i

LIVED EXPERIENCES OF PROFESSIONAL NURSES WHO

RECOVERED FROM COVID-19

A Thesis Presented to
The Faculty of the College of Nursing
University of St. La Salle
Bacolod City

In Partial Fulfillment
Of the Requirements for the Degree
Bachelor of Science in Nursing

JON MICHAEL T. SION

SYLVIA S. TABIA
SOPHIA MARIE O. TAGAMOLILA
ANN FRANCES TAN
ROEFAIRAH GIJYL P. TURCO

October 2021
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TABLE OF CONTENTS

Page
TITLE PAGE i
TABLE OF CONTENTS ii
LIST OF FIGURES iii
INTRODUCTION 1
Background of the Study 1
Statement of the Problem 4
Theoretical and Conceptual Framework 5
Scope and Limitations 7
Significance of the Study 8
Definition of Terms 9
Review of Related Literature 11
METHODS 19
Research Design 19
Participants of the Study 20
Research Instrument 22
Data Gathering Procedure 24
Data Analysis 25
Ethical Considerations 27
REFERENCES 29
APPENDICES 33
Appendix A: Sample Instrument 33
Appendix B: Letter of Permission to Hospital Administrators 35
Appendix C: Letter of Permission to Participants 38
Appendix D: Gantt Chart 42
Appendix E: Budget Plan 43
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LIST OF FIGURES*

Figure Page
1. Schematic Diagram of the Conceptual Framework of the Study 7
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INTRODUCTION

Background of the Study (Tan and Tagamolila)

Humanity is currently witnessing one of the century's most significant problems --

the coronavirus disease (COVID-19) pandemic, which significantly impacted the health

of individuals physically and mentally. It continues to be a leading source of fatalities for

innumerable people worldwide. This disease is a currently identified viral infection

aggravated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Healthcare workers, such as nurses and doctors, are one of the frontlines who are doing

their utmost to eradicate the spread of this invincible enemy. Hence, they are the ones

who this disease has severely impacted due to the heavy burden of caring for the rising

number of infected patients, which requires them to have longer shifts and withstand

added responsibilities to compensate for the lack of human resources. Thus, this caused

the development of their anxiety and fears of being infected or infecting others, including

their family, friends, and peers. In addition, the newly developed COVID-19 procedures

and protocols, the lack of medical supplies and equipment, and higher patient loads

increased the sense of panic among these nurses.

According to Pasay-an (2020), the number of affected healthcare workers is

constantly rising. Based on the announcement from Russia that was issued on the 8th of

April 2020, over 450 medical personnel have been afflicted, and at the minimum of 40

(29%) frontline workers of 138 hospitalized victims' were compromised via hospital-

related exposures in Wuhan, China, in January 2020. In April 2020, Spain declared the

most affected cases, with 14% verified cases from health provider sectors. On the same
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date, the Department of Health of the Philippines delineated 252 COVID-19 positive

healthcare professionals. Similarly, a recent study in Manila, Philippines, found that out

of 324 healthcare workers tested, 141 physicians, 299 nurses, 198 nursing assistants, 90

clinical personnel, 485 nonclinical professionals, and administrators were assessed. The

majority of individuals sampled (216, 67%) were women between the ages of 30 and 39

years (140, 43%). Eight among 324 (2%) were positive for SARS-CoV-2 illness through

reverse transcription-polymerase chain reaction (rRT-PCR). Nurses constitute a large

proportion of medical professionals that are assessed and tested (203, 63%), subsequently,

nursing assistants (61, 19%), medical physicians (37, 11%), laboratory staff (12, 4%), and

diagnostic imaging technologists (6, 2% ) (Villanueva et al. 2020). As a result, the

government has implemented many public health measures to decrease virus transmission

and disease impact, including isolation of infected individuals and quarantine of close

contacts (Lohiniva et al., 2021). Globally, approximately 2.6 billion people have been

isolated or placed under lockdown. (Ganesan et al. 2021). According to a national study,

34.1 percent of those restricted or quarantined had suffered from extreme stress,

anxiousness, despair, or sleep disturbances (Al-Jumaily et al. 2021). Moreover, a recent

study revealed that frontline healthcare workers had been subjected to prejudice and

discrimination. In the Philippines, allegations of assaults on frontline healthcare workers

(FHW) became headlines and a contentious issue on media platforms. Numerous reported

being evicted, ridiculed, and harassed in their jobs and boarding places. (Corpuz, 2021).

There is also an existing research study carried out by Lohiniva et al. (2021) which

indicated in their findings that the respondents did not feel a sense of closure following

the end of their isolation and quarantine due to perceived stigma and self-stigma, as well
 3

as concern that they could still infect others. Stigma limited their desire to report their

coronavirus status or any family history of infection, resulting in psychological and social

hardship. Besides, the risk of suicide may be increased by social distancing or social

isolation. Suicidal thoughts and ideas may be triggered by a variety of adverse outcomes,

including isolation associated with extended quarantine and tension, fear of acquiring the

disease from everyone else, and social detachment caused by a preexisting mental illness,

along with the possibility of the loss of employment, financial insecurity, death of

beloved family members or missing close relatives, and a sense of uncertainty about the

years ahead. (Ganesan et al. 2021).

This study seeks the lived experiences of professional nurses who recovered from

COVID-19. Most of the studies related to this topic were conducted internationally.

There may be local research studies regarding the lived experiences of nurses during their

isolation due to being tested positive for COVID-19; however, they are inadequate.

Moreover, the participants of this study are limited, which is different from the studies

conducted by other countries that have hundreds of participants due to the data privacy

and confidentiality where some hospitals and health institutions do not want their nurses

to disclose their nurses' lived experiences. Additionally, published journals and research

have not yet addressed the concern of local nurses' experiences during their isolation

compared to the global scale of nurses who openly talks about the first-hand experience

of being diagnosed with COVID-19. The researchers are currently exploring the lived

experiences of nurse professionals who recovered from COVID-19 in the Philippines,

specifically in Bacolod City, Negros Occidental. Presumably, this research will

contribute to new development and a contribution to future researchers.

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Currently, nurse professionals from Bacolod City, Negros Occidental, face

different challenges due to the rising number of cases. People still become infected

despite the government's attempt to raise community awareness, implement preventive

measures, and curb transmission using isolation and social distancing measures. In spite

of the fact that the nurses poured their blood, sweat, and tears in preventing the spread of

this infection, it implies that their hard work or labor is being neglected by the people that

although it is not necessary, there are still those who can not discipline themselves from

going out. Thus, causing them to be easily infected resulted in the battles faced by the

nurses in Bacolod City, Negros Occidental, such as anxiety, fears, stress, discrimination,

etc. Moreover, nurses are traumatized from socializing with other people, and they suffer

from serious mental health issues because of the problem mentioned above.

The aim of this research study is to discover the lived experiences of professional

nurses who recovered from COVID-19, specifically on how they cope up with the

impacts or experiences when being isolated, quarantined, and recovering from the disease

for a long period. The researchers were prompted to do this study as it can help

healthcare workers, including the nurse professionals, determine how to reduce the

trauma, stress, personal battles, and other aftermaths that each of them may face in the

future. Also, for other nursing staff and people, in general, be aware and be prepared

towards the necessary measures or interventions if infected with COVID-19.

Statement of the Problem (Tan)

This study aims to discover the lived experiences of professional nurses who

recovered from COVID-19.

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Theoretical Framework (Turco)

The public health crisis has put health care professionals into the line, expected to

step up, be courageous, and provide care and comfort to those impacted, owing to their

commitment to containing the disease. Thus, challenges have occurred, and the fear of

contracting the virus themselves is terrifying as they are in direct contact with the

infected patients (Vo, 2020). Built on this problem, the theory of comfort and adaptation

model identifies problems pertaining to the lived experiences of nurses. According to the

adaptation model of Sister Callista Roy, adapting processes constantly change that

represent a person's own standard range of stimuli in coping to the changes in the

environment. An environment that either undermines or fosters a person's wholeness and

the alterations that occur due to these environmental stressors. Furthermore, it examines

how a particular group or individual adapts and engages with a dynamic environment. In

correlation to Katharine Kolcaba's theory of comfort, it explains how nurses' comfort care

of plan, with the goal of enhancing patient's comfort, is compromised when nurses

become vulnerable while providing care. Comforting strategies to alleviate and lessen the

discomfort associated with transcending conditions promote health-seeking behavior on

the part of the family, person, and society in stressful situations. Thereby, the adaptation

model and comfort theory specifically explicate that nurses' coping mechanisms and

adaptation to the pandemic affect their care to patients. The well-being of nurses

continues to become compromised, evidenced by increasing moral distress, compassion

fatigue, and burnout. Anchored in these theories, the study will elucidate how the

experiences of nurses that are infected with COVID-19 affect their overall care to the

patient.
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Conceptual Framework (Tabia and Sion)

The Comfort Theory and Adaptation Model analyze issues relating to nurses'

lived experiences (Roy, n.d). Specifically, the adaptation and comfort theory explains

how nurses' coping mechanisms and adaptation to the pandemic affect their patient care.

Nurses' well-being continues to deteriorate, as shown by rising moral anguish,

compassion fatigue, and burnout. These ideas were the basis of the thinking that coping

strategies should be identified to promote the wellness of nurse professionals after being

infected with COVID-19.

In this study, the analysis of lived experiences of nurses who recovered from

COVID-19 starts by taking into account the socio-demographic factors, which include

age, sex, marital status, number of children, area of exposure, and years in service,

following the adaptation model of nursing and theory of comfort. Age and sex play an

important aspect of this study to determine which among them are the most vulnerable to

experience the negative impacts of COVID-19 transmission on nurses, so it is included in

the nurse professionals' profile. Moreover, marital status will determine how it affects the

lives of nurses infected with COVID-19, as having significant others may imply

additional assistance, care, and support that may enable them to increase their confidence

in the recovery. Still, at the same time, it may also cause infected nurses to feel anxious,

as they had contact with them, which may endanger their own lives. In addition, it is vital

to include the number of nurses' children in the study because household size may alter

the social connection between parent nurses and their child, causing fear of transmitting

or spreading the virus to other family members. Furthermore, the area of exposure is the

foremost point in this study as this is the environment in which most nurses are assigned
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to work and provide care, wherein hospital-related transmissions are a factor that may

affect nurses' lived experiences, particularly in areas that are lacking medical supplies and

equipment, and increased patient loads positive for COVID-19 increased the sense of

panic among these nurses. The nurse professionals' profile may affect nurses' mental

health, as they may undergo anxiety, depression, and panic attacks, resulting in

inadequate comfort care to patients and themselves and impairs their ability to adapt to

constantly changing circumstances and conditions of the environment. The primary focus

of this study is to discover the lived experiences of professional nurses who recovered

from COVID-19, considering that these topics are rarely emphasized due to the lack of

local studies relevant to the current research study.

Professional
Nurses’ Profile Theories: Lived Experiences
- Age - Adaptation Model of Professional
- Sex of Nursing Nurses Who
- Marital Status - Theory of Recovered from
- Number of Comfort COVID-19
Children
- Area of Exposure
- Years in Service

Figure 1. Schematic diagram showing the conceptual framework of the study.

Scope and Limitations (Sion)

This study seeks the lived experiences of professional nurses who recovered from

coronavirus disease (COVID-19). In this qualitative approach, the researchers will utilize

an individual narrative survey form to be sent via the participant’s email, which will be
 8

collected from the nurse professionals, specifically, 10-15 nurses, who were infected with

COVID-19 which were confirmed positive via a swab test, that is working from the

Doctor’s Hospital, Bacolod City, Negros Occidental. This will occur during the

Academic Year 2021-2022 Second Semester and be completed in a four-month period

within the same year.

Significance of the Study (Tabia)

This research study may be beneficial to the following:

Hospital Administrators. This research may benefit the Hospital Administrators

in making high-level decisions about developing and reviewing plans regarding the lived

experiences of professional nurses who recovered from COVID-19.

Patient care managers. This study may benefit the patient care managers to

manage the stress of nurse professionals infected with COVID-19 to fulfill their duties

appropriately and ensure that they are carried out. This may further inform them how to

keep the line of communication open.

Staff Nurses. This study may benefit the staff nurses as this may expand their

knowledge on how they can cope up with the impacts or experiences when being infected,

isolated, quarantined, and recuperating from the COVID-19.

Nurse Educators. This study may aid their discussion to their students related to

the lived experiences of professional nurses who recovered from COVID-19. This may

serve as a source of reference as they tackle the said circumstance. Moreover, this may

guide them in overcoming such problems since they are also considered nurse

professionals aside from being Clinical Instructors.

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Patients with COVID-19. The result of the study may benefit the patients with

COVID-19 admitted to the hospital as they are one of the carriers of COVID-19. This

will further improve on disseminating the message of how COVID-19 greatly affects the

lives of nurse professionals.

Nursing students. This research may help the nursing students identify, perceive,

and understand the lived experiences of professional nurses who recovered from COVID-

19. This may also serve as their awareness and preparation on the possible circumstances

that they might encounter in their future career in order for them to have a grasp on

handling a similar situation.

Future researchers. The result of the study may serve as a guide and reference

for future researchers in relation to the same topic, may it be for replication,

improvements, or any related studies.

Definition of Terms (Turco)

Age. This term refers to the interval between the hours of the day and night; it is

a measurement of time rather than a representation of age-associated growth and

progression. (Borman, 2012). In this study, this term refers to how old the nurse

professionals are when being recovered from COVID-19.

Area of Exposure. This term refers to the end goal for which information and

sources are analyzed in order to determine if an individual has been exposed to a

particular element of interest (Lee, 2013). In this study, this term refers to the place where

the respondents were exposed in a hospital.

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COVID-19. This term refers to a coronavirus outbreak, a global pandemic

(Cucinotta, et al., 2020). Operationally, this term refers to a factor that affects the lived

experiences of Professional Nurses.

Lived Experiences. This term refers to the researcher's or study subject's personal

circumstances encountered, perspectives, and decisions, which are depicted and

understood within the context of how such aspects influence one's viewpoint of

knowledge. (Given, 2008). In this study, this term refers to the identified situation or

experience of nurse professionals who recovered from COVID-19.

Marital Status. This term refers to the status of a person of each individual in

relation to the law of marriage or custom of a country (United Nations, 2008). In this

study, this term refers to whether the nurse professionals are married, single, widowed, or

divorced.

Number of children. This term refers to the total number of children born to

mothers throughout their lives (Croft, 2018). In this study, this term refers to the number

of children the respondents have and its effect on the lived experiences of the respondents

who recovered from COVID-19.

Nurse Professionals. This term refers to the primary members of healthcare

providers entrusted with the responsibility of containing and preventing the transmission

of contagious diseases. Nurse professionals operate on the front lines, providing direct aid

and service to people who have been infected with COVID-19. (CHEN et al., 2020). In

this study, this term is used as a noun that refers to one of the healthcare workers or

frontlines affected by COVID-19.

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Recovered. This term refers to a patient with moderate disease who met a specific

criteria that can be released from quarantine without needing to be retested due to

emerging evidence that indicates a lower transmission rate after 10 days of symptom

onset (Department of Health, 2020). In this study, this term refers to professional nurses

who experienced being infected with COVID-19 and have been discharged afterwards,

and restored to wellness after being quarantined.

Sex. This term refers to an individual being male and female according to human

anatomy (Tannenbaum, 2006). In this study, this term refers to the identity and number of

males and females among the nurse professionals who recovered from COVID-19.

Years of service. This term refers to the length and number of years spent

working for a present employer (Brown, 2015). In this study, this term refers to the years

the respondents have been working in the hospital.

Review of Related Literature (Tan and Tagamolila)

This review contains related studies and concepts conducted internationally, for

the most part, which are related to the research problems, particularly the lived

experiences of professional nurses who recovered from COVID-19. These studies guided

the researchers in doing their work regarding the topic concerned.

On Lived Experiences

Concerns are growing about the sufferings and hardships endured by patients

affected by the serious health repercussions of COVID-19. Participants in the study

conducted by Alimohammadi et al. (2020), which consist mainly of female nurses

(66.66%) ages between 25-29 with work experience between 3-10 years, stated that they

reported feeling restrained by the policies regarding quarantine and isolation, which
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directly impacted their parenting practices and job performance, and that their profession

of providing quality palliative care had been challenged by the complexities and

emotional commitment with patients in the COVID-19 institutions. According to Famaz

& Samaha (2020), it was found that after serving in COVID-19 areas and being isolated

caused by vulnerability, medical professionals within Lebanon, there are 11 (94.61%)

married respondents while 2 (15.38%) of them were single and 7 (53.8%) of the

respondents had children while 6 (46.2%) of them did not have children. The said

participants began exhibiting manifestations such as extreme stress, aggravation, conflict,

and rage as a direct consequence of isolation, stigma, concern about contracting the

disease, and the conflict between family obligations and professional

responsibilities. Moreover, the risk of suicide may be increased by social distancing or

social isolation, and suicidal viewpoints may be triggered by a wide range of adverse

outcomes, including exclusion associated with extended quarantine and stress, fear of

contracting the infection from others, and social detachment due to having a pre-existing

mental illness, along with the possibility of the loss of employment, financial insecurity,

death of beloved family members or missing close relatives, and an uncertainty

feeling about the years ahead. (Al-Jumaily et al., 2020). Furthermore, in the result of the

study of He et al. (2021), the female nurses aged between 24-42 with working experience

between 2-25 years stated that after learning that they had been infected with COVID-19,

nurses experienced a period of psychological shock. They were terrified, disoriented, and

even guilty, and they began to place the blame on themselves. Nevertheless, despite their

challenges, anxieties, worries, and depression-related symptoms, they exemplified the

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noble qualities of their profession, societal duty, and a willingness to make sacrifices for

patients, families, and humanity as a whole.

On Stigma and Discrimination

Apprehensions about health and boredom were prevalent throughout quarantine

and isolation experiences, and social stigma adds another layer of complexity by

affecting social relationships and causing psychological discomfort, which is likely to

harm the quality of life, particularly following the illness. The findings in the study of

Lohiniva A-L et al. (2021) denote that respondents did not feel a sense of closure

following the end of their isolation and quarantine due to perceived stigma and self-

stigma, as well as concern that they could still infect others. Thus, stigma limited their

desire to report their coronavirus status or any family history of infection, resulting in

psychological and social hardship. According to a recent study by Corpuz (2021),

frontline healthcare workers have been subjected to prejudice and discrimination. In the

Philippines, allegations of assaults on frontline healthcare workers (FHW) became

headlines and a contentious issue on media platforms. Numerous reported being evicted,

ridiculed, and harassed in their jobs and boarding places. Additionally, it is disclosed that

with respect to the discrimination against frontline healthcare workers (FHW), the

government and the general public must redouble their efforts in formulating safety

regulations. In the same study, it was decided that stigma, discrimination, and physical

injury directed towards frontline healthcare workers and individuals presumed of

possessing COVID-19 have been declared illegal across all 17 localities throughout

Metro Manila, as proclaimed in the Universal Declaration of Human Rights and

established in the 1987 Philippine Constitution, that each and every individual are
 14

empowered to rights of citizenship regardless of ethnicity, color, gender, nationality,

religion, political or other opinions, national or social heritage, inheritance, birth, or

different position. In addition, the anti-discriminatory provisions of the statutory laws,

including Article 9 of the Magna Carta for Public Health Workers, are in effect. In line

with that, various regulations and ordinances have been enacted. In Metro Manila, City

Ordinance No. 8624, or the 'Anti COVID-19 Discrimination Ordinance of 2020,' forbids

any type of assault or prejudice against the individuals as mentioned above along with

frontline government forces. Furthermore, the result of the study of Liu et al. (2021)

signifies that the diagnosis of COVID-19 caused nurses to express feeling alienated and

discriminated against from the outside world, particularly when they were initially

isolated at home, under a great deal of psychological pressure, and experiencing anxiety

and insomnia as a result. Due to the virus' infectious nature, nurses were placed in

isolation and admitted to a hospital to cure the illness, which increased their feelings of

loneliness and societal limitations.

On Mental Health

According to a national study, 34.1 percent of those restricted or quarantined had

suffered from extreme stress, anxiousness, despair, or sleep disturbances, which are

considered mental health problems. (Al-Jumaily et al. 2021). According to Hwang et al.

(2020), quarantine and social isolation are vital strategies to limit the transmission of the

virus. Still, they also result in heightened levels of loneliness and social separation, which

have a detrimental effect on both physical and emotional well-being. This is in

correlation to the study carried out by Wang et al. (2021), wherein it is indicated that

quarantine measures implemented during the COVID-19 outbreak are correlated to an

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elevated prospect of mental health burden, particularly for vulnerable groups such as

those with pre-existing mental or physical illnesses, frontline workers, those living in the

most severely affected areas, and those with less financial means. Besides, the risk of

suicide may be increased by social distancing or social isolation. Suicidal viewpoints may

be triggered by a wide range of adverse outcomes, including exclusion associated with

extended quarantine and stress, fear of contracting the infection from others, and social

detachment due to having a pre-existing mental illness, along with the possibility of the

loss of employment, financial insecurity, death of beloved family members or missing

close relatives, and an uncertainty feeling about the years ahead. (Ganesan et al. 2021).

As stated by Alimohammadi et al. (2020), nurses in COVID-19 institutions face high

mental demands, which may endanger the level of treatment they can deliver to their

patients. Anxiety, tension, and fear, according to nurses, have a significant impact on the

care for patients with COVID-19. Therefore, local, regional, and national governments

must take immediate action, in collaboration with mental health practitioners, to

implement up-to-date mental health regulations and expand access to mental health

support for all masses, including those with COVID-19 contagion, medical professionals,

anyone within quarantine or exclusion, individuals with previously existing mental health

conditions, schoolchildren, and elderly persons, to impede suicide as a result of the

COVID-19 pandemic. (Fong et al. 2021)

On Stress

In the cross-sectional study conducted by Da Rosa et al. (2021), there is a

significant rate of existential anguish among nurse professionals, and identify

risk associated with such distress throughout the COVID-19 pandemic. It is critical to
 16

provide proper assistance to nurses in order to prevent mental distress and promoting

psychological well-being during the COVID-19 global health crisis and any subsequent

pandemics. Furthermore, concerns about the rapidly deteriorating of previous mental

health conditions, as well as the increasing cases of the global pandemic, especially at

one's work venue, lack of employee satisfaction, worry of becoming compromised at

work, and feeling unprepared for the COVID-19 pandemic, were all consistently linked

to varying severity anxiety, depression, and stress. In detail, the majority of the women in

the study were married female nurses, in which half of them were less than 39 years old.

According to the study conducted by TMGH-Global COVID-19 Collaborative (2021),

their research included both healthcare and non-healthcare professionals, thus proving

that the number of quarantine days is linked to an increase in stress levels. Along with

their personal health risks, nurses expressed concern for their relatives and coworkers

who had contact with them and were frightened with regards to transmitting the virus to

others, all of which contributed to increased internalized stress and dread (Chen et al.,

2021).

Synthesis

Healthcare workers, specifically nurses, unceasingly deal with patients infected

with COVID-19, which signifies that they have a high risk for infection and have been

experiencing the impact of this pandemic both in physical and mental health aspects.

Throughout the past almost two years of combatting this terrible illness, numerous

circumstances occurred. The aforementioned related studies are significant and beneficial

as the literature findings are relevant to the current worldwide challenges. These related

studies have stated that nurse professionals are experiencing emotional conflict, which
 17

results in stress, stigma, and discrimination, all of which contribute to their diverse

experiences in dealing with the virus. Moreover, previous studies have revealed that

individuals who have been quarantined and isolated suffer significantly from

psychological disorders that gradually take over their minds, resulting in anxiety and

depression, which is also related to the current state of nurse professionals in the

Philippines. These nurses' experiences demonstrate that their psychological health is

critical to patient care and that they are well aware of the implications of this condition on

patient management in the context of the current coronavirus outbreak. Furthermore,

nurses are subjected to a significant deal of trauma and public criticism and struggle

amongst themselves. In connection, a paradox has emerged due to the nurses'

psychological problems and dire situations. In the context of COVID-19 treatment,

nurses require additional assistance and support since nursing care measures are being

jeopardized. Despite these challenges, nurses remain committed to providing their

patients with the highest quality of care because it is what they have dedicated their lives

to.

In this research study that the researchers are currently investigating, the

coronavirus outbreak caused nurse professionals infected with COVID-19 to face

different challenges, which led to a psychological crisis. Despite the nurses' valiant

efforts to prevent the spread of infection caused by this virus, they continue to be ignored

by the general public. As a result, inequality exists, which has a substantial impact on the

psychological well-being of Filipino nurses. In relation to the studies conducted in

various countries, it has been discovered that there is a similarity between the current

study undertaken by researchers at the University of St. La Salle, in which stress is a

 18

significant contributor to nurses' current experiences in dealing with the virus.

Furthermore, as nurses face difficulties, anxiety, stress, and depression symptoms, they

emphasize the noble nature of their work, their societal obligations, and a sense of

sacrifice for patients, families, and society in general. Thus, healthcare administrators are

being urged to pay closer attention to the mental health and particular lifestyle demands

of COVID-19-infected nurses.
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METHODS

This section presents the research design, participants of the study, research

instrument, data gathering procedures, data analysis, and ethical considerations used to

answer the problems discussed in the study.

Research Design (Turco)

Given the study's primary objective of discovering the lived experiences of

professional nurses who recovered from COVID-19, the researchers use a qualitative

research approach. According to the study of Renjith et al. (2021), qualitative research is

commonly used to analyze health patterns of behavior, explain lived experiences,

establish psychological theories, investigate healthcare demands and preferences, and

devise solutions. It entails broad statements and questions about subjective experiences

and perceptions of humans that are investigated by constant contact with individuals in

their various settings and environments and the development of extensive, descriptive

data that aid in understanding the individuals' experiences (Munhall, 2012). In connection

to this study, it uses a wide range of words that precisely describe a patient's experiences

through an individual narrative survey form that comprises questions regarding their

demographic profiles, lived experiences, and coping strategies when quarantined in a

facility. This type of survey is common, practicing confidentiality where the researcher

analyzes and records how the respondents described their lived experiences. It uses open-

ended questions that help reveal the behavior and perception of the respondents with the

particular topic, which is the lived experiences of professional nurses who recovered

from COVID-19.
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Specifically, the type of qualitative research design that the researchers will use in

this study is a descriptive phenomenological design. Descriptive phenomenology is the

study of the substance of human experiences and how they fit into conditions in which

experienced phenomena can be described. (Cresswell, 2018). The focus should be on

elucidating the essence or fundamental component of a phenomenon under investigation

to provide a comprehensive explanation for the characteristics that define it, rather than

on demonstrating it to be something different. (Morrow, 2015). The purpose of this

method is to ascertain and explicate the significance of lived experiences and present a

richly detailed narrative of how participants described their experiences. (Donalek, 2004).

This type of method correlates this research study in the essence of explaining the

phenomena that the respondents personally experience. It is from the perspective of the

respondent rather than the personal opinion of the researcher.

Moreover, it encompasses words used by the respondents in which the researchers

try to analyze and obtain data from it. Likewise, it aims to get relevant information to

understand these professional nurses' lived experiences after they recovered from being

infected with COVID-19. This is essential as experiences differ in every respondent and

the explanation given by each of them allows researchers to view how these lived

experiences interconnect with other respondents. Thus, this method highlights the essence

of experiences, putting aside the researcher's perception of a phenomenon, giving

meaning to the nurses' lived experiences, and discovering new insights.

Participants of the Study (Tan and Tagamolila)

The participants of the study are professional nurses within the age range of 30-50

years old, working in a private hospital in Bacolod City who recovered from COVID-19.
 21

They are one of the hands-on healthcare providers that deliver concentrated and highly

individualized care who fight for the rights of their patients and their families. These

nurses attended and treated COVID-19 infected patients, which caused them to be

afflicted as well. Thus, it resulted in experiences of fear, stigma and discrimination, stress,

and any psychological changes. Moreover, in order to obtain relevant data, specified

inclusion criteria were enforced.

The participants eligible for the conduct of this study must be personnel or

workers, specifically the nurses in one of the chosen private hospitals in Bacolod City.

Likewise, this is only limited to nurses who got infected with COVID-19, as evidenced

by their positive results after going through a reverse transcription-polymerase chain

reaction test (rRT-PCR test). Further, these nurses may either be male or female and

single or married. This qualification will guarantee that the participants are aware of the

implications and purpose of this study, which will enable them to finish the questions

quickly and accurately.

Non-probability sampling, particularly a purposive sampling technique, is used by

the researchers in this study. According to Renjith et al. (2021), this sampling method

entails determining a population derived from pre-established inclusion criteria and then

selecting subjects who meet those requirements in order to enhance reliability and

integrity. In connection, the researchers sought to discover the lived experiences of

professional nurses who recovered from COVID-19, which leads to utilizing a specific

goal in mind: finding and gathering nurses who could convey and provide more

meaningful, significant, and pertinent data for the research questions. After acquiring the

informed consent, a total of 10-15 respondents may be selected to take part in this study.
 22

Research Instrument (Sion)

In acquiring appropriate data about the research problems to measure the desired

outcomes, the researchers will utilize the Individual Narrative Survey form. Participants'

stories are used to collect data in narrative research. In the Individual Narrative Survey

form, the researchers write narratives about human perspectives and experiences,

describe a life changing event, and analyze the event's significance with the person. With

relevance to the study, the researchers will use an individual narrative survey form which

will be sent to the participant's email address. This is to identify the lived experiences of

professional nurses working at a private hospital in Bacolod City, Negros Occidental,

who recovered from COVID-19, which was confirmed positive via reverse transcription-

polymerase chain reaction test (rRT-PCR test).

Additionally, the survey form is separated into two parts: a profile part and the

survey questions. The profile contains demographic characteristics of the respondents,

which comprises their (1) age, (2) gender, (3) marital status, (4) number of children, (5)

area of exposure, and (6) years of service. The survey questions will explore the lived

experiences of professional nurses who recovered from COVID-19, particularly the

challenges and issues they faced. Moreover, it also consists of questions that will identify

their coping strategies and assistance received during their isolation. The list of questions

included in the individual narrative survey form is based on the review of related

literature.

To ensure the validity of the questionnaire, the researchers will utilize the Lincoln

and Guba Trustworthiness validity test. This test will indicate how accurate the data is

and how truthful the results are to the extent. In line with that, the researchers will do an
 23

observation of the study to establish credibility. The four criteria for the validity test are

(1) credibility: the confidence in the truthfulness of the study results. Credibility is

determined by evaluating whether the research findings constitute probable information

derived from the respondents' original responses and accurately interpret the participants'

actual perspectives; (2) transferability: the extent to which findings from qualitative

research can be translated to several settings or situations with additional participants.

Through extensive explanation, the researcher aids the prospective person's judgment of

transferability; (3) dependability: the longevity of findings. It relates to respondents'

appraisals of the study's findings, analyses, and suggestions, which are all

substantiated by data gathered from survey respondents; (4) confirmability: the extent to

which the research findings can be validated by other experts. It is crucial for establishing

that the information and interpretation of the data collected are not fabricated by the

researchers but are clearly drawn from the data. (Korstjens and Moser, 2017). Prior to

validity testing, the instrument that contains questions that are included in the individual

narrative survey form will be requested to critique by the researchers' three chosen

experts, specifically nursing research facilitators. In addition, these experts will be

consulted for any ideas or necessary modifications to ensure the instrument's continued

progress and validity. This may assist researchers in eliminating irrelevant questions and

simplifying unclear or difficult terms to assure comprehension. Furthermore, to test the

instrument's reliability, the Lincoln and Guba Trustworthiness will also be used. This tool

will guarantee that there is consistency in the responses.

 24

Data Gathering Procedure (Tan and Tagamolila)

The researchers will begin this study by identifying the target participants, which

are the professional nurses working in a private hospital in Bacolod City who recovered

from COVID-19. A letter of consent, which nursing research facilitators will review, will

be addressed via email to the hospital administrators requesting permission to authorize

these nurses to disclose their lived experiences when quarantined. The researchers

likewise will solicit the participation and cooperation of the respondents to perceive their

willingness to partake in this research study. It is by contacting them with the guidance of

the significant other of one of the researchers working in the same hospital to inform

them about the study. Then the consent will be acquired by sending a letter which will be

consigned first via email to the same person who contacted the respondents.

Subsequently, the said email will be forwarded to the nurses. Following the acquisition

and approval of the letter of consent, the researchers will explain the purpose of the study

to the selected participants and the significance of their responses, ensuring and verifying

that each participant met the stated criteria. Then the researchers will use the individual

narrative survey form. According to Salkind (2012), the purpose of this form is to

investigate and comprehend human experience expressed in textual form. To delve

deeply into the meanings that the people attribute to their personal encounters, the

researchers study with a small number of participants to elicit rich and varied discourse.

The focus is on storied experience, which typically entails giving interviews about the

subject of interest, but may also include evaluation and interpretation of written

documents. In connection, the individual narrative survey form in this study is utilized to

discover the recovered nurses' detailed experiences and better understand their challenges.
 25

This form will be distributed through their email, which contains questions that are based

on the review of related literature regarding their age, sex, marital status, number of

children, area of exposure, years in service, lived experiences when being infected with

COVID-19 and after their recovery, and their coping strategies while being isolated.

Additionally, the researchers may elucidate several terminologies so that the

respondents can accomplish the individual narrative survey form aware of their role and

involvement as the study's subject. Then, the researchers will ask the respondents to be

honest and upfront in their responses. The study will be conducted from the last week of

October until the second week of November 2021. Succeeding, the respondents will

efficiently complete the form, which the researchers will then collect to check, tally,

interpret, and analyze the results.

Data Analysis (Tabia)

After sending the individual narrative survey form through email accounts of

nurses who recovered from COVID-19, the researchers will gather, note, organize,

analyze, and summarize their responses. The researchers will read, comprehend, and

translate their answers word for word from Hiligaynon to English if the respondent uses

the mother tongue language. During the translation, the researchers will type and store

the translated sentences on a separate document within 24 hours after the researchers

gather all the data. Hermeneutics method will be used for the data analysis of this study.

According to Oerther (2020), hermeneutics was used to describe the process of

interpreting, analyzing, or comprehending written works and documents. It is a

qualitative research method that enables researchers to examine the influence of

experiences, customs, beliefs, and heritage on routine, everyday behaviors. This method
 26

extracts participants' narratives and experiences as a source of knowledge. Hermeneutic

phenomenology is a valuable research tool because it enables researchers to express and

perceive how parents' regular, everyday activities and habits are influenced by their

family dynamics, childhood experiences, and day-to-day circumstances. Concerning, the

researchers' analysis will clarify the themes and their interconnections. The researchers

will then accomplish the study by categorizing, classifying, and discussing the lived

experiences of professional nurses who recovered from COVID-19. The researchers will

derive the theme from the completed collation and submit it back to the respondents for

validation if it accurately reflects its meanings. The key insights will be presented

through clustering the experiences of nurses into themes.

Moreover, to determine the reliability and credibility of the data, Lincoln and

Guba's Trustworthiness will be used as it is vital since researchers are obtaining personal

and sensitive details from the participants' responses. This term refers to the extent of

trust in the information, their analysis, and the methods utilized to guarantee the study's

authenticity (Pilot and Beck, 2014). Hence, this is fundamental for the study finding's

usability and integrity. (Cope, 2014). Trustworthiness comprises of the following criteria:

credibility, transferability, dependability, and confirmability. In light of this, researchers

can be entrusted to safeguard sensitive, significant, and confidential data.

With that, all research team members will agree on the final organization of the

topics and subsequent content justifications to ensure credibility. During the procedures,

the researchers will check and ensure that there are no discrepancies or inconsistencies.

Besides, credibility will be acquired by providing accurate and valuable information or

offering beneficial solutions consistently. The researchers will certify that the study
 27

measures or verifies what was intended. In addition, transferability will be performed by

declaring that the result of qualitative research regarding the lived experiences of

professional nurses who recovered from COVID-19 will provide evidence that the

participants' response from the narrative survey could be applicable or transferred beyond

the bound of this research study. To ensure dependability, the researchers will assess the

adequacy of the data and the preliminary results that will be obtained from checking the

accuracy of the findings. In addition to that, participants must speak the truth, not a

deception. To ensure their honesty and integrity, the researchers will place their whole

trust and confidence in their participants' sincerity in sharing their lived experiences when

infected and recovered from COVID-19. Further, to ensure confirmability, the

researchers will guarantee to gather enough information from the participants by

translating and examining the respondents' shared data and organizing it.

Ethical Considerations (Tan)

Attributed to the fact that this study will involve human respondents, notably

professional nurses who recovered from COVID-19, the researchers will exercise and

ensure the utmost care and address critical ethical considerations during the conduct of

the study. It is imperative to take these ethical considerations into account in order to

protect the participants' privacy and safety. This is with adherence to upholding Republic

Act 10173: Philippines Data Privacy Act of 2012, which aims to secure and vindicate

people's individual information stored in government and private sector data and

communication networks and facilities while maintaining the constitutionally protected

right to communication privacy (Pitogo, 2019). Among the fundamental ethical

implications, consent and confidentiality are the ones that will be included to be
 28

evaluated during the research procedure. Thereby, the researchers will first seek

permission from the hospital administrators of the chosen private hospital in Bacolod

City to conduct the study to their employees, specifically the nurses that were infected

with COVID-19, by sending them a letter of consent, which is subject to approval. If

permission is signed and granted, the researchers will obtain consent from the chosen

participants and communicate all pertinent information about the study, including its

purpose and objective.

Additionally, it will be indicated in the informed consent that the study will not

collect participants' names and that their identities will be withheld in maximum

concealment. The researchers will also state that any information the nurses disclose will

be solely used for academic purposes and researchers' thesis and will be discarded

properly without leakages. By emphasizing these fundamental aspects, respondents will

gain an awareness and understanding of the significance of their contribution to the

research's completion. Moreover, respondents will be informed that they could withdraw

from the research even throughout the conduct of this study. Thus, they will not be

compelled to partake in the study as this is only voluntary. Participants' privacy will also

be ensured by not exposing other identifying information in the research. Only pertinent

details that will aid in completing the study questions will be incorporated. Furthermore,

after transcribing the data gathered, the researchers will redirect it to the participants for

approval. Considering that the data collection will take place on an internet platform, the

study will ensure that participants' identities and privacy are protected from possible data

breaches and will be instantly extracted after the proposed research is reviewed, accepted,

and submitted.
 29

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 33

APPENDICES

APPENDIX A: Sample Instrument

University of St. La Salle

College of Nursing
S.Y. 2021-2022

Individual Narrative Survey Form for the Study Entitled “Lived Experiences of

Professional Nurses who Recovered from COVID-19”

Dear Nurses,

Good day! We, the third-year nursing students from the University of St. La Salle,

are conducting a survey on the topic “Lived Experiences of Professional Nurses Who

Recovered from COVID-19”. This is in compliance with our Nursing Research subject.

Please kindly answer the questions below honestly and completely.

Rest assured that we, the researchers, will treat all information given with utmost

confidentiality and respect. The information provided will be solely used for academic

purposes and will be discarded properly without leakages.

If you have any questions, please do not hesitate to ask and contact the

researchers. Thank you and God bless!

I. Demographic Profile of the Participants

1. Age: _________________

2. Sex: _________________

Male

Female
 34

3. Marital Status:

Single

Married

Divorced

4. Number of Children: _____________

5. Area of Exposure: (e.g. Surgical Ward, OB Ward, Emergency Room, etc.)

________________________________________

6. Years in Service: ________________

II. Lived Experiences of Professional Nurses who Recovered from COVID-19

1. What were your signs and symptoms before you learned that you were infected with

the virus?

2. What and how did you feel or react when you discovered you had COVID-19?

3. After being infected, what are your experiences during your quarantined days?

4. What do you believe may have led to your infection with COVID-19?

5. What issues have you encountered?

6. Did you get any assistance and support from your colleagues and family?

7. What were your coping strategies while being quarantined or isolated?

8. Is there something else you might want to share about your experience with infection

while working as a nurse?

 35

Appendix B: Letter of Permission to the Hospital Administrators

University of St. La Salle

College of Nursing
S.Y. 2021-2022

Informed Consent for Hospital Administrators

University of St. Lasalle – College of Nursing

La Salle Avenue, Bacolod 6100, Negros Occidental

Title of Research Project: LIVED EXPERIENCES OF PROFESSIONAL NURSES

WHO RECOVERED FROM COVID-19

Name of Principal Investigator: Nursing Students from University of St. La Salle

Phone Number of Principal Investigator: 09190050484

Authorization for use/disclosure of information: We, the administrators in a private

hospital in Bacolod City, voluntarily consent and authorize the Nursing Students from

University of St. La Salle- Bacolod to use or disclose the health information and

experiences of our professional nurses during the term of this Authorization to the

recipient(s) that I have identified below.

Recipient: We authorize the health care information and experiences of our nurses due to

COVID-19 to be released to the following recipient(s): Nursing Students from University

of St. La Salle
 36

Purpose: We authorize the release of the health information of our employees for the

following specific purpose: at the request of the Nursing Students from University of St.

La Salle-Bacolod who are conducting research entitled, “LIVED EXPERIENCES OF

PROFESSIONAL NURSES WHO RECOVERED FROM COVID-19”. The purpose of

our nurses’ participation in this research is to help the researchers discover the lived

experiences of professional nurses who got infected and recovered from COVID-19,

specifically on how they cope up with the impacts or experiences when being isolated,

quarantined, and recovering from the disease for a long period of time.

Information to be disclosed: We authorize the release of the following health

information:

 All of our employee’s health information that the provider has in his or her

possession, including information relating to any medical history, mental or physical

condition, and personal experiences.

 Only the following records or types of health information: Age, Gender, Marital

Status, Number of Children, Area of Exposure and Years in Service.

Term: We understand that this Authorization will remain in effect:

 From the date of this Authorization until the ___ day of ______, 20___.

 Until the Provider fulfills this request.

 Until the following event occurs: ______________________________________

 37

Redisclosure: We understand that the researchers can guarantee that the records from

this study will be kept as confidential as possible. No individual identities will be used in

any reports or publications resulting from the study and will not disclose to a third party.

Only research members will have access to the files and survey forms distributed via

email and only those with an essential need to see other identifying information will have

access to that particular file. After the study is completed, all gathered information will

remain confidential and researchers will be held liable for it.

Refusal to sign/right to revoke: We understand that signing this form is voluntary and

that if they don’t sign, it will not affect the relationship with the College of Nursing

Department from University of St. La Salle. If the nurses choose to participate in this

study, they can withdraw their consent and discontinue participation at any time without

prejudice.

_________________________________________________________

Full Name of the Head of Hospital Administrators and Signature

_______________________________

Date
 38

APPENDIX C: Letter to the Participants

University of St. La Salle

College of Nursing
S.Y. 2021-2022

Informed Consent to Participate in a Research Study

University of St. Lasalle – College of Nursing

La Salle Avenue, Bacolod 6100, Negros Occidental

Title of Research Project: LIVED EXPERIENCES OF PROFESSIONAL NURSES

WHO RECOVERED FROM COVID-19

Name of Principal Investigator: Nursing Students from University of St. La Salle

Phone Number of Principal Investigator: 09190050484

Dear Nurses,

We, the nursing students from University of St. La Salle, is conducting a survey

in line with our research study entitled, “LIVED EXPERIENCES OF

PROFESSIONAL NURSES WHO RECOVERED FROM COVID-19”. The purpose

of your participation in this research is to help the researchers discover the lived

experiences of professional nurses who recovered from COVID-19, specifically on how

you cope up with the impacts or experiences when being isolated, quarantined, and

recovering from the disease for a long period. You were selected as a possible participant

in this study as you are one of the nurses who recovered from COVID-19 that faced

ample experiences.
 39

If you agree to participate in this research study, the following will occur: The

researchers will use an individual narrative survey form that will be sent to your email

address to identify your lived experiences when being infected with COVID-19.

Additionally, the survey form is separated into two parts: a profile part and the survey

questions. The profile contains your demographic characteristics, which will require you

to answer and put a check mark regarding your age, gender, marital status, number of

children, area of exposure, and years of service. Part 2 of the survey form contains

questions that will explore your experiences, particularly the challenges and issues you

faced. Moreover, it also consists of questions that will identify your coping strategies and

assistance received during your isolation. Your participation in the survey indicates you

read this consent information and agreed to participate in this anonymous survey.

Depending upon the depth of your responses, participation time varies from 20 minutes to

45 minutes.

The possible risks or discomforts of the study are minimal. You may feel a little

uncomfortable or embarrassed answering regarding personal and sensitive survey

questions. But rest assured that all details disclosed will be understood and appreciated.

The records from this study will be kept as confidential as possible. No individual

identities will be used in any reports or publications resulting from the study. All

individual narrative survey forms which contains questions regarding age, sex, marital

status, number of children, area of exposure, years in service, lived experiences when

being infected with COVID-19 and after recovery, and coping strategies while being

isolated will be given codes and stored separately from any names or either direct

identification of participants. Research information will be kept in locked files at all times.
 40

Only researchers will have access to the files and survey forms distributed via email and

only those with an essential need to other identifying information will have access to that

particular file. After the study is completed, all gathered information will remain

confidential and researchers will be held liable for it.

There will be no direct benefit to you from participating in this study. The

anticipated benefit of your participation in this study will help future researchers and

nurses to:

 Give knowledge and awareness about the situation, and be prepared for the worst

scenarios to come.

 Serve as a guide on what to do and how to cope up when infected with COVID-19.

 Show future nurses the lived experiences of professional nurses who recovered from

COVID-19.

Your decision whether or not to participate in this study is voluntary and will not

affect your relationship with the College of Nursing Department from University of St.

La Salle. If you choose to participate in this study, you can withdraw your consent and

discontinue participation at any time without prejudice. If you have any questions about

the study, please contact Nursing Students from University of St. La Salle by contacting

+639190050484.
 41

CONSENT SLIP

YOU ARE MAKING A DECISION WHETHER OR NOT TO PARTICIPATE IN

A RESEARCH STUDY. YOUR SIGNATURE BELOW INDICATES THAT YOU

HAVE DECIDED TO PARTICIPATE IN THE STUDY AFTER READING ALL

OF THE INFORMATION ABOVE AND YOU UNDERSTAND THE

INFORMATION IN THIS FORM, HAVE HAD ANY QUESTIONS ANSWERED

AND HAVE RECEIVED A COPY OF THIS FORM FOR YOU TO KEEP.

Signature __________________________________ Date ____________________

Research Participant

Signature __________________________________ Date ____________________

Nursing Student Researcher

 42

APPENDIX D: Gantt Chart

 43

APPENDIX E: Budget Plan

BUDGET PARTICULAR AMOUNT TOTAL

AMOUNT
A. Research  Snacks w/ Php 150 x 5 per Php 750
Team drinks person for weekly
Synchronous meetings
Meetings
 Brainstorming
 Discussion
B. Materials,  Grammarly Php 240 x 1-month Php 240
Equipment’s subscription
and Supplies  USB Php 300 x 1 Php 300
 Ink for the Php 1000 x 1 Php 1000
Printer package (Colored,
Black and White)
 Folder Php 120 x 1 Set Php 120
(10 pieces)
 Bond paper Php 250 x 1 Rim Php 250
C. Internet  Wifi Php 500 x 5 per Php 2500
Connection person monthly
(August –
December)
 Load Php 350 x 5 Php 1750
monthly (August –
December)
D. Defense  Panel Php 500 x 5 from Php 2500
each researcher
 Snacks w/ Php 120 x 5 per Php 600
drinks for the person
 44

Panel
 Token for the Php 200 x 5 per Php 1000
Panel person
Total Proposed Php 11,085
Budget