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PREVALENCE OF HYPERTENSION AMONG FIRST YEAR COLLEGE STUDENTS OF UPHSD-LP S.Y. 20112012 IN RELATION TO THEIR PROFILE AND LIFESTYLE: BASIS FOR COMPREHENSIVE HEALTH PROGRAM

A Masters Thesis Presented To the Faculty of Graduate School University of Perpetual Help System DALTA Las Pias City

In Partial Fulfillment of the Requirements for the Degree Master of Arts in Nursing Major in Nursing Administration

By LAILANI CAPARROSO LADIOS

MARCH 2012

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APPROVAL SHEET This Thesis entitled, PREVALENCE OF HYPERTENSION AMONG FIRST YEAR COLLEGE STUDENTS OF UPHSD-LP S.Y. 20112012 IN RELATION TO THEIR PROFILE AND LIFESTYLE: BASIS FOR A COMPREHENSIVE HEALTH PROGRAM prepared and submitted by LAILANI CAPARROSO LADIOS in partial fulfillment for the requirements for the Degree Master of Arts in Nursing, Major in Nursing Administration, has been examined and recommended for acceptance and approval for oral examination.

AMELIA M. MENDOZA, R.N., M.A.N. Adviser

ORAL EXAMINATION COMMITTEE Approved by the Committee on Oral Examination with the grade of ___________.

FLORENCIA C. MARFIL, Ph.D. Member

YOLANDA T. CANARIA, Ph.D. Member

GLORIA M. ALBERTO, Ph.D. Chairman

Accepted and approved in partial fulfillment of the requirements for the Degree Master of Arts in Nursing.

ATTY. IRINEO F. MARTINEZ, JR., Ph.D. Dean, Graduate School

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ACKNOWLEDGMENT The researcher would like to extend her utmost gratitude to the following people who contributed their significant parts in the realization of this humble piece of work: TO THE TAMAYO FAMILY, founders of the University of Perpetual Help System DALTA, for the scholarship they have given to the researcher so that she can pursue her Masters degree and for the continuous support to all the students of the Graduate School. The researcher will truly be forever grateful; ATTY. IRINEO F. MARTINEZ, JR., Ph.D., Dean, Graduate School, University of Perpetual Help System DALTA, for the unending support to all graduate students in their earnest desire to finish and attain their degrees; MS. AMELIA MENDOZA, R.N., M.A.N., O.I.C., Nursing Service of University of Perpetual Help Medical Center- Las Pias and Thesis Adviser, for her brilliant suggestions, inputs, and encouragement from the start until the end of her journey in writing; DR. GLORIA M. ALBERTO, DR. FLORENCIA C. MARFIL, and DR. YOLANDA T. CANARIA , members of the thesis review panel for their scrutiny of the contents and references used in the study and the directions and inspiration given for a better outcome of the study;

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DR. JESUS B. GOLLAYAN, Professorial Lecturer of the Graduate School of UPHSD-Las Pias, for his expertise in the statistical treatment of the data that provided the researcher with substantial inputs and clear directions in the accomplishment of the thrust of the study; DR. ALFONSO H. LORETO, School director of UPHSD-LP, for his approval to conduct the study and the support he has shown in pursuing her Masters degree; DR. RENO RAYEL, School Director of UPHSD-Molino Campus for his approval to conduct the pilot study; TO MS. REVELINA MATEO, Clinic Nurse of UPHSD-Molino Campus, who helped facilitate the survey; TO ALL THE UPHSD-LP PROFESSORS, and most importantly, to the STUDENTS, for the great support and cooperation tendered sincerely during the time of gathering information; TO ALL HER MAN PROFESSORS AND CLASSMATES, especially Dr. Hazel Villagracia, Dean Francisco Sosa, Ms. Julie Rojo, Precious Nario, Nina Villa, and Mr. Carlo Almazar, for the words of encouragement and support that led the researcher to pursue and accomplish this study;

TO ALL THE UPHSD-LP CLINIC STAFF, the researchers costaff, for the love and support to finish the entire program up to the final thesis writing; TO ENGR. ILUMINADO B. LADIOS, ever-loving father of the researcher, for the continuous understanding and support, especially financially, to conduct and accomplish this work; TO MRS. ANTONIETA C. LADIOS, kind and understanding mother of the researcher, for all the prayers and encouragement to finish the degree for a better future; TO ALL HER FRIENDS, FAMILY AND RELATIVES, especially 3rd Engineer Melani C. Ladios; E/Cadet Laddie C. Ladios II; Ms. Evelyn R. Caparroso; and Atty. Teodoro R. Caparroso, who served as the researchers financer during her Thesis writing, inspiration, and source of continuous support; TO MS. JASMIN VITA, for all the understanding and providing all the researchers needs to complete the study and the entire program; TO FO1 ROLAND SULIBA, researchers bestfriend, for all the inspiration, words of wisdom, and faith in the Almighty that made the researcher pursue the entire program and accomplish this study; TO ENGINEER VIRGILIO BARDA, the researchers inspiration, for all the tender love and support, making each day light and easy;

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Finally, TO GOD ALMIGHTY, for the strength and wisdom bestowed on the researcher that made her accomplish her goal and utmost dream.

L.C.L.

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ABSTRACT

Name of the Institution Address Title

: University of Perpetual Help System DALTA : Alabang-Zapote Road, Las Pias City : Prevalence of Hypertension Among First Year College Students of UPHSD-LP S.Y. 2011-2012 In Relation To their Profile and Lifestyle: Basis for Comprehensive Health Program

Author Degree Major Date of Completion

: Lailani Caparroso Ladios : Master of Arts in Nursing : Nursing Administration : March 2012

STATEMENT OF THE PROBLEM The study determined the prevalence of hypertension among the first year college students in relation to their profile and lifestyle. The following questions were answered by this study.

1. What is the profile of the respondents as to: 1.1 Age; 1.2 Gender; 1.3 Program/ Course:

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1.3.1 Cluster 1; 1.3.2 Cluster 2; 1.3.3 Cluster 3; and 1.3.4 Cluster 4? 2. Based on existing medical records, what are the respondents 2.1 BP reading; 2.2 Body Mass Index (BMI) 2.2.1 Height; 2.2.2 Weight; 2.3 Existing Medical Conditions; and 2.4 Awareness on having high blood pressure? 3. What is the lifestyle of the respondents as to: 3.1 Eating and drinking habits; 3.2 Physical activities; 3.3 Sleeping patterns; and 3.4 Study habits? 4. Is there a significant relationship between the respondents being hypertensive and: 4.1 Profile; and 4.2 Lifestyle?

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5. Is there a significant relationship between the respondents profile and lifestyle? 6. Based on the results of the study, what comprehensive health program may be proposed? Null Hypotheses 1. There is no significant relationship between the

respondents being hypertensive to their profile and lifestyle. 2. There is no significant relationship between the

respondents profile and lifestyle Methodology The study made use of the Descriptive Methodology that enabled the researcher to ascertain the extent to which variation in one variable are associated with variations in another which specifically involved the identification of relationship of respondents hypertension; profile; and lifestyle, in terms of eating and drinking habits, physical activities, sleeping patterns, and study habits. The respondents were 46 first year college students who were enrolled in UPHSD-LP, S.Y. 2011-2012. Purposive Sampling Technique was utilized. It is a form of sampling wherein samples came from a specific group-and these were the hypertensive students.

This study involves the collection of data in order to test the hypothesis and to answer questions concerning the current status of the subjects of the study. To support the study, the researcher utilized a selfmade questionnaire that was given to selected respondents to further investigate on the subjects eating and drinking habits, physical activities, sleeping patterns, and study habits. It was composed of two (2) parts. Part 1 consists of information about the respondents in terms of the respondents name, which is optional, age, gender, and program of study or course. Part 2 was composed of statements on the relationship of the respondents hypertension and lifestyle. A Likert Scale was used to determine how often they practice the factors that are believed to be prevalent to hypertension. Aslo, the researcher reviewed the history and physical examination findings of each respondent. The following statistical measures were used in obtaining answers to the specific problems of the study: a combination of Descriptive and Inferential Statistics was used in the analysis and interpretation of data, Frequency Count and Percentage Distribution, Weighted Mean and Correlation Analysis using Pearsons Co-efficient of Correlation. Summary of Findings Based on the results of the study, the following questions were answered:

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1. 1.1

What is the profile of the respondents as to: Age; Most of the respondents were from 21-30 y/o of age (26.09%)

followed by 16 y/o (23.91%), 17 y/o (19.57%), 18 y/0 (13.04%), 20 y/o (10.87%), and the least 19 y/o (6.52%). 1.2 Gender; Most of the respondents were male (98%), and only one female (2%) qualified in the study. 1.3 Program/ Course? 24 or 52.17% came from cluster 2 (Maritime, Engineering and Criminology students) then 14 were from cluster 4 (CIHM -HRM and Tourism, and College of Computer Studies Program), followed by 6 students from cluster 1 (Allied Courses) then lastly 2 of them were from cluster 3 (CAS, Business, and Education programs). 2. 2.1 Based on existing medical records, what are the respondents: BP reading; Blood pressure taken at 120/90 mmHg had the most number of respondents which comprises of 15 respondents or 32.16%. Followed by 130/90 mmHg with 8 respondents (17.39%), 130/80 mmHg had 6 respondents (13.04%), then 140/90 had 4 respondents or 8.70%, 110/90mmHg had 3 respondents (6.52%). Then 140/80, 140/100 and

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150/80 mmHg had 2 respondents respectively that corresponds to 4.35%. Lastly, 100/90, 130/70, 140/70 and 150/90 mmHg had 1 respondent each that corresponds to 2.17%. 2.2 Body Mass Index (BMI) Most of the respondents, 16 or 34.78% were in the Obese Class 1 category. Such was followed by 11 respondents (23.91%) who were Obese Class 2; 9 respondents (19.57%) had a normal weight; 6 respondents (13.04%) were underweight; and 4 respondents (8.70%) were overweight. 2.3 Existing Medical Conditions; 36 or 78.26% of them did not respond which means they did not manifest any medical illness or condition as revealed in their history and physical examination record. Then, 5 respondents or 10.87% had asthma, 3 respondents (6.52%) had allergy, while 1 respondent (2.17%) had diabetes and lastly, 1 respondent (2.17%) had asthma, allergy and diabetes. 2.4 Awareness on Having High Blood Pressure? 44 respondents, or 96%, were not aware that their blood pressure is high. It was only during their annual medical examination that they learned about their elevated BP reading. Meanwhile, 2 respondents (4%)

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were already aware that their BP is high, yet non-compliant with the hypertension treatment protocol. 3. 3.1 What is the lifestyle of the respondents as to: Eating and Drinking Habits; Most of the respondents often include fish sauce, soy sauce, and/or bagoong during mealtime, they prefer to eat fried foods, enjoy eating junk and fatty foods, consume large quantities of coffee and cola and other caffeine-containing foods and drinks and consume more than 2-3 bottles of alcoholic beverages during drinking sessions based on the mean ratings of 3.54 to 3.72. On the other hand, the Weighted Mean of 2.76 tells one that sometimes they do not like to eat fruit and/or vegetables. 3.2 Physical Activities; Most of the respondents often prefer to take a ride instead of walking to places; found it difficult to find time to exercise; and had difficulty in maintaining normal body weight based on the mean rating of 3.63 to 3.70. Results revealed that most of them answered sometimes which had a mean rating 3.56 which indicates that they spend much of their time watching TV and/or playing video games and that they do not join sports activities in school and/or in the community.

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3.3

Sleeping Patterns; Most of the respondents often have 6 hours, or less than 6 hours,

of sleep at night and they usually do their school-related tasks at night, making them awake, which results to lack of sleep based on the mean ratings of 4.20 to 4.22. Also, most of them sometimes (with a mean rating of 3.17 to 3.46) take a nap during a prolonged sitting position, easily disturbed by any kind of noise during sleep, and tend to wake up when changing position and light changes. 3.4 Study Habits? The respondents are often pressured when they do not meet the target date and time of submission of projects and assignments; hardly find time to organize their daily review of lessons; and easily become tense during interactive sessions in class. They are also often confused in prioritizing what subject to study first when two or more subjects are scheduled on the same day based on the mean ratings of 3.50 to 3.62. Most of the respondents were Sometimes stressed when they cram to review all the lessons with little time left prior to exam date and time and they also get nervous or tense Sometimes during examination days based on the mean ratings of 3.35 to 3.46.

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4.

Is there a significant relationship between the respondents

hypertension and their: 4.1 Profile as to: 4.1.1 Age; There is no significant relationship between the respondents hypertension and profile as to age. 4.1.2 Gender; The profile with respect to gender was not included in the analysis since there is only one female respondent which renders correlation analysis inapplicable. 4.1.3 Program/ Course; There is no significant relationship between the respondents hypertension and profile as to program/ course. 4.1.4 Body Mass Index (BMI) and; There is no significant relationship between the respondents hypertension and profile as to BMI. 4.2 Lifestyle as to: 4.2.1 Eating and Drinking Habits; There is no significant relationship between the respondents hypertension and lifestyle as to eating and drinking habits. 4.2.3 Physical Activities;

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There is no significant relationship between the respondents hypertension and lifestyle as to physical activities. 4.2.3 Sleeping Patterns There is no significant relationship between the respondents hypertension and lifestyle as to sleeping patterns. 4.2.4. Study Habits? There is no significant relationship between the respondents hypertension and lifestyle as to study habits.

5.

Is there a significant relationship between the respondents profile

and lifestyle? There is no significant relationship between the respondents profile and lifestyle.

6. Based on the results of the study, what comprehensive health program may be proposed? The proposed comprehensive health program is a plan that contains strategies on Promotive and Preventive and Curative and Rehabilitative aspects. Mainly, the goal of the program is on lifestyle modifications focused on eating and drinking habits, physical activities, sleeping patterns, and study habits.

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Conclusions The following conclusions were drawn on the basis of the findings of the study: 1. The incidence of hypertension appeared to be increasing among adolescents, specifically college students. 2. Increased BMI, specifically in the obese category is related to the increased prevalence of hypertension. 3. Hypertension remains to be a silent killer wherein, most of the respondents not aware of their elevated blood pressure. 4. Unhealthy poor lifestyle in terms of eating and drinking habits, physical activities, sleeping patterns and study habits among the college students is indeed an important risk factor regarding the prevalence of hypertension where early modifications should be practiced. 5. Clinic staff and administrators of UPHSD-LP and other universities and schools should implement a health promotion program that shall identify hypertensive students and decrease the prevalence of hypertension among them.

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Recommendations Based on the findings and conclusions made, the following recommendations were suggested: 1. The university clinic, together with the school administrator, should provide a comprehensive health program for the hypertensive students in terms of the following aspects: a. PROMOTIVE Hypertension awareness campaign for High School and College students. It is said that as early as adolescence, hypertension can now be manifested. So, it is better if, as early as their high school years, an awareness campaign be conducted. DOH updates on hypertension. From time to time, medications and treatments change. Updates on trends in hypertension treatment can be of big help to increase the level of awareness and promotion of health. b. PREVENTIVE Diagnosed students may follow-up with the university doctor for laboratory requests for the early detection of causes of hypertension

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Monitoring of diet, specifically, Diet Approaches to Stop Hypertension (DASH) food plan may be successful in lowering blood pressure in adolescence. Increased intake of potassium and calcium have also been suggested as nutritional strategies to lower blood pressure. Regular exercises that can be included in Physical Education (P.E.) classes. c. CURATIVE The student-patient with hypertension can be under the care of the university doctor for prescriptions and follow-ups. Daily monitoring of BP should be done by the clinic staff as well as follow-up compliance as treatment protocol. d. REHABILITATIVE When the student-patient attains the normal BP reading, they may undergo rehabilitation programs, such as daily personal exercises or have exercises during their P.E. classes, and monitoring of diet. This can be done by counseling and focus group discussions (FGDs) 2. The faculty should stress the importance of regular and daily exercises among their students during their Physical Education or health

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subjects so that they are always reminded on ways to keep a healthy lifestyle to prevent the prevalence of hypertension. 3. The parents/ guardians should assess and guide their children. Prevention is the best strategy for dealing with any epidemic. For prevention to be successful, a significant societal change is needed. It is very difficult for individuals who are not ill to make wise health choices given the foods that are available. Whatever lifestyle changes are recommended, a family-centered, rather than patient-oriented approach usually is more effective. 4. Researchers should continue to promote and support basic research in hypertension and related areas. Despite good medication, the treatment of hypertension is still inadequate and empiric and fails to reverse all of the risk for cardiovascular disease. Hypertension is an important public health problem that needs a better solution especially among adolescents. Future researchers may replicate this study with sufficient data in another institution.

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TABLE OF CONTENTS TITLE PAGE APPROVAL SHEET ACKNOWLEDGMENT ABSTRACT TABLE OF CONTENTS LIST OF TABLES LIST OF FIGURES CHAPTER 1 THE PROBLEM AND ITS BACKGROUND Introduction Theoretical and Conceptual Framework Statement of the Problem Null Hypothesis Scope and Delimitation of the Study Significance of the Study Definition of Terms 1 4 12 14 15 16 18 i ii iii vii xxi xxiv xxvi

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REVIEW OF RELATED LITERATURE AND STUDIES Related Literature Related Studies Foreign Local Synthesis 31 37 38 21

RESEARCH METHODOLOGY Research Design Population and Sampling Respondents of the Study The Research Instrument Validation of Instrument Data Gathering Procedure Statistical Treatment of Data 40 41 42 43 44 45 46

PRESENTATION, ANALYSIS, AND INTERPRETATION OF DATA Problem No. 1 Problem No. 2 Problem No. 3 Problem No. 4 Problem No. 5 48 51 57 64 70

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Problem No. 6 5 SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS Summary and Findings Conclusions Recommendations REFERENCES APPENDICES A-Letter of Request I B-Letter of Request II C-Questionnaire D-History and Physical Examination Record E-Distribution of Respondents Profile F-The International Classification of adult underweight, overweight, and obesity according to BMI G-Certification of Statistical Treatment H-Certification of Editing CURRICULUM VITAE

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76 88 89 92

94 95 96 98 99 100

101 102 103

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LIST OF TABLES TABLE 1 Interpretation of the Weighted Mean of the Respondents Lifestyle in the Questionnaire 2 Distribution of Respondents according to Age 3 Distribution of Respondents according to Gender 4 Distribution of Respondents according to Program 5 Distribution of Respondents according to Existing Medical Record in terms of Blood Pressure 6 Distribution of Respondents according to Existing Medical Record in terms of Blood Pressure Reading According to Mode 7 Distribution of Respondents according to Existing Medical Records in terms of BMI 8 Distribution of Respondents according to Existing Medical Records in terms of Existing Medical Condition 9 Distribution of Respondents according to Existing Medical Records in terms of Awareness 10 Mean Ratings of Respondents in terms of Eating and Drinking Habits 11 Mean Ratings of Respondents in terms of Physical Activities 12 Mean Ratings of Respondents in terms of Sleeping Patterns 13 Mean Ratings of Respondents in terms of Study Habits 14 Correlation of Respondents Hypertension and Profile PAGE 43

48 49 50 51

53

54

55

56

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60

61

63

65

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15 Correlation of Respondents Hypertension and Lifestyle 16 Correlation of Respondents Profile in terms of Age and Lifestyle 17 Correlation of Respondents Profile in terms of Program and Lifestyle 18 Correlation of Respondents Profile in terms of BMI and Lifestyle

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71

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LIST OF FIGURES FIGURE PAGE

1 Orems Self-Care Deficit Theory 2 Transtheoretical Model 3 Social Cognitive Theory 4 Conceptual Paradigm 5 Proposed Comprehensive Health Program Utilizing Transtheoretical Model

6 8 10 11 74

Chapter 1 THE PROBLEM AND ITS BACKGROUND Introduction Hypertension is the leading cause of cardiovascular disease worldwide. Prior to 1990, population data indicates that hypertension prevalence was decreasing; however, recent data shows that it is again on the rise. In 1999-2002, 28.6% of the U.S. population had hypertension. Hypertension prevalence has also been increasing in

other countries, and an estimated 972 million people in the world are suffering from this problem. Incidence rates of hypertension range between 3% and 18%, depending on the age, gender, ethnicity, and body size of the population studied. Despite advances in hypertension treatment, control rates continue to be suboptimal. Only about one third of all hypertensive are controlled in the United States. Programs that improve hypertension control rates and prevent hypertension are urgently needed (Hajjar I., 2006). The World Health Organization attributes hypertension or high blood pressure as the leading cause of cardiovascular mortality. A study done by the Philippine College of Cardiology in 2007 also reported that 21 percent of Filipinos were hypertensive, and 80 percent of them have

uncontrolled hypertension; this predisposes patients to complications such as heart disease, stroke and kidney damage. The Philippine Society of Hypertension revealed in the study that one out of five Filipinos is hypertensive and not even aware of the condition, while 90 percent of the countrys population has one or more of the risk factors that contributed to high blood pressure which afflicts 17 percent of the population and could be considered an epidemic (Abarquez, MD, 2006). Diagnosing high blood pressure in teenagers is more complicated than diagnosing high blood pressure in adults. In adults, there are clear numerical guidelines for diagnosis which is not true among teenagers, since most teenagers do not have the same risks as adults. The diagnosis of hypertension in the young is becoming more difficult because statistics in percentiles are only relied upon instead of using absolute guidelines, just like in adults. Official diagnosis of hypertension is complicated, that is why high blood pressure should only be diagnosed by a doctor, according to the American Heart Association in 2007. However, the researcher believes that nurses must also take the responsibility of identifying, taking note of patients with high blood pressure reading, and reporting them right away. There are various types and stages of hypertension. Primary or essential hypertension is more common in adolescents and has multiple risk factors, including

obesity and a family history of hypertension, and its management is multi-faceted. Secondary hypertension is more common in preadolescent children, with most cases caused by renal disease. Stages include stage 1 hypertension which is considered when the blood pressure hits 140 to 159 over 90 to 99, while stage 2 hypertension are those systolic pressures of 160 or higher, or diastolic pressures of 100 or higher (Chockalingam A., 2007). The researcher, who also happens to be a school nurse, has been encountering students with elevated blood pressure. From the data obtained in 2010 UPHSD-LP, University Clinics annual medical examination, 212 first year students, or 18% out of 1,195, were diagnosed to have primary hypertension, while this year, 2011, 46 first year students, or 3%, out of 1, 744, were also found to be with the same condition. Taking into account that the age range of the students was 1630 y/o, the researcher believes that this should be given much attention. So, with the cited number of students who were found to have been diagnosed with hypertension, the researcher has great interest in determining the prevalence among the first year college students. The researcher has the responsibility of caring and looking after the welfare of the students. The results inspire the researcher to propose an appropriate and comprehensive health program based on the prevalence

of hypertension among the first year college students in relation to their profile and lifestyle. We may not have accurate and updated data here in the Philippines, but the researcher believes that we are fast adapting to the lifestyle of western countries. Based on the researchers observation, overweight and obese persons, including our young students, are increasing in number, particularly in the urban areas where the study was held. High blood pressure reading has been noted currently among UPHSD first year college students; hence, this study prompted the researcher to determine the prevalence of hypertension among the first year college students at UPHSD-LP, S.Y. 2011-2012. Oftentimes, many believe that only the adults and the aged are the ones experiencing the said condition. It is alarming to note that the prevalence and rate of diagnosis of hypertension in children and adolescents appear to be increasing (Luma, 2006). Theoretical and Conceptual Framework Once hypertension has been confirmed, an extensive history and careful physical examination should be conducted to identify underlying causes of the elevated blood pressure and to detect any end-organ

damage (Luma, 2006). Therefore, it is important to know the causes of hypertension among the college students that will help them be aware that hypertension is not only for adults, but can now be manifested as early as their college life. It is expected that they have not reached the physical, emotional and psychological maturity of an adult; hence, the diagnosis of hypertension may just simply be a condition that goes away after taking a couple of medicines. The importance of compliance to a lot of required regimen could not even be as important. As such, they need other people to provide them the best information possible regarding the complexities of hypertension. This study is anchored on the theory of Dorothea Orem (as shown in Figure1) where she stated that self-care is the practice of activities that individuals personally initiate and perform on their own to maintain life, health and well-being, and the persons on-going contribution to his own health and well-being. As college students, they are already responsible for their self-care because they are now spending more time away from home. But once they are in school, the persons responsible in promoting their health are the medical clinic nurses.

Figure 1. Orems Self-Care Deficit Theory. The nurses assess the patients level of functioning and ability to care for himself or herself then provides the type of self-care needed. This type of care and includes Wholly Compensatory, Care. In a Partially Wholly

Compensatory

Supportive-Educative

Compensatory System, the patient has no active role in the performance of his care for the nurse accomplishes the patients therapeutic self-care; compensates for patients inability to engage in self-care; and supports and protects patients. In a Partially

Compensatory System, both nurse and patient work together to perform activities to achieve the desired self-care goals; here the nurse

compensates for the self-care limitations of the patient. In the Supportive-Educative system, it requires use of resources and educational tools to teach the person and his family to perform self-care. Therefore, the patient can meet self-care requisites, but needs help in decision-making, behavior control, or knowledge acquisition. In the case of hypertensive college students, what they actually need is supportiveeducative care because of the fact that they really need to be provided with a lot of support and education so that they will be able to adhere to whatever programs or management they will have to undergo to achieve optimum health and prevent further damage to their body parts.

Figure 2. Transtheoretical Model. This study is supported by James Prochaskas Transtheoretical Model (Shown in Figure 2), which claims that individuals move through a series of five stages of change in the adoption of healthy behaviors or cessation of unhealthy ones. These five stages are Pre-Contemplation, Contemplation, Preparation, Action and Maintenance. The

Transtheoretical Model is often used in tailored health interventions. The model describes how people modify a problem behavior or acquire a

positive behavior. The central organizing construct of the model is the Stages of Change. The model also includes a series of independent variables, the Process of Change, and a series of outcome measures, including the Decisional Balance and the Temptation Scales. Processes of change are ten cognitive and behavior activities that facilitate change. Therefore, one must provide important guides for intervention programs, since the processes are the independent variables that people need to apply, or be engaged in, to move from stage to stage. The ten processes are Consciousness Raising, Dramatic Relief, Environmental Reevaluation, Social Liberation, Self-Re-evaluation, Stimulus Control, Helping Relationships, Counter-Conditioning, Reinforcement

Management, and Self-Liberation.

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Figure 3. Social Cognitive Theory. This study is also supported by Albert Banduras Social Cognitive Theory (Shown on Figure 3), wherein personal factors, behavior, and the environment are the main independent factors. In the model, the interaction between the person and behavior involves the influences of a persons thoughts and actions. The interaction between the person and the environment involves human beliefs and cognitive competencies that are developed and modified by social influences and structures within the environment. The third interaction between the environment and behavior involves a persons behavior determining the aspects of environment and, in turn, their behavior is modified by that environment.

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INPUT
1. Profile of respondents 1.1 Age 1.2 Gender 1.3 Program/Course according to cluster: 1.3.1 Cluster 1 1.3.2 Cluster 2 1.3.3 Cluster 3 1.3.4 Cluster 4

PROCESS
Documentary Analysis of Respondents Profile Medical Records Lifestyle

OUTPUT
A Proposed Comprehensive Health Program on: Promotive; Preventive; Curative; and Rehabilitative aspects

1. 2.

3.

2.Respondents Medical Records regarding: 2.1 BP reading; 2.2 Body Mass Index (BMI); 2.2.1 Heig ht; 2.2.2 Wei ght; 2.3 Existing medical conditions; and 2.4 Awareness on having High Blood pressure 3. Lifestyle of respondents as to: 3.1 Eating and Drinking Habits 3.2 Physical activities 3.3 Sleeping patterns 3.4 Study habits

Interview Self-made Questionnaire

Figure 4.Conceptual Paradigm. The concepts and theories have been brought to bear on the present study by incorporating them in a paradigm patterned after Schutzes Input-Process-Model as shown in Figure 4.

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The paradigm shows the Inputs of the study, such as the profile of the first year college students through age, gender, program/ course (according to its clusters) that the respondents are enrolled in, documentary review of respondents health records in BP reading, Body Mass Index (BMI), which includes height and weight, existing medical conditions, awareness on having high blood pressure, and the lifestyle of respondents as to eating and drinking habits, physical activities, sleeping patterns and study habits. The Process includes documentary analysis of factors affecting hypertension combined with the use of questionnaires and random interview to eventually come up with the Output. Finally, the researcher plans to develop a comprehensive health program for the hypertensive freshmen college students as to Promotive, Preventive, Curative and Rehabilitative aspects. Statement of the Problem This study sought to determine the prevalence of hypertension among the first year college students of the University of Perpetual Help System Dalta-Las Pias campus in relation to their profile and lifestyle. The findings of the study will serve as basis for a comprehensive health program.

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Specifically, the study answered the following questions: 1. What is the profile of the respondents as to: 1.1 Age; 1.2 Gender; 1.3 Program/ Course: 1.3.1 Cluster 1; 1.3.2 Cluster 2; 1.3.3 Cluster 3; and 1.3.4 Cluster 4? 2. Based on the existing medical records, what are the respondents 2.1 BP reading; 2.2 Body Mass Index (BMI) 2.2.1 Height; 2.2.2 Weight; 2.3 Existing Medical Conditions; and 2.4 Awareness on having high blood pressure?

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3. What is the lifestyle of the respondents as to: 3.1 Eating and drinking habits; 3.2 Physical activities; 3.3 Sleeping patterns and 3.4 Study habits? 4. Is there a significant relationship between the respondents being hypertensive and their: 4.1 Profile and 4.2 Lifestyle? 5. Is there a significant relationship between the respondents profile and lifestyle? 6. Based on the results of the study, what comprehensive health program may be proposed? Null Hypotheses 1. There is no significant relationship between the respondents being hypertensive and their profile and lifestyle. 2. There is no significant relationship between the respondents profile and lifestyle.

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Scope and Delimitation of the Study This study was conducted to ascertain the prevalence of hypertension among the first year college students of UPHSD-LP as basis for a proposed comprehensive health program. The respondents in this study were all first year college students enrolled at UPHSD-LP for S.Y. 2011-2012 who have high blood pressure readings as assessed by the nurse and diagnosed by the university physician during their annual medical examination. First year college students were the target population for this study because it is in this year level wherein the annual medical examination for students starts; thus, the gathering of data is accessible. Respondents are those with medical conditions, especially hypertension, and can fully comprehend, or has the ability to respond to, the survey questionnaires given. The study is limited to finding out the prevalence of hypertension among the first year college students and will not include the actual observation of the activities, instances, or situations that predispose the respondents to hypertension.

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Significance of the Study The researcher is a university school nurse at the University of Perpetual Help System DALTA who is deeply-motivated to determine the prevalence of hypertension among the first year college students as a basis for a comprehensive health program. As such, the results of the study are of tremendous significance to the following: College Students. The findings in this study will provide them awareness on hypertension, thereby, promoting their own wellness and create preventive management techniques in order to maintain their acceptable blood pressure. The study may also open their minds and hearts on the long-term effect of this health condition and their well-being as they grow older which will make them more health-conscious at this early stage of their lives. Clinic Staff. The findings in the study will be utilized as baseline data on incidences of hypertension among the students that they care for and will serve as basis for a comprehensive health program that will give direction to and establish standard management; it shall afford them the opportunity to disseminate hypertension awareness as well as health education among the students and their families.

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School Administrators. The findings in this study will pave the way for possible intensive health promotion programs in the university. This study will also be able to facilitate decision points regarding healthrelated concerns in the school which will particularly promote the achievement of optimum health among its students and employees as well. Faculty. The proposed program can be integrated in the instructional design and learning activities in related Physical Education syllabi. Parents.The findings of this study will be able to help the parents obtain awareness of their childrens health status to provide needed support on whatever resources that their children will need. It will also lead them to adapt a lifestyle that will promote better health among their family members, especially the younger ones. Future Researchers. This study may serve as a springboard for future researchers who would like to pursue further studies which will give deeper and better understanding on the effects of certain health conditions on the well-being of the students.

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Definition of Terms For a clearer understanding of the study, the following terms will be operationally defined: Blood pressure. Basis for identifying if the respondents are to be considered hypertensive or not; such is measured using a

sphygmomanometer and stethoscope BMI. Body Mass Index, thru which height and weight will be computed and categorized according to the WHO BMI classification as

underweight, normal, overweight, obese class 1, and obese class 2, that is said to be one of the factors affecting the respondents high blood pressure Formula:
BMI =
( kg/m )

weight in kilograms

height in meters

First Year College Students. They are the actual respondents in this study Comprehensive Health Program. A program created to help establish Preventive, Promotive, Curative and Rehabilitative Management in response to the prevalence of hypertension among the college students regarding their profile and lifestyle

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Curative. Treatment management for hypertensive respondents in the proposed comprehensive health program Hypertension. A medical condition in which the systemic blood pressure is elevated Likert Scale. A psychometric scale used to measure the respondents answer in the self-made questionnaire regarding their lifestyle Medical condition. Any disease condition that the respondents may be diagnosed with which may be a cause of elevation in blood pressure Prevalence. The incidence in the occurrence of hypertension among the first year college students Preventive. Management that would prevent the prevalence of hypertension in the proposed comprehensive health program Program of Study / Course. What the respondents are presently

pursuing in the university which was divided into four (4) clusters by the author: Cluster 1 - Allied Health Courses: Nursing, Midwifery, PT/OT, Radiologic Technology, Medical Technology, Respiratory Therapy and Dentistry Cluster 2 - Maritime, Criminology and Engineering

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Cluster 3

- CAS (Psychology and Mass Communication), Business and Education Programs

Cluster 4

- CIHM (HRM and Tourism) and College of Computer Studies Program

Promotive. Management for the promotion of health in the proposed comprehensive health program Purposive Sampling Technique. Research Sampling used to select the hypertensive respondent.. Rehabilitative. Interventions that would facilitate maintenance of health in the proposed comprehensive health program

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Chapter 2 REVIEW OF RELATED LITERATURE AND STUDIES Related Literature The Blood Pressure Blood Pressure (BP) is the pressure exerted by

circulating blood upon the walls of blood vessel, and is one of the principal vital signs. When used without further specification, "blood pressure" usually refers to the arterial pressure of the systemic

circulation. During each heartbeat, BP varies between a maximum (systolic) and a minimum (diastolic) pressure. Normal blood pressure is less than 120/80. When blood pressures hit 140 to 159 over 90 to 99, they are considered Stage 1 hypertension. Systolic pressures of 160 or higher, or diastolic pressures of 100 or higher, are considered Stage 2 hypertension. Pre-hypertensive levels are those between the normal levels and Stage 1 hypertension (Agunod-Cheng, 2011) In the study entitled Worldwide prevalence of hypertension: a systematic review conducted by Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine in January 2004, they examined the prevalence and the level of awareness, treatment, and control of hypertension in different world regions. The

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reported prevalence of hypertension varies around the world, with the lowest prevalence in rural India (3.4% in men and 6.8% in women) and the highest prevalence in Poland (68.9% in men and 72.5% in women). Awareness of hypertension was reported for 46% of the studies and varied from 25.2% in Korea to 75% in Barbados; treatment varied from 10.7% in Mexico to 66% in Barbados and control (blood pressure < 140/90 mmHg while on antihypertensive medication) varied from 5.4% in Korea to 58% in Barbados. Therefore, the study concludes that hypertension is an important public health challenge in both

economically-developing and developed countries. Significant numbers of individuals with hypertension are unaware of their condition and, among those with diagnosed hypertension, treatment is frequently inadequate. Measures are required at a population level to prevent the development of hypertension and to improve awareness, treatment and control of hypertension in the community. Understanding Hypertension and Its Type A majority of the hypertension cases are known as essential, idiopathic, or primary hypertension where the exact cause of the condition has not been clearly identified. However, a number of factors contribute to primary hypertension (Agunod-Cheng, 2011).

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Secondary hypertension is more common in pre-adolescent children, with most cases caused by renal disease. Primary or essential hypertension is more common in adolescents and has multiple risk factors, including obesity and a family history of hypertension. Evaluation involves a thorough history and physical examination, laboratory tests, and specialized studies (Luma, 2006). The World Health Organization attributes hypertension, or high blood pressure, as the leading cause of cardiovascular mortality. The World Hypertension League (WHL), an umbrella organization of 85 national hypertension societies and leagues, recognized that more than 50% of the hypertensive population worldwide is unaware of their condition (Chokalingam, 2008). Hypertension "can exist without symptoms and called it a silent killer. Dr. Ramon Abarquez, Jr., a medical doctor from the Philippine Society for Hypertension, pointed out cases in which damage had already been caused to a persons organs before high blood pressure was detected. Unless BP (blood pressure) is recorded, target organs like the heart, brain, or kidneys can be irreversibly damaged to compromise life. He added that hypertension detection is paramount and once established, it is for life. Dr. Yolanda Oliveros (2000), Director of

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the Department of Healths National Center for Disease Prevention and Control, said that, based on 2003 mortality data, heart

and vascular diseases, often caused by hypertension, were the top two causes of death in all age groups in the country. She said that 90 percent of Filipinos have one or more risk factors or combinations. Philippine Heart Association (PHA) president Dr. Efren Vicaldo pointed out that hypertensive patients do not die of hypertension but from the complications. He said that Filipinos tend to be complacent in watching their lifestyle in the absence of clear symptoms of hypertension, which is generally asymptomatic or does not exhibit signs (Philippine Daily Inquirer, 2008). The prevalence of hypertension according to the new criteria (>140/90 mmHg) varies between 15-35% in urban adult populations of Asia. In rural populations, the prevalence is two or more three times lower than in urban subjects. Hypertension and stroke occur at a relatively younger age in Asians and the risk of hypertension increases at lower levels of body mass index of 25-35 kg/m2 (Journal of Human Hypertension, 2000).

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Causes/Risk factors of Hypertension Dra. Yolanda Oliveros (2000) stated that risk factors for hypertension include: smoking; obesity; lack of exercise; dangerously low consumption of fruits and vegetables; heredity; smoking; unhealthy diet; and lack of physical activity. Overweight, sedentary behavior, alcohol, higher social class, salt intake, diabetes mellitus, and smoking are risk factors for hypertension in most of the countries of Asia. A number of factors contribute to primary hypertension, including: too much salt consumption; family history of hypertension; stress; sedentary lifestyle; smoking; excessive alcohol intake; obesity; male gender; older age being above 35; and African-American ethnicity. About five percent of hypertensive cases have secondary hypertension, wherein a direct cause (usually another disorder) can be determined. Some of these are: kidney diseases, such as infection, inflammation, stone formation, or structural problems; endocrine disorders (hormonal imbalances). adrenal gland tumors that secrete hormones that raise blood pressure and overly active or underactive thyroid glands, among others; Drugs, such as steroids, migraine medicines, non-steroidal antiinflammatory drugs (such as ibuprofen or amphetamines), oral contraceptive pills, and medications that cause arteries to tighten, such

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as allergy or cold medications containing ephedrine or pseudoephedrine; and obstructive sleep apnea (Agunod-Cheng, 2011). Getting too little sleep may be a significant risk factor for high blood pressure. In a study of more than 4,800 men and women, people ages 32 to 59 who got five hours of sleep a night or less were about 60 percent were more likely to develop hypertension than those who slept six to eight hours (Nicholas, 2006). Recent research conducted at the Case Western Reserve University in Cleveland, Ohio, has suggested that lack of sleep, as well as poor sleep quality, can cause elevated blood pressure levels in healthy adolescents. These associations could not be explained by being overweight, socio-economic status, sleep apnea, or known comorbidities (Chow, 2008). Poor study habits may also cause increased anxiety that will affect ones blood pressure. "Stress, "Pressure," "Tension," and "Anxiety" are often synonymous. Therefore, it is not surprising that hypertension is viewed by many as also being indicative of a state of increased emotional tension, anxiety, or stress. Some believe that patients with hypertension are characterized by a generalized state of increased anxiety, while others claim that feelings of suppressed anger are more

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common. A tendency towards submissiveness and introversion has also been suggested, and increased denial and resistance to pain have been reported in those with a family history of high blood pressure (Retrieved on December 8, 2011 from URL:http://www.stress.org/topic-

hypertension.htm). Signs and Symptoms of Hypertension Others may feel one or more of the following symptoms: headaches; nape pains; sleepiness; confusion; nausea or vomiting; chest pain; shortness of breath; easily fatigued; blurring of vision; and weakness or numbness (Agunod-Cheng, 2011). Hypertension in the Young The prevalence and rate of diagnosis of hypertension in children and adolescents appear to be increasing. This is due in part to the increasing prevalence of childhood obesity as well as growing awareness of this disease. There is evidence that childhood

hypertension can lead to adult hypertension. Hypertension is a known risk factor for coronary artery disease (CAD) in adults, and the presence of childhood hypertension may contribute to the early development of CAD. Reports show that early development of atherosclerosis does exist

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in children and young adults and may be associated with childhood hypertension (Luma, 2006). Hypertension is a common clinical problem in the emergency units in children's population, but only 1% of children and adolescent have elevated blood pressure level on repeated measurements. Established hypertension is blood pressure above 95th centile regarding children's age, gender, and body height. Diagnostic procedures are aimed at establishing blood pressure levels, identifying secondary causes of hypertension, and evaluating the possible cardiovascular risk factors (Zakanj, 2007). While high blood pressure is commonly thought of as an "adult problem," teenagers, and even younger children, can develop high blood pressure. Teenagers in the U.S. now weigh more and exercise less than teens of past generations. As a result, high blood pressure among teens has increased as well. A large authoritative study showed that high blood pressure in teenagers increased from 1 percent to 5 percent between 1989 and 2002. Most cases of high blood pressure in teenagers are

classified as primary hypertension. As with adults, the underlying causes of primary hypertension are not entirely understood. Some teenagers appear to inherit the tendency to develop high blood pressure from their parents, while others fall victim to poor lifestyle choices, which result in

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obesity and becoming out of shape - what doctors would call "decreased cardiovascular fitness." It is important to realize that teenagers are not just smaller versions of adults. The hormonal changes of adolescence change some of the dynamics that affect high blood pressure risk (Weber, 2007). While the precise roles these hormones play are complex and not fully understood, it has been shown that teenagers who begin puberty at a younger age tend to have an increased overall risk of developing high blood pressure. Diagnosing high blood pressure in teenagers is more complicated than diagnosing high blood pressure in adults. Because teenagers with high blood pressure tend to suffer more blood vessel and cardiovascular problems later in life, preventing and controlling high blood pressure is especially important during the adolescent years.The acceptance of childhood hypertension guidelines must be an

interdisciplinary process, which includes regional experts to draw up recommendations specifically directed toward the management of patients at the local level (Zakanj, 2007).

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Management of Hypertension Management of hypertension is multi-faceted. Non-pharmacologic treatments include weight reduction, exercise, and dietary modifications. Recommendations for pharmacologic treatment are based on

symptomatic hypertension and evidence of end-organ damage in stage 2 hypertension and in stage 1 hypertension, unresponsive to lifestyle modifications, and hypertension with diabetes mellitus. Despite the complexity of diagnosis, the rules of prevention in teenagers are the same as those for adults: Maintain a healthy body weight, eat a healthy diet, do not smoke, exercise regularly (at least 20 minutes on 3 or more days per week), and limit alcohol and drug use - these are important causes of hypertension among teens (Luma, 2006). Abarquez (2008) suggested that lifestyle modifications within the family or household should start before hypertension develops. It is difficult to quit smoking, lose weight or exercise, and eat appropriate balanced meals if other family members or neighborhoods or office mates will not do the same. Therapeutic intervention includes both lifestyle changes and pharmacologic therapy. The goal of the therapy is to reduce blood pressure to levels lower than the 90th percentile for both systolic and

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diastolic blood pressure for children of similar age, gender, and height. By reducing blood pressure to normal range, long-term cardiovascular morbidity and mortality may be reduced (Zakanj, 2007). Treatment options for teenagers with high blood pressure vary. As with adults, more severe forms of high blood pressure require more aggressive treatment. Unlike adults, however, lifestyle adjustments tend to be the first treatment option, though medicines are still used when needed. The actual medicines used to treat high blood pressure in teenagers are the same as those used in adults, and the prescribed dose is usually similar to what would be considered an "introductory" or "trial" dose in adults (Weber, 2007). Compliance to prescribed medication and clinic follow-ups are mandatory to prevent target organ damage. A balanced diet, regular exercise, and appropriate medication under the supervision of medical professionals are key elements in controlling hypertension and its complications (Agunod-Cheng, 2011). RELATED STUDIES Foreign In the study conducted by Livingston (2008) entitled The Awareness of Hypertension among Black College students: An

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Exploratory Study with Counseling Implications, he explored awareness of hypertension among a sample of black, urban college students. Results indicated that the predominant misconception held was that hypertension only affects the elderly. Therefore, it suggests group counseling methods to increase black college students awareness of hypertension. New data on the widely unstudied demographic of college students indicates that a group of 18-24 years old are on the path to chronic diseases (Science Daily, 2007). In the University of New Hampshire, data were collected from more than 800 undergraduates enrolled in a general nutrition course found 60 percent of men had high blood pressure. The research conducted helped inform the school that there should be a policy of a routine blood pressure screening at health service (Morrell, 2007). In the study conducted by Hosseini (2010) entitled The Relation of Body Mass Index and Blood Pressure in Iranian Children and Adolescents Aged 7- 18 Years Old, the association between BMI and BP among Iranian children and adolescents 7 to 18 yr. old was assessed. This study indicates that elevated BP is more prevalent among overweight healthy children and adolescents. They demonstrated

33

that the mean of SBP (Systolic blood pressure), DBP (Diastolic Blood Pressure), BP, and MAP (Mean Arterial Pressure) are significantly associated with an increase in the amount of BMI that is detectable in all age groups. Furthermore, from an ecological view, an increase in age is associated with an increase in BP and Iranian boys have higher BP compared with their girls peers respecting each age and BMI groups. Also, data was collected from different primary, guidance, and high schools of Tehran and it was assumed the representative sample of Iranian children and adolescents. High BMI and elevated BP are among the important risk factors of cardiovascular disease, diabetes mellitus, hypertension, and dyslipidemia. Childhood BP predicts risk of

cardiovascular disease in adulthood period and concomitant high BMI with elevated BP increase risk of cardiovascular disease. Dealing with high BMI and elevated BP can help to prevent the upcoming threats in adulthood period through public health policies as both high BMI and elevated BP are considerable risk factors for such diseases. In conclusion, we have demonstrated that there was an association between blood pressure and body mass index in children and adolescents. It showed that SBP, DBP and MAP are associated with a rise in BMI and age in society. Generally, BP was lower in girls than boys in age range we studied were. Such data can provide basics for public

34

health policy-makers to estimate the risk of cardiovascular disease through BMI and BP estimates of children and adolescence. This data can also be used for primary prevention policies in the country. Meanwhile, the study on the Effects of Aerobic Exercise Training on Arterial Function and Insulin Resistance Syndrome in Obese Children: A Randomized Controlled Trial determined the effects of physical activity on systemic blood pressure (BP) and early markers of atherosclerosis in pre-pubertal obese children. They performed a 3month randomized controlled trial with a modified crossover design: 44 pre-pubertal obese children (age 8.9 + or - 1.5 years) were randomly assigned (1:1) to an exercise (n = 22) or a control group (n = 22). As a result, Obese children had higher BP, arterial stiffness, body weight, BMI, abdominal fat, insulin resistance indexes, and C-reactive protein levels, and lower flow-mediated dilation, VO(2)max, physical activity, and high-density lipoprotein cholesterol levels than lean subjects. Therefore, physical activity reduces systemic blood pressure and improves early markers of atherosclerosis in pre-pubertal obese children.(Retrieved on January 2012 from JAm Coll Cardiol. 2009 Dec 15;54(25):2407-8) In the study conducted by Humayon (2009) entitled Relation of hypertension with body Mass index and Age in Male and Female

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Population of Peshwar, Pakistan, it was noted that hypertension, a condition developed as a result of high blood pressure, is strongly correlated with Body Mass Index (BMI). Obesity was noted to be a single best predictor of hypertension incidence, and was regarded as a major controllable contributor to hypertension. Overweight and obesity is conveniently determined from BMI. The results indicate that there was a strong association of hypertension to BMI rather than age. However, the increased prevalence of hypertension with advancing age was also evident from the results. The females in the overweight BMI category indicates a significant prevalence of hypertension than their male counterparts in the same BMI category, while for the rest of the BMI categories, high blood pressure was prevalent in males. Hypertension is directly related with BMI; it shows that with an increase in the BMI, the trend of hypertension rises in both females and males. Hypertension is strongly related to age and gender. In males, the prevalence of hypertension in general is high in all age groups. (URL:

http://www.ayubmed.edu.pk/JAMC/PAST/21-3/Anjum.pdf) In an article Declines in Physical Activity and Higher Systolic Blood Pressure in Adolescence, the authors examined the potential association between changes in the number of moderate-to-vigorous physical activity (MVPA) sessions per week, adiposity, and systolic blood

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pressure (SBP) during adolescence. Estimates of initial level and rate of decline in number of MVPA sessions per week from individual growth models were used as predictors of SBP in linear regression models. A decline of 1 MVPA session per week, with each year of age, was associated with 0.29-mm Hg and 0.19-mm Hg higher SBPs in girls and boys, respectively, in early adolescence (ages 12.815.1 years) and 0.40-mm Hg and 0.18-mm Hg higher SBPs, respectively, in late adolescence (ages 15.217.0 years). These results support prevention of declines in MVPA during adolescence to prevent higher blood pressure in youth. In conclusion, declines in the number of MVPA sessions per week during adolescence were inversely associated with SBP in youth. A decline of 1 MVPA session per week, with each year of age was associated with 0.29-mm Hg and 0.19-mm Hg higher SBPs in girls and boys, respectively, in early adolescence and 0.40-mm Hg and 0.18-mm Hg higher SBPs, respectively, in late adolescence. These results may have public health importance, because they suggest that by preventing declines in physical activity during adolescence through continued participation in MVPA, one may potentially prevent some of the blood pressure increases observed in the youth sector (American Journal of Epidemiology, 2009, Vol. 170, No. 9).

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Local The Philippine Society of Hypertension (PSH) conducted a study showing that high blood pressure afflicts 17 percent of the population and could be considered an epidemic (Andrade, 2008). Cases of hypertension are increasing in the Philippines. A study by Sison (2007) fellow and diplomate of the Philippine College of Cardiology, showed that 21 percent of Filipinos were reported to have hypertension in 2007, a significant increase from only 17 percent in 2003. There is now a growing awareness that overweight and obesity as well as the disease conditions associated with them, pose an emerging public health problem in the country. A review of local existing data revealed a dearth of information along this area, especially on certain biological relationships with overweight and obesity among Filipino adults. The objective is to determine the relationships between selected anthropometric measurements of overweight and obesity and risk to hypertension and dyslipidemia among Filipino adults. Variables include Body Mass Index (BMI), Waist Circumference (WC), Waist-Hip Ratio (WHR), and Mid-Upper Arm Circumference (MUCR).The study

concluded that at 75th percentile levels of BMI, WC, WHR, and MUAC for defining overweight, and at 90th percentile levels for defining obesity,

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the Filipino adults have an increased likelihood to develop hypertension. High WHR doubles the pre-disposition to hypercholesterolemia. Synthesis The reviewed studies and literatures have given the researcher invaluable insights on the factors affecting hypertension that will eventually help for the proposal of health promotion program. The information obtained from various literatures contributed to the understanding of initial manifestations of symptoms of hypertension that led to todays new studies and further evaluation of causes of hypertension. Webers (2007) literature is related to the researchers study of hypertension because it clarifies that being hypertensive is not just for adults but for all age groups. Oliveros (2000) stated that risk factors for hypertension include: smoking; obesity; lack of exercise; dangerously low consumption of fruits and vegetables; heredity; smoking; unhealthy diet; and lack of physical activity; being overweight; sedentary behavior; alcohol; higher social class; salt intake; diabetes mellitus; and smoking are risk factors for hypertension in most of the countries of Asia. This related literature helped the researcher formulate the questionnaire regarding the respondents profile and lifestyle, while the researchers study will guide

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the young ones realize the importance of having a good lifestyle as early as their entry point in college. Meanwhile, the study conducted by Hosseini gave the researcher an insight that BMI is an important variable to be included and it educates one in knowing its significance among the respondents. The study conducted by Livingston apprises one regarding the misconception of having hypertension; it underscored the long-felt need for the development and implementation of comprehensive health programs.

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Chapter 3 RESEARCH METHODOLOGY This chapter deals with the research procedure that used in this study; namely: Research Design; Population and Sampling; Research Instruments; Validation of the Survey Questionnaire; Data Gathering Procedure and Statistical Treatment of Data. Research Design To achieve the fundamental thrust of the study, Descriptive Design was employed using a survey questionnaire. Polit and Beck (2006) stated that the purpose of descriptive studies is to observe, describe, and document aspects of a situation. This method also describes the nature of the situation as it exists at the time it was studied. Descriptive Method is most appropriate for this study because it will ascertain the prevalence of hypertension among first year college students which will serve as basis for developing a comprehensive health program. This method also enabled the researcher to ascertain the extent to which variation in one variable is associated with variations in another, and not to infer cause-and-effect relationships. Information on the first year college students profile and family background were taken

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into consideration to establish the relationship of the students profile with the lifestyle. This study involved the collection of data to test the hypothesis and answer questions concerning the current status of the subjects of the study. To support the study, self-made questionnaires were administered to further investigate on the subjects eating and drinking habits, physical activities, sleeping patterns and study habits. The researcher basically gathered information that are perceived to be factors affecting hypertension by freshmen college students. The main objective of the proposed comprehensive health program is that of creating a practice leading to lifestyle changes, proper diet, increased physical activities, and good study and sleeping habits. Population and Sampling Purposive Sampling technique was utilized in this study. It is a form of sampling where samples are selected from a specific group, and these are the hypertensive students for purposes of this study. The respondents here were the first year college students enrolled at UPHSD-LP for S.Y. 2011-2012 and who have high blood pressure readings as assessed by the nurse and diagnosed by the university physician during their annual medical examination. First year

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college students were the target population for this study since it is in this year level that the annual medical examination is strictly observed; thus, gathering of data can be accessible to the researcher. The respondents had medical conditions. Respondents of the Study Respondents were first year college students who have hypertension or high blood pressure and were enrolled for School Year 2011-2012. Said respondents accounted for 46 out of the 1, 744 students found to have high blood pressure readings during the clinics annual medical check-up conducted last July 2011 at the university clinic. The programs / courses were clustered into four groups by the author for better documentation; thus: Cluster 1 Allied Health Courses: Nursing, Midwifery, PT/OT, Radiologic Technology, Medical Technology, Respiratory Therapy, and Dentistry Cluster 2 Cluster 3 Maritime, Criminology, and Engineering CAS (Psychology and Mass Communications), Business, and Education Programs

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Cluster 4

CIHM (HRM and Tourism) and College of Computer Studies Program

Research Instrument The researcher utilized a self-made survey questionnaire that was strictly reviewed by nursing experts from UPHSD to determine the factors affecting hypertension as perceived by the respondents. It is composed of two (2) parts. Part 1 consists of information on the respondents age, gender, and program of study or course. Part 2 is composed of statements regarding the lifestyle of the respondents. These will be the basis by which results of the study will be obtained. Using the Likert Scale, the following rating scale was used: Table 1 Interpretation of the Weighted Mean of the Respondents Lifestyle in the Questionnaire Value Scale 5 4 3 2 1 Statistical Limit 4.50-5.00 3.50-4.49 2.50-3.49 1.50-2.49 1.00-1.49 Verbal Interpretation Always Often Sometimes Rarely Never

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In interpreting the results of this study, the Weighted Mean was taken to know the lifestyle that affects the increase of blood pressure of freshmen college students.

Validation of Instrument The survey questionnaire that was used in the study was shown to the researchers adviser for comments and suggestions. As soon as modifications were incorporated, a pilot-testing of the said tool was undertaken among the college students who were not part of the actual respondents. A statistician was requested to do Face and Content Validation and examine whether the said tool will actually show statistical significance. Suggestions by the three validators were integrated as well. Content validation was done by the panel of nursing experts from UPHSD; their suggestions and recommendations were incorporated in the actual questionnaire. The revised questionnaire underwent pilot testing to hypertensive college students in another campus of the UPHSD, that is, in Molino. Clarity and comprehensibility of the subjects with respect to the questions asked were tested. After the pilot study, the results were then given to the statistician. The reliability of the questionnaire was tested and analyzed by using the Split-Half Method with the application of Pearson-Product Moment of Coefficient of

45

Correlation and based on data obtained. The final form of the questionnaire was then reproduced and distributed to the respondents. Data-gathering procedure In gathering the data needed for this study, the following steps were observed: 1. A letter of permission was sent to the UPHSD School Director of both Molino and Las Pias asking for approval to conduct the survey questionnaire to selected first year college students in the university, as the site for pilot testing and actual conduct of the study. 2. After the approval, the survey questionnaire was distributed to the respondents. Questionnaires were retrieved right away when the respondents completed answering them. 3. Data was sorted, arranged and encoded for analysis and interpretation. 4. Unstructured and informal interviews were had involving Internal Medicine Residents and consultants of the UPHSD Medical Center to support to the empirical data and answers to questions sought for.

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Statistical Treatment of Data The following statistical measures were used in obtaining the answers to the specific problems of the study: a combination of Descriptive and Inferential Statistics was used in the analysis and interpretation of data. Frequency Count and Percentage Distribution. This was utilized in presenting the profile data on the mean age, gender, course of the respondents, data analysis of profiles, and existing medical records. Table 1 Interpretation of the Weighted Mean of the Respondents Lifestyle in the Questionnaire Value Scale 5 4 3 2 1 Statistical Limit 4.50-5.00 3.50-4.49 2.50-3.49 1.50-2.49 1.00-1.49 Verbal Interpretation Always Often Sometimes Rarely Never

Weighted Mean. This was employed in getting needed data about the lifestyle affecting hypertension as perceived by the freshmen college students. This statistical measure was applied to the assessment in the questionnaire. The Weighted Mean obtained was interpreted with the use of a scale as shown in Table 1 above.

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Correlation Analysis. Pearsons Co-efficient of Correlation or Persons r Inferential Statistics was applied to test the significant relationships between the respondents profile and lifestyle. The test was subjected to five percent (5%) level of significance using t-test; the formula therefor is:

t=r

n 2 1- r 2

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Chapter 4 PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA

This chapter presents the findings of the study based on the

content analysis of the data collected and their corresponding interpretations. Results and discussions were organized in terms of the sequence of the research problems stated in the previous chapter. Problem No. 1. What is the profile of the respondents as to: 1.1 Age; 1.2 Gender; and 1.3 Program/ Course? Table 2 Distribution of Respondents according to Age FREQUENCY AGE 16 17 18 19 20 21-30 TOTAL 11 9 6 3 5 12 46 23.91 19.57 13.04 6.52 10.87 26.09 100.00 PERCENTAGE

Table 2 shows the profile of the 46 respondents; most of them were between 21-30 y/o of age (26.09%); followed by 16 y/o (23.91%);

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17 y/o (19.57%); 18 y/0 (13.04%); 20 y/o (10.87%); and the least at 19 y/o (6.52%). Analysis revealed that the youngest group that was hypertensive is 16 y/o. Oftentimes, many believe that only adults and the aged are the ones who experience the said condition; however, it must be noted that the prevalence and rate of diagnosis of hypertension in children and adolescents appear to be increasing (Luma, 2006). In fact, in the current study, there are 46 students out of 1, 744or 3% were diagnosed as having hypertension at UPHSD. Table 3 Distribution of Respondents according to Gender FREQUENCY GENDER MALE FEMALE TOTAL 45 1 46 PERCENTAGE 98 2 100.00

As may be see in Table 3, most of the respondents were male (98%) and only one female (2%) qualified for the study. Hypertension is strongly related with age and gender. In males, the prevalence of hypertension in general is high in all age groups (Humayon, 2009). It was proven true in this study, for males

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outnumbered the girls with 98% (45) and 2% (1) distributions respectively. Table 4 Distribution of Respondents according to Program FREQUENCY PROGRAM Cluster 1 Cluster 2 Cluster 3 Cluster 4 TOTAL 6 24 2 14 46 PERCENTAGE 13.04 52.17 4.35 30.44 100.00

In Table 4, 24 of them, or 52.17%, came from Cluster 2 (Maritime, Engineering and Criminology students); 14 are from Cluster 4 (CIHM HRM and Tourism and the College of Computer Studies Program); 6 students from Cluster 1 (Allied Courses); and 2 were from Cluster 3 (CAS and the Business and Education programs). The researcher noticed that most of the respondents from Cluster 2 are males who are said to be more prone to being hypertensive. In males, the prevalence of hypertension, in general, is high in all age groups (Humayon, 2009).

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Problem 2. Based on existing medical records, what are the respondents: 2.1 BP reading; 2.2 Body Mass Index (BMI); 2.3 Existing Medical Conditions, and 2.4 Awareness on having high blood pressure? Table 5 Distribution of Respondents according to Existing Medical Record in terms of Blood Pressure FREQUENCY BP READING 100/90 110/90 120/90 130/70 130/80 130/90 140/70 140/80 140/90 140/100 150/80 150/90 TOTAL 1 3 15 1 6 8 1 2 4 2 2 1 46 PERCENTAGE 2.17 6.52 32.61 2.17 13.04 17.39 2.17 4.35 8.70 4.35 4.35 2.17 100.00

Table 5 shows the medical record of the respondents in terms of blood pressure reading. Blood pressure taken at 120/90 mmHg had the

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most number of respondents with 15 respondents or 32.16%; followed by 130/90 mmHg which had 8 respondents (17.39%); 130/80 mmHg with 6 respondents (13.04%); those with 140/90 had 4 respondents or 8.70%; 110/90mmHg had 3 respondents (6.52%); 140/80, 140/100 and 150/80 mmHg had 2 respondents (which corresponds to 4.35%); and 100/90, 130/70, 140/70, and 150/90 mmHg had 1 respondent each, that corresponds to 2.17%. BP taking during the course of the study was for monitoring purposes. The researcher noted no big difference in the initial reading when they were diagnosed with hypertension. There are various types and stages of hypertension. Primary or essential hypertension is more common in adolescents and has multiple risk factors, including obesity, and a family history of hypertension and its management is multi-faceted. It is to be noted that blood pressure reading varies depending on the position, state of health, and other factors such as drugs, food activity and rest. The prevalence and rate of diagnosis of hypertension in children and adolescents appear to be increasing. This is due in part to the increasing prevalence of childhood obesity as well as growing awareness of this disease. There is evidence that childhood hypertension can lead to adult hypertension. Hypertension is a known risk factor for coronary artery disease (CAD) in adults, and

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the presence of childhood hypertension may contribute to the early development of CAD (Luma, 2006).

Table 6 Distribution of Respondents according to Existing Medical Record in terms of Blood Pressure Reading according to Mode

FREQUENCY BLOOD PRESSURE MAXIMUM (150/90) MINIMUM (100/90) MODE (120/90) SYSTOLIC MAXIMUM (150) MINIMUM (100) MODE (120) DIASTOLIC MAXIMUM (100) MINIMUM (70) MODE (90) 1 1 15 3 1 15 2 2 32

PERCENTAGE 2.17 2.17 32.61 6.52 2.17 32.61 4.35 4.35 69.57

Table 6 interprets the number of respondents on its maximum systolic and diastolic reading. The maximum blood pressure reading is 150/90 mmHg, while the minimum is 100/90 mmHg which corresponds to 2.17% respectively. The blood pressure reading of 120/90 mmHg had the most number of respondents at frequency of 15 or 32.61%. Meanwhile, in systolic blood pressure, the maximum reading of 150 was noted in 3 respondents, or 6.52%, and the minimum is 100, with

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1 frequency, or 2.17%. In the most number of respondents, the systolic reading of 120 has 15 frequency or 32.61%. On the other hand, diastolic blood pressure, at its maximum was 100 and the minimum was 70 which had a 2 frequency or 4.35%. According to mode, the diastolic reading of 90 had the most number of respondents with a frequency of 32 or 69.57%. Analysis revealed that most of the respondents according to its mode are pre-hypertensive. BP varies between a maximum (systolic) and a minimum (diastolic) pressure. Normal blood pressure is less than 120/80. When blood pressures hit 140 to 159 over 90 to 99, they are considered Stage 1 hypertension. Pre-hypertensive levels are those between the normal levels and Stage 1 hypertension (Agunod-Cheng, 2011); was confirmed by this author. Table 7 Distribution of Respondents according to Existing Medical Records in terms of BMI FREQUENCY BMI Underweight Normal weight Overweight Obese Class 1 Obese Class 2 TOTAL 6 9 4 16 11 46 PERCENTAGE 13.04 19.57 8.70 34.78 23.91 100.00

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In Table 7, the computed height and weight considered WHOs BMI classification (as shown in Appendix-F). Most of the respondents, 16 or 34.78% were in the Obese Class 1 category. Such was followed by 11 respondents (23.91%) who were Obese Class 2; 9 respondents (19.57%) had a normal weight; 6 respondents (13.04%) were underweight; and 4 respondents (8.70%) were overweight. In relation to the study conducted by Humayon (2009), hypertension is directly related to BMI; it shows that, with an increase in the BMI, the trend of hypertension rises in both females and males. The current study favors the result of the study adopted by Humayon. Table 8 Distribution of Respondents according to Existing Medical Records in terms of Existing Medical Condition

EXISTING MEDICAL CONDITION ASTHMA ALLERGY DIABETES ASTHMA/ALLERGY/DIABETES NO RESPONSE TOTAL

FREQUENCY 5 3 1 1 36 46

PERCENTAGE 10.87 6.52 2.17 2.17 78.26 100.00

Table 8, reveals that 36, or 78.26% of the respondents did not respond, which means that they did not manifest any medical illness or condition as per their history and physical examination records. There

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were 5 respondents, or 10.87%, which had asthma; 3 respondents (6.52%) had allergy; 1 respondent (2.17%) had diabetes; and 1 respondent (2.17%) had asthma, allergy, and diabetes. About five percent of hypertensive has secondary hypertension, wherein there is a direct cause (usually another disorder), can be determined. Some of these are: kidney diseases, such as infection, inflammation, stone formation, or structural problems; and endocrine disorders (hormonal imbalances) (Agunod-Cheng, 2008). The results revealed that only 2 of the respondents have diabetes, an endocrine disorder, which indicates that it might be one of the causes of hypertension. Table 9 Distribution of Respondents according to Existing Medical Records in terms of Awareness

AWARENESS Not Aware Aware TOTAL

FREQUENCY 44 2 46

PERCENTAGE 96 4 100

As may be gleaned from table 9, 44 respondents, or 96%, were not aware that their blood pressure is high. It was only during their annual medical examination that they learned about their elevated BP

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reading. Meanwhile, 2 respondents (4%) were already aware that their BP is high, yet non-compliant with the hypertension treatment protocol. The World Hypertension League (WHL), an umbrella organization of 85 national hypertension societies and leagues, recognized that more than 50% of the hypertensive population worldwide is unaware of their condition (Chockalingam, 2007). In this study, the theory of WHL was observed by the researcher with 96% of the respondents not being aware that they are indeed hypertensive. Future studies may also confirm these findings with a similar perspective. Problem 3. What is the lifestyle of the respondents as to: 3.1 Eating and drinking habits; 3.2 Physical activities; 3.3 Sleeping patterns; and 3.4 Study habits?

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Table 10 Mean Ratings of Respondents in terms of Eating and Drinking Habits

EATING AND DRINKING HABITS 1. I include fish sauce, soy sauce, and/or bagoong during mealtime
2. I prefer to eat fried foods, enjoy

MEAN 3.57 3.54

DESCRIPTION OFTEN OFTEN

eating junk foods and/or fatty foods.

3. I consume large quantities of coffee

3.72

OFTEN

and/ or cola, and other caffeinecontaining foods and drinks.

4. I consume more than 2-3 bottles of

3.59

OFTEN

alcoholic beverages during drinking sessions.

5. I do not like to eat fruit and/or

2.76

SOMETIMES

vegetables. OVERALL 3.43 SOMETIMES

As shown in Table 10, most of the respondents often include fish sauce, soy sauce, and/or bagoong during mealtime, they prefer to eat fried foods, enjoy eating junk and fatty foods, consume large quantities of coffee and cola and other caffeine-containing foods and drinks and consume more than 2-3 bottles of alcoholic beverages during drinking sessions based on the mean ratings of 3.54 to 3.72. On the other hand, the Weighted Mean of 2.76 tells one that sometimes they do not like to eat fruit and/or vegetables. The lifestyle of the respondents is favorable

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to the prevalence of hypertension as depicted in the table above considering the evident descriptive context. Thus, Oliveros (2000) stated that risk factors for hypertension include: smoking; obesity; lack of exercise; dangerously low

consumption of fruits and vegetables; heredity; smoking; unhealthy diet, and lack of physical activity. Overweight, sedentary behavior, alcohol, higher social class, salt intake, diabetes mellitus, and smoking are risk factors for hypertension in most of the countries in Asia. Table 11 Mean Ratings of Respondents in terms of PHYSICAL ACTIVITIES 1. I prefer to take a ride instead of walking to places.
2. I find it difficult to find time for

MEAN 3.63

DESCRIPTION OFTEN

3.67 3.46

OFTEN SOMETIMES

exercise.
3. I spend much of my time

watching TV and/ or playing video games

4. I dont join in sports activities in

3.46 3.70

SOMETIMES OFTEN

school and/or community

5. I find it difficult to maintain normal

body weight. OVERALL 3.58 OFTEN

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In Table 11, it is plain that most of the respondents often prefer to take a ride instead of walking to places; found it difficult to find time to exercise; and had difficulty in maintaining normal body weight based on the mean rating of 3.63 to 3.70. Results revealed that most of them answered sometimes which had a mean rating 3.56 which indicates that they spend much of their time watching TV and/or playing video games and that they do not join sports activities in school and/or in the community. In an article entitled Declines in Physical Activity and Higher Systolic Blood Pressure in Adolescence, the authors examined the potential association between changes in the number of moderate-tovigorous physical activity (MVPA) sessions per week, adiposity, and systolic blood pressure (SBP) during adolescence. The results support prevention of declines in moderate to vigorous physical activity during adolescence to prevent higher blood pressure in youth. This can be utilized by the author in the development of the proposed health promotion program.

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Table 12 Mean Ratings of Respondents in terms of SLEEPING PATTERNS 1. I have 6 hours or less than 6 hours of sleep at nights.
2. I used to take a nap during

MEAN 4.22 3.46 3.30 3.17 4.20

DESCRIPTION OFTEN SOMETIMES SOMETIMES SOMETIMES OFTEN

prolonged sitting.
3. I am easily disturbed by any kind

of noise during sleep

4. I tend to wake-up when changing

position and light changes.

5. I usually do my school-related

tasks late at night making me awake which results to lack of sleep. OVERALL 3.67 OFTEN

In Table 12, one can see that most of the respondents often have 6 hours, or less than 6 hours, of sleep at night and they usually do their school-related tasks at night, making them awake, which results to lack of sleep based on the mean ratings of 4.20 to 4.22. Also, most of them sometimes (with a mean rating of 3.17 to 3.46) take a nap during a prolonged sitting position, easily disturbed by any kind of noise during sleep, and tend to wake up when changing position and light changes. Getting too little sleep may be a significant risk factor for high blood pressure. In a study of more than 4,800 men and women,

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people whose ages are from 32 to 59 who got five hours of sleep a night or less were about 60 percent more likely to develop hypertension than those who slept six to eight hours (Bakalar, 2006). The researcher noted though that, by virtue of the description stated above, lack of sleep was evident with an overall mean of 3.67, which is, descriptively speaking, Often Experienced. Recent research conducted at the Case Western Reserve University in Cleveland, Ohio, suggested that lack of sleep, as well as poor sleep quality, can cause elevated blood pressure levels in healthy adolescents (Chow, 2008). In the authors planned proposed health promotion program, such findings were found to be relevant.

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Table 13 Mean Ratings of Respondents in terms of Study Habits STUDY HABITS 1. I am usually pressured when I dont meet the target date and time of submission of projects and assignments.
2. I hardly find time to organize my

MEAN 3.63

DESCRIPTION OFTEN

3.52

OFTEN

daily review of lessons and easily become tense during interactive session in class.
3. I am confused in prioritizing what

3.50

OFTEN

subject to study first when two or more subjects are scheduled on the same day.
4. I am usually stressed when I

3.46

SOMETIMES

cram to review all lessons with little time left prior to exam date and time.
5. I usually get nervous or tense

3.35

SOMETIMES

during examination day.

OVERALL

3.49

SOMETIMES

The respondents in Table 13, in terms of study habits, are often pressured when they do not meet the target date and time of submission of projects and assignments; hardly find time to organize their daily review of lessons; and easily become tense during interactive sessions in class. They are also often confused in prioritizing what subject to study first when two or more subjects are scheduled on the same day based

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on the mean ratings of 3.50 to 3.62. Most of the respondents were Sometimes stressed when they cram to review all the lessons with little time left prior to exam date and time and they also get nervous or tense Sometimes during examination days based on the mean ratings of 3.35 to 3.46. In an article, it was pointed out that poor study habits may also cause increase anxiety that affects ones blood pressure. "Stress, "Pressure, "Tension, and "Anxiety" are often synonymous. Therefore, it is not surprising that hypertension is viewed by many as also being indicative of a state of increased emotional tension, anxiety, or stress. (Retrieved on: December 8, 2011 from URL:http://www.stress.org/topichypertension.htm) Problem 4. Is there a significant relationship between the respondents being hypertensive and their 4.1 Profile; and 4.2 Lifestyle?

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Table 14 Correlation of Respondents Hypertension and Profile PROFILE HYPERTENSION INTERPRETATION r-value t-value* SIGNIFICANCE -0.169 0.147 0.072 -1.134 0.988 0.477
NOT SIGNIFICANT NOT SIGNIFICANT NOT SIGNIFICANT

AGE PROGRAM BMI

Ho; accepted Ho; accepted Ho; accepted

*Critical t-value ( =0.05, 2 tailed, 44 degrees of freedom) = 2.021 **Null hypothesis stated in Chapter 1

In Table 14, it must be noted that the profile, with respect to gender, was not included in the analysis since there was only one female respondent which renders correlation analysis inapplicable. As to age, the computed r-value = -0.169, being negative, indicates that there is an inverse relationship between age and hypertension. It means that older respondents tend to have lower blood pressure. Results of the t-test revealed that the relationship was insignificant since the t- value of 1.113 did not exceed the critical t-value of 2.021 at five percent level of significance. Hence, the Null Hypothesis that there is no significant relationship between the profile, age in particular, and hypertension is not rejected. Data did not provide sufficient evidence to reject the Null Hypothesis.

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On the other hand, program, and BMI computed r-values were positive, indicating a direct relationship hypertension. Direct relationship means that, on program, respondents at lower numbered cluster tend to be less-hypertensive while those at higher numbered cluster tend to be more hypertensive, the same with BMI, in that the higher the BMI, the more that they are prevalent to hypertension. Results of the t-test revealed that the relationships of respondents program and BMI with hypertension were insignificant since the computed t- values did not exceed the critical t-value of 2.021 at five percent level of significance. Hence, the Null Hypothesis that there is no significant relationship between profile in terms of program and BMI, in particular, and hypertension is not rejected. Data did not provide sufficient evidence to support relationship at five percent level of significance.

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Table 15 Correlation of Respondents Hypertension and Lifestyle LIFESTYLE HYPERTENSION INTERPRETATION r-value t-value* SIGNIFICANCE
0.223 -1.519 NOT SIGNIFICANT Ho; accepted

EATING AND DRINKING HABITS

PHYISICAL ACTIVITIES SLEEPING PATTERNS STUDY HABITS

0.022

0.144

NOT SIGNIFICANT NOT SIGNIFICANT NOT SIGNIFICANT

Ho; accepted

-0.056

0.375

Ho; accepted

-0.164

-1.104

Ho; accepted

*Critical t-value ( =0.05, 2 tailed, 44 degrees of freedom) = 2.021 **Null hypothesis stated in Chapter 1

Table 15 tells one that as to eating and drinking habits and physical activities, the computed r-values of 0.223 and 0.022, respectively, were are positive, which indicate that there is a direct relationship between eating and drinking habits and hypertension and also between physical activities and hypertension. It means that respondents who eat and drink more often tend to have higher blood pressure and that those who often engage in physical activities tend to have higher blood pressure. Result of the t-test revealed that the relationship was insignificant on both

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lifestyle categories since the t- values did not exceed the critical t-value of 2.021 at five percent level of significance. Hence, the Null Hypothesis that there is no significant relationship between lifestyle, and hypertension is not rejected. Data did not provide sufficient evidence to reject the null hypothesis. The author believes that, had there been more than 3% of freshmen population diagnosed with hypertension, the results could have been parallel with the available literatures and completed studies stated in this humble work. However, the overall descriptive value connotes that the highest mode for eating and drinking habits is intake of cola or other caffeinated food and drinks which had 3.72-that is favorable to prevalence of hypertension among the subjects in this study. The lowest value was on lack of intake of fruits and vegetables that leads to an increase in the hypertension prevalence rate if to be considered has been noted 2.76 though the final correlation in the next pages of this paper suggests the same as not being significant on the basis of an averaging scheme. On the other hand, analysis on sleeping patterns and study habits showed negative r-values, indicating an inverse relationship vis-a-vis hypertension. Inverse relationship means that, on these lifestyle categories, respondents who have less-frequent sleeping patterns tend

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to be more hypertensive, and those who often have time tend to be more hypertensive. Results of the t-test revealed that the relationships of respondents lifestyle in said categories with hypertension were insignificant since the computed t- values did not exceed the critical tvalue of 2.021 at five percent level of significance. Hence, the Null Hypothesis that there is no significant relationship between these particular lifestyle categories and hypertension is not rejected. The data did not provide sufficient evidence to support relationship at five percent level of significance. Delving on the descriptive aspect by way of review, in Table 9, the item that I tend to wake up when changing position with the mean of 3.17; I used to take a nap during prolong sitting with a mean of 3.46 and I am easily disturbed by any king of noise during asleep with a mean rating of 3.30 , conforms to studies conducted by Bakalar and Nicholas (2006) that too little sleep may be a significant factor for high blood pressure; the same can be said in so far as the work of Chow (2008) is concerned which suggested that lack of sleep can cause elevated blood pressure levels in healthy adolescence. The respondents in this study often do not have enough rest which has been favorable to the prevalence of hypertension among UPHSD freshmen students.

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Problem 5. Is there a significant relationship between the respondents profile and lifestyle? Table 16 Correlation of Respondents Profile in terms of Age and Lifestyle

LIFESTYLE r-value
EATING AND DRINKING HABITS

AGE INTERPRETATION t-value* SIGNIFICANCE 1.858 NOT SIGNIFICANT Ho; accepted

0.270

PHYISICAL ACTIVITIES SLEEPING PATTERNS STUDY HABITS

0.138
0.010

0.921
0.066

NOT SIGNIFICANT NOT SIGNIFICANT NOT SIGNIFICANT

Ho; accepted

Ho; accepted

0.125

0.837

Ho; accepted

*Critical t-value ( =0.05, 2 tailed, 44 degrees of freedom) = 2.021 **Null hypothesis stated in Chapter 1

Table 16 shows that the profile, with respect to gender, was not included in the analysis since there is only one female respondent which renders correlation analysis inapplicable. On eating and drinking habits, the computed r-value = 0.270. Results of the t-test revealed that the relationship was insignificant since the t- value of 1.858 did not exceed the critical t-value of 2.021 at five percent level of significance.

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Table 17 Correlation of Respondents Profile in terms of Program and Lifestyle LIFESTYLE r-value
EATING AND DRINKING HABITS

AGE INTERPRETATION t-value* SIGNIFICANCE -0.549

NOT SIGNIFICANT

-0.083

Ho; accepted

PHYISICAL ACTIVITIES SLEEPING PATTERNS STUDY HABITS

0.186
0.298

1.253
2.072

NOT SIGNIFICANT NOT SIGNIFICANT NOT SIGNIFICANT

Ho; accepted

Ho; not accepted

-0.128

-0.855

Ho; accepted

*Critical t-value ( =0.05, 2 tailed, 44 degrees of freedom) = 2.021 **Null hypothesis stated in Chapter 1 Table 17 shows the results on eating and drinking habits, which had a computed r-value = - 0.083. Result of the t-test revealed that the relationship was insignificant since the t- value of -0.549 did not exceed the critical t-value of 2.021 at five percent level of significance. As for physical activities and study habits, the r-value of 0.186 and -0.128 were had; the relationship was also insignificant for the result of the t-test revealed a t-value of 1.253 and -0.855. Meanwhile, on sleeping patterns, the computed r-value = 0.298 wherein the t-test revealed a t-value of 2.072 which means that there is a significant relationship. Therefore, the

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hypothesis stated in Chapter 1 was accepted in terms of the relationship of lifestyle (in terms of sleeping patterns) and program. Table 18 Correlation of Respondents Profile in terms of BMI and Lifestyle

LIFESTYLE r-value
EATING AND DRINKING HABITS

AGE INTERPRETATION t-value* SIGNIFICANCE 0.865

NOT SIGNIFICANT

0.129

Ho; accepted

PHYISICAL ACTIVITIES SLEEPING PATTERNS STUDY HABITS

0.094 0.011 0.025

0.629 0.011 0.163

NOT SIGNIFICANT NOT SIGNIFICANT NOT SIGNIFICANT

Ho; accepted

Ho; not accepted

Ho; accepted

*Critical t-value ( =0.05, 2 tailed, 44 degrees of freedom) = 2.021 **Null hypothesis stated in Chapter 1 Table 18 presents the fact that, on eating and drinking habits, which had a computed r-value = 0.129. Results of the t-test revealed that the relationship was insignificant since the t- value of 0.865 did not exceed the critical t-value of 2.021 at five percent level of significance. On physical activities and study habits, the r-value of 0.094 and 0.025 respectively, the relationship was also insignificant since the result of ttest revealed t-value of 0.629 and 0.163 respectively. Concerning

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sleeping patterns, the computed r-value = 0.011 where the t-test revealed t-value of 0.011 means that there is a no significant relationship. Therefore, the hypothesis stated in chapter 1 is accepted. Hence, the null hypothesis that there is no significant relationship between the respondents profile and lifestyle is accepted. The data did not provide sufficient evidence not to accept the same.

Problem 6. Based on the results of the study, what comprehensive health program may be proposed? In accordance with the descriptive value or interpretation of the results, a comprehensive health program that is recommended for the hypertensive respondents are lifestyle modifications in terms of eating and drinking habits, physical activities, sleeping patterns, and study habits. This comprehensive health program was conceptualized to increase the level of awareness on hypertension among the participants. A framework was hereby had based on the needs of the respondents within the context of the health care system of our country Preventive and Promotive, Curative and Rehabilitative .

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Figure 5. Proposed Comprehensive Health Program Utilizing the Transtheoretical Model

CURATIVE AND REHABILITATIVE

PROMOTIVE AND PREVENTIVE

As shown in Figure 5, the Hypertension Awareness Program, Case Review and Inclusion of MVPA (Moderate to Vigorous Physical Activities) in Physical Activities corresponds to the promotive and preventive aspect of the comprehensive health program. It is the desire of the researcher to promote and increase the level of awareness among the participants. FGDs, Follow-ups, and Seminar on Hypertension are Curative and Rehabilitative aspects that aim to maintain their acceptable

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and normal blood pressure through frequent FGDs, in compliance with treatment regimen through follow-ups and updates through seminars.

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Chapter 5
SUMMARY OF FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS

The final chapter of this thesis consists of a summary of the findings, the conclusions drawn and recommendations of the researcher. Specifically, the following questions were answered in the study. 1. What is the profile of the respondents as to: 1.1 Age; 1.2 Gender; 1.3 Program/ Course? 2. Based on the existing medical records, what are the respondents: 2.1. 2.2. 2.3. 2.4. BP reading; Body Mass Index (BMI) Existing Medical Conditions; and Awareness on having high blood pressure?

3. What is the lifestyle of the respondents as to: 3.1 Eating and drinking habits; 3.2 Physical activities; 3.3 Sleeping patterns and 3.4 Study habits?

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4. Is there a significant relationship between the respondents being hypertensive and their 4.1 Profile and 4.2 Lifestyle? 5. Is there a significant relationship between the respondents profile and lifestyle? 6. Based on the results of the study, what comprehensive health program may be proposed?
Null Hypotheses

1. There

is

no

significant

relationship

between

the

respondents being hypertensive to their profile and lifestyle. 2. There is no significant relationship between the

respondents profile and lifestyle Methodology The study made use of the Descriptive Methodology that enabled the researcher to ascertain the extent to which variation in one variable are associated with variations in another which specifically involved the identification of relationship of respondents hypertension; profile; and lifestyle, in terms of eating and drinking habits, physical activities, sleeping patterns, and study habits.

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The respondents were 46 first year college students who were enrolled in UPHSD-LP, S.Y. 2011-2012. Purposive Sampling Technique was utilized. It is a form of sampling wherein samples came from a specific group-and these were the hypertensive students. This study involves the collection of data in order to test the hypothesis and to answer questions concerning the current status of the subjects of the study. To support the study, the researcher utilized a selfmade questionnaire that was given to selected respondents to further investigate on the subjects eating and drinking habits, physical activities, sleeping patterns, and study habits. It was composed of two (2) parts. Part 1 consists of information about the respondents in terms of the respondents name, which is optional, age, gender, and program of study or course. Part 2 was composed of statements on the relationship of the respondents hypertension and lifestyle. A Likert Scale was used to determine how often they practice the factors that are believed to be prevalent to hypertension. Aslo, the researcher reviewed the history and physical examination findings of each respondent. The following statistical measures were used in obtaining answers to the specific problems of the study: a combination of Descriptive and Inferential Statistics was used in the analysis and interpretation of data,

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Frequency Count and Percentage Distribution, Weighted Mean and Correlation Analysis using Pearsons Co-efficient of Correlation.

Summary of Findings Based on the results of the study, the following questions were answered: 1. What is the profile of the respondents as to: 1.1 Age; Most of the respondents were from 21-30 y/o of age (26.09%) followed by 16 y/o (23.91%), 17 y/o (19.57%), 18 y/0 (13.04%), 20 y/o (10.87%), and the least 19 y/o (6.52%).

1.2 Gender; Most of the respondents were male (98%), and only one female (2%) qualified in the study. 1.3 Program/ Course? 24 or 52.17% came from cluster 2 (Maritime, Engineering and Criminology students) then 14 were from cluster 4 (CIHM -HRM and Tourism, and College of Computer Studies Program), followed by 6

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students from cluster 1 (Allied Courses) then lastly 2 of them were from cluster 3 (CAS, Business, and Education programs). 2. Based on existing medical records, what are the respondents: 2.1 BP reading; Blood pressure taken at 120/90 mmHg had the most number of respondents which comprises of 15 respondents or 32.16%. Followed by 130/90 mmHg with 8 respondents (17.39%), 130/80 mmHg had 6 respondents (13.04%), then 140/90 had 4 respondents or 8.70%, 110/90mmHg had 3 respondents (6.52%). Then 140/80, 140/100 and 150/80 mmHg had 2 respondents respectively that corresponds to 4.35%. Lastly, 100/90, 130/70, 140/70 and 150/90 mmHg had 1 respondent each that corresponds to 2.17%. 2.2 Body Mass Index (BMI) Most of the respondents, 16 or 34.78% were in the Obese Class 1 category. Such was followed by 11 respondents (23.91%) who were Obese Class 2; 9 respondents (19.57%) had a normal weight; 6 respondents (13.04%) were underweight; and 4 respondents (8.70%) were overweight.

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2.3 Existing Medical Conditions; 36 or 78.26% of them did not respond which means they did not manifest any medical illness or condition as revealed in their history and physical examination record. Then, 5 respondents or 10.87% had asthma, 3 respondents (6.52%) had allergy, while 1 respondent (2.17%) had diabetes and lastly, 1 respondent (2.17%) had asthma, allergy and diabetes. 2.4 Awareness on Having High Blood Pressure? 44 respondents, or 96%, were not aware that their blood pressure is high. It was only during their annual medical examination that they learned about their elevated BP reading. Meanwhile, 2 respondents (4%) were already aware that their BP is high, yet non-compliant with the hypertension treatment protocol. 3. What is the lifestyle of the respondents as to: 3.1 Eating and Drinking Habits; Most of the respondents often include fish sauce, soy sauce, and/or bagoong during mealtime, they prefer to eat fried foods, enjoy eating junk and fatty foods, consume large quantities of coffee and cola and other caffeine-containing foods and drinks and consume more than 2-3 bottles of alcoholic beverages during drinking sessions based on the mean ratings of 3.54 to 3.72. On the other hand, the Weighted Mean of

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2.76 tells one that sometimes they do not like to eat fruit and/or vegetables. 3.2 Physical Activities; Most of the respondents often prefer to take a ride instead of walking to places; found it difficult to find time to exercise; and had difficulty in maintaining normal body weight based on the mean rating of 3.63 to 3.70. Results revealed that most of them answered sometimes which had a mean rating 3.56 which indicates that they spend much of their time watching TV and/or playing video games and that they do not join sports activities in school and/or in the community. 3.3 Sleeping Patterns; Most of the respondents often have 6 hours, or less than 6 hours, of sleep at night and they usually do their school-related tasks at night, making them awake, which results to lack of sleep based on the mean ratings of 4.20 to 4.22. Also, most of them sometimes (with a mean rating of 3.17 to 3.46) take a nap during a prolonged sitting position, easily disturbed by any kind of noise during sleep, and tend to wake up when changing position and light changes. 3.4 Study Habits? The respondents are often pressured when they do not meet the target date and time of submission of projects and assignments; hardly

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find time to organize their daily review of lessons; and easily become tense during interactive sessions in class. They are also often confused in prioritizing what subject to study first when two or more subjects are scheduled on the same day based on the mean ratings of 3.50 to 3.62. Most of the respondents were Sometimes stressed when they cram to review all the lessons with little time left prior to exam date and time and they also get nervous or tense Sometimes during examination days based on the mean ratings of 3.35 to 3.46. 4. Is there a significant relationship between the respondents hypertension and their: 4.1 Profile as to: 4.1.1 Age; There is no significant relationship between the respondents hypertension and profile as to age. 4.1.2 Gender; The profile with respect to gender was not included in the analysis since there is only one female respondent which renders correlation analysis inapplicable.

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4.1.3 Program/ Course; There is no significant relationship between the respondents hypertension and profile as to program/ course. 4.1.4 Body Mass Index (BMI) and; There is no significant relationship between the respondents hypertension and profile as to BMI. 4.2 Lifestyle as to: 4.2.1 Eating and Drinking Habits; There is no significant relationship between the respondents hypertension and lifestyle as to eating and drinking habits. 4.2.3 Physical Activities; There is no significant relationship between the respondents hypertension and lifestyle as to physical activities. 4.2.3 Sleeping Patterns There is no significant relationship between the respondents hypertension and lifestyle as to sleeping patterns. 4.2.4. Study Habits? There is no significant relationship between the respondents hypertension and lifestyle as to study habits.

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5.

Is there a significant relationship between the respondents profile

and lifestyle? There is no significant relationship between the respondents profile and lifestyle. 6. Based on the results of the study, what comprehensive health program may be proposed? The proposed comprehensive health program is a plan that contains strategies on Promotive and Preventive and Curative and Rehabilitative aspects. Mainly, the goal of the program is on lifestyle modifications focused on eating and drinking habits, physical activities, sleeping patterns, and study habits. Details regarding the proposed Comprehensive Health Program is as follows:

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Conclusions The following conclusions were drawn on the basis of the findings of the study: 1. The incidence of hypertension appeared to be increasing among adolescents, specifically college students. 2. Increased BMI, specifically in the obese category is related to the increased prevalence of hypertension. 3. Hypertension remains to be a silent killer wherein, most of the respondents not aware of their elevated blood pressure. 4. Unhealthy poor lifestyle in terms of eating and drinking habits, physical activities, sleeping patterns and study habits among the college students is indeed an important risk factor regarding the prevalence of hypertension where early modifications should be practiced. 5. Clinic staff and administrators of UPHSD-LP and other universities and schools should implement a health promotion program that shall identify hypertensive students and decrease the prevalence of hypertension among them.

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Recommendations Based on the findings and conclusions made, the following recommendations were suggested: 1. The university clinic, together with the school administrator, should provide a comprehensive health program for the hypertensive students in terms of the following aspects: a. PROMOTIVE Hypertension awareness campaign for High School and College students. It is said that as early as adolescence, hypertension can now be manifested. So, it is better if, as early as their high school years, an awareness campaign be conducted. DOH updates on hypertension. From time to time, medications and treatments change. Updates on trends in hypertension treatment can be of big help to increase the level of awareness and promotion of health. b. PREVENTIVE Diagnosed students may follow-up with the university doctor for laboratory requests for the early detection of causes of hypertension

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Monitoring of diet, specifically, Diet Approaches to Stop Hypertension (DASH) food plan may be successful in lowering blood pressure in adolescence. Increased intake of potassium and calcium have also been suggested as nutritional strategies to lower blood pressure.

Regular exercises that can be included in Physical Education (P.E.) classes.

c. CURATIVE The student-patient with hypertension can be under the care of the university doctor for prescriptions and follow-ups. Daily monitoring of BP should be done by the clinic staff as well as follow-up compliance as treatment protocol. d. REHABILITATIVE When the student-patient attains the normal BP reading, they may undergo rehabilitation programs, such as daily personal exercises or have exercises during their P.E. classes, and monitoring of diet. This can be done by counseling and focus group discussions (FGDs) 2. The faculty should stress the importance of regular and daily exercises among their students during their Physical Education or health

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subjects so that they are always reminded on ways to keep a healthy lifestyle to prevent the prevalence of hypertension. 3. The parents/ guardians should assess and guide their children. Prevention is the best strategy for dealing with any epidemic. For prevention to be successful, a significant societal change is needed. It is very difficult for individuals who are not ill to make wise health choices given the foods that are available. Whatever lifestyle changes are recommended, a family-centered, rather than patient-oriented approach usually is more effective. 4. Researchers should continue to promote and support basic research in hypertension and related areas. Despite good medication, the treatment of hypertension is still inadequate and empiric and fails to reverse all of the risk for cardiovascular disease. Hypertension is an important public health problem that needs a better solution especially among adolescents. Future researchers may replicate this study with sufficient data in another institution.

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REFERENCES American Journal of Epidemiology, 2009, Vol. 170, No. 9 Andrade, J. (2008). Philippine Daily Inquirer, Health Disease Article Agunod-Cheng, P. (2011). Health Today Magazine, May Issue Bakalar, N. (April 2006). Research Ties Lack of Sleep to Risk for Hypertension, The New York Times Retrieval Date: Dec. 8, 2011 URL: http://www.nytimes.com/2006/04/18/health/18slee.html Carretero OA, and Oparil S (January 2000). "Essential hypertension. Part I:definition and etiology." Circulation Retrieval Date: Dec. 8, 2011 URL :http://circ.ahajournals.org/content/101/3/329.long Chockalingam, A. (May 2007). "Impact of World Hypertension Day". The Canadian Journal of Cardiology Chockalingam, A. (June 2008). "World Hypertension Day and global awareness". The Canadian Journal of Cardiology Chow, R. (2008). Poor Sleep and Lack of Sleep Can Cause Elevated Blood Pressure in Adolescents, Natural News.Com Hajjar, I. (2006). Public Health Hypertension: trends in prevalence, incidence and control Retrieval Date: Dec. 8, 2011 URL: http://www.annualreviews.org/doi/abs/10.1146/annurev.publhealth .27.021405.102132?journalCode=publhealth Hosseini M. (2010). The Relation of Body Mass Index and Blood Pressure in Iranian Children and Adolescents Aged 7- 18 Years Old, Iranian J Public Health, Vol. 39, No.4, 2010, pp. 126-134 Humayon, A. (2009). Relation of hypertension with body Mass index and Age in male and Female population of Peshwar, Pakistan Retrieval Date: Dec. 9, 2011 URL: http://www.ayubmed.edu.pk/JAMC/PAST/21-3/Anjum.pdf

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Journal of Human Hypertension (2000). 14, 749-763 Review Article Retrieval Date: Dec. 8, 2011 URL: http://www.nature.com/jhh/journal/v14/n10/abs/1001057a.html Kearney PM. (2004). Journal on Hypertension, Worldwide prevalence of Hypertension: a systematic review Retrieval Date: Dec. 8, 2011 URL: http://www.ncbi.nlm.nih.gov/pubmed/15106785 Livingston, I. (2008). Journal of Non-White Concerns in Personnel and Guidance, v10 n3 p.102-11, Education Resources Information Center Mendoza, T. (2011). Association of Selected Anthropometric measurements of overweight and obesity with risk to hypertension and dyslipidemiaNutrition Epidemiology Section, NSTD Morrell (2007). College Students Face Obesity, High Blod Pressure, Metabolic Syndrome, Science Daily WHO (2004). BMI Classification Retrieval Date: March 2012 URL:http://apps.who.int/bmi/index.jsp?introPage=intro_3.html

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Appendix-A Letter of Request I

DR. ALFONSO H. LORETO School Director UPHSD- Las Pinas City Sir: Greetings!

I am currently enrolled in thesis writing as a final requirement for the degree Master of Arts in Nursing Major in Nursing Administration in the University of Perpetual Help System-DALTA, Las Pinas. My research problem is Prevalence of Hypertension Among the First Year College Students of UPHSD-LP S.Y. 2011-2012 in Relation to their Profile and Lifestyle: A Basis for Comprehensive Health Program. The focus of the study is to know the prevalence of hypertension in relation to their profile and lifestyle. In line with objective of the study, I would like to seek your assistance that I be allowed to conduct the survey using attached questionnaire so that I can gather information on prevalence of hypertension among the respondents related to profile and lifestyle as a basis for the development of comprehensive health program. Your favorable response will help me finish my study at the soonest time possible. Thank you and God bless! Very respectfully yours, Sgd. Lailani C. Ladios MAN Candidate Noted: Sgd. ATTY. IRINEO F. MARTINEZ, JR. Dean, Graduate School of Education

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Appendix-B Letter of Request II

DR. RENO RAYEL School Director UPHSD-Molino Campus Sir: Greetings!

I am currently enrolled in thesis writing as a final requirement for the degree Master of Arts in Nursing Major in Nursing Administration in the University of Perpetual Help System-DALTA, Las Pinas. My research problem is Prevalence of Hypertension Among the First Year College Students of UPHSD-LP S.Y. 2011-2012 in Relation to their Profile and Lifestyle: A Basis for Comprehensive Health Program. The focus of the study is to know the prevalence of hypertension in relation to their profile and lifestyle. In line with objective of the study, I would like to seek your assistance that I be allowed to conduct a PILOT TESTING or a survey using attached questionnaire so that I can test the comprehensibility and clarity of the research instrument. Your favorable response will help me finish my study at the soonest time possible. Thank you and God bless! Very respectfully yours, Sgd. Lailani C. Ladios MAN Candidate Noted: Sgd. ATTY. IRINEO F. MARTINEZ, JR. Dean, Graduate School of Education

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Appendix-C
Questionnaire on the Respondents Profile and Lifestyle Affecting the Prevalence of Hypertension Dear Respondents, Greetings! The questionnaire below is part of an on-going research to determine the prevalence of hypertension among the first year college students. All the answers will be very important in creating a comprehensive health program that will later reduce the incidence of hypertension among adolescents. Rest assures that the information that will be gathered in this study will be kept with utmost confidentiality. Thank you very much for your cooperation Sincerely yours, Sgd. Lailani C. Ladios, MANc Researcher Noted: Sgd. ATTY. IRINEO F. MARTINEZ, JR. Dean, Graduate School of Education PART I. Profile Name : __________________________________ (optional) Age :______________ Gender : ________________

Program/ Course: ( ) Cluster 1 - Allied Health Courses: Nursing, Midwifery, PT/OT, Radiologic Technology, Medical Technology, Respiratory Therapy and Dentistry ( ( ( ) Cluster 2 - Maritime, Criminology and Engineering ) Cluster 3 - CAS (Psychology and Mass. Com), Business and Education Programs ) Cluster 4 - CIHM (HRM and Tourism) and College of Computer Studies Program

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PART II. Directions : Kindly rate the following which you think are related to high blood pressure. Use the following rating scale in providing the responses applicable to you : (Please Check) 5 - Always 4 - Often 3 - Sometimes 2 - Rarely 1 - Never
EATING AND DRINKING HABITS 5 4 3 2 1

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20.

I include food condiments like fish sauce, soy sauce, and/or bagoong during mealtime. I prefer to eat fried foods, enjoy eating junk foods and/or fatty foods. I consume large quantities of coffee and/ or cola, and other caffeine containing foods and drinks. I consume more than 2-3 bottles of alcoholic beverages during drinking sessions. I do not like to eat fruit and/or vegetables. PHYSICAL ACTIVITIES I prefer to take a ride instead of walking to places. I find it difficult to find time to exercise. I spend much of my time watching TV and/ or playing video games. I dont join in sports activities in school and/or community. I find it difficult to maintain normal body weight. SLEEPING PATTERNS I have 6 hours or less than 6 hours of sleep at nights. I used to take a nap during prolonged sitting. I am easily disturbed by any kind of noise during sleep I tend to wake-up when changing position and light changes. I usually do my school related tasks late at night making me awake which results to lack of sleep. STUDY HABITS I am usually pressured when I dont meet the target date and time of submission of projects and assignments. I hardly find time to organize my daily review of lessons and easily become tense during interactive session in class. I am confused in prioritizing what subject to study first when two or more subjects are scheduled on the same day. I am usually stressed when I cram to review all lessons with little time left prior to exam date and time. I usually get nervous or tense during examination day. 5 4 3 2 1 5 4 3 2 1

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Appendix-D History and Physical Examination Record

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Appendix-E Distribution of Respondents Profile

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Appendix-F
The International Classification of Adult Underweight, Overweight and Obesity according to BMI Classification BMI(kg/m2) Principal cut-off points Underweight Severe thinness Moderate thinness Mild thinness Normal range Overweight Pre-obese Obese Obese class I Obese class II Obese class III <18.50 <16.00 16.00 - 16.99 17.00 - 18.49 18.50 - 24.99 25.00 25.00 - 29.99 30.00 30.00 - 34.99 35.00 - 39.99 40.00 Additional cut-off points <18.50 <16.00 16.00 - 16.99 17.00 - 18.49 18.50 - 22.99 23.00 - 24.99 25.00 25.00 - 27.49 27.50 - 29.99 30.00 30.00 - 32.49 32.50 - 34.99 35.00 - 37.49 37.50 - 39.99 40.00

Source: Adapted from WHO, 1995, WHO, 2000 and WHO 2004.

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Appendix-G

March 2012

CERTIFICATION OF STATISTICAL TREATMENT

This is to certify that the thesis entitled Prevalence of Hypertension Among First Year College Students of UPHSD-LP S.Y. 2011-2012 In Relation to their Profile and Lifestyle: Basis for Comprehensive Health Program of Ms. Lailani C. Ladios was statistically analyzed by the undersigned. Sgd. DR. JESUS B. GOLLAYAN Statistician Noted: Sgd. ATTY. IRINEO F. MARTINEZ, JR., Ph.D. Dean, Graduate School

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Appendix-H April 2012

CERTIFICATION OF EDITING

This is to certify that the thesis entitled Prevalence of Hypertension Among First Year College Students of UPHSD-LP S.Y. 2011-2012 In Relation To their Profile and Lifestyle: Basis for Comprehensive Health Program of Ms. Lailani C. Ladios was edited by the undersigned.

Sgd. MR. FRANCISCO RIVAS Editor Noted: Sgd. ATTY. IRINEO F. MARTINEZ, JR., Ph.D. Dean, Graduate School

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CURRICULUM VITAE

Name Address Gender Date of Birth Place of Birth Civil Status Religion Present Position Office Address

: Lailani Caparroso Ladios : Blk 29, Lot10, B. Sacrament St., South City Homes Bian, Laguna : Female : August 21, 1986 : Sampaloc, Manila : Single : Roman Catholic : University Nurse : UPHSD Alabang-Zapote Rd., Las Pias City

EDUCATIONAL BACKGROUND Graduate School : Degree Master of Arts in Nursing Major in Nursing Administration : University of Perpetual Help System DALTA : Address Las Pias City : Inclusive Years 2009 - PRESENT : Degree Bachelor of Science in NURSING : UPH-Dr. Jose G. Tamayo Medical University
(Formerly University of Perpetual Help System Laguna)

Tertiary

: Inclusive Years 2003-2007

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Secondary

: Graduated 2003 : Name of School Sta. Catalina College : Address Bian, Laguna : Graduated - 1999 : Name of School South City Homes Academy : Address Bian, Laguna

Elementary

EXAMINATIONS PASSED Philippine Nursing Licensure Examination Certified Basic Life Support Certified IV Therapist

WORK EXPERIENCES 2007-PRESENT 2008-PRESENT Member Philippine Nurses Association (PNA) University Nurse University of Perpetual Help System DALTA Alabang-Zapote Road, Las Pias City Volunteer Nurse King Jurelang Lying-In, Molino, Cavite City Auditor / Member (Volunteer) Skwelahang Sikolohiya, Inc. PJPS, Muntinlupa City

2010 2010-PRESENT