an investigation into consumer attitudes and perception towards self-medication in pakistan in...

An Investigation into

Consumer Attitudes and Perception towards

Self-Medication in Pakistan in light of the

Cultural Dimension of Uncertainty Avoidance

Submitted by

Khawaja Saleem Ahmed (1058138)

Fatima Haider (1058117)

Yousuf Zahid (1058156)

Asma Zuberi (1058108)

For the course Research Project

EMBA 66 (6)

Submitted to Faryal Salman on Thursday, February 14, 2013

Faculty of Management Sciences, SZABIST

Shaheed Zulfikar Ali Bhutto Institute of Science & Technology (SZABIST) – Karachi

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Table of Contents

Acknowledgement ........................................................................................................................................ 4

Abstract ......................................................................................................................................................... 5

1. INTRODUCTION ................................................................................................................................ 6

1.1 Background of the Study............................................................................................................... 6

1.2 Problem Statement .............................................................................................................................. 7

1.3 Research Gap ...................................................................................................................................... 8

1.4 Research Objectives ............................................................................................................................ 9

1.5 Research Questions ........................................................................................................................... 10

1.6 Theoretical Framework ..................................................................................................................... 11

1.7 Significance and Scope of the Study ................................................................................................. 12

1.8 Limitations of the Study .................................................................................................................... 13

2. LITERATURE REVIEW ................................................................................................................... 14

2.1 Self-Medication: Definition .............................................................................................................. 14

2.2 Self-Medication: Spread and Frequency ........................................................................................... 14

2.3 Self-Medication: Reasons and Ailments Treated .............................................................................. 15

2.4 Self-Medication: Consumer Behavior .............................................................................................. 15

2.5 Self-Medication: Effect of Population Spread, Income and Literacy ............................................... 16

2.6 Self-Medication: Perception of Risk ................................................................................................. 17

2.7 The National Cultural Dimensions of Hofstede ................................................................................ 18

2.8 Pakistan: The Cultural Dimension of Uncertainty Avoidance .......................................................... 19

2.9 Hofstede: Criticism ........................................................................................................................... 20

3. RESEARCH METHODOLOGY ........................................................................................................ 21

3.1 Research Design ................................................................................................................................ 21

3.1.1 Qualitative Research .................................................................................................................. 21

3.1.1.1 Focus Group ........................................................................................................................... 21

3.1.2 Quantitative Research ................................................................................................................ 23

3.1.2.1 Desk Research ......................................................................................................................... 23

3.1.2.2 Survey and Questionnaire Design ........................................................................................... 23

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3.2 Sampling Procedure and Design ....................................................................................................... 25

3.2.1 Sampling Frame ......................................................................................................................... 25

3.2.2 Sampling Size and Selection ...................................................................................................... 25

3.3 Field Work for the Survey ................................................................................................................ 27

3.4 Research Hypothesis ......................................................................................................................... 28

4. DATA ANALYSIS ............................................................................................................................. 29

4.1 Reliability Analysis ........................................................................................................................... 29

4.2 Instrument Validity ........................................................................................................................... 31

4.3 Demographics ................................................................................................................................... 32

4.3.1 Frequency Tables ....................................................................................................................... 32

4.3.2 Bar Charts .................................................................................................................................. 35

4.4 Behavioral Analysis .......................................................................................................................... 39

4.5 Confirmatory Factor Analysis ........................................................................................................... 41

4.6 Pearson’s Correlation Matrix ............................................................................................................ 45

4.7 Hypothesis Testing ............................................................................................................................ 46

5. CONCLUSION AND RECOMMENDATIONS .................................................................................... 49

5.1 Conclusion ........................................................................................................................................ 49

5.2 Recommendations ............................................................................................................................. 51

AREAS OF FURTHER STUDY ................................................................................................................ 52

BIBLIOGRAPHY ....................................................................................................................................... 53

APPENDIX ................................................................................................................................................. 57

a. Focus Group Guide ......................................................................................................................... 57

b. Survey Questionnaire ...................................................................................................................... 61

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Acknowledgement

The authors of the study express a sincere gratitude to Ms. Faryal Salman for providing guidance

throughout the semester and especially on the continuous improvement of data collection and its

compilation.

A profound appreciation also goes out to all our classmates who had been instrumental in

extending support in their respective organizations for collection of data through the survey

questionnaire.

Special thanks are conveyed to Mr. Asad Subzwari for taking out time and assisting the authors

during coding and data entry of the survey on the software of SPSS 17 and PASW Statistics 18.

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Abstract

The purpose of the research study is to investigate the perception and attitudes of consumers

towards self-medication in light of Hofstede’s cultural dimension of uncertainty avoidance. The

study had been conducted in Karachi and a sample size of 200 had been utilized for the purpose.

Analysis of data obtained from specially designed questionnaire had been fed into statistical

software to acquire descriptive statistics together with confirmatory factor loading and

correlation matrix analysis. The empirical findings showed that the consumers are risk averse

but will be willing to practice self-medication based upon the specific situation they may face in

life or due to operational variables which they may be exposed to at any given time e.g. cost of

medicine being too high or unavailability of time to wait at a doctor’s clinic. Additionally, the

consumer may engage into self-medication based upon good past experience or group influence.

Studies in Pakistan have been undertaken on self-medication but not in juxtaposition with any

cultural dimension. Future researches on different cultural dimensions of Hofstede vis-à-vis self-

medication and for other risk-taking and risk-averse behavior can be conducted in light of this

research.

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1. INTRODUCTION

1.1 Background of the Study

The people of Pakistan have been observed to take risks, knowingly and unknowingly, in

every walk of life. The authors in light of their everyday observation have seen countless

people take a risk while undertaking a specific action. These actions arise from an attitude

that the people have created due to a wide range of reasons. Without contemplating on the

reasons as to why people have developed such attitudes, consider the people who take risks

while riding motorcycles without helmets, violating traffic signals on the red light,

attempting to cheat in exams, swimming at the seaside without knowing how to swim,

talking on the cell phone while driving, making an expensive lease-based investment but

without a plan of how future payments will be made, providing children at home with

computer and internet facilities and then not keeping a check and control over their activities,

procrastinating at workplace despite being aware of work deadlines and visiting public places

during times of public unrest and turmoil.

The list of such activities in which an apparent risk-taking behavior is observed is endless but

then risk is a subjective term and what is considered to be a risk for one person may not be so

for another. This is where perceptions of people come into interplay.

The authors of the study have attempted to narrow the focus on the apparent risk-taking

behavior of people in the act of self-medication. Self-medication is not only common in

Pakistan but all over the world as well and it is practiced due to a large number of reasons;

reasons which encourage people to avoid consulting the physician. Regardless of the reasons,

it is a human behavior which requires to be studied in order to determine the factors which

play a role in developing perception and attitudes among people.

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1.2 Problem Statement

According to the cultural dimension of uncertainty avoidance put forth by Hofstede (geert-

hofstede.com), the people of Pakistan have been found as risk-averse and with a considerably

high uncertainty avoidance index. On the contrary, the act of self-medication as per common

knowledge and based upon general scientific evidence is a risk-taking behavior. This

contradiction is the essence of the problem because on one hand, Pakistanis refrain from

taking risks and on the other, indulge in treatment of ailments through self-medication

without seeking professional advice from doctors.

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1.3 Research Gap

The research conducted in Pakistan almost thirty years ago (Hofstede & Bond, 1984), had

established the basis of the society as high on uncertainty avoidance but the authors intend to

conduct a study because of some apparent gaps that have been identified in the research.

a) Has the society’s risking-taking attribute changed and evolved over the years?

b) Is the society still risk-averse and had the original research missed out key aspects

which had failed to show the larger picture?

c) Do other cultural dimensions of Hofstede influence or have started to influence the

uncertainty avoidance index of Pakistanis?

d) Is it just a perception or a fact that self-medication is dominantly practiced amongst

the educated people?

e) Is the consumer behavior of self-medication influenced by personality characteristics

of an individual and by formal/informal reference groups?

The research being undertaken will eventually benefit to understand and identify the hidden

reasons of this specific consumer behavior and bring to light possible other aspects besides

Hofstede’s theory when it comes to declaring the Pakistani society as high on uncertainty

avoidance.

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1.4 Research Objectives

The primary objective of the study is to learn how consumers develop perceptions and form

an attitude towards the act of self-medication and whether consumers take this risk willingly

or unknowingly. At the same time, the study will also assist in the determination and analysis

of reasons behind this act in contrast with the cultural dimension of uncertainty avoidance.

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1.5 Research Questions

The core research questions arising as a result from the research objectives and the research

gap are:

a) How do the people in Pakistan perceive risk when it comes to management of health

matters?

b) Despite being a risk-averse nation, why do the people in Pakistan practice self-

medication?

c) Which attributes contribute in forming an attitude towards the specific consumer

behavior of self-medication?

d) If and whether socio-economic factors play a role in motivating people to practice

self-medication?

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1.6 Theoretical Framework

The practice of self-medicating students has reached a significantly high percentage despite

the fact that the majority of students understand that self-medication practice is incorrect

(Zafar et al., 2008). This means that people take a risk even after knowing the fact that it is a

risk. This postulation has been clarified in the theoretical framework which incorporates the

research hypothesis in light of the uncertainty avoidance index and the different variables.

Figure 1. The theoretical framework

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1.7 Significance and Scope of the Study

The research study strives to identify reasons by means of which consumers develop an

inclination towards risk-averse or risk-taking behavior in the practice of self-medication

based upon the perceptions that are developed leading to attitude formation.

Findings of the study will possibly pave the way for managerial implications in terms of

identifying ways and means of implementing stringent pharmacy regulations, stabilizing the

cost of medicines and sustaining the quality of health care otherwise a strong probability

exists that consumers will continue to jeopardize individual and family health care through

self-medication practices. Subsequently, tactical measures by all concerned stake holders will

ensure that a larger strategy is formulated which also incorporates the aspect of imparting

awareness on self-medication towards the people.

In order to conduct the research, specific units have been considered and which constitute of

male and female adults hailing from different income groups and belonging to different age

segments. These units are students and working individuals both in terms of profession.

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1.8 Limitations of the Study

The study is restricted to the research of consumer behavior on self-medication only with a

focus on Karachi that represents the major urban areas of Pakistan. The drawn sample size is

however not sufficient as it may not represent the total population of the city and the other

principle urban hubs of the country.

The other cultural dimensions of Hofstede besides uncertainty avoidance have not been

considered and which may establish an-interplay among all the dimensions in order to

analyze consumer perception and attitude.

An element of bias may also exist in the replies received by the respondents due to individual

perception and attitude towards the personal subject of health care. Other factors that have

not been considered in the study include elements of religion and locus of control by means

of which people govern their lives in Pakistan. Personalities also play a role and which

motivates a person to develop an attitude and behave in a particular manner; this dimension

also has not been taken into consideration.

Based upon the lines of the study undertaken, additional in-depth research is required which

may bring to light hidden variables that act as trigger points when it comes to understanding

consumer behavior and the cultural dimensions of Pakistan.

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2. LITERATURE REVIEW

2.1 Self-Medication: Definition

The act treating an ailment either for diagnosis or prescription, by purchasing and consuming

medicines without consulting an authorized doctor is called self-medication (Montastruc et

al., 1997) The methods of self-medication are several and include purchase of drugs without

a doctor’s prescription, using old prescriptions to acquire medicines, consuming in-stock

medicines at home or workplace and exchanging, sharing and recommending drugs with

friends, family members and colleagues (Filho et al., 2004).

Self-medication is a widespread international occurrence and it has been around since ages

because human beings have a natural disposition to reduce and eradicate health related issues

with some medicine (Baig, 2012). Self-medication has been recognized at the highest level as

well and the World Health Organization has pronounced the act as one where a person,

during sickness will choose and consume a drug for self-treatment (WHO, 1998).

2.2 Self-Medication: Spread and Frequency

The impulsive use of medicines based upon self-conceived notions and through influencing

references has been a matter of all-round concern (Filho et al., 2004) Self-medication as an

act is spread all over the world and has considerably high rates of occurrence; up to 68% in

European countries (Bretagne et al., 2006). The developing countries have an even higher

rate (Shankar et al., 2002); up to 92% in Kuwait (Abahussain et al., 2005). India has 31%

(Deshpande & Tiwari, 1997) whereas Nepal has a prevalence rate of 59% (Shankar et al.,

2002). In Pakistan, however, just a few undertakings have come to light which elucidate the

spread of self-medication but which have nonetheless confirmed a high rate of 51% spread in

the country (Haider & Thaver, 1995).

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2.3 Self-Medication: Reasons and Ailments Treated

In a research that had been undertaken among Karachi-based university students, it was

discovered that up to 76% students have engaged in the act of self-medication (Zafar et al.,

2007). The study disclosed a number of reasons based upon which students self-medicate;

most notable among which were the past experience of respondents with similar health

indications (50.1%) and the perception itself of the petty nature of the problem (48.3%).

Ailments for which the students practiced self-medication included headaches (72.4%), fever

(55.2%) and common cold (65.5%). Accordingly, the respondents consumed medicines for

relief and which fell into the category of painkillers (88.3%), fever relieving medicines

(65.1%), anti-allergics (44.1%) and antibiotics (35.2%). These drugs had been mostly

purchased from pharmacies (64.6%) or/and consumed from available medicines stored at

home (64.4%) or acquired from class mates and friends (9.7%). It had also been reported in

the study that more than one-third (43.3%) students who had approached a physician had

later modified the dosage of the prescribed medicine on their own accord.

2.4 Self-Medication: Consumer Behavior

Self-medication is practiced by students in all academic disciplines and its commonness is

more or less equal among medical and non-medical students (Zafar et al., 2007).

Traditionally, it is assumed that non-medical students do not engage in the practice of self-

medication in comparison with medical students due to the possession of limited knowledge

of medicines but the research findings proved otherwise. In contrast, another research shows

an exceptionally higher rate of self-medication among medical students and professionals

(James et al, 2006).

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A study that had been carried out on women and specifically mothers in Pakistan brought to

light that positive past experience (61.3%) with drugs had been the primary reason for self-

medication (Haider & Thaver, 1995) Such consumer attitudes are developed through

perception that is reinforced by gaining good experience through repeated acts of self-

medication but it is negative in outlook and identifies that people, despite being educated

remain ignorant of possible problems that may arise through self-medication.

2.5 Self-Medication: Effect of Population Spread, Income and Literacy

Self-medication in Pakistan is practiced more in the urban as compared to rural areas and that

its prevalence ratio goes up with the gradual increase in literacy levels (Baig, 2012). The

households in urban and rural areas together constitute 64.2% in terms of presence of

contemporary medicines at home with urban household leading within the percentage

(Hussain et al., 2011).

Results from a research puts skilled labor over unskilled labor (by 21%) when it comes to

practicing self-medication (Baig, 2012). The research also showed that respondents (76.6%)

earning a monthly income of above Rs. 10,000 self-medicated more than those (57.2%) with

a monthly income of less than Rs. 10,000 per month.

Another study presented interesting facts which proved the common knowledge that illiterate

people abide by basic rules more than literate people; rules that govern specific situations in

life. The results of the study revealed that literate people have a greater tendency to self-

medicate in comparison with illiterates (Klemenc-Ketis et al., 2010; Henry et al., 2006).

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2.6 Self-Medication: Perception of Risk

A research study discovered that in Pakistan, a very low proportion of university students

consult a physician for ailments and that the reason for not consulting a doctor includes a

number of factors besides the issue of cost of treatment. The study shows that the risk and

hazard perception of the students towards self-medication is considered as inconsequential

(Mumtaz et al., 2006).

According to the Australian Council for Safety and Quality in Health Care, the specific

consumer behavior of borrowing and sharing of medicines prescribed by physicians is

recognized as a risk factor by the health and medical field stakeholders exclusively in

medication errors which subsequently result in adverse drug events (Runciman et al., 2003).

This specific patient behavior negatively affects the quality use of medicine (Bolton et al.,

2002) and that there is a risk of underestimating the impact of this behavior on the incidence

of adverse drug events which include drug-drug interactions, poisoning and the development

of antibiotic resistant strains of pathogens (Ellis, 2009).

In another study conducted at two medical and two non-medical universities, it was

discovered that the frequency of self-medication had been as high as 76 percent (Zafar et al.,

2008). Within the research it had been noted that 87.4% of the respondents were aware of the

risks to health through self-medication. The respondents had accepted the fact that self-

medication is harmful and this shows the aspect of absence of knowledge. A similar result

had also come to light in a research carried out in Turkey where it was found out, that despite

majority of the students (89%) understood the reason of consulting a doctor before

consuming antibiotics, 45% nonetheless continued the practice of self-medication (Buke et

al., 2005).

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2.7 The National Cultural Dimensions of Hofstede

Despite being common in all segments of society, the factors which encourage a person to

indulge in self-medication are still not clear and the risks arising from this practice continue

to bring forth serious dangers to health (Baig, 2012). The awareness of health and its

management in contemporary times by ordinary people is a result of the difference between

culture and language, and the socioeconomic ranks together with the capacity of a person to

comprehend and act on a doctor’s advice which depends upon cultural beliefs on the broad

subject of health (Shaw et al., 2008).

In a study conducted in United States of America, it was found that African-Americans

consume medicines for symptoms like headaches, nosebleeds and hallucinations by taking

decisions based upon culturally-informed experiences (Schoenberg and Drew, 2002). There

is a definite influence of cultural dimensions on the behavior of a person at the time of an

illness and upon the subsequent consumption of drugs (Deschepper et al., 2008).

The scrutiny of differences in culture is carried out by a number of different models and from

which the most-well renowned is Hofstede’s National Cultural Dimensions. Hofstede defines

culture as “the collective programming of the mind that distinguishes the members of one

human group from another” (Hofstede & Bond, 1984). Based upon moderating variables

such as education, the following of people of each other will increase the possibilities of

perceiving the social environment and sharing of a subjective culture all from the same or a

similar window (Hofstede & Bond, 1984).

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2.8 Pakistan: The Cultural Dimension of Uncertainty Avoidance

Hofstede has labeled the people of Pakistan as risk averse in the cultural dimension of

uncertainty avoidance (geert-hofstede.com). With a score of 70, Pakistan is categorized as

high in uncertainty avoidance or where people have a high preference for avoiding

uncertainty. “It means that Pakistanis adhere to specific codes of belief; are intolerant of

unorthodox behavior and ideas; have an emotional need for rules; give importance to time;

have an urge to work hard; resist innovation at times; observe punctuality as a norm and

individual motivation is driven by security” (geert-hofstede.com). In other words, on the

uncertainty avoidance index, the people of Pakistan feel threatened by unknown, ambiguous,

uncertain or unstructured situations.

According to Hofstede, the people in Pakistan possess an emotional need for rules even if

these rules do not seem to work (geert-hofstede.com). On the other hand, rules and

regulations exist in Pakistan to govern the functioning of a pharmacy but in Karachi alone, all

kinds of drugs are available at a chemist without prescription. This fact proves Hofstede’s

point but the medicines at these pharmacies are being sold because there are customers who

will purchase them. It is a two-way intentional violation of the governing rule for a pharmacy

to function (Strum et al., 1997).

However, in a study on the cultural diversity in Pakistan (Shah & Amjad, 2011), the results

showed that the Pakistani society by and large does not feel threatened by uncertainty,

unknown, ambiguous or unstructured situations. From the study, it is interesting to note that

the findings on uncertainty avoidance index are amidst terrorist attacks, political instability

and increasing stagflation in Pakistan, and calls for more research into this phenomenon

(Shah & Amjad, 2011).

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2.9 Hofstede: Criticism

Hofstede’s cultural dimensions have been criticized as not being a valid instrument to

determine cultural differences because of the almost thirty years that have lapsed since 1984

and the study is far too obsolete and could not be implemented in contemporary times of fast

evolving environment, convergence and globalization (Shariq et al., 2011). A number of

researchers have put forth compelling argument against Hofstede. The argument includes

Hofstede’s variables varying in sensitivity from one culture to another (Schwartz, 1999); the

original study by Hofstede had been based on an assessment of individuals and then applied

in large on the overall community, which skewed the results (Dorfman & Howell, 1988);

culture is not necessarily bounded by national borders therefore entire nations cannot be the

valid unit of analysis (McSweeney, 2000); Hofstede’s research had been conducted on the

data collected from one company in different countries and a the findings of one company in

each country could not be implemented on the entire nation to determine cultural dimensions.

(Graves, 1986; Olie, 1995);

Therefore, the purpose of this study is to learn how consumers develop perceptions and form

an attitude towards the act of self-medication and whether consumers take this risk willingly

or unknowingly. This study also undertakes to discover the behavior of consumers in

Pakistan; their level of awareness and the factors which trigger the specific act of self-

medication.

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3. RESEARCH METHODOLOGY

3.1 Research Design

The development of the study is based on applied research with an approach encompassing

cross-sectional and snap-shot research parameters.

Quantitative and qualitative research methodologies have been implemented in order to

explain the contradiction in actual consumer behavior towards the risk-bearing act of self-

medication and the risk-averse label suggested on the people of Pakistan in light of the

cultural dimension of uncertainty avoidance as formulated by Hofstede.

The research design for the study will subsequently assist in bringing forth an analysis that

will allow suggesting logical recommendations.

3.1.1 Qualitative Research

3.1.1.1 Focus Group

The focus group analysis had been designed and implemented in order to assess the

perception and attitude of the three identified respondent clusters viz., students, households

and corporate professionals.

A focus group is used as a tool to manage, conduct, write and record the feedback received

from a specific group of people who are selected as per pre-defined criteria. The focus group

participants are managed by a moderator who asks questions and probes deeper to obtain a

true understanding of the replies provided by the participants (Prince and Davies, 2001). For

the undertaken research, a focus group had been conducted to obtain a better understanding

of opinions and attitudes of consumer behavior towards the act of self-medication in light of

the underlying cultural dimension variable. The discussion guide for the focus group

consisted of unstructured questions according to the information needed to extract responses

through a conversation.

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The sample size for the focus group constituted of seven individuals and which represented

educated and different socio-economic classes specifically hailing from the clusters of

corporate sector, household and students. The overall age group was between 20-35 years

with average house hold income of Rs. 100,000 per month.

The major findings which came forth elucidated that the participants have practiced self-

medication due to five main reasons viz., (a.) time constraints (b.) avoiding the queue time at

a clinic/hospital (c.) non-accessibility to a qualified physician (d.) negligence of doctors in

terms of imparting service as per general perception (d.) non-availability of quality doctors at

the time when treatment of an ailment had been required.

According to participants’ perspective, self-medication is a risk towards health by which

various negative consequences can occur and which often leads to serious complications in

the form of side effects and even causing death.

The participants opined that factors exist which can motivate an individual to take a

calculated or blind risk in terms of self-medication and in life in general. These factors

interplay with an individual’s personality based upon aspects of recognition in society, a

powerful external locus of control and group influence. The participants also disclosed that

they will avoid an uncertain situation as and where logically possible.

The focus group findings disclosed that homogeneity in approach existed among the three

respondent clusters towards the act of self-medication. Accordingly, the outcome of the focus

group determined the constructs for the quantitative survey.

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3.1.2 Quantitative Research

3.1.2.1 Desk Research

Research in Pakistan has been undertaken in the past on self-medication but not in light of

the cultural dimension of uncertainty avoidance. With regard to the act of self-medication,

consumer behavior including consumer knowledge, perception and attitude has either not

been measured in depth or has been missed out altogether. A thorough study of different

literature has been conducted to develop an understanding of the consumer behavior in this

study and to ascertain if the Pakistani people are genuinely risk averse as declared by

Hofstede. Secondary data has been collected from different data bases of trustworthy and

genuine research journals of medicine, consumer behavior, psychology and sociology.

3.1.2.2 Survey and Questionnaire Design

In terms of applied research, a self-monitored questionnaire based survey has been deployed

in light of a cross-sectional study in Karachi.

The survey has been designed to measure the consumer perception and attitude in terms of

behavioral intention, uncertainty avoidance, perceived risk and risk aversive behavior

towards self-medication. The questionnaire has been designed to provide simplicity,

understandability and comprehensiveness for the respondent and for the ease in post survey

proceedings.

The structure of the statements in the survey had been supported by the likert scale had been

developed to determine the strength of opinion of the respondents. The scale had been

balanced in terms of favorable and unfavorable responses and was non-comparative in

nature.

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According to the conceptual model of the undertaken research, uncertainty avoidance serves

as the independent variable and the consumer attitude and behavior as the dependent

variables. The underlying operational elements of medicine cost, waiting time for treatment,

consumer’s awareness, external legal environment, consumer’s locus of control and

physician’s service quality shaped up the questionnaire statements and which also included

constructs to ascertain the influence of reference groups on consumer behavior.

In the questionnaire, specific constructs also carried the rank-order scale to measure ailments

most commonly treated through self-medication the situations which encourage a consumer

to opt for self-medication. The profile of the respondent had also been developed based upon

scales requesting for data pertaining to gender, age group, education, employment status and

household income.

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3.2 Sampling Procedure and Design

3.2.1 Sampling Frame

The focus group findings brought to light that there is no significant difference in opinion

among the three clusters of corporate, household and student representatives. Therefore, the

sample of respondents had been chosen from the corporate sector and university students.

Homogeneity within these clusters may exist but the respondent background within the

clusters will lead to heterogeneity due to diversity in income and age groups, corporate

position, marital status and gender.

For the respondents, the city of Karachi had been selected because of its universal influence

on other cities of Pakistan and thereby it would depict an appropriate representation of the

major urban areas.

3.2.2 Sampling Size and Selection

The sample size constituted of 200 educated respondents residing in different localities of

Karachi. The principle criterion for selecting the sample was based on probability of

stratified random sampling. This is type of sampling technique is where every individual has

an equal and known chance of being selected (Sekaran, 2000).

The respondents had been selected on a chance-basis from the population of those available

at the point of contact at the time of approach. At the private firms and university, the contact

persons had been advised to pre-qualify the respondents on behalf of the authors vis-à-vis

willingness of the respondents to participate neutrally in the survey and by considering the

ability of a respondent to comprehend the importance of the research survey and articulate

the replies accordingly.

26

The respondents from the students’ cluster had been approached in the BBA and MBA

programs of Shaheed Zulfiqar Ali Bhutto Institute of Science and Technology whereas the

working professionals (as respondents) had been approached in a number of private

companies which included MCB, HBL, Habib Metro, Bayer, Habib Public School, AKUH,

Multinet and Ibrahim Fibers.

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3.3 Field Work for the Survey

The authors of the study had approached the private firms in two teams by contacting the

resource individuals and obtaining necessary permission. It took 16 days from first contact

till the receipt of completed survey forms. Research quality had been assured by maintaining

a Chinese wall (wikipedia.org) during all communication to ensure that the element of bias is

kept at the lowest possible level.

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3.4 Research Hypothesis

The study puts forth specific hypothesis for empirical testing in light of the research

objectives and with the help of secondary data and insights from focus group.

Risk is perceived by self-medicating people in individual capacities and which leads the

people to be either risk-averse or risk-takers. As a result, the people may be high or low on

the uncertainty avoidance index which reflects on the specific (positive or negative) attitudes

that are developed and which will eventually initiate or avoid the consumer behavior towards

self-medication.

The following hypotheses were generated:

a. H0: The behavioral intention is significantly correlated to uncertainty avoidance

H1: The behavioral intention is not significantly correlated to uncertainty avoidance

b. H0: The behavioral intention is significantly correlated to perceived risk

H1: The behavioral intention is not significantly correlated to perceived risk

c. H0: The behavioral intention is significantly correlated to risk aversive behavior

H1: The behavioral intention is not significantly correlated to risk aversive behavior

d. H0: The uncertainty avoidance is significantly correlated to perceived risk

H1: The uncertainty avoidance is not significantly correlated to perceived risk

e. H0: The uncertainty avoidance is significantly correlated to risk aversive behavior

H1: Uncertainty avoidance is not significantly correlated to risk aversive behavior

f. H0: The perceived risk is significantly correlated to risk aversive behavior

H1: The perceived risk is not significantly correlated to risk aversive behavior

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4. DATA ANALYSIS

The data collected from field survey of the study had been analyzed by means of four

specific tests through SPSS 17 and PASW Statistics 18 software. The tests included the

reliability analysis, instrument validity, factor analysis and correlation matrix. Subsequently,

the hypothesis put forth will be concluded.

4.1 Reliability Analysis

The internal consistency of a test is expressed between 0 and 1 (Cronbach, 1951). The

internal consistency measures the statements under each of the variables with respect to

reliability i.e. if the constructs are reliable enough to measure what is intended to be

measured.

As the credibility estimate increases, the fraction of the test score which may be derived from

a mistake should decrease (Nunnally and Bernstein, 1994). The Cronbach is a measurement

of the credibility of a result and locates and assigns errors at specific respondent instead of on

the researcher (Tavakol and Dennick, 2011).

The four constructs of the research study presented acceptable reliability figures of 0.5 and

greater Cronbach’s alpha and depicted in the tables on the following page.

30

Behavioral Intention

Cronbach's Alpha Cronbach's Alpha Based on Standardized Items N of Items

.775 .775 12

Uncertainty Avoidance


.643 .646 5

Perceived Risk


.813 .818 5

Risk Aversive Behavior


.824 .825 7

31

4.2 Instrument Validity

The instrument for conducting research has to be checked for validity before implementation.

The questionnaire deployed for the research had been replicated from that administered on

self-medication with antibiotics from an international study (plosone.org). For the specific

requirement of the research, the authors customized the original questionnaire to

accommodate the four constructs of behavioral intention, uncertainty avoidance, perceived

risk and risk aversive behavior. These constructs cumulatively accentuate the different

research studies undertaken in Pakistan and internationally on self-medication, risk aversive

behavior, cultural dimension of uncertainty avoidance, and consumer behavior. Face validity

had also been acquired from course advisor to the extent that the said constructs and scales

will amicably fulfill the purpose of measuring the needful.

32

4.3 Demographics

The survey questionnaire constituted of items related to identify the basic demographic

structure of the respondents. Six basic demographic dimensions had been used in the survey

instrument, viz. (a) gender (b) marital status (c) age group (d) education (e) employment

status (f) household income.

4.3.1 Frequency Tables

Gender

Frequency Percent Valid Percent Cumulative Percent

Valid Male 132 66.0 66.0 66.0

Female 67 33.5 33.5 99.5

3 1 .5 .5 100.0

Total 200 100.0 100.0

Marital Status


Valid Single 135 67.5 67.5 67.5

Married 65 32.5 32.5 100.0

Total 200 100.0 100.0

33

Age Group


Valid 18-20 25 12.5 12.5 12.5

21-26 93 46.5 46.5 59.0

27-32 48 24.0 24.0 83.0

33-38 21 10.5 10.5 93.5

39-34 9 4.5 4.5 98.0

45-50 3 1.5 1.5 99.5

50-55 1 .5 .5 100.0

Total 200 100.0 100.0

Education


Valid undergraduate 37 18.5 18.5 18.5

Graduate 87 43.5 43.5 62.0

Post Graduate 76 38.0 38.0 100.0

Total 200 100.0 100.0

34

Employment Status


Valid employed 96 48.0 48.0 48.0

self employed 18 9.0 9.0 57.0

unemployed 85 42.5 42.5 99.5

5 1 .5 .5 100.0

Total 200 100.0 100.0

Household Income


Valid 0 5 2.5 2.5 2.5

Rs. 50k-74k 47 23.5 23.5 26.0

75k-99k 46 23.0 23.0 49.0

100k-124k 60 30.0 30.0 79.0

125k-149k 12 6.0 6.0 85.0

150k+ 30 15.0 15.0 100.0

Total 200 100.0 100.0

35

4.3.2 Bar Charts

38

4.3.3 Findings

The demographic results of the study presented 66% male and 33% female respondents and

out of the total sample size 67.5% were married and 32.5% single. Majority of the

respondents i.e. 46.5% hailed from the age group of 21-26 years, followed by 27-32 years

group at 24%. Age groups of 33-38 and up to 20 years old represented 10.5% and 12.5%

respectively. With regard to education, 43.5% respondents were graduates, 38% post-

graduates and 18.5% undergraduates. Nearly half the respondents were employed at 48%.

The unemployment percentage was 42.5% and the reason for this high ratio was the fact that

close to a hundred respondents had been students in their final semester. On the household

income front, diverse readings came to light. Most notable was the 15% representation from

the Rs. 150,000 plus income bracket. Rs. 50,000-74,000, Rs. 75,000-99,000 and Rs. 100,000-

124,000 per month household income groups were represented by 23.5%, 23% and 30%

respectively.

39

4.4 Behavioral Analysis

The research had also incorporated two specific items to identify the behavior of respondents

in terms of self-medication i.e. the situations under which they are motivated to self-

medicated and the ailments for which they engage into this practice.

The empirical findings brought to light that 19% of the respondents practice self-medication

in order to save the fee of a doctor. Another 21% self-medicate to avoid the waiting time at a

doctor’s clinic or a health-care facility. The lack of trust on the competency and quality of a

doctor constituted 10% whereas the most significant reason stood out as the easy of

availability of medicines at a chemist without having to show a doctor’s prescription at 29%.

A notable 21% of the respondents engage into self-medication because going over to the

doctor is considered as a hassle.

Legend: B1: Save doctor’s fee B2: Avoid waiting at the doctor’s clinic

B3: Lack of trust on doctor B4: Ease of availability of medicines

B5: Hassle going to the doctor

40

The other questions asked from respondents regarding the ailments for which they usually

self-medicate presented the fact that for perceived to-be minor ailments, self-medication

practice is high among consumers whereas for ailments which are perceived to be serious or

complex in nature, the practice of self-medication is considerably low.

The most common ailments for which consumers self-medicate include cold (18%),

headaches (13%), cough and sore throat (11% each), nasal congestion (10%) and ordinary

fever (9%).

For serious ailments, the percentages were low which show the behavioral trend that

consumers will prefer to visit a doctor. Lack of sleep, depression, nausea and diarrhea had

represented less than 10% each.

41

4.5 Confirmatory Factor Analysis

Reducing from a large to an achievable choice of factors is factor analysis (Zikmund, 2002).

In factor analysis, all variables are grouped together in order to display the capability of

individual items to depict a specific construct. For all the four constructs i.e. behavioral

intention, uncertainty avoidance, perceived risk and risk aversive behavior; factor analysis

had been conducted separately.

The Kaisr-Meyer-Olkin (KMO) measures the adequacy of the sample and presents an index

(between 0 and 1) of the proportion of variants among the variables that might be common

variant. A KMO close to 1.0 indicates a factor analysis and if it is less than 0.5 then it is not

appropriate (Dr. Komata). KMO identifies the specific item which has to be discarded in

factor loading.

The final solution had been constructed and based upon the criteria that each factor must

possess a minimum of three item loadings greater than 0.3 and that any item loading on more

than one factor subject to acquiring the final solution, will be placed only in the factor on

which it loads most highly.

Since the data is based upon perceptions therefore for the constructs of behavioral intention,

uncertainty avoidance, perceived risk and risk aversive behavior, the score of 0.3 as the

baseline against each variable of the construct has been considered. This has been done due

to the reason that perceptions cannot be accurate. A score of 0.5 on the other hand would

have been considered if the findings had been healthier.

The following tables present the communalities derived from factor analysis.

42

Behavioral Intention

Initial Extraction

If I am cured by a medicine through self-medication then I will not visit a doctor 1.000 .624

I take advice for self-medication from the chemist 1.000 .400

Based upon my past experience with medicines, I self-medicate on my own 1.000 .653

I use medicines based upon the references provided by my family and friends 1.000 .550

I favorably recommend medicines to family and friends which made me better 1.000 .605

I switch to another medicine on my own, if a doctor's prescription doesn't make me feel

better

1.000 .515

I switch to any economical medicine brand if the one prescribed by the doctor is expensive 1.000 .562

If I run-out of medicine prescribed by the doctor, I switch to another alternative medicine

available at home

1.000 .592

I switch to any other alternative medicine if side-effects are experienced from the doctor’s

prescribed medicine

1.000 .606

I discontinue using a medicine without consulting the doctor 1.000 .695

I discontinue using a medicine on my own after the symptoms disappear 1.000 .676

I discontinue using a medicine after it runs out 1.000 .578

Findings: For the construct of behavioral intention, twelve items had been loaded and all were

accepted. The KMO had been determined at 0.782 whereas the approximate chi-square came out

to be 658.054.

43

Uncertainty Avoidance

Initial Extraction

Through self-medication, the risk that I take is high 1.000 .603

There may be side-effects from the medicines I use through self-medication 1.000 .603

I may suffer harmful side-effects if I take an over/under dose of a medicine 1.000 .735

I may suffer from severe allergic reactions from the medicine I use through self-medication 1.000 .598

People practice self-medication because medicines are freely available (without

prescription)

1.000 .378

Findings: Five items were loaded for the construct of uncertainty avoidance and all had been

accepted. The KMO came out to be 0.678 and with a chi-square of 140,803 approximately.

Perceived Risk

Initial Extraction

I always read the medicine pack/label even if the medicine has been prescribed by the

doctor

1.000 .689

I always read the medicine information sheet (inside the pack) even if the medicine has

been prescribed by the doctor

1.000 .653

I always follow the doctor's instructions while taking medicine 1.000 .576

I always discontinue using medicine after consulting the doctor 1.000 .553

Rules and regulations should be strictly implemented so that chemists sell medicines only

through a doctor's prescription

1.000 .700

Findings: The perceived risk construct was loaded for a total number of five items and all of

them had been accepted. KMO was derived at 0.800 and the approximate chi-square was

344.999.

44

Risk Aversive Behavior

Initial Extraction

I ensure that I always take medicines that are prescribed by the doctor 1.000 .500

When I take a medicine, I ensure that no health risks are involved 1.000 .608

I don’t want to be unsure about the medicines I take 1.000 .388

I would be rather safe than sorry 1.000 .466

I only change medicine if my doctor tells me to do so 1.000 .582

I always take the exact dosage of medicine as prescribed by the doctor 1.000 .492

I always check the expiry date on medicine before consuming them 1.000 .395

Findings: The construct of risk aversive behavior had a total of seven items that had been loaded

and all were accepted. Accordingly, the KMO came out to be 0.823 and with an approximate

chi-square of 439.382.

45

4.6 Pearson’s Correlation Matrix

The correlation matrix of Pearson has been used to identify the correlation between no less

than continuous factors. The worth of the correlation may fall between 0.00 (i.e. no

correlation) and 1.00 (i.e. absolute best correlation). The different components corresponding

to team size should resolve whether or not the correlation is important. In most cases,

however, correlations about 0.8 are thought to be high.

Descriptive Statistics

Mean Std. Deviation N

Behavioral Intention 2.8858 .65836 200

Uncertainty Avoidance 3.3890 .79652 200

Perceived Risk 3.4270 .87962 200

Risk Aversive Behavior 3.7136 .73327 200

Correlations

Behavioral

Intention

Uncertainty

Avoidance

Perceived

Risk

Risk

Aversive

Behavior

Behavioral

Intention

Pearson Correlation 1

Sig. (2-tailed)

N 200

Uncertainty

Avoidance

Pearson Correlation -.233** 1

Sig. (2-tailed) .001

N 200 200

Perceived Risk Pearson Correlation -.269** .282

** 1

Sig. (2-tailed) .000 .000

N 200 200 200

Risk Aversive

Behavior

Pearson Correlation -.213** .443

** .418

** 1

Sig. (2-tailed) .002 .000 .000

N 200 200 200 200

**. Correlation is significant at the 0.01 level (2-tailed).

46

4.7 Hypothesis Testing

In light of Pearson’s Correlation Matrix, the hypothesis could now be concluded.

a. H0: The behavioral intention is significantly correlated to uncertainty avoidance

H1: The behavioral intention is not significantly correlated to uncertainty avoidance

Null hypothesis is accepted and believed that the two variables have some association in

the population. The two variables are correlated significantly and correlate together due

to the negative finding (-0.233). It is believed that the consumer behavior towards self-

medication is triggered with the uncertainty avoidance index. The consumer with a high

uncertainty avoidance index will act in a safe manner and not take the risk to engage into

self-medication and had the uncertainty avoidance been low then the consumer’s

behavior would have been more towards a risk-taking attitude. As a situational need of a

person comes to light it may diminish the high uncertainty avoidance index and the

consumer will likely to be engaged in self-medication.

b. H0: The behavioral intention is significantly correlated to perceived risk

H1: The behavioral intention is not significantly correlated to perceived risk


the population. The two variables are correlated significantly and negative in its empirical

outcome (-0.269). It is believed that the consumer will act depending upon how risk is

perceived. How a consumer perceives risk and whether it leads to a risk-taking or risk-

aversive behavior towards self-medication are linked together. Risk perception of a

consumer could be either experiential or influenced by a group reference thereby

increasing or decreasing the confidence and motivation to engage or refrain from self-

medication.

47

c. H0: The behavioral intention is significantly correlated to risk aversive behavior

H1: The behavioral intention is not significantly correlated to risk aversive behavior


the population. The two variables are correlated significantly but are negative in nature (-

0.213). It is believed that the intent of a consumer to behave towards self-medication is

directly linked with the risk aversive behavior. A consumer will refrain from taking risk

if the perception has been developed to avoid risk unless a specific situation arises which

demands a person to practice self-medication. This situation may also be influenced upon

a person.

d. H0: The uncertainty avoidance is significantly correlated to perceived risk

H1: The uncertainty avoidance is not significantly correlated to perceived risk


the population. The two variables are correlated significantly. It is believed that with high

perception of risk, the uncertainty avoidance index of consumers will also remain high

and vice versa that is if the consumer perceives that there is no risk in the act of self-

medication then a low uncertainty avoidance index will be observed. This correlation acts

inversely due to its positivity (0.282) and therefore the perception of risk will vary on the

risk-aversive and risk-taking continuum.

48

e. H0: The uncertainty avoidance is significantly correlated to risk aversive behavior

H1: Uncertainty avoidance is not significantly correlated to risk aversive behavior


the population. The two variables are correlated significantly but the finding is positive in

nature (0.443) and therefore as uncertainty goes up or down, the risk-aversive behavior

increases or decreases accordingly. It is believed that consumers at the time of being risk

aversive towards self-medication display a high uncertainty avoidance index.

f. H0: The perceived risk is significantly correlated to risk aversive behavior

H1: The perceived risk is not significantly correlated to risk aversive behavior


the population. The two variables are correlated significantly but due to positive (0.418)

in nature they move inversely. Therefore the higher the perception of risk, the higher will

be the risk-aversive behavior and vice-versa. It is believed that consumers in accordance

with their perception of risk behave in a risk aversive manner when it comes to self-

medication. If the consumers perceive that there exists a risk then they will avoid the act

of self-medication.

49

5. CONCLUSION AND RECOMMENDATIONS

5.1 Conclusion

The basic purpose of this research study was to gauge the perception and attitude of

consumers towards self-medication in light of the cultural dimension of uncertainty

avoidance. In addition to this an investigation was made to discover the relationship between

the four survey constructs of behavioral intent, uncertainty avoidance, perceived risk and risk

aversive behavior.

In a nutshell, with regard to self-medication, the assertion put forth by Hofstede that Pakistanis are

risk-averse people due to a high index of uncertainty avoidance index is true. Regardless of the fact

that the act of self-medication is considered as a risk-taking behavior, the people operate their

behavior with a two-prong strategy. On one hand, as evident from the focus group finding

and acceptance of all null hypotheses, the people refrain from self-medicating because they

are aware of the risks attached; at the same time they also engage into the practice of self-

medication due to (1) they lack complete knowledge about adverse drug reactions and (2)

they justify their act by citing reasons which in their specific state of affairs holds true. Cost

of medicines, competency of doctors and long waiting queues all play a role independently

and together in motivating a person to self-medicate. This contradiction brings to light the

elements of locus of control which according to research studies in case of Pakistanis is

external (Shah & Amjad, 2011). The locus of control is also directly linked with the religious

beliefs of a person. (Shah & Amjad, 2011) This aspect however demands a separate study.

The demographic findings from the research bring to light the fact that educated people

earning average and above average income though are risk-averse but are inclined towards

self-medication as per situations which they face in their lives and that have been identified

above. This fact establishes the rationale that people with education, who are employed and

earning respectable income engage into this act (Klemenc-Ketis et al., 2010; Henry et al.,

2006). But the study could not acquire a respondent base from a lower socio-economic class

which could further justify that people from this group either do not self-medicate or do it

nominally because of their strong affinity towards rules and regulations (Klemenc-Ketis et

al., 2010; Henry et al., 2006).

50

From the literature that had been reviewed and the empirical findings it also came to light

that the consumers are aware of the risks attached with self-medication but they still pursue

the practice basically because of a positive past experience and the influence of credible

reference groups, both of which encourages them to consider the self-medication issue as too

petty. Additionally, the consumers do not perceive the act of self-medication itself to be one

that involves risk. At the same time, where Pakistan’s uncertainty avoidance index states that

people have an affinity towards rules and regulations then these same people at their own

free accord purchase all types of medicines from a pharmacy. That the government

regulations have not been implemented is one aspect but the consumers themselves have

totally disregarded the rule.

The universal fact remain that consumers develop a perception and then form an attitude

leading either towards the act of self-medication or refraining from it. The risk consumers

take towards self-medication is both willing and unknowingly. It’s a matter of how the risk is

perceived to be. The establishment of risk perception comes into action from operational

variables which surround a consumer e.g. lack of regulations, cost of medicine, unawareness

of the danger involved, competency of physicians, etc. Subsequently, the empirical findings

of the research also concluded and accepted the null hypotheses that had been derived

initially.

The risk-taking attribute of the society may have changed over the years if a general

observatory glance is given over the people but just as in selective ethics which a person may

practice, in a similar way, situation-based and experience-based risk-taking behavior is

displayed. Socio-economic factors play a role and so specific situations upon which a person

may not have any control; therefore attitude formation takes place and selective risk-aversive

behavior (e.g. in case of serious ailments such as diarrhea and sleeping disorder) and risk-

taking behavior (e.g. in case of minor ailments such as sore throat and cough) is witnessed.

51

5.2 Recommendations

The primary understanding is that self-medication is not in benefit of a consumer unless it is

an over-the-counter medicine like paracetamol which can be sold and purchased without the

prescription of a physician.

Things can be done to reduce self-medication in any country and it can also be done in third

world countries like Pakistan. Educate, is the number one thing which pharmaceutical

companies, the ministry of health and other stake holders need to plan and initiate. Another

solution could be the reduction in price of medicines and to revisit the overall health care cost

in Pakistan. Stringent implementation of pharmacy regulations is also long overdue.

Finally, in light of the logical criticism of Hofstede, consumer perception and attitude has to

be checked not only for different product and service categories, which can identify risk-

taking consumer behavior but also on the platform of social sciences and coupling it with all

the cultural dimensions of Hofstede and not only uncertainty avoidance. Only then, after

comparing multiple dimensions which a person is exposed to and experiences in life in

general, will the actual uncertainty avoidance index by identified.

52

AREAS OF FURTHER STUDY

At this time on an academic level, the authors have attempted to define the effects of

perception and attitude on consumer behavior towards self-medication. The unanswered

question of ‘why they do it’ could be comprehended in totality if the dimensions of locus of

control and religion are taken into account, both of which are strongly and deeply rooted in

the Pakistani society and serve as a bench mark towards countless deeds and acts by the

people from all walks of life. Additionally, all cultural dimensions put forth by Hofstede have

to be measured parallel and not only uncertainty avoidance because these dimensions possess

an interplay and based upon which consumers behave towards different objective and

subjective elements.

53

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57

APPENDIX

a. Focus Group Guide

Thank you for agreeing to participate. We are very interested to hear your valuable opinions.

The purpose of this study is to learn how consumers develop perceptions and form an attitude

towards the act of self-medication and whether consumers take this risk willingly or

unknowingly. We hope to learn about consumer behavior in Pakistan; their level of awareness

and the factors which trigger the specific act of self-medication.

The information you give us is completely confidential, and we will not associate your name with

anything you say in the focus group. We will ask participants to respect each other’s

confidentiality.

We would like to record the focus group so that we can make sure to capture the thoughts,

opinions, and ideas we hear from the group. No names will be attached to the focus group and

the audio file will be destroyed as soon as they are transcribed. You may refuse to answer any

question or withdraw from the study at anytime.

Please check the boxes below to the best of your knowledge and to show that you agree to

participate in this focus group.

Gender: Male Female Marital Status: Single Married

Age Group: 21-26 27-32 33-38 39-44 45-50 50-55 55+

Education: Intermediate Graduate Masters

Employment Status: Employed Self-Employed Unemployed

Household Income: Rs. 50,000-74,000 Rs. 75,000-99,000 Rs. 100,000-124,000

Rs. 125,000-149,000 Rs. 150,000 +

Family Members: ___ Adults ___ Children (up to 12 y.o) ___ Children (13-17 y.o)

58

The focus group session will last for 60 minutes approximately and during which you should feel

free to sit and walk, take notes or use the white board to express your thoughts.

Beginning the Focus Group Session

Welcome and introduce yourself and the note-taker, and send the Consent Form around to the

group.

Introducing the focus group with a review on:

a) Who we are and what we’re trying to do?

b) What will be done with this information?

c) Why we asked you to participate?

Explanation of the process.

Ask the group if anyone has participated in a focus group before. Explain that focus groups are

being used more and more often in consumer research.

About focus groups

a) We learn from you (positive and negative).

b) Not trying to achieve consensus, we’re gathering information.

c) No virtue in long lists: we’re looking for priorities.

d) The reason for this focus group is that we can get more in-depth information from a

smaller group of people. This allows us to develop the statements for the subsequent

survey questionnaire.

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Ground Rules

a) Everyone should participate.

b) Information provided in the focus group must be kept confidential.

c) Stay with the group and please don’t have side conversations.

d) Turn off cell phones.

e) Turn on Audio Recording

f) Ask the group if there are any questions before we get started, and address those

questions.

g) Participant Introductions (name, working where and as, born where, hobbies & family)

Discussion begins, make sure to give people time to think before answering the questions and

don’t move too quickly. Use the probes to make sure that all issues are addressed, but move on

when you feel you are starting to hear repetitive information.

Focus Group Questions

a) What are your thoughts about self-medication? (Your feelings and approach) Why and

how?

b) Which ailments do you think individual typically opt for self-medication?

c) Which drugs are usually brought for self-medication purpose?

d) Do you think it’s a risk or is it safe to self-medicate?

e) Why do people prefer self-medication? (if people are in the habit to do so)

f) Who’s opinion matters in using drugs?

g) How do you perceive risks in general, in your life?

h) Why do people take risks? (helmet, swimming, CNG, overhead bridge, smoking)

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Underlying variables:

a) Situation faced before self-medication

b) Ailment treated

c) Decision to do so – past experience and/or under influence

d) Medicines consumed

e) Cost

f) Time

Probes for Discussion:

a) Personal satisfaction

b) Ego, self-concept and confidence

c) Belief in your self

d) Belief in fate and destiny

e) Experiential perception

f) Family traditions

g) Knowledge based decisions

That concludes our focus group. Thank you for coming and sharing your thoughts and opinions

with us. If you believe that you have missed a certain point or fact which you wanted to share

then please note it down on the sheet provided so that it may assist in compilation of the

research.

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b. Survey Questionnaire

an investigation into consumer attitudes and perception towards self-medication in pakistan in...

Documents

research gap

research objectives

research questions

course research project

consumer attitudes

perception of risk

consumer behavior

fatima haider