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COLLEGE OF MEDICINE

LA CONSOLACION UNIVERSITY PHILIPPINES


BULIHAN, CITY OF MALOLOS,BULACAN,3000

Informed Consent Form

This Informed Consent Form has two parts:


• Part I: Information Sheet
• Part II: Consent Form

PART I: INFORMATION SHEET

Introduction
We are third-year medical students from La Consolacion University Philippines currently conducting
a study entitled “Perception of Filipino Physicians on Patients Seeking Online Health Information
regarding their Illness in Metro Manila and Bulacan: A Qualitative Case Study”. This study is in
lieu of the rampant use of the internet as a source of health information, this research is significant
among Filipino physicians for them to duly perform their duties and obligations as a doctor honed
with skills and knowledge that can keep up with the growing demands of the internet-dependent
population. The researchers also want this research to help Filipino medical students in their future
practice, especially when they interact with their prospective patients. Through this, we highly
encourage you to be part of our study.

Purpose of the Research


In this study, we want to know the perception of Filipino physicians on patients seeking online
health information regarding their illness. We believe that you can help us by telling us how you feel
in the practice. Our objectives are (1) to explore the underlying meaning of the physician’s
perception of their patient’s online health-seeking behavior, (2) to explain how do advance internet
researches affect the physicians' way of diagnosing and treating their patients (3) to elicit the
opinion of the physician's on how the internet affects the doctor-patient relationship.

Type of Research Intervention


This research will involve your participation in a one-hour interview. For validity and reliability, the
researchers will employ member checking to determine the accuracy of the qualitative findings
through taking final report back to participants.

Participant Selection
You are invited to take part in this research because we believe that your experience as a clinician can
contribute to our study. Also, you are fit for our criteria of participant selection of Filipino physicians
who are currently practicing and doing consultations with patients.

Voluntary Participation
Your participation in this research is entirely voluntary. It is your choice whether to participate or not
and we respect your decision. You may change your mind later and stop participating if you agreed
earlier.
Procedures
If you agreed to be part of our study, we will schedule the interview within August 25-September 12,
2020 with consideration of your availability. This will be thirty minutes to a one-hour interview via
ZOOM and we will be asking questions about your experience in the clinic.

Risks
There is a risk that you may share some personal or confidential information, or that you may feel
uncomfortable talking about some topics. However, we do not wish for this to happen. You do not have
to answer any question or take part in the discussion/interview if you feel the questions are too
personal or if talking about them makes you uncomfortable.

Benefits
In this study, there will be no direct benefit to you, but your participation will help us know more
about the perception of Filipino physicians about the online seeking behavior of their patients and this
can contribute to the field ok knowledge.

Confidentiality
We will not be sharing information about you to anyone outside of the research team. The information
that we collect from this research will be kept private. Any information about you will have a number
on it instead of your name. Only the researchers will know what your number is and we will lock that
information up. It will not be shared with or given to anyone.

Who to Contact?
If you have any questions, you can ask them now or later. If you wish to ask questions later, you may
contact the person indicated below.

Name: Mary Grace B. Mangahas


Contact No.: 09175252741
E-mail: mangahasmarygrace2@gmail.com

Ethics Review Committee Panel has approved the study, and maybe reached through the following
contact for information regarding rights of study participants, including grievances and complaints:

Dr. Maria Evangeline L. Paraan


Chair, LCUP- Research Ethics Committee

Location: Rm. 118, Mother Rita Bldg. La Consolacion University Philippines


Bulihan, City of Malolos, Bulacan, 3000

REC-Secretariat Contact Information: lcupgaddi.kaye18@gmail.com


PART II: CONSENT FORM

Consent Form

I voluntarily agree to participate in this research entitled


“Perception of Filipino Physicians on Patients Seeking Online Health Information
regarding their Illness in NCR and Bulacan: A Qualitative Case Study”. I agree to
participate now and withdraw anytime and refuse to answer questions without
consequences of any kind. The purpose of this study has been explained to me, and I had
the opportunity to ask about the study.

I understand that my participation involves answering the questions by the interviewer,


and I will be audio recorded throughout the interview. I appreciate that all the
information I provide for this study will be treated confidentially, and the report on the
results of this research and my identity will remain anonymous.

I understand that I am free to contact any of the people involved in the research to seek
further clarification and information.

By my signature, I acknowledge that I have read, understand, and agree to the policies and
procedures of the research.

Signature over printed name of the Participant Date

Conducted by:

Katrina B. Quibinit
Mary Grace B. Mangahas Researcher
Researcher
Faith B. Reyes
Ma. Lourdes B. Mangahas
Researcher
Researcher

Approved by:
Dr. Ma. Cristina E. Zulueta, MD, MSPH Dr. Maria Evangeline L. Paraan
Dean, College of Medicine Chair, LCUP- Research Ethics Committee

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