POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

DEPRESSIVE SYMPTOMS AMONG PRE-MEDICAL STUDENTS OF A PRIVATE

COLLEGE: BASIS FOR A PROPOSED COUNSELING PROGRAM

A Research

Presented to Dr. Nicolas Mallari of the Graduate School

Polytechnic University of the Philippines

Sta. Mesa, Manila

In Partial Fulfillment of the Requirements for Research 1

by

Marjorie Z. Poticano, RPm

January 2018
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

Chapter 1

THE PROBLEM AND ITS BACKGROUND

Introduction

Students of the 21st century generation are way harder to handle than of that

previous generation. According the Buchanan (2012), many people experience the

first symptoms of depression during their college years. True enough since as a

college student, they might be leaving home for the first time, learning to live

independently, taking tough classes, meeting new people, and getting a lot less

sleep. Small or large setbacks can seem like the end of the world, but these feelings

usually pass with a little time. Depression is now a global problem. It does not

choose age, educational attainment, occupation, or socio economic status. This

affects not only the self but people relation to the individual experiencing depression.

Dr. NorietaCalma-Balderrama, chairperson of the Philippine Board of Child

and Adolescent Psychiatry, said the rise in teenage depression came with the

changes in the environment, technology and parenting practices in the past years. "It

can also be related to the environment such as relationships with family, traumatic

incidents that children experience in school and in their relationships," she said.

Traumatic incidents may include loss of a loved one or even bullying in school. Teen

depression may even lead to suicide if not addressed accordingly. She added that
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

teachers and guidance counselors should also be on the lookout for possible signs

of depression, since teens spend more time in school (Corporation, 2017).

One of the guidance and counseling services’ job is to help students on their

school and personal life. However sadly very seldom does student ask for help with

regards to this event and most of the time, students who has identifies that exhibiting

depressive symptoms are less likely to be given an ample attention.

Background of the Study

The researcher focuses the study among pre-medical students of a private

college. However, having almost thousands of students’ means thousands of

responsibility. This is why the researcher specifically chooses the school to where

the study must be taken.

Depression is the psychiatric diagnosis most commonly associated with

suicide. Lifetime risk of suicide among patients with untreated depression ranges

from 2.2% to 15%.Some that 15% of patients with treated depression eventually die

by suicide and depression is present in at least 50 percent of all suicides cases

(Suicidology, 2014).

Villanueva said the NPMCC reported during the hearing of the Senate

committee on youth that 46 percent of the total suicide cases recorded since 2010 is

from the youth. The report, he said, showed that 30% of those who committed

suicide are young adults aged 20 to 35 years old while the remaining 16% are teens
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

aged 10 to 19 years old. “Some people are afraid to report or consult their suicidal

ideation because they do not want to be judged as someone with mental disorder.

This stigma must be addressed and support system especially in schools must be

readily available,” he said (Ager, 2016). Villanueva sees the need to intensify

education on mental health and suicide prevention. He stressed the need to

increase investment in research on these aspects, and a bigger budgetary allocation

for medical support and services which are crucial to prevent suicide.

Schools should also be mandated to have suicide hotlines and the

appropriate system to support the movement against depression and suicide.

Access to healthcare and support system are very limited in the Philippine school

settings. There should intensify public education and mandate the setup of support

systems in schools and communities to help prevent suicide. Training that school

counselors had previously undertaken which they believed helped them to work

effectively with depressed students; the experiences of liaison with and referral to

adolescent mental health services; as well as the perceived training is a need in this

area.

In the present study, the researchers’ aims are to assess the guidance

services relating to students with depressive symptoms among pre-medical students

in a private college. This will help greatly the Guidance and Counseling Office have

a transparent in terms of the amount or degree of their output and demonstrate the
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

effectivity of different programs being implemented, are some ineffective programs,

innovative changes may take place.

Theoretical Framework

The study used the context-input-process-output (CIPO) model. It is a basic

systems model of school functioning, which can be applied to several levels within

education, namely system level, school level and classroom level. The model also

functions as analytical framework through which the educational quality can be

reviewed. According to his model, education can be seen as a production process,

whereby input by means of a process results in output. Input, process and output are

all influenced by context. The context gives input, provides resources for the process

and sets requirements to the output. In this way all components of the CIPO-model

are interconnected to each other (Scheerens, Luyten, & Van Raven, 2011).

Perspectives on education quality can be clarified on the basis of a conceptual

framework that describes education. The most frequently used method is to depict

education as a productive system, in which inputs are transferred into outcomes.

Steps in elaborating this basic scheme consist in:

(a) Including a context dimension that functions as a source of inputs and constraints

but also as a generator of the required outputs that should be produced;

(b) Differentiating outcomes into direct outputs, longer-term outcomes and ultimate

societal impact;
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

(c) Recognizing the hierarchical nature of conditions and processes, which comes

down to considering the functioning of public education as just another example of

‘‘multilevel governance’’.

Figure 1: Context-Input-Process-Output (CIPO) Model

The model depicted in Figure 1, shows the basic ingredients of this

framework. In the schematic presentation of the framework in Figure 1 there are

various options for choosing at which level the central ‘‘black-box’’ is described.

When analyzing the impact of policy measures at the national level, one might

choose the education system in a country as the central black box. In applications

where the quality of schools is the center of attention one would choose the school

as the level where the transformation of inputs to outputs is studied. A perhaps more

interesting option, however, is to distinguish several levels in the central black box,

for example, the national educational system, the school level and the level of the
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

group where the teaching and learning at school takes place, traditionally, the

classroom level. But other options are possible: the students could explicitly be

incorporated as a separate level and one might wish to include local community as a

level as well. Finally, one or more controlling levels could be placed in the context.

‘Helping’ is one of those taken-for-granted words. It is a familiar part of our

vocabulary. Traditionally, for example, social workers, youth workers and support

workers have been talked about as members of the ‘helping professions’. The

question, ‘do you need some help?’ is part of our daily business as informal

educators and social pedagogues. Yet what we mean by ‘helping’ isn’t that obvious

– and the qualities we look for in ‘helping relationships’ need some thinking about.

Here we try to clear away some of the confusion.(Smith, 2008). For many people

within the social professions – social work, youth work and community work (Banks

2004: 1-3) – the notion of helping is tied up with counseling and guidance. The same

is probably true of those working within informal education and social pedagogy

more broadly. People having to deal with difficult situations and choices, worrying

feelings and/or a sense of having missed opportunities may well feel they need

someone to listen and to assist them to make sense of what is going on, and to

move on. Sometimes it will be others who judge that it is in the best interests of

people that they receive such ‘help’. Gerard Egan, whose book The Skilled Helper

(first published in 1975) did much to arouse the interest in ‘helping’ within the

counseling arena, has argued that it involves two basic goals. Each of these is
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

based in the needs of the person seeking help. The first relates to those they are

helping to manage specific problems. It is to ‘help clients manage their problems in

living more effectively and develop unused or underused opportunities more fully

(1998: 7). The second helping goal looks to their general ability to manage problems

and develop opportunities. It is to help ‘clients become better at helping themselves

in their everyday lives’ (Egan 1998: 8).

Figure 2: Helping Relationship Theory

As well as being linked to counseling and guidance, helping is often used to

talk about specific moments of teaching e.g. ‘helping’ someone with their homework

or filling in an income-support form. It is also associated with giving direct physical

assistance – for example, helping someone to wash or to go to the toilet – or

practical aid such as giving clothing or money. Many of the people whose work

Smith and Smith explored in The Art of Helping Others (2008) – youth workers,

housing support workers; priests, nuns and lay workers within churches and
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

religious groups; and learning mentors – engaged in all these areas and placed an

emphasis upon developing and sustaining relationships.

Conceptual Framework

Input Process Output

Survey Questionnaire on the

different Guidance Services
in terms of:
Respondent’s Profile
- Awareness level on
- Age the guidance and
- Gender counselling goals
- Family Income and objectives
Status - Dissemination of
Information on the Identify the
Guidance Services Guidance services strength and
being offered weaknesses of
- Orientation - Sufficiency of the guidance
- Individual/Group physical facilities, services
Counselling school equipment
- Testing & Inventory and material
- Follow up & resources used in
Referrals guidance Recommendation
- Research - Extent of
for guidance and
collaboration of the
Depressive Symptoms counsellor-faculty- counseling
administrator and services for
- Score from PHQ - 9 other personnel in improvement
the delivery of
guidance services
- Extent of
implementation of
guidance services
- Levels of satisfaction
of the respondents
on the different
guidance services

Feedback

Figure 4 Conceptual paradigm of the study

 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

The objective of this study is to assess the guidance services relating to

students with depressive symptoms at the Philippine College of Health Sciences,

Inc. Upon learning this, the researcher can have a better understanding and have an

in-depth knowledge regarding their difference and make a recommendation for

improvement of the guidance and counseling services.

As reflected in the paradigm, the inputs in the study are the demographic

information like sex, year level, age and socio-economic status. Guidance and

Counseling Services such as orientation, individual/group counseling, testing &

inventory, follow up & referrals, and research. Also scores from PHQ – 9 was

garnered for analysis.

Statement of the Problem

The study sought to answer the following questions:

1. What is the profile of the respondents in terms of the following:

1.1 Age

1.2 Gender

1.3 Family Monthly Income Status

2. What are the depressive symptoms of the respondents in terms of the following:

2.1 Feelings of helplessness and hopelessness

2.2 Loss of interest in daily activities

2.3 Appetite or weight changes

 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

2.4 Sleep changes

2.5 Anger or irritability

2.6 Loss of energy

2.7 Self-loathing

2.8 Reckless behavior

2.9 Concentration problems

3.0 Unexplained aches and pains

3. Is there a significant difference in the depressive symptoms of the respondents

when grouped in terms of the following:

3.1 Age

3.2 Gender

3.3 Family Income Status

4. Based on findings, what counseling program can be proposed?

1.1 Age

1.2 Gender

1.3 Family Monthly Income Status

Hypothesis

1. There is no significant difference in the depressive symptoms of the respondents

when grouped according to the following:

1.1 Age

1.2 Gender
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

1.3 Family Monthly Income Status

Scope and Limitations of the Study

The research focuses on depressive symptoms among pre-medical students

in a private college.Variables such as age, gender and family monthly income status

were to be acquired.

Significance of the Study

The study will benefit the following:

Respondents of the study. As the center of the research, they are the

source of information that leads to people’s awareness of the characteristics and

intensity of their relationships and it turns open opportunity for understanding the

guidance and counseling program of their school.

Students of the university. To be mindful in their dealing with their friends,

classmates and peers who are engaged in same-sex relationship to avoid conflicts

with them.

Educators. This study may serve as a guide to them to understand more and

have a profound insight of the features that this group of people possesses. These

may have a great impact on educators that they may share to the students.
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

The Researchers. The process and outcome of this study will produce a

great satisfaction, competence and professionalism to the field. The purpose is a

diversity and idea about the field rather than the abnormalities of human behavior.

The result may be used for further research regarding the topic on the future.

Definition of Terms

The following terms are conceptually or operationally defined to enhance the

understanding of the readers of this paper.

Depression – A depressive disorder is an illness that involves the body,

mood, and thoughts. It interferes with daily life, normal functioning, and causes pain

for both the person with the disorder and those who care about him or her.

(Psychology Today, 2015)

Depressive Symptoms – The signs and symptoms of depression include

loss of interest in activities that were once interesting or enjoyable, including sex;

loss of appetite, with weight loss, or overeating, with weight gain; loss of emotional

expression (flat affect); a persistently sad, anxious, or empty mood; feelings of

hopelessness, pessimism, guilt, worthlessness, or helplessness; social withdrawal;

unusual fatigue, low energy level, a feeling of being slowed down; sleep disturbance

and insomnia, early-morning awakening or oversleeping; trouble concentrating,

remembering, or making decisions; unusual restlessness or irritability; persistent

physical problems such as headaches, digestive disorders, or chronic pain that do

 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

not respond to treatment, and thoughts of death or suicide or suicide

attempts (Medical Definition of Depression, 2018).

Guidance Services – A group of services given to individuals to assist them

in securing knowledge and skills needed in making plans and devices, and in

interpreting life. It includes tools and facilities in discharging its services to

individuals (Ognilla, 2014).

PHQ-9 – A tool specific to depression, scores each of the 9, DSM-IV related

criteria based on the mood module from the original PRIME-MD. The PHQ-9 is

both sensitive and specific in its diagnoses, which has led to its prominence in the

primary care setting. This tool is used in a variety of different contexts, including

clinical settings across the United States as well as research studies.

 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

Chapter 2

REVIEW OF RELATED LITERATURE AND STUDIES

This chapter presents the related literature and studies after the thorough and

in-depth search done by the researchers. This will also present the synthesis of the

art, theoretical and conceptual framework to fully understand the research to be

done and lastly the definition of terms for better comprehension of the study.

Foreign Literature

Fatigue is highly prevalent among undergraduate college students; it

negatively impacts academic performance,cognitive functioning, and psychological

well-being. Fatigue in college students may be related to many factors, such as a

heavy course load, extracurricular activities, work obligations, social activities, or

drug use. Interestingly, social support has been found to negatively correlate with

perceptions of fatigue (Nyer, 2015). Depressed college students with symptoms of

fatigue demonstrated functional impairment and symptomatic burden that worsened

with increasing levels of fatigue.

Many factors of college life contribute to risk factors of depression. Many

students are unprepared for university life. Today’s students face high debt. They

also have fewer job prospects after graduation than previous generations. These

added concerns can lead to depressive episodes in college students.

 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

Depressed students are at a greater risk of developing problems such as substance

abuse. Depressed college students are more likely to binge drink, smoke marijuana,

and participate in risky sexual behaviors to cope with emotional pain than are their

nondepressed peers (Legg, 2017).

The relationship between depression and gender differences are well

established in existing literature. In a nationally representative sample in the US,

women were found to be roughly 1.7 times more likely to have reported a history of

major depressive episodes than men. These results are further supported in the

above studies on SES and depression, which found women to also have a higher

frequency of depression. Furthermore, in a review of existing literature, determined

which risk factors did or did not explain gender differences in rates of depression.

They concluded that the reason women are more likely to have depressive disorders

than men is not because of genetic or biological factors but rather an increased

likelihood of adverse experiences as a child and role strain due to cultural norms,

which in turn interacts with how women experience adverse life events (Carrico,

2017).

The deleterious impact of depression on functioning is well-documented

among college students. Students with depression tend to have lower grade point

averages and are more likely to drop out of college than their non-depressed peers

(Eisenberg et al., 2009; Haines, Norris, & Kashy, 1996; Hysenbegasi et al., 2005).
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

Depression also impairs social functioning. Depressed college students tend to use

maladaptive interpersonal strategies that elicit negative reactions, including social

rejection, from peers. Aside from conferring risk for academic and psychosocial

impairments, college depression is a major public health concern because of the

strong link between depression and suicide.

The prevalence of depression among medical students is significantly higher

than that from the general population or other undergraduate students and can result

in dropping out, in such a way that the growing number of students who have

dropped out due to their poor performance or their vocational indecision could be

related to the presence of this condition (Morales, 2013). Depressive

symptomatology is an important risk factor for failing a subject or having a poor

academic performance.

College is a very unique time in a person’s life. Some students are young and

away from home for the first time. Other students are going back to school with

familial responsibilities. Regardless of students’ reasons for attending college,

lessons learned and obstacles overcome can provide opportunities for emotional

growth and maturity. The college experience can also include issues and events that

bring about overwhelming stress and psychological problems that affect the personal

life and academic performance of the student. Counseling services are designed to
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

assist students with both addressing difficulties encountered and promoting greater

overall wellness (Brunt, 2010).

Foreign Studies

College students are becoming increasingly depressed; however, many do

not attend university counseling to seek help. A survey was administered to N = 107

American undergraduate college students to ascertain the students’ understanding

of depression and their views of counseling services on campus. Both likelihood of

using alternative therapies and perceived discrimination of social network accounted

for 18% of the variance for likelihood of participants seeking campus counseling. (D'

Amico, 2016). When a young adult college student perceives stigma or

discrimination of depression from family and friends, then they may be less likely to

seek university counseling for depression as well as possible applications with

alternative therapies as a favorable option.

A cross-sectional study was conducted among Omani students attending the

students’ clinic of the Sultan Qaboos University (SQU). A systematic sampling of

students, males and females, from different colleges, who visited the clinic during

the study period, was carried out. The self-administered Patient Health

Questionnaire (PHQ-9) was used to screen for propensity to depression. A total of

481 students participated in the study (243 males and 238 females). Overall, 133

(27.7%) of the participants (66 males and 67 females) had depression of various
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

grades based on the PHQ-9 diagnostic criteria using a cut point of more than 11.

Depression score at the cut point of 11 was not statistically associated with gender,

college and the academic year. Tendency for depression might be a common health

problem among college students in Oman attending primary health care facilities.

Further research on socio-demographic characteristics and the effect of depression

on the academic performance is needed (Al-Busaidi, 2011). They found that

depression is common in SQU students with no preponderance between males and

females. Further research studying socio-demographic factors and the effect of

depression on the academic performance is needed.

Another cross-sectional study was undertaken from January 2016 to June

2016 in adolescents studying in 9-12th standard from forty schools located in an

urban area of Patna, Bihar. The self-administered questionnaire of Beck's

Depression Inventory II was utilized to assess the prevalence of depression.

Statistical analysis was done with Pearson's Chi-square test using SPSS software

version 21.0. Among the 1412 selected students, the prevalence of depression was

found to be 49.2%, wherein the prevalence of severe depression was 7.7%. The

overall prevalence of depression was significantly (P < 0.001) higher among girls

(55.1%) than boys (45.8%). The prevalence of depression was found to be higher

among students belonging to minorities (Buddhism, Jainism, etc.) (63.3%, P <

0.001). Elder students were found to be more depressed than younger students.

Depression was found to be statistically significantly associated with gender and

 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

religion (P < 0.005). Guilty feeling (69.48%) was one of the most prominent clinical

factors associated with depression followed by pessimism (58.14%), sadness

(56.52%), and past failure (55.81%) (KK, 2017). Mental health is one of the most

neglected aspects of our society. There is a need to increase awareness about

depression among teachers and parents to identify and help depressed adolescents

in the school.

Nursing College is recognized as a stressful environment that often exerts a

negative effect on the academic performance, physical health and psychological

wellbeing of the student. Depression among nursing students is an area of

increasing concern worldwide. This study aimed to assess the prevalence of

depression and its associated factors among nursing students of Kolar district. A

stratified random sample of 430 students was assessed using separate

questionnaire by investigators. Association between depression and class of

studying, age group, social factors like family problems, family history of depression

and staying away from home were analyzed.(Nagaraja, 2015). Prevalence of

depression is highly prevalent among nursing students in this area. Their findings

point to the importance of broad screening and psychiatric counseling of this

vulnerable population.

Sources of stress and coping strategies have not been previously studied at

Xavier University School of Medicine, Aruba. Hence the present study was carried

out to obtain information about sources of stress and coping strategies among
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

different groups of students and note differences, if any, among subgroups of

respondents. Sources of student stress and coping strategies were studied using the

medical student stressor questionnaire (MSSQ) and the brief COPE. The present

study was carried out among premedical and basic science undergraduate medical

students during June 2014. Demographic characteristics like gender, semester of

study, age and nationality were noted. Mean scores of different groups of stressors

and coping strategies were calculated and compared among various subgroups of

respondents using appropriate statistical tests (p <0.05). Ninety-two of the 108

students (85.2%) participated. Cronbach’s alpha values for various categories of

stressor scores were high. The major categories of stressors were academic related

and group activity related. Certain stress scores were higher among female

respondents and undergraduate medical (MD) students especially those studying in

the fourth and fifth semester. The main coping strategies employed were planning,

active coping, positive reframing, and acceptance. There were differences in use of

certain coping strategies among subgroups of respondents(Shankar , 2014).

Academic related stressors were high especially among fourth and fifth semester

students. Longitudinal studies following students over their basic science years are

required. Studies among students doing their clinical rotations in the United States

are required. Studies among students in other Caribbean medical schools are

needed.
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

A cross sectional study was carried out on medical students of Karachi. The

province of Sindh has 21 Medical Schools out of which 14 are in Karachi. Data was

gathered from medical students of 10 medical schools of Karachi who were willing to

participate in the study. A self-administered questionnaire was given to each

student. The Quick Inventory of Depression Symptoms (QIDSR16) scale was used

as an instrument to access the students for depression. For data analysis Statistical

Package of Social Sciences (SPSS v.21) software was used.There are

approximately 10,000 students currently studying medicine in Karachi from 1st year

to 5th year MBBS. Approximately 4000 questionnaires were distributed among the

students. 2270 students filled and returned the questionnaires either by hand or

email with a response rate of 56.75%. Prevalence of Depression in 1st, 2nd, 3rd, 4th

and 5th year MBBS students were found to be 45.5%, 50.1%, 76.5%, 38.1% and

31.6% respectively. The total percentage of depression among the medical students

was found to be 48.9%. Significance with gender was seen but no change with age

was seen (Shabbir, 2016). The study suggests that a lot of medical students feel

depression; the finding is consistent with a few western and local studies [1]. The

study finding stresses a need for psychiatric counseling and support services for

vulnerable students. Furthermore a longitudinal study should be carried out to

pinpoint the stressors so that appropriate steps could be taken for students and help

them improve their productivity.

Local Literature
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

Prevention of depression, particularly among university students in

developing countries, is urgent. With their large student populations and the

developmental propensity of students for depression , the burden of the mental

disorder is heavy on this demographic sector. Preventive efforts in the developing

world, however, are rare. Consistent with observations elsewhere, depression is

widely perceived in this part of the world as innocuous and as part and parcel of

normal adolescent development. Students with the mental disorder are not only

suffering in silence, but are also placing their academic and future life goals in peril.

Depression can be averted if students with depressive symptoms, comprising not

only physical but also non-physical conditions (e.g., cognition-emotion and

motivation), are promptly and properly identified and helped. Extent studies suggest

that students with higher levels of symptoms tend to be women, older and in their

senior year, and Catholics and/or Jews. Moreover, research indicates that highly

symptomatic students do not reside with their parents in one household, and are

smoking and drinking alcohol, and belong to the low-income bracket. Furthermore,

students with more severe levels of depressive symptoms have lower levels of

closeness with their parents or with friends (Lee, 2013).

According to Atik and Yalçýn (2011) when students in a university faced with

various challenges that require psychological help, an attitude toward seeking help is

a salient factor that affects their decision. The decision is to seek or not to seek

psychological assistance. The informal ways could be asking help from a family or
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

friends and other support system and the formal ways is asking help from a

counselor, a social worker, psychologist, psychiatrist and other mental health

practitioners.

Despite the fact that free counseling services is provided in the academic

institutions, studies has been shown that only percentage of students make use of

the services available for them. The arguments about underutilization of services of

counseling whether it is available in the campus or outside the campus has been

clearly revealed by research and has been a growing concern in the field of mental

health (Gulliver, et al., 2012; Massey, 2010; Que-Legaspi, Reyes & Datu, 2014).

Filipinos place a high premium on formal education; a university degree is

strongly regarded as a primary requirement for social and economic mobility. In the

context of the collective aspirations of Filipinos to go abroad for lucrative

employments, the need for university education is even more compelling. Individual

students are thus pressured to excel or complete a degree, lest they bring dishonor

to their family and friends, and endanger their employment and life prospects. In this

respect, academic-related matters are salient issues for individual students and in

their relationships and conflicts with parents; these, too, can induce higher levels of

depressive symptoms in students (Lee, 2013).

Higher level of depressive symptoms was also confirmed on students with low

or moderate level of closeness with their parents and peers, and those who were not
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

living with biological parents. The absence of closeness to parents and peers, limited

parental presence, and conflicts in the families and peers could trigger more

depressive symptoms to adolescents, as researchers emphasized. The financial

condition of students’ families was another factor as students who were not satisfied

with their financial condition elicited higher level of depressive symptoms than those

who answered “somewhat satisfied/satisfied/very satisfied” (Lee, 2013). Knowing

these factors, researchers hoped to guide the development of on-campus programs

for preventing depression and subsequently, suicides among Filipino students.

Local Studies

Depression can be prevented if its symptoms are addressed early and

effectively. Prevention against depression among university students is rare in the

Philippines, but is urgent because of the rising rates of suicide among the group.

Evidence is needed to systematically identify and assist students with higher levels

of depressive symptoms. We carried out a survey to determine the social and

demographic factors associated with higher levels of depressive symptoms among

2,436 Filipino university students. The University Students Depression Inventory with

measures on lethargy, cognition-emotion, and academic motivation, was used. Six

of the 11 factors analyzed were found to be statistically significantly associated with

more intense levels of depressive symptoms. These factors were: frequency of

smoking, frequency of drinking, not living with biological parents, dissatisfaction with

one’s financial condition, level of closeness with parents, and level of closeness with
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

peers. Sex, age category, course category, year level and religion were not

significantly related. In identifying students with greater risk for depression,

characteristics related to lifestyle, financial condition, parents and peers are crucial.

There is a need to carry out more surveys to develop the pool of local knowledge on

student depression(Lee, 2013).

In the study of personal problems and depression among college students

and their perceptions of school social support, it investigates the relationship

between the personal problems and depression among college students. Three

hundred ninety three (393) first year college students participated in the study. They

ranged in age from 16 to 17 years old. The sample purposively considered students

enrolled across programs: fine arts, business administration, engineering, and arts

and sciences. Descriptive analysis revealed that parents are frequent source of

problems for first year college students. Based on estimated correlation, personal

problems and depression are significantly related. Regression analysis was utilized

to determine which of the personal problems had the most effect on depression and

results indicate that problem situations involving parents were found to be the crucial

factor. Of the 393 participants in the study, one hundred twelve (112) or almost thirty

percent (30%) of the first year college students who participated in the study are

suffering from “borderline” to “extreme” levels of depression. Moreover, it was found

that almost half (186 or 47%) of the respondents perceived that they cannot count

on adults (e.g., teachers, guidance counselors, school administrators) at their school

 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

for emotional support. Results of the study highlight the importance of mental health,

psychological wellness, and counseling among adolescents(Go-Monilla, 2015).

Medical students are trained to maintain the health of patients, but such

training may have undesirable effects on medical students’ personal health. One

study therefore aimed to assess the health-related quality of life (HRQOL) of medical

students and to determine the factors that are associated with the students’ HRQOL.

The target population included all students enrolled at the Saint Louis University

School of Medicine in Baguio City, Philippines, during school year 2012-2013. The

measurements included the 36-Item Short Form Health Survey (SF-36)

questionnaire for HRQOL, Beck Depression Inventory, abbreviated Maslach Burnout

Inventory, Perceived Stress Scale, Holmes and Rahe Stress Scale, and self-report

items for other exposure variables. A total of 527 medical students participated in the

study. The mean scores in all of the eight domains of HRQOL ranged from 51.36 to

85.83. The highest mean scores were along the areas of physical functioning (85.83)

and bodily pain (69.20), whereas the lowest mean scores were in the areas of vitality

(51.72) and role limitations due to emotional problems (51.36). Depression, stress,

and burnout were associated with lower scores in most of the domains of HRQOL

(Domantay, 2014). Medical students in their school are generally in a satisfactory

state of functional health and well-being, but have a lower level of mental health as

compared with physical health.

 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

Chapter 3

RESEARCH METHODOLOGY

The chapter presents the research design of the study, research locale,

instrumentation and statistical treatment of data gathered in the study.

Method of Research Used

This study utilized the descriptive survey method of research. According to

Sanchez (1998), this includes all those studies that purports to present facts

concerning the nature and status of anything - group of person, a number of

objectives, a set of condition, a class of events, a system of thoughts, or any other

phenomenon which one may wish to study.

This study aimed to assess the guidance services relating to students with

depressive symptoms among pre-medical students in a private college. This will help

greatly the Guidance and Counseling Office have a transparent in terms of the

amount or degree of their output and demonstrate the effectivity of different

programs being implemented, are some ineffective programs, innovative changes

may take place.

Population, Sample Size, and Sampling Technique

The population comes from the students of the pre-medical students in a

private college. There is no equal number of male and female respondents since
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

researcher used the simple random sampling technique.The total population of the

pre-medical students in a private college was _____. Using the sloven’s formula to

get the sample size:

Where n = number of sample size

N = population size

e = estimated error

Description of Respondents

Respondents come from the population of Philippine College of Health

Sciences. Inc. (PCHS) students. PCHS was established since which was on

February 1, 1993, the birthday of its first President and Chief Executive Officer

(CEO), Dr. George C. Cordero.The School was conceived as complimentary to Dr.

Cordero’s review center, the Institute of Review and Special Studies popularly

known as INRESS REVIEW Center. PCHS first location was a 3-story rented

building with 10 classrooms in Coramina’s St. along Claro M. Recto Avenue, Manila.

Dr. Cordero received his investiture as President in 1996.

PCHS opened its doors on June 1994 with 124 students. The first

baccalaureate courses it offered are BS in Nursing , BS in Physical Therapy, BS in

 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

Occupational Therapy, BS in Radiologic Technology and BS in

Psychology, Associate in Radiologic Technology (A.R.T) and Graduate in Midwifery

(G.M). Its post-graduate courses include Master of Arts in Nursing (M.A.N), Master

of Arts in Education (M.A.E.d), Master of Public Administration (M.P.A), Doctor of

Education (Ed.D) and Doctor of Philosophy (PhD) On the succeeding years its

student population reached the one thousand mark and it almost reached the three

thousand-student enrolments.

As a testament to his passion and dedication in providing high quality and

cost-effective education, Dr. Cordero transferred to his newly acquired building, the

Doña Narcisa Building along Recto Avenue. All classrooms and offices are fully air-

conditioned and with state-of-the-art laboratories, PCHS is considered young as an

academic institution yet is has transformed the lives and influenced the future of

thousands of students. Several PCHS students garnered top places in professional

examinations and many are now occupying respectable positions in various private

and government institutions both local and international.

Instrumentation

The study employed the used of the Patient Health Questionnaire (PHQ-9) to

screen the depressive symptoms of the students and a survey questionnaire to

assess the guidance and counseling program with the use of four (4) point scale.

The survey questionnaire was adapted from the research conducted by Mr. Elmer
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

SauJimez last 2012 which was entitled “The Guidance Services of De la Salle

University - Dasmarinas: An Assessment” since it was already validated and

reliability was also already checked by Mr. Jimez. The questionnaire consists of

personal profile such as age, sex and economic status and the question proper.

Respondents rated each statement using the Likert scale and the result was

interpreted using the arbitrary scale:

Likert Scale Verbal Interpretation Arbitrary Scale

4 To a great extent (GE) 3.26 - 4.00

3 To a moderate extent (ME) 2.51 - 3.25

2 To a limited extent (LE) 1.76 - 2.50

1 Not at all attained (NA) 1.00 - 1.75

Data Gathering Procedure

The researcher sent a request letter to the school asking permission to

conduct the study and to identify the population of the pre-medical students in a

private college. The data for this research were collected using a survey

questionnaire. The survey was created using suitable questions modified from the

related research and individual questions adapted by the researcher. The survey
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

questionnaire comprises of seven (7) parts which has a total of 35 checklist items.

Before answering the survey questionnaire, the researcher gives the instructions

then informed the confidentiality of the data to be gathered. It was given to the

students then asks for 10-15 minutes to answer the questionnaire. No incentive

given to the participants.

Statistical Treatment of Data

After the data was gathered, sorted and tabulated, the gathered

information was subjected to statistical treatment in order to answer the problem.

The treatment includes the following:

Frequency and Percentage.Frequency distribution is an orderly grouping

system which can be done through the tabulation and classification of data.

The formula to be used shall be:

𝑓
%= × 100
𝑁

Where:

%= Percentage

f= Frequency of distribution

N= Total number of population

 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

Weighted Mean. This will be used to compute the arithmetic mean that gives

different observations an equal weight in accordance with their unequal relative

importance.

The formula of weighted mean is:

∑ 𝑓𝑥
𝑥= 𝑛
Where:

∑=Summation

X=Mean

W= Weight

N=Total number of population

Data were analyzed using statistical software. Frequency and percentage

were calculated to draw a descriptive profile of the respondents.

 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

Bibliography

(2015, December 27). Retrieved January 5, 2018, from Psychology Today:

https://www.psychologytoday.com/conditions/depressive-disorders

Adelman, H., & Taylor, L. (2015). Conduct and Behavior Problems: Intervention and
Resources for School Aged Youth. Center for Mental Health in School . Los
Angeles, CA. Retrieved from http://smhp.psych.ucla.edu

Agi, C. W. (2013). Evaluation of the Status of Guidance Services in Secondary

Schools in Rivers State, Nigeria. Journal of Education and Practice , 9.

Al-Busaidi, Z. e. (2011). Prevalence of Depressive Symptoms among University

Students in Oman. Oman Medical Journal , 5.

Bernal, B. (2013, April 23). Youth activism: More than just organized action.
Retrieved August 2017, from Rappler: https://www.rappler.com/move-ph/27023-
youth-activism-organized-action

Brunt, B. V. (2010). The Preparation and Role of College Counselors.

Carrico, P. (2017). Depressive Symptoms among College Students:.

Comprehensive guidance and counseling program. (2007). Retrieved August 2017,

from
https://studentservices.ednet.ns.ca/sites/default/files/Comp%20Guidance%20and%2
0Couns%20Prog.pdf

Comprehensive School Counseling. (2008). Connecticut: State of Connecticut.

Corey, G. (2006). Theories and practice of counselling and psychotherapy (7th ed.).
Belmont, CA: Wadsworth.

D' Amico, N. (2016). American College Students’ Views of Depression and

Utilization of On-Campus Counseling Services. Journal of American Psychiatric

Nurses Association .
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

Dahir, C. (2009). Comprehensive School Counseling Program Guide. New York:

Springfield Publication Schools.

De Guzman, M. (2013). History of school counseling. Retrieved August 2017, from

www.slideshare.net: http://www.slideshare.net/msk1r1ko/history-of-guidance-and-
counseling

Dogar, A., Azeem, M., Majoka, M. I., Mehmood, A., & Latif, S. (2011). Need
Assessment of Students' Guidance and Counseling. British Journal of Arts and
Social Sciences , 17.

Domantay, J. (2014). Health-Related Quality of Life of Future Physicians at a

Medical School in the Philippines.

Esguerra, A. Q. (2016, March 16). Which school is most preferred by employers? It’s
not from ‘Big 4’. Retrieved August 2017, from Inquirer.net:
http://newsinfo.inquirer.net/774086/which-school-is-most-preferred-by-employers-its-
not-from-big-4

Gabbey, A., & Jewell, T. (2016, March 7). Aggressive Behavior. Retrieved from
Healthline: http://www.healthline.com/health/aggressive-behavior#Causes2

Go-Monilla, M. (2015). Personal Problems and Depression among College Students

and Their Perceptions of School Social Support. Philippine E-Journal .

Guidance, Counseling and Testing Services. (2017). Retrieved August 2017, from
Polytechnic University of the Philippines:
https://www.pup.edu.ph/studentservices/gcts/

Ibarrientos, J. R. (2015). Implementation and Effectiveness of Student Affairs

Services Program in One Polytechnic College. Asia Pacific Journal , 3, 13.

Ivey, A. (2006). Theories of counselling and psychoanalyzing: A multicultural

perspective (6th ed.). Boston: Allyn & Bacon.

Kanga, B. M., Nyaga, V. K., & Barchok, H. K. (2015). Effectiveness of Guidance and
COunselling Services in Enhancing Students' Adjustment to School Social
Environment in Public Boarding Secondary Schools in Kenya. Research on
Humanities and Social Sciences , 5, 8.
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

Kaye, A. J., & Erdley, C. A. (2011). Physical Aggression. Retrieved February 16,
2017, from Springer Link:
http://link.springer.com/referenceworkentry/10.1007%2F978-0-387-79061-9_2156

Kelly, T. J. Effects of Aggressive Behavior on Academic Performance.

KK, J. (2017). Prevalence of Depression among School-going Adolescents in an

Urban Area of Bihar, India. Indian J Psychol Med. .

Kozina, A. (2007). Measurement of Students' Aggressive Behavior in School

Settings. European Conference on Educational Research. Slovenia.

Lee, R. (2013). Factors Associated with Depressive Symptoms among Filipino

University Students.

Legg, T. (2017, July 5). Healthline. Retrieved from

https://www.healthline.com/health/depression/college-students#1

Leonard, R. L. (2005). Aggression: Relationship with Sex, Gender-Role Identity, and

Gender-Role Stress. Tennessee: East Tennessee State University.

Loyola, A. d. (2017). OFFICE OF GUIDANCE AND COUNSELLING. Retrieved

August 2017, from Ateneo De Manila: http://www.ateneo.edu/ls/office-guidance-and-
counselling

Malinauskiene, O., Vosylis, R., & Zukauskiene, R. (2011). Longitudinal Examination

of Relationaships Between Problem Behavior and Academic Achievement in Young
Adolescents. Retrieved from ScienceDirect: http://www.sciencedirect.com

Manila, U. o. (2014). Guidance and Counseling Program. Retrieved August 2017,

from University of the Philippines Manila: https://www.upm.edu.ph/node/1330

Medical Definition of Depression. (2018). Retrieved January 5, 2018, from

medicinenet.com: https://www.medicinenet.com/script/main/art.asp?articlekey=2947

Morales, C. F. (2013). Depressive symptoms and academic.

Muango, G., & Joel, O. J. (2012). An evaluation of the effectiveness of guidance and
counselling services in public universities in Kenya. Journal of Emerging Trends in
Educational Research and Policy Studies , 4.
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

Nagaraja, G. (2015). Study the Prevelence of Depression among Nursing College.

IOSR Journal Of Humanities And Social Science (IOSR-JHSS) , 5.

Neeley, S. J. (2004). A model Comprehensive, Developmental Guidance and

Counseling Program. Texas: Texas Education Agency.

Nyamwange, C. B., Nyakan, P. O., & Ondima, P. C. (2012). Assessment of

Challenges facing Secondary School Guidance and Counselling Teacher in Nyamira
District, Kenya. Journal of Education and Practice , 8.

Nyer, M. (2015). College students with depressive symptoms with and without
fatigue: Differences in functioning, suicidality, anxiety, and depressive severity.

Ognilla, E. L. (2014, March 26). Retrieved January 5, 2018, from LinkedIn

Corporation: https://www.slideshare.net/erlisonlorenzognilla/the-guidance-
servicesmatapineda

Owino, E. A. (2015). Assessment of Service Delivery in Guidance and Counseling

units in Selected Secondary Schools in Eldoret Municipality, Kenya. Journal of
Education and Practice , 15.

Princeton University. (2013, February 11). Children and Electronic Media. Retrieved
from The Future of Childre:
http://www.futureofchildren.org/publications/journals/article/index.xml?journalid=32&
articleid=60&sectionid=291

Ridley, C. R., Mollen, D., & Kelly, S. M. (2011). Beyond Microskills: Toward a Model
of Counseling Competence. SAGE Publication , 40.

Sabellina, I. (2014). History of guidance in the Philippines. Retrieved August 2017,

from www.slideshare.net: http://www.slideshare.net/iandwightsabellina/history-of-
guidance-in-philippines

Scheerens, J., Luyten, H., & Van Raven, J. (2011). Perspectives on Educational
Quality. Retrieved August 2017, from Springer:
file:///C:/Documents%20and%20Settings/igloo1/My%20Documents/Downloads/9789
400709256-c2%20(1).pdf

Sculli, N. (2011). Assessing the Counseling Needs of High School Students: The
Role of Needs Assessment in Comprehensive School Counseling Programs and the
 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

ASCA National Model. New York: The College at Brockport: State University of New
York.

Shabbir, M. (2016). Depression Among Medical Students. Journal of Psychology

and Clinical Psychiatry , 3.

Shankar , P. (2014). Stress and Coping Strategies among Premedical and

Undergraduate Basic Science. Education in Medical Journal , 9.

Shaver, P. R., & Mikulincer, M. (2011). Human Aggression and Violence: Causes,
Manifestations, and Consequences. US.

Smith, M. (2008). Helping relationships – principles, theory and practice. Retrieved

August 2017, from infed: http://infed.org/mobi/helping-relationships-principles-theory-
and-practice/

Solutions, V. B. (2016, November). Guidance and counseling in the Philippines: A

journey to maturity. Retrieved August 2017, from The Dailly Guardian:
https://thedailyguardian.net/option/guidance-and-counseling-in-the-philippines-a-
journey-to-maturity/

Tanalega, N. (2004). Counseling Filipinos briefly. Quezon City, Philippines: Ugnayan

at Tulong Para sa maralitang Pamilya Foundation.

The Educational Attainmentof the Household Population (Result from the 2010
Census). (2013, January 10). Retrieved February 16, 2017, from Philippines
Statistics Authority: https://psa.gov.ph/content/educational-attainment-household-
population-results-2010-census

Tremblay, R. E. (2012). The Development of Physical Aggression. Encyclopedia on

Early Childhood Development .

Tuason, M. e. (2012). Counseling in the Philippines: Past, Present, and Future.

Journal of Counseling and Development , 373-377.