Research Title/Research Confronting Stigma: A Phenomenological Study of Health Care

Proposal: Provider In Social Hygiene Facilities______________________

Student Researchers/ Abella, Catherine M.______ Vallejo, Timmy Rose C.______
Faculty Researcher/s: Gemperona, Justin Ross L._ Villaret, Dianne Nicole_______
Palima, Edrea Dieserhe B._ _________________________
Usop, Al-Nazaer A._______ _________________________
Name of Sponsor (if applicable): _________________
Date Submitted: July 24, 2014____________
Date Received: _______________________


Form 6. [Informed Consent Form for Participants]
This Informed Consent Form is for the healthcare providers at Reproductive Health Wellness
Center (RHWC)

Research Title/Research Confronting Stigma: A Phenomenological Study of Health Care
Proposal: Provider In Social Hygiene Facilities______________________
Student Researchers/ Abella, Catherine M.______ Vallejo, Timmy Rose C.______
Faculty Researcher/s: Gemperona, Justin Ross L._ Villaret, Dianne Nicole_______
Palima, Edrea Dieserhe B._ _________________________
Usop, Al-Nazaer A._______ _________________________
Name of Sponsor
[Confronting Stigma: A Phenomenological Study of Health Care Provider In Social Hygiene
Facilities]
This Informed Consent Form has two parts:
Information Sheet
Certificate of Consent
You will be given a copy of the Full informed Consent Form


PART I: Information Sheet
Introduction

We are nursing students from San Pedro College. We are doing research on Confronting
Stigma: A Phenomenological Study of Health Care Provider in Social Hygiene Facilities. We
are going to give you information and invite you to b a part of this research. You do not have
to decide today whether or not you will participate in the research. Before you decide, you
can talk to anyone you feel comfortable with about the research.

There may be some words that you dont understand. Please ask us to stop as we go through
the information and I will take time to explain.

Purpose
With this research we will be able to show the importance of healthcare providers in
implementing social hygiene measures such as counselling and providing health teachings on
prevention towards acquiring the infection efficiently. The findings of this study will also
enhance the effective interviewing and counselling skills of the healthcare providers
characterized by respect, compassion and a non-judgemental attitude toward all patients
through the elimination or minimizing stigma.

Participant Selection
We are inviting all healthcare providers who are working at Reproductive Health Wellness
Center to participate in the research with regards to their lived experiences in dealing with
their clients.

Voluntary Participation
Your participation in this research is entirely voluntary. It is your choice whether to
participate or not. You may change your mind later and stop participating even if you agreed
earlier.









































Part II: Certificate of Consent

I have been invited to participate in the research regarding live experiences of health care
providers in dealing with client. I understand that it will involve audio recording and semi
structured questionnaire. I have been informed that there is no risk involve in this research. I
am aware that there may be benefit to me as a health care provider. I have been provided with
the name of researcher.
I have read the foregoing information, or it has been read to me. I have had the opportunity to
ask questions about it and any questions that I have asked have been answered to my
satisfaction. I consent voluntarily to participate as a participant in this research and I
understand that I have the right to withdraw from the research at any time without in any way
affecting my profession.

Print Name of Participant______________________________
Signature of Participant_____________
Date________________________
Day/Month/Year

If illiterate
I have witnessed the accurate reading of the consent form to the potential participant, and the
individual has had the opportunity to ask questions. I confirm that the individual has given
consent freely.

Print Name of witness _________________
Signature of witness __________________
Date _______________________
Day/month/year
AND
Thumb print of participant
I have accurately read or witness the accurate reading of the consent form to the potential
participant, and the individual has had the opportunity to ask question. I confirm that the
individual has given consent free.

Print Name of Research ___________________
Signature of the Researcher ________________
Date ________________________
Day/month/year

A copy of this Informed Consent Form has been provided to the participant_________
(initiated by the researcher/assistant)

Submitted by:
Name Signature Name Signature
Abella, Catherine M._____ ____________ Vallejo, Timmy Rose C. _____________
Gemperona, Justin Ross L. ____________ Villaret, Dianne Nicole_ _____________
Palima, Edrea Dieserhe B. ____________ ___________________ _____________
Usop, Al-Nazaer A._____ ____________ ___________________ _____________

Endorsed by/ Recommended by _______________________________
Research Adviser