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UNIVERSITY OF THE EAST RAMON MAGSAYSAY MEMORIAL MEDICAL CENTER, INC.
MEDITATION, PRAYER AND PRESENCE (MPP) AND ITS INFLUENCE ON
UNCERTAINTY, COPING AND ADHERENCE TO ANTIRETROVIRAL THERAPY
AMONG PERSONS LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS
A Thesis
Presented to
The Faculty of the Graduate School
University of the East
Ramon Magsaysay Memorial Medical Center, Inc.
In partial fulfillment
Of the Requirements for the Degree
Master of Science in Nursing
By
Sr. Cleofe M. Macalino, SMI, RN
2014
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UNIVERSITY OF THE EAST RAMON MAGSAYSAY MEMORIAL MEDICAL CENTER, INC.
This thesis hereto entitled:
MEDITATION, PRAYER AND PRESENCE (MPP) AND ITS INFLUENCE ON
UNCERTAINTY, COPING AND ADHERENCE TO ANTIRETROVIRAL THERAPY
AMONG PERSONS LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS
Prepared and submitted by Sr. Cleofe M. Macalino, in partial fulfillment of the requirements for the degree Master of Science in Nursing major in Adult Health has been examined and isrecommended for acceptance and approval for ORAL EXAMINATION.
___________________________________ WILHELMINA Z. ATOS, PhD, RN
Adviser
Approved by the committee on Oral Examination with a grade of PASS on March 22, 2014.
______________________________ GLENDA S. ARQUIZA, PhD, RN
Chair
________________________________ _______________________________ NORMA G. NASTOR, MAN, RN CARMELITA R. SALVADOR, MAed
Member Member
Accepted in partial fulfillment of the requirements for the degree of Master of Science in Nursing major in Adult Health.
_______________________________________MARIA LUISA T. UAYAN, DHSc, MSN, RN
Program Coordinator MSN/MAN
________________________________________ GEMILIANO D. ALIGUI, MD, MPH, PhD
Dean Graduate School
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UNIVERSITY OF THE EAST RAMON MAGSAYSAY MEMORIAL MEDICAL CENTER, INC.
ACKNOWLEDGEMENTS
For the people who have made this study possible, first of all I would like to
express my deepest gratitude to Dr. Wilhelmina Z. Atos, my thesis adviser, for her
invaluable guidance, wisdom and genuine support throughout the course of this study.
With heartfelt gratitude to Dr. Carmelita C. Divinagracia, for her encouragement,
trust and confidence in me, and most importantly for allowing me to adapt her
COMPOSURE Behavior Model in my study.
To Dean Gemiliano D. Aligui for his kind understanding and patience, to Dr. Luisa
T. Uayan, for her enthusiasm, concern and generous support, to my thesis panellists:
Dr.Glenda S. Arquiza, Mrs. Norma G. Nastor and Mrs. Carmelita R. Salvador for their
helpful suggestions and expertise, to my professors in the College of Nursing and
Graduate School who inspired and motivated me, for the knowledge shared and lessons
learned from them.
I would like to acknowledge the financial support extended to me by the
Commission on Higher Education (CHED) in the grant of a postgraduate research
scholarship through the UERM College of Nursing that provided me the necessary
financial support for this research.
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UNIVERSITY OF THE EAST RAMON MAGSAYSAY MEMORIAL MEDICAL CENTER, INC.
My sincerest thanks to Rev. Fr. Rodolfo Vicente Dan Cancino, MI, Director of St.
Camillus Woodwater Center for Healing and Miss Gerlita Enrera, Social Worker, for the
invaluable help and support extended to me; to Mr. Paul Darren Katigbak and Mr. Sharl
Lucero, Nurse - Research Assistants, for their time and efforts in data collection. I will
always be thankful.
I am truly grateful to all my sisters in the Philippine Delegation for their spiritual
and moral support especially to Sr. Bernadette Faustino and Sr. Liberty Elarmo; to Sr.
Asuncion Gipoleo and to my sisters of OMD community – Sr. Veronica Mondia, Sr. Fe
Santos and Sr. Teofanisa Ochavo for their loving presence, care and understanding.
To Sr. Benilda Quimio for allowing me to use the prayer “I pray you O Lord”
which she composed; for her availability and generosity in translating the questionnaires
in my study thank you so much.
To the positive community who have willingly participated in this study; for their
insightful reflections and sincerity. May this serve as one pathway that will lead them to
embark on a spiritual journey with God.
I would also like to extend my thanks to my classmates and friends in the Graduate
School for the encouragement, suggestions and companion.
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UNIVERSITY OF THE EAST RAMON MAGSAYSAY MEMORIAL MEDICAL CENTER, INC.
I am most grateful to my parents, my brothers Bong and Jone, and my sisters
Jeannette and Lingling especially to my mother Vicky who is always there for me; for her
selfless love and loving support.
And most importantly to God in whom I dedicate and offer this work, for the gift
of my life and my vocation, for nourishing my spirit and giving me the inner strength
that I need, and for everything that He has done for me particularly for the people who
were instruments in making this study possible with my deepest gratitude.
Sr. Cleofe M. Macalino SMI, RN
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UNIVERSITY OF THE EAST RAMON MAGSAYSAY MEMORIAL MEDICAL CENTER, INC.
ABSTRACT
Macalino, Cleofe M. (2014) MSN Major in Adult Health. University of the East Ramon Magsaysay Memorial Medical Center. Meditation, Prayer and Presence and its Influence on Uncertainty, Coping, and Adherence to Antiretroviral Therapy among Persons Living with
Human Immunodeficiency Virus
This study aimed to determine the influence of meditation, prayer, and presence (MPP) to
the adherence of antiretroviral therapy (ART) among the respondents. It specifically
sought to answer the following: the level of uncertainty and adherence before and after
meditation, prayer and presence, the coping styles utilized; relationship between level of
uncertainty, coping styles utilized and adherence to ART; factors that influence level of
uncertainty, coping, and adherence to ART; lastly, relationship between uncertainty and
adherence before and after MPP.
It utilized a quantitative, descriptive correlation method of study. This design is a one
group pretest – post test for single group. Sampling method utilized was non-probability
snowball sampling. Sixty (60) persons living with HIV were recruited but only 30 of
them were qualified. St. Camillus Woodwater Center for Healing was the site of the
study. The following were the tools utilized in this study Mishel Uncertainty in Illness
Scale-Community form (MUIS-C), the Jalowiec Coping Scale (JCS) and the Visual
Analogue Scale (VAS). Statistical program system software (SPSS) tool box was the
method of analysis used to obtain statistical
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UNIVERSITY OF THE EAST RAMON MAGSAYSAY MEMORIAL MEDICAL CENTER, INC.
data. Results shows that there was a slight decrease in the level of uncertainty and a
marked decrease in adherence before and after MPP, coping style most often used was
supportant (mean = 0.53) and coping style used as most effective was optimistic (mean =
0.13). There is a low negative correlation between uncertainty and coping. Gender and
educational background were the factors found to be significant in terms of level of
adherence. There was a significant difference among the three variables between coping
and uncertainty (p-value = 0.033), uncertainty and adherence (p-value = 0.000), coping
and adherence (p-value= 0.000) before and after MPP.
Therefore, the results showed that there is a positive correlation among the three variables
and that the intervening variables - meditation, prayer and presence can influence a
person’s perceived uncertainty, coping and degree of adherence to antiretroviral therapy.
Thus meditation prayer and presence can be used as an intervention in clinical settings as
a complementary therapy or as an adjunct to a therapy particularly for ART adherence
among persons with HIV.
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UNIVERSITY OF THE EAST RAMON MAGSAYSAY MEMORIAL MEDICAL CENTER, INC.
TABLE OF CONTENTS
Page
Title page i
Approval sheets ii
Acknowledgements iii
Abstract iv
Table of Contents viii
List of Tables xi
List of Figures xii
Appendices xiii
I. INTRODUCTION 1
Review of Related Literature 3
Theoretical Framework 21
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UNIVERSITY OF THE EAST RAMON MAGSAYSAY MEMORIAL MEDICAL CENTER, INC.
Conceptual Framework 22
Statement of the Problem 23
Definition of Terms 24
II. METHODS 27
Research Design 27
Participants 27
Sampling 27
Setting 28
Measures 29
Procedures for Meditation, Presence and Prayer 31
Data Analysis and Treatment 32
III. RESULTS 34
IV. DISCUSSION 40
A. Respondents Demographic Profile 40B. Level of Uncertainty and Adherence 41C. Coping Styles Utilized 42D. Level of Uncertainty and Coping 45E. Factors that Influence Level of Uncertainty, Coping and Adherence 46F. Meditation, Prayer and Presence, and Adherence 49
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UNIVERSITY OF THE EAST RAMON MAGSAYSAY MEMORIAL MEDICAL CENTER, INC.
Limitations of the Study 51
V. CHAPTER V 52
Summary of Findings 52
Conclusion 53
Recommendations 53
References 54
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UNIVERSITY OF THE EAST RAMON MAGSAYSAY MEMORIAL MEDICAL CENTER, INC.
List of Tables
Table 1: Demographic Profile of Respondents 34Table 2: Level of Uncertainty and Adherence to ART of
Respondents Before and After MPP 35Table 3: Coping Styles Often Utilized 35Table 4: Coping Styles Utilized as Effective 36Table 5: Correlation between Levels of Uncertainty,
Coping Styles and Adherence 36
Factors that Influence Respondents ‘Level of Uncertainty, Level of Coping and Level of Adherence 37
Table 6: Age, Gender, Educational Background, Latest CD4 37Count and Level of Coping
Table 7: Age, Gender, Educational Background, Latest CD4 37Count and Level of Uncertainty
Table 8: Age, Gender, Educational Background, Latest CD4 38Count and Level Adherence
Table 9: Significant Differences in Uncertainty and Adherence 38to ART after Meditation, Prayer and Presence
Table 10: Summary of Significant Results 39
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UNIVERSITY OF THE EAST RAMON MAGSAYSAY MEMORIAL MEDICAL CENTER, INC.
List of Figures
Figure 1: Schematic Presentation of Mishel’s Theory of Uncertainty 21
Figure 2: Adaptation of Merle Mishel’s Uncertainty in Illness Theory 22
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UNIVERSITY OF THE EAST RAMON MAGSAYSAY MEMORIAL MEDICAL CENTER, INC.
APPENDICES
A.1 “COMPOSURE BEHAVIORS” Nursing Measure Protocol (CBNMP) - Presence 65A.2 “COMPOSURE BEHAVIORS” Nursing Measure Protocol (CBNMP) –Prayer 67A.3“COMPOSURE BEHAVIORS” Nursing Measure Protocol (CBNMP) –Meditation 68B. I Pray You O Lord 71C. Mishel Uncertainty In Illness Scale – Community Form 72D. Jalowiec Coping Scales (English) 75