PERCEPTION OF STRESS AND STRESS MANAGEMENT ACTIVITIES AMONG THIRD

YEAR NURSING STUDENTS OF PHINMA –CAGAYAN DE ORO

COLLEGE, 1ST SEMESTER, S.Y. 2015-2016 AS BASIS FOR
EFFECTIVE QUALITY NURSING CARE

An Undergraduate Thesis
Presented to
the Faculty of the College of Nursing
PHINMA – Cagayan de Oro College

In Partial Fulfillment of the

Requirements for the Subject
Research II

By:

Mary Yvonne S. Razo

Robert Tayapad

September, 2015
 APPROVAL SHEET

This thesis entitled “PERCEPTION OF STRESS AND STRESS

MANAGEMENT ACTIVITIES AMONG THIRD YEAR NURSING STUDENTS OF PHINMA
–CAGAYAN DE ORO COLLEGE, 1ST SEMESTER, S.Y. 2015-2016 AS BASIS
FOR EFFECTIVE QUALITY NURSING CARE” prepared and submitted by
Mary Yvonne S. Razo and Robert Tayapad in partial fulfillment of
the requirements for the degree of Bachelor of Science in Nursing
has been examined for oral examination.

NURSE JOSEPH BAHIAN ABANG

Adviser

PANEL OF EXAMINEES

Approved by the Committee on Oral Examination with a grade

of .

LUCILLE L. LAGSA, RN, MN CARLITO FABILLAR

Chairman Member

Accepted and approved in partial fulfillment of the

requirements for the degree of Bachelor of Science in Nursing.

ROSITA P. GUTIERREZ, RN, MN

Dean, College of Nursing

October 2015
 “PERCEPTION OF STRESS AND STRESS MANAGEMENT ACTIVITIES AMONG
THIRD YEAR NURSING STUDENTS OF PHINMA –CAGAYAN DE ORO
COLLEGE, 1ST SEMESTER, S.Y. 2015-2016 AS BASIS FOR
EFFECTIVE QUALITY NURSING CARE”

ABSTRACT

What happens in the mind and body to trigger the stress

response? First there must be an event or situation, which is

perceived by the mind as undesirable or threatening and that is

called stress.

This study is all about the “PERCEPTION OF STRESS AND STRESS

MANAGEMENT ACTIVITIES AMONG THIRD YEAR NURSING STUDENTS OF PHINMA

–CAGAYAN DE ORO COLLEGE, 1ST SEMESTER, S.Y. 2015-2016 AS BASIS

FOR EFFECTIVE QUALITY NURSING CARE.” The descriptive method of

research was utilized and the questionnaire serves as the

principal data gathering instrument. There were 16 respondents

who fill up the survey questionnaire. The results of the

questionnaire were tabulated and interpreted from which the

findings and conclusion were drawn.

Based on the findings of the study, the researchers

formulated the following conclusions:

1. That the level III nursing students consider “Finishing

charting on time” as the greatest stressors they have encountered

during their clinical duties and the least is the relationship

with the physicians. Meanwhile, the rest of the stressors show

that they can also affect the respondents clinical performance

during the tour of duty.

2. That the level III nursing students continuously prayed to

God and optimistic that the number one stress management they

usually performed is when they feel stress.

3. The result of the study would benefit to the nursing intern in

rendering effective quality nursing care. The identification of

the possible cause and effect of stressors on the level III

nursing students would provide them adequate academic and

clinical knowledge on stress. This study would serve as a guide

to them on how to manage stress with regards to their clinical

duties. These also provide information to the Clinical

Instructors, healthcare team in the hospital. The 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.

 ACKNOWLEDGMENT

The researchers would like to extend their sincerest thanks

to the following individuals who share their talents and skills

to make this study a successful one.

First, our deepest thanks and gratitude to God Almighty for

the abundant blessings and graces, the gift of life, and a

healthy mind. The researchers made a very successful study

through Him serving as their light and beam of hope;

Second, to our parents for their unending financial support

that inspired the researchers to make this study a possible one;

Third, to Nurse Joseph Bahian Abang for his all-out support

and unselfish dedication as an educator. Also to his persistence

and encouragement, for providing direction in writing the study

and for painstakingly editing this manuscript;

Fourth, to the librarians of PHINMA – Cagayan de Oro

College, for their assistance and benevolent response on the

researchers’ request to avail for the resources in the library;

Fifth, to the Level III Student Nurses of PHINMA-COC College

of Nursing who participated in the study. These respondents

responded accordingly to the survey tool distributed to them;

Sixth, to Mrs. Lucille Lagsa, RN, MN for the continuing

effort she made. Her motherly love and the encourage the

researchers to pursue the course;

 Seventh, to our understanding friends for the inspiration

and motivation despite of their hectic schedules;

Finally, to those names not mentioned but in one way or

another have helped the researchers to finish this study on time,

our heartfelt and sincerest thanks to all.

The Researchers
 TABLE OF CONTENTS

CONTENTS PAGE

TITLE PAGE i
APPROVAL SHEET ii
THESIS ABSTRACT iii
ACKNOWLEDGEMENT v
TABLE OF CONTENTS vii
LIST OF TABLES xvi
LIST OF FIGURE xvi
CHAPTER I: PROBLEM AND ITS SETTINGS
Introduction …………………………………………………………………………………………………………1
Theoretical Framework …………………………………………………………………………………5
Conceptual Framework ……………………………………………………………………………………6
Statement of the Problem …………………………………………………………………………8
Significance of the Study ………………………………………………………………………9
Definition of Terms ………………………………………………………………………………………11
Scope and Delimitation ………………………………………………………………………………13
CHAPTER II: THEORETICAL ORIENTATION
AND REVIEW OF RELATED LITERATURES AND STUDIES

Theoretical Orientation ……………………………………………………………………………14

Foreign Literature …………………………………………………………………………………………15
Local Literature ………………………………………………………………………………………………19
Foreign Studies …………………………………………………………………………………………………20
Local Studies ………………………………………………………………………………………………………21
Justification of the Studies ……………………………………………………………23
CHAPTER III: RESEARCH METHODOLOGY
 Research Setting ………………………………………………………………………………………………24
Respondents ……………………………………………………………………………………………………………25
Research Instrument ………………………………………………………………………………………25
Data Collection……………………………………………………………………………………………………27
Statistical Treatment of Data ……………………………………………………………28
CHAPTER IV: PRESENTATION, ANALYSIS
AND INTERPRETATION OF DATA

Results and Discussion ………………………………………………………………………………31

Implication of Study ……………………………………………………………………………………40
CHAPTER V: SUMMARY, CONCLUSIONS AND RECOMMENDATIONS
Summary Findings ………………………………………………………………………………………………41
Conclusions ……………………………………………………………………………………………………………45
Recommendations …………………………………………………………………………………………………47
BIBLIOGRAPHY…………………………………………………………………………………………………………………………49

APPENDICES………………………………………………………………………………………………………………………………51

A. Sample Letter to the Dean…………………………………………………………………51

B. Sample Letter to the Respondents………………………………………………52
C. Perception of Stress Questionnaire…………………………………………53
D. Intrapersonal Stress Management Questionnaire……………54
E. Interpersonal Stress Management Questionnaire……………55
F. Impersonal Stress Management Questionnaire……………………56

CURRICULUM VITAE……………………………………………………………………………………………………………57
 LIST OF TABLES
TABLE TITLE PAGE
1.1 Distribution of Respondents According to Age 31
1.2 Distribution of Respondents According to Gender 32
2 Stressors of Level III Nursing Students 32
3.1 Interpersonal Stress Management 35
3.2 Intrapersonal Stress Management 37
3.3 Impersonal Stress Management 39

FIGURE
FIGURE TITLE PAGE

1 Research Paradigm 7
 CHAPTER I

THE PROBLEM AND ITS SETTING

Introduction

Throughout its distinguished history, nursing has 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 intricately 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

appreciated when they are in actual hospital situation. Any

nursing student who does not undergo sufficient clinical duties

is 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 different

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

experiences while undergoing RLE program. It is in this view

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 a 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.

 Stress is stimuli response to changes in life. Since life

involves constant change (ranging from changing locations from

home to work, to major life changes like marriage, divorce, or

death of a love one), there exist unavoidable stress. This is why

our goal is not to eliminate all stress, but to get rid of

unnecessary stress, and effectively manage the rest. Some common

causes of stress that many nurses encounter are increasing the

severity of clients’ illnesses, adjusting to various work shifts

assuming responsibilities for which one is not prepared, and

inadequate support from supervisors and peers.

There are different types of stress that ranges 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 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.
 All of us feels 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 can quickly reverse our body’s reaction to stress,

like buffering the damage to our health and keeping our thinking

clear in order for us to deal effectively with what’s going on in

the moment.

It may seem that there is nothing that all of us can do

about our stress level. However, there are things that can

possibly be done to have control of these stressors. In fact, the

simple realization that there exists a 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

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.

In the Philippines there were only few studies conducted

regarding the topic. It is for this reason that the researchers

embarked to this study that is designed to measure the

“PERCEPTION OF STRESS AND STRESS MANAGEMENT ACTIVITIES AMONG

THIRD YEAR NURSING STUDENTS OF PHINMA –CAGAYAN DE ORO COLLEGE,

1ST SEMESTER, S.Y. 2015-2016 AS BASIS FOR EFFECTIVE QUALITY

NURSING CARE.”

Theoretical Framework

This study would employ a Transactional Model of Stress and

Coping in exploring the “PERCEPTION OF STRESS AND STRESS

MANAGEMENT ACTIVITIES AMONG THIRD YEAR NURSING STUDENTS OF PHINMA

–CAGAYAN DE ORO COLLEGE, 1ST SEMESTER, S.Y. 2015-2016 AS BASIS

FOR EFFECTIVE QUALITY NURSING CARE.” According to this model

(Lazarus & Folkman, 1984), stress is an outcome of a transaction

or relationship between the person and the environment where two

processes are identified that is critical to the immediate and

long range outcomes of the transaction. Cognitive appraisal is

the process through which the person evaluates the relevance and
the impact of a particular encounter with the environment or the

well-being of the person. Coping, the constantly changing

cognitive and behavioral efforts to manage specific external and

internal demands that are appraised as taxing or exceeding the

person’s resources to cope.

Conceptual Framework

Research paradigm is shown on Figure 1. This included the

INDEPENDENT VARIABLES, and the DEPENDENT VARIABLES. The

independent variables contains the profile of the level III

nursing students of PHINMA – CAGAYAN DE ORO COLLEGE, COLLEGE OF

NURSING, the different stressors they encountered, and the

different stress management they performed to alleviate their

stress.

The dependent variables were consisting of the findings

about the stress management performed by the respondents.

 INDEPENDENT DEPENDENT

Perception of
Level III
Nursing Profile 1. Student Nurse
Age Centered
Gender
Stressors

2. Patient Centered
Stressors

3. Instructor
Centered Stressor
Stress Management Performed by student
Interpersonal Activities
Intrapersonal Activities 4. Peer Centered
Impersonal Activities Stressor

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.

Statement of the Problem

This study sought to measure the “PERCEPTION OF STRESS AND

STRESS MANAGEMENT ACTIVITIES AMONG THIRD YEAR NURSING STUDENTS OF

PHINMA –CAGAYAN DE ORO COLLEGE, 1ST SEMESTER, S.Y. 2015-2016 AS

BASIS FOR EFFECTIVE QUALITY NURSING CARE” were examined to

provide significant data and reliability towards the

Specifically, this study aims to answer the following

questions:

1. What is the profile of the respondents when grouped

according to:

1.1 age

1.2 gender

2. What are the common stressors encountered by the level

III nursing students of PHINMA – Cagayan de Oro College, with

regards to their first clinical duties?

3. How do the different stressor affect the respondents

while performing their clinical duties among the following

indicators:

3.1 interpersonal management

3.2 intrapersonal management

3.3 impersonal management

 4. What are the precautionary measures the respondents will

do considering the following:

4.1 interpersonal management

4.2 intrapersonal management

4.3 impersonal management

Significance of the Study

This study would be beneficial to the following individuals:

To the nursing students, this study would give them better

insights on how to identify the stressors and problems

encountered all throughout their clinical duties. The knowledge

gained will give them better and wider perspective about the

nursing profession and it also aid them in enhancing self-

confidence.

To 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.

To 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 improve the quality of nursing education for the

benefit of the students and the institution as well.

To 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.

To the patients, who are the recipients of the healthcare

service given by the nursing students.

To 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

For a clearer understanding of the study, the following

terms are conceptually and operationally defined:

Age – how old somebody or something is, the length of time

that somebody or something has existed, usually expressed in

years (Encarta Dictionary, 2010)

In this study, it refers to the development and maturation

of level III and IV nursing students of PHINMA – Cagayan de Oro

College in years as of last birthday.

 Gender – either of the two reproductive categories (Encarta

Encyclopedia 2010)

In this study, it refers to being a male or female of the

respondents of the study

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.

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 PHINMA – Cagayan de Oro College,

College of Nursing.

PHINMA – Cagayan de Oro College. This is an institution 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

– 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.

Scope and Limitation of the Study

This study was entitled “PERCEPTION OF STRESS AND STRESS

MANAGEMENT ACTIVITIES AMONG THIRD YEAR NURSING STUDENTS OF PHINMA

–CAGAYAN DE ORO COLLEGE, 1ST SEMESTER, S.Y. 2015-2016 AS BASIS

FOR 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 PHINMA – Cagayan de Oro College, College of

Nursing as respondents of the study during the 1 st Semester of

School Year 2015-2016

 Chapter 2

Review of Related Literature

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 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 program

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 confident 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 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.

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 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.

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 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

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

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

According 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 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

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 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 3

Research Design and Methodology

This chapter describes the methodology of the research. It

covers the research questions, the research design, the

population and sampling procedures, the data gathering processes,

and the researcher’s role. Furthermore, it discusses the process

used for data analysis and interpretation, as well as strategies

used to attain trustworthiness.

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.

Research Setting

The research was conducted between June and August 2015 at

PHINMA – Cagayan de Oro College, College of Nursing located at

Max Suniel Street Carmen Cagayan de Oro City. PHINMA – COC

College of Nursing was used for convenience. Also because PHINMA

– COC College of Nursing is a large, urban, diverse institution,

which admits students at all levels of study, conducting this

study at PHINMA – COC College of Nursing gave the research an

opportunity to obtain a diverse sample of participants.

Respondents

The population of this study was comprised of Level III

nursing students from PHINMA – COC College of Nursing. The

participation in the study was voluntarily resulting in a non-

probability, purposive sampling. Merriam (1998) states that

“purposeful sampling is based on the assumption that the

investigator wants to discover, understand, and gain insight and

therefore must select a sample from which the most can be

learned” (p. 61).

Purposive samples include 16 subjects nursing students which

are readily available. It was less costly sampling technique and

easy to administer.

A total of 16 questionnaires were distributed to the

respondents of Level III nursing students respectively.

Confidentiality was ensured from the responses given by then

respondents, because of the sensitive nature of the study. It was

done by anonymity and supplying envelopes for return of the

completed questionnaire.

Research Instrument

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 PHINMA – Cagayan de Oro College, College of Nursing.

Problem no. 2 involves the different stressors encountered by the

level III nursing students of PHINMA – Cagayan de Oro College,

College of Nursing 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.
Data Collection

Data collection took place at PHINMA – COC College of

Nursing. The researchers of the study sent a letter of consent to

the PHINMA – COC College of Nursing Dean asking permission to

conduct the study in the department. Another letter was

formulated as consent for the researches to conduct a survey to

the respondents particularly the level III nursing students of

the department. During the conduct of the survey, it only took up

to a maximum time of 15 minutes. After the respondents answered

the survey questions, the researchers got the survey tool

enclosed in the envelope provided.

Statistical Data Analyses

The result of the study was analyzed using the SPSS version

12 statistical package. The following statistical technique was

used:

Descriptive statistics was used to process all biographical

information. Descriptive statistics describe the data of samples

of subjects in terms of variables. The technique includes

measures of central tendency and measures of variability. The aim

was to organize and reduce the information to manageable

proportions and to readily communicate some of the information

(Howell, 1989).
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

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

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.

Chapter 4
 Results and Discussion

This chapter provides the findings of the survey conducted.

This study measured the “PERCEPTION OF STRESS AND STRESS

MANAGEMENT ACTIVITIES AMONG THIRD YEAR NURSING STUDENTS OF PHINMA

–CAGAYAN DE ORO COLLEGE, 1ST SEMESTER, S.Y. 2015-2016 AS BASIS

FOR EFFECTIVE QUALITY NURSING CARE”.

Specifically, the following answers the questions formulated

in the making the study

1. What is the profile of the respondents when grouped

according to:

1.1 age

Table 1.1
Distribution of Respondents According to Age

Age Frequency Percentage Rank

18years old 1 6.25 4
19years old 7 43.75 1
20years old 2 12.50 3
21years old 3 18.75 2
22years old 1 6.25 4
23years old 2 12.50 3
TOTAL 16 100.00

Table 1.1 present the data of the respondents in terms of

their age. There was no respondent who are 17 years old which

ranked last; 1 or 6.25% of the respondent who was 18 years old

and 22 years old which ranked 4 respectively; 7 or 43.75% of the

respondents who were 19 years old which ranked 1; 2 or 12.50% of

the respondents who were 20 years old and 23 years old which

ranked 3; 3 or 18.75% of the respondents who are 21 years old

which ranked 2.

1. What is the profile of the respondents when grouped

according to:

1.2 gender

Table 1.2
Distribution of Respondents According to Gender

Gender Frequency Percentage Rank

Male 4 25.00 2
Female 12 75.00 1
TOTAL 16 100.00
Table 1.2 presents the data of the respondents in terms of

their Gender. There were 4 of the respondents who are male and 12

of the respondents who are female.

Men and women report different reactions to stress, both

physically and mentally. They attempt to manage stress in very

different ways and also perceive their ability to do so — and the

things that stand in their way — in markedly different ways.

Findings suggest that while women are more likely to report

physical symptoms associated with stress, they are doing a better

job connecting with others in their lives and, at times, these

connections are important to their stress management strategies. 

Table 2
 Stressors of 3rd Year Nursing Students

ITEM STRESSORS WM SD DESCRIPTION RANK

STUDENT CENTERED
1 Recognition of some evident 3.29 0.25 SOMETIMES 8
changes concerning patient’s
symptoms
2 Mixed cases of patients due 3.31 0.27 SOMETIMES 7
to lack of room
3 Unfamiliar healthcare setting 3.21 0.20 SOMETIMES 9
in the hospital
4 Wrong procedure performed to 3.01 0.32 SOMETIMES 10.5
the patient
PATIENT CENTERED
5 Doing bedside care to the 3.60 0.50 OFTEN 5
patient.
6 Patient with serious cases 3.62 0.51 OFTEN 4
7 Lack of hospital facilities 3.43 0.48 OFTEN 6
and equipments
8 Relationship with the patient 2.94 0.15 SOMETIMES 15
INSTRUCTOR CENTERED
9 Finishing charting on time 3.89 0.62 OFTEN 1
10 Handling too many patients 3.67 0.53 OFTEN 2.5
11 Preparation and submission of 3.67 0.53 OFTEN 2.5
requirements
12 Relationship with Clinical 2.97 0.16 SOMETIMES 14
Instructors
PEER CENTERED
13 Relationship with the co- 3.01 0.32 SOMETIMES 10.5
students
2.14 Relationship with staff 3.01 0.32 SOMETIMES 10.5
nurses
15 Relationship with the 2.79 0.14 SOMETIMES 16
physicians
16 Relationship with patient’s 2.99 2.17 SOMETIMES 13
family, relatives, and
visitors
TOTAL 3.27 0.33

Table 2 indicate the interpretation and analysis of the data

gathered based on the respondents stressors. The same table

reflects that item No. 9 which is “finishing charting on time”,

and a mean score of 3.89 quantitatively described as “Often”.

This is subsequently followed by item No. 10 which is “handling

too many patients” and item No. 11 “preparation and submission of

requirements” with a mean score of 3.67 respectively described as

“Often”. The least was item No. 15 which is “relationship with

the physician with a mean score of 2.79.

This indicates that the routine practices in the hospitals

are one of the reasons 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 No. 8 “Relationship with the patient” got a

weighted mean of 2.94, item No. 13 “Relationship with the co-

students” got a weighted mean of 3.01, item 2.12 “Relationship

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

2.14 “Relationship with the staff nurses” got a weighted mean of

3.01, item 2.15 “Relationship with the physicians” got a weighted

mean of 2.79, item 2.16 “Relationship with the patient’s family,

relatives and visitors” got a weighted mean of 2.99, item 2.1

“Recognition of some evident changes concerning patient’s

symptoms” got a weighted mean of 3.29, item 2.2 “Mixed cases of

patients due to lack of rooms” got a weighted mean of 3.31, item

2.3 “Unfamiliar healthcare setting in the hospital” got a

weighted mean of 3.21 and item 2.4 “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

personnel’s 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 3.1
Interpersonal Stress Management Performed By the
Level III Nursing Students

ITEM STRESSORS WM SD DESCRIPTION RANK

INTERPERSONAL
3.1.1 Spending time with your love 3.84 OFTEN 5
ones.(Family, friends or
even pets) 0.15
3.1.2 Watching movies and other 3.71 OFTEN 7
programs on television 0.18
3.1.3 Engaging into sports 3.31 0.15 SOMETIMES 10
3.1.4 Asking for assistance to the 3.67 OFTEN 8
Clinical Instructor 0.17
3.1.5 Verbalization of feelings to 3.64 OFTEN 9
a fellow student 0.16
3.1.6 Sleeping 3.75 0.14 OFTEN 6
3.1.7 Managing your time better 3.99 0.35 OFTEN 1
3.1.8 Eating your favorite foods 3.88 0.2 OFTEN 4
3.1.9 Using the internet 3.89 OFTEN 3
(chat,instagram, facebook,
etc.) and playing on line
games 0.29
3.1.10 Calling and texting your 3.90 OFTEN 2
family members, relatives,
friends, etc. 0.30
AVERAGE 3.75 0.19

Table 3.1 presents the interpersonal stress management

performed by the respondents to handle and alleviate their

stress. Item 3.1.7 “Managing your time better” got a weighted

mean of 3.99 and interpreted as “Often”. On the other hand, item

3.1.3 “Engaging into sports got a weighted mean of 3.31 and

interpreted as “Sometimes”.
 This indicates that time management is essential in every

field of life because time is the precious recourse one has to

accomplish a task. A very single moment which passed once will

never come back to be availed. Time management helps you do your

task in time and utilize your time more productively. It helps

you to identify the useless activities which can be avoided and

time can be saved. It helps you give proper time to a task and

perform the task more efficiently. No one wastes time

intentionally. Time is always wasted in insensible way that’s why

a student does not feel when he wastes time but he realizes in

the days of exam. So it is better to utilize the present time

more effectively than crying over past in future.

If a student wastes time it means he is careless about his study

or he does not know how to manage time. So you should know about

the importance of time and should be particular about it. You

should learn how to manage time.

On the other hand, engaging into sports is ranked last in

the Interpersonal Stress Management Activities of the Level III

nursing students indicates that nursing students have a limited

time for sports due a very hectic schedule while in school.

Recent statistics suggest that, participation in organized sport

has increased only marginally for boys, with no significant

change for girls. Coaches and parents continue to be dismayed

when a child says ‘I just don’t want to do it any more’.

By understanding what motivates students to participate in sport,

and putting in place the strategies suggested in this study,

coaches will be seen as playing their part in helping student

experience sport in the positive way — the way we know it can.

3.2
Intrapersonal Stress Management Performed By the
Level III Nursing Students

ITEM STRESSORS WM SD DESCRIPTION RANK

INTRAPERSONAL
3.2.1 Thinking positive and being 4.23 0.76 ALWAYS 1
confident in whatever you do
3.2.2 Day dreaming 2.98 0.63 SOMETIMES 7

3.2.3 Listening to music, singing 3.73 0.65 OFTEN 3

and dancing
3.2.4 Enjoying pleasurable 3.31 0.63 SOMETIMES 4
activities. (Playing
instrument, reading,
drawing, painting, etc.)
3.2.5 Knowing your limits and 3.85 0.69 OFTEN 2
stick to them
3.2.6 Making yourself busy by 3.28 0.62 SOMETIMES 6
doing household chores
3.2.7 Drinking alcoholic beverages 2.18 0.6 SELDOM 9
and smoking
3.2.8 Taking medication as a 2.42 0.59 SELDOM 8
reliever
3.2.9 Doing physical exercises. 3.09 0.68 SOMETIMES 5
(Jogging, running, aerobics,
etc.)
AVERAGE 3.23 0.65
 With the item 3.2.1 “Thinking positive and being confident

in whatever you do” got a weighted mean of 4.23 and interpreted

as “Always”. On the other hand item 3.2.7 “Drinking alcoholic

beverages and smoking” got a weighted mean of 2.18 and

interpreted as “Seldom”.

This indicates that it is necessary to develop self-

confidence and it is important for nursing students, particularly

when caring for people whose situations are uncertain or whose

prognoses are unclear. Patients and clients seek confidence and

control in turbulent times. It is important for nursing students

to be calm, decisive and reassuring. However, acquiring these

skills can be difficult in the early stages of training when

knowledge and proficiency are limited. Central to gaining self-

confidence is a belief that the ability to fulfill your potential

is within reach. A further strategy is to draw up short-term and

long-term personal and professional goals to boost career

objectives.

Clinical experience is important in nurse education and many

factors influence the way that students learn. Olsson and

Gullberg (1987) say that being able to derive maximum benefit

from a placement is a complex process, involving a lot more than

merely allowing oneself to be influenced by the environment.

Student nurses must be able to be active participants within

their clinical setting if they are to optimize their learning

potential.

3.3

Impersonal Stress Management Performed By the

Level III Nursing Students

ITEM STRESSORS WM SD DESCRIPTION RANK

IMPERSONAL
3.3.1 Taking time to rest and 3.78 0.67 OFTEN 5
relax
3.3.2 Praying to God 3.86 0.73 OFTEN 2

3.3.3 Simply stay at the corner of 2.27 0.61 SELDOM 11

your own room and crying
3.3.4 Ignoring the problem 3.33 0.63 SOMETIMES 7

3.3.5 Getting angry and having 2.86 0.60 SOMETIMES 9

mood swings
3.3.6 Laughing at it 3.79 0.68 OFTEN 4

3.3.7 Reasoning out or answering 3.29 0.61 SOMETIMES 8

back
3.3.8 Taking it as a challenge 4.66 0.75 ALWAYS 1

3.3.9 Limiting your contact to the 3.42 0.65 OFTEN 6

source of stress
3.3.10 Cursing 2.67 0.61 SOMETIMES 10

3.3.11 Accepting the reality that 3.81 0.72 OFTEN 3

sometimes it merely happens
AVERAGE 3.43 0.66

Table 3.3 showed the impersonal stress management performed

by the level III Nursing Students in order to alleviate stressors

felt during the first clinical exposure. With the item 3.3.8

“Taking it as a challenge” with a weighted mean of 4.66 and

interpreted as “Always” while item 3.3.3 “Simply stay at the

corner of your own room and crying” with a weighted mean of 2.27

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 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 “PERCEPTION OF STRESS AND STRESS

MANAGEMENT ACTIVITIES AMONG THIRD YEAR NURSING STUDENTS OF PHINMA

–CAGAYAN DE ORO COLLEGE, 1ST SEMESTER, S.Y. 2015-2016 AS BASIS

FOR EFFECTIVE QUALITY NURSING CARE”.

The descriptive method of research was utilized and the

questionnaire serves as the principal data gathering instrument.

There 16 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.

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 equipment’s 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 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 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 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.

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 nursing

students to manage their stress and be competent enough in

different clinical area.

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.

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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 Appendix A

Letter to the Dean

August 15, 2015

Rosita P. Gutierrez, RN, MN

College Nursing Dean

COC-PHINMA

Dear Ma’am:

We, the Level IV nursing student of PHINMA – Cagayan de Oro

College, College of Nursing from Cagayan de Oro City are
conducting a study about the “PERCEPTION OF STRESS AND STRESS
MANAGEMENT ACTIVITIES AMONG THIRD YEAR NURSING STUDENTS OF PHINMA
–CAGAYAN DE ORO COLLEGE, 1ST SEMESTER, S.Y. 2015-2016 AS BASIS
FOR EFFECTIVE QUALITY NURSING CARE.” In line with this, we are
asking your permission to allow us to conduct this study in the
department by giving us the approval to get respondents from 3rd
year students. We hope that you can accommodate our request.

Sincerely yours,

Mary Yvonne S. Razo

Robert Tayapad

Appendix B
Letter to the Respondents

August 15, 2015

The Respondents

Level III Nursing Students

PHINMA – COC College of Nursing

Dear Respondents:

We, the Level IV nursing student of PHINMA – Cagayan de Oro

College, College of Nursing from Cagayan de Oro City are
conducting a study about the “PERCEPTION OF STRESS AND STRESS
MANAGEMENT ACTIVITIES AMONG THIRD YEAR NURSING STUDENTS OF PHINMA
–CAGAYAN DE ORO COLLEGE, 1ST SEMESTER, S.Y. 2015-2016 AS BASIS
FOR EFFECTIVE QUALITY NURSING CARE.” This letter is to request
your assistance in gathering the data of the study. There is, of
course, no penalty should you decide not to participate or later
to withdraw from the study. If you agree to participate, please
complete the attached questionnaire and place it in the envelope
we have provided. Completion of the questionnaire will be
considered permission to use the information you provide in the
study.

Please be assured that your responses will be kept absolutely

confidential. All of the questionnaires and return envelopes are
identical. Neither we nor anyone else will be able to identify
your response from those of other participants.

Sincerely yours,

Mary Yvonne S. Razo

Robert Tayapad

Appendix C

Perception of Stress Questionnaire

 ITEM STRESSORS 1 2 3 4 5
STUDENT CENTERED
2.1 Recognition of some evident
changes concerning patient’s
symptoms
2.2 Mixed cases of patients due to
lack of room
2.3 Unfamiliar healthcare setting
in the hospital
2.4 Wrong procedure performed to
the patient
PATIENT CENTERED
2.5 Doing bedside care to the
patient.
2.6 Patient with serious cases
2.7 Lack of hospital facilities
and equipments
2.8 Relationship with the patient
INSTRUCTOR CENTERED
2.9 Finishing charting on time
2.10 Handling too many patients
2.11 Preparation and submission of
requirements
2.12 Relationship with Clinical
Instructors
PEER CENTERED
2.13 Relationship with the co-
students
2.14 Relationship with staff nurses
2.15 Relationship with the
physicians
2.16 Relationship with patient’s
family, relatives, and
visitors
Legend:

5– Always
4– Often
3 - Sometimes
2 - Seldom
1 – Never
Appendix D
Intrapersonal Stress Management Questionnaire

ITEM STRESSORS 5 4 3 2 1
 INTERPERSONAL
3.1.1 Spending time with your love
ones.(Family, friends or
even pets)
3.1.2 Watching movies and other
programs on television
3.1.3 Engaging into sports
3.1.4 Asking for assistance to the
Clinical Instructor
3.1.5 Verbalization of feelings to
a fellow student
3.1.6 Sleeping
3.1.7 Managing your time better
3.1.8 Eating your favorite foods
3.1.9 Using the internet
(chat,instagram, facebook,
etc.) and playing on line
games
3.1.10 Calling and texting your
family members, relatives,
friends, etc.
AVERAGE

Legend:

5– Always
4– Often
3 - Sometimes
2 - Seldom
1 – Never

Appendix E
Intrapersonal Stress Management Questionnaire

ITEM STRESSORS 5 4 3 2 1
 INTRAPERSONAL
3.2.1 Thinking positive and being
confident in whatever you do
3.2.2 Day dreaming

3.2.3 Listening to music, singing

and dancing
3.2.4 Enjoying pleasurable
activities. (Playing
instrument, reading,
drawing, painting, etc.)
3.2.5 Knowing your limits and
stick to them
3.2.6 Making yourself busy by
doing household chores
3.2.7 Drinking alcoholic beverages
and smoking
3.2.8 Taking medication as a
reliever
3.2.9 Doing physical exercises.
(Jogging, running, aerobics,
etc.)
AVERAGE

Legend:

5– Always
4– Often
3 - Sometimes
2 - Seldom
1 – Never

Appendix F
Impersonal Stress Management Questionnaire

ITEM STRESSORS 5 4 3 2 1
 IMPERSONAL
3.3.1 Taking time to rest and
relax
3.3.2 Praying to God

3.3.3 Simply stay at the corner of

your own room and crying
3.3.4 Ignoring the problem

3.3.5 Getting angry and having

mood swings
3.3.6 Laughing at it

3.3.7 Reasoning out or answering

back
3.3.8 Taking it as a challenge

3.3.9 Limiting your contact to the

source of stress
3.3.10 Cursing

3.3.11 Accepting the reality that

sometimes it merely happens
AVERAGE

Legend:

5– Always
4– Often
3 - Sometimes
2 - Seldom
1 – Never

Curriculum Vitae

Personal Details
Name: Mary Yvonne S. Razo

Date of Birth: April 13, 1993

Age: 22

Place of Birth: Dipolog City

Civil status: Single

Religion: Roman Catholic

Education Qualifications

College: Bachelor of Science in Nursing

Cagayan de Oro College- PHINMA EDUCATION NETWORK

Max Suniel St. Carmen,Cagayan de oro City (2014-2015)

Secondary: East Gusa National High School (2007-2008)

Elementary: Gusa Elementary School (2005-2006)

Personal Details
Name: Robert Z. Tayapad

Date of Birth: November 25, 1991

Age: 25

Place of Birth: Ozamis

Civil status: Single

Religion: Roman Catholic

Education Qualifications

College: Bachelor of Science in Nursing

Cagayan de Oro College- PHINMA EDUCATION NETWORK

Max Suniel St. Carmen,Cagayan de oro City (2014-2015)

Secondary: St. Mary’s Academy Carmen

Elementary: km5 Elementary School