Name: _____ Date: 12-06-21

Group: 4A Name of CI: Ms. ______

I.
TITLE: LEVEL OF KNOWLEDGE AND ATTITUDE TOWARDS DIABETES MELLITUS (TYPE II)
AMONG SELECTED BUSINESS PROCESS OUTSOURCING (BPOS) EMPLOYEES IN MAKATI
AUTHOR: Espinola, J., et al.
SOURCE: https://psa.gov.ph/sites/default/files/4.2.3%20Level%20of%20Knowledge%20and%20Attitude%20Towards%20Diabetes%20Mellitus%20%28Type%20II%29%20Among%20Selected%20Business
%20Process%20Outsourcing%20%28.

YEAR OF PUBLICATION: 2019

II. SUMMARY

Type 2 diabetes mellitus (T2DM) comprises the vast majority of all diabetes cases in employees, with
alarmingly increasing prevalence and risks over the past few decades worldwide especially here in the
Philippines. It is very alarming that even though its prevalence is high, the attitude of selected Philippine
employees is remarkable that they don’t perceive the risks as current problem.

III. NURSING IMPLICATIONS

To Nursing Practice

Health education is one of the main roles of nursing. Respondents attitude towards diabetes is significantly
low. This means that the wider the knowledge on diabetes the more
positive their attitude will be. That is why enforcing educations, seminar and workshops to employees may
have to lead on a better outlook on how it can be prevented and controlled. In addition to this, family
members of the employees may be encouraged to join education sessions toward lifestyle management of
type 2 diabetes.

To Nursing Education

Level of education could be a key determinant to level of knowledge. Thus, it is important to update nursing
knowledges, even attend seminars and gather certificates. To increase level of significant knowledge to be
imparted on to clients especially current issues and trend in diabetes type 2 related to lifestyle managements.

To Nursing Research

The study is limited to specific business employees. For the next researches who will be conducting the
same study may be able to address it in a wide variety form. Also, may be able to specifically address the
employer’s connection with the lifestyle of the employees.

IV. PERSONAL INSIGHTS

I strongly agree on the data presented that attitude towards diabetes reflects from people’s level of
understanding toward diabetes and employee’s lifestyle at work. Because major portions of employees here
at the Philippines work daily for long hours that may have affected their physical activities, appetite, time to
eat and even correlates to chronic stress. Although some of have significant knowledge on diabetes but
some still does not care, regardless the growing number of patients being diagnosed with diabetes because
of some priorities. Which is to earn money for the family. That is why in my opinion the government should
provide free medications to those people who have diabetes,
especially, the ones who are not financially stable. And also offer free check-ups for diabetes and free
consultation from doctors for at least once a month. And lastly as mentioned earlier to support allied health
professionals in enforcing seminars on proper education on prevention and control, mostly for those who
are unaware of diabetes risks.

Received: (Signature of CI/Date)

14th National Convention on Statistics (NCS)

Crowne Plaza Manila Galleria Ortigas Ave.
October 1-3, 2019
 LEVEL OF KNOWLEDGE AND ATTITUDE TOWARDS
DIABETES MELLITUS (TYPE II) AMONG SELECTED
BUSINESS PROCESS OUTSOURCING (BPOS) EMPLOYEES
IN MAKATI

by

John Chiristian Espinola, Alora de Guzman, Khali Junatas, Julius Pedro, Mark
Anthony Sio, Giulian Tabanao, Jhames Santos, Nicole Labine and Christina
Lugue

For additional information, please contact:

Author’s name John Chiristian Espinola

Designation Content Lead for Research
Co-author’s name Alora de Guzman, Khali Junatas, Julius Pedro, Mark
Anthony Sio, Giulian Tabanao, Jhames Santos, Nicole Labine
and Christina Lugue
Affiliation Lyceum of the Philippines University
Address Muralla St, Intramuros, Manila, 1002 Metro Manila
Tel. no. 0906-412-5790
E-mail christian.espinola@lpu.edu.ph

Level of Knowledge and Attitude towards Diabetes Mellitus (Type

II) among selected Business Process Outsourcing (BPOs)
Employees in Makati
 by

John Chiristian Espinola, Alora de Guzman, Khali Junatas, Julius Pedro, Mark
Anthony Sio, Giulian Tabanao, Jhames Santos, Nicole Labine and Christina
Lugue

ABSTRACT

The Department of Health desires to promote good health and wellbeing by addressing
employees. Increasing number of patients with diabetes who work in call centers most of them
are incapacitated by obesity and other contrasting lifestyle-related issues. This
ComparativeCorrelation study aims to test the level of knowledge and attitude towards diabetes
among selected BPO Companies. Using Stratified sampling, the researchers gathered their 334
respondents from Makati. Data gathered from the adapted survey-questionnaire of Garcia
(2001) and Evans (2010) were treated using ANOVA, Chi-Square and Pearson Correlation. Their
level of knowledge is approaching proficiency (50%) and was also found out that there is a
significant difference in their responses based on their age (p-value=0.41). Their attitude towards
diabetes is moderately positive (77.8%) and shows that there is a significant difference based on
their daily work hours (p-value=.012) and employment status (p-value=.006). The two variables
are significantly correlated categorically (x2=22.634) and has significant low positive correlation
(0.01 level of significance, r=.270). These proves that they are at risk of having diabetes but with
the strong desire of the employers and the government to do information dissemination,
massive campaign, and policy making, there is a hope to minimize the cases.

Keywords—BPO Employees, Diabetes, Health and Wellness, Sociology.

I. INTRODUCTION
According to Philippine Daily Inquirer (2018), Philippines is a diabetes hotspot over the western
pacific region with at least 6 million Filipinos have been diagnosed with diabetes. Diabetes is reaching
epidemic proportions and the government knows it. Just this year 2018, the government increase
the tax on sugary drinks, this is one-step that the government is doing to fight the epidemic that is
killing people every day. The United Nation Sustainable Goals: to promote good health and well-
being, desires to address the needs of the BPO employees prone to suffer various diseases by
educating them how to take care of their health. In the western side of the pacific, the third world
country, Philippines being fifth in the over-all ranking when it comes to people diagnosed with
diabetes. Preventing diabetes and diagnosing it is one way. Filipinos are known for their hardworking
attitude and sometimes they often sacrifice their health just for their job. Those are the things that
concern the researchers thus making a study about diabetes to workers.
Nowadays, most of Filipino call center agents are being diagnosed with diabetes that can be
considered as a chronic disease. In the Philippines, call center agents are highly exposed in different
diet that made them highly active in the environment they are in. Also, some of the family members
of the researchers have a history of diabetes. DOH stated that BPO employees are now becoming a
big contributor to the workforce of the Philippines as of today, thus it is vital to spread awareness of
the health risks that they are facing with their everyday lives. Lack of sleep, job – related stress and
other unhealthy practices or lifestyle can lead to serious health conditions, and one of this condition
is diabetes (Ubial, 2016).
Having said that, the researchers adhered to the UN Strategic Framework of the 2030 Sustainable
Developmental Goals. In line with this, the researchers looked through the perspective of the
acclimatization of promoting the good health and well-being of an individual of all ages. Here fore,
through this research, it comprehends to supplementary knowledge of the public to be properly
informed through preventions and possible treatments.
A. Statement of the Problem
The primary purpose of this study is to identify the level of knowledge and attitude of BPO
Employees toward Diabetes Mellitus II. Specifically, it sought to answer the following questions:
1. What is the demographic profile of the respondents?
a. Gender
b. Age in years
c. Civil Status
d. Years in BPO Industry
e. Daily work hours
f. Employment Status
2. What is the difference in the level of knowledge toward Diabetes Mellitus of BPO
employees based on their demographic profile?
3. What is the difference in the attitude toward diabetes of BPO employees based on their
demographic profile?
4. What is the relationship between the level of knowledge and attitude toward diabetes
of BPO employees?

B. Scope and Delimitation

The researchers performed a survey consisting different questions that were consulted to medical
practitioners (Doctor of Medicine/ Applied Health Science). The researchers started gathering
information on September and conducted the survey in the mid-October of 2018.
The study intended to determine the awareness of BPO Employees specifically, call center agents on
having this kind of chronic disease and also their attitude about it. The survey will not be limited to a
certain age, for as long as the respondent is a call center agent. The researcher chose the call center
agents because they are highly exposed to different kinds of stress and workloads of task, they are
also known for night shift and also, they usually drink a lot of coffee and sugary drinks.
The researchers will not include the lifestyle of the respondents, including the family background of
the respondents, and their health status in the past 6 months.

II. METHODOLOGY
A. Research Design
The study is a descriptive type of study, (Shuttleworth, 2008) this type of design is a scientific method
which involves observing and describing the behavior of a subject without influencing it in any way. It
identified and compared the current status and the relationship between the level of knowledge and
attitude among selected BPO in Makati

B. Research Locale
The researchers chose BPOs in Makati because it is known as the center of business here in the
Philippines. It was also named as the Makati CBD or Makati Central Business District where the
leading financial and central business are found. Philamlife tower Makati, Teleperformance Makati,
Telus International Philippines and Convergys Makati, companies that accommodated the
researchers, were used as the locale

C. Sampling Design
The method used in the study is Purposive sampling. Etikan et.al. (2016) stated that purposive
sampling deals with the need of the researcher even without underlying theories behind it. The
researchers chose call center agents, specifically in BPOs in Makati. First the researchers identified
the different BPO in Makati. The researchers decided to survey a total of 400 call center agents
working in different BPO companies, but with several uncontrolled circumstances, the number of
survey questionnaires was decreased to 334.

D. Instrumentation
Questionnaires were gathered by the researchers for the mentioned studies, which was validated by
Lezzie F. Baes M.D. and Pinky Marie Nilo R.N. from Lyceum of the Philippines University-Manila.
Questions were about the level of knowledge and attitude towards diabetes. It is composed of 57
total items and are all in Likert scale. The first part of the questionnaire is the demographics,
consisting the respondent’s gender, age, civil status, years rendered in the BPO industry, daily work
hours and employment status. The first part of the questionnaire is about the level of knowledge,
consisting 24 items with a score range of 1 (Yes), 1 (No), and 0 (I don’t know), adapted from Garcia A.
A., Villagomez, E.T., et al (2001)
On the other hand, the next part of the questionnaire is about the attitude towards diabetes
consisting 33 questions with scores ranging 5 (Strongly agree), 4 (Agree), 3 (Neutral), 2 (Disagree), 1
(Strongly disagree) from Evans (2019).

E. Data Gathering Procedure

The researchers called different BPO companies located in Makati and sent a letter to conduct a
thesis survey. Upon approval, the researchers went on with their study. They visited offices located
in Makati, with the help and assistance of their family and teachers, the researchers were enable too
conduct the survey and had some conversation with some of the employees and head.

F. Statistical Treatment
The researchers used Pearson R Moment Correlation. According to David M. Lane (n.d.), it is a
process to measure the relationship between two variables. If the relationship is not linear, then it
does not sufficiently represent the strength of the relationship between the two variables. The study
use two main variables, specifically, the level of knowledge and attitude towards diabetes among
selected BPO companies in Makati. The researchers will analyze the data gathered and identify if
there is a significant relationship between the mentioned subjects.
There are four sections in the questionnaire: Section A: Demographic Profile · Section B: Level of
Knowledge · Section C: Diabetes Attitude Survey Section D: The Correlation.
In the questionnaire about the employee’s level of knowledge, there are only two answers that may
be considered as correct or wrong, yes or no. The scoring used for testing the level of knowledge of
the employees if there answer is correct is equivalent to 1, while 0 if it is wrong or if they answered I
don’t know. It was tallied by adding the sum of the scores of the respondents and through this the
researchers were able to determine the 5 most correct answers and the 5 most wrong answers from
them. This part of the test will determine if they have already enough knowledge about diabetes or
they lack knowledge about it.
The second part of the questionnaire is about the employee’s level of attitude towards diabetes,
wherein there is a flip scoring to further analyze their attitude about it since some of the questions
can be seen are tricky. Those questions with negative statements had a reverse scoring. Instead of a
5 (Strongly agree), 4 (Agree), 3 (Neutral), 2 (Disagree), 1 (Strongly disagree), the least was
interchanged to score the highest, which will turn out to be 5 (Strongly Disagree), 4 (Disagree), 3
(Neutral), 2 (Agree), 1 (Strongly Agree), due to the reason that it gives the correct answer if the
respondent disagrees with the negative attitude indicated in the question. In order for the
researchers to know the question with the highest positive score of the respondents, they had
computed their scores and discovered the results by checking the weighted mean of it.
Table 1 interprets the level of knowledge based on numerical rating and its verbal interpretation;
while table 2 interprets the level of attitude with specific range and its verbal interpretation.

Table 1 Verbal Interpretation Based on Their Level of Knowledge

Table 2 Verbal Interpretation Based on Their Level of Attitude

III. RESULTS AND ANALYSIS
A. Demographic Profile
The researchers prepared four hundred survey questionnaires and only three hundred thirtyfour
(334) came back. There is a total of 186 (55.7%) female respondents and 148 (44.3%) male
respondents. Call center agents aged from 18 to 62 years old, with the majority being 25 as 36
(10.8%) respondents were at this age followed by 22 years old (9.3%) and 24 years old (8.4%). Two
hundred seventy (270) of the respondents were single, while twenty-six (26) are married. Two
hundred four (204) have worked for eight (8) hours a day, while one hundred five (105) answered
that they have nine (9) hours of working time. The respondent’s year in BPO industry ranges
between 1-3 years with a percentage of 14.7. Although there are also years that gain a lot of answers
the respondents’ answers varies from 1 year, 6 years and above. The employment status of each
respondents varies from contractual, probationary and regular. Two hundred sixty-four (264) are
regular workers, thirty-nine (39) are contractual and thirty-one (31) are still under probationary.

B. Level of Knowledge on Diabetes Milletus II

Call center agents working in Makati have “Approaching proficiency” level of knowledge when it
comes to diabetes. One hundred sixty-seven (167) of the respondents are on this level while eighty-
five (85) of them are on “Proficient” and sixty-two (62) on “Developing” level of knowledge. Only
fourteen (14) got in “Advance” level and only six (6) are identified as beginners when it comes to the
knowledge they have on diabetes.
Based on Table 3, question number 1 got the highest correct answer wherein two hundred ninety-
five (295) or 88.3% of call center agents answered it right. This shows that the respondents are
aware that one cause of diabetes is eating too much sugar or other sweet products. On the other
hand, the statement that got the lowest correct answer is “Shaking and Sweating are signs of high
blood sugar,” with 21.6% or seventy-two (72) of the respondents who got it right. This is concretized
by Eisenstat (2006), that diabetes mellitus is really a group of diseases, and that it is a general
knowledge that someone has diabetes if the level of sugar (glucose) in one’s bloodstream is
elevated. This happen when the body does not produce enough insulin, when the body does not
properly utilize the insulin it produces, or both. Diabetes is a disease that causes one’s blood sugar to
increase compare to the normal blood sugar level. It can be acquired through genetics and also
through unhealthy lifestyle (ADA, n.d.).
The p-value of .099 (p>0.05) shows that there is no significant difference in the level of knowledge on
diabetes among BPO employees in Makati based on their gender. Gender and Type 2 Diabetes is
closely related to one another. According to Diapedia (n.d.), women have higher prevalence towards
diabetes compared to men. This learning lead to another study that is contradictory to the previous
research which proves that sedentary life making it one of the risk factors for diabetes despite the
gender of a person. It is said that there is no sex differences in risk factors for diabetes, as observed
from those who had lost body weight (Perreault.et.al, 2008). Body weight yields a great reduction in
risk factors for both men and women.
The p-value of .041 (p<0.05) shows that there is a significant difference in the level of knowledge on
diabetes among BPO employees in Makati based on their age. This supports the statement of
Diabetes UK (n.d.) that age is a factor of why diabetes can have a great effect to the risks of
diabetes. It also added that the higher the age the risky it becomes on becoming directly
proportional to it. A person who is white and aged over 40 is at higher risk while an African –
Caribbean , Black African, or South Asian over 25 will be at higher risk ( Heart Matters, 2019)
The p-value of .737 (p>0.05) shows that there is no significant difference in the level of knowledge on
diabetes among BPO employees in Makati based on their civil status. In a study conducted by
Rashedi et. al (2017) on the relation of Type 2 Diabetes Mellitus with gender, education and marital
status in an Iranian urban population, it was fond out that with the use of binary logistic regression,
marital status and other subjects related to civil status were not significantly related to the risk of
acquiring Type 2 diabetes. Unfavorable changes in lifestyle practices, adiposity and diet are the main
factors that affects a relationship or civil status that makes a man or a woman acquire diabetes
(Rahmanian et.al, 2013).
The p-value of .241 (p>0.05) shows that there is no significant difference in the level of knowledge on
diabetes among BPO employees in Makati based on their daily work hours. Simmon (2007) attest to
this by stating in his article that learning is the best investment of our time that we can make.
Furthermore, Western research also shown the same idea that working long hours have detrimental
effect on health (Wu, et. al. 2019).
The p-value of .167 (p>0.05), this shows that there is no significant difference in the level of
knowledge on diabetes among BPO employees in Makati based on their years in BPO industry.
Rapaport (2018) supports this and stated that work hours had no influence with the risk of diabetes
in men, unlike to women who is more prone to diabetes by working for at least 45 hours a week.
63% of women are more likely to have diabetes than those who only work for 30 to 40 hours weekly.
Gilbert-Ouimet (2018) elaborated and stated that long work hours does not increase the risk of men
developing from diabetes.
The p-value of .058 (p>0.05) shows that there is no significant difference in the level of knowledge on
diabetes among BPO employees in Makati based on their employment status. According to American
Diabetes Association (n.d.), agreed and stated that diabetes has no connection and relation on an
individual’s ability to work and do a particular job and an employer himself might not even know if
one has diabetes while continually working. As of 2007, there is an estimated value of 23.6 million
Americans who have diabetes. Thus, it is stated that a person who may have type 1 or type 2
diabetes should still be qualified and eligible for any employment. (Disability Benefits Help, 2019).

Table 3 Respondents Knowledge based on Individual Item

C. Attitude Towards Diabetes Milletus II

The study reveals the attitude of call center agents who answered the survey got a “Moderately
Positive” with two hundred sixty (260) or 77.8 %.. While, neutral and extremely positive resulted to
13.2 % and 9.0 % respectively. This proves the journal written by M. Dhanya (2016) wherein she
states that people who have the lifestyle which is not healthy, can acquire diabetes. Thus, people
working in the BPO companies often have unhealthy lifestyle. Type 2 diabetes has several causes:
genetics and lifestyle are the most important ones. A combination of these factors can cause insulin
resistance, when your body doesn’t use insulin as well as it should. Genes do play a role in type 2
diabetes, but lifestyle choices are also important. (Leontis et. al. 2019)
It is notable in Table 4 statements with verbal interpretation of “Extremely Positive”. In statement #1
(Health care professionals who treat people with Diabetes should be trained to communicate well
with their patients) and statement #33 (Support from family and friends is important in dealing with
Diabetes.), the highest mean values of 4.65 and 4.63 respectively. The lowest mean value with the
verbal interpretation of ‘Neutral” refers to statement #2 (People who do not need to take insulin to
treat their Diabetes have a pretty mild disease.) and statement #26 (Tight control is too much work.)
each acquiring 2.50 and 2.58.
 Table 4 Respondents Knowledge based on Individual Item

D. Correlation Between Level of Knowledge and Attitude towards Diabetes Mellitus II

Using Chi-Square with p-value of .004 shows that there is a significant correlation between the level
of knowledge and the attitude towards diabetes, categorically, among selected BPO Employees in
Makati while after Using Pearson R at 0.05 level of significance with r-value of .270 shows that there
is a significant low positive correlation between the variables under study.
Health is wealth but when money talks, it speaks bills not wellness. Finally, level of education could
be a key determinant of knowledge of the disease and its transmission, as well as attitudes and
practices. The Department of Health cited a study at 2017, conducted by the International Labor
Organization Asia-Pacific: “Business Process Outsourcing in the Philippines: Challenges for
Decent Work” showing the concern of the government to the worsening health condition of the BPO
sector. This is because of the stress and environment they’re working at which they try to counteract
with their unhealthy lifestyle (Ubial., 2017). In a report done by the Manila Bulletin at 2017 they
state that because of the different risk factors that the BPO employee may have, the DOH will be
partnering with J&J in solving the health challenges of call center agents, which include their lifestyle.