Knowledge of and Attitude Towards Breast Feeding of Mothers in a Selected Women

Embed Size (px)

Citation preview

KNOWLEDGE OF AND ATTITUDE TOWARDS BREASTFEEDING OF MOTHERS IN A SELECTED WOMEN'S HOSPITAL IN DOHA, QATAR According to medical study, breastfeeding is the very important benefit that an infant can get from her mother. Furthermore, continuous breastfeeding for six months of life is the best protection of the babies from various diseases like diarrhea, polio, skin diseases among others. Similarly, it strengthens the immune system and lungs of the babies; as well as it boost the mental ability of the babies. More than that, many mothers in Doha Qatar, do not know the benefits of breastfeeding their babies is the most effective way to protect them from ovarian cancer, breast cancer and osteoporosis. In the same way, it strengthens the471 relationship of the baby to his or her mother. In fact, this is the most economic way of feeding their babies economically, but nutritionally. As a result of the survey made in Qatar, 65 percent of mothers are breastfeeding their babies, while 35 percent do not practice breastfeeding. In addition to that, there are 53 % of mothers who are both aware of breastfeeding protection for them against any diseases. In view of this, it is obvious that mothers in Qatar are breastfeeding their babies just to follow traditions. But, they do not have complete knowledge about the great benefits of breastfeeding to them and to their babies health. Moreover, it is also revealed in this study that some mothers do not practice breastfeeding in some women hospitals in Doha, Qatar, because they are not aware and knowledgeable about tremendous advantages of breastfeeding. (http://www.education.gov.qa/research/samples/breastfeeding.pdf)

Therefore, the first objective of this research is to determine if mothers in Doha, Qatar are knowledgeable and aware about the benefits of breastfeeding to their own health, as well as to their babies. Second, is to know the reasons why some mothers in Doha, Qatar do not practice breastfeeding with their newly born babies. Third, is to gather vital information about the attitude and perception of mothers towards breastfeeding in some womens hospitals in Doha, Qatar. A related literature shows that in some womens hospitals in the said country; breastfeeding has been associated with socioeconomic conditions among women in their society. Based on the survey made among 340 women in Qatar, it is revealed that only 32 percent of the mothers exclusively breast feed their babies since birth. This low rate of breastfeeding cases is attributed by the massive media advertisement by various formula companies, as well as the growing power of the Qataris. It is found out that 515 percent of the mothers used both breast milk and formula. However, 13 percent only used bottle feeding for their infants. More than that, 50 percent of below average income mothers breast feed their babies in a full time basis. Nevertheless, only 12 percent from the higher income group breast feed their babies. While 55 percent of mothers who just acquired elementary education, breast feed their infants completely. On the other hand, only 25 percent of group of mothers who acquired secondary and college education breastfeed their babies. The descending rate of breastfeeding mothers in Doha, Qatar, which has been observed since 1980s; is being given serious attentions to some womens

hospitals in the country. Most of the physicians are recommending the mothers to breastfeed their babies, especially while in the hospitals. (http://www.education.gov.qa/research/samples/breastfeeding.pdf) In any case, public health practitioners must do their best effort to disseminate information about the advantages of breastfeeding practice among mothers in the region. Mothers milk is highly recommended by most doctors, and strongly supported by different health organizations together with various sectors of government because it provides complete nutrients to the infants. Similarly, offers tremendous advantages and benefits to the well being of both mother and child. Equally important, the World Health Organization recommends

breastfeeding until two years of age of the child. Continuous breastfeeding for the first six month of life of the babies is greatly crucial for fighting various diseases, until they are growing up. For the nutritional components of mothers milk are multifunctional to human bodies. It has bacteriostatic and immune modulating properties for easy digestion; it is anti inflammatory, and very economical. Significantly important is the benefit of loosing weight for the breastfeeding mothers after giving birth. (http://informahealthcare.com/doi/abs/10.3109/01443618909151290? journalCode=jog) As a result most mothers, who belong to rich families in the State of Qatar, do not breastfeed their babies. This is more impossible among highly educated mothers

with high positions in different industries. Possibly because of the wrong information they have got about breastfeeding or they do not have proper educational system about the real benefits of breastfeeding to their children. (http://informahealthcare.com/doi/abs/10.3109/01443618909151290? journalCode=jog) References: (http://www.education.gov.qa/research/samples/breastfeeding.pdf) (http://www.education.gov.qa/research/samples/breastfeeding.pdf) (http://informahealthcare.com/doi/abs/10.3109/01443618909151290? journalCode=jog) (http://informahealthcare.com/doi/abs/10.3109/01443618909151290? journalCode=jog) Literature Review on the Improvement of the Performance of Nurses through Training and Development There are many various ways that training and development may help to improve the performances of the nurses in the field. First, training and development provides them great motivation to learn more, to increase their knowledge and skills on how to redesign their jobs. Innovative interventions are very essential in determining the capability of the nurses to step up into higher level in the health

care profession. The retention of knowledge and skills gained from training and development programs among nurses are crucial element to examine their ability to cope up with different tasks assigned to them. Assigning them to different hospital departments will be easier then, with their acquired knowledge and skills in different areas such as cardiopulmonary, critical care, practice development resuscitation, among others. Furthermore, educational strategies are very important in identifying educational approaches they learn from various trainings and developments. Through enhancing the retention of knowledge and skills during and after resuscitation training, it will absolutely optimize the rate of survival patients from cardiopulmonary arrest. In contrast, poor knowledge and skill retention among medical staff increases the cardiac arrest cases in most hospitals in every part of the world. In view thereof, it is a mandatory for nursing staff to know how to give resuscitation procedure to the patients in cardiopulmonary cases. As a matter of fact, it has been recommended for more than 20 years that nursing and medical staff should know cardiopulmonary resuscitation. (http://gerontologist.oxfordjournals.org/content/32/3/327.short) Another literature review which was undertaken by using Cumulative Index to Nursing and Allied Health Literature, Medline and British Nursing Index databases; as well as the basic methods of cardiopulmonary resuscitation as both basic life support and advanced life support and training given to many nurse. Relatively, during resuscitation training, different areas of studies are

being thought to nurses such as cardiac arrest simulation, peer tuition, video selfinstruction, various utilization of resuscitation guidelines, computer-based learning programs, voice activated manikins, external defibrillators and the use of action cards. In this regard, resuscitation training is mainly based on in-hospital scenarios. An expert instructor is giving feedbacks to the nurses if they do the steps correctly. It includes the present-situational guidelines like how to do simulations in different cardiac arrest cases. Correspondingly, this training program ensures the potentials of many nurses to go far beyond their duties in nursing practice. This is also the major reason, why World Health Organization, is recommending to nurses in clinical areas to undergo receive automated external defibrillation training. Plus, having access to defibrillators and resuscitation training equipment should always made available in the regional clinics; in order to prevent delays in resuscitation among the patients. In addition to that, many hospitals today, show video self-instruction, in order to many health care personnel to watch it every now and then, as well as to they will able to improve their efficacy and competence in resuscitation.

(http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2648.2005.03491.x/full) Subsequently, health professionals such as nurses are in the right post to alleviate the high risks of related disorders and psychological problems among cancer patients. How can this be done effectively? But, of course proper communication training and development are important to attain this goal. Various medical communication researches proved that the problem-focused training workshop is an effective way to address these psychological related

issues among cancer patients in the hospitals. This particular related literature, implies that the role of problem-focused workshops that entail adequate knowledge and skills, along with the ability and willingness of the nurses to assess their patients emotionally; has been a basic guide for them to develop some effective approaches on how to communicate effectively with the cancer patients as well to their families. (http://www.sciencedirect.com/science/article/pii/S0277953696001487) Nevertheless, the common problem in nursing training and development is the transformation process of learning ideas to clinical practice. And, this write ups considered peer coaching as the best solution to the problem. This is easily done through the help of nursing educators of course; peer coaching describes the learning process, characteristics, components; as well as the benefits of the process both to nurses and the patients. And, clinical breast examination skills are one of the important training skills that nurses must acquire with accuracy and efficiency. With all these in mind, it may therefore conclude that the efficacy and high standard of nursing practice greatly depends on the nurses advanced educational attainment in the medical and health care profession.

(http://www.slackjournals.com/article.aspx?rid=4295) References: (http://gerontologist.oxfordjournals.org/content/32/3/327.short) (http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2648.2005.03491.x/full)

(http://www.sciencedirect.com/science/article/pii/S0277953696001487) (http://www.slackjournals.com/article.aspx?rid=4295) Introduction With more than 3 billion of the world's population living in cities, and accelerating urban expansion arising from globalization, population growth and migration, today's urban settings are redefining the field of public health. The complex dynamics of cities, with their concentration of the poorest and most vulnerable, pose an urgent challenge to the health community. While retaining fidelity to the core principles of disease prevention and control, major adjustments are needed in systems and approaches to effectively reach those with the greatest health risks within today's urban environment. Controlling and preventing HIV/AIDS, tuberculosis and other diseases are among the key global health priorities, particularly in poor urban settings. The challenge for infectious disease control in slums and informal settlements is not in identifying which interventions work, but rather ensuring that slum dwellers are captured in health statistics that define disease epidemiology, and are provided opportunities equal to the rest of the population to access proven interventions. Background of the Study Global databases consistently demonstrate the higher incidence,

prevalence, mortality and burden of HIV/AIDS, tuberculosis and other communicable diseases in developing countries.

According to the work of Pillay (2004) entitled: Using GIS to spatially portray the prevalence of HIV/AIDS and Tuberculosis and its demographic consequences in selected countries in Sub-Saharan Africa, 32.8 % HIV and TB cases was recorded in South Africa from the estimated 180 507 TB cases against a TB incidence of 419/100,000 population. The analysis goes with more numbers and statistical data, but what the author found out was that the spatial dynamics of the problem can be analyzed using the GIS techniques via choropleth mapping of HIV/AIDS and TB prevalence data. He added that whatever the emerging patterns found in the proliferation of the diseases will give further researchers guidelines and framework to possibly trace the trend between the HIV/AIDS and TB relationship. Furthermore, some researchers established a close connection between TB and HIV/AIDS that each of them influenced the activation and reactivation of disease to each other. There are significant impacts which these diseases have to society. The diseases like this will have cultural, social and economic effects to one country with great number of victims. According to Indusa in his work The Use of GIS in Mapping, Analysis, and Evaluation of HIV/AIDS Occurrence Patterns, there is a growing consciousness that the 40 million people estimated to be currently infected with HIV will eventually die of AIDS or AIDS related illness and that "a set of inter-related social, economic and social crisis will increase unless effective action is pursued. For Indusa (2002), the decline in labor productivity brought about by workers' frequent absences and loss of experienced workers are significant economic impact while HIV/AIDS's epidemiological impact is

significant, yet, the social impact is more frustrating. In order to control and prevent the further transmission of HIV/AIDS there are considerable social actions that were made that resulted to the high number of orphans and some children are absorbed by the extended family members. Statement of the Problem The study seeks to answer the following problems: 1. What is the current status of HIV/AIDS globally? 2. What is the direct correlation between HIV/AIDS? 3. How HIV/AIDS and TB does affect each other and vice-versa? 4. How GIS does contribute to the prevention of HIV/AIDS and TB? 5. How GIS help establish the spatial autocorrelation between HIV/AIDS and TB? Objectives The general objective of this study is to find the spatial autocorrelation between HIV/AIDS and TB. Thus, in order to fulfill this goal some particular objectives are needed to be identified such as: 1. To assess the current status of HIV/AIDS globally. 2. To draw a clear line between the relationship of AIDS and TB 3. To find the role and importance of GIS in identifying the spatial autocorrelation between HIV/AIDS Significance

There are many researches about HIV/AIDS and TB. Using different approaches and epidemiological apparatuses and instruments in determining the cause-effect relationship of the disease and to come up with effective alternative and ways to control and prevent the proliferation of the disease yet there is no ample study on finding the relationship between AIDS/HIV and TB. Some researchers had pronounced the interrelationship between AIDS and TB yet, in different field of study. This study is significant in the sense that the new technological apparatus which is GIS will be the tool in identifying and supporting the claim of previous studies declaiming the direct relationship between HIV/AIDS and TB. This will help the health sector create more effective programs to prevent the rampant spread of the disease. Methodology The use of GIS is the primary tool for this study. Using the qualitative and quantitative approaches in research will help uncover the hidden clues about the relationship between HIV/AIDS and TB. Website of international agencies, organization, including national and regional non-governmental organizations known for their work in the areas of urban health, communicable disease control and prevention, and urban development were examined and links to potentially useful material. Suggested references were solicited from colleagues working in the area of urban health. In addition, information from colleague involved in field implementation of relevant projects was obtained through face-to-face, telephone or electronic interviews.

Time Table If this research will be approved by the panel of inspectors, the study will go according to the desire dateline. For the first two months of the research will be devoted on gathering literatures, conduct surveys and interviews. Following the consumed two months, will be further gathering of data and information. This time, conducting a case study, case observation, field observation and research and further interviews will be held. The next two months will be use to collecting the gathered information and data sheets and analysis will be made after the said exercise. The last few moths of the research will be preparation for the formal writing of the data and analysis and for the final presentation of the whole research study. Expected Result The expected result of this study is that towards the end of the research, we may be able to underline and draw a clear connection between the HIV/AIDS and TB. In this regards, the research expected to fulfill its entire task from gathering data and information, to analysis and presentation and that all the objective and problems stated in the first chapters will be answered clearly. Very important in this study is the fulfillment of providing a clear answer to the noble aim of this study. Moreover, to prove the claim of the study that there is

a preexisting direct connection between the two communicable and deadly diseases: HIV/AIDS and TB. Research Proposal on How does Stress at a Work Place Affect Employees at Home At this time and age, along with global crisis we are experiencing; most employees are having a hard time to cope with the stress in the work place Everyday, many employees are spending most of their time in the office rather than at their home. This is also the main reason that at the end of the day; most of them tend to be out of control, feeling exhausted and worn out after a long day work. . However, stress is already considered a normal part of any organization; regardless of positions and salary level in the company. And, the only thing to do in managing stress is to learn how to deal and cope with it. Focusing on the tasks that you do everyday, is somewhat relevant in minimizing the stress level you feel when you are doing your work. Remember, it is more relaxing, if you are doing something that you are well-knowledgeable and equipped with, rather than doing something which you are inadequately capable of. So, the bottom line is to master your tasks, in order you to do them with more ease and confidence. By this way, makes you more relaxed in your work place; at the same time you are still capable of doing your tasks when you reach home with less stress. (http://helpguide.org/mental/work_stress_management.htm)

Based on the various studies made, too much stress of a person really affects his or her state being; up to the extent that he or she can not function effectively inside the house. In addition, many employees, especially working in a call center environment, show a lot of irate behaviors at home. Meaning, they even take with them whatever unpleasant atmosphere they encounter in their workplace. As a result, excessive stress hinders a persons productivity, as well as it reduces the physical and emotional heath being of a person. Now, how to avoid stress getting into your nerves even at your own home? For this kind of economy we have right now, it is inevitable to feel like you are relax and contented of what you have got. Layoffs and budget wise are very common sentiments of many workers in various industries; which caused many people to become feared and uncertain of what their future has in store for them. But, the ability to manage stress in the workplace not only improves the physical and emotional health condition of many employees; as well as it is also the basis of attaining success or failure in the workplace. And, whatever, achievements you attain in your work place, it automatically reflects on the way you behave when you arrive home. If you have a happy and stable disposition in the company your work with, the more it may show when you are with your family at home. Naturally, you are somewhat happy and proud to share whatever accomplishments you acquire in your work place. The more you are able to do your job well, the more you are inspired to do some of your stuff inside the house. Therefore, it is very important to learn some guidelines in reducing job stress; so as it will not affect your disposition towards your own family life.

(http://www.hse.gov.uk/stress/furtheradvice/stressathome.htm) Medical experts suggest that learning how to communicate effectively, is one way of avoiding stress; excellent communication and interrelation skills are crucial factors in improving your working relationships with your co-workers, as well as to your family. Aside from that, taking charge voluntarily tasks that you can do better, is another way to feel good about yourself. Plus, avoidance of procrastination habit must be taken into high consideration, in order to reducing your accountabilities in the company. Avoid negative attitudes and perceptions; they may escalate the level of stress you feel towards your work. It is best to have fun while working; and you can only do this through building good rapport and pleasant relationship with your superiors and co-workers. Moreover, every employee must be aware that excessive stress in the work place is associated with various signs and symptoms such as feeling anxious, irritable, or depressed, muscle tension or headaches, loosing confidence and less productive most of the time. All these warning signs must not be ignored, because they will cause bigger problems eventually; not only to the workplace, but also to your personal life. Nonetheless, there is no other way to prevent this to happen, but by taking care of yourself, do not set aside your personal needs, happiness and most especially your family; they are the mainstream why you are working. You must take good care first of these important personal things that you have, so that you will feel better about yourself. Always find time to get moving, get enough amount of sleep, exercise regularly, make healthy food choices, drinking moderately of alcohol without nicotine is good for your heart and blood circulation. More than

anything else, fill your hear with love. Naturally, the better you feel as an individual, the better you can manage work stress without becoming overwhelmed. (http://www.hse.gov.uk/stress/furtheradvice/stressathome.htm) References: (http://helpguide.org/mental/work_stress_management.htm) (http://www.hse.gov.uk/stress/furtheradvice/stressathome.htm)

2.0

Clinical

management

Clinical management involves not just application of the nursing interventions but managing all aspects of nursing and healthcare within the clinical setting. Some topics for your nursing dissertation could include:

Issues and risks in the clinical management of patients with prostate New directions in management of patients in the adult intensive care Perceived management issues in the care of elderly patients. Optimal management strategy for patient with post traumatic stress Management and treatment outcomes of acute ischemic stroke. Clinical management and psychosocial treatment of drug dependence Patients' self assessments and decision making: Management Strategies in management and care of patients with chronic and acute

cancer.

units.

disorder.

in prison settings.

approaches in surgical cases.

pain.

Possible interventions in the clinical management and control of Clinical management of inpatients with cardiovascular disease and high

infectious diseases.

blood pressure.

3.0

Public

health

Public health highlights all those issues that affect the health of the people and focus more on large scale health problems rather than individual concerns. Some of these that you could base your nursing dissertation hereby follow:

Evaluating the impact of health promoting interventions on public health Contamination of drinking water in developing nations and its effects on Evaluating health consequences of the public affected by natural AIDS and its social impact: A study in public health. Exercise habits and its relation with the epidemiological patterns of The importance of a public health policy for controlling obesity in Poverty and its role in childhood diseases a public health issue. Public health responses and approaches for the prevention of cancer. Diabetes as a public health problem and associated lifestyle The growing problem of alcoholism and binge drinking among

in the UK.

public health.

disasters.

cardiovascular risks.

children.

interventions.

teenagers as an issue in public health

4.0

Community

Nursing

Community nursing shows the importance of social interventions in healthcare, especially for the elderly or disabled, and is a generic term for school and health or district nursing. If you are looking to base your nursing dissertation in this area, the following topic suggestions may help you.

The care of the elderly outpatients and community nursing services. Assessment of nutritional status of children as an essential part of The provisions for integrated community nursing services and its impact Health promotion through community nursing practice. The collaborative roles of GPs, nurses, social workers and policy The use of community nursing services by patients following surgical The role of community nursing in improving quality of life of the elderly. Community nursing for the care of elderly suffering from chronic A comparative study of community nursing and health care needs in An evaluation of community nursing services available for pregnant

community nursing.

on individual health costs.

makers in a community nursing centre.

procedures.

illnesses.

different cities.

women and neonates.

5.0

Midwifery

The nursing practice related to midwifery deal with not just problems of pregnant women but also nursing and clinical interventions in pregnancy and the health issues involved. There are several topics within this area that you could explore for your nursing dissertation.

The role of the midwife in high-risk pregnancies. Supportive nurse-midwife intervention team in managing caesarean Model of care followed in standard midwifery practice within UK. Improving pregnancy outcomes and care with the help of midwives. Do the midwives influence decision-making and facilitate informed Factors affecting the competence of midwives in a clinical setting. Midwives' descriptions and perceptions of pregnant women with

sections.

choices among pregnant women?

problems of substance abuse.

Health risks of women due to postpartum depression and the role of the The long-term effects of social support and midwifery support during The attitudes towards confidentiality of patient information among

midwife.

pregnancy.

midwives in the UK.

10.0

Mental

Health

The mental health needs of the population may vary and from women to the youth, mental illness could be prevented by maintaining appropriate mental health interventions. The topics below could be discussed further in your nursing dissertation on mental health.

The efficacy of psychiatric treatment and medicine for schizophrenic Attending to mental health needs of older adults suffering from Youth and adolescent problem of drinking and drugs and its relation Understanding the mental health needs of women subjected to sexual A comparative study of mental health issues in urban and rural Stress and mental illness among gays, lesbians and bisexuals, due to Unemployment as a factor in aggravating mental health problems. Socioeconomic backgrounds of individuals and evidence of mental The link between mental illnesses and suicides in the urban youth Understanding the legal aspects of mental health research.

patients.

depression and loneliness.

with mental health.

and physical abuse.

societies.

social pressures.

illness.

population.

11.0

Nursing

models

and

theories

The application of nursing theories and models aids in clinical decision-making

and provides the theoretical basis for changing healthcare perspectives in nursing. For further suggestions on topics for your nursing dissertation, please see below.

The perspectives from nursing theories as used in nursing practice and Application of nursing theories in clinical decision-making. The Roper Logan Tierney model and its application in nursing practice, Understanding holistic nursing practice with the McGill Model of Studying the role and importance of nursing models and theories in

interventions.

considering a case study of an emergency patient.

Nursing

clinical interventions, and the efficacy of conceptual models in nursing practice.

A comparative study of Neuman's systems model, Roper Logan Roles of nurses and nursing models considering changing health care The importance of reflection in nursing theory and practice. Public health nursing interventions using the Neuman systems model. Operationalisation of the Roper Logan Tierney model in nursing

Tierney model, and McGill model of nursing.

and nursing needs.

practice for treatment and care of psychiatric patients. THE PESTEL SYSTEM AND ITS RELEVANCE TO ORGANIZATION The PESTEL or PESTLE Analysis is an important model theory in United Kingdom, it stand for Political, Economic, Social, Technological, Legal and Environmental component that is use to develop a strategic management system in an organization. It is highly recommended as important factors in an organization to consider the following external component to serve as a determinant in their position they can give a highlighted overview in understanding the growth or decline of business industry in present past and future operation. All organization can simply use the system. The Macro and Micro analysis pertaining to business may show the strength and weaknesses through simple and complex analysis using all or any other parts of the system for these is highly influential and highly identified components of the industry and of society. Technically the organization can adjust to advance, resume or defer their plan if they found out the one of the component is likely to happen so that the risk of such

occurrence may be prevented. Even if a certain business is just newly starting using the PESTEL system can be a vital tool to pursue its business at work; this analysis can set a trend in business with respect to the management or marketing plan of an organization. Political Factor can be highly considered as a part of management and marketing plan. A certain organization may consider the stability of the rules and regulation of the government for example if a certain business exist in Asia and there is need for expansion in other neighboring countries, considering the political factors we may consider Saudi Arabia as a highly political stable nations rather than Syria or Lebanon or Iran and Iraq the political factor is always at risk and the nation is always at war may be traced through history up to their present times. If a certain political consideration is tough or unstable the organization may defer or deny expansion in such area to look for another consideration or they may not be able to grow in a certain country that lacks such political affluence. Consider what will be its policy, culture, etc? Economic factor is a consideration in business, the first thing you need to ask would be what is their standing? What would be their inflation consideration? Will they be able to afford my products and services? The way of life of people and their buying power should be economically considered before putting up or establishing a business in such location, or it can also be dependent on your products and services. Socio-cultural factor is a good consideration of business; they must carefully study their position in the society so they do not put their organization at risk. Consider the following; religion, attitude of the people, the population and their lifestyle. A certain company from China has established a restaurant in the Philippines without investigating their cultural preferences and later found out that they have established their store in a Muslim community who never eat meat, not just their business loses some people even curse them and condemn them for selling meat. They transfer to another location only then they have survived. Technological factor is vital for competitive advantages of business if they have a strong foundation in technology for example in a production company who uses machineries can spend less overhead and produce more products. Depending on consideration they may adapt a certain technology like computer and other high tech gadget as basic tools to do multi task. The power of the internet and the information it can bring is outrageous they can perform online transaction that is fast, efficient, reliable and most of all it can reach a wider market all over the world. Farmer in Africa have adapted some machinery in Asia that can speed up the production of their crops the result is that they yield more than double of what they expected they also uses various fertilizer to grow their crops. Legal factor is minimal and open consideration, a certain business old and new should understand their responsibility so as they will not be prevented or discriminated by the government. The following legal factor may affect the company on how they can operate in a certain state if they do not follow such rules example; Health and safety measures, labor law, consumer law and etc. if a certain law has been violated the government may have the rights and obligation to prevent the business from operation.

Environmental factor or environmental risk in business may be hard to prevent and identify natural climate such as storms, earthquake, climate change etc. is highly unexpected but considering the ecological balance and tourism of such location in establishing a business may be favorable to business.