HEALTH PRACTICES AND HEALTH PROBLEMS AMONG TRICYCLE DRIVERS OF TUBURAN LIGAO CITY
A Practical Research Proposal Presented to the Senior High School Department Bicol Regional Science High School
In Partial Fulfillment of The Requirements for the Senior High School STEM Track
SARAH FAYE D. ALSUA LIEZL G. DEL VALLE October 2017
CHAPTER I
Introduction There is nothing as important and valuable as health. Being healthy is necessary to be productive in life and to carry out your daily tasks. Health, as they say, is wealth. The World Health Organization (WHO) defined health in its broader sense in its 1948 constitution as a “state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity1.” But there are several factors that can compromise your health, one of these can be your work. In the Philippines, 2tricycle drivers are Filipino who work long days and endure a lot of difficulties to provide the needs for their daily living. Drivers must have specialized licenses, regular routes, and reasonably fixed fares. Most tricycle drivers are comfortable with regard to seat, access, gauges, ride quality and alighting practices but they wish to improve some parts of the tricycle. Moreover, majority of the drivers agreed with the standardization of the tricycle. From the passengers’ perspective, the tricycle is uncomfortable due to insufficient seating space. Most of the passengers are annoyed with the noise and smoke of the tricycle. They perceived that most serious problems of tricycle vehicle are driver behavior, air pollution, vehicle construction and noise pollution. 3The
tricycle is a Philippine transportation vehicle that rules inner roads and alleys.
Many aver tricycles started appearing on the road scene after World War II. Others declare it almost co-existed with the converted GI army jeeps. Accordingly, excess body
parts left after the conversions were used to assemble sidecars attached to motorcycles, and thus the “tricycle” that has been known since in Philippine transportation. The tricycle is a Philippine transportation vehicle that is so versatile. It is adaptable in rural and urban applications. It can serve passengers rain or shine. It can take one to several street corners, the next town, or even the next city or province for the right contract fare. Tricycles are known to rule even national highways. Normally, a tricycle can accommodate 4 passengers (including the driver), if safety measures are considered. But often one will see this Philippine transportation vehicle carrying 10 to 20 passengers, mostly daring students or youths, squeezed in the sidecar and at the backseat behind the driver, some hanging from the rear and side of the sidecar and more atop its roof. Tricycle drivers are exposed to polluted environment that can cause a number of concerns towards health. They are prone on acquiring non-communicable diseases such as cough, pulmonary diseases and respiratory diseases. Sudden change in weather can also affect the health of the tricycle drivers. They are also prone to having discomforts and body pains since they spend an average of at least ten hours on the road. They are subjected to improper or awkward positions for a long period and vehicle measurements do not suit their needs. The researchers decided to have an in depth study and analysis on the health practices and health problems in the Barangay Tuburan of Ligao City due to curve and blind roads that can be an accident prone area especially to tricycle drivers who has a heavy load of passengers. Also, the researchers want to know if it can be risky to drive especially to tricycle drivers who are experiencing health problems. The absence of
street lights and lack of sleep while driving can be a factor of many accidents in the road. Due to several health practices of tricycle drivers, it can lead them to road accidents. The researcher wanted to address the health practices and health problems to be able to offer recommendations and to prevent and control possible aggravation of health problem. Statement of the Problem 1. What is the socio-demographic profile of the tricycle drivers in terms of: a.
Age
b.
Civil status
c.
Highest educational attainment
d.
Number of family members
e.
Daily income
f.
Number of hours working per day
g.
Number of years working as a driver
2. What are the health practices of the tricycle drivers? a.
Personal Hygiene
b.
Nutrition
c.
Activity
d.
Elimination
e.
Maintenance medication
3. What are the health problems of the tricycle drivers? 4. What measures may be proposed to prevent health problems of the tricycle drivers?
Scope and Delimitation The researchers will focus mainly on the health practices and health problems of tricycle drivers with the route of the Barangay Tuburan of Ligao City. Tricycle drivers must be at least 20 years old and not older than 50 years old, male, single or married, with or without medical conditions. They must be at least three years in service. Significance of the Study Conducting this study about health practices and health problems among tricycle drivers will be a great help and shall benefit a lot of endeavor. This study shall benefit
the
respondents/drivers,
family
members,
Traffic
Enforcers,
Land
Transformation Office administration, Health Care Providers, Community and future researchers Respondents/drivers- We often ride on a tricycle because it is the cheapest mode of public transportation. It is vital to evaluate the health conditions of the tricycle drivers to ensure safety of the passengers and safety in the aspect of road security and their health. As a subject of investigation, tricycle drivers will be able to improve their health condition. Family Members- they may realize that their support and understanding is of great importance to the head of the family. Health Care Providers. This may help them to give more emphasis on the
health
needs
diseases/disorders.
of
the
drivers
and
may
provide
health
orientation
on
Community- this will increase their knowledge, awareness and better understanding among health concerns of the tricycle drivers. Future Researchers-the findings of this study will be a great help and motivate them to conduct similar study.
Bibliography 1. Stanhope, M. (2017). Foundations of Nursing in the Community, Community-Oriented Practice. Content Technologies. 2. Staff, F. k. (2016, December 29). Filipino Icon: Tricycle and Pedicab. Retrieved from The Magazines for Filipinos in Europe: http://ffemagazine.com/filipino-icon-tricyclepedicab/
3. The Versatile Philippine Tricycle. (2017, April 10). Retrieved from Philippines Insider: http://www.philippinesinsider.com/transport/the-versatile-philippine-tricycle/
CHAPTER II
REVIEW OF RELATED LITERATURE AND STUDIES
This chapter presents the review of related literature and studies that are found related and useful in the current study. The theoretical framework and conceptual framework were discussed to explicate the nature of the study. It also includes the synthesis of the state of the art, gaps bridged of the study, and definition of terms necessary to study. Related Literature The tricycle is a Philippine transportation vehicle that is so versatile. It is adaptable in rural and urban applications. It can serve passengers rain or shine. It can take one to several street corners, the next town, or even the next city or province for the right contract fare. Tricycle drivers work in an average of 14 hours a day. Most of them start driving at 5am in the morning and end at about 9pm in the evening. They are prone to some diseases like respiratory infection. The usual age of Tricycle drivers ranges from 25-60 years old. The highest educational attainment of tricycle drivers is elementary graduate, high school graduate and college undergraduate. Their usual earning is P300-P500 a day and is insufficient with the daily needs of their family. According to the study of College of Engineering of University of the Philippines (Diliman) reveals that the drivers are suffering from body pain because of the poor design of vehicle. According to the study, the driver’s seat design is based on persons
with a body-length of 1.50 meter up to 1.75 meter also offers inadequate support and barely any comfort for the driver. Aside from the seats, the fixed side mirrors are also source of difficulty for the driver. The drivers just choose to ignore these problems simply because there will be monetary costs in solving these problems and because they have grown accustomed to these conditions. The sitting comfort is important, especially for disabled people who have to sit for long periods of time. If the pressure on the buttocks is too high (due to a bad surface or a footrest which is too high) the blood circulation will be bad. For a comfortable seat the following dimensions are important: seat-depth, seat-width, back-height, armrest-height and footrest-height. The footrest is adjustable to the individual user. Cushions are important to avoid pressure sores on the driver's buttocks and springs will absorb shocks during driving.
Related Studies In the study of Bawa and Srivastav (2013) entitled “The Epidemiological Profile of Taxi Drivers in the Background of Occupational Environment, Stress and Personality Characteristics”. Studies indicates the various factors that influence physical and emotional wellbeing of taxi drivers into theoretical model that shows work environment, stress and personality characteristics directly influence taxi drivers’ health. The individuals of type A personality do not cope well with stress and prone to develop stress related illness such as cardiac problems. The taxi drivers in present study always felt stressful towards traffic congestion, narrow bottle neck roads, too many speed breakers, rude gesture and behavior by other drivers.
The studies conducted by Duffy and McGoldrick confirmed that traffic congestion as a significant stressor in professional drivers. The other important stressors were related to road conditions and rude gesture and behavior by other drivers. Gastrointestinal and musculoskeletal symptoms are common in studied taxi drivers. The cardiovascular complaints can be a symptom of coronary heart disease. The study by Kurosaka confirms high prevalence of coronary heart disease in taxi drivers as compare to non-drivers. It can be explained by higher presence of coronary risk factors like hypertension, smoking and job stress in taxi driver. The other common symptom found was headache; it may be caused by stress, lack of sleep or may be the symptom of hypertension. Xiong found that the level of drivers’ mental health is much lower than that of common people. There are several factors like hazards in the work environment, individual factors, and the organizational factor together responsible for lower levels of emotional well-being in taxi drivers. Soodabeh found that driving increases systolic, diastolic and mean arterial BP by about 20 mmHg. The increase risk of hypertension in taxi drivers was also confirmed. Ueda (1992) in a Japanese Taxi Driver Health Study in a taxi driver study conducted in Iran agreed that hypertension and known coronary artery diseases risks were high amongst drivers who were employed for a period of more than 4 years. The study also found that obesity, gastrointestinal diseases, fatigue, musculoskeletal system complaints, sensory complaints including hemorrhoids were higher than in general population.
Dahl (2009) in a study conducted in Teamster in the United States found drivers working for Motor Freight Carriers were obese. The study found that half of the drivers had a BMI in the obese range which was double compared to the general population. Obesity was a concern amongst drivers who were frequently hospitalized with obstructive sleep apnea and reported sleeping while driving. Chen (2005) conducted a study amongst taxi drivers in Taipei, Taiwan, confirmed that taxi drivers had suffered from systemic inflammatory diseases. In the current findings, obesity, elevated BP, fatigue and known diabetes mellitus were reported by participants. These are health risk factors associated with CV diseases. Further stated that high prevalence of lower back pain (LBP) could be associated with long driving time, physical and psychosocial factors Furthermore, AL-Dubai (2012) in a study conducted in Malaysia showed that there were high levels of low-back pain and found that taxi drivers were reluctant to disclose LBP because of fear of loss of income and unemployment should they be unable to work. In the current study, the respondents also reported that they experience LBP. Apontaku-Onayeni (2012) a study conducted among taxi drivers in Chicago found that their poor health practices contributed to low risk profile. A recent study conducted by Ncama (2013) reported that taxi drivers practiced unsafe sexual intercourse without use or inconsistent use of condoms. This study became more significant as taxi drivers are a relatively autonomous and hard-to-reach group, and there is proven paucity in knowledge about their health. Most taxi drivers
were of early adulthood to middle age. Taxi drivers have proven from other studies in various countries to be a vulnerable group, leading an unhealthy lifestyle in general with consequential health effects. In this study of Bray (2009), evidence has shown that taxi drivers were obese to morbidly obese. They reported to be eating anything they could grab on the road. This behavior entails unhealthy imbalance diet or poor eating behavior. The consequences of obesity are that participants were exposed to conditions such as CV disease, hypertension, type 2 diabetes mellitus and other morbidity and co-morbidity. Furthermore, drivers led a sedentary lifestyle evidenced by lack of exercise which posed to a health risk. Commercial truck drivers experience all four occupation related risk factors for obesity: sedentary lifestyle, poor opportunities for regular, healthy meals, irregular hours and sleep schedules. Some taxi drivers indicated that they are on chronic medications for HBP, diabetes and joint pain. In a study conducted in Singapore by Lim and Chia (2015), similar results were found suggesting that a high proportion of the taxi drivers were obese and self-reported diagnosed with hypertension, diabetes mellitus. These two conditions could lead to fatigue, predisposing taxi drivers and their passengers to risk of accidents. The physiological assessment also found that drivers had elevated HBP and sugar level without their knowledge. Implication of this identification of health risks amongst taxi drivers is that interventions could be planned to improve the well-being of taxi drivers and avoid lifestyle illnesses that could be prevented and effectively managed which if unknown could be life-threatening for drivers, commuters and other road users.
There were reports of joint back problems and discomforts. Chan and Chen (2009) suggest that there is an increased association between obesity and musculoskeletal pain that makes vulnerability to fracture risks to escalate. Furthermore, BMI directly reflects in the drivers’ level of activity and overall functional capacity. These findings imply the need to motivate for the provision of occupational health medical surveillance screenings to assess wellness and opportune them to have early diagnosis and treatment of communicable diseases. This move could be beneficial to the community at large because of the fact that taxis are the highest mode of transport from local townships to the central business district area. A study conducted by Ramukumba and Mathikhi (2016) was to assess the health profile and the influence of driving on the taxi drivers in Tshwane. It is with no reservation to state that driving has consequential effects on the health of the driver, especially in the taxi industry, which results in prolonged driving as it was revealed in this study. The study results revealed that taxi drivers are sick and have a gap of knowledge of what the meaning of health and wellness was. Furthermore, taxi drivers spent most of their time behind the wheel carrying passengers wherein they do not even have the skill of people management, which results in stress to carry their tasks. It was also revealed that taxi drivers did not have access to health screening facilities. The taxi industry is one of the vulnerable male-dominated groups. Especially, taxis form part of the largest public transport and therefore an urgent need of intersectional collaboration is required, involving Department of Transport, Department of Health and Department of Labor for creating a work environment that can ensure promotion of health amongst taxi drivers. Also men’s health clinics need to be put in place; there should be mobile clinics
on site and calendar dates for massive campaigns of health screening, and other health services at taxi ranks. A recent study was conducted by Choi (2016) entitled “Ambulatory Heart Rate of Professional taxi drivers while driving without their typical psychosocial work stressors: a pilot study” suggest that the impact of physical worksite hazards (inside-taxi-cab temperature, relative humidity, noise, PM2.5, and CO2) on ambulatory HR of professional taxi drivers while driving without being exposed to their typical psychosocial work stressors generally appeared to be minor. More ambulatory HR studies including both physical and psychosocial hazards of professional taxi drivers are warranted for both clarifying the etiology of CVD and developing and prioritizing CVD prevention strategies in taxi drivers. A 2001 survey by the New York Taxi Worker’s Alliance found that more than 20 percent of drivers had cardiovascular disease or cancer. And it is often difficult for taxi drivers to get the health care they need. Another study conducted by the city council in 2009 found that 52 percent of the city’s cabbies are uninsured, twice the rate of the average American. Drivers often face language and cultural barriers to health care access as well. A 2006 study by a taxi industry consultant found that 91 percent of the city’s taxi drivers were born in another country. But fortunately for drivers, hospitals and healthcare initiatives across the city are offering an increasing number of free health screening and information programs aimed specifically at taxi drivers. Taxi drivers like are highly susceptible to a number of health problems because of their sedentary lives spent sitting behind the wheel, studies have found. Drivers are often forced to eat on the go, making fast food their easiest option. Few of them get any exercise whatsoever,
and often suffer from back, hip and leg pain from sitting in a car all day. This lack of exercise combined with a bad diet has led to high rates of diabetes and high blood pressure among cabbies, according to health experts. Many of them even have kidney problems because they frequently can’t find a place to park when they need to use a bathroom.
Coz (2015) with their study entitled “An ergonomic study on the UP-Diliman jeepney driver’s workspace and driving conditions”. Filipino jeepney drivers are exposed to sustained awkward postures. Results reveal that jeepney drivers’ working conditions pose danger to their health and safety. For instance, there is an insufficient distance between the steering wheel and driver’s seat causing restraint to the drivers’ mobility. The limited height of the windshield also blocks the driver’s line of sight keeping the drivers leaning forward when looking for traffic signs. Recommendations were made to improve the working conditions of the Filipino jeepney drivers. With these analyses, the researchers had found out that the current dimensions of the jeepneys are inadequate and not ergonomic enough to fit the built of a driver based from the anthropometric measurements of average Filipino workers.
Cabalquinto had a study about “Life behind the Wheel: A Study on Katipunan and Recto Jeepney Drivers”. The typical Jeepney driver’s life is a hard one. Through this study, we have seen that Recto and Katipunan Jeepney drivers function within an income that is enough to provide for all of the basic needs of their families. This study also showed the importance of handling income budget allocation properly, and how through the years, the Jeepney drivers have effectively created their own social
systems and structures which helped them organize themselves among the increasing demands of the consumers: the daily commuters. This is proven by the existence of certain boundary systems and Jeepney associations that exist in certain areas or stopping points of the routes that the drivers are obligated to join. The health budget allocations of the drivers are not that prioritized, and were commend that a more comprehensive case study must be done, wherein follow-ups with the interviewees would be conducted, in order to properly gauge or measure their health. It is also important to address the issue of their negligence of portioning some of their income for future health expenditures, and their suggestion would be to increase their awareness to the benefits of registering and signing up for PhilHealth insurance, since this would not be too hard for them to do, considering that some of them can even afford to have vices like smoking and/or drinking.
According to Guillen (2004) which studied about the “A Study on Development of Local Public Transport Policy: The Case of Tricycles and ‘Habal-habal’ in Davao City, Philippines”. This study determines the presence of tricycle or “habal-habal” if it is informal or an illegal transport mode. Informal transport emerged because there is a need and there are no provisions such as safety, health and environment being violated. Illegal public transport are those units that clearly violate national policies such as those of the public service act. Francisco (2010). The study shows that Metro Manila households have a positive and significant willingness to pay for the benefits of cleaner public transport amounting PHP 173.10 (USD 3.85) per month. Income and education were found to be
strong determinants of willingness to pay. Practically all respondents were knowledgeable about the harmful effects of vehicle-related air pollution and recognized that air pollution is a major problem in Metro Manila, ranking it as their second most important environmental concern.
In a study conducted by Suarez (2006) entitled "The Perceptions of Pulmonary Tuberculosis among public utility Jeepney Drivers on selected barangays in Zamboanga City". The findings reported in this study show that the perceptions of the drivers on tuberculosis were mostly wrong notions about the disease. Many have no knowledge about the nature and general idea of TB. Majority has wrong perceptions regarding TB’s mode of transmission. Only a handful of the respondents knows the true etiology of TB. While several do not know anything of TB’s signs and symptoms and that their management/treatment procedures were wrong. It was also found that almost one-third of the population were found to fit the category of TB symptomatics. The sputum microscopy revealed that these symptomatics were negative for Acid-fast Bacilli. However, the survey revealed that 9 old cases of tuberculosis was found. But based on prevalence rate computation which includes old and new cases, the prevalence rate of TB symptomatics was found to be 26%. The sputum microscopy TB prevalence was only 3.92 per 100 population. This prevalence rate is relatively better compared to the prevalence of TB among PUJ drivers in Manila (17.5%).
Synthesis of the State-of-the-Art In the study of Bawa and Srivastav concludes that stress and personality characteristics affects in the health of taxi drivers. Type A personality do not cope well with stress and prone to develop stress related illness such as cardiac problems. While the study of Duffy and McGoldrick suggest that traffic congestion as a significant stressor in professional drivers. Most stressors of drivers were related to traffic congestion. The study by Kurosaka suggests that headache be caused by stress, lack of sleep or may be the symptom of hypertension. A recent study was conducted by Choi impact of physical worksite hazards (inside-taxi-cab temperature, relative humidity, noise, PM2.5, and CO2) on ambulatory HR of professional taxi drivers while driving without being exposed to their typical psychosocial work stressors generally appeared to be minor.
According to Duffy and McGoldrick musculoskeletal symptoms are common to taxi drivers. In the study conducted by Ueda, musculoskeletal complaints were higher among taxi drivers. In the study of Chen confirmed that that high prevalence of lower back pain (LBP) could be associated with long driving time, physical and psychosocial factors. Furthermore, AL-Dubai in a study conducted in Malaysia showed that there were high levels of low-back pain. Chan and Chen (2009) suggest that there is an increased associated with musculoskeletal pain. There were reports of joint back problems and discomforts. Coz study reveals that the current dimensions of the jeepneys are inadequate and not ergonomic enough to fit the built of a driver based from the anthropometric measurements of average Filipino workers that can cause an
awkward position. While Bacero study shows that majority of the drivers agreed with the standardization of the jeepney because the jeepney drivers are uncomfortable due to insufficient seating space and difficulty in getting in and out of the vehicle
According to Duffy and McGoldrick study shows that cardiovascular complaints can be a symptom of coronary heart disease. While the study of Kurosaka confirms high prevalence of coronary heart disease in taxi drivers as compare to non-drivers. Because most drivers are at risk for hypertension and smoking. In the study of Soodabeh found that there is a risk of acquiring hypertension among taxi drivers because driving increases systolic, diastolic and mean arterial BP by about 20 mmHg. According to Ueda hypertension and known coronary artery diseases risks were high amongst drivers who were employed for a period of more than 4 years. While Dahl’s study confirmed that obesity was a concern amongst drivers who were frequently hospitalized with obstructive sleep apnea and reported sleeping while driving. Chen studied that obesity, elevated BP, fatigue and known diabetes mellitus were reported by drivers. These are health risk factors associated with CV diseases. While in this study of Bray evidence has shown that taxi drivers were obese to morbidly obese. They reported to be eating anything they could grab on the road that could lead to unhealthy lifestyle. In another study conducted in Singapore by Lim and Chia, similar results were found suggesting that a high proportion of the taxi drivers were obese and self-reported diagnosed with hypertension, diabetes mellitus. A 2001 survey by the New York Taxi Worker’s Alliance found that more than 20 percent of drivers had cardiovascular disease or cancer. And it is often difficult for taxi drivers to get the health care they need.
In the study conducted by Xiong found that the level of drivers’ mental health is much lower than that of common people. Hazards in the work environment can be a cause of lower levels of emotional well-being in taxi drivers. Apontaku-Onayeni study conducted among taxi drivers in Chicago found that their poor health practices contributed to low risk profile. While a recent study conducted by Ncama reported that taxi drivers practiced unsafe sexual intercourse without use or inconsistent use of condoms. Taxi drivers have proven from other studies in various countries to be a vulnerable group, leading an unhealthy lifestyle in general with consequential health effects. A study conducted by Ramukumba and Mathikhi, results revealed that taxi drivers are sick and have a gap of knowledge of what the meaning of health and wellness was. It was also revealed that taxi drivers did not have access to health screening facilities. In a study conducted by Suarez, findings reported in this study show that the perceptions of the drivers on tuberculosis were mostly wrong notions about the disease. Many have no knowledge about the nature and general idea of TB. While in the study of Francisco, all respondents were knowledgeable about the harmful effects of vehiclerelated air pollution and recognized that air pollution is a major problem.
Gaps bridged by the Study There are differences noted from our studies compared to our study. The present study will find the health practices and health problems among tricycle drivers as well as to offer safety precautions to prevent and control possible diseases in order to reduce the mortality and morbidity rate in Tuburan Ligao city. Since there are only few studies
that has been conducted along this line, this is the gap that present study aims to bridged. Theoretical Framework The researcher chose the Health Promotion Model by Nola J. Pender. Health promotion is the science and art of helping people change their lifestyle to move toward a state of optimal health. Promoting health in an individual is very important in decreasing the possibility in acquiring diseases and lessening the chance of transferring the disease. The HPM is similar in construction to the health belief model (Becker, 1974) but is not limited to explaining disease prevention behavior. The HPM differs from health belief model in that the HPM does not include fear or threat as source of motivation for health behavior. For this reason, the HPM expands to encompass behaviors for enhancing health and potentially applies across the life span (Pender, 1996; Pender et al., 2002). The HPM identifies cognitive and perceptual factors as major determinants of health-promoting behavior. The Exercise Benefits/Barriers Scale (EBBS) measures the cognitive and perceptual factors of perceived benefits and perceived barriers to exercise. The following are individual characteristics and experiences that affect subsequent health actions.
NOTE: INSERT THEORETICAL FRAMEWORK
Individual Characteristics and Experiences includes prior related behavior and personal factors; biological; psychological and sociocultural. Prior related behavior is the frequency of the same or similar behavior in the past. Direct and indirect effects on the likelihood of engaging in health-promoting behaviors. Personal factors are the categorized as biological, psychological and sociocultural. These factors are predictive of a given behavior and shaped by the nature of the target behavior being considered. Personal biological factors include variables such as age, gender, body mass index, pubertal status, menopausal status, aerobic capacity, strength, agility or balance. Personal Psychological Factors include variables such as self-esteem, self-motivation, personal competence, perceived health status and definition of health. Behavior-Specific Cognitions and affect includes the Perceived benefits of action which is the anticipated positive outcomes that will occur from health behavior. Perceived barriers to action are anticipated, imagined, or real blocks and personal costs of undertaking a given behavior. Perceived self-efficacy is the judgment of personal capability to organize and execute a health-promoting behavior. Perceived self-efficacy influences perceived barriers to action so higher efficacy results in lowered perceptions of barriers to the performance of behavior. Activity-related affect is the subjective positive or negative feelings that occur before, during and following behavior based on the stimulus properties of the behavior itself. Activity-related affect influences perceived self-efficacy, which means the more positive the subjective feeling, the greater the
feeling of efficacy. In turn, increased feeling of efficacy can generate further positive affect. Interpersonal influences (family, peers, providers), norms, support, models. It is a cognitions concerning behaviors, beliefs, or attitudes to others. Interpersonal influences include: norms (expectations of significant others), social support (instrumental and emotional encouragement), and modeling (vicarious learning through observing others engaged in a particular behavior). Primary sources of interpersonal influences are families, peers, and healthcare providers. In Situational Influences, it is personal perceptions and cognitions of any given situation or context that can facilitate or impede behavior. Includes perceptions of options available, demand characteristics and aesthetic features of the environment in which given health-promoting behavior is proposed to take place. Situational influences may have direct or indirect influences on health behavior. The following are immediate antecedents of behavior or behavioral outcomes. A behavioral event is initiated by a commitment to action unless there is a competing demand that cannot e avoided or a competing preference that cannot be registered. Behavioral Outcome includes Commitment to a plan of action. The concept of intention and identification of a planned strategy leads to implementation of health behavior. In Immediate competing demands are those demands alternative behaviors over which individuals have low control because there are environmental contingencies such as work or family care responsibilities. Competing preferences are alternative behaviors over which individuals exert relatively high control, such as choice of ice cream or an apple for snack. Health Promoting Behavior is the endpoint or action outcome directed toward attaining positive health outcomes such as optimal well-being,
personal fulfillment, and productive living. Examples of health-promoting behavior are eating a healthy diet, exercising regularly, managing stress, gaining adequate rest and spiritual growth and building positive relationship.
Conceptual Framework This study aims to determine the health practices and health problems among tricycle drivers of Tuburan Ligao City. It uses variables that are included to the profile of tricycle drivers. The socio-demographic profile of the respondents compromising of age, number of hours working per day, number of years working as a driver, daily income, highest educational attainment and number of family members. And in the Health Practices and Health Problems of the respondents includes the personal hygiene, nutrition, medical check-up and maintenance of medication. There are also measures to improve health problems of tricycle drivers. As the conceptual framework presents, it shows the four main variables of the study. The first box that shows the profile of the respondents which is the sociodemographic profile. The second box shows the health practices of the respondents. The third box is the health problems. The said factors may also be the root cause of improved or unimproved quality of life.
1. SOCIO-DEMOGRAPHIC PROFILE a. Age b. Number of hours working per day c. Number of years working as a driver d. Daily income e. Highest educational attainment f. Number of family members
2. HEALTH PRACTICES a. Personal Hygiene b. Nutrition c. Activity d. Elimination e. Maintenance medication
3. HEALTH PROBLEMS OF THE TRICYCLE DRIVERS
4. MEASURES TO IMPROVE HEALTH PROBLEMS OF TRICYCLE DRIVERS
Figure 3. Paradigm of the Conceptual Framework
Definition of Terms The terms used in the study are hereby conceptually and operationally defined for better understanding and clarity. TRICYCLE- a vehicle in the Philippines used as a form of public transport TRICYCLE DRIVERS- professionals making a living out of driving a public utility tricycle
HEALTH PROBLEMS- is a state in which you are unable to function normally. It also refers to health problems that are resulted from the nature of work of Tricycle drivers HEALTH PRACTICES- refers to health practices utilized by Tricycle drivers HEALTH- state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. It also refers to the ability of Tricycle drivers to perform activities of daily living without distress
Notes Ueda Bawa, M.S., Srivastav M. (2013). Study the epidemiological profile of taxi drivers in the background of occupational environment, stress and personality characteristics. Retrieved
from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4035606/
Ueda, T., Hashimoto, M., Kosaka, M., Higashida, T., Hara, I. & Kurimoto, T., 1992, ‘A study on
work
and
driver’, EuropePubMed
daily
life
factors
Central 39(1),
affecting
the
health
of
the
11–21. Retrieved
taxi from
http://europepmc.org/abstract/med/1600205 Dahl, S., Kaerlev, L., Jensen, A., Tuchsen, F., Hannerz, H., Nielsen, P.S. et al., 2009, ‘Hospitalization for lifestyle related diseases in long haul drivers compared with truck drivers and the working population at large’, Work 33(3), 345–353.Retrieved from http://dx.doi.org/10.3233/WOR-2009-0882 Chen, J.C., Chen, Y.J., Chang, W.P. & Christiani, D.C., 2005, ‘Long driving time is associated
with haematological markers of increased cardiovascular risk in taxi
drivers’, Occupational & Environmental Medicine 62(12), 890Retrieved
894.
from http://dx.doi.org/10.1136/oem2005.020354
AL-Dubai, S.A.R., Qureshi, A.M., Ismail, N.H. & Rampal, K.G., 2012, ‘Prevalence and determinants of low back pain among taxi drivers in Malaysia. A cross sectional study’, Journal of Advanced Medical Research 2(4), 129–143. Beechy, T., Oglesby, W.H. & Ahern, J., 2014, A heavy load: BMI and commercial truck drivers,
The Centre for Community Solutions, Columbus Ohio: Kent State
University College.Retrievedfrom https://www.researchgate.net/publication/268151026_A_ Heavy Load_BMI_and_Commercial_Truck_Drivers Lim, S.M. & Chia, S.E., 2015, ‘The prevalence of fatigue and associated health and safety risk 92–
factors among taxi drivers in Singapore’, Singapore Medical Journal 56(2),
97. Retrieved from http://dx.doi.org/10.11622/smedj.2014169
Gany, F., Gill, P., Baser, R. & Leng, J., 2014, ‘Supporting South Asian taxi drivers to exercise
through pedometers (SSTEP) to decrease cardiovascular disease
risk’, Journal of Urban
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463–476.
Retrieved
from
http://dx.org/10.1007/s11524-013-9558-zBongkyoo, C., et al (2016). Ambulatory heart rate of professional taxi drivers while driving
without their typical psychosocial work
stressors:
study.
a
pilot
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from
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CHAPTER III
RESEARCH DESIGN AND METHODOLOGY This chapter presents the research methods and procedures employed by the researchers. Chapter three (3) includes the Research Design, Sources of Data, Respondents of the Study, Research Instrument and Validation, Data Gathering and Statistical Treatment of Data.
Research Design The descriptive method of research will be used in this study. Descriptive research aimed at casting light on current issues or problems through a process of data collection that enables to describe the situation more completely. (Fox &Bayat 2001) This research study will describe the demographic and work profile of the respondents, their health practices, and the health problems they have been experiencing because of their work. This study will also include the identification of health measures to alleviate their suffering. Quantifiable information will be used for statistical inference on the target population through data analysis. It is the most appropriate method to use since accurate account of characteristics of individuals and situations will be needed to determine the work-related health practices and problems among Tricycle drivers Ligao City, Albay.
Sources of Data The study will utilize two main sources the primary and secondary sources of data. The primary source of data for this study will be acquired from the respondents’ responses to the questionnaire. Other print and online resources like books and internet websites will also be used as the secondary sources of data. These sources will help in the analysis and completion of the study.
Respondent of the Study The respondents of this study will consist of Tricycle drivers in the Ligao City, Albay. The criteria for the selection of respondents are Tricycle drivers who have been working for at least three years preceding the period of study and have been driving routes along the Barangay Tuburan Ligao City. The respondents will be limited to male drivers aging at least 20 years old and not older than 50 years old, with or without medical conditions.
Research Instrument The study will make use of a questionnaires its primary research instrument. The respondents will put a check on their corresponding answers on the provided questions. The questionnaire will consist of four (4) parts. The first part includes the demographic profile of the respondents; their age, civil status, highest educational attainment, no. of family members, daily income, no. of hours working per day and no. of years as a Tricycle driver. Part two and part three will be comprised of their work profile and of queries about health practices and problems among Tricycle drivers during and after
long hours of working. Part four will contain questions on the health measures the respondents do to minimize and alleviate the incidents of health problems Tricycle drivers experience at work.
Validation of Research Instrument The study will utilize a questionnaire checklist as its main tool for data gathering. The researchers will undergo a dry-run with the help of ten (10) of selected Tricycle drivers, who have been driving barangay Tuburan routes, to test the effectiveness of the instrument. The suggestions, recommendations and corrections which will be made by the ten (10) selected Tricycle drivers will be considered to formulate the final draft of the questionnaire.
Data Gathering Prior to conducting the study, the researchers will secure permission and approval of their research adviser. The researchers will then start with the actual data gathering by producing copies of the questionnaire and reviewing the questions therein. After the initial preparations, the researchers will conduct the research proper. They will start with an introductory explanation about the study to the qualified respondents and the researchers will emphasize that their identities will be highly confidential. The researchers will then start giving out the questionnaires to selected Tricycle drivers. A direct and informal interview with the respondents will also be conducted for additional information. The said respondents will be interviewed at their respective Tricycle
terminals. After data gathering, the researchers will organize, interpret and analyze the information and will finally draw conclusions based from the data collected.
Statistical Treatment of the Data The researchers will analyze and interpret the gathered data using statistical tools. The responses of respondents will be classified and will be tabulated systematically according to different variables that will be included in the study. Frequency count, percentage and ranking will be used to assess the sub-problems on the demographic and work profile, the work-related health problems of Tricycle drivers. Frequency count will be used in tallying the responses of respondents from the collected questionnaires. Ranking will also be used to strengthen the interpretation. With this, a percentage frequency distribution will be used as a statistical tool for data analysis. A percentage frequency distribution is a display of data that specifies the percentage of observations that exist for each data point or grouping of data points. It is a particularly useful method of expressing the relative frequency of survey responses and other data. (Lavrakas, P.J.2008)
The researcher used the formula: P= F/N x 100
Where: P = percentage (%)
N = number of respondents
F = frequency
100 = constant
NOTES Fox, W. &Bayat, M.S. (2007)“A Guide to Managing Research”Juta Publications, p. 45 Lavrakas, Paul J. (2008)“ Percentage Frequency Distribution” SAGE ResearchMethods
