ATTITUDE OF WEST NEGROS UNIVERSITY LEVEL 3 STUDENT NURSES TOWARDS SMOKING

A Research Paper Presented To Faculty And Staff of College of Nursing West Negros University Bacolod City

In Partial Fulfillment of the Requirements In Bachelor of Science In Nursing

by: Gangoy, Lalaine Gellada, Pamela Pearl Genovea, Dona Suegay, Charmy Tomugdan, Michelle Marie

2 Group 6 N3 - 5 Chapter 1 INTRODUCTION

Background of the Study Smoking is a habit but curable. Considered as curable but few people try to control themselves from doing it. People, students and even professionals are often tempted to smoke. For some, smoking relieves tension; superiority among others, curiosity, satisfaction, and a form of self deception but the adverse consequences of smoking is ones own health. Smoking exist everywhere even in school campuses that conclude to be huge problem. According to Toni Christopherson, a problem that everyone tries to eradicate but fails to act on it because they themselves cannot practice what they preach1. It is obvious that smoking is one of the major problems of every college student. Many college students are fond of smoking, it driven one self to heavenly feeling. But it is not an excuse to be free from any complication someday. Many people tried self discipline to control the temptation of smoking. Others would try re- lifestyle and refocus their attention just to stop themselves from doing it. But worse, others dont know what to do and they simply give in. Others on the other hand, would smoke not because they dont know what to do but simply because they wont get belong to the in group.

Toni Christopherson, Working Nurse, (Working World, June 11- July 2, 2004), pp. 22.

As mentioned earlier, smoking is curable; one always has the power to control ones self. Because of smoking, few qualified people get to be successful. It's because of smoking is one of the reason that word's mortality rate. Smoking could never be eradicated unless we try to start the battle against it and heart attack in those with heart disease. Studies have indicated that some student does smoking during their vacant time than studying their lessons. Smoking in college especially in nursing students is becoming popular substitute for learning. There are some factors of smoking which has the social approval from parents, faculty and friends. Some studies shows that student with low self esteem is actually more likely to smoke than student with high self esteem because of the negative evaluation that they might receive from the people around them.2 3

Objectives of the Study

2 3

Keller, Kimberly, Great Emphasis, 1976, pp.32 Polacheck, Whitney, Guiding Rules for a Better, 1996, pp. 45

4 The main purpose of this is to know the attitude of West Negros University student nurses towards smoking. Specifically, this study answers the following questions: 1. What are the attitudes of WNU student's nurses toward smoking? a. favorable b. unfavorable 2. What are the attitudes of male and female student nurses toward smoking? 3. What are the attitudes of regular and second courser students toward smoking? 4. What is the influence of smoking on the academic and clinical performance of the student in WNU College of nursing? 5. What will WNU do for student nurse to stop smoking? a. Prohibit smoking inside the campus, or within the parameter of 200m away from school. b. Fine of 100 pesos when caught of smoking. c. Make an incident report when caught of smoking while on school or clinical area.

Assumptions

5 The basic assumptions considered in this investigation are as follows: 1. Male and Female student nurses possess different attitude toward smoking. 2. Everyone is entitled to choose his or her own recreational activities. 3. Each school has certain ways to prevent unnecessary misdoing inside the school campus. Theoretical Framework Smoking has been practiced in one form or another since ancient times. Perception surrounding smoking has varied over time and from one place to another; holy and sinful, sophisticated and vulgar, a panacea and deadly health hazard. Only recently, and primarily in industrialized Western countries, has smoking come to be viewed in a decidedly negative light. Today medical studies have proven that smoking is among the leading causes of diseases such as stenosis, lung cancer, heart attacks and chronic obstructive pulmonary disease, and can also lead to birth defects. The well-proven health hazards of smoking have caused many countries to institute high taxes on tobacco products and anti-smoking campaigns are launched every year in an attempt to curb smoking. The reasons given by smokers for this activity are broadly categorized as "addictive smoking", "pleasure from smoking", "tension reduction/relaxation", "social smoking", "stimulation", "habit/automatism", and "handling". There are gender differences in how much each of these reasons contribute, with females more likely than males to cite "tension reduction/relaxation", "stimulation" and "social smoking"

6 A clear majority of alcoholics smoke. According to Evelyn Lutz4, between 80 and 95 percent of alcoholics smoke cigarettes, which is more than three times higher than among the population as a whole. Research has also shown that smokers with a history of alcoholism are more nicotine dependent than smokers with no such history, and suggests smoking cessation may prompt a relapse to drinking among a small number of smokers with a history of alcoholism. "This study refutes the common perception that smokers with a history of alcoholism have more difficulty quitting smoking and are likely to relapse back to alcoholism," said John R. Hughes5, professor of psychiatry at the University of Vermont and lead author of the study. "Our results suggest smokers with this history need to be encouraged to attempt to stop smoking." Hughes also said that for "for 85 percent of smokers with past alcoholism, quitting smoking is not a problem. Furthermore, as our findings indicate, we found smokers with past but not current alcoholism were able to quit as well and benefited from nicotine-patch treatment to the same degree as smokers without this history.

4 5

Evelyn Lutz, Philippine Journal of Alcohol Abuse and Alcoholism, January-June 2006,pp.23 John R. Hughes, Smoke Alarm, Volume 76, March-December 1998

7 Social approval whether it is from parents, faculty or friends, is a factor that attributes to smoking. Crowne and Marlou6 found college student with a high need for approval of smoking more often because they as concerned about negative evaluation. Attitudes and Values as Motivational Perceptual State Attitudes and values can be thought and will be dealt with here as motivational perceptual states7. An individuals attitude set a respond through the perceptual quality of selecting, categorizing, and interpreting experience in the line of expectation; individuals' values are associated with the central tendency of cluster of his attitude in a long range motivational sense. Attitudes are learned in terms of restricting of the psychological fields. This process is a dynamic one in so far as attitudes and values are subject to change though the acquisition of new information. However, attitudes appear to be more susceptible to apparent change while the basic values underlying them persist. Attitudes are important in social psychology because they sum up the past experience of the individual in terms of directive motivational perceptual states, growing out of learning. This process therefore has consequences not only in terms of observable behaviors but also with respect to potentials fro the individual's action.

The Structures and Functions of Attitudes

6 7

Erik Crowne and Marlou, Your Health Guide, February-August 2005, pp. 85 Franklin Allport, Choose life, not smoking, pp. 106

8 In the early studies of attitudes, it was quite common to rely largely on the description on individual's attitudes, their direction in terms of valence, and the belief system that they constituted. More recently, attitudes have been viewed with considerably greater stress on what can be called their structural relationships and functional features. The first of these newer emphases has been called "cognitive interaction'' which conveys the idea of a relationship between attitudes within the psychological field. It also encompasses the process by which new experiences become absorbed as added information. Within this approach a great deal of contemporary research has been directed toward attitudinal consistency and congruity, about which we shall say more shortly. The second emphasis, on functional features, concerns especially the motivation serve. Components and Aspects of Attitudes There are great ways to approach the organization of attitudes, but for convenience, we can consider them with reference the three major components and three aspects of study. Regarding the components, Katz8 observes that attitudes have been treated with respect to a cognitive component, which refers to belief disbelief, affective components, which deal with like dislike, and an action components, which embodies a readiness to respond. The relationship of these components continues to be a lively interest in contemporary social psychology. Thus believing or not believing something, and liking one or the other alternatives, is by no means simple distinctions to make.
8

Emily Katz, Aspects of Behavior, pp:123-124 h

9 As Rokeach9 has pointed out, a firmly entrenched belief, especially when challenge, is usually found to have considerable positive effect. There maybe a little apparent liking in the sense of positive valence associated with one's belief that the earth is round, yet a contradiction of it would generate strong feeling. This point bears on consistency which will be considered below. The three major aspects in the study of attitudes are: the relationships of their components, especially in terms of cognitive interaction and individual adjustment; their source, that is, the patterns by which attitudes are acquired through learning; and attitude change, with reference to the influences on the individual which result in the incorporation of new experience and the modification of attitudes10. View broadly; there are several qualities of attitudes which may we may now generalize as follows: they are beliefs and feelings about an object or set of objects in the social environment; they are learned; they to persist, though subject to the effects of experience; and they are directives states in the psychological field which affects action.

Scope This study covers all the level 3 nursing student of West Negros University Bacolod. The sample size was predetermined because of the inadequate list of student involves in smoking. To enable to identify male and female respondents in their affection in smoking and school objectives to handle the necessary precautions toward smoking.
9 10

Rokeach, Beliefs & Attitude,pp89 Elliot Karen, Significant Gains, 1996, pp. 63

10 Limitations In view of financial and time constraints on the part of the researchers, only level 3 student nurses were selected: Level 3 because it is easy and accessible on the part of the researchers as they are also in the same year level. Aside from that, level 3 is the time were the student nurses are expose to the clinical area for their internship.

Definition of Terms Academic Performance conceptually academic performance refers to the over all evaluation of the academic performance reflected in student's grades. Operationally, these terms refer to the over all grades of students in all his subjects. Age refers to the length of time of level 3 students which measured by years from birth that considerably existed.

11 Attitude refers to mental disposition, feelings or emotion toward a state or fact. In this study, this term means the student's feeling and disposition toward smoking. Clinical Performance the term refers to the evaluation of the performance in the clinical setting, hospital or community. Sex- conceptually this term refers to the sum of structural and functional differences of every individual. Operationally this term refers to male and female engage in smoking. Smoking - is a practice where a substance, most commonly tobacco, is burned and the smoke tasted or inhaled. This is primarily done as a form of recreational drug use, as combustion releases the active substances in drugs such as nicotine and makes them available for absorption through the lungs. In this study, this term refer to the inhalation of burned tobacco stick of the students.

Significance of the Study This study will be great significance to the following: Clinical Instructors in WNU. As clinical instructors guide and are the one who are always there for the students, they have a great responsibility in motivating the students. This study will provide and support the students in giving good quality education and health teaching which could necessarily extend benefits in the school and for the students. In terms of school performances, level 3 student nurses could practice

12 self discipline through the help of Clinical Instructors who handle them. They should give advices and health teachings for the students to be more aware of the effects of smoking towards their health, academic and clinical performance. Dean of the College of Nursing. In order for the dean to assess the immediate needs of the student services and supervises the level 3 student nurses through their academic performance and health status. Furthermore, to determine whether this study towards smoking has a great impact in the student nurse's academic and clinical performance. Also for the dean of the college to be alarmed and to implement actions that could alleviate the students attitude towards smoking. This is not only for the college but also for the school to uplift its name and produce quality nurses in the near future. For Academic Performance Administrators. For them to give a future program that will draw out a plan for the school. They could provide objectives and support the program which could serve as baseline for decision making. For the class advisers, who could give student nurses care and guidance and which could possibly help students in managing their life. They could provide objectives and identify all their perspective needs from the different policy of the school. For Level 3 student nurses, so their goals could be identified, and for the benefits of their future plans, health and career. This could be chance of opportunity for them to gain self discipline and be a role model to their responding clients in the clinical area, school and community. They will realized that what they are doing will affect their studies.

13 For the researcher, to encourage changes in the health habit of their fellow students and be knowledgeable on the effects of smoking, health discipline and an anchor individuals to maintain and strengthen the health condition of the students nurses in terms of promotive, preventive and curative aspects of the course.

Chapter II REVIEW OF RELATED LITERATURE

This chapter covers more on the study, which is basically related to the research study of the attitude of West Negros University College of Nursing level 3 student nurses towards smoking. This chapter contains the related reading, ideas, concept and research studies of different authors and sources in relation to the effect of smoking to one's attitude. Conceptual Literature

14 Smoking is the practice of inhaling tobacco from a pipe or cigarette. The custom of smoking tobacco is thought to have started in the Americas. In the late 1400's, English and Spanish explorers returning from the New World brought back to Europe the custom of pipe smoking, which they had learned from Indians. Cigarette smoking may have started among the Aztecs of Mexico, who smoked shredded tobacco rolled inside corn husks. Until the 1900's tobacco was used mainly in cigars, chewing tobacco and snuff. Later cigarette smoking became popular and increased sharply after World War 1 (1918) and again after World War II (1945)11. In 1964 the United States Public Health Service released a landmark document, smoking in health: Report of the Advisory Committee to the Surgeon General, which concluded that smoking is a major cause of cancer of the lung, mouth and throat. Since, then researchers have shown that each year cigarette smoking cause more than 300,000 premature deaths in the United States alone, principally from the heart disease, cancer and chronic (long lasting) obstructive lung disease, such as emphysema. In 1965, congress adopted legislation requiring that all cigarette packages carry a warning about the health hazard of smoking. Cigarette advertisements on radio and television have been banned since 1970. One of the more recent concerns about smoking is the effects of tobacco smoke has on nonsmokers (" passive or involuntary'' smoking). The 1986 Surgeon General's Report, the health consequences of involuntary smoking, came to three major conclusion: (1) Involuntary smoking is a cause of disease, including lung cancer, in healthy nonsmokers; (2) the children of parents who smoke have more respiratory infection, such as pneumonia and bronchitis, than the children on non- smokers. (3) The separation of
11

The New Book of Knowledge, 1992, pp. 243

15 smokers and non- smokers may reduce, but does not eliminate, the exposure of nonsmokers to environmental tobacco smoke12. These findings support recent trend towel restricting or banning smoking in public places and in the workplace. In fact, the surgeon general and Public Health Service have called fro smoke free society in succeeding years. Campaigns aimed at educating the Public about the health hazards of smoking have been very successful. Studies shows that 90% of the U.S. adult population now recognizes that cigarette smoking cause lung cancer, heart disease and emphysema. Teenagers have begun turning away from cigarettes. The percentage of high school seniors who smoke every day has fallen from 29 % in 1977 to about 20% in 1987. It is critical that people recognize that dangers of smoking before they consider taking up the habit. Smoking causes smokers cough, a lower capacity for exercise, addiction to nicotine, and in the long run, severe disability and death13. Local Literature In the Philippines, the number of women who smoke is constantly on the rise. It is a phenomenon that, in recent years, seems to affect the youngest most of all: 30% of girls between the ages of 13 and 18 smoke regularly. According to a recent study conducted by the Southeast Asia Tobacco Control Alliance, 18.7% of Filipino young women between the ages of 13 and 25 smoke cigarettes. The numbers go up if the sample is restricted to teenagers between 13 and 15: 3 out of 10 already have the smoking habit. Among female smokers, 60% say that they smoked their
12 13

Time Magazine, Volume 44, 1995, pp.5 The New Book Of Knowledge, 1992, pp. 587

16 first cigarette at the age of 18, while the remaining 40% say they started when they were still very young. They continue to smoke despite the fact that they are aware of the risks connected to smoking: nine girls out of ten know that smoking can cause lung cancer, infertility, early menopause, osteoporosis, and hysterectomy. For this reason, the country has begun an anti-smoking campaign supported by the local Catholic Church: the first initiatives include that of putting warning labels on packaging14.

Research Literature Alarm more teens are lighting up and making smoking a habit. But do they really know the harm they're doing to their young bodies? Some teens are asked why they smoke. They mostly answered to relieve tension; to be in "in" the group, fashion and make them feel strong and heavenly feeling. There are only some teenagers being asked for the reasons of why they smoke. True that we all die but dont we know the adverse consequences smoking has on one's health. More than just addictive nicotine, these are the poisons that go into our lungs each time we inhale cigarette smoke. ARSENIC: used in rat poison; ACETIC ACID: hair dye and developer; ACETONE: main ingredients in paint and fingernail polish remover; AMMONIA: a typical household cleaner; BENZENE: rubber cement; CADIUM: found
14

AsiaNews.It.com, February 05, 2007

17 in batteries and artist oil plant that carries carbon monoxide; FORMALDEHYDE: used to embalm dead bodies; HYDRAZINE: used in jet and rocket fuels; HYDROGEN CYANIDE: poison in gas chambers; NAPTHALINES: used in explosive moth balls and pain pigments; NICKEL: used in the process of electroplating; PHENOL; used in disinfectants and plastics; POLONIUM: radiation dosage equal to 300 chest X-ray in one year; STYRENE: found in isolation material; TOLUENE: embalmers glue; VINYL CHLORIDE: ingredients found in garbage bags15. The gross truth, the damage of smoking does to our insides eventually shows in our physical appearance. It's not about beig vain, but puffing can really strip our pretty points. Its stained teeth that either yellowish or brownish, bad breath, a yellow stain in the fingertips, black lips, facial wrinkles and an over all odor of stale smoke that everyone, except a smoker that can detect.

15

The Script, 2002, pp.41

18

Chapter III METHODOLOGY

This chapter discusses the method of research use, the subject and respondent of the study, the sampling procedures, the research instrument, the data gathering procedure and the data processing technique use. Since the main purpose of this study was to determine the effect of smoking in the health condition and the academic and clinical performances of the student nurses.

Research Design In this study, the descriptive research design is use because we want to know if smoking has great effect on the clinical and academic performance of nursing students. What is really their reason of smoking? Descriptive research is the most widely research

19 design, indicated by the numerous thesis dissertations and non-academic researches, the primary aim of which is to describe existing belief, opinion or condition of social group; compare sub groups in terms of selected variables; determine the relationship between among variables covered16.

Respondents of the study The respondents of the study will be the level 3 male and female student nurses of West Negros University. These students' respondent will be identified in terms of their academic performance, and clinical performance. With the use of purposive sampling procedure, there were 300 level student nurses who were taken as respondent. To determine the sample size, Solvin's formula was used. n = __N__ 1 + Ne Where: n = sample size N = population size e = desired margin of error set at 0.5 level of confidence Thus: n = _200_ 1+ 500(.05)

Data gathering Procedure The researcher requested the approval of the dean of College of Nursing to gather the pertinent data necessary to answer the objectives of the investigation. Approval from the College Registrar for the procurement of grades was also sought upon approval; the
16

Ardales, Venancio, 3rd Edition, 2008.

20 researcher personally copied the averages of the academic grades as well as the clinical grades of the level 3 student nurses. Other information which was needed to establish the profile of the respondents was also gathered from the same office.

Research Instrument This study will make use of a survey questionnaire compose parts to gather the needed data. It will be supplemented by the academic and clinical record of the level 3 student nurses in second semester S.Y. 2008 2009. It will be further supplied with interview to level 3 student nurses to collaborate and substantiate the information gathered from the questionnaire.

Data Analysis Procedure The following statistical tools were utilized to analyze the gathered data to answer the first objective which sought whether level 3 student nurses of WNU are favorable or not, towards smoking. Objective 2 and 3 determine the attitudes between the male and female and the regular and second courser level 3 student nurses towards smoking. The formula to be used: Descriptive Statistics % = F/N 100 % = percent F = frequency N = total # of the respondent

21 Objectives 4 sought to determine the level of academic and clinical performance of the level 3 nursing student when group according to attitude of student, regular or second courser, smoking habit, the mean was used. According to Basilio, the mean is the most dependable measure of central tendency.

The formula is as follows: X = __efx__ N

where: x = the mean efx = sum of the weighted scores N = total # of the respondents

22

QUESTIONNAIRE PART I. Bio Profile Direction: Please indicate your response by checking the appropriate box or by filling the blank. 1. Name (optional)___________________ 2. Sex: ( ) Male ( ) Female 3. Age: _____________ 4. Estimated allowance for a week ______________ 5. Regular: ( ) Second Courser: ( ) Passive Smoker: ( )

6. Active Smoker: ( ) PART II.

Direction: Please check the parenthesis which corresponds to your answer. 1. I usually smoke when I'm bored. 2. I usually smoke when I see my classmates do the same. ( ) Yes ( ) No ( ) Yes ( ) No

23 3. I consume more than 5 sticks of cigarette per day. 4. I smoke when I encounter problems. ( )Yes ( )No ( ) Yes ( ) No

5. Smoking affect my study habits, my performance in the academic and clinical area. I believe smoking makes me release my tension. 6. I believe smoking is risk full in my health in the future. 7. I believe smoking is already a part of my lifestyle. ( ) Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No

8. West Negros University should implement rules and regulations to eliminate smoking. BIBLIOGRAPHY ( ) Yes ( ) No

BOOKS Ardales, Venancio B. 2008 Basic Concepts and Methods in Research. 3rd edition. Ermita, Manila: Educational Publishing Company Christopherson, Toni G. 2004 Working Nurse, Working world. New York: Wadsworth Publishing Company. Hughes, John R. 1996 Smoke Alarm. San Diego State University Keller, Kimberly F. 1996 Great Emphasis. California: Polacheck, Whitney. 1996 Guiding Rule for a better. New Jersey: Prentice Hall Inc. The New Book of Knowledge 1992 History of Smoking PERIODICALS

24 Philippine Journal of Alcohol Abuse and Alcoholism. (January / June 2006) The Script. (2002) Time Magazine, Volume 44, (1995). INTERNET www. AsiaNews.It.com

TABLE OF CONTENT PAGE APPROVAL SHEET ACKNOWLEDGEMENT ABSTRACT LIST OF TABLES LIST OF FIGURES ii iii iv

CHAPTER I INTRODUCTION Background of the study Statement of the Problem Hypothesis

25 Theoretical Framework Conceptual Framework Significance of the Study Scope and Delimitations of the study Definition of Terms