FAMILY & COMMUNITY MEDICINE II Sampling Method

Prepared by: GROUP 8 A Alaba, Abigail Aileen Atienza, Kriska Bayting, Ormalyn* Boussati, Jamela Merriam Collante, Maria Lourdes Delos Santos, Christian Fernando, Emily Han, Joo Yeon Liu, Francesca Debbie

August 19, 2011

Dr. M. Sosa Adviser

I. Research Topic

The relationship of age, gender, socioeconomic status, feeding habits, heredity, and geography to the prevalence of Atopic Dermatitis among the pediatric patients (0-6 years old) of the De La Salle University Medical Center (DLSUMC) in the year 2010-2011 II. Research Question Is there a relationship between age, gender, socioeconomic status, feeding habits, heredity, geography and prevalence of Atopic Dermatitis among the pediatric patients (0-6 years old) of the De La Salle University Medical Center (DLSUMC) in the year 2010-2011? III. Objectives A. General Objective To determine the relationship of age, gender, socioeconomic status, feeding habits, heredity, and geography to the prevalence of Atopic Dermatitis among the pediatric patients (0-6 years old) of the De La Salle University B. Specific Objectives 1. To determine which of the age groups is more vulnerable to Atopic Dermatitis among the pediatric patients (0-6 years old) from DLSUMC in 2010-2011 2. To identify which gender among the pediatric patients (0-6 years old) from DLSUMC in 2010-2011 is more susceptible to Atopic Dermatitis 3. To determine which socioeconomic status is more prone to of Atopic Dermatitis 4. among the pediatric patients (0-6 years old) Medical Center (DLSUMC) in the year 2010-2011

DLSUMC in 2010-2011 To determine if feeding habits of the infant and/or mother is associated to the prevalence of Atopic Dermatitis among the pediatric patients (0-6 years old) from DLSUMC in 2010-2011 5. To determine if family history of having skin allergies is associated to the prevalence of Atopic Dermatitis among the pediatric patients (0-6 years old) from DLSUMC in 2010-2011
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6.

To verify if living in the rural or urban area is associated to the

prevalence of Atopic Dermatitis among the pediatric patients (0-6 years old) from DLSUMC in 2010-2011 IV. Background information regarding the research question The researchers are interested to determine the relationship of demographic characteristics such as age, gender, socioeconomic status, feeding habits, heredity, and geography to the prevalence of Atopic Dermatitis because the disease is disturbingly getting rampant nowadays. Moreover, AD is not a simple disease for it is in fact very damaging affecting the quality of life of patients. AD is a serious disease that it could shrink the patients self-esteem and could be a hindrance in building interpersonal relationships. Furthermore, it is indeed disheartening to see infants and children who have lesions on the skin which could impede in their daily living. These children could be subject to criticisms and may not enjoy life as normal children should. There are many foreign researches regarding AD, however, locally, research about it is nil. Hence, the researchers would like to expand the knowledge regarding AD which could be, hopefully, instrumental to further researches to alleviate, if not eliminate, the rising prevalence of this disease. V. Research Hypothesis There is no significant relationship between age, gender, socioeconomic status, feeding habits, heredity, and geography to the prevalence of Atopic Dermatitis among the pediatric patients (0-6 years old) from the De La Salle University Medical Center (DLSUMC) in the year 2010-2011. VI. Conceptual Framework

VII.Operational Definition of Variables 1. PREVALENCE OF ATOPIC DERMATITIS As defined in the study indicates the total number of pediatric patients from 0 to 6 years of age in the DLSUMC who met all the inclusion criteria for Atopic Dermatitis specifically from January 2010 to December 2011. Inclusion criteria are: 1) must be aged 0 - 6 years old; 2) must have pruritus; 3) rashes must be distributed in the face, neck, extensors, flexor surfaces, wrists, or ankles; diaper area must be spared for infants; and 4) must have raised serum IgE. These pediatric AD cases are counted in prevalence until they recover or die. 2. AGE Indicates the duration of the existence of the pediatric patient. For the study, this will be limited to 0 to 6 years old. Hence, the developmental milestones of the pediatric AD patients are considered. 3. GENDER means the sex of the patient (i.e., male or female) 4. SOCIOECONOMIC STATUS - Socioeconomic status or stature, as used in the study, will be based 1) upon the type of consultation made whether it Is in the private clinic or charity clinic; 2) if the patient consistently follow-ups for check up; 3) annual income (if declared); 4) other criteria such as lifestyle (e.g., residence, brand of milk) and educational attainment of the significant other/parent are also considered. 5. FEEDING HABITS - Defined as the history of the pediatric patients diet from ante partum to postpartum from 0 to 6 years of age. Breastfeeding is also noted whether the baby is poorly breastfed <6 months or well breastfed >6 months with the indication whether it is continuous or discontinuous. Type and frequency of food is also noted according to the developmental milestones. Moreover, feeding habits of the mother during pregnancy shall be looked into.

6. HEREDITY Defined as the presence of AD, allergic rhinitis, asthma or any other familial allergic diseases that contributed to the pediatric patients AD occurrence. 7. GEOGRAPHY As defined in the study, this is the place of residence of the patient (i.e., region, province, specific town) 8. ENVIRONMENT In the study, this will provide an estimate of the susceptibility of the patient to pollutants or allergens. This would be measure by taking note of the patients residence (i.e., village/ subdivision, along the road, near industrial establishments)

VIII.

Methodology The present study will utilize a Cross-sectional research design in which a

Study Design cross-section of the population is studied at a defined time and the differences within the population will be compared. This aims to provide data on the population under study and determine the relationship between the factors contributing to the development of AD. Cross-sectional research designs are often used to assess the prevalence of acute or chronic conditions, or to be able to identify causes of disease or the results of medical treatments. Study Population The study focuses on the pediatric patients aged 0 to 6 years old at the DLSUMC from January 2010 to December 2011. The study shall select pediatric patients who are diagnosed to have Atopic Dermatitis based on the following inclusion criteria: 1) Must be aged 0 - 6 years old 2) Must have pruritus 3) Rashes must be distributed in the face, neck, extensors, flexor surfaces, wrists, or ankles; diaper area must be spared for infants; and 4) Must have raised serum IgE. Sampling Method
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The present study will utilize purposive sampling method since only those who will meet the inclusion criteria will be included as sample population. Procedure The study will be conducted at the DLSUMC under the supervision of Family and Community Medicine Department (FCMD), College of Medicine. A letter of communication will be made addressed to the Medical Records of DLSUMC noted by Christine S. Tinio, MD, FCMD Head. This is to seek permission for access of the medical records of patients who were diagnosed to have AD from January 2010 to December 2011. Upon approval of Medical Records, medical files will be screened and patients who will meet all of the inclusion criteria shall be selected for the study. Each atient's data such as age, gender, socioeconomic status, environmental status, feeding habits, heredity, geography, and environmental factors will be noted by filling out a protocol because these are the variables of the study. The data gathered will be subjected to analysis in order to determine the relationship of the aforementioned variables or risk factors to prevalence of AD. Data collection Figure 1 shows the protocol to be accomplished in order to measure the variables and the tables on the next page will be showing the data for data analysis.

Figure 1. Sample protocol Gender Male Female TOTAL Age <1 year old 1 2 years old 2 3 years old SES 3 4 years old 4 5 years old High years old 56 TOTAL Middle Low TOTAL Frequency Percent

Frequency

Percent

Frequency

Percent

Table 1. Frequency Distribution of Participants According to Age Table 2. Frequency Distribution of Participants According to Gender

Table 3. Frequency Distribution of Participants According to SES

Table 4. Frequency Distribution of Participants According to Breastfeeding Duration

Duration < 1 month 1 6 months 6 months 1 year 1 year 1.5 years 1.5 2 years > 2 years Continuous Discontinuous TOTAL

Frequency

Percentage

Table 5. Frequency Distribution of Participants According to Hereditary Stimulus Hereditary Positive Negative TOTAL Frequency Percentage

Table 6. Frequency Distribution of Participants According to Environmental Factor Environment Village/Subdivision Along the road Near industrial establishments TOTAL Frequency Percentage

Table 7. Frequency Distribution of Participants According to Geographical Factor Location Dasmarinas Imus Bacoor Trece Martires Indang GMA Kawit Carmona Silang Others TOTAL Frequency Percent

Figure 2. Schematic diagram of research design

Research biases are unavoidable but in the present study, the researchers aim to understand, limit and, if possible eliminate, these biases. Biases include inclusive bias wherein target population is selected in convenience. In the present study, subjects are taken from De La Salle University Medical Center, which tends to fit a narrow demographic range. Another one is recall or memory bias which can be a problem because outcomes being measured require the subjects to recall past events like onset of atopic dermatitis, feeding habits and aggravating environmental factors. More importantly, measurement bias that arises from an error in the data collection and the process of measuring. In order to avoid problems with inclusive bias, researchers must understand that they cannot extrapolate the results to fit the entire population. Getting patients with AD in the out-patient department of DLSUMC will not give a fully representative group but should not amend the purpose of the study. Finally, in controlling measurement bias, in-depth review of the medical charts should be done to avoid missing out pertinent data.

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