CHAPTER V

SUMMARY, FINDINGS, CONCLUSIONS, AND RECOMMENDATION

SUMMARY
SUMMARY

The main objective of the study was to provide information and knowledge regarding the

help-seeking behavior from respondents and to produce a basis that will contribute a lot to the

development of functional mental health mobile applications. Specifically, it determined the

level of knowledge about mental health, the level of mental health help-seeking behavior, and the

barriers to access to care of nursing students. It also measured the significant difference in the

level of knowledge about mental health applications and the help-seeking behavior in nursing

students in the Pamantasan ng Lungsod ng Maynila before and after using the mental health

application.

The study employs a multi-phase method research design to investigate the effects of a

mental health mobile application on nursing students' help-seeking behavior. In the initial phase,

a descriptive survey analysis is conducted to comprehensively identify and understand the

problems and concerns faced by nursing students when seeking professional help for mental

health issues. The second phase utilizes correlational design, focusing on examining the

relationship between the students' level of knowledge on mental health and their actual help-

seeking behaviors. Following this, the third phase involves the use of linear regression analysis

to assess the linear association between knowledge on mental health and help-seeking behaviors

among nursing students. The fourth and final phase focuses on the practical application,

encompassing the development of a mental health mobile application with features such as
relaxation exercises, mindfulness videos, and chat support. This application is subjected to a pre-

experimental pilot test, evaluating its effectiveness through pretest and post-test scores to discern

any significant differences in nursing students' mental health outcomes before and after utilizing

the mobile application. The comprehensive methodology aims to provide valuable insights into

the complex dynamics of mental health among nursing students and the potential efficacy of

digital interventions in addressing these concerns.

FINDINGS

1. Regarding the profile of the respondents,

1.1 The year level of the respondents that took 30% of the chosen population were from third-

year nursing students, while there is equally another 30% comprising fourth-year nursing

students. 2 respondents from the first year represented 20% of the population while similarly, an

additional 2 respondents from the second year constituted 20% of the population.

1.2 In terms of the gender ratio of the population, 80% of the respondents constituted female

nursing students, whereas 20% represented male nursing students.

1.3 The majority of the respondents amounting to 70% of the population disclosed having

previous experiences with mental health issues. Meanwhile, the remaining 30% reported having

no prior experiences concerning mental health issues.

1.4 For the geographic location of the nursing students’ respondents, all ten participants are

situated in an urban setting. 50% of these participants are located in Manila city, while 20% are

from Las Piñas. The remaining 3 participants live in different cities, each representing 10% of

the population: Taguig City, Caloocan City, and Pasay City.

1.5 Similarly, all of the participants, which is 100% of the population, disclosed that their

workload and stress levels are heavy.

 2. In phase 1, the qualitative part of this study where survey questionnaires containing open-

ended questions were utilized. The results of the first domain, which is the Level of

Knowledge about Mental Health of nursing students, are as follows:

2.1 The item that has the highest mean score of 5.8 (SD = 0.919) is item number 2 (When you

hear about mental health, what is the first thing that comes to your mind?). Concerning the level

of knowledge about mental health, this value interprets to a medium level of knowledge.

2.2 The item that scored second highest, with a mean score of 5.6 (SD = 1.075), is item number 1

(How would you define mental health in your own words?). Similar to the interpretation of item

number 2, this value translates to a medium level of knowledge regarding mental health.

2.3 The questions that have the lowest mean scores of only 4.7 (SD = 1.767) are item number 6

(How often is mental health talked about in your day-to-day life in general?) and item number 7

(What are some of the steps individuals can take to maintain good mental health and prevent

mental health issues?). Both items interpret a low to medium level of knowledge.

2.4 The overall value of the mean scores totaled 5.2 (SD = 1.651) which translates to the

participants having a medium level of knowledge about mental health.

3. Following the first domain of the qualitative part of the study, the results of domain 2,

which is the Level of Mental Health Help-Seeking Behaviors of nursing students, are as

follows:

3.1 The item that scored the highest mean of 6.9 (SD = 2.234) is item number 8 (In the future,

would you be willing to seek help or support for mental health concerns if needed? Why or why

not?). This value interprets the participants sometimes seeking help.

3.2 The item that scored second highest with a mean of 5.9 (SD = 1.595) is item number 2 (Do

you prefer using self-help resources (e.g. books, or online articles) before seeking professional

help for mental health concerns? If so, where do you gather the information from?). Likewise,

the item that has the highest mean score, this value is interpreted as “sometimes seeks help”.

3.3 The lowest mean score of 3.8 (SD = 2.098) is from item number 4 (What are your thoughts

about how others might perceive you if they were to learn that you were seeking professional

care?), which interprets participants rarely seeking help.

3.4 The overall value of the mean scores amounted to 5.35 (SD = 1.989) which is equivalent to

the interpretation of “sometimes seeks help”

4. The Barriers to Access to Care Evaluation version 3 (BACE v3) is another questionnaire

additionally utilized to further comprehensively understand barriers that stop, delay, or

discourage help-seeking behaviors among individuals. Listed below are the results from

the nursing students’ participants.

4.1 The item that scored the highest mean of 2.67 (SD = 0.483) is item number 2 (Wanting to

solve the problem on my own.). This value interprets that the statement inhibits help-seeking

behavior quite a lot.

4.2 The item that has the second highest mean score of 2.5 (SD = 0.850) is item number 10 (Not

being able to afford the financial costs involved.) which is also interpreted as “quite a lot”.

4.3 Alternately, the item that has the lowest mean score of 0.1 (SD = 0.316) is item number 20

(Having had previous bad experiences with professional care for mental health). This value

translates to “a little”.
4.4 The overall value of the mean scores amounted to 1.351 (SD = 1.023). This score equates to

the interpretation of “a little”.

5. In phase 2, the Mobile Mental Health Application Pre-test and Post-test Survey (MMHA-

PPS) was utilized. The comparison of the results from the pre-test and the post-test of

domain 1: Knowledge about Mental Health Applications are presented below.

5.1 The item that scored the highest mean of 3.4 (SD = 0.563) in the pre-test is item number 6

(An initial detailed tutorial on the usage of the mobile mental health application would be

helpful.). In the post-test, item number 15 (Interactive design and features in applications for

mental health make me feel involved.) has the highest mean score of 3.8 (SD = 0.430). Both

mean scores have an equivalent interpretation of “Agree”.

5.2 The item that scored second highest in the pre-test with a mean of 3.2 (SD = 0.461) is item

number 15 (Interactive design and features in applications for mental health make me feel

involved.). In comparison, the second highest mean scores of 3.7 in the post-test are items

number 1 (SD = 0.479) , 2 (SD = 0.466), 4 (SD = 0.450), 6 (SD = 0.606), and 10 (SD = 0.450).

Both mean scores of the pre-test and post-test equate to the interpretation “Agree”.

5.3 In contrast, the lowest mean score of 2.4 (SD = 0.850) in the pre-test is from item number 5

(There were no challenges encountered while using a mental health application.). In the post-test,

the item that scored the lowest mean of 3.4 (SD = 0.490) is item number 8 (The mobile mental

health application was what I expected it to be.). The lowest mean from the pre-test translates to

“Disagree” while the lowest mean from the post-test translates to “Agree”.
5.4 The overall score of the mean of the pre-test amounted to 2.87 (SD = 0.724) whereas the

overall mean score of the post-test totaled 3.61 (SD = 0.492). The result of the pre-test is

equivalent to “Disagree” whilst the value of the post-test translates to “Agree”.

6. The comparison of the results from the pre-test and the post-test of domain 2: Help-

Seeking Behavior are listed below.

6.1 The items that scored the highest in the pre-test with a mean of 2.9 are item number 8 (I

believe that using mobile mental applications will improve my lifestyle and mental state.) with a

standard deviation of 0.759, and item number 11 (I find mental health applications encouraging.)

with a standard deviation of 0.662. On the other hand, the highest mean score of 3.7 (SD =

0.450) in the post-test is from item number 11 (I find mental health applications encouraging.).

The interpretation of the value of the pre-test translates to “Disagree”, whereas the interpretation

of the post-test is “Agree”.

6.2 The items that scored second highest in the pre-test with a mean of 2.8 are items number 4

(SD = 0.805), 5 (SD = 0.568), 6 (SD = 0.648), and 10 (SD = 0.747). Moreover, the second

highest mean score of 3.6 in the post-test is item number 10 (Using this mobile mental health

application made me feel calm.) with a standard deviation of 0.504, and item number 15 (I get

emotional support whenever I use mental health applications) with a standard deviation of 0.679.

The equivalent interpretation for the second highest mean value of the pre-test is “Disagree”

while the post-test interpretation translates to “Agree”.

6.3 The lowest mean score of 1.8 (SD = 0.950) in the pre-test is from item number 1 (I am

currently using a mental health mobile application.). For the post-test, the lowest mean score of 3

(SD = 0.718) is from item number 3 (I see myself using a mental health application daily.). The
lowest value of the pre-test equates to “Strongly Disagree” while in contrast, the lowest value of

the post-test translates to “Agree.”

6.4 The overall mean score of the pre-test is 2.61 (SD = 0.760) whereas the post-test has an

overall mean score of 3.41 (SD = 0.605). In contrast to the interpretation of both, the result of

the pre-test translates as “Disagree” and the post-test is translated as “Agree”.

7. Pearson Correlation Coefficient was used to assess the strength and direction of the

association between Nursing Students' Level of Knowledge and Mental Health Help

Health-Seeking Behavior

7.1 There’s a strong correlation between Nursing Students' Level of Knowledge and Mental

Health Help-Seeking Behavior, the result lying between the range 0.5 and 1.0

7.2 10 people responded to the questions about their level of knowledge and mental health help-

seeking behaviors. The means of the two variables were then found to determine the coefficient

correlation using Pearson’s r, which r = 0.71

7.3 Compared to critical r, a specific type of t-test was chosen, which assisted the researchers in

determining the importance in either direction. The variables are, df = 8, ɑ = 0.05 these implies

that the critical value is 0.632.

7.4 When the estimated r is compared to the value of Pearson’s r, where r = 0.71 and critical

value = 0.632, the calculated r is greater than the critical value, indicating that the Ho is rejected.

This implies that there’s a significance between level of knowledge and mental health help

seeking behavior.
 8. In phase 3, linear regression analysis was utilized to test the significant linear regression

between mental health to mental health seeking behavior.

8.1 There is a statistically significant positive and linear relationship between the level of

knowledge about mental health and help-seeking behavior among Nursing students at PLM.

8.2 Regression equation determines y = 0.9663x + 8.6517, where y is help-seeking behavior and

x is level of knowledge. For each unit increase in knowledge, help-seeking behavior increases by

0.189 to 1.744 points. R-squared of .507 suggests that level of knowledge can predict 50.7% of

the variance in help-seeking behavior.

8.3 The p-value (< 0.001) is statistically significant at the 0.05 alpha level. This means there is

strong evidence to reject the null hypothesis of no correlation between the two variables.

9. In phase 4, Mann-Whitney U Test was utilized to examine variations between two data

sets' medians.

9.1 There was a statistically significant difference in the pre-test scores between domain groups

one and two (U= 49.500, p= 0.009). This suggests that the two groups initially had different

perspectives and knowledge levels regarding mental health mobile applications.

9.2 While the post-test U score (71.00) and p-value (0.085) technically did not reject the null

hypothesis, there was a trend towards higher scores compared to the pre-test. This indicates that

the mental health mobile application may have positively influenced the participants’ knowledge

and perspectives.
CONCLUSION

Quantitative

After analyzing and interpreting all the gathered data from the nursing students of Pamantasan ng

Lungsod ng Maynila, the researchers came to the following conclusions:

1. The respondents are mostly female.

2. Most of the respondents reported having previous experience with mental health

problems.

3. The respondents experienced heavy academic workloads and stress.

4. The respondents are mostly residing in Manila City.

5. The respondents are situated in urban geographic locations.

6. For domain 1, which measures one's level of knowledge about mental health applications,

item number 6 had the highest mean value. Meanwhile, item number 5 has the lowest

mean value.

7. For domain 2, which measure’s one’s help-seeking behavior, item number 8 and 11 have

the highest mean value while item number 1 has the lowest mean value.

8. For domain 1, item number 15 has the second highest mean value in terms of the level of

knowledge about mental health applications before the development of the mobile

application.

9. For domain 2, items number 4, 5, 6, and 10 have the second highest mean value in terms

of level of help-seeking behavior.

 10. After using the developed mental health application, item number 15 has the highest

mean value in terms of level of knowledge in mental health application while item

number 8 has the lowest mean value in domain 1.

11. After using the developed mental health application, item number 11 has the highest

mean value in terms of help-seeking behavior while item number 3 has the lowest mean

value.

12. After using the developed mental health application, items number 1, 2, 4, 6 and 10 have

the second highest mean value in terms of level of knowledge in mental health

application.

13. After using the developed mental health application, items number 10 and 15 have the

second highest mean value in terms of help-seeking behavior.

Qualitative

In conclusion, the majority of nursing students’ respondents had a medium level of

awareness regarding mental health, nevertheless, they all understood the concept or idea of it.

Nursing students commonly seek mental health assistance for a variety of reasons, as seen by

their level of help-seeking behavior. In addition, as evidenced by the evaluation barriers to access

to care (BACE), respondents face challenges associated with stigma an discrimination while

attempting to get mental health services.

Furthermore, interactive design and features in applications for mental health that make the

respondents involved and in which they find mental health applications encouraging showed

higher results after utilizing mental health applications. The higher assessment scores from using
the mental health application also indicated that the features of the application and the way the

respondents found it encouraging increased their knowledge about the mental health application

and their chances of seeking help using it. The mental health application lays the foundations for

expanding the knowledge of the targeted participants through different discussions of concepts,

which increases their mental health help-seeking behavior. Using a mental health application

enabled the participants to acquire reliable information about their mental health and ways of

managing stress and obtaining overall mental well-being. Acquiring a broad understanding of

mental health through the use of a mental health application that includes a lot of interactive

design and features on handling stress and getting emotional and mental support is more likely to

help the participants cope with mental health challenges.

RECOMMENDATION

Based on the accumulated findings and conclusion derived from the study, the researchers

recommend the following:

I. For Public Health Care Staff, who manages social media pages for Online Medical

Consultation. To include mental health applications in actively promoting awareness and

education about mental health. Use of several features such as having an automated bot

for managing stress and obtaining overall mental well-being.

II. For App Developers, seeking to integrate machine learning algorithms into their mobile

health apps to improve tailored user experiences, the study suggests that using machine

learning algorithms can greatly increase the efficacy and personalization of health apps.

The findings also show how machine learning-enhanced applications may help medical

professionals track patients' development and provide more individualized feedback.

Working together, developers and healthcare professionals can ensure that machine

learning models are efficient and appropriate.

III. For future researchers who will conduct an identical study, (Redoblado & Torres)

A. To perform a usability test with a larger group of students with varying age groups to be

able to further improve the application's design.

B. To make use of and incorporate newer features, user interfaces, and engagement

strategies based on evolving user preferences and technological capabilities.

C. To collaborate with mental health providers to further develop the contents of the

application while guaranteeing that they align with professional practices and principles.
D. To promote the integration of accessibility and inclusivity features, considering global

relevance and cultural sensitivity in the application’s design, making mental health

support more universally accessible.

E. To foster collaboration among researchers working on similar topics and create

opportunities for interdisciplinary collaboration, sharing resources, and combining

expertise for continuous innovation and improvement in addressing mental health needs

through technological interventions.