (Braz Med Biol Res, 2005).

But in a conducted study, there are currently three main reasons explaining patient's choice of alternative medicine. One is the dissatisfaction with conventional medicine. People usually are not satisfied with conventional medicines because of negative past experiences and they turn to alternative medicines because they see them as effective, milder and causing less adverse side effects. Second reason is that they want to have a more personal involvement in the healing process to keep control over their own health care decisions. The third reason is that alternative medicines are more congruent with their spiritual or religious values, beliefs or philosophy regarding the nature and meaning of health and illness (Wapf and Busato, 2007).

Though herbal medicines have so many advantages, herbal medicine does not necessarily mean safe for users always. Many natural substances and herbal medicines can be harmful if taken in over doses or if used wrongly. More over, herbal medicines may not be pure sometimes. Unregulated herbal products may be mislabeled and may contain undeclared additives and adulterants. They may also include other things such as plant pollen or contaminants that could make users sick. Also, the active ingredients in many herbal supplements and treatments remain unknown. Some supplements have been found some to contain metals, prescription drugs mixed in without any mention on the label, microorganisms or other substances (Ipsum, 2009).

In an article published in the American Academy of Family Physicians by Melanie Johns Cupp, Pharm.D, ginkgo biloba is often used by patients for the treatment of many common disorders. These range from anxiety to minor blood disorders, such as hypertension (otherwise known as high blood pressure). However, this herbal supplement has also been known to cause bleeding in some patients after prolonged use. Other examples of side effects associated with the herb include dry mouth, dizziness, confusion and stomach irritation (Fonseca, 2010).

Hence, it is always wise to consult with the doctor first before taking herbal medications. Testing and standardized manufacturing of herbal medicines and supplements are needed, to have the full benefits of herbal medicines. Researches reveal that all herbal medicines should be stopped two weeks before any surgery (Ipsum, 2009).

METHODOLOGY

Research Design

The propopents used the descriptive research design for this study since there was no manipulation of variables. The type of descriptive design employed was the causal-comparative research design. This type of descriptive research aims to discover the possible causes and effects of a behavioral pattern, in this case, the use of herbal medications. This type of research design is also useful since it does not employ the need for variable manipulation and at the same time allows the study for many relationships at a given time.

Research Locale

The researchers conducted the research in four communities: Labangon, Mabolo, Buhisan, and Busay. The first two communities are classified as urban being near the city proper while the latter two are rural being located in mountain areas.

Research Respondents

The researchers selected 30 adults from each selected community. The adults selected were either mother or father (heads) of the family. About 15 of these adults are those who use herbal medications while the other 15 are those who did not utilize herbal medications. The researchers set the following inclusion criteria: a) must be head of the family who either used or did not utilized herbal medications, b) must be adult aging at least 18 years old and c) must be able to comprehend and must be able to speak their thoughts well.

Research Sampling Techniques

The study used the typical case purposive sampling. This sampling technique selects a sample in a deliberative and non-random fashion to achieve a certain goal. It focuses more on cases that are not unusual in any way. The utilization of herbal medication is already widely practiced in the community, especially in rural areas.

Research Instruments

For this study, the researchers conducted the interview to the respondents involved in the study. Structured types of questions were utilized. This was used to obtain specific answers from the respondents regarding their utilization of herbal medicines.

Research Data Gathering Procedures

The start of data gathering involved the submission of letter of request to the respective captains of each community selected for the research. After the approval of the request, selection of respondents took place. Prior to the interview, informed consents were given to the selected respondents. Once they agreed to participate, the interview process began. Each interview lasted approximately 5-10 minutes and was conducted at their respective households.

Research Statistical Analysis

The researchers used the Discriminant Analysis. This is a statistical method that is used to understand the relationship between a dependent variable and one or more independent variables. In discriminant analysis, the dependent variable must be a categorical variable. The values of a categorical variable serve only to name groups and do not necessarily indicate the degree to which some characteristic is present. The categories must be mutually exclusive; that is, a subject can belong to one and only one of the groups indicated by the categorical variable. In this case, the categories are the ones who use herbal medicines and the ones who don't use them.

RESULTS AND DISCUSSION

Most herbal users are from ages 31-40 years old, followed by those who are above 50 years old and 25-30 years old, those who are 41-50 years old, then lastly by those who are 18-24 years old. This shows that most users are those who are influenced by past generations, specifically the middle-age adults, while the least users are from the new generation, or the young adults. Most non-herbal users are from ages 18-24 and those who are above 50 years old, followed by those who are 31-40 years old, those who are 41-50 years old, and those who are 25-30 years old. This shows that most non-users are young adults and late-age adults. There is an equal number of users and non-users aged above 50 years old, but there are more non-users aged 18-24 years old than herbal users of the same age group.

Based on Figure 4, there are more female than male users in contrast to Figure 5 where there is an almost equal ratio between the two sexes. This shows that most herbal users are female while there is almost equal number of male and female non-herbal users in a community.

Most herbal users are already married, implying that these respondents probably already have their own children, therefore have more expenses resort to the use of herbal medications. Most non-herbal users are still single, meaning that they have lesser expenditures and can afford conventional medicines rather than use herbal medicines.

Most herbal users are those who are high-school graduates, followed by those who are of high-school level, with the least users from those who studied college. On the other hand, most non-herbal users are those who are of high-school level, with the least non-users from those who are of elementary level and of college level.

Respondents have an average income of P3001-P6000 per month and have an almost the same proportion of respondents per range of monthly income. This shows that monthly income is not a big consideration in determining whether one will use herbal medications or not.

It can be gleaned from the table, the three factors predict herbal medication utilization namely: family tradition (0.726), number of known users (0.523), total monthly income (0.53). The results implied that the factor with the biggest impact of determining whether one will use herbal medications are cultural values and lifeways, followed by kinship and social factors, and lastly by economic factors. Significantly, the highest specific determinant is having a family tradition of using herbal medications. This result is supported by the study conducted by Ergil, Kramer and Ng (2002) which found that Chinese patients based their decisions about using herbal medicines on family traditions.

CONCLUSION

Based on the research findings, there were three (3) predictors of herbal medication utilization namely: family tradition, number of known users, total monthly income. The results implied that the factor with the biggest impact of determining whether one will use herbal medications is cultural values and lifeways, followed by kinship and social factors, and lastly by economic factor.

RECOMMENDATIONS

Based on the research findings, the researchers of the study came up with the following recommendations:

1. That the family influence in the usage of herbal medications should be preserved and should be enhanced by instilling more knowledge regarding these herbal medications, how these medications work and how they can be used in different situations.

2. That information regarding the 10 herbal medications being approved by the Department of health should be thoroughly discussed to both the health care practitioners and the consumers in order to give more knowledge to the people about alternative medications.

3. That proper usage of herbal medications should be described during teachings in schools, health centers and other institutions that promote health in order to rule out beliefs and to facilitate learning.

4. That teaching herbal medications should be made in different areas not only those areas with easy access to technology but also to remote areas where they can put to consideration the practice in the usage of herbal medications.

doi: http://dx.doi.org/10.7828/ajoh.v3i1.409

LITERATURE CITED

Braz Med Biol Res 2005 Tropical Plant Database. Retrieved October 7, 2010 from http://www.raintree.com/peppertree.htm#.UR3TKB2xWSo

Ergil, Kramer and Ng. 2002 Chinese Herbal Medicines. Retrieved October 8, 2010 from http://www. ncbi.nlm.nih.gov/pmc/articles/PMC1071750/

Fonseca, A. 2010 Side Effects of Herbal Medicine. Retrieved October 7, 2010 from http://www. livestrong.com/article/113026-negative-side-effects-herbal-medicine/. Negative

Ipsum, L. 2009 Benefits of Using Herbal Medicine. Retrieved October 7, 2010 from http:// www.energy4youth.com/benefits-of-using-herbal-medicine.htm#

Leininger, M. M. 1995 Transcultural nursing: Concepts, theories, research, and practice (2nd ed.). New York: McGraw-Hill.

Wapf and Busato. 2007 Patient's Motives for Choosing a Physician: Comparison between Conventional and Complementary Medicine in Swiss Primary Care. Retrieved September 30, 2010 from http://www.biomedcentral.com/1472-6882/7/41

RONDY ARDOSA

ORCID NO.:0000-0001-8288-4687

rardosa.orcid@gmail.com

KATHE ALEXIS CABRERA

ORCID NO.:0000-0001-6476-6513

kacabrera.orcid@gmail.com

FRANCES MARGARETTE CENIZA

ORCID NO.:0000-0002-2914-1531

fmceniza.orcid@gmail.com

SHAZEL DAWN CUIZON

ORCID NO.:0000-0002-3725-2573

sdcuizon.orcid@gmail.com

KATRINA FAYE FUENTES

ORCID NO.:0000-0002-9599-3839

kffuentes.orcid@gmail.com

JEZYL T. CEMPRON

ORCID NO. 0000-0002-6549-8052

cempronjezyl@gmail.com

Cebu Normal University, Philippines
Table 1. Structure matrix for herbal medication utilization

Factors                                     Factor Loading

I. Educational Factors
  A. Taught in School                            .284
  B. Taught in Health Centers                    .352
  C. Educational Background                      .111
II. Economic Factors
  A. Total Monthly Income                        .53
  B. Family Size                                 .166
  C. Medicine Budget                            -.013
III. Religious and Philosophical Factors
  A. Reasons of Preference                       .293
  B. Recommended by Religious Leaders            .134
  C. Recommended by Church Members               .292
IV. Kinship and Social Factors
  A. Influence                                   .100
  B. Number of Known Users                       .523
  C. To Whom Will Promote                        .204
V. Cultural Values and Lifeways
  A. Family Tradition                            .726
  B. Purpose of Using                            .360
VI. Political and Legal Factors
  A. Extent of Legal Knowledge                   .269
  B. Herbal Plants Identified                    .211
  C. Advocated by Community Leaders              .162
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Article Details
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Author:Ardosa, Rondy; Cabrera, Kathe Alexis; Ceniza, Frances Margarette; Cuizon, Shazel Dawn; Fuentes, Katr
Publication:Asian Journal of Health
Article Type:Report
Geographic Code:1USA
Date:Jan 1, 2013
Words:2530
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