MENTAL HEALTH STATE OF NURSING STUDENTS

AMIDST PANDEMIC

CARYL JADE E. SANIEL

JAZZLEA A. FEROLINO
SHELDON JET S. PAGLINAWAN

May 2022
MENTAL HEALTH STATE OF NURSING STUDENTS

AMIDST PANDEMIC

A Research Paper

Submitted to

The Faculty of Notre Dame of Kidapawan College

Integrated Basic Education Department

Senior High School

In Partial Fulfillment of the Requirements for

Practical Research 1

CARYL JADE E. SANIEL

JAZZLEA A. FEROLINO
SHELDON JET S. PAGLINAWAN

May 2022
 Chapter 1

INTRODUCTION

Background of the Study

On January 22, 2020, the Philippines reported its first probable case of

Covid-19 also known as SARS-CoV-2 On March 11, 2020, the World Health

Organization declared Covid-19 a pandemic. Following the declaration of the

2019 coronavirus illness (COVID-19) as a global pandemic in March 2020,

numerous governments have implemented statewide lockdowns and social

distance among their citizens. While necessary, such public-health initiatives

have posed significant logistical challenges in a wide range of enterprises around

the world. Severe interruptions in education have been recorded, affecting over

94 percent of the global student population (1.6 billion learners), ranging from

elementary school pupils to those in postsecondary institutions from more than

190 nations. More than 90% of all currently enrolled students, and 60.2 million

educators from 190 countries will be required to stay at home to avoid the spread

of the fatal virus (Yanan Hu, 2022)

Both theoretical lectures and practical skills-based learning are

emphasized in nursing education: nurses are required to have not only bedside

skills such as managing medications, administering injections, and wound care,

but also soft skills such as patient care, counseling, and behavioral management.

Pandemic-related limitations in face-to-face tutor-student contacts and hospital-

based patient-care possibilities have posed significant challenges to nursing

education (Laura Ortega, 2021).

 The researchers came up with this study to know the mental health of

nursing students during this pandemic. They further seek to explore their coping

mechanism in overcoming those difficulties.

Statement of the Problem

This study mainly focusses on the mental health of the nursing students

in the midst of pandemic. Specifically, this study will aim to answer the following

research questions:

1. What are the challenges that the nursing students encounter that affects their

mental health amidst the pandemic?

2. What are the coping mechanisms to overcome the challenges that the nursing

students encountered that affects their mental health amidst the pandemic?

Objectives of the Study

This study aims to identify the nursing students who are experiencing

mental health problems during the COVID-19 pandemic. In addition, it has a

following specific goals:

a) Identify the challenges that the nursing students encounter amidst

pandemic regarding their mental health.

b) To determine the coping mechanism of the nursing and what are the

circumstances that nursing students facing about their mental health.

Scope and Limitation of the Study

This study will be conducted to observe the mental health state of nursing

students amidst pandemic. The study only covers nursing college students. The

researcher will gather data by the use of questionnaires that will be given to them

randomly through a google form. This study will only be limited to analyzing the

mental health matters of nursing students of college student’s respondents.

Theoretical Lens

In general, the study emphasizes the mental health of the nursing student

that focuses on 1st year and 2nd year nursing college that experiences mental

problems and coping strategies of their mental health issues for the reason that

they are nursing students are perceived stress and anxiety have increased in

response to the pandemic; for example, many nursing students are worried about

the risk of infection (Aslan and Pekince, 2020; Savitsky et al., 2020; Fitzgerald

and Konrad, 2021). In the theory of Miller (2022) the progression of mental health

follows a predictable pattern. In order to survive, people try to adapt to their

surroundings. When a person develops maladaptive techniques in reaction to

new surroundings, problems arise.

In this regard, the theory will serve as a foundation for the study's primary

goal: to identify the mental health difficulties that nursing students face in the

midst of a worldwide pandemic. These obligations could severely affect the

mental health of the nursing students. Recent research has found that frontline

nurses, particularly women, have a significant psychological load that manifests

as PTSD, depression, anxiety, and sleeplessness (Lai et al., 2020). Nursing

students provide a new and vital reserve force in the fight against COVID-19 and

other illnesses. Nursing students in China must complete three to five years of

college study. They must also have completed clinical training as hospital interns

the previous year. Some nursing students continue their education after

graduation, whereas the majority begin working as professional clinical nurses

(Gao et al., 2021).

Significance of the Study

The significance of the study is to find out the nursing students’ mental

health amidst the pandemic. The result of this study will be of great benefit to the

following:

Nursing Community. This research intends to assist and learn about nursing

students' mental health issues and what they are doing to cope with their troubles

in the event of a pandemic, as well as providing a thorough and in-depth

guidance to mental health issues.

Future Researchers. The data of this research should provide information for

future researchers on this subject matter on the mental health of nursing

students.

Students into Nursing. This data of the research will help them by preparing

themselves for what they will encounter for being a nurse student not only in

physical health but also in mental health that will affect their emotional health
Definition of Terms

Mental Health

It is the identifying of the most vulnerable people and securing

resources to address their needs, as well as developing social programs for their

care, treatment, and recovery.

Curriculum

It is a summary of the things that a school or a certain grade or year

level needs to accomplished at the end of the semester or the school year.

Curriculum also refers to the means and materials with which students will

interact for the purpose of achieving identified educational outcomes.

Distance learning

Education in which one or more technologies are used to offer

teaching to students who are away from the instructor and to promote regular

and substantive synchronous or asynchronous interaction between the students

and the instructor.

 Chapter 2

REVIEW AND RELATED LITERATURE

This chapter presents the discussion of relevant undertakings on the topic

under study. The different concepts, theories, and studies on the mental health

state of nursing students amidst pandemic.

The global pandemic has proven to be challenging for students in more

ways than one. Ever since in-person classes moved online and “Stay Home Stay

Safe” executive order was implemented; many students have faced a distressing

change in their employment status. The present study aimed to assess perceived

stress and coping strategies amidst the COVID 19 lockdown, among the BSc

Nursing students studying in nursing colleges located in Pune Objectives: The

objectives of the study are to assess the perceived stress and coping strategies

of the BSc Nursing students of all batches in regard to COVID 19 lockdown, and

to determine the association of stress and coping with selected demographic

variables. (Amita, 2020)

The coronavirus disease 2019 (COVID-19) pandemic is a global disaster,

and recent studies have shown its association with increasing mental health

problems such as post-traumatic stress disorder (PTSD), depression, anxiety,

and stress. Nursing students, especially nursing interns, maybe shunned,

harassed, and even blamed as potential COVID-19 spreaders, though they were

an important reserve force against COVID-19 and other diseases. Of note, the
psychological influences of COVID-19 on nursing students remained unclear.

(Juan 2021)

In the study of Mahadeo (2014) he stated that stress is fact of life that

every human deal with on a daily basis. Stress has long been regarded as a

common part of the graduate school experience, compared with medical, law,

psychology, and chemistry graduate students. The stressors include struggling to

meet academic standards, time and money management, worries, and concerns

over grades and relationships with senior students, faculty, and family members.

Coping with stress is the recognition of what aspects of life are contributing to

excessive stress. Knowledge about stressors can help in coping and thus

reduces the severity of stress reactions.

According to Kristen (2013) “the support system” nursing students

experience high levels of stress. Coping mechanisms such as utilization of social

support are effective in managing the effects of stress and promoting individual

well-being. The use of social support from faculty members and peers in nursing

programs has not been studied sufficiently. Faculty members who can perceive

and understand student emotions add to the students' positive perception of the

educational environment, making it more conducive to learning.

Akara (2019), observes that the stress levels of nursing students should

be monitored in order to facilitate their ability to cope with stressful situations

during their training, and components for coping with stress should be included in

the curricula of nursing departments for them to bring back their hopes.

Modern students face significant challenges to their mental health. It is

acknowledged that both the academic and clinical components of nursing

programs have the potential to act as stressors for students; however, beyond

this little is known about specific stressors of students and their relationship to

students' lifestyle or mental health. (Mooney and Timmins 2011).

According to the study of Mooney and Timmins (2019), many students

experienced program-related stressors including examinations and assignments

and studies in general, although most considered their mental health to be good.

However, final‐year students were more likely to rate their mental health poorly.

Most students reported drinking alcohol to be sociable or have fun; small

numbers of students reported using alcohol to relieve stress. Students also faced

pressure from work outside of college (29.5%, n= 73). Nurse educators need to

consider the support systems that are currently available to nursing students, and

particularly those in the clinical area. Consideration Students in this study found

within their lifestyle many ways of dealing with stress. A small percentage of

students turned to drugs or alcohol to relieve their stress. also need to be given

to curriculum preparation for nursing students. In addition, students in this study

found within their lifestyle many ways of dealing with stress. A small percentage

of students turned to drugs or alcohol to relieve their stress.

 Nursing and midwifery students are exposed to high stress as they face

multiple stressors in their educational and clinical experiences. This can threaten

their mental health, which in turn, can affect their function. Considering the

impact of mental health on individual performance, this study examined mental

health and its relationship with academic achievement in students of Tabriz

nursing-midwifery school. (Asan and Arshadi, 2013)

Nurses consistently report the highest levels of job stress among all

health professionals. To best prepare students for such a high-stress profession,

insights into the onset of stress are warranted, especially with the literature

supporting that nursing students experience significant stress during their

education. Elevated levels of stress, anxiety, and depression are common

symptoms in graduate students pursuing a degree in the health care professions.

The onset of the COVID-19 pandemic likely complicated these existing issues.

(Michelle and Heidi, 2016).

These problems have been proved to greatly affect nursing students’

mental health and in light being the study undertaken there is also a high

probability that these problems also affect other students as well.

 Chapter 3

METHODOLOGY

This chapter presents the research design, source of data and data

gathering instrument it also presents how the data were analyzed.

Method Used

This study employed qualitative-phenomenological method of research. A

qualitative research analyzes data from direct fieldwork observations, in‐depth,

open‐ended interviews, and written documents. Qualitative researchers engage

in naturalistic inquiry, studying real‐world settings inductively to generate rich

narrative descriptions and construct case studies. Inductive analysis across

cases yields patterns and themes which serve as the fruit of qualitative research

(Patton, 2005).

The phenomenological method aims to describe, understand and interpret

the meanings of experiences of human life. It focuses on research questions

such as what it is like to experience a particular situation (Bloor & Wood 2006).

Phenomenology is the study of structures of consciousness as experienced from

the first-person point of view. The central structure of an experience is its

intentionality and its being directed toward something, as it is an experience of or

about some object. An experience is directed toward an object by virtue of its

content or meaning (which represents the object) together with appropriate

enabling conditions (Stanford Encyclopedia, 2013).

Detailed summary of the phenomenon under review was validated by the

participants. The approach relied on rich first-person accounts of experience

which were obtained from through face-to-face interviews (Colaizzi’s, 1978). By

using this method, the researchers identified the psychosocial impact of

pandemic that the frontliners experienced during the quarantine and their coping

mechanism. This qualitative method, is believed to provide a deeper

understanding of social phenomena and to explore sensitive topics, where

participants may not want to talk about in a group environment (Gill, et.al, 2008).

Sources of Data

Primary data were used in the study. These data were obtained directly

from the nursing students of Notre Dame of Kidapawan College.

Data Gathering Instrument

The researcher-made interview guide was used to gather the data for the

research study. It was divided into three main parts with 3 probing questions in

each part.

Population and Sampling Technique

The target population includes 1st year and 2nd year nursing students who

currently enrolled at Notre dame of Kidapawan college. A total of 14 nursing

student.

Procedure of the Study

 To make sure that the research process was properly conducted the

following were the series of activities done:

First, the researchers prepared an interview guide questions composed on

the life’s experiences, coping strategies, challenges and struggles of nursing

students during this pandemic. This interview guide was made and validated by

the experts. Criteria, approval, sign, consent, and with permission granted by the

participants the researchers posted the interview guide using the online

platforms. The participants were informed how the interview would be conducted.

Their responses were recorded using cellphone. The data gathered were

analyzed using Colaizzi’s Phenomenological Method.

Ethical Consideration

Dresser (1998) said that the administrative burden of ethical reviews and

procedures is balanced by the protection of participants. She suggested close

monitoring of high-risk studies. In qualitative studies, researchers rely heavily on

collecting data through interviews, observations, written materials, and

audiovisual material. Although qualitative research methods make it difficult to

predict how data will be collected through interviews or observation, researchers

have the obligation to anticipate the possible outcomes of an interview and to

weigh both benefits and potential harm (Streubert & Carpenter, 1999).

Research involving human participants should be based on a fundamental

moral commitment to the individuals concerned and to advancing human welfare,

knowledge and understanding. A number of guiding moral principles govern the

ethical review of research, and these principles aim to protect the well-being and

rights of research participants (Irish Council for Bioethics, 2004).

There are basic principles, which are generally accepted in our cultural

tradition, are particularly relevant to the ethics of research involving human

subjects.

Respect of human beneficence and justice is made of two important, but

distinct requirements; first is that, every person is autonomous and entitled to

his/her own opinions and choices and the second one is that due to various

reasons, not all people are capable of self-determination; instead they require

protection. The amount of protection provided to an individual should depend on

the risk of harm and likelihood of benefit offered by the research. Respect for

persons demands that people enter into research involuntarily and with adequate

information.

In Beneficence, people are treated in an ethical manner by respecting

their decisions, protecting them from harm, but also by making efforts, or more

specifically, making it an obligation to secure their well -being. The last basic

ethical principle is justice. This raises questions about who ought to receive the

benefits of research and who ought to bear its burdens.

Researcher’s moral obligation is to refer participants to counseling or

ensure that they have regained control of the situation by talking. In some cases,

the follow up phone call may be appropriate. Ethical dilemmas that may arise

from an interview are difficult to predict. Thus there is, a need to be aware of

sensitive issues and potential conflicts of interest.

 An interview is usually equated with confidentiality, informed consent, and

privacy. The interview opens new risks to both researchers and participants.

Therefore, it is the researchers’ responsibility to conceal the identities of

personalities involved. In this way, the confidentiality of information is enhanced.

It is normally the duty of the research team not to expose the research

participants. Moreover, it is the duty of the research team to provide appropriate

information to the participants so that they can determine.

Data Analysis

The researchers used a qualitative-phenomenological method to analyze

the data gathered through face to face interview. This study focused on the

gathered data from nursing students who were enrolled at Notre Dame of

Kidapawan college. This aimed to determine and identify factors affecting their

mental health and well-being.

The data collected by the researchers were analyzed using the Colaizzi

Phenomenological Method (1978). In this method the essential structure of any

phenomenon under investigation is revealed. There are seven steps that

represent Colaizzi process for phenomenological data analysis (Sanders 2003;

Speziale & Carpenter,2007).

First, the researchers read a description of each nursing students

participating in the study. Next, the researchers extracted the statements that

have significance to the research question, such as descriptions of how they

manage all the challenges they encountered in the during pandemic. The

significant statements were formulated as direct quotations from the participants.

To analyze the significant statements, the researchers articulated what the

statements meant and created themes from these meanings. The researchers

grouped all the similar themes together and organized them into categories.

Finally, the researchers integrated the results into a comprehensive description

of the topic and went back to the participants to verify the result.

Colaizzi’s method of descriptive enquiry through the inclusion of symbolic

representations offers an opportunity for the researcher to gain a deeper

understanding of the individuals intended meaning which was not accessible

through linguistic text alone.

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