SAN LORENZO RUIZ COLLEGE OF ORMOC INC.

Brgy. San Pablo, Ormoc City

A research project in partial fulfilment for Mrs. Aballe in Research II s.y. 2019-2020 at San
Lorenzo Ruiz College of Ormoc Inc.

“A STUDY ON THE RELATIONSHIP BETWEEN BURNOUT AND

OCCUPATIONAL STRESS AMONG NURSES IN ORMOC CITY”

Researchers:

Alessandro Peñala
Ma. Angelita Tumulak
Shaina Lee. Cuevas
Frences Bhea Abejar
Felianne Parilla

March, 2020
Chapter I

Introduction

Background of the Study

It is not uncommon for stress to be prevalent in the working industry. Occupational stress is

a term commonly used in the professional industry, and refers to the ongoing or progressing

stress an employee experiences due to the responsibilities, conditions, environment, or other

pressures in the workplace. Job burnout is a special type of work-related stress – a state of

physical or emotional exhaustion, depersonalisation, reduce sense of personal accomplishment,

and, sometimes, loss of personal identity.

In modern society, it has become a growing concern that burnout is a major problem for

many occupations, particularly in the medical field of professions. This issue is important for

health care providers because not only are they endangering their own health but that of their

patients as well…

…Nurses are one of the health care workers that are “overworked yet underpaid”. The

Department of Labor and Employment (DOLE) announced last year, mid-2019, that there are not

enough nurses in the Philippines. In addition to a national shortage, growing concern that high-

level burnout could adversely impact patient outcomes.

A nurse plays a larger role in the overall management of patient care. They provide more care

coordination, post-discharge management and pre-discharge work. Many nurses are taking on

leadership roles in health systems and have great influence in accommodating patients.

Simply put, a compromise in the wellness of nurses requires immediate attention as it

greatly affects the quality of patient care and satisfaction; it literally involves life-or-death
circumstances.

This study aims to determine the factors of a nurse’s burnout in addition to determining

the relationship of the occupational stress with a nurse’s burnout particularly in Ormoc City.

Statement of the Problem

To determine the relationship between burnout and occupational stress among nurses in

Ormoc City. The research will be conducted in a selected private hospital in Ormoc City from

January till March of the year 2020.

Specific Questions

1. What are the factors of occupational stress in Nurses?

2. To what degree does occupational stress affect nurses’ burnout?

3. How does it affect the patient’s care?

Scope and Delimitation

 This study focuses on determining the relationship between occupational stress and

burnout of nurses particular in Ormoc City, Leyte province, Philippines. Additionally, the factors

that may affect a nurse’s burnout; for instance, their age, gender, working hours, etc. are

included, any other information that is deemed unrelated or unnecessary to the study will be

henceforth disregarded.

Significance of the Study

This study would substantially benefit the following:

 Nurses. This would allow nurses to investigate or assess themselves in regards to their

profession and take action in developing countermeasures against stress.

 Patients. Their health or their lives rests in the hands of nurses; it would be detrimental

to their care if the nurses’ health are diminished

 Future Generations/Classes. They may use this study as a reference if ever they have a

similar or a related topic.

CHAPTER II

Review of Related Literature

Introduction

As society continues to evolve and grow so does work or the kind of work that people
can part-take in. One such work is nursing, in the Philippines nurses are faced with lots of hours
of heavy work and still receive barely sufficient salaries. Due to this relatively busy and tedious
work environment some nurses are left exhausted in what is known a burnout and a few feel
pressurized by the amount of precision and expertise that nursing demands leading to
occupational stress.

Burnout

According to a trusted dictionary, Merriam Webster, a burnout is a state of exhaustion of

physical or emotional strength or motivation as result of extensive stress or frustration. This
phenomenon is effectively observed in lack of determination and activeness in nurses or in their
resilience in their work as seen in Yu‐fang Guo, Yuan‐hui Lou ,Louisa Lam ,Cross, Virginia
,and Jing‐ping Zhang research study (2017). Furthermore, burnouts can lead to inefficiency in
carrying out job tasks such as increase or decrease in patients’ mortality rates, poor level of
teamwork, medical malpractices and errors and even infections from medical professionals
which can be seen in a research study by Lotte Dyrbye (2017). Thus overall satisfaction of
patients can be diminished or decrease and even cause lawsuits among medical professionals.

Occupational Stress

According to a trusted dictionary, Cambridge Dictionary, Occupational is of relation to a

person’s work or activity. While stress is defined as great worry due to a difficult situation.
Therefore we can say that occupational stress is great worry or pressure in a person’s job or
work, in this study we deduce to nurses.
 Occupational stress is extreme pressure with regards to one’s work. Nurses tend to be
interacting with different kinds of people and the high demand for precision and expertise can
sometimes be the negative cause of this phenomenon among nurses. This stress is caused by
excessive workloads and time pressure, issues in their careers, management and interpersonal
relationships, and problems in resources and the environment with reference to a research study
by Gu, Bo; Tan, Qiling, Zhao, Shangping (2019).These can bring about anxiety, depression,
sleep quality, headaches, dizziness, fainting and other somatic symptoms which is seen in the
research study by Gu, Bo, et al. (2019). By this Nurses can become too overwhelmed and can
lead to serious problems inside the hospital.

Conceptual Framework
Hypothesis of the Study

 Nurses’ burnouts and occupational stress can lead to poor occupational satisfaction and
patient-care satisfaction.
 Nurses’ burnouts and occupational stress can lead to good occupational satisfaction and
patient-care satisfaction.

Assumptions of the Study

The researchers assume that nurses who are experiencing burnouts and occupational
stress will greatly affect their work performances and may also affect the health of their
respective patients in the clinical setting. They also speculate that these factors burnouts and
occupational stress are caused by negative relationship inside the hospital.

Definition of Terms

 Burnout – State of exhaustion due to heavy or extreme work.

 Occupational Stress – Stress associated with the work/job and its activities/practices.
 CHAPTER III

Methodology
Research Design

The research design for this study is a non-experimental, cross-sectional, and causal
research, using the qualitative research method. By which, the researchers gathered data during a
period of days or weeks, that aims to explore and describe the 2 stated variables, in addition to
finding the cause and effect relationship of said variables.

Respondents of the Study

The participants for this study are 14 medical practitioners [nurses] from a selected
private hospital in Ormoc City. The medical institution was chosen based on their availability
and convenience of the researchers.

Instruments of the Study

In order to gather the necessary data needed for the study, the researchers made use of a
structured survey questionnaire, in which the Likert scale is used for the respondents to choose
from. The given questions pertain to their emotional exhaustion, sense of personal achievement,
and depersonalisation. The researchers have also included a single question, wherein the
respondent is asked to state his/her opinion on the issue that the study is tackling.

Validity and Reliability

The questionnaire has high content validity and reliability as it was based on the Maslach
Burnout Inventory (MBI), particularly the MBI-GS: for general use, measures burnout as defined
by the World Health Organization (WHO), and is used in 88% of burnout research publications
(Boudreau, Boudrea & Mauthe-Kaddoura, 2015).
Statistical Treatment

The researchers tallied the number of nurses who answered a particular level in each
item; to determine their emotional exhaustion, sense of personal accomplishment, and
depersonalization. A table showing the results of nurses from the Gatchalian Medical Hospital
was made to assess the nurses’ psychological, physical and emotional state level. Also, a single
question was included asking for the opinion of the nurses in regards to the relationship of the
stress they deal with daily and to the increasing numbers of burnout from their profession, which
was generalized and was included in the summary. The data gathered from the questionnaire was
used to draw conclusions from.
PURPOSE: This survey questionnaire aims to assess the health of Ormoc City’s nurses in regards to the
occupational stress that comes with being a nurse. The information requested below will be used for
finding the correlation between occupational stress and burnout of Ormoc City’s nurses, and nothing
more.
Age: ____________________________
Gender: _________________________
Station: _________________________
No. of hours per shift: ______________

(1) Never, (2) A few times a year, (3) A few times a month, (4) A few times a week, (5) Everyday

Emotional Exhaustion 1 2 3 4 5
I feel used up at the day’s end
I feel emotionally drained from my work
I feel extremely stressed
I feel I’m working too hard on my work
Working with people every day is
becoming a strain
I feel exhilarated
I feel very energetic
I can easily create a relaxed atmosphere
with my patient/s
Personal Accomplishment 1 2 3 4 5
I can easily understand my patient/s need
I can deal effectively
I feel I’m positively influencing others
through my work
I can deal with emotional problems very
calmly
Depersonalization 1 2 3 4 5
I feel I treat some patients as if they were
impersonal ‘objects’
I’ve become more callous toward people
throughout working in this job
I worry that this job is hardening me
emotionally
I don’t really care what happens to some
patients
I feel patients blame me for some of their
problems

What is your thought/opinion on the discussion of what causes a nurses’ burnout?

CHAPTER IV
 Presentation, Analysis, and Interpretation of Data

Presentation of Data

(1) Never, (2) A few times a year, (3) A few times a month, (4) A few times a week, (5) Everyday
Total no. of Nurses: 14

Emotional Exhaustion 1 2 3 4 5
I feel used up at the day’s end 0 1 3 7 3
I feel emotionally drained from my
0 2 4 5 3
work
I feel extremely stressed 1 3 4 3 2
I feel I’m working too hard on my
1 2 5 1 4
work
Working with people everyday is
2 3 5 2 1
becoming a strain
I feel exhilarated 0 4 4 2 2
I feel very energetic 0 0 5 3 6
I can easily create a relaxed atmosphere
0 2 5 4 3
with my patient/s
Table 1.1

Personal Accomplishment 1 2 3 4 5
I can easily understand my patient/s
0 0 2 4 8
need
I can deal effectively 0 0 1 5 7
I feel I’m positively influencing others
0 0 4 5 5
through my work
I can deal with emotional problems very
0 0 3 3 8
calmly
Table 1.2

Depersonalization 1 2 3 4 5
I feel I treat some patients as if they
7 3 0 1 3
were impersonal ‘objects’
I’ve become more callous toward
7 2 2 1 2
people throughout working in this job
I worry that this job is hardening me
6 4 2 0 2
emotionally
I don’t really care what happens to some 10 1 1 0 2
 patients
I feel patients blame me for some of
7 3 1 0 2
their problems
Table 3

Results of the Survey Questionnaire

In table 1: Emotional Exhaustion. There have 50% says that few times a week they got used up
at the end of the day. And none of them have ever felt used up at the end of the day. There have
36% says few times a week they got felt emotionally drained from the work. None of them have
felt emotionally. There have 29% says few times a month they extremely stressed and 7% have
never feel extremely stressed. 36% says few times a week felt working is too hand on their work.
2% have never felt that the working is too hand on the work. 36% of nurses say that a few times
a month they felt exhilarated and none of the nurses ever felt any exhilarated. 43% says that
every-day they felt very energetic in there works and none of them felt of non-energetic. 36%
says they got a few times a month of easily create a relaxed atmosphere with patients. And none
of them felt any easily create a relaxed atmosphere.

In table 2: Personal Accomplishment. There have 57% of the nurses can easily understand there
patient. There have 36% says that few times a week and every-day they felt positively
influencing others through their works. 57% of the nurses say that every-day they can deal with
their emotional problems very calmly.

In table 3: Depersonalization. There have 50% says they never felt any treat some patients as if
they were impersonal. 50% of nurses say that they never felt a more callus toward people
throughout work in this job. 43% never felt worried that their job hardening an emotionally. 71%
never felt really care what happens to some patient. 50% also never felt patients blame them for
some of their problems.

Analysis, Interpretation and Discussion of Data

Table 1: Emotional Exhaustion

 50
45 In the
40 first
35 table,
30
the
never
25
a few times a year
20 a few times a month
Table 2: Personal Accomplishment
a few times a week
15
everyday
10
5
0
1 2 3 4 5 6 7 8
on tio on on on tio on on
esti ues esti esti esti u es esti esti
Qu Q Qu Qu Qu Q Qu Qu

statements were more focused in determining the stress level of a nurse in terms of “emotional
exhaustion”. Most of them checked the middle column, stating that they feel emotionally
exhausted “a few times a month”, followed by the second most answered: “a few times a week”,
third: “everyday”, and lastly, a total of only four people answered in the first column: “never”.
This suggests that nurses experience weariness frequently despite being energetic every day.

60

50

40
never
a few times a year
30
a few times a month
a few times a week
20 everyday

10

0
Question 1 Question 2 Question 3 Category 4
 In the second table, it focuses on the positive feedback in being a nurse; their sense of
personal accomplishment. Majority of the answers were in the fifth column: “everyday”, while
not a single one answered in the first (never) or second (a few times a year) column.

80 Table 3: Depersonalization

70

60

50
never
a few times a year
40
a few times a month
a few times a week
30 everyday

20

10

0
Question 1 Question 2 Question 3 Question 4 Question 5

In the third and last table, the statements were focused on the negative feedback of nurses
towards their work, patients, and themselves. It shows a greater number of nurses have “never”
felt these statements; however there are a few who answered in the fifth column stating they felt
a sense of shift in their personality due to their work.

The last question in the survey;

“What is your thought/opinion on the discussion of what causes a nurses’ burnout?”

When asked, the nurses reported the main cause of burnout is stress –stress caused from their
workplace being understaffed, thus increasing the workload of the remaining nurses.
 CHAPTER V

Summary, Conclusion, and Recommendation

BIBLIOGRAPHY
 notes
Burned out nurses can affect the quality of patient care and satisfaction. Hospitals are financially
affected as well; nurses that are underpaid has a high chance of leaving their work to look for
higher-paying employment, which results to hospitals having to recruit, hire, train, and orient
new nurses. That costs a lot of money, not to mention what constant turnover can do to staff
morale.

In the first table, the statements were more focused in determining the stress level of a nurse in
terms of “emotional exhaustion”. Most of them checked the middle column, stating that they feel
emotionally exhausted “a few times a month”, followed by the second most answered: “a few
times a week”, third: “everyday”, and lastly, a total of only four people answered in the first
column: “never”. This suggests that nurses experience weariness

In the second table, it focuses on the positive feedback in being a nurse; their sense of personal
accomplishment. Majority of the answers were in the fifth column: “everyday”, while not a
single one answered in the first (never) or second (a few times a year) column.

In the third and last table, the statements were focused on the negative feedback of nurses
towards their work, patients, and themselves. It shows a greater number of nurses have “never”
felt these statements; however there are a few who answered in the fifth column stating they felt
a sense of change in their personality due to their work.