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STRESS MANAGEMENT PERFORMED BY THE LEVEL III NURSING STUDENTS OF

NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY WITH REGARDS TO


THEIR CLINICAL DUTIES: BASIS FOR A PROPOSED
EFFECTIVE QUALITY NURSING CARE

An Undergraduate Thesis
Presented to
the Faculty of the College of Nursing
Nueva Ecija University of Science and Technology

In Partial Fulfillment of the


Requirements for the Subject
Research I

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By:

Danica Paula Bianca D. Castillo


Mark Anthony S. Castillo
Gerly P. Carrasco
Jayson A. Cardenas
Alona Joy G. Mandia

April 2009

APPROVAL SHEET

This thesis entitled “Stress Management Performed by the

Level III Nursing Students of Nueva Ecija University of Science

and Technology with regards to their Clinical Duties: Basis for

a Proposed Effective Quality Nursing Care” prepared and

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submitted by Danica Paula Bianca D. Castillo, Mark Anthony S.

Castillo, Gerly P. Carrasco, Jayson A. Cardenas and Alona Joy G.

Mandia in partial fulfillment of the requirements for the degree

of Bachelor of Science in Nursing has been examined for oral

examination.

ZENAIDA A. VILLARIAZA Ph.D

Adviser

Accepted and approved in partial fulfillment of the

requirements for the degree of Bachelor of Science in Nursing.

EPPIE D.C. BUGARIN RM, RN, MAN

Dean, College of Nursing

STRESS MANAGEMENT PERFORMED BY THE LEVEL III NURSING STUDENTS OF

NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY WITH REGARDS TO

THEIR CLINICAL DUTIES: BASIS FOR A PROPOSED EFFECTIVE QUALITY

NURSING CARE

THESIS ABSTRACT
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This study is all about the “Stress Management Performed by

the Level III Nursing Students with Regards to their Clinical

Duties: Basis for a Proposed Effective Quality Nursing Care”.

The descriptive method of research was utilized and the

questionnaire serves as the principal data gathering instrument.

There are 267 respondents who fill up the survey questionnaire.

The results of the questionnaire were tabulated and interpreted

from which the findings and conclusion were drawn.

Summary of the findings

The following are the summary of findings of the study

based from all the data presented, analyzed and interpreted in

chapter IV.

1. Majority of the respondents are in 19 years of age.

2. Majority of the respondents are female.

3. The researchers used sixteen (16) items to enumerate the

different stressors encountered by the level III nursing

students with regards to their clinical duties namely: Doing

bedside care to the patient with weighted mean equivalent to

3.60 was interpreted as “Often”; Finishing charting on time with

weighted mean equivalent to 3.89 was interpreted as “Often”;

Handling too many patients with weighted mean equivalent to 3.67

was interpreted as “Often”; Preparation and submission of

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requirements with weighted mean equivalent to 3.67 was

interpreted as “Often”; Patients with serious cases with

weighted mean equivalent to 3.62 was interpreted as “Often”;

Lack of hospital facilities and equipments with weighted mean

equivalent to 3.43 was interpreted as “Often”; Relationship

with the patients with weighted mean equivalent to 2.94 was

interpreted as “Sometimes”; Relationship with the co-students

with weighted mean equivalent to 3.01 was interpreted as

“Sometimes”; Relationship with the Clinical Instructor with

weighted mean equivalent to 2.97 was interpreted as “Sometimes”;

Relationship with the staff nurse with weighted mean equivalent

to 3.01 was interpreted as “Sometimes”; Relationship with the

physicians with weighted mean equivalent to 2.79 was interpreted

as “Sometimes”; Relationship with the patient’s family,

relatives and visitors with weighted mean equivalent to 2.99 was

interpreted as “Sometimes”; Recognition of some evident changes

concerning patient’s symptoms with weighted mean equivalent to

3.29 was interpreted as “Sometimes”; Mixed cases of patients due

to lack of rooms with weighted mean equivalent to 3.31 was

interpreted as “Sometimes”; Unfamiliar healthcare setting in the

hospital with weighted mean equivalent to 3.21 was interpreted

as “Sometimes”; And lastly wrong procedure performed to the

patients with a weighted mean equivalent to 3.01 was interpreted

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as “Sometimes” also with the total average mean of 3.28 was

interpreted as “Sometimes”.

4. The researchers used thirty (30) items to determine the

different stress management performed by the respondents with

regards to their clinical duties namely: Thinking positive and

being confident in whatever you do with weighted mean equivalent

to 4.23 was interpreted as “Always”; Taking time to rest and

relax with weighted mean equivalent to 3.78 was interpreted as

“Often”; Spending time with your love ones with weighted mean

equivalent to 3.84 was interpreted as “Often”; Praying to God

with weighted mean equivalent to 4.66 was interpreted as

“Always”; Watching movies and programs on television with

weighted mean equivalent to 3.71 was interpreted as “Often”;

Daydreaming with weighted mean equivalent to 2.98 was

interpreted as “Sometimes”; Listening to music, singing, and

dancing with weighted mean equivalent to 3.73 were interpreted

as “Often”; Enjoying pleasurable activities with weighted mean

equivalent to 3.31 was interpreted as “Sometimes”; Knowing your

limits and stick to them with weighted mean equivalent to 3.85

was interpreted as “Often”; Engaging into sports with weighted

mean equivalent to 3.31 was interpreted as “Sometimes”; Simply

stay at the corner of your room and crying with weighted mean

equivalent to 2.27 was interpreted as “Seldom”; Eating your

favorite foods with weighted mean equivalent to 3.88 was


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interpreted as “Often”; Using the internet and playing online

games with weighted mean equivalent to 3.89 was interpreted as

“Often”; Calling or texting your family members, relatives,

friends, etc... with weighted mean equivalent to 3.90 was

interpreted as “Often”; Making yourself busy by doing household

chores with weighted mean equivalent to 3.28 was interpreted as

“Sometimes”; Ignoring the problem with weighted mean equivalent

to 3.33 was interpreted as “Sometimes”; Getting angry and having

mood swings with weighted mean equivalent to 2.86 was

interpreted as “Sometimes”; Laughing at it with weighted mean

equivalent to 3.79 was interpreted as “Often”; Asking for

assistance to the Clinical Instructor with weighted mean

equivalent to 3.67 was interpreted as “Often”; Verbalization of

feelings to fellow students with weighted mean equivalent to

3.64 was interpreted as “Often” ;Reasoning out or answering back

with weighted mean equivalent to 3.29 were interpreted as

“Sometimes”; Taking it as a challenge with weighted mean

equivalent to 3.86 was interpreted as “Often”; Limiting your

contact to the source of stress with weighted mean equivalent to

3.42 was interpreted as “Often”; Cursing with weighted mean

equivalent to 2.67 was interpreted as “Sometimes”; Drinking

alcoholic beverages and smoking with weighted mean equivalent to

2.18 was interpreted as “Seldom”; Taking medication as a

reliever with weighted mean equivalent to 2.42 was interpreted


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as “Seldom”; Doing physical exercise with weighted mean

equivalent to 3.09 was interpreted as “Sometimes”; Accepting the

reality that sometimes it merely happens with weighted mean

equivalent to 3.81 was interpreted as “Often”; Sleeping with

weighted mean equivalent to 3.75 was interpreted as “Often”;

Managing your time better with weighted mean equivalent to 3.99

was interpreted as “Often”; With the total average mean of 3.48

was interpreted as “Often”.

Conclusions:

Based on the findings of the study, the researchers arrived

at the following conclusions:

1. That the level III nursing students consider “Finishing

charting on time” as the greatest stressors they have

encountered with regards to their clinical duties and the least

one is the relationship with the physicians. Meanwhile, the rest

of the stressors show that they can also affect the respondents

somehow.

2. That the level III nursing students consider praying to God

and thinking positive as the number one stress management they

usually performed when they feel stress. While simply staying at

the corner of the room and crying followed by drinking alcoholic

beverages and smoking does not play much role.

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3. The result of the study stands benefit to the nursing

practice in rendering effective quality nursing care. The

identification of the possible cause and effect of stressors on

the level III nursing students will provide them adequate

academic and clinical knowledge on stress. This study will serve

as a guide to them on how to manage their stress with regards to

their clinical duties. This will also provide information to the

Clinical Instructors, healthcare team in the hospital, and

school administrators on how they can help the students upon

dealing with stress properly in order for students to be

competent enough in different clinical area and to render

quality and effective nursing care to the patients.

Recommendations:

After the conclusions were drawn, the researchers of the

study hereby recommended that:

1. The students must develop not only their nursing skills but

also their ability on handling problems.

2. The students must learn how to rest and relax.

3. The students also need to develop their good working

relationship to others especially with the patients to avoid pro

4. Proper utilization of coping mechanism will help the

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nursing students to manage their stress and be competent enough

in different clinical area.

blems that lead to create stressor.

5. The Clinical Instructors must support their students all

the time to establish a harmonious and professional relationship

with them and guide them in rendering quality nursing care to

the patient.

6. Doctors and Clinical Instructors as well as the staff

nurses should be invited at times as a resource person during

ward class and case presentation to give them a sense of

recognition thereby improving good working relationship in the

clinical area.

7. The proper approach and continuous support of the staff

nurse and other healthcare provider must be present to help the

students cope and deal with the possible problems that they

might encounter in the clinical area.

8. Discussion for the most practical adaptation to prevent the

existence of excessive amount of stress in the individual should

be conducted and if found to be already existed, the most

possible activities should be given to decrease the strength of

stressors that could affect on physiological, psychological and

behavioral make up of the individual.

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9. The college of nursing should conduct seminar workshops and

trainings that will further develop the student ability and

capacity to cope up with stress.

10. The future junior nursing students must be properly

equipped with enough knowledge in nursing for them to become

confident. Hence, improper coping with stress will be lessened

and prevented.

11. Conducting another study using more variable and bigger

sample frame should be considered to arrive at a more

comprehensive and meaningful conclusion.

ACKNOWLEDGMENT

This work is an outcome of the writers’ struggles and

hardships for the completion of their college degree. This is to


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express the writers’ grateful appreciation to all the people

whose assistance helped them accomplish this study:

Sincerest and profound gratitude is extended to their

professor Zenaida A. Villariaza Ph. D. for her all out support

and for her unselfish dedication as an educator, persistence and

encouragement;

To Mrs. Maura Usita their critic, for providing direction

in writing the study and for painstakingly editing their

manuscript;

To the librarians of the Nueva Ecija University of Science

and Technology and Wesleyan University of the Philippines, for

their assistance and benevolent response on the researchers’

request to avail the rich resources in their library;

To the students who serve as their respondents, for their

willingness and cooperation during the conduct of this research;

To all their esteemed friends, brothers and sisters, for

their prayers and moments they have shared with the researchers

which are worthy to treasure and cherish;

To their most loving parents, for their love and care,

patience and undying support and aspirations to give the

researchers a brighter future; and

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Most and foremost, the researchers offer praises and

thanksgiving to our Almighty God, for lavishly equipping the

researchers with divine support and guidance, knowledge, and

skills.

The Researchers

DEDICATION

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With love and sincerity, this humble piece of work is

heartily dedicated to the people whose contribution is

significant in making this study a reality.

To our mentors, for the great effort they have exerted in

molding us to become well rounded and competent students of this

institution.

To our families, friends and fellow students, for their

cooperation for the completion of this work and for their moral

support which inspired us in making things possible and in

pursuing our ambition.

Above all, to Almighty God who continually showers His

infinite wisdom, blessings, and skills to the researchers.

Danica

Mark

Gerly

Jayson

Alona

TABLE OF CONTENTS
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CONTENTS PAGE

TITLE PAGE i
APPROVAL SHEET ii
THESIS ABSTRACT iii
ACKNOWLEDGEMENT xi
DEDICATION xiii
TABLE OF CONTENTS xiv
LIST OF TABLES xvi
LIST OF FIGURES xvi
CHAPTER I: PROBLEM AND ITS SETTINGS
Introduction …………………………………………………………………………………………………………1
Statement of the Problem …………………………………………………………………………5
Scope and Delimitation ………………………………………………………………………………6
Significance of the Study ………………………………………………………………………7
Definition of Terms ………………………………………………………………………………………9
CHAPTER II: THEORETICAL ORIENTATION
AND REVIEW OF RELATED LITERATURES AND STUDIES

Theoretical Orientation ……………………………………………………………………………11


Conceptual Framework ……………………………………………………………………………………12

Research Paradigm ……………………………………………………………………………………………13


Foreign Literature …………………………………………………………………………………………14
Local Literature ………………………………………………………………………………………………18
Foreign Studies …………………………………………………………………………………………………19
Local Studies ………………………………………………………………………………………………………20
Justification of the Studies ……………………………………………………………21

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CHAPTER III: RESEARCH METHODOLOGY
Method of Research …………………………………………………………………………………………22
Research Instruments ……………………………………………………………………………………23
Sources of Data …………………………………………………………………………………………………24
Statistical Treatment of Data ……………………………………………………………24
CHAPTER IV: PRESENTATION, ANALYSIS
AND INTERPRETATION OF DATA

Interpretation of the Study …………………………………………………………………27


CHAPTER V: SUMMARY, CONCLUSIONS AND RECOMMENDATIONS
Summary Findings ………………………………………………………………………………………………36
Conclusions ……………………………………………………………………………………………………………40
Recommendations …………………………………………………………………………………………………41
BIBLIOGRAPHY

APPENDICES

A. Sample Letter to the Dean


B. Sample Letter to the Level III Coordinator

C. Sample Letter to the Respondents


D. Sample Questionnaires
E. Table Presentations

CURRICULUM VITAE

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LIST OF TABLES
TABLE TITLE PAGE
1.1 Distribution of Respondents According to Age 27
1.2 Distribution of Respondents According to Gender 28
2 Stressors of Level III Nursing Students 29
3 Stress Management Performed By the Level III 31
Nursing Students
FIGURE
1 Research Paradigm 13

CHAPTER I
THE PROBLEM AND ITS SETTING

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Introduction
Throughout its distinguished history, nursing has had a

significant effect on people’s lives. As rapid change continuous

to transform the profession of nursing and healthcare delivery

system with which it is indicately linked, nurses embrace

broader opportunities to influence human well-being. Today,

nurses bring knowledge, leadership, spirit, and vital expertise

to expanding roles that afford increase participation,

responsibility, and rewards. However, nursing continuous to

evolve, underlying all is time-honored, fervent and profound

commitment to caring.

This profession requires academic and clinical training.

The clinical duties that the nursing students have to undergo

are an integral part of the course. Related Learning Experiences

(RLE) is required in the nursing curriculum. The RLE training is

necessary to all nursing students in order that their clinical

exposure becomes an in-depth experience, meaningful and early

appreciated when they are in actual hospital situation. Any

nursing student who does not undergo sufficient clinical duties

maybe considered ill prepared to undergo further hospital

training and may fail miserably in the major nursing course.

Every nursing student needs to be given sufficient duties

in the different hospital wards/ areas as well as in the

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different types of hospital services in order to broaden his/her

learning experiences while undergoing his or her RLE program. It

is in this respect where the clinical duties plays a vital role

in the development of proper skills, attitudes, and behavior

among nursing students so that when they graduate, take the

board examination and become professional nurses in the future

their conducts and work ethics will be greatly influenced by

what they have experienced during clinical duties.

As the nursing profession continuously emerges, there is

always a question on how a healthcare provider renders service

to humanity. Many things that someone is experiencing can give

rise to what kind of nurse he/she could be. As these nursing

students undergo clinical duties, they will meet some kinds of

stressors that produce discomfort and irritation conducive to

stress that if not given proper attention may affect their

learning experiences and their future professional practice

because stress interferes with learning. It is in this context

that the study is focused to help the nursing students identify

some stressors during their clinical duties and to recommend

possible solutions on how to manage this stress most importantly.

Stress is our body’s response to changes in our life. Since

life involves constant change (ranging from changing locations

from home to work each morning to adapting to major life changes

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like marriage, divorce, or death of a love one), there is no

avoiding stress. This is why our goal isn’t to eliminate all

stress, but to get rid of unnecessary stress, and effectively

manage the rest. Some common causes of stress that many nurses

are experiencing are increasing the severity of clients’

illnesses, adjusting to various work shifts, being expected to

assume responsibilities for which one is not prepared, and

inadequate support from supervisors and peers.

There are different types of stress that range from

Eustress, which is a positive and exciting form of stress, to

Chronic Stress, which has been linked to many serious health

issues, and is the type of negative stress most often mentioned

in the news. While we want to manage or eliminate the negative

types of stress, we also want to keep positive forms of stress

in our lives to help us remain vital and alive.

Stress affects us in different ways, not all of which are

negative. In fact, the stress of an exciting life can actually

serve as a good motivator and keep things interesting. However,

when stress levels get too intense, people will experience its

negative effect. Some of it are headaches, irritability and

‘fuzzy thinking’. These effects are evident that we’re under too

much stress. However, not everybody who is under stress will

experience these specific symptoms.

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We all feel overwhelmed from time to time; that is normal.

It is virtually impossible to eliminate times when events

conspire and the body’s stress response is triggered, but there

are ways that we can quickly reverse our body’s reaction to

stress, like buffering the damage to our health and keeping our

thinking clear so we can more deal effectively with what’s going

on in the moment.

It may seem that there is nothing we can do about our

stress level. However, we have a lot more control than we might

think. In fact, the simple realization that we are in control of

our life is the foundation of stress management.

Managing stress is all about taking charge of our thoughts,

our emotions, our schedule, our environment, and our problems.

The ultimate goal is a balanced life, with time for work,

relationships, relaxation, and fun – plus the resilience to hold

on under pressure and to meet challenges head on.

There are many ways to manage unhealthy stress in our life.

The key to stress reduction is identifying strategies that work

for us. As we begin to understand more about how stress affects

us, we will develop our own ideas to help relieve the tension.

Because each person is unique, some of these stress

management strategies will be more helpful for you than others,

and some will be new skills that require practice to be


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effective. Think about learning to ride a bicycle. There was a

time when this was a new skill and felt very unnatural and

awkward. You probably needed help at first but with some

coaching, practice, and stress management, cycling or any other

skill, becomes easier and more effective.

Statement of the Problem

This study was conducted to analyze the “Stress management

performed by the level III nursing students of Nueva Ecija

University of Science and Technology with Regards to their

Clinical Duties: Basis for a Proposed Effective Quality Nursing

Care”.

Specifically, this study aims to answer the following

questions:

1. How may the profile of the level III nursing students of

Nueva Ecija University of Science and Technology be described in

terms of the following:

1.1 age

1.2 gender

2. What are the different stressors encountered by the level III

nursing students of Nueva Ecija University of Science and

Technology with regards to their clinical duties?


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3. What are the different stress management performed by the

respondents with regards to their clinical duties?

4. What are the implications of this study to nursing practice

in rendering effective quality nursing care?

Scope and Delimitation

This study was entitled “Stress Management Performed by the

Level III Nursing Students of Nueva Ecija University of Science

and Technology with regards to their Clinical Duties: Basis for a

Proposed Effective Quality Nursing Care”.

The primary focus of this study was directed toward the

different stress management that the third year nursing students

usually utilized and performed to alleviate their stress and to

render effective quality nursing care to their patients.

The data however were limited from those gathered from the

nursing students from Nueva Ecija University of Science and

Technology as respondents of the study during the second

semester of school year 2008-2009.

Significance of the Study

The researchers believe in the merits of the study

especially to the following:

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the researchers, conducting this kind of study brought a

learning experience for them. It handed them the pulse of the

major level III nursing students when it comes to stress

management they performed with regards to their clinical duties,

which was hardly known without survey.

the nursing students, who may acquire greater insights of the

stressors, problems and challenges they may encounter all

throughout their clinical performances which is part of their

chosen career. This knowledge will give them better and wider

perspective about their profession and aid them in enhancing

their coping abilities and self-confidence.

the Clinical Instructors, the findings may provide them

understanding why nursing students behave like they do. This

study will also provide them hints of what remedial measures

they need to institute to lessen the learning difficulties of

their students while undergoing clinical exposure. Further, it

will eventually help them to build a better relationship with

the students, promote educational growth, and improve human and

public relations with the identified clinical area of operation.

the school administrators and faculty, who may help to work out

solutions and course of action that will improve the students’

performance and to lessen their burden in their clinical duties

while on the learning process. It also gives them the chance to


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improve the quality of nursing education for the benefit of the

students and the institution as well.

the parents, this study will gives insights to the parents about

the stressors encountered by their siblings and to prepare them

nor strengthen them by means of giving emotional and moral

supports in ways that may help them how to face and manage their

stress during their clinical duties.

The patients, who are the recipients of the healthcare service

given by the nursing students.

the future researchers, this study can serve as reference

material to those students who will conduct exactly the same or

related studies.

Definition of Terms

To convey clearly the meaning of the words used in this study,

the researchers defined the terms used operationally, as follows:

Clinical Area. This pertains to the hospital setting wherein the

nursing students apply and practice what they have learned in

terms of rendering or applying nursing care and focusing on the

holistic being of the patient.


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Clinical Instructors. These refer to persons who impart

knowledge to the students.

Clinical Duties. These refer to the exposure of the nursing

students in different hospital wards/areas as well as in

different types of hospital services in order to broaden his/her

learning experiences while undergoing the Related Learning

Experience program.

Coping. This refers to the adaptation to stress events.

Management. This refers to the act or art of managing the whole

system of care and treatment of a sick individual.

Nursing Students. These refer to the students enrolled in the

College of Nursing in Nueva Ecija University of Science and

Technology.

Nueva Ecija University of Science and Technology. This is a

state university that provides advanced instructional training

in arts, science and technology, education and other related

fields. It also leads the leader to attain perfection at a level

that will enable him to pursue higher education of gainful

occupation.

Related Learning Experience. This pertains to the clinical

exposure, which the nursing students have to undergo. It is

required to all nursing students in order for them to have an in


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– depth and meaningful experience and easily appreciated when

they are already in actual hospital situation.

Stressors. This pertains to the factors affecting the

performances of the nursing students.

CHAPTER II

THEORETICAL ORIENTATION

AND REVIEW OF RELATED LITERATURE AND STUDIES

This chapter presents the theoretical orientation and

review of related literature and studies by the researchers that

are relevant to the present investigation.

Theoretical Orientation

According to Richard Lazarus and Susan Folkman(1984) stress could

be thought of as resulting from an “imbalance between demands and


27
resources” or as occurring when “pressure exceeds one's perceived

ability to cope”. Stress management was developed and premised on the

idea that stress is not a direct response to a stressor but rather

one's resources and ability to cope mediate the stress response and

are amenable to change, thus allowing stress to be controllable.

In order to develop an effective stress management

programme it is first necessary to identify the factors that are

central to a person controlling his/her stress, and to identify

the intervention methods which effectively target these factors.

Lazarus and Folkman's interpretation of stress focuses on the

transaction between people and their external environment (known

as the Transactional Model). The model conceptualizes stress as

a result of how a stressor is appraised stressor-stress link by

proposing that if stressors are perceived as positive or

challenging rather than a threat, and if the stressed person is

confident that he/she possesses adequate rather than deficient

coping strategies, stress may not necessarily follow the

presence of a potential stressor. The model proposes that stress

can be reduced by helping stressed people change their

perceptions of stressors, providing them with strategies to help

them cope and improving their confide Stress is a condition in

which the person responds in the normal balanced state. Most of

the concerns and worries are commonly repetitive, ongoing,

extreme and in most cases, out of proportion to the actual


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situation. Some of these things are relationships, work, health

or family’s health and finances. Because of these worries, the

person experiences very high level of stress on regular basis.

Conceptual Framework

Research paradigm is shown on Figure 1. This included the input,

the process, and the output. The input contains the profile of the

level III nursing students of Nueva Ecija University of Science and

Technology, the different stressors they encountered, and the

different stress management they performed to alleviate their stress.

In the process, questionnaires were distributed and observations were

conducted to gather pertinent information from the respondents. It


• Students’ • Distribution of “STRESS MANAGEMENT
also included the analysis and evaluation of the gathered data and
Profile Questionnaire PERFORMED BY THE
information from the respondents using statistical treatment such as
• Observation
• The different LEVEL III NURSING
frequency count, percentage, average mean,
• Analysis and weighted means, and
stressors STUDENTS OF NUEVA
analysis. by evaluation using
encountered
statistical ECIJA UNIVERSITY OF
the level III
treatment
nursing The output was consist of the findings about SCIENCE the stress AND
1.Frequency
students
management of
performed by the respondents. TECHNOLOGY WITH
Count
Nueva Ecija
2. Percentages REGARDS TO THEIR
University of Research Paradigm
3. Average Mean CLINICAL DUTIES:
Science and
Input
Technology with Process Output
4. Weighted Mean BASIS FOR A
regards to
PROPOSED EFFECTIVE
their clinical
duties. QUALITY NURSING

CARE”
• The different
stress
management 29
performed by
the respondents
to alleviate
their stress
30
Figure 1

Research paradigm used in this study is illustrated in Figure 1.

It shows the steps adopted by the researchers in order to come up with

the output of the study. It best describes the idea of the procedural

design used by the researchers.

Foreign Literature

Stress is a feeling that is created when we react to particular

events. It is the body's way of rising to a challenge and preparing to

meet a tough situation with focus, strength, stamina, and heightened

alertness.

The events that provoke stress are called stressors, and they

cover a whole range of situations everything from outright physical

danger to making a class presentation or taking a semester's worth of

your toughest subject.

The human body responds to stressors by activating the nervous

system and specific hormones. The hypothalamus signals the adrenal

glands to produce more of the hormones adrenaline and cortisol and

release them into the bloodstream. These hormones speed up heart rate,

breathing rate, blood pressure, and metabolism. Blood vessels open

wider to let more blood flow to large muscle groups, putting our

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muscles on alert. Pupils dilate to improve vision. The liver releases

some of its stored glucose to increase the body's energy. Moreover,

sweat is produced to cool the body. All of these physical changes

prepare a person to react quickly and effectively to handle the

pressure of the moment.

This natural reaction is known as the stress response. Working

properly, the body's stress response enhances a person's ability to

perform well under pressure. However, the stress response can also

cause problems when it overreacts or fails to turn off and reset

itself properly.( Wikipedia, 2008. "Stress (biological)"

http://en.wikipedia.org/wiki/Stress_(medicine))

Rebecca J. Frey(2009) said that stress in humans results from

interactions between persons and their environment that are perceived

as straining or exceeding their adaptive capacities and threatening

their well-being. The element of perception indicates that human

stress responses reflect differences in personality, as well as

differences in physical strength or general health.

Risk factors for stress-related illnesses are a mix of personal,

interpersonal, and social variables. These factors include lack or

loss of control over one's physical environment, and lack or loss of

social support networks. People who are dependent on others (e.g.,

children or the elderly) or who are socially disadvantaged (because of

race, gender, educational level, or similar factors) are at greater

risk of developing stress-related illnesses. Other risk factors

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include feelings of helplessness, hopelessness, extreme fear or anger,

and cynicism or distrust of others.

Selye explained that stress is non specific response of the

body to pay demand made upon it under ordinary circumstances,

the body’s reaction to specific stimulus anticipate because of

its repetitive pattern. Therefore, a person experiences pain.

When the body is warm, it perspires and when it is used the body

shivers. All human exhibits uniform response to stimulus because

of homeostasis. When response is erotic and does not uniform to

the usual reaction expected from the application of the

stimulus, the body is said to be in stress.(“The Nature of

Stress” http://www.icnr.com/articles/thenatureofstress.html)

Walter Cannon(2009) in the meantime said that the human

body reacts either positively or negatively to a stress factor

producing two kinds of possible reaction. When the human body

tries to flee from stress situation, negative reaction is

exhibited. Positive reaction comes about when the body makes the

principle of homeostasis apply the body to overcome stressful

situation which is known as adaptation or coping. He advocated

that while the concepts of stress is an absolute fact, its

presence and intensity reception are all relative in accordance

with the physical and psychological make up of the individual.

All people therefore, experience stress but the way stress is


33
present and is handled by each individual is unique for each

other. A little difficulty is hardly felt by another.

By understanding, we can more easily identify stress factors and

their effects on who need or seek healthcare. Each individual is

experiencing stress, in her own particular manner. How the individual

adopt or fails to adopt depend on several factors: personality and

conditional make past experiences dealing with stress.

It is important to remember that stress syndrome can be both

positive and negative. Any change or alteration in the balance of life

can create stress. We are all unique individual, we respond

differently to various stressors. Thus, it neither does nor matter.

Whether, it is positive or negative light or severe. What matter is

how we developed adoptive mechanism to cope with these stressors and

can be translated as the ability to withstand stress and create a life

experiences that do not work against you. The implication of stress

theory is by being able to withstand stress and by coping with it.

Diluting it when occurs and eliminating it, you can actually affect

your life. You are not programmed for premature aging. The fact is you

control your own health. The quote of the journal of American Medical

Association says, “Nature did not intend to grow old and ill, we were

designed to die young in old age but free of disease”.

Schafer (2000) defined stress as the “arousal of mind and

body in response on the demand made upon them”. The concept of

stress is important because it provides a way of understanding

34
the person as a human being who responds in totality (mind, body

and spirit) to a variety of changes that takes place in daily

life.

Local Literature

Accrding to Maraya de Jesus Chebat stress is here to stay. What

people must do is to learn more about its nature, sources and

alternatives so that people used the energy positively and work in the

best possible way.

Orlandi stated, “Your ability to tolerate stressors depends on

the number of stressors in your life”. People who can handle stress

use their coping mechanism, which is powerful tool to use, to analyze

events objectively and observe calmly. Gather information at the state

of equilibrium, understanding of what to produce the tension that

helps you feel that the stress is alleviated.

Miranda specified that the most effective way of managing stress

are through relation and exercise which ironically are extremely

aesthetical acts which involved dynamics of the mind and body. People

who are always stress survivors stay healthy throughout their lives.

They consider stressful situation opportunist for growth.

Foreign Studies

According to Ann Marriner Tomey et. Al,(2004) Stress is a part of

every student's daily life. Leaving home or commuting daily managing,

finances, living with roommates, and juggling work, classes, and

35
relationships all contribute to the normal stress of being a student.

In addition, it is not uncommon for students to feel stressed and

anxious about wasting time, meeting high standards, or being lonely.

Stress can also come from exciting or positive events. Falling in

love, preparing to study abroad, or buying a car can be just as

stressful as less-happy events.

One of the most important things you can do is to recognize when

your stress levels are building. The amount of stress that you can

tolerate before you become distressed varies with your life situation

and your age. A critical first step in coping with stress is taking

stock of the stressors in your life.

Whenever stress is present, your body reacts. It acts like an

alarm system that prepares your body to depend yourself. A little

stress is good. It helps you think faster and harder and makes you put

that extra bit of effort to meet in the challenge of life.

On the other hand, Lether and Woolfolk say that the relaxation is

the very valuable stress management technique that can soothe the

emotional turmoil and suppress problematic psychological arousal.

While Martin and Lefcourt, suspected humor might be worthwhile coping

response. Empirical evidence to that effect has emerged only recent

years. For them good humor functions as buffer to lessen the negative

impact of stress.

Local Studies

36
According to Calderon, people who experience a high level of

stress for a long time and who cope poorly with this stress may become

irritable, socially withdrawn, and emotionally unstable. They may also

have difficulty concentrating and solving problems. Some people under

intense and prolonged stress may start to suffer from extreme anxiety,

depression or other severe emotional problems.

Odrigo G. Ancheta says that, “Stress gives us energy to cope with

the demanding activity of life. It is true that stress is a normal

constant part of our life because it involves changes, challenges and

emotions. Try to imagine life without stress. You would not have any

challenges anything to affect your emotions and anything new and

exciting. It gives as energy because it activity involves physically

and emotionally. Stress might be considered as a problem because we

often bear about stress in a negative light that people may only

associate’s bad experiences with stress. How you perceived and handled

stressors will determine whether the stress is good or bad for you. A

situation that seems extremely stressful to you could leave very calm

to somebody.

Flores (2000) said that a person who is stressed typically less

anxious thoughts and difficulty concentrating or remembering. Stress

can also change outward behaviors. Teeth clenching, hand wringing,

pacing, nail biting, and heavy breathing are common signs of stress.

People also feel physically different when they are stress.

Butterflies in the stomach, cold hands and feet, dry mouth and

37
increase heart rate are all physiological effects of stress that we

associate with the emotion of anxiety.

Justification of the Study

The past study discussed in this chapter has given the researcher

the concept, theories and principles that pave the way to the ideas of

the present study and good starting point for the researcher in

assessing the stressors and the stress management performed by the

respondents with regards to their clinical duties.

The review has enabled the researchers to have a better

understanding of ideas of different well known writers which resulted

to broadening the researchers own thinking in relation to the present

study.

CHAPTER III

METHODS, PROCEDURES, AND SOURCES OF DATA

38
This chapter presents the method of research used, the

instruments, the sources of data and the procedures used in gathering

of data which employed by the researchers.

Methods of Research

The researchers took into consideration the present factors and

current conditions of a group of persons, events or a class in finding

facts and data to be interpreted. This summary includes in the

descriptive method, which was used to accomplish this study.

Descriptive research is a study in which bodies of data are collected,

recorded and analyzed. It is used to answer questions, satisfy

curiosity established a cause and effect relationship.

Moreover, descriptive researching is the most popular approach in

research. It systematically, factually and accurately describes an

area of interest or situation. Description, analysis and

interpretation of conditions that exist are involved. Researchers may

also deal with comparison and contrast or the discovery of existing

relationship between events or groups.

In addition, as this method of research was used in the study it

describes systematically the nursing course and stress management

performed by the level III nursing students of Nueva Ecija University

of Science and Technology with regards to their clinical duties: Basis

for a Proposed Effective Quality Nursing Care. The study describes

also its symptoms, management or treatment and situations in which

39
stress may arise in order to obtain a factual and accurate result of

the research in which student could avail.

Research Instruments

The researchers used the questionnaire as the primary tool in

gathering data. This was made from created materials and statements

that could generate the desired result when the correspondents

followed correctly the direction given by the researchers for

answering.

The construction of the questionnaire was preceded by intensive

perusal and review of related literature, which provided the

researchers insights in forming the questionnaire. The researchers

formulated questions based on their readings from various books,

manuals, journal and experiences as nursing students.

The questionnaire was first drafted for the approval of their

adviser and other members of the faculty who are knowledgeable on the

topic. This is composed of 4 problems. Problem no. 1 involves the

profile of the level III nursing student of Nueva Ecija University of

Science and Technology. Problem no. 2 involves the different stressors

encountered by the level III nursing students of Nueva Ecija

University of Science and Technology with regards to their clinical

duties. Problem no. 3 is the different stress management performed by

the respondents. While, Problem no. 4 is the implication of the study

to nursing practice in rendering effective quality nursing care. Then

the final draft was reproduced for distribution to the respondents.

40
Sources of Data

The researcher used the level III nursing students of Nueva Ecija

University of Science and Technology as their respondents who were

randomly selected from eleven sections.

They were chosen using single random sampling, each number of the

population has an equal chance to be included in the sample gathered.

(Ymas Jr, et. al. 2006)

Their reactions, opinions and suggestions were analyzed and

reported.

Statistical Treatment of Data

After the distribution, collection and completion of distributed

questionnaires, the researchers tallied the gathered data and used

frequency, percentage, average mean, weighted mean, and interpretation

and ranking

The following statistical computations were accomplished using

the following formula:

For the Percentage

Computation of the percentage was made using the expression:

Percentage (%) = F x 100

Where:

%- Percentage
41
F- Frequency or number of response to every item or question

N- Total number of respondents

For the Average Mean

Computation of the average mean was made using the expression:

AM= F x E (DoR)

Where:

AM- Average mean

F- Frequency used

E- Numerical equivalent/ degree of response

For the Weighted Mean

Computation of the weighted mean was made using the expression:

WM=AM

Where:

WM- Weighted mean

AM- Summation of the degree of response multiply frequency (F x E

(DoR))

N- Total number of respondents

42
The researcher used ranking to determine the position of
each variable.

NUMBER VALUE E (DoR) INTERPRETATION

4.20-5.00 5 Always

3.40-4.19 4 Often

2.60-3.39 3 Sometimes

1.80-2.59 2 Seldom

1.0-1.79 1 Never

Finally, the findings were summarized and compared with each

work; conclusions were drawn, and recommendations were formulated.

43
CHAPTER IV
PRESENTATION, ANALYSIS, AND INTERPRETATION OF DATA

This chapter presents the data gathered in this study which

has been carefully presented, analyzed, and interpreted. These

data were gathered by the researchers to the two hundred sixty

seven (267) junior nursing students enrolled at the College of

Nursing, Nueva Ecija University of Science and Technology as of

A.Y. 2008-2009.

Table 1.1
Distribution of Respondents According to Age

Age Frequency Percentage Rank


17years old 2 0.75% 6
18years old 67 25.09% 2
19years old 152 56.93% 1
20years old 35 13.11% 3
21years old 6 2.25% 4
22years old 3 1.12% 5
23years old 2 0.75% 6
TOTAL 267 100% 27

Table 1.1 presents the data of the respondents in terms of

their age. There are 2 or 0.75% of the respondents who are 17

years old which ranked 6; 67 or 25.09% of the respondents who

are 18 years old which ranked 2; 152 or 56.93% of the

respondents who are 19 years old which ranked 1; 35 or 13.11% of

the respondents who are 20 years old which ranked 3;6 or 2.25%

44
of the respondents who are 21 years old which ranked 4; 3 or

1.12% of the respondents who are 22 years old which ranked 5;2

or 0.75% of the respondents who are 23 years old and above which

also ranked 6.

The data indicate that the respondents are at the right age

to consider them as mature individuals capable of managing

stress. It also shows that majority of the respondents are 19

years old.

Table 1.2
Distribution of Respondents According to Gender

Gender Frequency Percentage Rank

Male 114 42.70% 2

Female 153 57.30% 1

TOTAL 267 100% 3

Table 1.2 presents the data of the respondents in terms

of their gender. There are 114 or 42.70% of the respondents who

are male and 153 or 57.30% of the respondents who are female.

45
This indicates that majority of the students enrolled as

nursing students are female.Wherein, they are more capable of

adjusting to the stressors resulting to stress management rather

than males.

Table 2

Stressors of Level III Nursing Students

ITEM STRESSORS WM VERBAL INTERPRETATION RANK

2.1 Doing bedside care to the patient. 3.60 OFTEN 5


2.2 Finishing charting on time 3.89 OFTEN 1
2.3 Handling too many patients 3.67 OFTEN 2.5
2.4 Preparation and submission of requirements 3.67 OFTEN 2.5
2.5 Patient with serious cases 3.62 OFTEN 4
2.6 Lack of hospital facilities and equipments 3.43 OFTEN 6
2.7 Relationship with the patient 2.94 SOMETIMES 15
2.8 Relationship with the co-students 3.01 SOMETIMES 10.5
2.9 Relationship with Clinical Instructors 2.97 SOMETIMES 14
2.10 Relationship with staff nurses 3.01 SOMETIMES 10.5
2.11 Relationship with the physicians 2.79 SOMETIMES 16
2.12 Relationship with patient’s family, 2.99 SOMETIMES 13
relatives, and visitors
2.13 Recognition of some evident changes 3.29 SOMETIMES 8
concerning patient’s symptoms
2.14 Mixed cases of patients due to lack of room 3.31 SOMETIMES 7
2.15 Unfamiliar healthcare setting in the hospital 3.21 SOMETIMES 9
2.16 Wrong procedure performed to the patient 3.01 SOMETIMES 10.5
TOTAL WEIGHTED MEAN 3.28 SOMETIMES

Table 2.1 presents the different stressors of level III

nursing students with regards to their clinical duties. Item 2.1

“Doing bedside care to the patient” got a weighted mean of 3.60,

item 2.2 “Finishing charting on time” got a weighted mean of

3.89, item 2.3 “Handling too many patients” got a weighted mean

46
of 3.67, item 2.4 “Preparation and submission of requirements”

got a weighted mean of 3.67, item 2.5 “Patient with serious

cases” got a weighted mean of 3.62 and item 2.6 “Lack of

hospital facilities and equipments” got a weighted mean of 3.43

and interpreted as “Often”.

This indicates that the routine practices in the hospitals

is one of the reason for the nursing students to be

stressed.This also indicate that a holistic approach should also

maintain in dealing with patients and in treating them as a

human being or as a whole with body, mind, and spirit and not

just merely a person with a specific disease.

With the item 2.7 “Relationship with the patient” got a

weighted mean of 2.94, item 2.8 “Relationship with the co-

students” got a weighted mean of 3.01, item 2.9 “Relationship

with the Clinical Instructors” got a weighted mean of 2.97, item

2.10 “Relationship wit the staff nurses” got a weighted mean of

3.01, item 2.11 “Relationship with the physicians” got a

weighted mean of 2.79, item 2.12 “Relationship with the

patient’s family, relatives and visitors” got a weighted mean of

2.99, item 2.13 “Recognition of some evident changes concerning

patient’s symptoms” got a weighted mean of 3.29, item 2.14

“Mixed cases of patients due to lack of rooms” got a weighted

mean of 3.31, item 2.15 “Unfamiliar healthcare setting in the

47
hospital” got a weighted mean of 3.21 and item 2.16 “Wrong

procedure performed to the patient” got a weighted mean of 3.01

and interpreted as “Sometimes”.

This indicates that sometimes dealing with the hospital

personnels makes the students feel uncomfortable when they ask

questions,expect satisfactory performances from them, and do not

trust the students own capabilities that’s why instead of

relying on the staff nurses and even Clinical Instructor they

prefer to rely on their own. Thus, resulting in failure to

establish harmonious and good working relationship with them.

Table 3

Stress Management Performed By the Level III Nursing Students

ITEM STRESSORS WM VERBAL INTERPRETATION RANK

3.1 Thinking positive and being confident in 4.23 ALWAYS 2


whatever you do
3.2 Taking time to rest and relax 3.78 OFTEN 12

3.3 Spending time with your love ones.(Family, 3.84 OFTEN 9


friends or even pets)
3.4 Praying to God 4.66 ALWAYS 1

3.5 Watching movies and other programs on television 3.71 OFTEN 15

3.6 Day dreaming 2.98 SOMETIMES 25

3.7 Listening to music, singing and dancing 3.73 OFTEN 14

3.8 Enjoying pleasurable activities. (Playing 3.31 SOMETIMES 20


instrument, reading, drawing, painting, etc.)
3.9 Knowing your limits and stick to them 3.85 OFTEN 8

3.10 Engaging into sports 3.31 SOMETIMES 21

3.11 Simply stay at the corner of your own room and 2.27 SELDOM 29
crying
3.12 Eating your favorite foods 3.88 OFTEN 6

3.13 Using the internet (chat,friendster, facebook, 3.89 OFTEN 5


etc.) and playing on line games

48
3.14 Calling and texting your family members, 3.90 OFTEN 4
relatives, friends, etc.
3.15 Making yourself busy by doing household chores 3.28 SOMETIMES 23

3.16 Ignoring the problem 3.33 SOMETIMES 19

3.17 Getting angry and having mood swings 2.86 SOMETIMES 26

3.18 Laughing at it 3.79 OFTEN 11

3.19 Asking for assistance to the Clinical Instructor 3.67 OFTEN 16

3.20 Verbalization of feelings to a fellow student 3.64 OFTEN 17

3.21 Reasoning out or answering back 3.29 SOMETIMES 22

3.22 Taking it as a challenge 3.86 OFTEN 7

3.23 Limiting your contact to the source of stress 3.42 OFTEN 18

3.24 Cursing 2.67 SOMETIMES 27

3.25 Drinking alcoholic beverages and smoking 2.18 SELDOM 30

3.26 Taking medication as a reliever 2.42 SELDOM 28

3.27 Doing physical exercises. (Jogging, running, 3.09 SOMETIMES 24


aerobics, etc.)
3.28 Accepting the reality that sometimes it merely 3.81 OFTEN 10
happens
3.29 Sleeping 3.75 OFTEN 13

3.30 Managing your time better 3.99 OFTEN 3

TOTAL WEIGHTED MEAN 3.48 OFTEN

Table 3.1 presents the stress management performed by the

respondents to handle and alleviate their stress. Item 3.1

“Thinking positive and being confident in whatever you do” got a

weighted mean of 4.23 and item 3.4 “Praying to God” got a

weighted mean of 4.66 are interpreted as “Always”.

This indicates that the rspondents believe that praying is

the most and above all the effective and reliable stress

management that they can perform because this can give us a

renewed sense of clarity, purpose, and peace that’s why we

should never loose hope because God is always with us. A sincere

prayer from the heart can instantly bring soothing comfort and

49
quick stress relief. Prayer reminds us we are not really alone.

Prayer can give us an immediate and deep sense of safety, and

peace regardless of the external circumstances we face.

With the item item 3.2 “Taking time to rest and relax” got

a weighted mean of 3.78, item 3.3 “Spending time with your love

ones (Family, friends, or even pets)” got a weighted mean of

3.84, item 3.5 “Watching movies and other programs on

television” got a weighted mean of 3.71, item 3.7 “Listening to

music, singing, and dancing” got a weighted mean of 3.73, item

3.9 “Knowing your limits and stick to them” got a weighted mean

of 3.85, item 3.12 “Eating your favorite foods” got a weighted

mean of 3.88, the item 3.13 “Using the internet (chat, face

book, friendster, etc.) and playing online games” got a weighted

mean of 3.89, item 3.14 which is “Calling and texting your

family members, relatives, friends, etc.” got a weighted mean of

3.90, item 3.18 “Laughing at it” got a weighted mean of 3.79,

item 3.19 “Asking for assistance to the Clinical Instructor” got

a weighted mean of 3.67, item 3.20 “Verbalization of feelings to

fellow student” got a weighted mean of 3.64, item 3.22 “Taking

it as a challenge” got a weighted mean of 3.86, item 3.23

“Limiting your contact to the source of stress” got a weighted

mean of 3.42, item 3.28 “Accepting the reality that sometimes it

merely happens” got a weighted mean of 3.81, item 3.29

50
“Sleeping” got a weighted mean of 3.75 and item 3.30 “Managing

your time better” got a weighted mean of 3.99 and interpreted as

“Often”.

This indicates that it is necessary to alter one’s

attention so that stress will not be the primary of interest.

With the item Item 3.6 “Daydreaming” got a weighted mean of

2.98, item 3.8 “Enjoying pleasurable activities (Playing

instruments, reading books or magazines, drawing, painting,

etc.)” got a weighted mean of 3.31, item 3.10 “Engaging into

sports” got a weighted mean of 3.31, item 3.15 “Making oneself

busy by doing household chores” got a weighted mean of 3.28,

item 3.16 “Ignoring the problem” got a weighted mean of 3.33,

item 3.17 “Getting angry and having mood swings” got a weighted

mean of 2.86, item 3.21 “Reasoning out or answering back” got a

weighted mean of 3.29, item 3.24 “Cursing” got a weighted mean

of 2.67 and item 3.27 “Doing physical exercise (jogging,

running, and aerobics)”got a weighted mean of 3.09 and

interpreted as “Sometimes”.

This indicates that the respondents do cursing and

reasoning out just to manage the stress.

And lastly, item 3.11 “Simply staying at the corner of your

room and crying” got a weighted mean of 2.27, item 3.25

51
“Drinking alcoholic beverages and smoking” got a weighted mean

of 2.18 and item 3.26 “Taking medication as a reliever” got a

weighted mean of 2.42 and interpreted as “Seldom”.

This implies that the respondents are mature enough to

adjust and manage their stress because instead of staying at the

corner of the room and crying for nothing they prefer to do

something to work for possible solutions. This implies also that

the nursing students believe that drinking alcoholic beverages

and smoking is inappropriate management for stress because it

might increase the risk for illnesses instead.

Implication of the Study

The result of the study on the “Stress management performed

by the respondents with regards to their clinical duties” stands

benefit to the nursing practice. The identification of the

possible cause and effect of stressors on the level III nursing

students will provide them adequate academic and clinical

knowledge on stress. This study will serve as a guide to them on

how to manage their stress with regards to their clinical

duties. This will also provide information to the Clinical

Instructors, healthcare team in the hospital, and school

administrators on how they can help the students upon dealing

with stress properly in order for students to be competent

52
enough in different clinical area and to render quality and

effective nursing care to the patients.

CHAPTER V
SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS

This presents the summary of the study, formulated

conclusion and recommendations offered.

Summary of the findings:

This study is all about the “Stress Management Performed by

the Level III Nursing Students with Regards to their Clinical

Duties: Basis for a Proposed Effective Quality Nursing Care”.

The descriptive method of research was utilized and the

questionnaire serves as the principal data gathering instrument.

There are 267 respondents who fill up the survey questionnaire.

The results of the questionnaire were tabulated and interpreted

from which the findings and conclusion were drawn.

The following are the summary of findings of the study

based from all the data presented, analyzed and interpreted in

chapter IV.
53
1. Majority of the respondents are in 19 years of age.

2. Majority of the respondents are female.

3. The researchers used sixteen (16) items to enumerate the

different stressors encountered by the level III nursing

students with regards to their clinical duties namely: Doing

bedside care to the patient with weighted mean equivalent to

3.60 was interpreted as “Often”; Finishing charting on time with

weighted mean equivalent to 3.89 was interpreted as “Often”;

Handling too many patients with weighted mean equivalent to 3.67

was interpreted as “Often”; Preparation and submission of

requirements with weighted mean equivalent to 3.67 was

interpreted as “Often”; Patients with serious cases with

weighted mean equivalent to 3.62 was interpreted as “Often”;

Lack of hospital facilities and equipments with weighted mean

equivalent to 3.43 was interpreted as “Often”; Relationship

with the patients with weighted mean equivalent to 2.94 was

interpreted as “Sometimes”; Relationship with the co-students

with weighted mean equivalent to 3.01 was interpreted as

“Sometimes”; Relationship with the Clinical Instructor with

weighted mean equivalent to 2.97 was interpreted as “Sometimes”;

Relationship with the staff nurse with weighted mean equivalent

to 3.01 was interpreted as “Sometimes”; Relationship with the

physicians with weighted mean equivalent to 2.79 was interpreted

54
as “Sometimes”; Relationship with the patient’s family,

relatives and visitors with weighted mean equivalent to 2.99 was

interpreted as “Sometimes”; Recognition of some evident changes

concerning patient’s symptoms with weighted mean equivalent to

3.29 was interpreted as “Sometimes”; Mixed cases of patients due

to lack of rooms with weighted mean equivalent to 3.31 was

interpreted as “Sometimes”; Unfamiliar healthcare setting in the

hospital with weighted mean equivalent to 3.21 was interpreted

as “Sometimes”; And lastly wrong procedure performed to the

patients with a weighted mean equivalent to 3.01 was interpreted

as “Sometimes” also with the total average mean of 3.28 was

interpreted as “Sometimes”.

4. The researchers used thirty (30) items to determine the

different stress management performed by the respondents with

regards to their clinical duties namely: Thinking positive and

being confident in whatever you do with weighted mean equivalent

to 4.23 was interpreted as “Always”; Taking time to rest and

relax with weighted mean equivalent to 3.78 was interpreted as

“Often”; Spending time with your love ones with weighted mean

equivalent to 3.84 was interpreted as “Often”; Praying to God

with weighted mean equivalent to 4.66 was interpreted as

“Always”; Watching movies and programs on television with

weighted mean equivalent to 3.71 was interpreted as “Often”;

Daydreaming with weighted mean equivalent to 2.98 was


55
interpreted as “Sometimes”; Listening to music, singing, and

dancing with weighted mean equivalent to 3.73 were interpreted

as “Often”; Enjoying pleasurable activities with weighted mean

equivalent to 3.31 was interpreted as “Sometimes”; Knowing your

limits and stick to them with weighted mean equivalent to 3.85

was interpreted as “Often”; Engaging into sports with weighted

mean equivalent to 3.31 was interpreted as “Sometimes”; Simply

stay at the corner of your room and crying with weighted mean

equivalent to 2.27 was interpreted as “Seldom”; Eating your

favorite foods with weighted mean equivalent to 3.88 was

interpreted as “Often”; Using the internet and playing online

games with weighted mean equivalent to 3.89 was interpreted as

“Often”; Calling or texting your family members, relatives,

friends, etc... with weighted mean equivalent to 3.90 was

interpreted as “Often”; Making yourself busy by doing household

chores with weighted mean equivalent to 3.28 was interpreted as

“Sometimes”; Ignoring the problem with weighted mean equivalent

to 3.33 was interpreted as “Sometimes”; Getting angry and having

mood swings with weighted mean equivalent to 2.86 was

interpreted as “Sometimes”; Laughing at it with weighted mean

equivalent to 3.79 was interpreted as “Often”; Asking for

assistance to the Clinical Instructor with weighted mean

equivalent to 3.67 was interpreted as “Often”; Verbalization of

feelings to fellow students with weighted mean equivalent to


56
3.64 was interpreted as “Often” ;Reasoning out or answering back

with weighted mean equivalent to 3.29 were interpreted as

“Sometimes”; Taking it as a challenge with weighted mean

equivalent to 3.86 was interpreted as “Often”; Limiting your

contact to the source of stress with weighted mean equivalent to

3.42 was interpreted as “Often”; Cursing with weighted mean

equivalent to 2.67 was interpreted as “Sometimes”; Drinking

alcoholic beverages and smoking with weighted mean equivalent to

2.18 was interpreted as “Seldom”; Taking medication as a

reliever with weighted mean equivalent to 2.42 was interpreted

as “Seldom”; Doing physical exercise with weighted mean

equivalent to 3.09 was interpreted as “Sometimes”; Accepting the

reality that sometimes it merely happens with weighted mean

equivalent to 3.81 was interpreted as “Often”; Sleeping with

weighted mean equivalent to 3.75 was interpreted as “Often”;

Managing your time better with weighted mean equivalent to 3.99

was interpreted as “Often”; With the total average mean of 3.48

was interpreted as “Often”.

Conclusions:

Based on the findings of the study, the researchers arrived

at the following conclusions:

1. That the level III nursing students consider “Finishing

charting on time” as the greatest stressors they have

57
encountered with regards to their clinical duties and the least

one is the relationship with the physicians. Meanwhile, the rest

of the stressors show that they can also affect the respondents

somehow.

2. That the level III nursing students consider praying to God

and thinking positive as the number one stress management they

usually performed when they feel stress. While simply staying at

the corner of the room and crying followed by drinking alcoholic

beverages and smoking does not play much role.

3. The result of the study stands benefit to the nursing

practice in rendering effective quality nursing care. The

identification of the possible cause and effect of stressors on

the level III nursing students will provide them adequate

academic and clinical knowledge on stress. This study will serve

as a guide to them on how to manage their stress with regards to

their clinical duties. This will also provide information to the

Clinical Instructors, healthcare team in the hospital, and

school administrators on how they can help the students upon

dealing with stress properly in order for students to be

competent enough in different clinical area and to render

quality and effective nursing care to the patients.

Recommendations:

58
After the conclusions were drawn, the researchers of the

study hereby recommended that:

1. The students must develop not only their nursing skills but

also their ability on handling problems.

2. The students must learn how to rest and relax.

3. The students also need to develop their good working

relationship to others especially with the patients to avoid pro

4. Proper utilization of coping mechanism will help the

nursing students to manage their stress and be competent enough

in different clinical area.

blems that lead to create stressor.

5. The Clinical Instructors must support their students all

the time to establish a harmonious and professional relationship

with them and guide them in rendering quality nursing care to

the patient.

6. Doctors and Clinical Instructors as well as the staff

nurses should be invited at times as a resource person during

ward class and case presentation to give them a sense of

recognition thereby improving good working relationship in the

clinical area.

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7. The proper approach and continuous support of the staff

nurse and other healthcare provider must be present to help the

students cope and deal with the possible problems that they

might encounter in the clinical area.

8. Discussion for the most practical adaptation to prevent the

existence of excessive amount of stress in the individual should

be conducted and if found to be already existed, the most

possible activities should be given to decrease the strength of

stressors that could affect on physiological, psychological and

behavioral make up of the individual.

9. The college of nursing should conduct seminar workshops and

trainings that will further develop the student ability and

capacity to cope up with stress.

10. The future junior nursing students must be properly

equipped with enough knowledge in nursing for them to become

confident. Hence, improper coping with stress will be lessened

and prevented.

11. Conducting another study using more variable and bigger

sample frame should be considered to arrive at a more

comprehensive and meaningful conclusion.

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BIBLIOGRAPHY

Books

• Deborah Antai-Otong et. Al, Thomson Asian Ed. Psychiatric


Nursing Book

• Ann Marriner Tomey et. Al, Guide to Nursing Leadership and


Management 7th Ed. Copy Right 2004 by Mosby, Inc.

• Barbara Kozier MN, RN, Glenora Erb BSN, RN, Audrey Berman
Ph. D., RN, MAN Funadamental of Nurszing 7th Ed.

• Brunner and Suddart’s Textbook of Medical-Surgical Nursing


Volume1 11th Ed. / (Edited by) Suzanne C.Smeltzer…( et al )

• Stress (2008). Encyclopedia Britannica. Encyclopedia


Britannica 2007 Deluxe Edition. Chicago: Encyclopedia
Britannica.
• "Cannon, Walter Bradford." Encyclopedia Britannica from
Encyclopedia Britannica 2007 Deluxe Edition. (2009)
• Lazarus, R.S., & Folkman, S. (1984). Stress, Appraisal and
Coping. New York: Springer.
Article

• [2009 Article by: Paula Ford-Martin; Rebecca J. Frey, PhD]


Website

• Selye, Hans. “The Nature of Stress.”


http://www.icnr.com/articles/thenatureofstress.html
• Wikipedia, 2008. "Stress (biological)"
http://en.wikipedia.org/wiki/Stress_(medicine)
• Wikipedia 2009. "Walter Bradford Cannon."
http://en.wikipedia.org/wiki/Walter_Bradford_Cannon
• en.wikipedia.org/wiki/Stress_management
Undergraduate Thesis

• Stress Experiences and Coping Mechanism of Third Year


Nursing Students of WUP
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• Stress Encountered by the Level IV Student Nurses of WUP in
conduct of their RLE

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